bluuebunny/crossref_metadata_2025_split huggingface dataset:
Locus Coeruleus and Neuronal Plasticity in a Model of Focal Limbic Epilepsy
Authors: Giorgi Filippo S. , Mauceli Giuseppe , Blandini Fabio , Ruggieri Stefano , Paparelli Antonio , Murri Luigi , Fornai Francesco 
Published: December 2006

Summary:  Purpose: A lesion of the noradrenergic nucleus Locus Coeruleus (LC) converts sporadic seizures evoked by microinfusion of bicuculline into the anterior piriform cortex (APC) of rats into limbic status epilepticus (SE). The purpose of this study was to evaluate the chronic effects of this new model of SE on the onset of secondary epileptogenesis. We further related the loss of noradrenaline (NE) with hippocampal mossy fiber sprouting. Methods: Male Sprague Dawley rats were treated with systemic saline or DSP‐4 (a neurotoxin selective for noradrenergic terminals originating from the LC), microinfused with bicuculline into the APC three days later, and sacrificed after 45 days. Naïve and DSP‐4 pretreated sham‐operated rats served as respective controls. The following evaluations were performed: (a) monitoring of acute seizures and delayed occurrence of spontaneous recurrent seizures (SRS); (b) NE levels in the hippocampus, frontal and olfactory cortex; (c) occurrence of mossy fiber sprouting into the inner molecular layer of the dentate gyrus of the dorsal hippocampus. Results: In 30% of rats lacking noradrenergic terminals, SE evoked from the APC was followed by SRS. Conversely, seizures evoked in intact rats did not result in chronic epileptogenesis. Seizures/SE did not modify NE levels as compared with baseline levels both in naïve and DSP‐4‐pretreated rats. Rats undergoing SE following DSP‐4 + bicuculline developed SRS which were accompanied by hippocampal mossy fiber sprouting. Conclusions: Noradrenergic loss converts focally induced sporadic seizures into an epileptogenic SE, which is accompanied by mossy fiber sprouting within the dentate gyrus.
Benign Myoclonic Epilepsy in Infancy (BMEI): A Longitudinal Electroclinical Study of 22 Cases
Authors: Darra Francesca , Fiorini Elena , Zoccante Leonardo , Mastella Laura , Torniero Claudia , Cortese Samuele , Meneghello Lisa , Fontana Elena , Bernardina Bernardo Dalla 
Published: December 2006

Summary:  Purpose: Benign myoclonic epilepsy in infancy (BMEI) is a nosologically well‐defined entity, characterized by myoclonic seizures (MS) in normal children younger than 3 years and by a good long term prognosis. In some cases the seizures are reflex. We studied 22 cases to better define the electroclinical semeiology and evolution of the disorder. Methods: Serial electroclinical and neuropsychological assessments, both during wakefulness and during sleep, were performed in 22 otherwise healthy children with spontaneous (17) or reflex (5) MS, recorded by video‐EEG‐polygraphy since clinical onset. Results: Seizure onset was between 3 months and 4 years 10 months (50% during first year, 86% before the third year); in reflex cases onset, was earlier than the 14th month. MS recurred during wakefulness and slow sleep in all cases and during REM sleep in reflex cases. MS and related EEG discharges were synchronous or asynchronous. Often ictal EEG discharges were limited to the rolandic and vertex regions (falsely focal paroxysms). Several seizures were subtle and could have escaped recognition. Unusually frequent sleep startles were recorded mostly in reflex cases. MS were well controlled by treatment. At follow‐up, between ages 3 and 19 years, four patients had occasional seizures; two had cognitive impairment and three had learning difficulties. No other seizures or cognitive deficits were observed in reflex cases. Conclusions: Seizures associated with BMEI are rarely truly generalized and are often so subtle and related to falsely focal paroxysms that their frequency can be underestimated. The reflex form is a well‐defined variant with an early onset, peculiar electroclinical features, and a good prognosis.
Long‐Term Outcome of Pattern‐Sensitive Epilepsy
Authors: Brinciotti Mario , Matricardi Maria , Cantonetti Laura , Lauretti Giada , Pugliatti Maria 
Published: December 2006

