bluuebunny/crossref_metadata_2025_split huggingface dataset:
An EEG Study of Patients with Unilateral Diffuse Cortical Dysplasia Who Underwent Hemispherectomy
Authors: Shigetomo Ritsuko , Shimizu Hiroyuki , Maehara Taketoshi , Kaito Nobuyoshi , Oda Masaya , Yagishita SAkira , Arai Nobutaka 
Published: August 2009

Purpose: Functional hemispherectomy was performed for patients with intractable epilepsy with unilateral diffuse cortical dysplasia. We retrospectively studied interictal scalp EEGs recorded both preoperatively and postoperatively. Methods: The cases were 12 (six male and six female) patients who had been definitively diagnosed as having unilateral cortical dysplasia by both neuropathologic and neuroradiologic findings. Five patients exhibited diffuse cortical dysplasia, and the other seven exhibited hemimegalencephaly. Their interictal scalp EEGs were classified into four groups based on the appearance of abnormal epileptiform discharges. The groups were focal, unilateral, bilaterally synchronous, and bilaterally nonsynchronous. We discussed the type of EEG, the magnetic resonance imaging (MRI) findings, and postoperative prognosis. Postoperative prognosis was made according to Engel's classification. The operation was functional hemispherectomy by disconnection. Results: The age at the time of the operation was from 5 months to 8 years and 6 months. The mean age was 3 years and 8 months. The age at the onset of the first seizure was from 0 days to 1 year and 8 months. All patients had frequent partial motor seizures caused by the affected side of the brain. Eight patients were associated with secondarily generalized seizures, and two were associated with drop attacks. All cases had various degrees of hemiparesis caused by the affected brain. The patients with hemimegalencephaly had more frequent attacks, resulting in epilepsia partialis continua in three cases. It was also striking that the onset time of the first seizure in these patients tended to be earlier than that in the patients with diffuse cortical dysplasia. The EEGs were classified as (1) in two cases, (2) in one case, (3) in five cases, and (4) in four cases. All patients, including even EEG types (3) and (4). became seizure free after the operation. Two patients were able to discontinue their antiepileptic medication. After functional hemispherectomy, even in a seizure‐free state, abnormal epileptic discharges remained in 10 patients on the affected side of the brain. Conclusions: We clarified the importance of the global assessment encompassing ictal symptoms, neuroradiologic findings, and EEG classification before the operation. The operative outcome was very excellent regardless of whether the EEG showed a unilateral or bilateral epileptiform discharge pattern. We concluded that the EEG type was not a conclusive factor. As stated previously, type (3) and (4) EEGs did not contraindicate hemispherectomy. Postoperative active epileptic discharges from the affected side of the brain indicated a viable state of the disconnected brain and are not related to the surgical outcome.
Children with Seizure Disorders After Administration of an Anti‐allergic Medicine
Authors: Yasuhara Akihiro , Ochi Ayako , Araki Atsushi , Kitamura Naoyuki , Harada Yoshiaki 
Published: August 2009

Purpose: Histamine is a neurotransmitter in the mammalian brain, and the central histaminergic system is known to have an inhibitory effect on epileptic seizures. We found 19 children with seizure disorders and EEG abnormalities after the administration of an antiallergic medicine (Ketotifen). Ketotifen has been used for its antihistaminergic action for the treatment of severe allergic disorders such as atopic dermatitis and bronchial asthma. Methods and Results: We classified the 19 patients into five groups as follows. Group A had two patients who had a previous history of seizures controlled by antiepileptic drugs (AEDs). They had convulsive disorders and EEG spikes after the administration of Ketotifen. After the cessation of Ketotifen, the seizures disappeared. Group B had two patients with a history of febrile convulsions. After the administration of Ketotifen for atopic dermatitis, they had nonfebrile convulsions. The seizures disappeared after discontinuance of Ketotifen. Group C had five patients who had nonepileptic symptoms, including premature birth or renal failure, and who showed spike discharges on the EEG after the administration of Ketotifen. The spike discharges disappeared after the discontinuance of Ketotifen. Group D had eight patients who had been treated with Ketotifen for atopic dermatitis or bronchial asthma, and who had febrile convulsions. The ages ranged between 10 months and 5 years. The prolonged convulsions lasted between 10 and 120 min, with a mean of 40 min. An abnormal EEG was recorded in seven of the eight patients. Group E had two patients with infantile spasms and hypsarrhythmia 8–10 days after the administration of Ketotifen at age 3 months. They were diagnosed as having West syndrome because of the tonic spasms, hypsarrhythmia, and developmental arrest. Conclusions: Histamine has an anticonvulsive effect through the histamine H1 receptor in the brain. Ketotifen has been used as an anti‐allergic medicine and is known to be a histamine H1 antagonist. The central histaminergic system plays an important role in inhibiting convulsions in infants, before the γ‐aminobutyric acid (GABA) system fully develops its inhibitory function. We analyzed the 19 patients with seizure disorders after Ketotifen administration and found that young children who were susceptible to seizures were triggered for seizures by this H1 antagonist. It is still unknown whether the administration of Ketotifen itself produces or triggers seizures during infancy.
Five Cases with Refractory Seizures Due to a Hypothalamic Hamartoma
Authors: Ohtsubo Toshiaki , Mihara Tadahiro , Inoue Yushi , Tanaka Masaki , Fukushima Katsuyuki , Kubota Yuko , Matsuda Kazumi , Tottori Takayasu , Yagi Kazuichi 
Published: August 2009

