bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Seprafilm on peritoneal fibrinolytic system
Authors: Tarhan Omer Ridvan , Eroglu Aydan , Cetin Recep , Ynce Ayper , Bulbul Mahmut , Altuntas Yrfan 
Published: August 2005

Background:  There is a high incidence of adhesions after ventral hernia repair with polypropylene mesh. The purpose of the present study was to evaluate the efficacy of Seprafilm in the prevention of adhesion formation and effect on peritoneal fibrinolytic activity.Methods:  An incisional hernia model was created in rats. In the experimental group Seprafilm was placed between polypropylene mesh and abdominal organs. On the 14th day adhesions were evaluated and tissue plasminogen activator (tPA), urokinase plasminogen activator (uPA), plasminogen activator inhibitor (PAI) type 1 and 2 were measured in peritoneal biopsy specimens.Results:  Adhesions were significantly reduced in the Seprafilm group (P = 0.002). Nevertheless, there were no difference between the two groups in levels of tPA, PAI‐1 and PAI‐2. However, the levels of uPA were significantly decreased in the Seprafilm group.Conclusions:  The adhesion preventive effect of Seprafilm is not directly related in peritoneal fibrinolytic activity. Instead, the physical properties (barrier, hydroflotation and sliconizing effect) of the membrane are primarily responsible for adhesion prevention.
Sleep Disturbance in Children with Rett Syndrome: A Qualitative Investigation of the Parental Experience
Authors: McDougall Allyson , Kerr Alison M. , Espie Colin A. 
Published: August 2005

Background  Sleep problems in children with intellectual disability can be precipitated and maintained by intrinsic and external factors. The present study comprised a qualitative investigation of the experiences of parents of children with Rett syndrome, a neurodevelopmental disorder where sleep disturbance is common.Method  Audio‐taped interviews were conducted with nine families. Transcripts were analysed by theoretical coding to develop categories and themes, facilitated by the computer package qsr nud*ist.Results  Themes and sub‐themes were identified in the areas of (1) parents’ beliefs about sleep problems, (2) coping with sleep problems, and (3) emotions, and an interactional model of the three systems was suggested.Conclusions  A proposed interactional model of parental beliefs, coping and emotions in relation to sleep disturbance in children with Rett syndrome is consistent with existing theoretical models. Further research is required to test out the applicability of this conceptual framework to parents of children with other aetiologies of intellectual disability.
Complex Febrile Seizures
Authors: Berg Anne T. , Shinnar Shlomo 
Published: August 2005

Summary:In the context of a prospective cohort study, we examined the associations between individual complex features of both first (n = 428) and recurrent (n = 240) febrile seizures and factors shown to predict outcome in children with febrile seizures. Thirty‐five percent of first and 33% of recurrent febrile seizures had one or more complex features (focal onset, duration ≥10 min, or multiple seizures during the illness episode). There were strong correlations between focality and prolonged duration for both first and recurrent febrile seizures. A low fever at the time of the seizure was marginally associated with prolonged duration. Most factors associated with either recurrent febrile seizures or subsequent unprovoked seizures were not associated with either the initial seizure being complex or the likelihood that a recurrence would be complex. However, in children with recurrent febrile seizures, complex features tended to repeat. This factor was statistically significant and particularly striking for prolonged duration. Genetic or other constitutional factors may explain why the prolonged feature recurs. Eleven (2.5%) children had three or four risk factors for recurrent febrile seizures and a first febrile seizure that was prolonged. Eight (72.7%) of them experienced a recurrent febrile seizure that was prolonged. This very small group of children may be candidates for abortive therapy to be administered at the onset of a recurrent seizure.
Cortical Benzodiazepine Receptor Changes are Related to Frequency of Partial Seizures: A Positron Emission Tomography Study
Authors: Savic Ivanka , Svanborg E. , Thorell J. O. 
Published: August 2005

