bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk factors of status epilepticus in children
Authors: KarasalİhoĞlu Serap , Öner Naci , ÇeLtik CoŞkun , Çelik Yahya , Biner Betül , Utku Ufuk 
Published: December 2004

Abstract
Background
: Although there is abundant literature about the morbidity and mortality rates of status epilepticus (SE), little is known about the risk factors of this medical emergency. The aim of the present study is to assess the risk factors of SE in children.
Methods
: The authors reviewed the medical records of 83 patients admitted to the Pediatric Neurology Unit of Trakya University Hospital, Edirne, Turkey from January 1994 to December 2001 with the diagnosis of SE. Eighty‐three patients were compared with 166 controls who were admitted to the same unit due to non‐status epilepticus (non‐SE) seizure.
Results
: The univariate analysis demonstrated that SE episodes were significantly associated with a history of birth asphyxia, neonatal seizure, discontinuation of antiepileptic medication, epilepsy, partial seizure evolving to secondary generalized seizures, myoclonic seizure, generalized abnormalities in the neurological examination, neuromotor retardation, generalized background abnormalities on electroencephalogram (EEG), generalized abnormalities on neuroimaging and polypharmacy than non‐SE episodes. Logistic regression was used to test the independence of these parameters as predictors of SE risk. Four parameters emerged as significant independent predictors of SE in children in multiple logistic regression: polypharmacy (Odds ratio (OR) 5.17, P = 0.0004), discontinuation of antiepileptic medication (OR 4.04, P = 0.0095), neuromotor retardation (OR 4.03, P = 0.0016) and generalized background abnormalities on EEG (OR 2.48, P = 0.0419).
Conclusion
: Polypharmacy, discontinuation of antiepileptic medication, neuromotor retardation and generalized background abnormalities on EEG are indicators in children of a higher risk of SE.
Testicular sperm extraction with intracytoplasmic sperm injection for male infertility
Authors: Imamoto Takashi , Suzuki Hiroyoshi , Ichikawa Tomohiko , Ito Haruo , Kawana Yoko , Shiseki Yoshio , Akama Haruo , Naito Masafumi 
Published: December 2004

Background and Aims: Testicular sperm extraction (TESE) and intracytoplasmic sperm injection (ICSI) is an effective procedure for the treatment of male infertility, obstructive and non‐obstructive azoospermia. We have reviewed our experience to investigate the correlation of TESE‐ICSI with morphological, biophysical and endocrine profiles in 27 men.Results:  Testicular spermatozoa could be retrieved in 25 of 27 patients who underwent TESE. In two cases, testicular spermatozoa could not be recovered and their serum follicle‐stimulating hormone (FSH) levels were significantly higher than those of the former group. However, spermatozoa could be retrieved in sufficient numbers for ICSI, even in the patient with the highest FSH concentration. Johnsen scores evaluated by diagnostic pre‐TESE open biopsies were significantly higher in the cases with viable testicular spermatozoa than those in the cases without spermatozoa. However, even in the patient whose Johnsen score was 2.1, testicular spermatozoa could be retrieved with TESE, and pregnancy was achieved by ICSI.Conclusions:  The serum FSH levels and the histological findings of the testes were strong predictors for successful TESE and provided useful information for consultation and making treatment decisions on an individual case. However, whether a patient has enough spermatozoa so that an IVF procedure with ICSI is possible can only be answered by a trial TESE. (Reprod Med Biol 2003; 2: 31–35)
Rapid emergence does not explain agitation following sevoflurane anaesthesia in infants and children: a comparison with propofol
Authors: Cohen Ira Todd , Finkel Julia C. , Hannallah Raafat S. , Hummer Kelly A. , Patel Kantilal M. 
Published: December 2004

Summary Background: Emergence agitation in children is frequently associated with the use of the new highly insoluble volatile anaesthetics. Rapid emergence has been cited as one of the possible causes. Propofol also permits rapid emergence from general anaesthesia but is not associated with agitation. Methods: The emergence characteristics of children receiving sevoflurane and propofol anaesthesia were examined. After induction with sevoflurane, 53 children, aged 2–36 months, who were undergoing ambulatory surgery, were randomized to receive maintenance anaesthesia with either sevoflurane or propofol. Introperative analgesia with either 2 µg·kg−1 of intravenous fentanyl or a caudal block with 0.25% bupivacaine was supplied according to surgical procedure. An observer blinded to anaesthetic technique recorded the time to achieve extubation and recovery and assessed emergence behaviour. Data were analysed using Wilcoxon scores, Kruskal–Wallis test, chi‐square and multiple regression analysis. Results: The results showed that the time to extubation and recovery were similar between the two study groups, but that emergence agitation was significantly higher in the sevoflurane group compared with the propofol group. No relationship between analgesic technique and agitation scores was found. Conclusions: Although both sevoflurane and propofol allow for rapid emergence from general anaesthesia, only sevoflurane is associated with a high incidence of emergence agitation in infants and young children. Rapid emergence does not fully explain this phenomena.
Perioperative care of the child with the Johanson–Blizzard syndrome
Authors: Fichter Christopher R. , Johnson Garry A. , Braddock Stephen R. , Tobias Joseph D. 
Published: December 2004