Summary:  Purpose: To evaluate the long‐term outcome of patients with pattern‐sensitive epilepsy. Methods: We prospectively studied 35 patients (21 females and 14 males) with pattern‐sensitive epilepsy (follow up ≥5 years; mean 13.9; range 6.4 – 27.6). All cases had regular clinical examinations and serial electroencephalographic (EEG) recordings. Photosensitivity and pattern sensitivity were ascertained neurophysiologically in all cases. Outcome was evaluated according to the following variables: duration of photosensitivity, rate of remission (seizure‐free period ≥ 2 years), withdrawal of therapy, and recurrence after drug discontinuation. Results: The epilepsy was generalized in 18 cases (17 idiopathic, one symptomatic) and partial in 17 (13 idiopathic, four symptomatic). Sixteen patients (46%) had a family history of seizures. The mean age at the last examination was 21.4 years (range 11.2–35.5 years). Five patients (14%) had only reflex seizures. The most common type of spontaneous seizures was generalized (60%), whereas reflex seizures were more frequently partial (74%). Mean epilepsy duration was 8.7 ± 6.3 years. Patients with only reflex seizures were instructed to avoid precipitating stimuli and were not treated with antiepileptic drugs. Treatment was gradually withdrawn in 10 out of 30 treated patients, with relapse in only two cases. At the end of follow up, 28 patients (80%) were seizure‐free. Conclusion: The long‐term outcome of patients with pattern‐sensitive epilepsy indicates a good prognosis with a favorable course for both spontaneous and reflex seizures.
Emotions Induced by Intracerebral Electrical Stimulation of the Temporal Lobe
Authors: Meletti Stefano , Tassi Laura , Mai Roberto , Fini Nicola , Tassinari Carlo Alberto , Russo Giorgio Lo 
Published: December 2006

Summary:  Purpose: To assess the quality and frequency of emotions induced by intracerebral electrical stimulation of the temporal lobe. Methods: Behavioral responses were obtained by electrical stimulation in 74 patients undergoing presurgical video‐stereo‐EEG monitoring for drug‐resistant epilepsy. Intracerebral electrical stimulation was performed by delivering trains of electrical stimuli of alternating polarity; the intensity could vary from 0.2 to 3 mA. Stimulation frequency was 1 Hz or 50 Hz. Nine hundred thirty‐eight stimulation procedures were performed. Results: Seventy‐nine emotional responses (ERs) were obtained (8.4%). Of these, 67 were “'fear responses.” Sad feelings were evoked 3 times, happy‐pleasant feelings 9 times. Anger and disgust were never observed. The following variables affected the incidence of ER: (a) Anatomical site of stimulation. ERs (always fear) were maximal at the amygdala (12%) and minimal for lateral neocortical stimulation (3%, p < 0.01). (b) Pathology. Stimulation of a temporal lobe with hippocampal sclerosis was associated with a lower frequency of ERs compared with stimulation of a temporal lobe with no evidence of atrophy in the medial temporal structures. (c) Stimulation frequency. ERs were 12% at 50 Hz versus 6.0% at 1 Hz (p < 0.01). (d) Gender. In women fear responses were 16% compared with 3% in men (p < 0.01). There were no gender differences when analyzing nonemotional responses. Conclusions: These data confirm the role of the medial temporal lobe region in the expression of emotions, especially fear‐related behaviors. Fear was observed more frequently in the absence of medial temporal sclerosis, supporting the hypothesis that emotional behaviors induced by stimulation are positive phenomena, strictly related to the physiological function of these regions. Further investigations should address why women express fear behaviors more frequently than men.
EEG/fMRI Study of Ictal and Interictal Epileptic Activity: Methodological Issues and Future Perspectives in Clinical Practice
Authors: Bonaventura Carlo Di , Vaudano Anna E. , Carnì Marco , Pantano Patrizia , Nucciarelli Valter , Garreffa Girolamo , Maraviglia Bruno , Prencipe Massimiliano , Bozzao Luigi , Manfredi Mario , Giallonardo Anna T. 
Published: December 2006