Summary:Measurements of benzodiazepine (BZD) receptor density with positron emission tomography (PET) are a promising method of identifying and localizing epileptogenic regions. We investigated whether the pattern of BZD receptor changes depends on seizure frequency, studying 19 patients with matching seizure semiology but different rates of seizure occurrence, using [11C] flumaze‐nil as the ligand. All patients had partial epilepsy and normal magnetic resonance imaging (MRI) of the brain. The visually determined PET focus, characterized by reduced BZD receptor density, corresponded to the epileptogenic focuslseizure onset region in all patients. The degree of BZD receptor reduction showed a positive correlation with seizure frequency. Patients with daily seizures differed from those with fewer seizures in two aspects: (a) the degree and extent of BZD receptor reduction was more pronounced, and (b) BZD receptors were also reduced in the primary projection areas of the focus. Flumazenil‐PET reliably identifies epileptogenic brain regions in patients with partial seizures. In addition, flurna‐zenil‐PET can distinguish patients with frequent seizures. The method therefore is not only suitable for noninvasive localization of the seizure focus, but also may provide a biochemical marker of epileptogenicity.
Comparison Between One and Three Years of Treatment in Uncomplicated Childhood Epilepsy: A Prospective Study. I. Outcome in Different Seizure Types
Authors: Braathen Gunnar , Anderson Thomas , Gylje Hans , Melander Hans , Naglo Anna‐Stina , Noren Lars , Person Anders , Rane Anders , Sjörs Kerstin , Theorell Klas , Wigertz Alf 
Published: August 2005

Summary: Purpose: The main purpose of this prospective study was to analyze whether 1 year of treatment was as effective as 3 years with respect to remission rate in children with idiopathic epilepsy.Methods: Treatment for epileptic seizures was started in 207 children aged 2–16 years. They were randomized to treatment for I or 3 years. At the end of the predetermined treatment period, 161 children had been seizure‐free for 6 months and the treatment could be gradually withdrawn.Results: The overall remission rate in our group of patients was significantly higher (71%) in the group treated for 3 years than in the group treated for 1 year (53%). However, comparison of remission rates between patients with different seizure types showed statistically significant differences in outcome depending on duration of treatment only in children with complex partial seizures (CPS).Conclusions: Our results show that 1 year of treatment can be recommended in children with benign partial epilepsy with rolandic spikes (BECT) and in children with simple partial seizures (SPS) but is clearly insufficient in children with CPS. A proper seizure classification is one important tool, although not sufficient, in offering recommendations concerning the duration of treatment in children with idiopathic epilepsy.
Neuronal Migration Disorders Increase Susceptibility to Hyperthermia‐Induced Seizures in Developing Rats
Authors: Germano Isabelle M. , Zhang Yang F. , Sperber Ellen F. , Moshé Solomon L. 
Published: August 2005

Summary: Purpose: Retrospective studies suggest that adult patients with intractable epilepsy may have a history of febrile seizures in childhood. Risk factors for a febrile seizure may include the rate of increase in the core temperature (T‐core), its peak (Tmax), the duration of the temperature increase, or an underlying brain pathology. Recently, neuronal migration disorders (NMD) have been diagnosed with increasing frequency in patients with epilepsy, but the link between NMD, febrile seizures, and epilepsy is unclear. We studied rat pups rendered hyperthermic to ascertain the incidence of seizures, mortality, and extent of hippocampal cell loss in each group.Methods: We exposed 14‐day‐old rat pups with experimentally induced NMD (n = 39) and age‐matched controls (n = 30) to hyperthermia (core body temperature >42°C).Results: The incidence of hyperthermia‐induced behavioral seizures and mortality rate were significantly higher in rats with NMD than in controls (p < 0·05). The longer duration of hyperthermia resulted in a higher incidence of behavioral seizures and higher mortality rate (p < 0·05). In rats with NMD, hyperthermia resulted in hippocampal pyramidal cell loss independent of seizure activity; the extent of neuronal damage correlated positively with the duration of hyperthermia. In control rats, occasional neuronal loss and astrocytosis occurred only after prolonged hyperthermia.Conclusions: In immature rats, NMD lower the threshold to hyperthermia‐induced behavioral seizures and hyperthermia in the presence of NMD may cause irreversible hippocampal neuronal damage.
Neuron‐Specific Enolase, a Marker of Acute Neuronal Injury, is Increased in Complex Partial Status Epilepticus
Authors: DeGiorgio Christopher M. , Gott Peggy S. , Rabinowicz Adrian L. , Heck Christi N. , Smith Thomas D. , Correale Jorge D. 
Published: August 2005