SummaryThe Johanson–Blizzard Syndrome (JBS) is an autosomal recessive disorder with a characteristic phenotype, including dwarfism, a beaked nose with aplastic alae nasi, a high forehead, mid‐line ectodermal scalp defects with sparse hair and absent eyelashes/eyebrows, prominent scalp veins, low set ears, a large anterior fontanelle, micrognathia, thin lips, absent permanent dentition and microcephaly. In addition to the characteristic facial features, associated conditions include congenital heart disease, exocrine/endocrine pancreatic dysfunction, hypothyroidism, hypopituitarism, mental retardation, sensorineural hearing loss and vesico‐ureteral reflux. A case is presented and the potential anaesthetic implications of this syndrome are discussed.
Haemodynamic changes during high spinal anaesthesia in children having open heart surgery
Authors: Finkel Julia C. , Boltz M. Gail , Conran Aisling M. 
Published: December 2004

Summary Background: This prospective series examined the haemodynamic effects of high spinal anaesthesia in combination with light general anaesthesia in infants and children undergoing open heart surgery who were candidates for immediate or early postoperative extubation. Methods: After midazolam premedication and sevoflurane inhalation induction, 30 patients, aged 7 months to 13 years, who were undergoing open heart surgery, received spinal anaesthetics with 0.5% tetracaine D10 mixed with morphine. The spinal blocks were placed at the L2,3 or L3,4 interspace with cephalad spread being promoted by positioning the patient in 30° of Trendelenburg for a minimum of 10 min. Maintenance of anaesthesia was with isoflurane 0.2–0.5% in 70% nitrous oxide to maintain heart rate and blood pressure within 20% of postinduction baseline values. Haemodynamic values were recorded at predetermined timed intervals and intraoperative events up to and including aortic cannulation. For analysis of the data, patients were divided into four age groups (< 1 years, 1–3 years, 4–6 years and > 7 years). Results: Haemodynamic stability was demonstrated in all four age groups. Statistically significant slowing of the heart rate did occur in the groups older than 1 year at 25 min, although clinically significant bradycardia requiring treatment never occurred. Hypotension did occur during specific surgical manipulations but recovered spontaneously. Atropine, fluid boluses and vasopressors were never used. At the conclusion of surgery, all patients met extubation criteria and could move all four extremities. Conclusions: High spinal anaesthesia with hyperbaric tetracaine and morphine in combination with light general anaesthesia is well tolerated haemodynamically by the paediatric population studied.
Cerebral blood flow velocity in children anaesthetized with desflurane*
Authors: Luginbuehl Igor A. , Fredrickson Michael J. , Karsli Cengiz , Bissonnette Bruno 
Published: December 2004

SummaryBackground: Desflurane allows for rapid emergence and changes in depth of anaesthesia which makes it especially suitable for neuroanaesthesia. This study was designed to determine the effects of different desflurane concentrations on cerebral blood flow velocity (CBFV) in healthy children.Methods: Twenty children, aged 1–7 years undergoing urological surgery were studied. Anaesthesia was induced with sevoflurane in oxygen. After tracheal intubation, sevoflurane was discontinued and ventilation with desflurane in air/oxygen was initiated and normoventilation maintained. A caudal block was performed. The patients were randomized to receive three different desflurane concentrations (0.5, 1.0 and 1.5 MAC). Fifteen minutes were allowed to reach steady‐state at which time CBFV was measured by transcranial Doppler sonography. Mean arterial pressure (MAP) and heart rate (HR) were simultaneously recorded at 1‐min intervals.Results: Cerebral blood flow velocity increased from 0.5 to 1.0 MAC (P < 0.05), but not from 1.0 to 1.5 MAC. HR increased from 0.5 to 1.0 (P < 0.001) and from 1.0 to 1.5 MAC (P < 0.001), whereas the MAP decreased only from 0.5 to 1.0 MAC (P < 0.001).Conclusions: Desflurane in concentrations of 1.0 and 1.5 MAC in children increases CBFV significantly when compared with 0.5 MAC. These changes were associated with a significant increase in HR and decrease in MAP.
Tramadol for pain relief in children undergoing tonsillectomy: a comparison with morphine
Authors: Engelhardt Thomas , Steel Elizabeth , Johnston Graham , Veitch Derek Y. 
Published: December 2004

