bluuebunny/crossref_metadata_2025_split huggingface dataset:
Computerized Motion Analysis of Videotaped Neonatal Seizures of Epileptic Origin
Authors: Karayiannis Nicolaos B. , Tao Guozhi , Xiong Yaohua , Sami Abdul , Varughese Bindu , Frost James D. , Wise Merrill S. , Mizrahi Eli M. 
Published: June 2005

Summary: Purpose:The main objective of this research is the development of automated video processing and analysis procedures aimed at the recognition and characterization of the types of neonatal seizures. The long‐term goal of this research is the integration of these computational procedures into the development of a stand‐alone automated system that could be used as a supplement in the neonatal intensive care unit (NICU) to provide 24‐h per day noninvasive monitoring of infants at risk for seizures.Methods:We developed and evaluated a variety of computational tools and procedures that may be used to carry out the three essential tasks involved in the development of a seizure recognition and characterization system: the extraction of quantitative motion information from video recordings of neonatal seizures in the form of motion‐strength and motor‐activity signals, the selection of quantitative features that convey some unique behavioral characteristics of neonatal seizures, and the training of artificial neural networks to distinguish neonatal seizures from random infant behaviors and to differentiate between myoclonic and focal clonic seizures.Results:The methods were tested on a set of 240 video recordings of 43 patients exhibiting myoclonic seizures (80 cases), focal clonic seizures (80 cases), and random infant movements (80 cases). The outcome of the experiments verified that optical‐ flow methods are promising computational tools for quantifying neonatal seizures from video recordings in the form of motion‐strength signals. The experimental results also verified that the robust motion trackers developed in this study outperformed considerably the motion trackers based on predictive block matching in terms of both reliability and accuracy. The quantitative features selected from motion‐strength and motor‐activity signals constitute a satisfactory representation of neonatal seizures and random infant movements and seem to be complementary. Such features lead to trained neural networks that exhibit performance levels exceeding the initial goals of this study, the sensitivity goal being ≥80% and the specificity goal being ≥90%.Conclusions:The outcome of this experimental study provides strong evidence that it is feasible to develop an automated system for the recognition and characterization of the types of neonatal seizures based on video recordings. This will be accomplished by enhancing the accuracy and improving the reliability of the computational tools and methods developed during the course of the study outlined here.
In Vivo Modulatory Action of Extracellular Glutamate on the Anticonvulsant Effects of Hippocampal Dopamine and Serotonin
Authors: Clinckers Ralph , Gheuens Sarah , Smolders Ilse , Meurs Alfred , Ebinger Guy , Michotte Yvette 
Published: June 2005

Summary:  Purpose: Our recent work (Clinckers et al., J Neurochem 2004;89:834–43) demonstrated that intrahippocampal perfusion of 2 nM dopamine or serotonin via a microdialysis probe offered complete protection against focal pilocarpine‐induced limbic seizures and did not influence basal extracellular hippocampal glutamate levels. Ten nanomolar dopamine or serotonin perfusion, however, worsened seizures and was accompanied by significant extracellular glutamate increases to ∼200%. The significance of these glutamate elevations in seizure generation remains unclear. The present microdialysis study investigated the modulatory role of extracellular hippocampal glutamate levels in these monoaminergic protective and proconvulsant effects. Methods: A first group of male Wistar albino rats was perfused intrahippocampally for 240 min with 6.25 μM glutamate alone to increase extracellular levels by 200%. Other animals were perfused with anticonvulsant concentrations of monoamines throughout the experiments while receiving continuous coperfusions of 6.25 μM glutamate either before, during, and after (240 min) or only after (100 min) pilocarpine perfusion (40 min). Rats were scored for epileptic behavior, and the mean scores were compared with those of the control group. Microdialysates were analyzed for monoamine and glutamate content with microbore liquid chromatography. Results: No convulsions occurred during glutamate perfusion alone. When monoamines and glutamate were coperfused before pilocarpine administration, the anticonvulsant effect of the monoamines was lost. Glutamate addition after pilocarpine administration did not affect monoaminergic seizure protection. Conclusions: These results indicate that extracellular glutamate increases per se do not necessarily induce seizures but that they can modulate the anticonvulsant effects exerted by hippocampal monoamines.
Epilepsy in Young Adults with Autism: A Prospective Population‐based Follow‐up Study of 120 Individuals Diagnosed in Childhood
Authors: Danielsson Susanna , Gillberg I. Carina , Billstedt Eva , Gillberg Christopher , Olsson Ingrid 
Published: June 2005

