bluuebunny/crossref_metadata_2025 huggingface dataset:
The Distinctive Headache of the Occipital Condyle Syndrome: A Report of Four Cases
Authors: Morís G. , Roig C. , Misiego M. , Alvarez A. , Berciano J. , Pascual J.
Published: June 2003

Four examples of occipital condyle syndrome, that is, unilateral occipital pain and ipsilateral tongue paralysis due to selective erosion of the occipital condyle, are reported. The four patients complained of a continuous, severe, unilateral, occipital pain which kept them with the head rotated to the side of the pain and held with their hands. The pain became unbearable with head rotation to the nonpainful side and with unilateral suboccipital palpation. The onset of this very characteristic unilateral headache antedated by as long as 2 1/2 months the ipsilateral hypoglossal paralysis. The occipital condyle syndrome may be the first manifestation of cancer or of chronic inflammatory lesions; recognition of this distinctive headache enables the clinical diagnosis to be made.
The Internet and Migraine: Headache Resources for Patients and Physicians
Authors: Genzen Jonathan R.
Published: June 2003

The Internet enables distribution of headache‐related resources to patients and physicians in a manner never before possible. While these opportunities for communication and education open many doors to an increased awareness of migraine, there are also dangers in the free flow of non‐peer‐reviewed information on the Internet. The practicing physician or headache specialist needs to be aware of what headache‐related resources are available on the Internet, both to recommend information to patients and to know what false information is being spread to headache sufferers. The purpose of this article is twofold: (1) to outline the types of headache‐related information available on the Internet, including actual examples that the astute physician can view as time permits, and (2) to present examples of how such information can be biased, inaccurate, and potentially problematic for the curious patient or physician.
Unilateral Exertional Headache as a Symptom of Cardiac Ischemia
Authors: Lance James W. , Lambros John
Published: June 2003

A 62‐year‐old man developed right frontal headache after mild exercise, relieved promptly by rest. Treadmill exercise (stress testing) demonstrated ST depression on the electrocardiogram as the headache appeared. The exertional headaches were cured by coronary bypass surgery. Possible mechanisms for this unusual pain referral pattern are discussed.
Successful Treatment of Headache Related to Intravenous Immunoglobulin With Antimigraine Medications
Authors: Finkel Alan G. , Howard James F. , Mann J. Douglas
Published: June 2003

In order to investigate headache related to intravenous immunoglobulin, we studied a 36‐year‐old woman with a history of migraine receiving weekly intravenous immunoglobulin for refractory myasthenia gravis who experienced severe headaches with each treatment. Neurological examination, CT scan of the head, and a lumbar puncture after the first headache were normal. Significant therapeutic response was based upon 50% reduction in pain and associated features. Headache features included throbbing pain which worsened with head movement and was associated with severe photophobia and nausea. Sumatriptan, 6 mg subcutaneous, reduced headache significantly with resolution of associated complaints. Treatment prior to intravenous immunoglobulin with dihydroergotamine mesylate resulted in development of only a mild dull ache without further development of severe head pain. Dihydroergotamine mesylate was also abortive in the few instances when the headache worsened. Headaches associated with intravenous immunoglobulin may have features of migraine and may be successfully prevented and/or treated with 5‐HT1D receptor agonists.
Leão's Cortical Spreading Depression and the Somatosensory Homunculus: A Contradiction?
Authors: Vanopdenbosch Ludo , Herroelen Luc
Published: June 2003

We present two clinical cases with presumed cortical spreading depression in a pattern which seems inconsistent with the classical drawing of Penfield and Rasmussen's somatosensory homunculus.
Oral Magnesium Oxide Prophylaxis of Frequent Migrainous Headache in Children: A Randomized, Double‐Blind, Placebo‐Controlled Trial
Authors: Wang Fong , Van Den Eeden Stephen K. , Ackerson Lynn M. , Salk Susan E. , Reince Robyn H. , Elin Ronald J.
Published: June 2003

Objective.—To assess whether, in children, oral magnesium oxide reduces migrainous headache frequency, severity, and associated features compared to placebo.

Background.—There is no single, safe, widely well‐tolerated, and effective prophylactic treatment for all children and adolescents with frequent migrainous headache.

Design.—Randomized, double‐blind, placebo‐controlled, parallel‐group trial.

Methods.—This study was conducted between June 1997 and January 2000 using 7 selected Northern California Kaiser Permanente sites. We recruited children of ages 3 to 17 years who reported a 4‐week history of at least weekly, moderate‐to‐severe headache with a throbbing or pulsatile quality, associated anorexia/nausea, vomiting, photophobia, sonophobia, or relief with sleep, but no fever or evidence of infection. Subjects were randomly assigned to receive either magnesium oxide (9 mg/kg per day by mouth divided 3 times a day with food) (n  =  58) or matching placebo (n  =  60) for 16 weeks. The number of headache days (days with at least one headache) during each of eight 2‐week intervals was chosen to be the primary outcome variable.

Results.—Of those enrolled, 86 (73%) completed the study (42 received magnesium oxide and 44 placebo); 74 of 192 eligible subjects declined to participate. Baseline information on demographic factors, health status, and headache history was similar comparing the 2 groups. By intention‐to‐treat analysis, we found a statistically significant decrease over time in headache frequency in the magnesium oxide group (P  =  .0037) but not in the placebo group (P  =  .086), although the slopes of these 2 lines were not statistically significantly different from each other (P  =  .88). The group treated with magnesium oxide had significantly lower headache severity (P  =  .0029) relative to the placebo group.