Summary Background: Pain control for paediatric patients undergoing tonsillectomy remains problematic. Tramadol is reported to be an effective analgesic and to have a side‐effect profile similar to morphine, but is currently not licensed for paediatric use in the UK. Methods: We conducted a prospective, double‐blind, randomized controlled trial in children who were scheduled for elective tonsillectomy or adenotonsillectomy at the Royal Aberdeen Children Hospital. Following local ethics committee approval and after obtaining a drug exemption certificate from the Medicines Licensing Agency for an unlicensed drug, we recruited 20 patients each into morphine (0.1 mg·kg−1), tramadol (1 mg·kg−1) and tramadol (2 mg·kg−1) groups. These drugs were given as a single injection following induction of anaesthesia. In addition, all patients received diclofenac (1 mg·kg−1) rectally. The postoperative pain scores, analgesic requirements, sedation scores, signs of respiratory depression and nausea and vomiting, as well as antiemetic requirements, were noted at 4‐h intervals until discharge. Results: There were no statistically significant differences in age, weight, type of operation or induction of anaesthesia, 4‐h sedation and pain scores and further analgesic requirements. There were no episodes of respiratory depression. Morphine was associated with a significantly higher incidence of vomiting following discharge to the wards (75% versus 40%, P=0.03) compared with both tramadol groups. Conclusions: Tramadol has similar analgesic properties, when compared with morphine. The various pharmaceutical presentations and the availability as a noncontrolled substance may make it a useful addition to paediatric anaesthesia if it becomes licensed for paediatric anaesthesia in the UK.
Spread of radioopaque dye in the epidural space in infants
Authors: Vas Lakshmi , Kulkarni Vinay , Mali Madhusudhan , Bagry Hema 
Published: December 2004

Summary Background: This prospective study aimed to assess the extent of spread of dye in the epidural space and whether it would vary in direct proportion to the volume when injecting two volumes of dye. Methods: Ten infants, aged 2–36 days (mean ± SD, 13.30 ± 13.68 days) and weighing 1.8−4.5 kg (mean ± SD, 2.60 ± 0.97 days), who were undergoing major thoracoabdominal surgery under epidural and general anaesthesia, were studied. At the end of surgery, two volumes of radioopaque dye (omnipaque) 0.5 ml·kg−1 and 1 ml·kg−1 were injected into the epidural space at a rate of 1 ml·2 min−1. The spread was studied by taking X‐rays after both injections in the left lateral position. Results: There were 10 different patterns of spread in the 10 cases. Uniformly circumferential and cylindrical spread was seen only in one infant. In the others, there were segregated patches of anterior and posterior spread with or without interspersed patches of circumferential spread. There was variation in the extent, location and the density of spread, filling defects and skipped segments with both volumes. Back leak of dye along the needle track was seen in three cases. Statistically, segments were 9.30 ± 3.68 for 0.5 ml·kg−1, for 1 ml·kg−1 11.50 ± 3.03, 3.03, S, P=0.014; circumferential spread for 0.5 ml·kg−1 2.70 ± 2.16, for 1 ml·kg−1 5.90 ± 3.14 3.59, P=0.006; anterior spread for 0.5 ml·kg−1 3.60 ± 1.58, for 1 ml kg−1 7.90 ± 2.33 5.88, P=0.001; posterior spread for 0.5 ml·kg−1 8.20 ± 3.71, for 1 ml·kg−1 9.80 ± 3.68 3.54, P=0.006. Doubling of spread with doubling of the volume occurred in only one patient. There was a variable increase in extent or in the density of spread with reduction of skipped segments with the 1 ml·kg−1. The probable reasons for this variable spread and the mechanism of epidural anaesthesia in the presence of such spread are discussed. Conclusions: There is a difference in quantitative as well as qualitative spread in different patients and in the same patient with different volumes. There were statistically significant increases in the number of segments, circumferential, anterior and posterior locations in the 1.0 ml group. Both extent and density of spread improve with the higher volume but not in direct proportion to volume. 1 ml·kg−1 has a better quantitative as well as qualitative spread than 0.5 ml and has a better chance of producing adequate anaesthesia.
Effects of halothane and sevoflurane on QT dispersion in paediatric patients
Authors: Gürkan Yavuz , Canatay Hakan , Agacdiken Aysen , Ural Ertan , Toker Kamil 
Published: December 2004