Summary:  Purpose: Electroencephalography/functional magnetic resonance imaging (EEG/fMRI) has been proposed recently as a tool to study electrophysiological activity and, consequently, detect brain regions activated during epileptiform EEG abnormalities. The purpose of the study was to review our two‐year experience with studying ictal and interictal activities in patients with epilepsy. Methods: Using EEG/fMRI, we studied hemodynamic changes associated with ictal and interictal EEG abnormalities in 43 patients with partial (31 cases) or generalized (12 cases) epilepsy. Using two different paradigms (block design and event‐related design), we studied several forms of EEG activity consisting of (i) interictal abnormalities constantly elicitable by specific stimulation (8 cases); (ii) focal and generalized interictal activity, such as focal spikes or typical and atypical generalized spike‐and‐wave discharges (18 cases); and (iii) focal and generalized ictal electro‐clinical activity, such as tonic seizures or pseudo‐absences in frontal lobe epilepsy, typical absences in idiopathic generalized epilepsy, complex partial seizures in temporal lobe epilepsy, and perisylvian seizures in special syndromes (17 patients). Results: EEG/fMRI revealed clear hemodynamic changes related to EEG abnormalities in 21 patients. In 18 of these patients, the changes were highly concordant with electro‐clinical findings. In the remaining 22 patients, fMRI analysis data failed to show activation or deactivation clusters, probably owing either to lack or inadequate amount of temporal distribution of abnormal EEG activity, or to intrinsic methodological problems. Conclusions: By defining the electro‐clinical and hemodynamic correlates of EEG activity, fMRI may shed light on the neurophysiological mechanisms underlying epileptic phenomena. However, as several methodological issues have yet to be addressed, further studies are warranted to assess the reliability and usefulness of EEG/fMRI in clinical practice.
Ictal Grasping: Prevalence and Characteristics in Seizures with Different Semiology
Authors: Gardella Elena , Rubboli Guido , Tassinari Carlo Alberto 
Published: December 2006

Summary:  Purpose: The aim of this study was to investigate ictal grasping (IG), defined as the act of gripping something firmly during focal epileptic seizures, and to evaluate whether it characterizes specific seizure types. Methods: We analyzed the video‐recordings of 694 seizures in 109 consecutive candidates to epilepsy surgery. Seizures with motor manifestations (n = 511) were selected and divided into four semiological groups: (a) frontal “hyperkinetic” seizures (FHS): 30 seizures, 12 patients, (b) frontal lobe seizures (FLS) other than FHS: 228 seizures, 26 patients, (c) temporal lobe seizures (TLS): 194 seizures, 55 patients, (d) extra‐frontal/extra‐temporal seizures (EF/ETS): 59 seizures, 16 patients. We evaluated IG features by means of video‐analysis. Results: IG was observed in 96.7% of FHS (100% of patients), with a mean latency of 3 s, and a mean prevalence of 7.9 IG per seizure, directed to a limited number of surrounding objects or body parts. In 22.4% of FLS (11.5% of patients) 1–3 prolonged IGs were present, with a mean latency of 2 s and mainly directed to a fixed external point. IG was occasionally present in TLS (10.3%, in 20% of patients) and EF/ETS (5.1%, in 12.5% of patients), with longer latencies and without any stereotypy. We did not find a reliable lateralizing value of IG. Conclusions: Prevalence of IG in FHS was significantly higher than in other seizure groups. In FHS and FLS, IG had shorter latency and stereotyped features, characterizing an automatic (“release”?) behavior. In extra‐frontal seizures, IG seemed to be an occasional purposeful movement.
Video‐EEG Study of Psychogenic Nonepileptic Seizures: Differential Characteristics in Patients with and without Epilepsy
Authors: Mari Francesco , Di Bonaventura Carlo , Vanacore Nicola , Fattouch Jinane , Vaudano Anna Elisabetta , Egeo Gabriella , Berardelli Alfredo , Manfredi Mario , Prencipe Massimiliano , Giallonardo Anna Teresa 
Published: December 2006