Purpose: In five patients with refractory seizures due to a hypothalamic hamartoma recently examined in our institute, we analyzed the electroclinical and the neuroimaging findings in detail. Methods: Three patients were men and two were women, and their ages at the time of the investigation ranged from 16 to 49 years (mean, 26 years). The age of seizure onset was <4 years, except for one patient in whom seizures began at 23 years. Seizures occurred daily in three patients and weekly in two patients. All patients received examinations for surgical candidates such as scalp‐recorded electroencephalography/closed‐circuit television (EEG/CCTV) monitoring, computed tomography (CT), magnetic resonance imaging (MRI), single‐photon‐emission computed tomography (SPECT), and neuropsychological and endocrinological tests. Magnetoencephalography (MEG) was investigated in two patients. Results: Gelastic seizures with facial expressions of laughter were manifested in all patients and were accompanied by a laughing voice in one patient. All patients had various kinds of psychomotor seizures. There were other seizure manifestations with lateralized signs, such as somatosensory sensation, facial twitching, and head/eye turning. No patient had precocious puberty or abnormal endocrinological test results. The interictal EEGs in four patients indicated unilateral or predominantly unilateral abnormalities in the frontal or frontotemporal areas, although the ictal EEG provided no information about side and site of seizure origin in three patients. MEG showed dipole clustering localized unilaterally in the temporal lobe in one patient. A unilateral hypoperfusion area in the temporal lobe on the interictal SPECT changed to hyperperfusion on the ictal SPECT in one patient. MRI or CT or both revealed a round isointensity mass buried in the hypothalamus near the mammillary body in all of the patients. The diameter was ∼1 cm in three patients and 2 cm in the other two patients. The direction of the tumor extension was toward the third ventricle in three patients and the basal cistern in the other two patients. The tumorous lesions were lateralized to the left side in four patients and to the right side in the other patient, and all were attached to the hypothalamus with a broad neck. Conclusions: The patients with a hypothalamic hamartoma in this study had electroclinically lateralized abnormalities somewhat similar to those of temporal or frontal lobe epilepsy. Such patients, therefore, may receive inappropriate resective surgery if the lesion fails to be noticed. Gamma knife therapy or stereotactic radiofrequency thermo‐coagulation for this lesion is probably a more secure and effective treatment, compared with the direct resection of the lesion.
The Course of Children with Epilepsy Who Discontinued Treatment 2–3 Years After Their Last Seizure
Authors: Hashimoto Takashi , Taketomi Hiroya 
Published: August 2009