Conclusions.—This study does not unequivocally determine whether oral magnesium oxide is or is not superior to placebo in preventing frequent migrainous headache in children, but treatment with the active agent did lead to a significant reduction in headache days. Larger trials involving this safe, appealing complementary therapy are needed.
Abnormal Neuromuscular Transmission in Cluster Headache
Authors: Ertas Mustafa , Baslo M. Baris
Published: June 2003

Objective.—To identify and investigate any dysfunction of neuromuscular transmission in episodic cluster headache.

Background.—Abnormal neuromuscular transmission has been shown in migraine with aura and in migraine without aura by using single fiber electromyography. Especially for migraine with aura, a genetic cause has been postulated. Episodic cluster headache is a primary headache disorder in which genetic factors may, at times, play a strong role.

Methods.—Single fiber electromyography during voluntary contraction of the extensor digitorum communis muscle, nerve conduction studies of upper and lower extremities, and concentric needle electromyography of the extensor digitorum communis were performed on 6 patients with episodic cluster headache and 6 age‐matched normal controls. Twenty potential pairs were recorded from each subject. Twenty individual jitter values and a mean jitter value were calculated for each subject. Both mean individual jitter values and numbers of abnormal individual jitter values were compared in patients with cluster headache versus normal controls.

Results.—Three of 6 patients with episodic cluster headache showed pronounced neuromuscular transmission abnormalities by single fiber electromyography. None of the controls had any neuromuscular transmission abnormality. Another patient with episodic cluster headache had borderline dysfunction of neuromuscular transmission. Transmission was clearly normal in only 2 of 6 patients with cluster headache.

Conclusion.—These results suggest that episodic cluster headache may share the same abnormality of neuromuscular transmission observed in migraine.
Impact of a Group‐Based Model of Disease Management for Headache
Authors: Maizels Morris , Saenz Valerie , Wirjo Jonathan
Published: June 2003

Objectives.—To assess the impact of a group‐based model of disease management for patients with headache.

Background.—Despite advances in the acute and preventive treatment of migraine, many patients with headache remain misdiagnosed and undertreated. Models of care that incorporate principles of disease management may improve headache care.

Design and Methods.—This was a prospective, open‐label, observational study. Patients with headache were referred by physicians or identified from emergency department records. Patients attended a group session led by a registered nurse practitioner, and later had follow‐up consultation. Charts and computer records were reviewed to document triptan costs and headache‐related visits for 6 months before and after the intervention. Changes in headache frequency and severity were assessed.

Results.—Triptan costs for 264 patients and chart review for 250 were available. Six‐month triptan costs increased $5423 (19%), headache‐related visits were reduced by 32%, and headache‐related emergency department visits were reduced by 49%. Severe headache frequency was reduced in 62 (86%) of 72 patients who initially had severe headaches more than 2 days per week. Patients identified by emergency department screening accounted for 21% of the study group, 31% of the baseline triptan costs, and 46% of the baseline visits. For the entire study group, reduced visits yielded a net savings of $18  757 despite increased triptan costs.

Conclusions.—Implementation of this group‐based model produced a reduction in emergency department and clinic visits, significant clinical improvement, a small increase in pharmacy costs, and overall cost reduction. The greatest improvement in each outcome measure was seen in patients most severely afflicted at baseline. Our results suggest that the principles of disease management may be applied effectively to a headache population, with a positive financial impact on a managed care organization.
Reduced Impact of Migraine in Everyday Life: An Observational Study in the Dutch Society of Headache Patients
Authors: Vos J. , Passchier J.
Published: June 2003

Objective.—To explore the percentage of patients who report a reduced impact of migraine on their life, and to which factors this improvement can be attributed.

Methods.—Four hundred forty‐eight members of the Dutch Society of Headache Patients answered a set of structured questionnaires, including the Migraine‐Specific Quality of Life instrument (MSQOL).

Results.—Of this group, 70% reported a reduced impact of migraine. The most frequently reported reason for this reduction was a change in medication (77%); in particular, change to a triptan. Other favorable factors included a change in life‐style (56%): 42% of patients reported more relaxed coping with migraine, a reduction of stress in general (28%) and of stress related to work (24%), and leading a more regular life‐style (21%). In addition, social support was frequently mentioned, particularly that offered by the Dutch Society of Headache Patients (58%), family (46%), and their general practitioner (28%). The patients who reported a reduced impact of migraine had less migraine attacks and a higher quality of life than those who did not report such a reduction.

Conclusion.—The results confirm that factors that are proven effective in clinical trials on migraine also have these effects outside a formal experimental environment.
Visual Distortion Provoked by a Stimulus in Migraine Associated With Hyperneuronal Activity
Authors: Huang Jie , Cooper Thomas G. , Satana Banu , Kaufman David I. , Cao Yue
Published: June 2003

Background.—Migraineurs with visual aura are highly susceptible to illusions and visual distortion and are particularly sensitive to a pattern of regularly spaced parallel lines or stripes.

Purpose.—To determine whether the high degree of susceptibility to illusions and visual distortion in migraineurs with aura is associated with hyperneurological activity of the occipital cortex.

Methods.—In order to investigate any relationships among neuronal activity, spatial frequency of square‐wave gratings, and self‐described visual distortion, we investigated the neuronal and psychophysical responses to square‐wave gratings in migraineurs with visual aura and in nonheadache controls.

