bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychosexual health 5 years after hysterectomy: population‐based comparison with endometrial ablation for dysfunctional uterine bleeding
Authors: McPherson Klim , Herbert Aleks , Judge Andrew , Clarke Aileen , Bridgman Stephen , Maresh Michael , Overton Chris 
Published: August 2005

AbstractBackground  We report a population‐based comparison of psychosexual health 5 years after contrasting amounts of surgical treatments for heavy periods [dysfunctional uterine bleeding (DUB)]. Women's fears about sexual function after hysterectomy might not be unfounded. The psychosexual problems may return and/or develop with time. The removal of ovaries at the time of hysterectomy is associated with greater deterioration of self‐reported sexual function. Surgical menopause significantly impairs sexual wellbeing. We failed to observe uniform beneficial effects of hormone replacement therapy (HRT) on reported psychosexual health.Objective  To compare self‐reported bothersome sexual function; loss of interest in sex, difficulty in becoming sexually excited and vaginal dryness 5 years after surgical management of DUB [transcervical endometrial resection/ablation (TCRE) or subtotal and total hysterectomy, with and without prophylactic bilateral oophorectomy (BO)].Design  Prospective cohort study up to 5 years post‐surgery for DUB, TCRE or hysterectomy, with or without BO.Setting  Over 400 NHS and private hospitals in England, Northern Ireland and Wales.Cohort  Of 11 325 women who responded to the 5‐year questionnaire, over 9500 (84%) were valid cases, and over 8900 (94%) did complete the questions relating to psychosexual function. Most were between the ages of 39 and 45 years, married or cohabiting.Main outcomes  Self‐reported experience of bother, recorded as ‘some’, ‘severe’ and ‘extreme’, to questions on (1) libido loss, (2) difficulty with sexual arousal, and (3) vaginal dryness during the past 4 weeks, 5 years after surgery.Results  Five years after surgery for DUB, the crude and adjusted prevalence of psychosexual problems was higher after hysterectomy than after TCRE. Amongst the women with concurrent BO, the age‐ and HRT‐adjusted odds ratios for extreme psychosexual problems were increased by 80% (libido loss), 82% (difficult sex arousal) and 69% (vaginal dryness) compared with TCRE.Conclusions  Five years after hysterectomy more women reported having bothersome psychosexual function than did the women who had a less invasive operation. Hormone therapy, although related to surgical method, did not reduce this long‐term detrimental effect. The odds were particularly high amongst women with concurrent BO. Women should be advised that they might be at higher risk of psychosexual problems following hysterectomy, compared with a less invasive procedure.
Structural changes in calcium‐binding allergens: use of circular dichroism to study binding characteristics
Authors: Hebenstreit D. , Ferreira F. 
Published: August 2005

Background:  Several studies showed that calcium‐binding proteins have a fixed place in the spectrum of allergenic substances. Often the binding of a calcium ion induces conformational changes and affects immunoglobulin E‐binding to the allergen. Hence, the quantitative characterization of the binding to calcium is of importance to understand both the biologic and allergenic activity of these proteins.Aims of the study:  In the present study we describe a procedure for determining the stoichiometry and dissociation constant (KD) of calcium‐binding allergens using circular dichroism (CD) techniques. For the experiments, we used recombinant Bet v 4, a two EF‐hand allergen from birch pollen.Methods:  Solutions of Bet v 4 were titrated with calcium and the change in molar ellipticity at 222 nm was monitored with a CD spectropolarimeter.Results:  The determination of the binding stoichiometry as well as of the KD for one EF‐hand (4 μM) demonstrated the applicability of the method.Conclusions:  CD‐monitored calcium‐titration of protein solutions represents a fast and easy method for determining the binding characteristics of calcium‐binding allergens.
Use of a single silastic chest drain following thoracotomy: initial evaluation
Authors: Kejriwal Nand K. , Newman Mark A. J. 
Published: August 2005

