bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence of needle tract seeding and responses of soft tissue metastasis by hepatocellular carcinoma postradiotherapy
Authors: Tung Wei‐Chih , Huang Yu‐Jie , Leung Stephen Wan , Kuo Fang‐Ying , Tung Hung‐Da , Wang Jing‐Houng , Hung Chao‐Hung , Lee Chuan‐Mo , Changchien Chi‐Sin , Yeh Shih‐An , Sun Li‐Min , Huang Eng‐Yen , Hsu Hsuan‐Chih , Wang Chong‐Jong , Lu Sheng‐Nan 
Published: December 2006

AbstractAim: To determine the incidence of needle tract seeding after fine needle aspiration (FNA) or percutaneous ethanol injection (PEI) and compare iatrogenic or spontaneous soft tissue metastasis (STM) by hepatocellular carcinoma (HCC) postradiotherapy (RT) in responses.Methods: From November 1997 to January 2006, those who presented with STM by HCC after our invasive procedures or developed spontaneously were enrolled into this retrospective study. Metastatic lesions could be divided into procedure related (PR), which were located at the liver span and were related to invasive procedures, and non‐procedure related (NPR), which were in extrahepatic areas. STM was treated with an electron or photon beam.Results: A total of 39 HCC cases with developed STM were referred for RT, including 17 in the PR group and 22 in the NPR group. During the same period, a total of 18 227 person‐times of FNA or PEI were performed on these HCC patients. The overall incidence of HCC with STM that was caused by invasive procedures was estimated at 0.13%. According to the Cox' regression model, the initial treatment modality influences the time duration after the initial diagnosis of HCC when STM has not occurred. None of these patients' soft tissue tumor increased in size during RT. The PR group had lower rates of bone metastasis (P=0.003) and coexisting extrahepatic metastasis (P=0.011) and a longer survival rate (P=0.003) than the NPR group. The estimated rates of 18‐gauge and 22‐gauge needle‐induced HCC‐related STM were 0.60% and 0.11%, respectively (P=0.064).Conclusion: The PR group bears a better prognosis than the NPR group post‐RT.
Temporal Lobe Epilepsy in Children: Electroclinical Study of 77 Cases
Authors: Fontana Elena , Negrini Francesca , Francione Stefano , Mai Roberto , Osanni Elisa , Menna Elisa , Offredi Francesca , Darra Francesca , Bernardina Bernardo Dalla 
Published: December 2006

Summary: Purpose:Temporal lobe epilepsy (TLE) is probably more difficult to recognize in children than in adults. In fact, ictal symptoms in children are less stereotyped and less obvious, and the neuropathological substrate is more heterogeneous than in adults. The aim of this study is to examine the relationships between etiology, age at onset and electroclinical findings in 77 children with TLE, 32 of whom were surgically treated.Methods:Electroclinical study including video‐EEG recording of seizures in 77 children with TLE. The investigation focused on the first five initial ictal symptoms.Results:Age at onset was less than 3 years in 39 cases, between 3 and 6 years in 17 cases and older than 6 years in 21 cases. Auras also occurred in younger children but were more common after the age of 6 years. A peculiar initial ictal semiology consisted in staring with arrest, lip cyanosis, and very slight oral automatisms. In some cases, EEG recordings documented seizures starting independently on both temporal lobes. Based on electroclinical and neuroradiological features, we recognized three subgroups: symptomatic TLE due to cortical malformations or nonevolutive tumors, TLE with mesial temporal sclerosis, and cryptogenic TLE.Conclusions:A correct electroclinical and neuroradiological approach allows in several cases early recognition of TLE even when onset is earlier than the age of 6 years. A correct definition of the localization relies primarily on video‐EEG recording of the seizures, possibly repeated during follow up in cases lacking obvious neuroradiological correlation.
Adult‐Onset Rasmussen's Encephalitis: Anatomical‐Electrographic‐Clinical Features of 7 Italian Cases
Authors: Villani Flavio , Pincherle Alessandro , Antozzi Carlo , Chiapparini Luisa , Granata Tiziana , Michelucci Roberto , Rubboli Guido , Simone Isa , Bellomo Rosella , Spreafico Roberto 
Published: December 2006

