bluuebunny/crossref_metadata_2025_split huggingface dataset:
Systematics of the Protohermes xanthodes species‐group in eastern Asia (Megaloptera: Corydalidae)
Authors: LIU Xingyue , HAYASHI Fumio , YANG Ding 
Published: December 2006

AbstractA new species‐group of the dobsonfly genus Protohermes is proposed, the Protohermes xanthodes species‐group. Three species from eastern Asia belonging to the new species‐group are redescribed and illustrated. Phylogenetic relationships among the species in this group, as well as the biogeography of these species, are discussed on the basis of a cladistic analysis.
Redefinition of Oligotrophus (Diptera: Cecidomyiidae) based on morphological and molecular attributes of species from galls on Juniperus (Cupressaceae) in Britain and Japan
Authors: HARRIS Keith M. , SATO Shinsuke , UECHI Nami , YUKAWA Junichi 
Published: December 2006

AbstractMorphological and molecular attributes of four species of Cecidomyiidae that induce galls on junipers, Juniperus spp., in Britain and Japan were used to redefine the genus Oligotrophus Latreille, which now includes Arceuthomyia Kieffer and Schmidtiella Rübsaamen (new synonyms). Illustrated morphological descriptions are provided for the four species Oligotrophus juniperinus (Linnaeus), Oligotrophus panteli Kieffer, Oligotrophus gemmarum (Rübsaamen) (new combination) and Oligotrophus nezu Kikuti (= Arceuthomyia nakaharai Inouye (new synonymy)) and phylogenies based on partial sequencing of the mitochondrial 12S rRNA gene are reported.
rTMS Reveals Premotor Cortex Dysfunction in Frontal Lobe Epilepsy
Authors: Löscher Wolfgang N. , Dobesberger Judith , Szubski Christoph , Trinka Eugen 
Published: December 2006

Summary: Purpose:Studies of motor cortex excitability provided evidence that focal epilepsies may alter the excitability of cortical areas distant from the epileptogenic zone. In order to explore this hypothesis we studied the functional connectivity between premotor and motor cortex in seven patients with frontal lobe epilepsy and seizure onset zone outside the premotor or motor cortex.Methods:Low‐frequency subthreshold repetitive transcranial magnetic stimulation was applied to the premotor cortex and its impact on motor cortex excitability was measured by the amplitude of motor‐evoked potentials in response to direct suprathreshold stimulation of the motor cortex.Results:Stimulation of the premotor cortex of the non‐epileptogenic hemisphere resulted in a progressive and significant inhibition of the motor cortex as evidenced by a reduction of motor evoked potential amplitude. On the other hand, stimulation of the premotor cortex of the epileptogenic hemisphere failed to inhibit the motor cortex. The reduced inhibition of the motor cortex by remote areas was additionally supported by the significantly shorter cortical silent periods obtained after stimulation of the motor cortex of the epileptogenic hemisphere.Conclusion:These results show that the functional connectivity between premotor and motor cortex or motor cortex interneuronal excitability is impaired in the epileptogenic hemisphere in frontal lobe epilepsy while it is normal in the nonepileptogenic hemisphere.
Electrical Stimulation of the Anterior Nucleus of the Thalamus for Intractable Epilepsy: A Long‐term Follow‐up Study
Authors: Lim Siew‐Na , Lee Shih‐Tseng , Tsai Yu‐Tai , Chen I‐An , Tu Po‐Hsun , Chen Jean‐Lon , Chang Hsiu‐Wen , Su Yu‐Chin , Wu Tony 
Published: December 2006