Background:  It is standard practice to use multiple large bore semi‐rigid chest tubes to drain the pleural cavity following thoracic procedures. These can cause pain and discomfort at the insertion site.Methods:  We describe our experience with the use of a single small silastic drain following thoracotomy. From November 2001 to November 2003, size19‐F silastic chest tubes (Blake drains) were used for drainage of the pleural cavity in 37 patients at our institution. The patients ranged in age from 18 to 81 years (mean 65). The operations included 22 lobectomies, two bilobectomies, 10 wedge resections, and three other procedures.Results:  Total drainage in each patient ranged from 420 to 5440 mL (mean 1387 mL). Tubes were left in place for an average of 4.3 days (range 1−12). The average postoperative length of stay was 7.6 days (range 3−44, median 5). Three patients required insertion of an additional tube for dislodgement, persistent air leak, and bronchopleural fistula, respectively. These complications occurred among the first 15 patients in the present series. None of the patients had persistent pleural effusion. Subjectively, these tubes were more comfortable for the patients and were easier to remove.Summary:  The use of a single, small silastic chest drains following thoracotomy may be safe and effective in draining both fluid and air, though an additional tube may be necessary for persistent leaks.
Internal mammary node metastasis from primary cutaneous melanoma on the anterior chest
Authors: Thompson John F. , Uren Roger F. , Saw Robyn P. M. , Stevens Graham N. 
Published: August 2005

Background:  Direct lymphatic drainage from the skin of the anterior chest and breast to internal mammary lymph nodes does not normally occur.Methods:  Preoperative lymphoscintigraphy was performed in a 55‐year‐old man with a 3.7 mm‐thick primary melanoma on his right anterior chest, who had undergone surgery and radiotherapy to successfully treat a localized lymphosarcoma in his right axilla 35 years earlier.Results:  The sentinel node in the lower right internal mammary chain, in the 5th interspace, was removed at the same time as the primary melanoma site was widely excised, and micrometastatic melanoma was subsequently identified in it. Second‐tier nodes in the 4th and 3rd right interspaces were therefore removed, and adjuvant radiotherapy was given to the entire internal mammary node chain.Conclusions:  This case demonstrates that major disturbance of normal lymphatic drainage pathways can result from previous surgery and/or radiotherapy. Also, the rarity of this drainage pattern indicates that attempts to identify sentinel nodes in breast cancer patients by injecting tracer into the skin overlying a tumour rather than into the breast tissue immediately adjacent to it are likely to be inaccurate in some patients, because cutaneous injection will not demonstrate the sentinel nodes in the internal mammary chain that are present in up to 40% of patients with a breast cancer.
Digital ultraviolet reflectance photography can be used to quantify improvements in photodamage
Authors: Freedman B M , Earley R V , Balakrishnan T P 
Published: August 2005

SummaryObjective  Increasing attention has focused on the treatment and reversal of ultraviolet‐ induced photodamage. This study was designed to determine whether ultraviolet reflectance photography could quantify the clinical effects of erbium:YAG laser resurfacing on photoaged skin.Methods  Twenty patients (ages 46–67) with moderate to severe photodamage underwent dual‐mode variable pulsed erbium:YAG laser facial resurfacing. Pretreatment and post‐treatment evaluations at 3 and 6 months were performed clinically and photographically with white and ultraviolet reflectance photography.Results  Image conversion of the ultraviolet reflectance imaging data demonstrated an average of 36% and 42% reduction in photodamage at 3 and 6 months, respectively. This correlated well with the wrinkle reduction and correction of dyspigmentation observed in all patients following laser resurfacing. Histologic examination confirmed a thicker, more orderly epidermis and dermal collagen remodeling after treatment.Conclusion  Reduction in photodamage using the dual‐mode variable pulsed erbium:YAG laser can be quantitatively measured with ultraviolet reflectance photography using digital imaging. This model should prove useful in developing treatment regimens for photodamage.
Carbamazepine‐Induced Tics
Authors: Robertson Patricia L. , Garofalo Elizabeth A. , Silverstein Faye S. , Komarynski Mary Ann 
Published: August 2005

Summary:A variety of movement disorders are known to occur in association with carbamazepine (CBZ) therapy in adults and children, but development of tics has been described infrequently and only in patients with underlying Tourette's syndrome or other movement disorders. We report 3 children with epilepsy who developed facial motor tics after initiation of CBZ for complex partial seizures. All 3 had documented CBZ blood levels in the therapeutic range at the time, and none had other symptoms or signs of clinical intoxication. Neurologic examinations were normal in 2 and showed developmental de lay of expressive language in the third. Brain imaging was normal in all. After development of the tics in 2, CBZ was continued at the same or higher dose, and the tics abated and then ceased spontaneously ≤6 months. In the third child, the tics ceased after CBZ discontinuation. These cases demonstrate that CBZ can induce simple motor tics in children. These idiosyncratic reactions may be transient and do not always necessitate drug discontinuation.
Change in Neurotrophins and Their Receptor mRNAs in the Rat Forebrain After Status Epilepticus Induced by Pilocarpine
Authors: Mudò Giuseppa , Jiang Xing H. , Timmusk Tõnis , Bindoni Mauro , Belluardo Natale 
Published: August 2005