Results.—Square‐wave gratings provoked various types of visual distortion and illusions and induced a hyperneuronal response in the visual cortex of migraineurs with visual aura, a response that strongly depended upon the stimulus spatial frequency.

Conclusion.—The hyperneuronal activity of the occipital cortex is consistent with general cortical hyperexcitability in migraine.
Clinical Characteristics of Patients With Comorbidity of Migraine and Epilepsy
Authors: Leniger Tobias , Von Den Driesch Sandra , Isbruch Katrin , Diener Hans Christoph , Hufnagel Andreas
Published: June 2003

Objective.—Neuronal hyperexcitability might explain the comorbidity of migraine and epilepsy. Spreading depression, a postulated pathophysiological mechanism of epileptic seizures and migraine with aura, may hypothetically be the link between the disorders in these comorbid conditions. The aim of the present study was to determine whether certain clinical characteristics associated with spreading depression are overrepresented in patients with comorbidity.

Methods.—In an outpatient clinic‐based series, clinical characteristics of 61 patients with a comorbidity of migraine and epilepsy were compared to those of 280 patients with epilepsy alone and 248 patients with migraine alone. Patients were interviewed with a standardized questionnaire.

Results.—The proportion of females was significantly higher in patients with comorbidity and patients with migraine as compared to patients with epilepsy (P  <  .001). Comparing patients with epilepsy and comorbidity, the frequency of epilepsy syndromes and seizure types was not significantly different. Comparing patients with migraine and comorbidity, migraine with aura was significantly more frequent in patients with comorbidity (P  =  .019). Other migraine features such as moderate to severe pain intensity, worsening of pain on activity, phonophobia, and photophobia were significantly more frequent in patients with comorbidity as compared to patients with migraine (P  ≤  .001).

Conclusion.—No specific epileptic characteristics could be found in patients with comorbidity. Altered cerebral excitability resulting in an increased occurrence of spreading depression may explain the differences in migraine attacks in patients with comorbidity as compared to patients with migraine alone.
Congenital Predisposition to Spontaneous Intracranial Hypotension: A Case Report
Authors: Ontachi Yasuo , Sakajiri Ken‐ichi , Higashi Sohtaro , Yokoyama Kunihiko , Suzuki Masayuki , Asakura Hidesaku , Nakao Shinji
Published: June 2003

Dural rupture, cerebrospinal fluid leakage, and spontaneous intracranial hypotension may complicate significant or minimal spinal trauma and cause chronic headache with a positional component. While such cases typically reflect no pre‐existing predilection, we encountered a patient whose cervicothoracic anatomy appeared to predispose him to this complication.
Prolonged Benign Exertional Headache. The Vågå Study of Headache Epidemiology
Authors: Sjaastad O. , Bakketeig L. S.
Published: June 2003

Objective.—To explore in detail the duration of exertional headache attacks and explicitly to identify cases of prolonged exertional headache.

Background.—The prevalence of exertional headache in general population samples may exceed 10%. The prevalence and distinguishing clinical characteristics of prolonged exertional headache are not well delineated.

Methods.—One author (O.S.) personally interviewed 1838 parishioners (88.6%) of ages 18 to 65 years living in a southern Norwegian commune. Questions relevant to exertional headache were included.

Results.—As recently reported elsewhere, exertional headache was present in 12.3% of those questioned. With 1 hour set as a tentative border for short‐ versus long‐duration exertional headache, there were approximately equal numbers with short‐ and long‐lasting attacks; prevalence of short‐lasting attacks was 6.3% and long‐lasting attack prevalence was 6.0%. In regards to other epidemiologic and clinical features, the long‐lasting cases did not seem to deviate from the short‐lasting cases; both categories had a moderate female preponderance and similar age of onset. There was a somewhat higher mean number of “migrainelike features” in the long‐lasting than in the short‐lasting variety of exertional headache. Exertional headache attacks could last up to 24 hours.

Conclusions.—There seems to be little reason to subdivide exertional headache into 2 separate varieties according to attack duration. Exertional headache attacks have “migrainelike” features but do not seem to be “form fruste” migraine attacks. The long‐lasting variety is not uncommon.
Is the Cell Death in Mesial Temporal Sclerosis Apoptotic?
Authors: Uysal Hilmi , Cevik Isin Unal , Soylemezoglu Figen , Elibol Bulent , Ozdemir Yasemin Gursoy , Evrenkaya Tulay , Saygi Serap , Dalkara Turgay
Published: June 2003

Summary:  Purpose: Mesial temporal sclerosis (MTS) is characterized by neuronal loss in the hippocampus. Studies on experimental models and patients with intractable epilepsy suggest that apoptosis may be involved in neuronal death induced by recurrent seizures.

Methods: We searched evidence for apoptotic cell death in temporal lobes resected from drug‐resistant epilepsy patients with MTS by using the terminal deoxynucleotidyl transferase (TdT) and digoxigenin‐11‐dUTP (TUNEL) method and immunohistochemistry for Bcl‐2, Bax, and caspase‐cleaved actin fragment, fractin. The temporal lobe specimens were obtained from 15 patients (six women and nine men; mean age, 29 ± 8 years).