Summary:  Purpose: A limited number of cases of adult‐onset Rasmussen's encephalitis (A‐RE) have been reported, but the features of the syndrome are still unclear. The aim of this study was to verify the clinical features of A‐RE, and outline a noninvasive approach that may allow its early diagnosis and treatment. Methods: Retrospective evaluation of extensive noninvasive work‐up of seven patients with A‐RE, including repeat clinical, neurophysiological, and neuroimaging investigations. Results: The study identified two distinct patterns of disease presentation, one characterized by focal motor epilepsy (the “epileptic” phenotype), and the other by focal cortical myoclonus (the “myoclonic” phenotype). Unilateral neurological deficits and brain atrophy were progressive in both phenotypes, but they were more prominent and were detected earlier in the “epileptic” phenotype. Conclusions: The anatomo‐electroclinical features of these patients allowed a noninvasive diagnosis of A‐RE and identification of two distinct disease phenotypes. Early noninvasive diagnosis can allow faster initiation of treatment.
Lateralizing Value of the Auditory Aura in Partial Seizures
Authors: Florindo Irene , Bisulli Francesca , Pittau Francesca , Naldi Ilaria , Striano Pasquale , Striano Salvatore , Michelucci Roberto , Testoni Stefania , Baruzzi Agostino , Tinuper Paolo 
Published: December 2006

Summary:  Purpose: To describe the semiological features of auditory aura and to assess their possible lateralizing value in partial epilepsy. Methods: Out of a series of 8,000 patients with epilepsy, we investigated 121 cases with partial seizures in whom auditory features were the first ictal symptom. According to the dominant type of aura, patients were divided into four subgroups—1A (67 cases), 1B (22 cases), 2A (14 cases), and 2B (18 cases)—corresponding to the presence of simple or complex hallucinations and positive or negative illusions, respectively. The side of the epileptic zone (EZ) was defined based on available data: surgical/presurgical study or presence of a neuroradiological lesion, corresponding interictal epileptiform EEG and ictal semiology (level 1); a left EZ was also hypothesized in right‐handed patients with ictal aphasia plus a left neuroradiological lesion or a left interictal EEG focus (level 2). Results: Forty‐five patients (37%) described the aura as unilateral. The side of epileptogenic zone (EZ) was definable in 36 patients (level 1: 24; level 2: 12). Overall, a unilateral auditory aura was contralateral to the EZ in half of the cases (8/16), but always contralateral in patients studied for presurgical evaluation (4/4). Simple hallucinations lateralized seizure onset on the right side in nine cases, on the left in 12. Among 1B patients (either musical and verbal contents), the EZ was on the left side in all cases (5/5). Positive illusions were associated with right foci in two cases, and left foci in two. Negative illusions always lateralized seizure onset to the dominant hemisphere (6/6). Conclusions: Auditory aura is a rare symptom in partial epilepsy. The perception of the auditory sensation referred to one ear is not a unique lateralizing sign for the contralateral temporal neocortex. Complex hallucinations with verbal content and negative illusion may lateralize seizure onset in the dominant hemisphere. The role of laterality for musical hallucinations remains unclear as it depends on individual musical ability and hemispheric dominance for music.
Excessive Daytime Sleepiness and Subjective Sleep Quality in Patients with Nocturnal Frontal Lobe Epilepsy: A Case‐Control Study
Authors: Vignatelli Luca , Bisulli Francesca , Naldi Ilaria , Ferioli Simona , Pittau Francesca , Provini Federica , Plazzi Giuseppe , Vetrugno Roberto , Montagna Pasquale , Tinuper Paolo 
Published: December 2006