Summary:We studied the effects of status epilepticus (SE) induced by lithium chloride/pilocarpine treatment on gene expression of neurotrophins of the nerve growth factor (NGF) family and of their high‐affinity receptors of the tyrosine protein kinase (trk) family in the forebrain. Using in situ hybridization (ISH), we demonstrated an early (3 h after treatment) increase in brain‐derived neurotrophic factor (BDNF) and trkB mRNA expression in the dentate gyrus, amygdala, and piriform cortex, as well as widespread increases in the cerebral cortex. NGF mRNA, but not the mRNA of its receptor trkA, was increased in the dentate gyrus. In contrast, 12 h after treatment, neurotrophin‐3 (NT‐3) decreased, and its receptor trkC mRNA increased. There was no change in NT‐4 mRNA levels. All changes were blocked by pretreatment with scopolamine, a muscarinic antagonist. The noncompetitive N‐methyl‐aspartate (NMDA) antagonist ketamine blocked NGF, BDNF, and trkB mRNA increases in the hippocampus and cerebral cortex, but not in the amygdala and piriform cortex. In contrast, ketamine did not affect NT‐3 and trkC changes. These results provide a complete description of changes in mRNA levels of neurotrophins and their receptors in the forebrain after SE and supply additional data supporting the view that neurotrophin gene expression is related to abnormal neuronal activity.
Relation of Cocaine Use to Seizures and Epilepsy
Authors: Koppel Barbara S. , Samkoff Lawrence , Daras Michael 
Published: August 2005

Summary: Purpose: Cocaine can provoke seizures, exacerbate a preexisting seizure disorder, or cause an ischemic or hemorrhagic stroke that leads to seizures. To determine the importance of cocaine use in patients with and without epilepsy, we studied these relations and other risk factors for seizures and the mode of cocaine use.Methods: We reviewed all charts of emergency department visits and hospitalizations of patients with discharge diagnoses simultaneously listing seizures, epilepsy, and cocaine use during a 24‐month period. Data collected included patient age, sex, route of cocaine use, seizure description and duration of epilepsy, provocative factors, results of electroencephalography and computed tomography, treatment, and outcome.Results: Of 67, 668 adult emergency department visits and 25, 768 adult admissions, 1, 900 were cocaine related, and 58 of these also had seizures or epilepsy. Seizure occurrences were approximately equally distributed among groups with idiopathic epilepsy, remote symptomatic localization‐related epilepsy, cerebrovascular disease, and acute symptomatic seizures due to cocaine use alone. Less frequently, seizures were cryptogenic or symptomatic of metabolic abnormalities.Conclusions: Cocaine use can reduce seizure threshold in patients with underlying epilepsy as a direct toxic effect or indirectly by contributing to poor compliance with antiepileptic drug treatment, poor diet, or poor sleep habits. In 12 of the 58 patients, cocaine appeared to be the only provocative factor. This may be a less significant risk factor for epilepsy than either alcohol or head trauma.
Benzodiazepine Antagonists Reduce Epileptiform Discharges in Rat Hippocampal Slices
Authors: Polc Petar , Jahromi Shokrollah S. , Facciponte Giovanni , Pelletier Marc R. , Zhang Liang , Carlen Peter L. 
Published: August 2005