Results: Unlike that in normal adult brain, we observed Bcl‐2 immunoreactivity in some of the remaining neurons dispersed throughout the hippocampus proper as well as in most of the reactive astroglia. Bax immunopositivity was increased in almost all neurons. Fractin immunostaining, an indicator of caspase activity, was detected in ∼10% of these neurons. Des pite increased Bax expression and activation of caspases, we could not find evidence for DNA fragmentation by TUNEL staining. We also could not detect typical apoptotic changes in nuclear morphology by Hoechst‐33258 or hematoxylin counterstaining.

Conclusions: These data suggest that either apoptosis is not involved in cell loss in MTS, or a very slow rate of cell demise may have precluded detecting TUNEL‐positive neurons dying through apoptosis. Increased Bax expression and activation of caspases support the latter possibility.
Myoinositol Abnormalities in Temporal Lobe Epilepsy
Authors: Wellard R. Mark , Briellmann Regula S. , Prichard James W. , Syngeniotis Ari , Jackson Graeme D.
Published: June 2003

Summary:  Purpose: This study used magnetic resonance spectroscopy (MRS) to examine metabolite abnormalities in the temporal and frontal lobe of patients with temporal lobe epilepsy (TLE) of differing severity.

Methods: We investigated myoinositol in TLE by using short‐echo MRS in 34 TLE patients [26 late onset (LO‐TLE), eight hippocampal sclerosis (HS‐TLE)], and 16 controls. Single‐voxel short‐echo (35 ms) MR spectra of temporal and frontal lobes were acquired at 1.5 T and analyzed by using LCModel.

Results: The temporal lobe ipsilateral to seizure origin in HS‐TLE, but not LO‐TLE, had reduced N‐acetylaspartate (NA) and elevated myoinositol (MI; HS‐TLE NA, 7.8 ± 1.9 mM, control NA, 9.2 ± 1.3 mM; p < 0.05; HS‐TLE MI, 6.1 ± 1.6 mM, control mI 4.9 ± 0.8 mM, p< 0.05). Frontal lobe MI was low in both patient groups (LO‐TLE, 4.3 ± 0.8 mM; p < 0.05; HS‐TLE, 3.6 ±.05 mM; p < 0.001; controls, 4.8 ± 0.5 mM). Ipsilateral frontal lobes had lower MI (3.8 ± 0.7 mM; p < 0.01) than contralateral frontal lobes (4.3 ± 0.8 mM; p < 0.05).

Conclusions: MI changes may distinguish between the seizure focus, where MI is increased, and areas of seizure spread where MI is decreased.
Intensity of Central Pain: Analysis of Pain Scores in 18 Patients
Authors: Yanagida Hisashi , Arakawa Kazuo , Sakai Katsuhiro , Sadohara Yumiko
Published: June 2003

Abstract: The aim of this clinical study was to investigate the intensity of central pain in 18 patients. Each patient systematically recorded their own pain scores a total of 700 times (ie, 7 times/day for 100 consecutive days) using a standard four‐point scale. In all 18 patients, the intensity of pain varied considerably (ranging in grade from no pain, mild pain, moderate pain to severe pain). During the 100 days, the average number of times (percentage of total) that each grade of pain intensity was scored was: no pain 7.4 (1.1%); mild pain 570.9 (81.6%); moderate pain 93.4 (13.3%), and severe pain 28.3 (4%). The difference between mild pain and moderate, severe, or no pain was significant. Thus, in our patient group the intensity of central pain was mostly mild, not severe. In contrast to other reports, our data suggest that to state that the intensity of central pain continues to be intolerable and severe throughout the day is an exaggeration. Among our 18 patients, an exacerbation of pain intensity was observed 507 times. Of these 507 events, 392 (77.3%) were due to specifiable factors and 115 (22.7%) were due to unknown factors. The specifiable factors could be attributed to: emotional factors 261 times (66.6%), somatic stimuli 44 times (11.2%), weather 38 times (9.7%), fatigue 29 times (7.4%), visceral activity 20 times (5.1%). Since there is no universally effective treatment for central pain, the strategy to manage central pain should primarily focus (if possible) on prevention of the exacerbating factors of central pain.
Pregnancy‐related Increases in Sensory Perception Thresholds Are Not Correlated with Serum Progesterone Levels
Authors: Oshima Masayuki , Inagi Toshiichiro , Yokoyama Kenji , Kikutani Takehiko , Sugimoto Kikuzo , Shimada Yoichi , Ogawa Ryo , Menkes Daniel L.
Published: June 2003

Background: Why pregnant women require smaller doses of anesthetic agents still remains speculative. One hypothesis proposes that pregnancy raises sensory perception thresholds, perhaps through a progesterone‐mediated effect. This study was undertaken in order to quantify any changes in sensory perception thresholds after parturition and to correlate these changes with the expected decrease in postpartum serum progesterone levels.

Methods: Nineteen gravid women scheduled to undergo an elective Cesarean section consented to participate. Sensory current perception threshold (CPT) testing was performed before and 7 days after an elective Cesarean section. CPT was defined as the minimum amount of constant current stimulation that can be reproducibly detected at a particular frequency. CPT values were determined on the distal phalanx of the nondominant index finger at 2000 Hz, 250 Hz, and 5 Hz monofrequency stimulation. Seven women permitted serum progesterone level determinations at the prepartum and the postpartum CPT testing sessions.

Results: Parturition resulted in a statistically significant decrease in the sensory CPT at all 3 frequencies tested, (p < 0.05). However, there was no significant correlation between the postpartum reduction in serum progesterone levels and the observed postpartum decrease in CPT for any frequency, (r < 0.5).