Summary:  Purpose: The anterior nucleus of the thalamus (ANT) modulates temporal lobe and hypothalamic activities, and relays information to the cingulate gyrus and entorhinal cortex. Deep brain stimulation (DBS) of the ANT has been reported to decrease seizure activity in a limited number of human subjects. However, long‐term effect of chronic ANT stimulation on such patients remains unknown. We report long‐term follow‐up results in four patients receiving ANT stimulation for intractable epilepsy. Methods: Four patients underwent stereotactic implantation of quadripolar stimulating electrodes in the bilateral ANT, guided by single‐unit microelectrode recording. Electrode location was confirmed by postoperative magnetic resonance imaging (MRI). The stimulator was activated 2–4 weeks following electrode insertion; initial stimulation parameters were 4–5 V, 90–110 Hz, and 60–90 μs. Seizure frequency was monitored and compared with preimplantation baseline frequency. Intelligence quotient (IQ) test and auditory P300 response were performed before and after implantation of electrodes. Results: Four patients (one man with generalized seizures, and three women with partial seizures and secondary generalization) aged 18–45 years old were studied with mean follow‐up period of 43.8 months. The four patients demonstrated a sustained effect of 49% (range, 35–76%) seizure reduction to ANT stimulation. Simple insertion of DBS electrodes (Sham period, no stimulation) produced a mean reduction in seizures of 67% (range, 44–94%). One patient was seizure‐free for 15 months with anticonvulsant medications. One patient had a small frontal hemorrhage and a second patient had extension erosion over scalp; no resultant major or permanent neurological deficit was observed. Preoperative IQ index and auditory P300 were not significantly different with those after electrodes implantation. Conclusions: Implantation of electrodes in the ANT and subsequent stimulation is associated with a significant reduction in seizure frequency. However, our study could not differentiate whether the implantation itself, the subsequent stimulation or postimplantation drug manipulation had the greatest impact. These experimental results prompt further controlled study in a large patient population.
Combined Ketogenic Diet and Vagus Nerve Stimulation: Rational Polytherapy?
Authors: Kossoff Eric H. , Pyzik Paula L. , Rubenstein James E. , Christina Bergqvist A. G. , Buchhalter Jeffrey R. , Donner Elizabeth J. , Nordli Douglas R. , Wheless James W. 
Published: December 2006

Summary: Objective:The concept of “rational polypharmacy” has been associated with anticonvulsant management for decades, but the term has not been applied to nonpharmacologic therapies.Methods:We conducted a multicenter, retrospective study of children who received concurrent diet (ketogenic or modified Atkins) and vagus nerve stimulation (VNS) treatment for medically intractable epilepsy.Results:Thirty children in total from six epilepsy centers were treated over a 6‐yr period. The median age at the initiation of combination therapy was 10 yr (range, 4–24 yr). Sixteen (53%) received dietary therapy followed by VNS; no differences were noted between centers. After 3 months, 21 (70%) had seizure reduced by >50% over the previous single nonpharmacologic treatment, of whom 13 (62%) had improvement within the first month. A 5‐min VNS off‐time correlated with >90% seizure reduction (p = 0.02). The median duration of nonpharmacologic polytherapy was 12 months (range, 0.5–96 months); 17 (57%) remain on dual therapy at this time. No side effects were noted. Most patients who discontinued combination therapy did so because of a lack of efficacy rather than restrictiveness.Conclusions:In this small group, the combined use of diet and VNS appeared synergistic and yielded rapid benefits. It may be more effective with longer VNS off‐times. Further prospective studies of this combination in refractory pediatric epilepsy are needed to help guide optimal use.
The Localization and Lateralization of Memory Deficits in Children with Temporal Lobe Epilepsy
Authors: Gonzalez Linda M. , Anderson Vicki A. , Wood Stephen J. , Mitchell L. Anne , Harvey A. Simon 
Published: December 2006

Summary:  Purpose: It is often reported that children with temporal lobe epilepsy (TLE) experience nonlateralized memory impairments. However, many of these studies have been exploratory and not based on memory theory. Further, differences between mesial and lateral subgroups have not been adequately examined. This study aimed to discern more specific patterns of memory impairment in children with TLE. Methods: Forty‐three children (5–16 years) with lesional TLE participated. Subjects were categorized in terms of lesion laterality (left, n = 21; right, n = 22) and intratemporal location (mesial, n = 31; lateral, n = 12). Verbal and nonverbal memory tasks were administered that reflected associative, allocentric and recognition paradigms. Results: Facial recognition was poorer in right TLE (p = 0.03). There were no differences between left and right groups on any other memory task, even when comparisons were restricted to cases with mesial involvement. Irrespective of laterality, clear differences were observed between mesial and lateral lesion subgroups (arbitrary associative learning, p = 0.01; complex figure recall, p = 0.03). The lateral lesion subgroup displayed intact memory function relative to normative standards. Conclusions: Memory is more frequently impaired in children with mesial as opposed to lateral TLE. Tasks with an associative component discriminated between these subgroups, supporting an associative model of hippocampal function. With the exception of facial recognition, memory deficits were not lateralized. Therefore, the nature of memory impairment experienced by children with TLE cannot be extrapolated from adult models.
Characterization of blood‐borne transmission of simian foamy virus
Authors: Brooks James I. , Merks Harriet W. , Fournier Jocelyn , Boneva Roumiana S. , Sandstrom Paul A. 
Published: December 2006