Summary:  Purpose: Nocturnal frontal lobe epilepsy (NFLE) may be associated with sleep fragmentation and reduced sleep efficiency. Daytime sleepiness and disturbed sleep quality have been reported in some patients. We investigated the occurrence of daytime sleepiness‐related symptoms and subjective sleep quality in patients with NFLE in comparison with matched controls. Methods: Patients with NFLE at a single epilepsy center and matched controls randomly selected from the general population self‐administered questionnaires on daytime sleepiness‐related symptoms and subjective sleep quality [Epworth sleepiness scale (ESS), Bologna questionnaire on sleepiness‐related symptoms (BQS), Berlin questionnaire]. Results: Thirty‐three patients with NFLE and 27 controls were enrolled. “Tiredness after awakening” and “spontaneous mid‐sleep awakenings” were more frequent in NFLE patients than in controls (36.4% versus 11.1%, p = 0.04, and 50.0% versus 22.2%, p = 0.03). The frequency of excessive daytime sleepiness (EDS) did not differ between groups. Posthoc analysis showed that patients with a complaint of “midsleep awakenings” had higher ESS and BQS scores than those without (7.3 versus 4.3, p = 0.004, and 5.0 versus 2.2, p = 0.001, respectively) and more frequent “tiredness after awakening” (56.3% versus 18.8%, p = 0.03). Conclusions: Patients with NFLE have no pathological level of EDS with respect to controls. However, daytime sleepiness‐related symptoms could be more frequent in a subgroup of patients with subjective disturbed sleep quality, irrespective of the perceived frequency of seizures.
REM Sleep Behavior Disorder and Epileptic Phenomena: Clinical Aspects of the Comorbidity
Authors: Manni Raffaele , Terzaghi Michele , Zambrelli Elena 
Published: December 2006

Summary:  Purpose: To document the occurrence of REM sleep behavior disorder (RBD) episodes in patients with epilepsy, and of interictal EEG epileptiform abnormalities (IEA) in patients with idiopathic RBD. Methods: Consecutive observations in a tertiary epilepsy center and a tertiary sleep center. RBD diagnosis was based on standard clinical and video‐polysomnographic findings. Results: Co‐occurrence of epileptic seizures and RBD episodes was found in six cases (all men; mean age 70.5 ± 11.1 years). Focal, isolated, sporadic sharp waves during wakefulness and/or during sleep were documented in 9 out of 34 (26.4%) patients with idiopathic RBD; no significant differences in age at onset and duration of RBD emerged between RBD patients with and without IEA. Conclusions: RBD episodes can occur in epilepsy patients and focal IEA in patients with idiopathic RBD. This, apart from being a possible cause for misdiagnosis, may indicate a possible link between the two disorders. Further systematic investigations of the occurrence of RBD episodes in epilepsy will help to establish the real extent of this comorbidity and its ultimate neurobiological significance.
Elderly People and Epilepsy: Cognitive Function
Authors: Piazzini Ada , Canevini Maria Paola , Turner Katherine , Chifari Rosanna , Canger Raffaele 
Published: December 2006

Summary:  Purpose: To evaluate cognitive function in a group of elderly patients with focal epilepsy versus healthy controls. Methods: A neuropsychological battery assessing major cognitive domains was administered to 40 patients with focal epilepsy aged ≥60 years, and to 40 controls matched for sex, age, and education. Results: Epilepsy patients performed significantly worse in most of the administered tests than controls (p < 0.05). Poor cognitive performances correlated with use of polytherapy. Conclusions: Given the high prevalence of epilepsy in the elderly, our results could have important implications for clinical and research purposes.
Direct and Indirect Costs of Refractory Epilepsy in a Tertiary Epilepsy Center in Germany
Authors: Hamer Hajo M. , Spottke Annika , Aletsee Christiane , Knake Susanne , Reis Janine , Strzelczyk Adam , Oertel Wolfgang H. , Rosenow Felix , Dodel Richard 
Published: December 2006