Conclusions: CPTs are significantly reduced after parturition. However, this reduction does not appear to be significantly correlated with the reduction in serum progesterone levels.
Safety and Efficacy of Percutaneous Neuromodulation Therapy in the Management of Subacute Radiating Low Back Pain
Authors: Borg‐Stein Joanne , Seroussi Richard E. , Gomba Lorraine , Meleger Alec , Schmitt Susan , Leep Eric , Glassman Jerel H. , Revord John , Condon Joseph , Bensen Elizabeth , Fitzthum Jeffery E. , Fowler Bradford C. , Gliner Bradford E. , Firlik Andrew D.
Published: June 2003

Objective: Percutaneous neuromodulation therapy (PNT) is a new minimally invasive, office‐based treatment for low back pain in which electrical stimulation is delivered to the paraspinal peripheral nerves. The purpose of this study was to determine the safety, tolerability, and clinical efficacy of PNT in a population of patients with subacute low back pain with radiation to the lower extremity.

Design: Open label prospective clinical trial.

Setting: Multi‐center outpatient setting.

Participants: We enrolled 83 patients who had radiating low back pain for 4 weeks to 6 months with a pain intensity of at least 4 on a visual analog scale of 0–10.

Interventions: Subjects were treated with PNT 1 to 2 times per week for at least 4 weeks. Based on clinical response patients were treated up to an additional 8 weeks.

Main Outcome Measures: We recorded baseline visual analog scale (VAS) scores of radiating pain, low back pain, physical activity, and sleep, as well as the Oswestry Disability Questionnaire. Follow‐up assessments were performed at each session, and at 5 and 12 weeks. Patients benefiting from treatments at 12 weeks were followed‐up at 6 months.

Results: Fifty‐nine patients completed the study protocol. Mean VAS scores improved as follows: leg/buttock pain decreased by 37% to 4.0 ± 2.6 from a baseline of 6.6 ± 1.7 (P < 0.001); low back pain decreased by 26% to 3.9 ± 2.4 from a baseline of 5.5 ± 2.2 (P < 0.001); activity levels improved by 38% to 3.6 ± 2.2 from a baseline of 6.0 ± 2.2 (P < 0.001); and sleep improved by 27% to 3.1 ± 2.5 from a baseline of 4.8 ± 3.0 (P < 0.001). The Oswestry Low Back Pain Disability scores improved by 24% to 32 ± 16 from a baseline of 43 ± 15 (P < 0.001). Pain relief was sustained over a 3‐month observation period.

Conclusion: For many patients with subacute radiating low back pain, PNT significantly reduced pain and self‐rated disability, and improved sleep quality and activity level. PNT is safe and generally well tolerated.
Antidepressant Pharmacotherapy: Considerations for the Pain Clinician
Authors: Jackson Kenneth C. , St. Onge Erin L.
Published: June 2003

Abstract: Antidepressant pharmacotherapy presents many challenges to clinicians dealing with patients suffering from chronic pain. Co‐existent depression and pain continues to present clinicians with a plethora of difficult treatment selections. Treated in isolation, each of these disease states can prove difficult to treat. Collectively, depression and pain often present significantly more difficult challenges to the clinician. Antidepressants may be used as a primary treatment modality for depression in a patient dealing with chronic pain. At other times these agents may be used to treat certain specific chronic pain syndromes, possibly in the face of concomitant depression. Clinicians should be aware of the many peculiarities associated with this broad class of medications. Included in this review are considerations for drug selection, dose escalation, and common drug related problems (eg, adverse drug reactions). In addition, attention is paid to the appropriate selection of an agent for use in either the primary management of pain or depression.
Management of Chronic Limb Pain with Spinal Cord Stimulation
Authors: Fogel Guy R. , Esses Stephen I. , Calvillo Octavio
Published: June 2003

Background: Spinal Cord Stimulation (SCS) is a treatment option for chronic pain patients. The most common indication for SCS is the failed back syndrome with leg pain. In the last decade, advances in our understanding of appropriate stimulation programming, lead placement and the physiology of SCS, have led to changes in multi‐site stimulation, and stimulation with differing programs. In the past, low back, axial neuropathic type pain was not responsive to SCS. With dual electrode arrays, and dual stimulation with alternating programs of stimulation, steering of stimulation paresthesia, and versatile programmable stimulation parameters, SCS has become a more versatile form of analgesia.

Purpose: To describe the current treatment rational for SCS and the results of that treatment.

Results: The SCS is most efficient in patients with neuropathic pain of the extremities and less efficacious in patients with axial pain.

