bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tonic–Absence Seizures: An Underrecognized Seizure Type
Authors: Shih Tina T. , Hirsch Lawrence J. 
Published: March 2003

Summary:  Purpose: The individual electroclinical patterns—tonic seizures with generalized paroxysmal fast activity (GPFA, activity >13 Hz), and absence seizures with generalized slow spike‐and‐wave activity (GSS&W, <3 Hz)—have been extensively described in the literature. However, only passing reference was made to the pattern of GPFA followed by GSS&W. In addition, these descriptions were formulated in the pre‐EMU (Epilepsy Monitoring Unit) era, without benefit of video/clinical correlation. We now characterize this underrecognized seizure type.Methods: We retrospectively reviewed the data from eight patients with seizures that demonstrated this stereotyped EEG and clinical pattern.Results: We identified eight patients (six female patients; age 6–29 years; age at seizure onset, neonate to 10 years) who were evaluated at the Columbia University Epilepsy Monitoring Units between 1993 and 2002. All eight had an International League Against Epilepsy (ILAE) diagnosis of symptomatic generalized epilepsy, with six of eight manifesting multiple seizure types, six of eight with mild static encephalopathy, and two with normal cognition. A total of 29 seizures of this pattern was recorded; 26 of 29 seizures demonstrated GPFA (frequency between 14 and 30 Hz, lasting 2–8 s) followed by GSS&W (frequency range between 1 and 2 Hz, lasting 3–50 s). The predominant clinical correlate was bilateral tonic activity followed by a period of inattentiveness. In general, these seizures were differentiated from the patient's typical tonic seizures by this protracted period of impaired attentiveness.Conclusions: We describe a heretofore underrecognized and poorly characterized seizure type in patients with symptomatic generalized epilepsy, which we have termed tonic–absence seizures. Clinically and electrographically, this consists of a tonic seizure with GPFA followed by an absence seizure with GSS&W.
Glutamatergic Modulation of GABAergic Signaling Among Hippocampal Interneurons: Novel Mechanisms Regulating Hippocampal Excitability
Authors: Kullmann Dimitri M. , Semyanov Alexey 
Published: March 2003

Summary:  Purpose: Because interneurons play a central role in regulating the excitability of the hippocampal formation, it is important to understand the mechanisms that modulate γ‐aminobutyric acid (GABA)ergic signaling among them. This study addresses the modulation of GABA release from interneuron terminals by presynaptic glutamate receptors.Methods: Whole‐cell recordings were obtained from CA1 stratum radiatum interneurons in guinea pig hippocampal slices. Selective agonists and blockers of glutamate receptors were used to study modulation of GABAergic transmission by group III metabotropic receptors or kainate receptors. Antidromic action‐potential initiation also was analyzed by stimulating the axons of interneurons.Results: Agonists of group III metabotropic glutamate receptors attenuated monosynaptic GABAergic signals in interneurons, but not in pyramidal neurons, in agreement with anatomic evidence on the distribution of these receptors. Submicromolar kainate enhanced the frequency and amplitude of spontaneous GABAergic signals in interneurons. Kainate also depolarized the axons of hippocampal interneurons, and triggered spontaneous ectopic action potentials in axons. Synaptically released glutamate reproduced many of the effects of both agonists, implying that these receptors can sense the ambient glutamate concentration, and therefore indirectly respond to the excitatory traffic in the hippocampus. When the two classes of receptors were stimulated simultaneously, complex interactions were obtained.Conclusions: Group III metabotropic receptors and kainate receptors profoundly affect GABAergic signaling among interneurons of the hippocampus. Glutamatergic modulation of GABAergic signaling among interneurons represents a novel class of mechanisms that potentially plays a major role in determining the initiation, propagation, and termination of seizures.
Short‐Term Effects of Pilocarpine on Rat Hippocampal Neurons in Culture
Authors: Priel M. R. , Albuquerque E. X. 
Published: March 2003