BACKGROUND: Simian foamy virus (SFV) is an endemic, nonhuman primate (NHP) retrovirus that is transmitted to individuals who work with or hunt NHPs. The cross‐species transmission of simian retroviruses is believed to be the etiology of human immunodeficiency virus and human T‐lymphotropic virus infections in humans. Although SFV is not pathogenic in the native host, the shared ancestry with other simian retroviruses has brought into question the potential for acquired pathogenicity after cross‐species transmission. This study examines whether SFV also shares the traits of transmissibility through the blood supply.STUDY DESIGN AND METHODS: Within a controlled environment, blood from an SFV‐infected monkey was transfused into an SFV‐uninfected monkey. Evidence of infection, pathogenic effects, immune correlates, and viral shedding were followed for 6 months after transfusion.RESULTS: Molecular evidence of SFV infection manifested 8 weeks after transfusion followed by seroconversion 1 week later. Quantitative analysis demonstrated that the highest level of detectable virus was concomitant with seroconversion followed by establishment of a viral “set‐point.” Analysis of circulating lymphocytes revealed changes early in infection. Potential routes of transmission of SFV and roles of site‐specific immune response are suggested by the late appearance of SFV shedding in the saliva of the transfused animal.CONCLUSION: The blood supply has historically provided a portal through which novel, occult viruses can become disseminated among humans. The demonstration of transmissibility of SFV through whole‐blood transfusion, in an NHP model, contributes to the understanding of potential risks associated with blood donation by SFV‐infected humans.
Platelet utilization and the transfusion trigger: a prospective analysis
Authors: Greeno Edward , McCullough Jeffrey , Weisdorf Daniel 
Published: December 2006

BACKGROUND: Prophylactic platelet (PLT) transfusion practices have become more conservative as studies support a threshold for transfusions at 10 × 109 per L. This change in practice may reduce our use of PLT transfusions.STUDY DESIGN AND METHODS: Data were prospectively collected to assess the impact at one academic hospital when the transition from a 20 × 109 to a 10 × 109 per L threshold prophylactic transfusion was made.RESULTS: A total of 503 patients received 7401 PLT transfusions. Seventy‐four percent of the transfusions were prophylactic. During the first phase of the study, only 53 percent of transfusions were given at a pretransfusion PLT count of less than 20 × 109 per L and 20 percent less than 10 × 109 per L. In the second phase of the study when the transfusion trigger was 10 × 109 per L, 28 percent of transfusions were given at this level.CONCLUSION: Many prophylactic PLT transfusions were given at PLT counts higher than the recommended trigger. Although the new transfusion guidelines altered transfusion practice, only a minor change in overall PLT usage was observed. Other changes in transfusion practices, such as dose per transfusion or sampling interval, will be required before significant reduction in the costs and hazards of prophylactic PLT transfusions can be realized.
Evaluation of platelet transfusion triggers in a tertiary‐care hospital
Authors: Cameron Bruce , Rock Gail , Olberg Bernard , Neurath Doris 
Published: December 2006

BACKGROUND: Our 1100‐bed referral hospital uses approximately 12,000 units of random‐donor platelets (PLTs) and 1,900 units of single‐donor apheresis PLTs per year with a mean of 23 percent outdating. An analysis of patterns of utilization has been undertaken to evaluate practice.STUDY DESIGN AND METHODS: Over a 9‐month period, data were collected on a total of 1682 transfusion episodes in 464 patients. When the pretransfusion count was greater than 10 × 109 per L an attempt was made to identify the specific indications for PLT transfusions such as bleeding.RESULTS: The majority (78%) of PLTs were transfused when the counts were above 10 × 109 per L. The mean pretransfusion counts for different services were: bone marrow transplant (BMT) 17.4 × 109 per L, hematology‐oncology 14.6 × 109 per L, the Heart Institute 3 × 109 per L, and other services 36 × 109 per L. The percentage of transfusions given to patients with a count greater than 10 × 109 per L varied by service with 79 percent in BMT, 60 percent in hematology and oncology, 98 percent at the Heart Institute, and 81 percent in other services. Routine monitoring of counts shows a mean increment of 10.2 × 109 per L per transfusion. One hour posttransfusion counts, 24‐hour posttransfustion counts, and documentation of clinical justification for transfusions was often not available.CONCLUSIONS: The data show that most patients who receive PLTs have pretransfusion counts of more than 10 × 109 per L and more than one‐third have pretransfusion counts of greater than 20 × 109 per L. The medical literature supports prophylactic PLT transfusion based solely on the count when the PLT number is 10 × 109 per L or less. Above this level additional justification is needed although there are different points of view concerning the appropriate triggers. Our data suggest that there is a need for clear hospital transfusion guidelines and ongoing monitoring of PLT use.
Calculating the required transfusion volume in children
Authors: Davies Patrick , Robertson Simon , Hegde Shilpa , Greenwood Rosemary , Massey Edwin , Davis Peter 
Published: December 2006