Summary: Purpose: The antiepileptic effects of benzodiaze‐pine‐receptor (BZR) agonists have been well documented. Surprisingly, an antiepileptic effect for the BZR antagonist, fluma‐zenil, has also been described, the mechanism of which is unknown. We investigated the effects of nanomolar concentrations of flumazenil and a structurally dissimilar BZR antagonist, propyl‐β‐carboline‐3‐carboxylate (β‐CCP), on normal synaptic responses and epileptiform discharges induced by a variety of methods in the CA1 region of rat hippocampal slices. Methods: Extracellular field potentials were recorded from stratum pyramidale of the CA1 region. Orthodromic stimulation was delivered by a bipolar electrode placed in the stratum radiatum at the border of the CA2/KA3 regions. Drugs were bath applied, and epileptiform discharges were quantified by using the Coastline Bursting Index, which calculates the total length of the discharge waveform of evoked multiple population spikes. For statistical comparisons, we calculated the Coastline Bursting Index for the average of five traces at the end of the control period (20 min), drug application (20 min), and washout (20–40 min). Results: Flumazenil was without effect on normal synaptic responses; however, flumazenil reduced epileptiform discharges evoked in the presence of high [K+]0, leu‐enkephalin, the BZR inverse agonist, methyl‐6,7‐dimethoxy‐4‐ethyl‐β‐carboline‐3‐carboxylate (DMCM), or after a cold‐shock procedure. β‐CCP exhibited an action similar to that observed for flumazenil, suggesting that the antiepileptic effect is due to properties common to BZR antagonists. Conclusions: We suggest that the antiepileptic effect we observed for flumazenil and (β‐CCP is mediated at the BZR and might be due to competition with endogenous BZR inverse agonists released preferentially during epileptiform activity.
Nocturnal Penile Tumescence and Rigidity Evaluation in Men with Epilepsy
Authors: Guldner Gregory T. , Morrell Martha J. 
Published: August 2005

Summary: Purpose: Men with epilepsy appear to have an approximately fivefold increase in risk of erectile dysfunction (ED). We attempted to determine whether ED in men with epilepsy was due to a physiological basis and whether erectile function could be adequately evaluated with an ambulatory nocturnal penile tumescence and rigidity monitor. Methods: The physiologic integrity of the sexual response in men with epilepsy and ED was assessed with an ambulatory nocturnal penile tumescence and rigidity monitor (NPTR). Six men with localization‐related epilepsy of temporal lobe origin (TLE) and ED, 2 men with TLE and normal sexual function, and 1 man with nonepileptic seizures (NES) and ED underwent evaluation of nocturnal erections for at least 2 nights. Results: Five of 6 men with TLE and complaints of ED had abnormal ambulatory NPTR evaluations. All others had normal ambulatory NPTR. All abnormal evaluations showed reduced levels of rigidity, often with normal levels of tumescence. Conclusions: Previous studies have shown this abnormal ambulatory NPTR pattern to be associated with neurogenic rather than vasogenic ED. Therefore, epilepsy‐related ED may have a substantial neurophysiologic component.
Validation of the Wechsler Memory Scale‐Revised in a Sample of People with Intractable Temporal Lobe Epilepsy
Authors: Moore Pascale M. , Baker Gus A. 
Published: August 2005

Summary: Purpose: The Wechsler Memory Scale‐Revised (WMS‐R) is used routinely for presurgical assessment of memory for patients considering elective resection of the temporal lobe and/or hippocampus for the relief of intractable temporal lobe epilepsy (TLE). We investigated the validity of the WMS‐R in a population of people with TLE. Methods: The sample consisted of 138 patients with a diagnosis of TLE in which the epileptogenic focus was clearly and exclusively lateralized to either the right or left hemisphere. They underwent a complete neuropsychological examination as a routine part of their investigation for epilepsy surgery. Psychometric scores included in this study were: Wechsler Adult Intelligence Scale‐Revised (WAIS‐R) I.Q. scores, National Adult Reading Test Revised (NART‐R) predicted‐I.Q. scores, and WMS‐R Memory Index and subtest scores. Results: Multiple univariate analyses were performed. The group with left temporal focus had significantly lower Verbal Memory Index, Logical memory (both immediate and delayed), and Digit Span scores. Visual/Verbal discrepancy scores incorrectly identified most patients with right temporal focus. Analyses of a total group of people with epilepsy (i.e., mixed temporal, frontal, occipital and unknown foci) as compared with the normative sample indicated that the patient group scored significantly lower across all memory index scores and most memory subtests. Conclusions: Our results confirm that the WMS‐R is capable of lateralizing to left hemispheric impairment but is more problematic in the assessment of right hemispheric impairment. The Visual/Verbal Memory Index discrepancy has questionable validity. People with epilepsy performed less well on the WMS‐R than did the normative sample. The need for reliable and valid nonverbal tests of memory is therefore warranted.
Bilateral Hippocampal Volume Loss in Patients with a History of Encephalitis or Meningitis
Authors: Free S. L. , Li L. M. , Fish D. R. , Shorvon S. D. , Stevens J. M. 
Published: August 2005