Summary:  Purpose: Status epilepticus (SE) has been considered an epileptogenic factor in humans. In the pilocarpine (PILO) model, after a brief period marked by SE, the rats exhibit recurrent spontaneous seizures, mimicking the clinical features of temporal lobe epilepsy. The aim of our study was to identify the molecular actions of PILO that could account for its ability to induce SE.Methods: Whole‐cell mode of the patch‐clamp technique was applied to cultured hippocampal neurons (2–3 weeks old) in the absence and in the presence of PILO (1–10 μM), to study the spontaneous activity, the evoked, and the miniature postsynaptic currents. The postsynaptic currents were isolated pharmacologically.Results: PILO (1 and 10 μM) caused an initial increase followed by a decrease in the frequency of spontaneous activity. The increase in the frequency of excitatory postsynaptic currents (EPSCs) and inhibitory PSCs (IPSCs) was blocked by atropine (1 μM), indicating that this effect is mediated through muscarinic receptors. PILO also promoted a brief increase of the amplitude of IPSCs indirectly evoked by stimulation of a neuron synaptically connected to the neuron under study. Conversely, PILO promoted a sustained increase on the amplitude of electrically evoked EPSCs. In presence of tetrodotoxin (TTX; 300 nM), PILO (1 μM) increased the frequency of miniature EPSCs and IPSCs without changing their amplitude during the first 3 min of application.Conclusions: These results indicate that PILO acting through muscarinic receptor causes an imbalance between excitatory and inhibitory transmission that can result in the generation of SE observed in animals acutely treated with PILO.
Upregulation of Cystatin C Expression in the Rat Hippocampus During Epileptogenesis in the Amygdala Stimulation Model of Temporal Lobe Epilepsy
Authors: Lukasiuk Katarzyna , Pirttilä Terhi J. , Pitkänen Asla 
Published: March 2003

Summary:  Purpose: Cystatin C is a cysteine proteinase inhibitor with widespread distribution in body fluids and tissues, abundant in the cerebrospinal fluid and in brain tissue. There is an implied role for cystatin C in several neurologic disorders, but the actual function of cystatin C in the brain remains unknown. Moreover, the reports on the distribution of cystatin C in the brain are controversial. We present the data on the distribution of cystatin C in normal brain tissue and during epileptogenesis.Methods: Epileptogenesis was triggered by inducing self‐sustained status epilepticus (SSSE) with a 20‐ to 30‐min electrical stimulation of the amygdala in rats. Animals were monitored continuously for 2 weeks with video‐EEG to ascertain that they were in an epileptogenic phase.Results: Analysis of double‐stained immunopreparations indicated that in normal brain, cystatin C is expressed mainly in microglia. In epileptogenic animals, immunostaining was increased in the microglia as well as in the neuropil at 4 days, 1 week, and 2 weeks after SSSE. Moreover, the density of cystatin C‐positive microglia was associated with the severity of neuronal damage in the CA1 subfield of the hippocampus.Conclusions: This is the first report linking cystatin C with epileptogenesis and epilepsy. Further studies will explore the potential neuroprotective functions of this protein during epileptogenesis and whether the manipulation of its expression or function will have therapeutic implications.
Clinical and Genetic Heterogeneity in Familial Temporal Lobe Epilepsy
Authors: Santos N. F. , Sousa S. C. , Kobayashi E. , Torres F. R. , Sardinha J. A. F. , Cendes F. , Lopes‐Cendes I. 
Published: March 2003

Summary:  Purpose: Familial forms of temporal lobe epilepsy have been described recently. A locus on ch 10q has been linked to partial epilepsy with auditory symptoms. We investigated the proportion of families segregating temporal lobe epilepsy (TLE) linked to ch 10q and sought to establish genotype–phenotype correlations.Methods: We studied 15 unrelated families segregating TLE. A total of 153 individuals, including 79 patients, were analyzed in this study. Family members were genotyped for four polymorphic dinucleotide repeat markers: D10S185, D10S574, D10S577, and D10S192, which flank the 15‐cM candidate interval on ch 10q. Two‐point lod scores were calculated for each family separately.Results: Fourteen of our families had ictal semiology of mesial temporal onset of seizures and magnetic resonance imaging (MRI) abnormalities in the mesial structures; only one family, with seven affected individuals, reported auditory symptoms and had normal MRIs. Pedigree analysis showed an autosomal dominant transmission with 0.75 penetrance. Only two families had informative lod scores. A large family, with 22 affected individuals segregating mesial TLE, had negative lod scores for all four markers genotyped. The lod scores were significantly negative (less than –2.00) up to 0.05 for D10S185, 0.10 for D10S574, 0.25 for D10S577, and 0.15 for D10S192. The single family with auditory symptoms had positive lod scores for all markers genotyped, with a Z max of 1.52 at 0.0 for D10S574.Conclusions: We identified two different clinical groups of families segregating TLE. Most families identified in this study had mesial TLE. Only one single family segregating lateral TLE was found. We significantly excluded linkage between familial mesial TLE and the locus on ch 10q. In addition, we showed evidence for linkage between one family with lateral TLE and markers on ch 10q. This is strong evidence for clinical and genetic heterogeneity among familial forms of TLE.
Behavioral, Morphologic, and Electroencephalographic Evaluation of Seizures Induced by Intrahippocampal Microinjection of Pilocarpine
Authors: De A. Furtado Marcio , Braga Glaucia K. , Oliveira José A. C. , Del Vecchio Flavio , Garcia‐Cairasco Norberto 
Published: March 2003

