bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of a Group‐Based Model of Disease Management for Headache
Authors: Maizels Morris , Saenz Valerie , Wirjo Jonathan 
Published: June 2003

Objectives.—To assess the impact of a group‐based model of disease management for patients with headache.Background.—Despite advances in the acute and preventive treatment of migraine, many patients with headache remain misdiagnosed and undertreated. Models of care that incorporate principles of disease management may improve headache care.Design and Methods.—This was a prospective, open‐label, observational study. Patients with headache were referred by physicians or identified from emergency department records. Patients attended a group session led by a registered nurse practitioner, and later had follow‐up consultation. Charts and computer records were reviewed to document triptan costs and headache‐related visits for 6 months before and after the intervention. Changes in headache frequency and severity were assessed.Results.—Triptan costs for 264 patients and chart review for 250 were available. Six‐month triptan costs increased $5423 (19%), headache‐related visits were reduced by 32%, and headache‐related emergency department visits were reduced by 49%. Severe headache frequency was reduced in 62 (86%) of 72 patients who initially had severe headaches more than 2 days per week. Patients identified by emergency department screening accounted for 21% of the study group, 31% of the baseline triptan costs, and 46% of the baseline visits. For the entire study group, reduced visits yielded a net savings of $18  757 despite increased triptan costs.Conclusions.—Implementation of this group‐based model produced a reduction in emergency department and clinic visits, significant clinical improvement, a small increase in pharmacy costs, and overall cost reduction. The greatest improvement in each outcome measure was seen in patients most severely afflicted at baseline. Our results suggest that the principles of disease management may be applied effectively to a headache population, with a positive financial impact on a managed care organization.
Reduced Impact of Migraine in Everyday Life: An Observational Study in the Dutch Society of Headache Patients
Authors: Vos J. , Passchier J. 
Published: June 2003

Objective.—To explore the percentage of patients who report a reduced impact of migraine on their life, and to which factors this improvement can be attributed.Methods.—Four hundred forty‐eight members of the Dutch Society of Headache Patients answered a set of structured questionnaires, including the Migraine‐Specific Quality of Life instrument (MSQOL).Results.—Of this group, 70% reported a reduced impact of migraine. The most frequently reported reason for this reduction was a change in medication (77%); in particular, change to a triptan. Other favorable factors included a change in life‐style (56%): 42% of patients reported more relaxed coping with migraine, a reduction of stress in general (28%) and of stress related to work (24%), and leading a more regular life‐style (21%). In addition, social support was frequently mentioned, particularly that offered by the Dutch Society of Headache Patients (58%), family (46%), and their general practitioner (28%). The patients who reported a reduced impact of migraine had less migraine attacks and a higher quality of life than those who did not report such a reduction.Conclusion.—The results confirm that factors that are proven effective in clinical trials on migraine also have these effects outside a formal experimental environment.
Visual Distortion Provoked by a Stimulus in Migraine Associated With Hyperneuronal Activity
Authors: Huang Jie , Cooper Thomas G. , Satana Banu , Kaufman David I. , Cao Yue 
Published: June 2003

Background.—Migraineurs with visual aura are highly susceptible to illusions and visual distortion and are particularly sensitive to a pattern of regularly spaced parallel lines or stripes.Purpose.—To determine whether the high degree of susceptibility to illusions and visual distortion in migraineurs with aura is associated with hyperneurological activity of the occipital cortex.Methods.—In order to investigate any relationships among neuronal activity, spatial frequency of square‐wave gratings, and self‐described visual distortion, we investigated the neuronal and psychophysical responses to square‐wave gratings in migraineurs with visual aura and in nonheadache controls.Results.—Square‐wave gratings provoked various types of visual distortion and illusions and induced a hyperneuronal response in the visual cortex of migraineurs with visual aura, a response that strongly depended upon the stimulus spatial frequency.Conclusion.—The hyperneuronal activity of the occipital cortex is consistent with general cortical hyperexcitability in migraine.
Clinical Characteristics of Patients With Comorbidity of Migraine and Epilepsy
Authors: Leniger Tobias , Von Den Driesch Sandra , Isbruch Katrin , Diener Hans Christoph , Hufnagel Andreas 
Published: June 2003