Purpose: Anticonvulsant drugs (AEDs) have potential side effects, and therefore, discontinuation of administration at an early stage is preferable. The general policy for treatment in Japan depends greatly on the electroencephalographic (EEG) findings. In Europe and America, however, the general policy is to discontinue treatment if no epileptic seizures have occured within 2 years. We followed the latter policy, and in cases of intractable seizures, the medication was discontinued 3 years after the cessation of seizures. Some cases in which the medication was discontinued within 2 years after cessation of the seizures were also included in this report. The risk factors were examined as indicated later. Methods: Between 1985 and 1996, the administration of AEDs was discontinued in 113 cases according to the aforementioned policy. After exclusion of six cases who could not be followed up and 15 cases who were observed for < 1 year after the discontinuation of medication, 92 patients were examined. The mean follow‐up period for the subjects who had no recurrence of seizures was 4.7 years (range, 1–10.5 years). The age when the first seizure occurred was younger than 1 year in 13 cases, 1–5 years in 42 cases, 6–12 years in 26 cases, and 13 years or older in six cases. Annual investigations were carried out either by telephone or mail since 1993. The results collected by December 1996 were analyzed. Kaplan‐Meier's method and the 2 test were used for statistical analysis. Results: Discontinuation of administration was performed 100 times in the 92 cases, and recurrence of seizures occurred 20 times. Seven recurrent cases underwent discontinuation repeatedly (a total of eight times) with successful results. The significant risk factors were symptomatic epilepsy, cryptogenic epilepsy, and age at the onset of seizures of 2 12 years. Sex, EEG abnormalities, general/focal convulsions, febrile convulsions, duration between seizures of >3 years, 3 12 years of age at last seizure, status epilepticus, family history of epilepsy, and seizures during sleep were not considered risk factors. Regarding idiopathic epilepsy, there were no significant differences among the groups treated for <2 years, 2 years, or 3 years. Conclusions: The risk factors were symptomatic epilepsy, cryptogenic epilepsy, and age at the onset of seizures of 312 years. In cases having such risk factors, drug discontinuation when recurrence has not occurred for 3 years is advisable. In children with idiopathic epilepsy, the policy of drug discontinuation when recurrence has not been observed for 2 years is fully acceptable, and further extension of the treatment period appears unnecessary. Even 1 year of absence of seizures may he sufficient for discontinuation of medication. Because EEG abnormalities are not considered risk factors, prognosis based on EEG observations should be abandoned.
Induction by Phenobarbital of Fetal and Neonatal Hepatic CYP2B1 and CYP3A2 in Rats
Authors: Asoh Masako , Yamamoto Hitoshi , Ohta Chikako , Murakami Hiroshi , Tateishi Tomonori , Kobayashi Shinichi 
Published: August 2009

Purpose: Phenobarbital (PB), an inducer of the hepatic CYP2B and CYP3A enzyme families, is widely used for the treatment of epilepsy. Patients with epilepsy are often required continuously to take antiepileptic drugs (AEDs) including during periods of pregnancy, delivery, and breast feeding. In this study, we sought to determine the effects of PB delivered via placenta (study I) and breast milk (study II) on the induction of hepatic CYP enzymes in fetal and neonatal rats. Methods: In study I, PB (80 mg/kg in saline) was administered intrapentoneally to pregnant rats once a day for 7 days just before delivery. The livers were removed from fetuses just before birth and from neonates 5, 10, 15, and 20 days after birth. In study II, pregnant rats were given free access to water containing PB (100 mg/ml) beginning 13 days before and for 3 weeks after delivery. The livers of the offspring were removed 3 and 4 weeks after birth, and microsomes were prepared for the analysis of CYP2B1 and CYP3A2 on Western blots. Pentoxyresorufin O‐deethylase (PROD) activity was also measured as an index of CYP2B1 activity and testosterone 6P‐hydroxylase activity was measured as an index of CYP3A2 activity. Results: In study I, PB administered through the placenta had little effect on the expression of the CYP2B1 and CYP3A2 proteins in fetuses. CYP2B1 protein was increased by 77% in 5‐day‐old rats, but this induction had disappeared in 10‐day‐old or older rats. PROD activity was similarly increased by 80% in 5‐day‐old rats but was unchanged from controls in 10‐day‐old or older rats. In study II, PB administered through breast milk resulted in a 40% increase in CYP2B1 protein in 3‐week‐old rats, but this increase was absent in 4‐week‐old rats (I week after weaning). CYP3A2 protein and testosterone 6P‐hydroxylase activity were not altered at any age examined in study I or II. Conclusions: These data demonstrate that PB administered through placenta or breast milk produces a transient induction of hepatic CYP2B1 in newborn rats. These observations suggest that unlike other stimulants (Pediatr Res 1994;35:255–9), PB does not produce an “imprinting” of the hepatic CYP enzymes that lasts into adulthood.
Functional Changes of the Brainstem Triggering Diffuse 3–Hz Spike‐and‐Wave Complexes
Authors: Kohsaka Shinobu , Sakai Taeko , Mizukami Susumu , Uetake Kimiaki , Kohsaka Masako 
Published: August 2009