Summary:  Purpose: We studied, by means of video‐EEG and neo‐Timm histochemistry, the behavioral, electrophysiologic, and structural characteristics of seizures induced by intrahippocampal microinjection of pilocarpine (HIP‐PILO), a selective model of temporal lobe epilepsy (TLE).Methods: We investigated the behavioral and electrophysiologic (hippocampus and amygdala EEG) evaluation of status epilepticus (SE) induced by HIP‐PILO and the consequent spontaneous recurrent seizures (SRSs). We evaluated hippocampal structural rearrangements after SE by means of neo‐Timm staining.Results: HIP‐PILO induced SE in 17 (71%) of 24 animals. Although three animals displayed spontaneous remission of SE (not used in analysis) before the established SE duration (90 min), none of those undergoing SE died. Of SE animals, 10 (71%) of 14 had SRSs. All animals with SE had clear‐cut mossy fiber sprouting (MFS) in the inner molecular layer of the dentate gyrus and epileptiform activity in hippocampus and amygdala.Conclusions: HIP‐PILO rats displayed SE, SRS, MFS, and limbic epileptiform activity, without animal loss after SE. Thus, our data support this as a selective and efficient model of TLE.
DRGs in der Dermatologie: Erlösoptimierung durch Sicherung der Kodierqualität
Authors: Hensen Peter , Fiori Wolfgang , Juhra Christian , Irps Sebastian , Bunzemeier Holger , Schwarz Thomas , Luger Thomas , Roeder Norbert 
Published: March 2003

Zusammenfassung Hintergrund: Die sachgerechte Abbildung der Behandlungsfälle im DRG‐System stellt die Grundlage der Vergütung für die durchgeführte Behandlung in deutschen Krankenhäusern dar. Dies kann nur über eine ausreichend gute Kodierung der medizinischen Daten ermöglicht werden. Ziel der vorliegenden Studie war, den Einfluß einer kontrollierten Leistungsdokumentation auf die klinischen Patientendaten zu untersuchen und die Auswirkungen einer verbesserten Kodierqualität auf die theoretischen Ertragsvolumina im australischen AR‐DRG‐System zu ermitteln. Patienten und Methodik: Im Rahmen einer prospektiven Studie sind 1 914 Patientendatensätze einer dermatologischen Universitätsklinik nach Anwendung unterschiedlicher Dokumentationsstandards auf der Basis des AR‐DRG‐Systems V4.1 gruppiert und analysiert worden. Zur besseren Differenzierung des dermatologischen Behandlungsspektrums wurden die Patienten in elf Behandlungsgruppen eingeteilt, um gezielter Schwerpunkte aufzeigen zu können. Ergebnisse: Durch eine kontrollierte Leistungsdokumentation konnten Steigerungen von Casemix, Casemix‐Index und mittlerem PKKS‐Wert erzielt werden. Ebenso zeigte sich, daßüber gesteuerte Maßnahmen zur Optimierung der Kodierqualität langfristig die tatsächliche durchschnittliche Fallschwere einer Klinik abgebildet werden kann. Schlußfolgerungen: Unterschiedliche Dokumentationsstandards können drastische Auswirkungen auf die Erlössituation eines Krankenhauses haben. Unvollständige Leistungsdokumentation, Fehl‐ und Überkodierung stellen ein großes ökonomisches Risiko für ein Krankenhaus dar. Nur die Sicherstellung und Überwachung einer hohen Kodierqualität kann eine kostendeckende Erlössituation garantieren.
Treatment of scleromyxoedema with hydroxychloroquine
Authors: Terheyden Patrick , Becker Jürgen C. , Lurz Christa , Kahaly George J. , Bröcker Eva‐B. 
Published: March 2003