Summary:  Purpose: Psychogenic nonepileptic seizures (PNES) are episodes that may resemble epileptic seizures (ES) but are not associated with abnormal electrical discharges in the brain. Video‐EEG recording of a typical episode is considered the best diagnostic tool available. PNES are, however, also documented in patients with epilepsy (PNES/ES). The purpose of this study was to assess this comorbid population, focusing on the differences between patients with PNES/ES and patients with PNES alone. Methods: We reviewed 110 PNES episodes, occurring spontaneously or induced by means of suggestion techniques, recorded in our video‐EEG laboratory over a period of eight years. We identified two subgroups of patients, consisting of 85 PNES cases and 25 PNES/ES cases, and assessed any differences in their characteristics by reviewing a number of variables (age, sex, clinical features, antiepileptic therapy, age of onset, time to diagnosis, pathological history, and length of follow‐up). Results: The comparison between the two subgroups revealed that PNES/ES patients displayed some statistically significant differences when compared with PNES alone patients, i.e., younger age, a higher percentage of spontaneously activated events, a shorter disease duration, a longer time to PNES diagnosis, and a lower percentage lost at follow‐up. Conclusions: This study confirms that PNES is a common, though probably underestimated, occurrence in epilepsy services. Our results shed light on some different characteristics between PNES and PNES/ES patients.
ICD Implantation in Infants and Small Children: The Extracardiac Technique
Authors: KRIEBEL THOMAS , RUSCHEWSKI WOLFGANG , GONZALEZ MARIA GONZALEZ Y , WALTER KATHARINA , KROLL JOHANNES , KAMPMANN CHRISTOPH , HEINEMANN MARKUS , SCHNEIDER HEIKE , PAUL THOMAS 
Published: December 2006

Background: There is no clear methodology for implantation of an internal cardioverter‐defibrillator (ICD) in infants and small children. The aim of this study was to assess efficacy and safety of an extracardiac ICD implantation technique in pediatric patients.
Patients and Methods: An extracardiac ICD system was implanted in eight patients (age: 0.3–8 years; body weight: 4–29 kg). Under fluoroscopic guidance a defibrillator lead was tunneled subcutaneously starting from the anterior axillar line along the course of the 6th rib until almost reaching the vertebral column. After a partial inferior sternotomy, bipolar steroid‐eluting sensing and pacing leads were sutured to the atrial wall (n = 2) and to the anterior wall of the right ventricle (n = 8). The ICD device was implanted as “active can” in the upper abdomen. Sensing, pacing, and defibrillation thresholds (DFTs) as well as impedances were verified intraoperatively and 3 months later, respectively.
Results: In seven of eight patients, intraoperative DFT between subcutaneous lead and device was <15 J. In the eighth patient ICD implantation was technically not feasible due to a DFT >20 J. During follow‐up (mean 14.5 months) appropriate and effective ICD discharges were noted in two patients. DFT remained stable after 3 months in four of six patients retested. A revision was required in one patient due to lead migration and in another patient due to a lead break.
Conclusions: In infants and small children, extracardiac ICD implantation was technically feasible. Experience and follow‐up are still limited. The course of the DFT is unknown, facing further growth of the patients.
Acute and Chronic Effects of Extensive Radiofrequency Lesions in the Canine Caval Veins: Implications for Ablation of Atrial Arrhythmias
Authors: FENELON GUILHERME , FRANCO MARCELLO , ARFELLI ELERSON , OKADA MIEKO , DE ARAÚJO SÉRGIO , DE PAOLA ANGELO A.V. 
Published: December 2006