Summary: Purpose: To determine whether complex partial status epilepticus (CPSE) causes brain injury in humans. Serum neuron‐specific enolase (s‐NSE) is an accepted marker of acute brain injury, and increases in s‐NSE have been correlated with the duration and outcome of generalized convulsive status epilepticus. s‐NSE levels in CPSE are unknown. Increase in s‐NSE in CPSE would provide new information about the degree of brain injury in CPSE and would help confirm that CPSE is a medical emergency. Methods: This was a pilot prospective study of serial levels of s‐NSE and outcome in CPSE. Eight patients with confirmed CPSE and no acute neurologic deficit were identified prospectively. Results were compared with those of normal and epileptic control groups, and outcome was assessed at hospital discharge or at 7 days with the Glasgow Oucome Scale (GOS). Results: The mean peak s‐NSE was 21.81 ng/ml, which for the 8 patients with CPSE was four times higher than that of normal controls (mean s‐NSE = 5.36 SD = 1.66, p = 0.0003) and epileptic controls (mean s‐NSE = 4.61 SD = 1.74, p. = 0.001). Conclusion: The increase in s‐NSE provides new evidence that CPSE causes brain injury in humans.
Five‐Year Outcome After Epilepsy Surgery in Nonmonitored and Monitored Surgical Candidates
Authors: Holmes Mark D. , Dodrill Carl B. , Ojemann Linda M. , Ojemann George A. 
Published: August 2005

Summary: Purpose: We wished to compare outcome 5 years after temporal lobectomy in 28 patients selected for surgery on the basis of interictal EEG patterns with that in 46 patients who underwent EEG‐video monitoring studies as part of their preoperative evaluation during the same era. Methods: The 28 nonmonitored patients had interictal EEG patterns that demonstrated a consistent, unilateral, anterior‐midtemporal epileptiform focus, without discordant findings from other studies. Outcomes were assessed for years 4 and 5 after operation. Results: Twenty‐six of 28 (92.9%) nonmonitored patients were seizure‐free or had at least 75% reduction in seizures. Twenty‐nine of 46 (63.0%) monitored patients were seizure‐free or had at least 75% reduction in seizures. Preoperative interictal EEGs of 29 of these patients showed independently localized bitemporal, ex‐tratemporal, midposterior temporal, or diffuse epileptiform patterns. The remaining 17 monitored patients had preoperative strictly unilateral anterior‐midtemporal interictal discharges, and their outcome was comparable to the nonmonitored group, with 15 (88.8%) seizure‐free or with at least 75% reduction in seizures. Conclusions: A proportion of candidates for epilepsy surgery can be selected without ictal recordings provided that interictal EEGs demonstrate consistent unilateral anterior‐midtemporal epileptiform discharges and that other data are not discordant.
Treatment with Vigabatrin May Mimic α‐Aminoadipic Aciduria
Authors: Vallat C. , Rivier F. , Bellet H. , de Bornier B. Magnan , Mion H. , Echenne B. 
Published: August 2005

Summary: Purpose: We describe a secondary effect of treatment with vigabatrin (VGB). A significant increase in α‐aminoadipic acid (AAA) occurred in plasma and urine of VGB‐treated children, thus mimicking a known rare metabolic disease, α‐aminoadipic aciduria (AAAuria). Methods: We studied eight children, aged from 3 months to 5 years, who were receiving VGB for drug‐resistant partial epilepsies. Plasma and urine amino acids were assayed with ninhydrin detection on an automated Beckman 6300 analyzer. Results: In eight out of eight children, there was a significant increase of AAA in plasma and in urine. Plasma values ranged from 7 to 18 μM (control values, < 5) and urinary values from 67 to 274 mmol/mol creatinine (control values, < 25). Conclusions: The concentrations of AAA in these VGB‐treated children were as high as the concentrations found in the inherited metabolic disease, AAAuria. This could lead to incorrect diagnosis and to inappropriate genetic counseling. Thus whenever a genetic metabolic disease is suspected, amino acid chromatography testing should be performed before initiation of treatment with VGB.
Nocturnal Sleep and Daytime Somnolence in Untreated Patients with Temporal Lobe Epilepsy: Changes After Treatment with Controlled‐Release Carbamazepine
Authors: Gigli Gian Luigi , Placidi Fabio , Diomedi Marina , Maschio Marta , Silvestri Giulia , Scalise Anna , Marciani Maria Grazia 
Published: August 2005