Conclusion: SCS is the most effective treatment for limb pain not amenable to surgical decompression. The success of SCS in this chronic pain group is 80% successful in treatment of leg pain, and much less effective in treatment of axial pain.
Diagnosis and Management of the Painful Shoulder. Part 2: Examination, Interpretation, and Management
Authors: Sizer Phillip S. , Phelps Valerie , Gilbert Kerry
Published: June 2003

Abstract: Diagnosis, interpretation and subsequent management of shoulder pathology can be challenging to clinicians. Because of its proximal location in the schlerotome and the extensive convergence of afferent signals from this region to the dorsal horn of the spinal cord, pain reference patterns can be broadly distributed to the deltoid, trapezius, and or the posterior scapular regions. This pain behavior can make diagnosis difficult in the shoulder region, as the location of symptoms may or may not correspond to the proximity of the pain generator. Therefore, a thorough history and reliable physical examination should rest at the center of the diagnostic process. Effective management of the painful shoulder is closely linked to a tissue‐specific clinical examination. Painful shoulder conditions can present with or without limitations in passive and or active motion. Limits in passive motion can be classified as either capsular or noncapsular patterns. Conversely, patients can present with shoulder pain that demonstrates no limitation of motion. Bursitis, tendopathy and rotator cuff tears can produce shoulder pain that is challenging to diagnose, especially when they are the consequence of impingement and or instability. Numerous nonsurgical measures can be implemented in treating the painful shoulder, reserving surgical interventions for those patients who are resistant to conservative care.
Thermodynamics of Chlorinated Phenols, Polychlorinated Dibenzo- p -Dioxins, Polychlorinated Dibenzofurans, Derived Radicals, and Intermediate Species
Authors: Burcat Alexander , Khachatryan Lavrent , Dellinger Barry L.
Published: June 2003

The thermodynamics of 31 chlorinated phenols, polychlorinated dibenzo-p-dioxins, polychlorinated dibenzofurans, and some chlorinated cyclo–C5 compounds have been calculated. Twelve of these species are radicals. Additionally the thermodynamic properties of temperature dependent tables (T=0 K–6000 K) of the ideal gas phase thermodynamic properties are listed, together with recommended values for the structure, vibrational frequencies, and enthalpy of formation either found in the literature or calculated.
Enthalpies of Vaporization of Organic and Organometallic Compounds, 1880–2002
Authors: Chickos James S. , Acree William E.
Published: June 2003

A compendium of vaporization enthalpies published within the period 1910–2002 is reported. A brief review of temperature adjustments of vaporization enthalpies from temperature of measurement to the standard reference temperature, 298.15 K, is included as are recently suggested reference materials. Vaporization enthalpies are included for organic, organo-metallic, and a few inorganic compounds. This compendium is the third in a series focusing on phase change enthalpies. Previous compendia focused on fusion and sublimation enthalpies. Sufficient data are presently available for many compounds that thermodynamic cycles can be constructed to evaluate the reliability of the measurements. A protocol for doing so is described.
NIST-JANAF Thermochemical Tables. II. Three Molecules Related to Atmospheric Chemistry: HNO3, H2SO4, and H2O2
Authors: Dorofeeva Olga V. , Iorish Vladimir S. , Novikov Vladimir P. , Neumann David B.
Published: June 2003

The structural, spectroscopic, and thermochemical properties of three polyatomic molecules with internal rotation—HNO3(g), H2SO4(g), and H2O2(g)—have been reviewed. Three revised ideal gas thermodynamic tables result from this critical examination. The revisions involved the consideration of new spectroscopic information and the use of theoretical results to model the internal rotation in the H2SO4 molecule. Compared to previous calculations, the entropies at 298.15 K are unchanged for HNO3 and H2O2, but the high temperature values (T>4000 K) are significantly different. As for H2SO4, its thermodynamic functions differ significantly from values calculated earlier.
Henry’s Constants and Vapor–Liquid Distribution Constants for Gaseous Solutes in H2O and D2O at High Temperatures
Authors: Fernández-Prini Roberto , Alvarez Jorge L. , Harvey Allan H.
Published: June 2003

We have developed correlations for the Henry’s constant kH and the vapor–liquid distribution constant KD for 14 solutes in H2O and seven solutes in D2O. The solutes considered are common gases that might be encountered in geochemistry or the power industry. Solubility data from the literature were critically assessed and reduced to the appropriate thermodynamic quantities, making use of corrections for nonideality in the vapor and liquid phases as best they could be computed. While the correlations presented here cover the entire range of temperatures from near the freezing point of the solvent to high temperatures approaching its critical point, the main emphasis is on representation of the high-temperature behavior, making use of asymptotic relationships that constrain the temperature dependence of kH and KD near the critical point of the solvent.
Could the Internet Defetishise the Commodity?
Authors: Miller Daniel
Published: June 2003

This paper is in three parts. In the first I summarise and argue for the continued importance of the critique associated with the fetishism of the commodity. In the second part I report on an ethnographic study of the Internet and the lessons learned for how it could most effectively be used. In the third part I present the outline of a programme for inclusion within the school geography curriculum to use the Internet to educate children in their responsibilities as consumers. This consists of following three products, all of which are personalised to the children as end consumers. Using the Internet they would follow all stages of production, distribution, transportation, and the combination of elements that constitute the commodity. All such processes are seen through the labour of those involved. The result may not fully defetishise the commodity in respect to wider issues of power and control, but it might turn the current interest in commodity chains into an attempt to transform the consciousness of consumers for the benefit of producers.
Gender, Modern Design, and Home Consumption
Authors: Leslie Deborah , Reimer Suzanne
Published: June 2003

Beset by a range of internal inconsistencies and contradictions, modernism never has been able to expunge completely that which has been constructed as its ‘Other’. Often coded as feminine, notions of ornamentation, decoration, craft, and ephemerality have long been defined in opposition to the modernist project. In this paper we chart a return to the aesthetics of modernism in the retailing, marketing, and consumption of household furniture during the 1990s as a means of extending existing assessments of modernist discourses. Given past associations between modernism and masculinity, we critically evaluate contemporary shifts in home consumption in the context of the gendering of the modern.
Uncanny Exchanges: The Possibilities and Failures of ‘Making Change’ with Alternative Monetary Forms
Authors: Maurer Bill
Published: June 2003