Summary Background: Scleromyxoedema is a rare disease of unknown aetiology that is characterized by deposition of mucin and sclerotic induration of the skin; it is associated with paraproteinaemia. Patients suffer from progressive disability due to immobilization and cosmetic disfigurement. Treatment of scleromyxoedema is a therapeutic challenge. The antimalarial hydroxychloroquine has a rapid and reliable effect in reticular erythematous mucinosis. Patients and methods: Four consecutive patients (two women, two men; median age: 50 years) with scleromyxoedema, three of them with IgG λ paraprotein, were treated with hydroxychloroquine. Treatment was initiated with 600 mg p. o. for 10 days, followed by 400 mg for at least 4 weeks, and 200 mg thereafter. Results: Complete remission of skin manifestations was achieved in one patient, whereas three patients achieved a partial remission of 61+, 5 and 25 months' duration. Notably, three patients felt increased mobility and reduced firmness of skin during the first week of treatment, which was reflected in a rapid reduction in dermal thickness. In one patient, dysphagia was reverted as evidenced by normalization of oesophageal clearance. Paraproteinaemia was not influenced at all. Side effects included one case of electroretinogram abnormalities after 19 months of therapy and one case of leucopenia after 3 months. Conclusion: Hydroxychloroquine is an effective form of therapy for scleromyxoedema, leading to rapid and prolonged alleviation of symptoms.
A normative and statistical approach to measuring classical horizontal inequity
Authors: Duclos Jean‐Yves , Lambert Peter J. 
Published: March 2003

A local measure of classical horizontal inequity (HI) in an income tax or tax‐benefit system is proposed and aggregated into a global index. This index expresses the revenue gain per capita that would come from eliminating HI welfare‐neutrally, and also reveals the loss of vertical performance, in terms of the Blackorby and Donaldson (1984) progressivity index, caused by the presence of HI. Non‐parametric estimation procedures that can be used to tackle the ‘identification problem’ are delineated. An application to the Canadian tax‐benefit system between 1981 and 1994 reveals the changing profile of local HI, its sources, and its aggregate significance. JEL Classification: C14, D31, D63, H23 Approche normative et statistique à la mesure de l'inéquité horizontale classique. Nous nous intéressons dans ce document au problème tenace de la mesure de l'inéquité horizontale. Nous proposons tout d'abord une mesure locale d'inéquité horizontale, que nous agrégeons ensuite en un indice global. A la différence d'autres approches, qui s'intéressent au gain en bien‐être social qu'il y aurait àéliminer l'inéquité horizontale en gardant constant le revenu de l'État, notre indice global mesure le gain fiscal per capita qui échoirait au gouvernement si l'inéquité horizontale était éliminée sans changement dans le niveau de bien‐être social. Lorsque ce gain fiscal est exprimé en proportion des revenus moyens nets, notre mesure constitue un élément (négatif) dans l'indice de progressivité de Blackorby et Donaldson (1984); elle quantifie alors la perte de performance verticale causée par un traitement fiscal discriminatoire vis‐à‐vis d'individus qui étaient égaux avant l'intervention de l'État. Notre ‐indice étant exprimé en unités monétaires, son interprétation est facile et intuitive. Nous proposons finalement des procédures d'estimation non‐paramétrique pour résoudre le problème important de l'identification des individus égaux dans une distribution de bien‐être. A notre connaissance, il s'agit d'ailleurs de la première solution statistiquement cohérente au problème classique de la mesure de l'inéquité horizontale. La méthode est appliquée à la distribution canadienne des revenus bruts et nets en 1981 et 1994, et révèle à la fois la variation du profil de l'inéquité horizontale le long des quantiles et son importance comme source de perte de progressivité et de redistribution. Nous décomposons aussi l'inéquité horizontale totale entre et à travers différents groupes socio‐économiques, et testons la sensibilité de ces estimés à la variabilitééchantillonnale ainsi qu'au choix d'échelles d'équivalence et d'intervalles des fonctions de noyaux.
Do stricter penalties deter drinking and driving? An empirical investigation of Canadian impaired driving laws
Authors: Sen Anindya 
Published: March 2003