Summary: Purpose: To define sleep disturbances in patients with temporal lobe epilepsy (TLE) and explore the association between carbamazepine (CBZ) therapy, sleep, and daytime somnolence. Methods: We recorded nocturnal polysomnography and measured subjective and objective daytime somnolence in a group of newly diagnosed TLE patients, who had no evidence of anatomic brain lesion on neuroimaging and had never been treated before. Recordings were performed at baseline, after the initial administration of 400 mg CBZ‐controlled release (CR) and after 1 month of treatment (400 mg twice daily b.i.d.). The findings were compared with those of a group of young healthy volunteers, both at baseline and after the first administration of CBZ. The chronic effect of CBZ‐CR treatment was evaluated only in TLE patients. Results: At baseline, nocturnal sleep patterns of TLE patients did not show marked alterations when the influence of seizures, cerebral lesions, and drugs had been ruled out. In both the TLE and the control groups, initiation of CBZ therapy provoked a reduction and a fragmentation of rapid eye movement (REM) sleep and an increase in the number of sleep stage shifts. In the TLE group, these effects were almost completely reversed after 1 month of treatment, and no significant difference was noted between baseline condition and long‐term follow‐up. With regard to daytime sleepiness, initial administration of the drug caused an increase in objective sleepiness only in the control group. Subjective sleepiness was higher in the control group than in the TLE group but was not modified by the drug. Conclusions: We conclude that CBZ‐CR has negative effects on REM sleep during initial administration but chronic treatment does not significantly modify nocturnal sleep or daytime somnolence.
Role of the Claustrum in Convulsive Evolution of Visual Afferent and Partial Nonconvulsive Seizure in Primates
Authors: Wada Juhn A. , Tsuchimochi Hirohito 
Published: August 2005

Summary: Purpose: We tested cross‐species validity of the role of the claustrum in the convulsive evolution of the visual afferent and amygdaloid seizure and the specificity of the claustral lesioning effect. Methods: In 7 Senegalese baboons, we examined the effect of unilateral claustral lesioning on generalized convulsive seizures either kindled from the amygdaloid nucleus (AM) and cingulate cortex (CG) or induced by intermittent photic stimulation (IPS) after systemic administration of D,L‐allylglycine (AG). Results: A lesioned area common to all animals was the anterior half of the left claustrum. Postoperative restimulation of the kindled left AM or CG evoked only nonconvulsive seizures. When few convulsive seizures emerged in 1 CG‐kindled animal, they were mirror image of the kindled seizure and arose from the nonlesioned right hemisphere. Restimulation of the kindled right AM or CG reactivated kindled seizures. An IPS‐induced generalized convulsive seizure was transformed into a secondarily generalized seizure arising from the nonlesioned right hemisphere. Conclusions: The primate claustrum regulates the convulsive evolution of partial seizures originating from nonmotor structures such as the AM and CG and also regulates the convulsive development that follows IPS. Our findings suggest that predisposed susceptibility expressed at the claustrum may be involved in the clinical variation with respect to convulsive evolution of nonmotor partial seizures and convulsive susceptibility to IPS in human primates.
Safety of Intrahippocampal Depth Electrodes for Presurgical Evaluation of Patients with Intractable Epilepsy
Authors: Fernández Guillén , Hufnagel Andreas , Van Roost Dirk , Helmstaedter Christoph , Wolf Helmut K. , Zentner Josef , Schramm Johannes , Elger Christian E. 
Published: August 2005

Summary: Purpose: Intracerebral depth electrodes are used in preoperative evaluation of selected patients with intractable epilepsies. In spite of their usefulness, safety of depth electrodes is disputed, and the number of insertions is decreasing. This study examined retrospectively possible deleterious effects such as perioperative complications, induction of epileptogenesis, and neuropsychologic deficits. Methods: Clinical course and neuroradiologic findings of 115 patients with bilaterally inserted longitudinal intrahippocampal depth electrodes (IDEs) were analyzed. Hippocampal resection specimens were examined histopathologically. To detect newly developed epileptogenic areas, EEG recordings, seizure control, and semiology after standardized resection procedures were compared between patients who received IDEs and those who did not. To demonstrate functional deficits caused by IDE insertion into an unaffected hippocampus of the speech‐dominant hemisphere, changes of verbal learning and memory performances before and after right amygdalohippocampectomy were compared between patients evaluated with and without IDEs. Results: Five significant complications without any permanent neurologic deficit were noted, and only one was specifically linked to IDE insertion. The tissue damage associated with the insertion was minimal and sharply circumscribed. No differences of seizure outcome after standardized resections were identified between patients with and without IDEs. In postoperative EEG recordings, there was no evidence of new epileptogenic areas. No verbal memory deficit caused by IDE implantation into the hippocampus of the speech‐dominant hemisphere was detectable. Conclusions: Results indicate that it is safe to implant these IDEs in selected patients.
Stereotactic Amygdalohippocampotomy and Mesial Temporal Spikes
Authors: Blume Warren T. , Parrent Andrew G. , Kaibara Masako 
Published: August 2005