In most standard accounts, modern money depends on its function as the general equivalent. Equivalence, in turn, rotates around a specific numerological metaphysics, including the concept of zero and the algebraic function. Yet, rarely are the mathematics of equivalence subject to critical scrutiny. In this paper I explore contemporary alternative numerologies of money and finance. The alternatives that I consider are a US local scrip currency and transnational Islamic finance experiments. My data come from fieldwork in Ithaca, New York, and from research among Islamic finance specialists devising new financial products. I am interested in how these alternatives make explicit the moral form of the mathematics of the general equivalent.
Commodifying Difference: Selling EASTern Fashion
Authors: Dwyer Claire , Jackson Peter
Published: June 2003

In this paper we explore the contested spaces of contemporary commodity culture through case-study research with two fashion companies that are involved, in linked but contrasting ways, with the production and marketing of cultural difference. One company, the British-based women's wear firm EAST, is striving to extend its high-street presence via a generalised ‘ethnic’ aesthetic, combined with culturally constructed notions of design individuality. The other firm, the Indian-based company Anokhi, has a more ambivalent relationship with the commercial ‘mainstream’, emphasising its use of traditional hand-block printing methods, combined with a sense of social responsibility and ethical commitment to its workforce. The case studies demonstrate that cultural difference is actively constituted through the process of commodification, justifying an emphasis on the production of difference as well as on its consumption. We draw on in-depth interviews and participant observation with key actors in both firms, examining how the meaning of goods is shaped as they move along the commodity chain from production to consumption. We examine the retail spaces and marketing strategies of the two firms and explore (via focus-group research) the further transformations of meaning and value undertaken by consumers as they purchase and wear these clothes. We conclude that commercial culture is a contested space characterised by competing discourses and practices, the outcome of which can only be determined empirically.
(De)commodification, Consumer Culture, and Moral Economy
Authors: Sayer Andrew
Published: June 2003

In this paper I attempt to develop understanding of commodification and consumption by relating ideas from the moral philosophy of Adam Smith and Alasdair MacIntyre to recent research on consumer culture by Pierre Bourdieu and Daniel Miller. I focus on how commodification affects how people value things, practices, themselves, and others. It is argued that, although traditional critiques of consumer culture have often been both elitist and weakly supported empirically, some of their normative distinctions can be used to illuminate more positive aspects of consumption. In particular, the distinction between internal and external goods enables us to appreciate that much consumption is not primarily a form of status seeking but a means to the development of skills, achievements, commitments, and relationships which have value regardless of whether they bring participants external rewards. Although Bourdieu's analysis of inequalities and the struggles of the social field misses this distinction, use of it helps to illuminate how the struggles are for internal goods as well as for status and power. Finally, by reference to recent work by Miller on altruistic shopping, I question the common related criticism of consumer culture as individualistic, and conclude.
Neuroglian, Gliotactin, and the Na+/K+ ATPase are essential for septate junction function inDrosophila
Authors: Genova Jennifer L. , Fehon Richard G.
Published: June 2003

One essential function of epithelia is to form a barrier between the apical and basolateral surfaces of the epithelium. In vertebrate epithelia, the tight junction is the primary barrier to paracellular flow across epithelia, whereas in invertebrate epithelia, the septate junction (SJ) provides this function. In this study, we identify new proteins that are required for a functional paracellular barrier in Drosophila. In addition to the previously known components Coracle (COR) and Neurexin (NRX), we show that four other proteins, Gliotactin, Neuroglian (NRG), and both the α and β subunits of the Na+/K+ ATPase, are required for formation of the paracellular barrier. In contrast to previous reports, we demonstrate that the Na pump is not localized basolaterally in epithelial cells, but instead is concentrated at the SJ. Data from immunoprecipitation and somatic mosaic studies suggest that COR, NRX, NRG, and the Na+/K+ ATPase form an interdependent complex. Furthermore, the observation that NRG, a Drosophila homologue of vertebrate neurofascin, is an SJ component is consistent with the notion that the invertebrate SJ is homologous to the vertebrate paranodal SJ. These findings have implications not only for invertebrate epithelia and barrier functions, but also for understanding of neuron–glial interactions in the mammalian nervous system.
Nanometer targeting of microtubules to focal adhesions
Authors: Krylyshkina Olga , Anderson Kurt I. , Kaverina Irina , Upmann Irene , Manstein Dietmar J. , Small J. Victor , Toomre Derek K.
Published: June 2003

Although cell movement is driven by actin, polarization and directional locomotion require an intact microtubule cytoskeleton that influences polarization by modulating substrate adhesion via specific targeting interactions with adhesion complexes. The fidelity of adhesion site targeting is precise; using total internal reflection fluorescence microscopy (TIRFM), we now show microtubule ends (visualized by incorporation of GFP tubulin) are within 50 nm of the substrate when polymerizing toward the cell periphery, but not when shrinking from it. Multiple microtubules sometimes followed similar tracks, suggesting guidance along a common cytoskeletal element. Use of TIRFM with GFP- or DsRed-zyxin in combination with either GFP-tubulin or GFP–CLIP-170 further revealed that the polymerizing microtubule plus ends that tracked close to the dorsal surface consistently targeted substrate adhesion complexes. This supports a central role for the microtubule tip complex in the guidance of microtubules into adhesion foci, and provides evidence for an intimate cross-talk between microtubule tips and substrate adhesions in the range of molecular dimensions.
Ras recruits mitotic exit regulator Lte1 to the bud cortex in budding yeast
Authors: Yoshida Satoshi , Ichihashi Ryuji , Toh-e Akio
Published: June 2003