Background: Although radiofrequency (RF) ablation within the caval veins has been increasingly used to treat a variety of atrial tachyarrhythmias, the consequences of RF ablation in the caval veins are unknown. We explored the acute and chronic angiographic and pathological effects of extensive RF ablation in the caval veins.
Methods: Under fluoroscopy guidance, conventional (4 mm tip, 60°C, 60 seconds) RF applications (n = 6–7) were delivered in each vena cava (from ±2 cm into the vein to the veno‐atrial junction) of 15 dogs (10 ± 3 kg). Animals were killed 1 hour and 5 weeks after ablation for histological analysis. Angiography was performed before ablation (acute dogs only) and at sacrifice to assess the degree of vascular stenosis.
Results: In acute dogs (n = 5), luminal narrowing was noted in 10/10 (100%) targeted veins (mild in two; moderate in three and severe in five, including two total occlusions). In the six chronic animals that completed the protocol (four died during follow‐up), stenosis was also observed in 12/12 (100%) ablated veins (mild in six; moderate in four and severe in two). Of these, one superior vena cava was suboccluded with development of extensive collateral circulation. Histologically, acute lesions displayed typical transmural coagulative necrosis, whereas chronic lesions revealed intimal proliferation, necrotic muscle replaced with collagen, endovascular contraction, and disruption and thickening of the internal elastic lamina.
Conclusion: In this model, extensive RF ablation in the caval veins may result in significant vascular stenosis. These findings may have implications for catheter ablation of arrhythmias originating within the caval veins.
Significance and Utility of Plasma Brain Natriuretic Peptide Concentrations in Patients with Idiopathic Ventricular Arrhythmias
Authors: TADA HIROSHI , ITO SACHIKO , SHINBO GORO , TADOKORO KAZUYOSHI , ITO ITARU , HASHIMOTO TOHRU , MIYAJI KOHEI , KASENO KENICHI , NAITO SHIGETO , NOGAMI AKIHIKO , OSHIMA SHIGERU , TANIGUCHI KOICHI 
Published: December 2006

Background: Secretion of B‐type natriuretic peptide (BNP) appears to be regulated mainly by wall tension, and an increase in the plasma BNP concentration is considered to reflect ventricular structural and functional abnormalities. The aim of this study was to clarify the significance and utility of the measurement of the plasma BNP in the setting of idiopathic ventricular arrhythmias (I‐VT/PVCs).
Methods: This study included 135 patients with symptomatic, monomorphic I‐VT/PVCs (73 women; 53 ± 17 years; 50 ventricular tachycardias [VTs], 85 premature ventricular contractions) who underwent radiofrequency catheter ablation. None had structural heart disease or renal dysfunction.
Results: The plasma BNP concentration exceeded the normal range (>18.4 pg/mL; high BNP concentration) in 79 patients (56%). The high BNP concentration was found more often in I‐VT/PVCs originating from the left ventricle (LV; 74%) than the right ventricle (RV; 49%; P < 0.01). The plasma BNP concentration correlated with the age (P = 0.0001) and frequency of premature ventricular contractions (P < 0.0001), and left‐sided I‐VT/PVCs and the presence of controlled hypertension were independent predictors of a high BNP concentration (both P < 0.05). In patients with a successful ablation and high BNP concentration before the ablation, the BNP concentration decreased to the normal range in 61% of patients after ablation. In patients with a failed ablation, the BNP concentration did not decrease to the normal range after ablation in any of the patients (P < 0.0005).
Conclusions: The plasma BNP concentration was elevated in about 60% of the patients with symptomatic I‐VT/PVCs. Normalization of the high BNP concentration after ablation may indicate a successful ablation.
Reduced midbrain‐pons serotonin transporter binding in patients with obsessive–compulsive disorder
Authors: Hasselbalch S. G. , Hansen E. S. , Jakobsen T. B. , Pinborg L. H. , Lønborg J. H. , Bolwig T. G. 
Published: December 2006