BACKGROUND: The traditional method of calculating blood volume for pediatric transfusion in the UK is weight (kg) × aimed increment in hemoglobin concentration (Hb; g/dL) × the transfusion factor, usually quoted at 3 or 4. This equation is without evidence base. The aim was to assess how the volume of red cells (RBCs) affects the increase in serum Hb in children and to devise a formula that allows accurate volume calculation.STUDY DESIGN AND METHODS: All pediatric intensive care charts for 2 years were examined retrospectively. The immediate pre‐ and posttransfusion Hb estimations and the precise volumes of RBC transfused were recorded. Fluid boluses and hemorrhagic loss during the transfusion were documented.RESULTS: A total of 7679 patient charts were examined with a total of 564 transfusions. All patients who were bleeding, had drain losses, or had concurrent colloid infusions were excluded, giving 379 data points. The correlation gradient between mL per kg blood transfused and increase in Hb was 5.02. There was no significant association between effect and patient weight, age, starting Hb, transfusion time, or sex. No significant difference was found in Hb at 1 and 7 hours posttransfusion.CONCLUSIONS: The following equation should be used to calculate transfusion volumes: weight (kg) × increment in Hb (g/dL) × 3/(hematocrit [Hct] level of RBCs). This predicts that with a UK standard Hct of 0.6, 10 mL/kg gives an increment of 2 g/dL. Care must be taken not to risk hypervolemia, while minimizing donor exposure. Hb estimation 1 hour after transfusion is the same as 7 hours after transfusion.
A comparative study of reducing the extracellular potassium concentration in red blood cells by washing and by reduction of additive solution
Authors: Bansal Ila , Calhoun Beverly W. , Joseph Cherilyn , Pothiawala Mohammad , Baron Beverly W. 
Published: December 2006

BACKGROUND: Extracellular potassium concentration (K+) increases in the supernatant of whole and packed red blood cell units (pRBCs) with duration of refrigerated storage in citrate‐phosphate‐dextrose‐adenine (CPDA‐1) and additive solution (AS). Studies have shown that to avoid hyperkalemia, washed pRBCs are preferred if relatively fresh pRBCs are not available. To determine whether a simpler procedure, AS reduction, results in lowering of K+ in pRBCs comparable to that achieved by washing, the K+ levels by both methods were compared.STUDY DESIGN AND METHODS: Pre‐ and post‐K+ levels were measured in 6 washed and 11 AS‐reduced pRBC units. Each unit was weighed, hematocrit was determined, K+ was measured, and total K+ was calculated. Washed units were 3 to 21 and AS‐reduced units were 4 to 30 days old. Statistical analysis was performed with a t test.RESULTS: There was no significant difference (p > 0.35) in the initial K+ between the two groups (mean ± SD, 36.95 ± 13.16 mEq/L before washing and 39.78 ± 19.94 mEq/L before AS reduction). Washing and AS reduction both led to a significant decrease in K+ levels (2.15 ± 0.10 mEq/L after washing and 4.41 ± 3.04 mEq/L after AS reduction, each p < 0.0005). Washing, however, was significantly better than AS reduction in reducing K+ in stored pRBCs (p < 0.05).CONCLUSIONS: Washing pRBCs results in very low levels of K+. AS reduction also significantly reduces K+ levels. Selection of the method of K+ reduction will depend on the stringency of K+ reduction needed, the time constraints, and the availability of facilities and staff for washing.
Accurate and Reproducible Target Navigation with the Stereotaxis Niobe® Magnetic Navigation System
Authors: ARMACOST MICHELLE P. , ADAIR JANET , MUNGER TORREY , VISWANATHAN RAJU R. , CREIGHTON FRANCIS M. , CURD DAVID T. , SEHRA RUCHIR 
Published: December 2006