ACdc25 family protein Lte1 (low temperature essential) is essential for mitotic exit at a lowered temperature and has been presumed to be a guanine nucleotide exchange factor (GEF) for a small GTPase Tem1, which is a key regulator of mitotic exit. We found that Lte1 physically associates with Ras2-GTP both in vivo and in vitro and that the Cdc25 homology domain (CHD) of Lte1 is essential for the interaction with Ras2. Furthermore, we found that the proper localization of Lte1 to the bud cortex is dependent on active Ras and that the overexpression of a derivative of Lte1 without the CHD suppresses defects in mitotic exit of a Δlte1 mutant and a Δras1 Δras2 mutant. These results suggest that Lte1 is a downstream effector protein of Ras in mitotic exit and that the Ras GEF domain of Lte1 is not essential for mitotic exit but required for its localization.
Dominant cataracts result from incongruous mixing of wild-type lens connexins
Authors: Martinez-Wittinghan Francisco J. , Sellitto Caterina , Li Leping , Gong Xiaohua , Brink Peter R. , Mathias Richard T. , White Thomas W.
Published: June 2003

Gap junctions are composed of proteins called connexins (Cx) and facilitate both ionic and biochemical modes of intercellular communication. In the lens, Cx46 and Cx50 provide the gap junctional coupling needed for homeostasis and growth. In mice, deletion of Cx46 produced severe cataracts, whereas knockout of Cx50 resulted in significantly reduced lens growth and milder cataracts. Genetic replacement of Cx50 with Cx46 by knockin rescued clarity but not growth. By mating knockin and knockout mice, we show that heterozygous replacement of Cx50 with Cx46 rescued growth but produced dominant cataracts that resulted from disruption of lens fiber morphology and crystallin precipitation. Impedance measurements revealed normal levels of ionic gap junctional coupling, whereas the passage of fluorescent dyes that mimic biochemical coupling was altered in heterozygous knockin lenses. In addition, double heterozygous knockout lenses retained normal growth and clarity, whereas knockover lenses, where native Cx46 was deleted and homozygously knocked into the Cx50 locus, displayed significantly deficient growth but maintained clarity. Together, these findings suggest that unique biochemical modes of gap junctional communication influence lens clarity and lens growth, and this biochemical coupling is modulated by the connexin composition of the gap junction channels.
Gliotactin, a novel marker of tricellular junctions, is necessary for septate junction development in Drosophila
Authors: Schulte Joost , Tepass Ulrich , Auld Vanessa J.
Published: June 2003

Septate junctions (SJs), similar to tight junctions, function as transepithelial permeability barriers. Gliotactin (Gli) is a cholinesterase-like molecule that is necessary for blood–nerve barrier integrity, and may, therefore, contribute to SJ development or function. To address this hypothesis, we analyzed Gli expression and the Gli mutant phenotype in Drosophila epithelia. In Gli mutants, localization of SJ markers neurexin-IV, discs large, and coracle are disrupted. Furthermore, SJ barrier function is lost as determined by dye permeability assays. These data suggest that Gli is necessary for SJ formation. Surprisingly, Gli distribution only colocalizes with other SJ markers at tricellular junctions, suggesting that Gli has a unique function in SJ development. Ultrastructural analysis of Gli mutants supports this notion. In contrast to other SJ mutants in which septa are missing, septa are present in Gli mutants, but the junction has an immature morphology. We propose a model, whereby Gli acts at tricellular junctions to bind, anchor, or compact SJ strands apically during SJ development.
The Lectin-like Receptor KLRE1 Inhibits Natural Killer Cell Cytotoxicity
Authors: Westgaard Ingunn H. , Dissen Erik , Torgersen Knut M. , Lazetic Sasha , Lanier Lewis L. , Phillips Joseph H. , Fossum Sigbjørn
Published: June 2003

We report the cloning and functional characterization in the mouse and the rat of a novel natural killer (NK) cell receptor termed KLRE1. The receptor is a type II transmembrane protein with a COOH-terminal lectin-like domain, and constitutes a novel KLR family. Rat Klre1 was mapped to the NK gene complex. By Northern blot and flow cytometry using newly generated monoclonal antibodies, KLRE1 was shown to be expressed by NK cells and a subpopulation of CD3+ cells, with pronounced interstrain variation. Western blot analysis indicated that KLRE1 can be expressed on the NK cell surface as a disulphide-linked dimer. The predicted proteins do not contain immunoreceptor tyrosine-based inhibitory motifs (ITIMs) or a positively charged amino acid in the transmembrane domain. However, in a redirected lysis assay, the presence of whole IgG, but not of F(ab′)2 fragments of a monoclonal anti-KLRE1 antibody inhibited lysis of Fc-receptor bearing tumor target cells. Moreover, the tyrosine phosphatase SHP-1 was coimmunoprecipitated with KLRE1 from pervanadate-treated interleukin 2–activated NK cells. Together, our results indicate that KLRE1 may form a functional heterodimer with an as yet unidentified ITIM-bearing partner that recruits SHP-1 to generate an inhibitory receptor complex.