In this paper I attempt to assess empirically the effects of Canadian impaired driving legislation enacted between 1976 to 1992. On average, penalties for impaired driving have limited impact on impaired driver fatalities. Instead, trends in impaired driver deaths are significantly correlated with the enactment of mandatory seatbelt legislation across provinces. Specifically, the implementation of mandatory seatbelt laws for drivers is significantly associated with a 27 per cent drop in impaired driver fatality rates. These findings suggest that more lives might be saved by focusing on initiatives aimed at enhancing vehicle safety. JEL Classification: H7, I1 Est‐ce que des punitions plus sévères découragent la conduite en état d'ébriété? Une étude empirique des lois canadiennes sur l'ivresse au volant. Ce texte tente de mesurer empiriquement les effets des lois sur l'ivresse au volant mises en place au Canada entre 1976 et 1992. En général, les punitions pour ivresse au volant ont eu un impact limité sur le nombre de décès de conducteurs en état d'ébriété. D'autre part, les tendances dans le nombre de décès de conducteurs en état d'ébriété sont reliées à la mise en place de législations obligeant le port de la ceinture de sécurité par les provinces. On peut dire que la mise en place de lois sur le port obligatoire de la ceinture de sécurité est associée à une chute de 27 pour‐cent dans le nombre de décès de conducteurs en état d'ébriété. Ces résultats suggèrent que beaucoup plus vies pourraient être épargnées en mettant l'accent sur des mesures qui amélioreraient la sécurité des véhicules.
Decomposing and Solving Timetabling Constraint Networks
Authors: Meisels Amnon , Ell‐sana Jihad , Gudes Ehud 
Published: March 2003

The binary version of the school timetabling (STT) problem is a real‐world example of a constraint network that includes only constraints of inequality. A new and useful representation for this real‐world problem, the STT_Grid, leads to a generic decomposition technique. The paper presents proofs of necessary and sufficient conditions for the existence of a solution to decomposed STT_Grids. The decomposition procedure is of low enough complexity to be practical for large problems, such as a real‐world high school.To test the decomposition approach, a typical high school was analyzed and used as a model for generating STT_Grids of various sizes. Experiments were conducted to test the difficulty of large STT networks and their solution by decomposition. The experimental results show that the decomposition procedure enables the solution of large STT_Grids (620 variables for a real school) in reasonable time. The constraint network of a typical STT_Grid is sparse and belongs to the class of easy problems. Still, due to the sizes of STTs, good constraint satisfaction problem search techniques (i.e., BackJumping and ForwardChecking) do not terminate in reasonable times for STT_Grids that are larger than 300 variables.
Empowerment, Performance, and Operational Uncertainty: A Theoretical Integration
Authors: Wall Toby D. , Cordery John L. , Clegg Chris W. 
Published: March 2003

L’accession au pouvoir est présentée comme une recette universelle pour améliorer la performance au travail. On défend ici l’idée qu’il existe déjà des arguments forts pour penser que cette conviction est des plus discutables, et que l’impact de la participation dépendra du degré de l’incertitude opérationnelle qui prévaut. Notre point de vue s’appuie sur une analyse des idées qui émergent conjointement de cinq domaines, à savoir les théories des organisations, la structuration du travail, le management “zéro défaut”, le management des facteurs humains et celui des ressources humaines. On met en évidence les conséquences théoriques et pratiques de nos investigations et certaines des pistes à suivre pour approfondir la réflexion.Empowerment is being promoted as a general recipe for enhancing work performance. We argue that there are already strong grounds for suggesting that this universalistic assumption is flawed, and that the effectiveness of empowerment practices will be contingent on the degree of operational uncertainty that prevails. This argument is supported by an analysis of ideas in common emerging from five different areas of inquiry, namely those concerned with organisational theory, work design, total quality management, human factors, and human resource management. We identify the theoretical and practical implications of our analysis, and some of the lines of investigation required to develop the ideas further.
Power Dynamics and Organisational Change: An Introduction
Authors: Munduate Lourdes , Bennebroek Gravenhorst Kilian M. 
Published: March 2003

Cet article propose un cadre conceptuel pour appréhender les dynamiques de pouvoir lors de changements organisationnels. Weick et Quinn (1999)établissent une distinction entre le changement épisodique, discontinu et intermittent, et le changement continu, évolutif et progressif. Après avoir discuté cette distinction, nous analysons comment les processus de l’influence et du pouvoir social peuvent constituer la base du changement continu. Les bases du pouvoir des agents du changement sont ensuite décrites. Puis nous portons notre attention sur les relations de pouvoir dynamiques entre les agents du changement et les cibles, ainsi que sur les processus sociaux qui facilitent le changement continu. L’article se termine par un survol des contributions à cette édition spéciale.This article offers a framework for understanding power dynamics in organisational change. Weick and Quinn (1999) make a distinction between change that is episodic, discontinuous, and intermittent, and change that is continuous, evolving, and incremental. After discussing this distinction, we analyse how processes of social power and influence can form the basis for continuous change. Subsequently, the power bases of change agents are described. Then we pay attention to the dynamic power relationships between change agents and targets as well as to the social processes that facilitate continuous change. The article ends with an overview of the contributions to this special issue.