Purpose: We investigated the functional changes of the brainstem to evaluate the “centrencephalic system” hypothesis in human primary generalized epilepsy (PGE) with diffuse 3–Hz spike‐and‐wave complexes (SWCs). Methods: In nine patients diagnosed with typical absence seizures, 3–HZ SWCs were recorded (six channel EEGs including Cz‐A1 and Cz‐A2) together with a binaural acoustic triggering signal (20 stimuli/s repetition rate). The EEG data were sampled (10 kHz for sampling frequency), and then brainstem auditory evoked potentials were analyzed sequentially (128 samples averaged) before and during the emergence of SWCs after trend‐subtraction in each sample. Sequential changes of four parameters (amplitude and area of both wave III and wave V) were tested for time course differences by one‐way analysis of variance (ANOVA) with repeated measures. Results: The wave‐III amplitude showed biphasic changes (an increment between 11.2 ± 3.2 and 6.4 ± 3.2 s followed by an abrupt decrement) before the onset of SWCs while at the same time, the wave‐III area showed a gradual decrement. Both wave‐V amplitude and area showed no significant changes. Conclusions: The results disclose the functional changes in the ventral part of the lower brainstem preceding the onset of 3–Hz SWCs. The results suggest that these changes of neuronal excitability trigger the SWCs and substantiate the centrencephalic system hypothesis for human PGE.
BLOOD DONORS AND BLOOD COLLECTION: Web interface–supported transmission risk assessment and cost‐effectiveness analysis of postdonation screening: a global model applied to Ghana, Thailand, and the Netherlands
Authors: Van Hulst Marinus , Hubben Gijs A.A. , Sagoe Kwamena W.C. , Promwong Charupon , Permpikul Parichart , Fongsatitkul Ladda , Glynn Diarmuid M. , Sibinga Cees T. Smit , Postma Maarten J. 
Published: August 2009

BACKGROUND: The goal of our research was to actively involve decision makers in the economic assessment of screening strategies in their region. This study attempted to accomplish this by providing an easy‐to‐use Web interface at http://www.bloodsafety.info that allows decision makers to adapt this model to local conditions.STUDY DESIGN AND METHODS: The cost‐effectiveness was compared of 1) adding antigen screening to antibody screening for hepatitis C virus (HCV) and human immunodeficiency virus (HIV); 2) adding nucleic acid amplification testing (NAT) on hepatitis B virus (HBV), HCV, and HIV in minipool (pool of 6 [MP6] and 24 [MP24]) to antibody screening and hepatitis B surface antigen (HBsAg) screening; and 3) individual‐donation NAT on HBV, HCV, and HIV to antibody screening and HBsAg screening for Ghana, Thailand, and the Netherlands.RESULTS: The combination of HCV antibody‐antigen combination (combo) and HIV combo added to antibody screening in Ghana and Thailand was cost‐effective according to the WHO criteria. MP24‐NAT screening in Ghana was also cost‐effective. MP24‐NAT on HBV, HCV, and HIV was not cost‐effective compared to the other screening strategies evaluated for the Netherlands. Large regional differences in cost‐effectiveness were found for Thailand.CONCLUSION: The young transfusion recipient population of Ghana in combination with a high risk of viral transmission yields better cost‐effectiveness for additional tests. The advanced age of the transfused population of the Netherlands and a small risk of viral transmission gives poor cost‐effectiveness for more sensitive screening techniques. It was demonstrated that a global health economic model combined with a Web interface can provide easy access to risk assessment and cost‐effectiveness analysis.
Endodontic treatment of teeth induces retrograde peri‐implantitis
Authors: Zhou Wei , Han Chun , Li Dehua , Li Yunming , Song Yingliang , Zhao Yimin 
Published: August 2009