Summary:  Purpose: Little is known about the long‐term outcome of epilepsy in autism and the epilepsy characteristics of adults with autism. This prospective population‐based study was conducted in an attempt to point out differences on a group basis between adults with autism with or without epilepsy, and to describe the occurrence, the seizure characteristics, and the outcome of epilepsy in autism. Methods: One hundred eight of 120 individuals with autism diagnosed in childhood and followed up prospectively for a period of 13–22 years were reevaluated at ages 17–40 years. As adults, the majority had mental retardation and autistic disorder or autistic‐like condition. Interviews were performed with the caretakers of 42 of 43 individuals with a history of epilepsy, and their medical records were reviewed. Results: Adults with autism and mental retardation constituted a severely disabled group. On a group basis, both the cognitive level and the adaptive behavior level were lower in the epilepsy group than in the nonepilepsy group (p < 0.05). In all, 38% had epilepsy. One third had epilepsy onset before age 2 years. Remission of epilepsy was seen in 16%. Partial seizures with or without secondarily generalized seizures were the dominating seizure type. Conclusions: In a community sample of individuals with autism followed up from childhood through to adult age, one of three had epilepsy since childhood/adolescence. Severe mental retardation and autism are significantly associated with epilepsy, especially in female patients. Seizure frequency has a great impact on the individuals' lives. Specialist medical care is needed in this severely communication‐disabled population.
Spontaneous Epileptic Rats Show Changes in Sleep Architecture and Hypothalamic Pathology
Authors: Bastlund Jesper F. , Jennum Poul , Mohapel Paul , Penschuck Silke , Watson William P. 
Published: June 2005

Summary:  Purpose: The goal of the present study was to investigate the relationship between sleep, hypothalamic pathology, and seizures in spontaneous epileptic rats. Methods: Rats were implanted with radiotelemetry transmitters for measuring electrocorticogram (ECoG) and stimulation electrodes in the hippocampus. Epileptogenesis was triggered by 2 h of electical stimulation–induced self‐sustained status epilepticus (SSSE). After SSSE, ECoGs were monitored over a 15‐week period for the occurrence of interictal high‐amplitude low‐frequency (HALF) acitvity and spontaneous reoccurring seizures (SRSs). Results: Spontaneous epileptic rats showed clinical features of temporal lobe epilepsy (TLE), such as spontaneous seizures, interictal activity and neuronal cell loss in the dorsomedial hypothalamus, a region important for normal sleep regulation. Interestingly, epileptic rats showed disturbances in sleep architecture, with a high percentage of the seizures occurring during sleep. Conclusions: Therefore we conclude that a close association exists between epileptiform activity and alterations in sleep architecture that may be related to hypothalamic pathology.
Early Thalamic Injury Associated with Epilepsy and Continuous Spike–Wave during Slow Sleep
Authors: Guzzetta Francesco , Battaglia Domenica , Veredice Chiara , Donvito Valeria , Pane Marika , Lettori Donatella , Chiricozzi Francesca , Chieffo Daniela , Tartaglione Tommaso , Dravet Charlotte 
Published: June 2005

Summary:  Purpose: Mechanisms inducing continuous spike–wave during slow sleep (CSWS) in encephalopathy with electrical status epilepticus during sleep are still unclear. Recently, some sporadic cases with early thalamic injury associated with CSWS have been reported. The aim of the study was to investigate in a population of patients with an early thalamic injury the presence of an activation of paroxysmal activities during sleep, their characteristics, and possible relations to neuroimaging and neuropsychological features. Methods: Thirty‐two patients with prenatal or perinatal thalamic injuries, mostly due to a vascular mechanisms, were fully examined, including neuroimaging, EEG monitoring, and cognitive follow‐up. Results and Conclusions: Twenty‐nine of 32 patients showed major sleep EEG activation. Among these 29 patients, two different groups were distinguished: the first included the more or less typical CSWS (12 cases), generally with symmetry of spike and waves (SWs) and often with no spindle at all. The other cases had an usual asymmetry of SWs and presence or reduction of spindles, plus other atypical features concerning synchronism and morphology of SWs. Behavioral disorders were significantly more present in patients with a true CSWS; their improvement (and in one case of the three thoroughly followed the improvement of cognitive competence) paralleled the disappearance of CSWS. The generally predominant injury of the lateral aspect of the thalamus included reticular nucleus and ventral nuclei. An imbalance of γ‐aminobutyric acid (GABA)B‐ versus GABAA ‐mediated receptors may be evoked as a cofactor predisposing to CSWS.
Cerebral Oxygenation During Defibrillator Threshold Testing of Implantable Cardioverter Defibrillators
Authors: MCNEILL ELIZABETH , GAGNON ROY E. , POTTS JAMES E. , YEUNG‐LAI‐WAH JOHN A. , KERR CHARLES R. , SANATANI SHUBHAYAN 
Published: June 2005