Introduction: The Stereotaxis Niobe® Magnetic Navigation System (MNS, Stereotaxis, Inc., St. Louis, MO, USA) allows for remote‐control navigation of magnetically enabled catheters and guidewires for clinical ablation and electrophysiology (EP) device placement using two permanent magnets located on opposite sides of the patient table. Our objective was to provide a clinical framework for expected navigational accuracy during a case by calibrating the system's reproducibility using a realistic heart phantom under various conditions. Methods and Results: We performed two sets of experiments to demonstrate the accuracy of magnetic catheters using the MNS. The first experiment calibrated deviations in the deflection of an EP catheter by the magnetic system from the expected angles using proprietary algorithms based on predicted geometry. We found that the magnetic fields produced catheter angulation movements within a mean of 4° of biophysical predictions. The second experiment used the MNS to navigate these catheters to previously labeled target positions within a phantom heart model and estimated the actual displacement from desired target positions. We found that the accuracy for reaching the desired targets was 100%. Conclusions: Remote navigation of magnetically enabled EP catheters using the MNS accurately and reproducibly navigates to target sites in a heart phantom. This may enable more complex, successful, and time‐efficient procedures in the cardiac catheterization laboratory.
Progressive Remodeling of the Atrial Substrate—A Novel Finding from Consecutive Voltage Mapping in Patients with Recurrence of Atrial Fibrillation After Catheter Ablation
Authors: LO LI‐WEI , TAI CHING‐TAI , LIN YENN‐JIANG , CHANG SHIH‐LIN , WONGCHAROEN WANWARANG , CHANG SHENG‐HSIUNG , HSIEH MING‐HSIUNG , TUAN TA‐CHUAN , UDYAVAR AMEYA R. , CHEN YI‐JEN , TSAO HSUAN‐MING , CHEN SHIH‐ANN 
Published: December 2006

Background: Atrial substrate properties have been demonstrated to be related to atrial arrhythmias. This study investigated whether the atrial substrate exhibits progressive remodeling in patients with recurrence of atrial fibrillation (AF) after catheter ablation. Methods and Results: Fifteen consecutive AF patients (52 ± 12 years old, 12 males) underwent the same mapping technique (NavX, St. Jude Medical, Minnetonka, MN, USA) and same ablation technique for primary AF and recurrence of AF (170 ± 66 days after the first procedure). The bipolar mean peak‐to‐peak voltage (PPV) of the global left atrium during sinus rhythm significantly decreased in the second procedure (2.25 ± 0.62 vs. 1.79 ± 0.60 mV, P = 0.008). Also, the percentage of the surface area of the low voltage zone (LVZ; less than 0.5 mV) in the left atrium increased from 6 ± 4% to 13 ± 6% (P = 0.001) in the second procedure. There was no significant change in the right atrial bipolar mean PPV or surface area of the LVZ in the second procedure. Conclusion: Atrial substrate remodeling with a progressive decrease in the left atrial voltage was demonstrated in patients with recurrent AF.
Identification of diabetic macular oedema using retinal thickness measurements
Authors: Knudsen Lars Loumann 
Published: December 2006

Abstract.Background:  Identification of clinically significant macular oedema (CSMO) involves human depth perception, which is subject to a degree of uncertainty. However, although the ability to obtain objective thickness measurements of the central macular region may be advantageous, the topography of the macular region suggests that average thickness measurements represent a simplification of the topographic profile of the region. This study explored the applicability of additional sub‐analysis of central macular thickness measurements.Methods:  The study included 47 eyes of 47 normal subjects and 158 ocular examinations of 38 eyes from 22 diabetic subjects with and without CSMO. All eyes underwent central macular thickness measurements using retinal thickness analysis equipment. Eyes of diabetes subjects were classified as being without CSMO (n = 53), with focal CSMO (n = 50) and with diffuse CSMO (n = 55). The central macular region was subdivided into narrow concentric rings around the foveola, using a new invention, and the thicknesses of the individual concentric rings were calculated. The sensitivity and specificity of the CSMO diagnosis were established using the average thickness and the thicknesses of the concentric rings.Results:  The average thickness of the central macular region was found to be 165.1 µm in eyes of normal subjects and 192.3 µm in eyes without CSMO. It increased non‐significantly to 198.2 µm in eyes with focal CSMO and significantly to 236.9 µm in eyes with diffuse CSMO. Sensitivity for focal CSMO was 48.0% with average thickness measurements and 83.6% with concentric rings. Corresponding values for detection of diffuse CSMO were 91.7% and 96.1%, respectively. Specificity was 77.4% with average thickness measurements and 79.7% with concentric rings.Conclusions:  Thickness measurements of the central macular region can be used to distinguish between eyes with and without diffuse CSMO, but not between eyes with and without focal CSMO. Additional sub‐analysis based on concentric rings around the foveola seems to be a useful clinical tool that increases diagnostic certainty in these eyes.