Summary:  Purpose: There are only few studies on the costs of epilepsy in Germany. Therefore, we performed a pilot study to estimate the direct and indirect costs of refractory epilepsy in a German epilepsy center. Methods: A “prevalence‐based,” cross‐sectional convenience sample of adults with active epilepsy attending the outpatient clinic of our tertiary epilepsy center was evaluated. Seizure‐free patients and patients presenting with their first seizure were excluded. Direct and indirect costs were prospectively recorded over a three‐month period using questionnaires and a patient diary. Cost driving factors were identified. Results: One hundred one patients were included (40.7 ± 15.2 years; disease duration: 18.1 ± 15.3 years; 6 patients had focal epilepsy with simple partial seizures only, 28 with complex partial seizures, 43 with secondarily generalized tonic–clonic seizures; 20 had idiopathic generalized epilepsy with generalized tonic–clonic seizures). The total costs of epilepsy per patient were in average € 2610 ± 4200 over the three‐month period. Direct cost contributed 39% to the total costs. Costs of anticonvulsant medication were the main contributor to the direct costs while indirect costs were caused mainly by losses due to early retirement. Cost driving factors included higher seizure frequency, longer disease duration, ictal falls, and situationally inappropriate complex behavior during or after the seizure. Conclusions: Indirect costs were higher than direct costs in adult patients with active epilepsy attending a German epilepsy center. Medication contributed the most to the direct costs and early retirement was the main factor for the indirect costs. The costs of poorly controlled epilepsy in this German study were above average of the European costs of epilepsy.
Cerebral Malaria and Sequelar Epilepsy: First Matched Case‐Control Study in Gabon
Authors: Ngoungou Edgard Brice , Koko Jean , Druet‐Cabanac Michel , Assengone‐Zeh‐Nguema Yvonne , Launay Marylène Ndong , Engohang Edouard , Moubeka‐Mounguengui Martine , Kouna‐Ndouongo Philomène , Loembe Paul‐Marie , Preux Pierre‐Marie , Kombila Maryvonne 
Published: December 2006

Summary:  Purpose: Cerebral malaria (CM) is suspected to be a potential cause of epilepsy in tropical areas. The purpose of this article was to evaluate the relationship between CM and epilepsy in Gabon. Methods: A matched case–control study was carried out on a sample of subjects aged six months to 25 years and hospitalized between 1990 and 2004 in three hospitals in Libreville, Gabon. Cases were defined as patients suffering from epilepsy and confirmed by a neurologist. Controls were defined as patients without epilepsy. The exposure of interest was CM according to WHO criteria. Results: In total, 296 cases and 296 controls were included. Of these, 36 (26 cases and 10 controls) had a CM history. The adjusted odds ratio (aOR) to develop epilepsy after CM was 3.9 [95% CI: 1.7–8.9], p < 0.001. Additional risk factors were identified: family history of epilepsy: aOR = 6.0 [95% CI: 2.6–14.1], p < 0.0001, and febrile convulsions: aOR = 9.2 [95% CI 4.0–21.1], p < 0.0001. Conclusions: This first case–control study on that issue suggests that epilepsy‐related CM is an underrecognized problem. It emphasizes the need for further studies to better evaluate the role of convulsions during CM.
A Survey of Public Awareness, Understanding, and Attitudes toward Epilepsy in Greece
Authors: Nicholaos Diamantopoulos , Joseph Kaleyias , Meropi Tzoufi , Charilaos Kotsalis 
Published: December 2006