Background: The induction of ventricular fibrillation (VF) during defibrillator threshold testing of implantable cardioverter defibrillators (ICD) provokes global cerebral hypoperfusion and impaired oxygen delivery. Limited data are available on the neurophysiological effects of defibrillator threshold testing. Near infrared spectroscopy (NIRS) can noninvasively measure changes in specific chromophores, which reflect cerebral oxygenation at the intravascular and mitochondrial levels. We performed a prospective trial using NIRS to analyze cerebral cortical oxygenation during defibrillator threshold testing.
Methods: Eleven patients (men = 9; age = 64 ± 11 years: LVEF = 44 ± 11%) underwent subpectoral ICD implantation and defibrillator threshold testing under general anesthesia. A NIRO 300 spectrometer was used to measure the absolute changes in the concentrations of oxyhemoglobin, de‐oxyhemoglobin, and cytochrome c oxidase copper moiety during each procedure. The mean arterial blood pressure was monitored simultaneously.
Results: The mean number of defibrillator threshold tests was two (range 2–6). Twenty‐six episodes of VF (duration 13.1 ± 9.7 seconds; cycle length 230.2 ± 20.8 ms) and two episodes of VT (duration 15 ± 2.8 seconds; cycle length 320 ± 11.3 ms) were induced. Each episode of VF and VT resulted in a decrease in the mean arterial blood pressure to 23.9 ± 7.5 mmHg (p ≤ 0.05) and oxyhemoglobin (−4.2 ± 1.7 μmol/L; p ≤ 0.05) and an increase in de‐oxyhemoglobn (2.7 ± 1.4 μmol/L). There was no change in the cytochrome c oxidase copper moiety redox status (0.09 ± 0. 30 μmol/L).
Conclusion: Our results suggest that impaired oxygen delivery during induced VF and VT does not affect oxygen availability at the cellular intra‐mitochondrial level.
Prevalence and Clinical Course of the Juveniles with Brugada‐Type ECG in Japanese Population
Authors: OE HIROKI , TAKAGI MASAHIKO , TANAKA ATSUSHI , NAMBA MASASHI , NISHIBORI YOSHIHARU , NISHIDA YUKIO , KAWARABAYASHI TAKAHIKO , YOSHIYAMA MINORU , NISHIMOTO MASAKI , TANAKA KUMEO , YOSHIKAWA JUNICHI 
Published: June 2005

Background: Although many studies on Brugada syndrome have been done, with many reports of genetic findings and clinical features, little evidence exists to support the role of this syndrome in sudden cardiac death in a juvenile population. We sought to determine the prevalence and clinical course in children exhibiting Brugada‐type ECG in a community‐based population.
Methods: Our study population comprised 21,944 subjects (11,282 boys and 10,662 girls) who underwent ECG during their first‐year elementary school health examinations between 1992 and 2001 in Izumi City, Osaka. Brugada‐type ECG was defined as demonstrating ST‐segment elevation (coved or saddle‐back type, J wave amplitude ≥0.2 mV) in the right precordial leads. We also divided Brugada‐type ECGs into three types according to a consensus report. Type 1: coved ST‐segment elevation displaying high J wave amplitude followed by a negative T wave; Type 2: high take‐off and gradually descending ST‐segment elevation (remaining ≥1 mm) followed by a positive or biphasic T wave; and Type 3: ST‐segment elevation of <1 mm of both types.
Results: Four subjects showed Brugada‐type ECG (0.02%) (2 boys and 2 girls). Only one subject, a girl, met Type 1 criteria (0.005%). No history of structural heart disease was documented in these four subjects. During 6.8 ± 1.0 years of follow‐up, no episode of unexpected sudden death, syncopal attack, and fatal arrhythmia occurred.
Conclusions: The prevalence of Brugada‐type ECG in a juvenile population was extremely low. To investigate when the typical Brugada‐type ECG might be manifested, it could be necessary to check ECGs after adolescence.
Detection of the Defibrillation Threshold Using the Upper Limit of Vulnerability Following Defibrillator Implantation
Authors: KIRILMAZ ATA , DOKUMACI BARBAROS , UZUN MEHMET , KILICASLAN FETHI , DINCKAL M. HAKAN , YUCEL OZCAN , KARACA MUSTAFA 
Published: June 2005