AbstractObjectives: Some cases of retrograde peri‐implantitis arise from adjacent natural teeth that have peri‐radicular infection. The present study was designed to investigate the incidence of retrograde peri‐implantitis from adjacent teeth with endodontic treatment.Materials and methods: One hundred and twenty‐eight patients of ages ranging from of 24–61 years were recruited for this study. A total of 128 ITI SLA implants with adjacent teeth that had received endodontic treatment at least 1 week before were placed in 128 patients. The date of endodontic therapy and the pulp status of the adjacent tooth before endodontic therapy were recorded. The distance between the implant and the adjacent tooth was determined using a radiograph. The stability of all implants was tested by OSSTELL and recorded at implant placement, after 4 and 12 weeks.Results: The incidence of retrograde peri‐implantitis was 7.8%. The duration from endodontic‐treated adjacent teeth to implant placement was 12.15±10.1 weeks, and the distance between the implant and the adjacent teeth was 2.99±1.4 mm. Distance and time were found to be related to retrograde peri‐implantitis (P<0.05). The stability of implants with retrograde peri‐implantitis was less than that of the normal implants, but the difference was not significant (P>0.05).Conclusions: The incidence of retrograde peri‐implantitis may reduce by increasing the distance between the implant and adjacent tooth, and/or the duration from endodontically treated adjacent tooth‐to‐implant placement. Although preliminary, these data might orient the practitioner to avoid retrograde peri‐implantitis.
Effect of surface topography of screw‐shaped titanium implants in humans on clinical and radiographic parameters: a 12‐year prospective study
Authors: Vroom Melle G. , Sipos Paul , De Lange Gert L. , Gründemann Lodewijk J. M. M. , Timmerman Mark F. , Loos Bruno G. , Van Der Velden Ubele 
Published: August 2009

AbstractObjectives: Although implants with a roughened surface are widely used today, little is known about the long‐term effect of a roughened surface compared with the conventional machined surface on clinical and radiographic parameters. The purpose of this study is to investigate the long‐term differences between moderately rough (tioblasted) titanium implants and minimally rough machined/turned surfaces with respect to marginal bone resorption and the peri‐implant soft tissues in the same patient.Material and methods: In 20 fully edentulous patients, with severely resorbed mandibles, a total of 80 Astra Tech dental implants were placed in the mandible to support a bar construction with a full overdenture. In each patient two minimally rough‐surfaced (turned) and two moderately rough‐surfaced (tioblast) implants were placed alternately. Clinical evaluation was carried out at base line (prosthetic installation), 6 months, 1, 2, 3, 4, 5 and 12 years. Radiographic evaluation using standardized individual filmholders was carried out at base line (prosthetic installation), 6 months, 1, 5 and 12 years.Results: In two patients, during the abutment surgery, one turned implant showed insufficient osseointegration and was replaced. One implant showed an abutment fracture after 9 years and was kept as a sleeper. From base line up to 12 years, no implant was lost. No significant differences were found between both implant surfaces concerning the clinical parameters such as plaque, calculus, bleeding and probing pocket depth. The mean (SD) marginal bone changes up to 12 years varied between –0.11 and +0.01 mm for the turned and −0.2 and +0.01 mm for the tioblast implants. No significant difference in marginal bone loss was found between both implant surfaces.Conclusion: We conclude that after 12 years of follow‐up, no differences could be found between the turned and the tioblasted implants, both for soft and for hard tissue parameters.
Fluoxetine‐induced sleep bruxism in an adolescent treated with buspirone: a case report
Authors: Sabuncuoglu Osman , Ekıncı Ozalp , Berkem Meral 
Published: August 2009

ABSTRACTSleep bruxism, the involuntary grinding and/or clenching of teeth during sleep, may occur in young children and may be secondary to medication use, especially selective serotonin reuptake inhibitors (SSRIs). The mesocortical disinhibition produced by SSRIs may lead to dopamine depletion that manifests itself as nocturnal bruxism, a specific form of akathisia. This may be prevented by using buspirone, a 5‐HT1A agonist that reduces serotonergic activity and increases dopaminergic activity. This article reports on a case history of an adolescent with fluoxetine‐induced bruxism that was successfully treated with buspirone. As SSRI use is on the rise for treating childhood psychiatric disorders, this case report highlights the importance of recognizing SSRI‐induced bruxism and the possible related adverse dental side effects. Furthermore, this report supports the efficacy of a treatment strategy in adolescents, which has previously been reported only for adult patients.
Oral health outcomes in an adult dental population: the impact of payment systems
Authors: Durham Timothy M. , King Kenneth A. , Salama Fouad S. , Lange Brian M. 
Published: August 2009

ABSTRACTThis study compared the effect of payment systems on recall visits and oral health outcomes for four patient payer groups. The authors reviewed recall audit data obtained over a 4‐year period. Dental payer groups in the study population differed with respect to dental outcomes. Patients who had recall visits at 1 year or longer had worse outcomes than patients seen more frequently. A Medicaid subgroup with the greatest number of risk factors displayed improved oral health outcomes when seen on a more frequent recall schedule. Study findings suggest that, given the increased risks to maintaining oral health, patients being supported by public‐funded programs would benefit from more frequent recalls. Such an emphasis would appear to provide the opportunity to improve outcomes in disadvantaged populations and increase the quality of care offered.