Summary Background: The QT dispersion (QTd) of the ECG is an indirect measure of heterogeneity of ventricular repolarization which may contribute to complex ventricular arrhythmias. We compared the effects of halothane and sevoflurane on QTd, and heart‐rate corrected QT dispersion (QTcd). Methods: Fifty ASA physical status I patients, aged 5–15 years, undergoing general anaesthesia were studied. A control ECG recording was printed before induction of anaesthesia. In the halothane group, anaesthesia was induced with halothane 4% in 2 : 1 ratio of air : O2 mixture and in the sevoflurane group with sevoflurane 8% in 2 : 1 ratio of air : O2 mixture. The ECG was recorded 1 and 3 min after induction of anaesthesia, 1 and 3 min after the administration of vecuronium 0.08 m·kg−1 intravenous and 1 and 3 min after the tracheal intubation. All ECGs were analysed by two cardiologists blinded to the anaesthetic. Results: Although QTd increased in both groups following intubation, this difference was not statistically significant when compared with control values. Following intubation five patients in the halothane group had ventricular arrhythmias of short duration, whereas no arrhythmias were recorded in the sevoflurane group (P = 0.052). Following intubation, QTd (45 ± 15 ms vs 40 ± 14 ms) and QTcd (60 ± 17 ms vs 55 ± 16 ms) values in the halothane group were significantly greater than the sevoflurane group (P < 0.05). Conclusion: Neither sevoflurane nor halothane caused a significant increase in QTd compared with control values before induction. Only QTd following intubation was significantly greater in the halothane group than the sevoflurane group.
Assessment of risk factors for emergence distress and postoperative behavioural changes in children following general anaesthesia
Authors: Tripi Paul A. , Palermo Tonya Mizell , Thomas Susan , Goldfinger Mark M. , Florentino‐Pineda Ivan 
Published: December 2004

SummaryBackground:  Emergence distress commonly occurs in children recovering from the immediate effects of general anaesthesia. This study was performed to (1) examine whether parental presence in the operating room during emergence from anaesthesia reduces the incidence or severity of emergence distress behaviour, and (2) assess psychosocial risk factors, including child temperament and sleep behaviour, for development of emergence distress.Methods:  A randomized and controlled trial of parental presence at emergence was conducted in 100 ASA class I and II children having general anaesthesia for inguinal or penile surgery. Children in the study group had a parent present at induction and emergence of anaesthesia, while children in the control group had a parent present only at induction. Emergence and postanaesthesia care unit (PACU) behaviour was monitored using both the Operating Room Behaviour Rating Scale (ORBRS) and a 7‐point Likert type cooperation scale.Results:  One‐way anovas showed no significant differences between the control group and the study group on emergence distress behaviour. The frequency of negative postoperative behavioural changes at 1 and 4 weeks postsurgery was low in both groups. Children described as clingy/dependent (χ2 = 5.57, P < 0.06) and children with frequent temper tantrums (χ2 = 7.44, P < 0.02) were more likely to have emergence distress behaviour.Conclusions:  Parental presence during emergence from anesthesia did not decrease the incidence or severity of emergence distress behaviour in children. Young children and children with a history of temper tantrums or separation anxiety may be more likely to develop such behaviour.
Antibiosis‐type insect resistance in transgenic plants expressing a teratocyte secretory protein (TSP14) gene from a hymenopteran endoparasite (Microplitis croceipes)
Authors: Maiti Indu B. , Dey Nrisingha , Pattanaik Sitakanta , Dahlman Douglas L. , Rana Rico L. , Webb Bruce A. 
Published: December 2004