Objective: This study was designed to test defibrillation threshold (DFT) with the least number of fibrillation inductions using upper limit of vulnerability (ULV) and to describe the most practical set of ICD during DFT following implantation.
Background: Although the correlation between ULV and DFT has been well described, there has been no uniform DFT testing protocol taking the advantage of ULV after defibrillator (ICD) implantation.
Methods: A total of 26 patients undergoing a new ICD implantation had a DFT induced with scanned T wave shock. The hypothesis that ventricular fibrillation (VF) could be defibrillated with 5 J higher than the highest T wave shock needed to induce VF or with 10 J if the T wave shock needed to induce VF was less than 5 J, was tested and 20 patients fulfilled these criteria. The methodology is improved by detecting peak T wave with 12‐lead ECG, applying biphasic T wave shock and scanning the T wave shock in a wider window.
Results: Five patients in the first group (n = 15) and one patient in the second group (n = 11) did not fulfill the above hypothesis. The common features of six patients who did not fulfill the hypothesis were that T wave shock needed to induce VF was either under 5 J (5 patients) or high (1 patient).
Conclusion: This study revealed the importance of methodology in studies regarding ULV and DFT. Following ICD implantation, we propose the first biphasic T wave detected by 12‐lead ECG and rescue shock set at 10 and 15 J, respectively. If any of the scanned T wave (40 ms before and 40 ms after the peak T wave with decrements and increments of 20 ms) shocks could not induce VF, then the T wave and the first rescue shock should be set at 5 and 10 J, respectively. If the induction of VF has been unsuccessful with T wave shock at 5 J, then a safe defibrillation with 10 J should be expected in majority.
Use of Preshaped Sheath to Plan and Facilitate Cannulation of the Coronary Sinus for the Implantation of Cardiac Resynchronization Therapy Devices: Preshaped Sheath for Implantation of Biventricular Devices
Authors: AL‐KHADRA AYMAN S. 
Published: June 2005

Objectives: The aim of the study is to describe a new technique for facilitating the implantation of cardiac resynchronization therapy (CRT) devices.
Background: CRT, by simultaneous pacing of the right and left ventricles has proven to be a useful treatment for patients with advanced heart failure and left ventricular (LV) systolic dysfunction, who have concomitant LV dyssynchrony. One of the greatest challenges to the wide applications of this therapy has been the technical difficulty encountered with implantation of the left ventricular lead. This is mainly due to the varied anatomy of the coronary venous system, which is further complicated by distortion of the anatomy in patients with advanced heart failure.
Methods: Details of the coronary venous anatomy are initially assessed by cannulating the coronary sinus (CS) using a specialized long preshaped sheath introduced from the femoral approach. Occlusive venography is performed in three views, and then the guide wire or the deflated balloon catheter is left in the CS for guidance. The most suitable equipment for the anatomy is chosen. Then, the operative site is prepped and the CS is approached from above.
Results: From November 2003 until December 2004, we have used this approach on all patients presenting for CRT device implantation at Prince Sultan Cardiac Center (n = 25). The CS was cannulated using the preshaped catheter in less than 5 minutes in all cases. After delineation of the anatomy, successful CRT implantation was achieved in all patients. Mean procedure time for the implantation was 110 ± 18 minutes. Uncomplicated minor CS dissection related to the use of the preshaped sheath was observed in 1 patient without consequences.
Conclusions: The use of preshaped sheath from the femoral approach facilitates planning the successful and safe implantation of CRT systems.
Intracardiac Ultrasound Detection of Thrombus on Transseptal Sheath: Incidence, Treatment, and Prevention
Authors: MALEKI KATANEH , MOHAMMADI REZA , HART DAVID , COTIGA DELIA , FARHAT NADA , STEINBERG JONATHAN S. 
Published: June 2005