Summary:  Purpose: To assess familiarity, understanding, and attitude toward epilepsy in Greece and identification of negative predictive factors. Methods: A 19‐item questionnaire was administered to 750 adults. The magnitude of social stigma toward epileptic people with epilepsy was measured with a quantitative scale of social rejection. Statistical analysis with chi‐square and multiple regression analysis were used to identify factors associated with negative attitudes. Results: Of our respondents 38.8% knew someone with epilepsy and 50.8% had witnessed a seizure. Ninteen percent believed that epilepsy is a type of mental retardation, 15% believed it is a type of insanity, 91.8% considered epilepsy as a brain disorder while 5.2% considered it as a supernatural phenomenon. Seventy‐seven percent considered epilepsy as a curable disease while 57.5% believed that the risk of inheriting it is very high. Regarding marriage to a patient with epilepsy 45.4% rejected it while regarding his employment 37.7% were positive, 47.8% were skeptical while 12.8% were against it. The Greek public's rejection tendency toward epileptic people was generally low. Negative predictive factors were older age, low educational level, unfamiliarity with epilepsy, and erroneous beliefs about epilepsy. Conclusions: The Greek public is familiar with epilepsy but has a suboptimal level of appropriate understanding of essential aspects of the disease. The overall public's level of rejection toward people with epilepsy is low but certain groups of people are highly rejective. Information campaigns targeting specific population subgroups are necessary in Greece in order to improve the public's understanding of epilepsy and tolerance toward people with epilepsy.
Validation of Criteria for Selective His Bundle and Para‐Hisian Permanent Pacing
Authors: CANTÙ F. , DE FILIPPO P. , CARDANO P. , DE LUCA A. , GAVAZZI A. 
Published: December 2006

Background: His Bundle (HB) pacing is a valid alternative to right ventricular pacing for patients with preserved His‐ventricle conduction who are candidates for permanent stimulation. Permanent pacing in the HB area enables Selective HB pacing (SHBP) or para‐Hisian pacing (PHP) to be achieved. The aim of our study was to draw up a set of easy criteria to differentiate and validate the two kinds of stimulations according to the pacing output and the ECG/EKG signals.
Methods and Results: From February to July 2005, 17 patients eligible for a pacemaker (PM) procedure underwent implantation with the Medtronic SelectSecure® lead (Medtronic, Minneapolis, MN, USA) screwed into the HB area.
SHBP was defined when the intrinsic QRS was equal, in both duration and morphology, to the paced QRS, the His‐Ventricular (H‐V) interval was equal to Pace‐Ventricular interval (Vp‐V) and, at low output, only the HB was captured, while increasing the output resulted in both the HB and right ventricular (RV) being captured (widening of QRS at high output). Conversely, PHP was defined when the intrinsic QRS differed from the paced one, either in morphology or in duration and, at high output, both the RV and HB were captured (non‐SHBP), while decreasing the output resulted in losing HB capture (widening of QRS at low output). According to these criteria, SHBP was achieved in 11 patients, while in the remaining 6, PHP was obtained. No adverse events were reported.
Conclusions: The above criteria enabled SHBP and PHP to be validated easily and clearly. A longer follow‐up will be needed in order to ascertain whether the clinical outcome of these two approaches differs.
Intrathoracic Far‐Field Electrocardiogram Allows Continuous Monitoring of Ischemia After Total Coronary Occlusion
Authors: ASBACH STEFAN , WEISS INGO , WENZEL BEATE , BODE CHRISTOPH , ZEHENDER MANFRED 
Published: December 2006