SummaryWe have isolated a teratocyte secretory protein (TSP14) gene product from a hymenopteran endoparasite that disrupts the growth of lepidopteran insect larvae. To evaluate the insecticidal activity of TSP14 for the protection of crops from insect damage, chimeric gene constructs of TSP14 were expressed in transgenic plants. The coding sequence of the TSP14 gene, with and without its native signal peptide, was placed between the modified peanut chlorotic streak virus (PClSV) full‐length transcript (FLt) promoter with duplicated enhancer domains and the terminator sequence from the rbcSE9 gene. These chimeric genes, expressed in transgenic tobacco (Nicotiana tabacum cv. Samsun NN) were stably inherited in successive plant generations (R0, R1 and R2 progeny) as shown by molecular analysis. A Western blot analysis of plant extracts showed the presence of a polypeptide of the expected size that cross‐reacted with TSP14‐specific antibodies. Larvae of the tobacco budworm (Heliothis virescens) and tobacco hornworm (Manduca sexta) which were fed with several independent homozygous transgenic plant lines (R2 progeny) exhibited mortality and reduced growth rates compared to those fed with plants transformed by a vector control. Our results demonstrate the potential for introduction of the TSP14 gene into plants in order to achieve protection against lepidopteran pests.
Forestry's fertile crescent: the application of biotechnology to forest trees
Authors: Campbell Malcolm M. , Brunner Amy M. , Jones Helen M. , Strauss Steve H. 
Published: December 2004

SummaryRelative to crop plants, the domestication of forest trees is still in its infancy. For example, the domestication of many crop plants was initiated some 10 000 years ago in the so‐called ‘Fertile Crescent’ of the Middle East. By contrast, the domestication of forest trees for the purposes of producing more fibre began in earnest in the last half century. The application of biotechnology to forest trees offers a great potential to hasten the pace of tree improvement for desirable end uses. This review outlines some of the progress that has been made in the application of biotechnology to forest trees, and considers the prospects for biotechnologically based tree improvement in the future.
Expression of the Arabidopsis ADS1 gene in Brassica juncea results in a decreased level of total saturated fatty acids
Authors: Yao Kening , Bacchetto Roberto G. , Lockhart Katherine M. , Friesen Laurie J. , Potts Derek A. , Covello Patrick S. , Taylor David C. 
Published: December 2004

Summary Brassica juncea plants transformed with the Arabidopsis ADS1 gene, which encodes a plant homologue of the mammalian and yeast acyl‐CoA Δ9 desaturases and the cyanobateria acyl‐lipid Δ9 desaturase, were found to have a statistically significant decrease in the level of saturated fatty acids in seeds. The decrease in the level of saturated fatty acids is largely attributable to decreases in palmitic acid (16:0) and stearic acid (18:0), although arachidic acid (20:0), behenic acid (22:0) and lignoceric acid (24:0) were also decreased in the transgenic seeds compared to the negative control lines. As a result, the level of oleic acid (18:1) was slightly increased in the transgenic seed lines compared to the non‐transformed controls. However, a decrease in saturated fatty acid is not always accompanied by the corresponding increase in mono‐unsaturated fatty acids. For example, palmitoleic acid (16:1), gondoic acid (20:1) and nervonic acid (24:1) were all found to be decreased in transgenic seeds. The levels of linoleic acid (18:2) and linolenic acid (18:3) were also notably changed in the transgenic lines compared to the controls.The present study provides preliminary experimental data suggesting that the Arabidopsis ADS1 encodes a fatty acid Δ9 desaturase and could be useful in genetic engineering for modifying the level of saturated fatty acids in oilseed crops. However, the effect of ADS1 gene expression on seed oil fatty acid composition is beyond the changes of total saturated and mono‐unsaturated fatty acids, which suggests a complex mechanism is involved in the regulation of fatty acid metabolism.
Population structure of Armillaria species in managed Norway spruce stands in the Alps
Authors: Prospero Simone , Rigling Daniel , Holdenrieder Ottmar 
Published: December 2004

Summary

The preferentially saprotrophic basidiomycete Armillaria cepistipes and the pathogenic Armillaria ostoyae occur sympatrically in many European forests.
The spatial population structure of both Armillaria species was investigated in three 1‐ha plots established in managed Norway spruce (Picea abies) forests in the Swiss Alps (1400 m asl). A total of 740 Armillaria isolates, 296 from rhizomorphs in the soil and 444 from the stumps, were recovered and identified to species and genets (somatic incompatibility groups).
The incidence of A. cepistipes and A. ostoyae varied greatly among the plots. Two to six genets of each Armillaria species were identified and mapped in each plot. Genets of the same species overlapped rarely and only on the borders. Large spatial overlaps between A. cepistipes and A. ostoyae genets were observed in the plot with the highest incidence of fragmented genets. In five subplots (c. 0.1 ha) established along interspecific boundaries, overlaps were found in all three plots.
Our study suggests a strong intraspecific competition in both Armillaria species. Evidence for competition between the two species, as indicated by spatial mutual exclusion, was only observed on parts of the investigated area.