Summary: Purpose: To investigate the mechanism of mesial temporal spike generation, we sought to determine whether amygdalohippocampotomy by radiofrequency lesions altered spike rates in patients with medically intractable temporal lobe epilepsy.
Successful Treatment by Direct Hemoperfusion of Coma Possibly Resulting From Mitochondria1 Dysfunction in Acute Valproate Intoxication
Authors: Matsumoto Jyunji , Ogawa Hisayuki , Maeyama Ryutaro , Okudaira Ken , Shinka Toshihiro , Kuhara Tomiko , Matsumoto Isamu 
Published: August 2005

Summary: Purpose: We evaluated the efficacy of direct hemoperfusion (DHP) for treatment of acute valproate (VPA) intoxication and speculate on the biochemical perturbations that suggest a mechanism of coma induced by VPA overdose. Patient and Methods: The comatose patient was hospitalized ˜6 h after ingesting 18 g VPA. DHP, with 200 g activated charcoal, was performed for 6 h. The plasma concentrations of VPA and Glasgow coma scale scores after admission were estimated. Before and after DHP, urine samples were tested in serial fashion for VPA metabolites, organic acids, and acyl carnitine esters of fatty acids. Results: Plasma VPA was efficiently adsorbed on activated charcoal. The patient's plasma concentration of VPA decreased from 471 μml (2,830 μM) to 45 pg/ml (270 μM), at which point the patient became alert. The half‐life (t1/2) of VPA was calculated as 4.4 h before DHP and as 1.8 h during DHP. Before DHP, lactate and VPA‐glucuronide markedly increased in urine samples, but β‐keto‐VPA, a major mitochondria1 metabolite, was not detected. Urinary excretion of carnitine esters of medium chain (C8‐C10) dicarboxylic acids was increased. After DHP, lactate and VPA‐glucuronide decreased, but a significant amount of β‐keto‐VPA was demonstrated. Carnitine esters of medium chain dicarboxylic acids were decreased. Conclusions: DHP with activated charcoal was effective treatment for the patient with acute VPA intoxication and coma. The onset of coma may have been related to inhibition of β‐oxidation in the mitochondria, which was reversible by elimination of plasma VPA by DHP.
Patients' Experiences of Injury as a Result of Epilepsy
Authors: Buck Deborah , Baker Gus A. , Jacoby Ann , Smith David F. , Chadwick David W. 
Published: August 2005

Summary: Purpose: The increased risk of mortality among people with epilepsy is well documented; people with epilepsy are more likely than the general population to die as a result of an accident. Data about incidence of nonfatal accidents and associated factors are not so readily available, even though such accidents are more common than fatal injuries. We report the proportion of people who sustain various injuries during a seizure and the key variables predicting injury.Methods: Questionnaires were mailed to an unselected, community‐based population of patients with epilepsy. The questionnaire included clinical and demographic details, previously validated scales of psychosocial well‐being, and questions about seizure‐related injuries.Results: Of patients who had had at least one seizure during the previous year, 24% sustained at least one head injury, 16% sustained a burn or scald, 10% a dental injury, and 6% some other fracture. Seizure type, seizure severity, and seizure frequency were key predictors of having sustained at least one of these four seizure‐related injuries. Key predictors of budscald were seizure severity, seizure frequency and sex; those of head injury were seizure severity and type; that of dental injury was seizure severity; and those of some other fracture were seizure severity, duration of epilepsy, and three or more drug‐related adverse effects.Conclusions: These data help identify significant risk factors associated with seizure‐related injuries and so facilitate sensible patient counseling about how the risks of such injuries can be minimized.