Introduction: Recording of intrathoracic far‐field electrocardiograms (FF‐ECG) via can and electrodes of implantable cardioverter‐defibrillators (ICD) is a promising method for continuous monitoring of myocardial ischemia. We assessed the hypothesis that experimentally induced ischemia provokes segment changes in the FF‐ECG that can be detected by the ICD.
Methods and Results: In seven pigs with an ICD implanted in the left pectoral region and electrodes placed in the right ventricle and the superior vena cava, we occluded all major coronary arteries in proximal and distal locations for 180 s each. Surface and FF‐ECGs were compared for presence and time course of ischemic ST segment changes. Reliable detection of ischemia by ST segment analysis was possible in all (38/38) experiments. Maximum deviation from baseline was larger in FF‐ECG (1.21 mV) than surface ECG leads (0.23 mV, P < 0.01) for all occlusion sites. Ischemia could be detected earlier (P < 0.05) in the FF‐ECG, with a sensitivity of 100%, 93%, and 100% after occlusions in the left anterior descending, left circumflex, and right coronary arteries, respectively.
Conclusion: Intrathoracic FF‐ECG allows reliable and reproducible detection of experimentally induced ischemia originating from all major coronary arteries and therefore could be an interesting tool for clinicians in monitoring high risk patients.
Perioperative Biventricular Pacing Leads to Improvement of Hemodynamics in Patients with Reduced Left‐Ventricular Function—Interim Results
Authors: DZEMALI OMER , BAKHTIARY FARHAD , DOGAN SELAMI , WITTLINGER THOMAS , MORITZ ANTON , KLEINE PETER 
Published: December 2006

Background: Cardiac resynchronization therapy (CRT) has been introduced as a new therapeutic modality in patients with chronic heart failure. However, most studies have investigated the hemodynamic effects in congestive, but not postoperative heart failure.
Objective: The following study investigates hemodynamic effects of perioperative temporary biventricular pacing in patients undergoing open heart surgery.
In 54 patients one left and one right ventricular epicardial wire was placed during open heart operations. Hemodynamic parameters were measured immediately after the operation and 6 as well as 24 hours postoperatively. Transesophageal echocardiography was performed 1 hour postoperatively.
Results: Of the 54 patients (59.2%), 32 responded to biventricular pacing with an increase in cardiac output; in these patients synchronized ventricular contraction could be verified echocardiographically. This hemodynamic benefit persisted 6 hours and 24 hours postoperatively. The remaining 22 patients did not show any hemodynamic improvement from biventricular stimulation.
Conclusion: Biventricular pacing leads to significant rise in cardiac output in approximately 59% of patients with severely reduced left ventricular function and widened QRS complexes. Further studies are necessary to define clearly the clinical characteristics of patients who show remodeling by CRT.
Pacemaker‐Induced Superior Vena Cava Syndrome: Clinical Evaluation of Long‐Term Follow‐Up
Authors: MELZER CHRISTOPH , LEMBCKE ALEXANDER , ZIEMER SABINE , EDDICKS STEPHAN , WITTE JOACHIM , BAUMANN GERT , BORGES ADRIAN C. 
Published: December 2006

Background: Pacemaker‐induced superior vena cava (SVC) syndrome is a rare but serious complication of permanent pacemaker implantation. Because of its rarity, little is known about the long‐term prognoses of such patients.
Methods: Five patients, mean age 62 ± 11.4 years, with pacemaker‐induced SVC syndrome for more than 10 years were investigated. The clinical evaluation included: exercise testing, thrombophilia lab tests, and a chest CT.
Results: Two of the patients manifested complications of SVC syndrome which included thoracoabdominal subcutaneous collaterals. One of these patients simultaneously developed an increase in the pacing threshold which required the implantation of epicardial leads. Three of the five patients had normal age‐adjusted VO2 AT und VO2 max. Four of the patients were both heterozygous for a polymorphism of PAI‐1 and were homozygous for a polymorphism of t‐PA. One of these patients also was heterozygous for a polymorphism of factor V and glycoprotein IIb/IIIa. The chest CTs revealed extensive and varying collateral circulation patterns in all of the patients.
Conclusions: The development of pacemaker‐induced SVC syndrome is the result of various predisposing factors including thrombophilia. Many patients retain normal age‐adjusted cardiopulmonary capacity and demonstrate stable clinical findings on the long‐term as the result of the development of extensive collateral vessel systems. The most serious complication was the combination of SVC syndrome and the simultaneous malfunctioning of one of the leads requiring implantation of a new lead.