Background: Transseptal (TS) catheterization is used for left atrial (LA) ablation procedures and a major risk is thromboembolism. The purpose of this study was to assess (1) the value of intracardiac ultrasound (ICUS) monitoring during LA ablation procedures, and (2) a new technique to reduce the risk of thrombus formation. Methods and Results: One hundred and eighty consecutive patients underwent TS catheterization under ICUS guidance with two sheaths for atrial fibrillation ablation and one for other LA procedures. Group I included the initial 90 patients in whom TS sheaths were flushed with a standard 2 U/cc concentration of heparin; group II consisted of the next 90 patients in whom sheaths were flushed with 1,000 U/cc concentration. All patients received bolus and infusion of heparin to maintain ACT between 250–300 seconds. ICUS was monitored throughout. In group I, echodense material at the tip of the sheath consistent with thrombus was observed on ICUS in 8 of 90 patients (9%) within 5–15 minutes of entering the LA. In group II, only 1 of 90 patient (1%) demonstrated thrombus (P < 0.001). There were no significant clinical differences in group I patients with and without thrombus. In all nine patients, the clot was removed with vigorous aspiration. No patients suffered a neurological event. Conclusion: Thrombus formation on TS sheath, detected by ICUS, may be more common than expected despite adequate anticoagulation. Using a higher concentration of heparin for the TS system before deployment reduced the risk. The thrombus was retrieved with aspiration without the need to abort the procedure.
Esophageal Temperature Monitoring During Radiofrequency Ablation of Atrial Fibrillation
Authors: REDFEARN DAMIAN P. , TRIM GEOFFREY M. , SKANES ALLAN C. , PETRELLIS BASILIOS , KRAHN ANDREW D. , YEE RAYMOND , KLEIN GEORGE J. 
Published: June 2005

Introduction: Ablative strategies for atrial fibrillation have centered on the left atrium, in particular the pulmonary veins. An emphasis on ablating outside the ostia of the pulmonary veins appears to have reduced the risk of pulmonary vein stenosis. Unfortunately, ablation in the posterior left atrium has been reported to result in fatal atrio‐esophageal fistula. Methods and Results: We monitored esophageal temperatures in 16 consecutive patients undergoing atrial fibrillation ablation. There were 14 men and 2 women; average age 54.7 ± 10.6 years. Eight patients had a lasso‐guided pulmonary isolation procedure, eight an electroanatomically guided left‐atrial circumferential approach. A commercially available esophageal temperature probe (Mallinckrodt Mon‐a‐therm 12F Esophageal Stethoscope with Temperature Sensor, Thermistor 400 Series) was positioned under general anesthesia. Temperature changes were noted and related to the relative location of the ablation catheter and the temperature probe during the temperature change. The esophagus was midline in three, right sided in three, and left sided in the remaining patients. Temperature rises could be recorded at the posterior aspect of any pulmonary vein. Detailed analysis of six patient maps revealed heating occurred with lesions created within 1 cm of the esophagus. Conclusion: The location of the esophagus relative to the back of the left atrium displays considerable variability. It is rarely midline and most often lies in close proximity to the left‐sided veins. Ablation in close radiographic proximity (approximately 1 cm) to the esophagus as defined by a radio‐opaque temperature probe can result in heating at the esophageal lumen.
Human Endometrial Epithelial Cells (EEC) Constitutively Express More Intercellular Adhesion Molecule (ICAM)‐1 than Endometrial Stromal Cells (ESC) in Culture
Authors: Defrère Sylvie , Van Langendonckt Anne , Moulin Pierre , Befahy Philippe , Gonzalez Dolores , Martinez‐Madrid Belen , Dolmans Marie‐Madeleine , Donnez Jacques 
Published: June 2005

Problem:  Intercellular adhesion molecule‐1 (ICAM‐1) is thought to play an important role in pathophysiological processes in endometrial tissue. The aim of this study was to quantify and compare the expression of ICAM‐1 mRNA and protein in cultured endometrial epithelial cells (EEC) versus endometrial stromal cells (ESC).Method of study:  EEC and ESC were isolated from human endometrium and cultured. At confluency, ICAM‐1 mRNA was measured by real‐time reverse transcriptase‐polymerase chain reaction, the membrane‐bound form (mICAM‐1) by immunocytodensitometry, and the soluble form (sICAM‐1) by enzyme‐linked immunosorbent assay.Results:  At the transcriptional level, we observed a 1.7‐fold increase in ICAM‐1 expression in EEC versus ESC. mICAM‐1 immunostaining in EEC [cell‐relative membrane‐bound signal‐specific optical density (CR‐M‐SOD): 0.056 ± 0.05] was stronger (P < 0.05) than in ESC (CR‐M‐SOD: 0.009 ± 0.07). EEC were found to secrete more (P < 0.01) sICAM‐1 ([sICAM‐1] = 15.59 ± 2.96 ng/mL) than ESC ([sICAM‐1] = 5.14 ± 2.61 ng/mL).Conclusions:  Cultured EEC constitutively express significantly more ICAM‐1 mRNA and protein than ESC.