Summary:Volumetric analysis of high‐quality magnetic resonance imaging (MRI) scans identifies asymmetric hippocampal atrophy in most patients with temporal lobe epilepsy. However, bilateral hippocampal atrophy can be missed by unnormalized volume measures. We considered two patient groups with temporal lobe epilepsy, one with a history of febrile convulsions (FC, n = 14) and one with a history of encephalitis or meningitis (E/M, n = 12), to compare the prevalence of bilateral volume loss between the groups. A volume normalization process defines a normal range of hippocampal volumes in control subjects (n = 32). Normalized volumes indicated that 11 of 14 subjects with a history of FC had unilateral hippocampal atrophy and 9 of 12 subjects with a history of E/M had bilateral hippocampal atrophy as compared with the controls. Visual assessments of unilateral hippocampal atrophy (n = 17) correlated well with measured unilateral volume loss (n = 14), but visual assessment of bilateral hippocampal atrophy (n = 3) correlated poorly with measured bilateral volume loss (n = 12). Mean age at seizure onset was lower in the FC group (7 years) than in the E/M group (13 years), but other clinical features were similar between the two groups. Hippocampal volume normalization is necessary to detect bilateral volume loss, which is common in patients with a history of encephalitis or meningitis.
Felbamate‐Induced Headache
Authors: Ettinger Alan B. , Jandorf Lina , Berdia Ajay , Andriola Mary R. , Krupp Lauren B. , Weisbrot Deborah M. 
Published: August 2005

Summary:We prospectively investigated drug‐induced headaches (HA) among 60 epileptic patients receiving felbamate (FBM). Twenty patients (33%) experienced HA. HA was pounding in 11 (55%), steady in 9 (45%), moderate or severe in 19 (95%), occurred at least once a week in all patients, and was relieved by nonnarcotic analgesics in 14 (70%). Mean duration on FBM before HA onset was 19 days. HA occurred with higher FBM doses and was relieved in 8 of 13 patients (62%) with FBM dose reduction. FBM was discontinued in most cases because of risks of anemia or hepatitis; not because of HA. Other side effects included insomnia (25%), gastrointestinal symptoms (27%), and agitation or restlessness (23%). HA is a common dose‐related complication of FBM, occurs early after initiation of FBM treatment, and is relieved by dose reduction.
Competitive NMDA‐Receptor Antagonists, LY 235959 and LY 233053, Enhance the Protective Efficacy of Various Antiepileptic Drugs Against Maximal Electroshock‐Induced Seizures in Mice
Authors: Borowicz Kinga K. , Gasior Maciej , Kleinrok Zdzislaw , Czuczwar Stanislaw J. 
Published: August 2005

Summary: Purpose: The objective of this study was to evaluate an interaction of two competitive N‐methyl‐D‐aspartate (NMDA)‐receptor antagonists, LY 235959 [(‐)‐3R,4aS,6R,8aR‐6‐(phosphonomethyl)‐decahydroiso‐quinoline‐3‐carboxylic acid; 50.5 mgikg] or LY 233053 [cis‐(±)‐4–[(2H‐tetrazol‐5–yl) methyl] piperidine‐2‐carboxylic acid; 5 mg/kg] with carbamazepine, diphenylhydantoin, phenobarbital, or valproate magnesium against maximal electroshock‐induced convulsions in mice. Methods: Electroconvulsions were produced by means of an alternating current (ear‐clip electrodes, 0.2‐s stimulus duration, tonic hindlimb extension taken as the end point) delivered by a Hugo‐Sachs stimulator (Type 221, Freiburg, FRG). Adverse effects were evaluated in the chimney test (motor performance) and passive‐avoidance task (long‐term memory). Plasma levels of antiepileptic drugs were measured by immunofluorescence. Results: Both LY 235959 and LY 233053 (=0.5 and 5 mg/kg, respectively) did not influence the electroconvul sive threshold but potentiated the anticonvulsant action of all antiepileptics studied. The combined treatment of LY 233053 (5 mg/kg) with carbamazepine, diphenylhydan‐toin, or phenobarbital (providing a 50% protection against maximal electroshock) resulted in the impairment of long‐term memory. No adverse effects were observed with combinations of LY 235959 with these antiepileptics. The combined treatment of valproate with either LY 235959 or LY 233053 was superior to valproate alone, as regards motor impairment, but not the impairment of long‐term memory. Neither NMDA‐receptor antagonist elevated the total plasma levels of antiepileptic drugs studied. Conclusions: It may be concluded that NMDA‐receptor blockade leads to the enhanced anticonvulsive action of conventional antiepileptics against maximal electroshock‐induced seizures. A pharmacokinetic interaction does not seem probable.