Objective:  To evaluate current hypothesis regarding the pathophysiology of obsessive–compulsive disorder (OCD) by studying the serotonin receptor binding in patients with OCD using single photon emission computerized tomography (SPECT).Method:  We studied nine patients (four men and five women, age range 21–56 years) fulfilling the DMS‐III‐R criteria for OCD using SPECT and the serotonin transporter (SERT) tracer 123I‐β‐CIT. SERT binding potential (BP2) was determined by Logan plot derived from seven scans obtained during 10–400 min.Results:  The binding of 123I‐β‐CIT in midbrain‐pons was reduced in OCD patients when compared with controls (BP2 0.97 ± 0.07 vs. 0.84 ± 0.12, P = 0.011). There was no correlation between BP2 and any of the clinical variables (age at onset, disease duration, and Yale‐Brown Obsessive–Compulsive Scale score).Conclusion:  This study suggests a reduced serotonergic input into the fronto‐subcortical circuits in OCD, thereby diminishing the inhibitory regulation of serotonin on these circuits.
Abnormality of CD4+CD25+ regulatory T cells in idiopathic thrombocytopenic purpura
Authors: Liu Bin , Zhao Hui , Poon Man‐Chiu , Han Zhibo , Gu Dongsheng , Xu Maoqiang , Jia Hairong , Yang Renchi , Han Zhong Chao 
Published: December 2006

Abstract Objectives: The aim of this study was to explore the profile and function of CD4+CD25+ regulatory T cells (Treg cells) in idiopathic thrombocytopenic purpura (ITP) patients. Methods: Treg cell numbers were analyzed by flow cytometric analysis in peripheral blood mononuclear cells collected from healthy donors or patients with ITP. Quantification of cell proliferation was assayed by an enzyme‐linked immunosorbent assay kit, based on the measurement of BrdU incorporation during DNA synthesis. Results: The percentage of Treg cells was significantly decreased in ITP patients in active and non‐remission state(5.79 ± 1.22%) when compared with the patients in remission(11.63 ± 4.56%) and to healthy subjects(12.68 ± 3.59%). The suppressive activity of Treg cells in ITP patients was also found to be impaired. Conclusion: These results suggest that decreased number and function of Treg cells might be one of mechanisms that cause immune regulation dysfunction in ITP.
Argatroban for anticoagulation during cardiac surgery
Authors: Martin Monte E. , Kloecker Goetz H. , Laber Damian A. 
Published: December 2006

Abstract Background: The aim of this study was to report our experience and review the published data on argatroban administration during adult cardiac surgery. Methods: The information on all reported cases of argatroban use in adults, during cardiac surgery was reviewed, including that of the patient described here. This analysis focused on patient characteristics, type of surgery, argatroban dosing schedule, monitoring of anticoagulation and outcomes. Results: Twenty‐one cases have been reported. Fifteen patients underwent off‐pump surgical procedures with the argatroban dose adjusted to maintain an activated clotting time (ACT) range between 200 and 300 s. Three intraoperative thrombi occurred in two patients when the ACT was <280 s. None had coagulopathy. Six cases reported the use of argatroban during on‐pump cardiac surgery dosed to keep the ACT >400 s. Intraoperative thrombotic complications were not reported in this group; however, one clot in the pump was noted after the procedure when the ACT was between 300 and 350 s. All six cases required larger volumes of perioperative blood products and three had severe coagulopathy. Of the 21 cases, seven had an indication for continued anticoagulation following surgery. Four cases did not report further use of argatroban after surgery. Three patients received argatroban after surgery without complications. Recommendations for how to use argatroban during cardiac surgery are proposed. Conclusions: Argatroban, with ACT monitoring, might be safely used for anticoagulation during cardiac surgery.