Objective.—Neuronal hyperexcitability might explain the comorbidity of migraine and epilepsy. Spreading depression, a postulated pathophysiological mechanism of epileptic seizures and migraine with aura, may hypothetically be the link between the disorders in these comorbid conditions. The aim of the present study was to determine whether certain clinical characteristics associated with spreading depression are overrepresented in patients with comorbidity.Methods.—In an outpatient clinic‐based series, clinical characteristics of 61 patients with a comorbidity of migraine and epilepsy were compared to those of 280 patients with epilepsy alone and 248 patients with migraine alone. Patients were interviewed with a standardized questionnaire.Results.—The proportion of females was significantly higher in patients with comorbidity and patients with migraine as compared to patients with epilepsy (P  <  .001). Comparing patients with epilepsy and comorbidity, the frequency of epilepsy syndromes and seizure types was not significantly different. Comparing patients with migraine and comorbidity, migraine with aura was significantly more frequent in patients with comorbidity (P  =  .019). Other migraine features such as moderate to severe pain intensity, worsening of pain on activity, phonophobia, and photophobia were significantly more frequent in patients with comorbidity as compared to patients with migraine (P  ≤  .001).Conclusion.—No specific epileptic characteristics could be found in patients with comorbidity. Altered cerebral excitability resulting in an increased occurrence of spreading depression may explain the differences in migraine attacks in patients with comorbidity as compared to patients with migraine alone.
Prolonged Benign Exertional Headache. The Vågå Study of Headache Epidemiology
Authors: Sjaastad O. , Bakketeig L. S. 
Published: June 2003

Objective.—To explore in detail the duration of exertional headache attacks and explicitly to identify cases of prolonged exertional headache.Background.—The prevalence of exertional headache in general population samples may exceed 10%. The prevalence and distinguishing clinical characteristics of prolonged exertional headache are not well delineated.Methods.—One author (O.S.) personally interviewed 1838 parishioners (88.6%) of ages 18 to 65 years living in a southern Norwegian commune. Questions relevant to exertional headache were included.Results.—As recently reported elsewhere, exertional headache was present in 12.3% of those questioned. With 1 hour set as a tentative border for short‐ versus long‐duration exertional headache, there were approximately equal numbers with short‐ and long‐lasting attacks; prevalence of short‐lasting attacks was 6.3% and long‐lasting attack prevalence was 6.0%. In regards to other epidemiologic and clinical features, the long‐lasting cases did not seem to deviate from the short‐lasting cases; both categories had a moderate female preponderance and similar age of onset. There was a somewhat higher mean number of “migrainelike features” in the long‐lasting than in the short‐lasting variety of exertional headache. Exertional headache attacks could last up to 24 hours.Conclusions.—There seems to be little reason to subdivide exertional headache into 2 separate varieties according to attack duration. Exertional headache attacks have “migrainelike” features but do not seem to be “form fruste” migraine attacks. The long‐lasting variety is not uncommon.
Is the Cell Death in Mesial Temporal Sclerosis Apoptotic?
Authors: Uysal Hilmi , Cevik Isin Unal , Soylemezoglu Figen , Elibol Bulent , Ozdemir Yasemin Gursoy , Evrenkaya Tulay , Saygi Serap , Dalkara Turgay 
Published: June 2003

Summary:  Purpose: Mesial temporal sclerosis (MTS) is characterized by neuronal loss in the hippocampus. Studies on experimental models and patients with intractable epilepsy suggest that apoptosis may be involved in neuronal death induced by recurrent seizures. Methods: We searched evidence for apoptotic cell death in temporal lobes resected from drug‐resistant epilepsy patients with MTS by using the terminal deoxynucleotidyl transferase (TdT) and digoxigenin‐11‐dUTP (TUNEL) method and immunohistochemistry for Bcl‐2, Bax, and caspase‐cleaved actin fragment, fractin. The temporal lobe specimens were obtained from 15 patients (six women and nine men; mean age, 29 ± 8 years). Results: Unlike that in normal adult brain, we observed Bcl‐2 immunoreactivity in some of the remaining neurons dispersed throughout the hippocampus proper as well as in most of the reactive astroglia. Bax immunopositivity was increased in almost all neurons. Fractin immunostaining, an indicator of caspase activity, was detected in ∼10% of these neurons. Des pite increased Bax expression and activation of caspases, we could not find evidence for DNA fragmentation by TUNEL staining. We also could not detect typical apoptotic changes in nuclear morphology by Hoechst‐33258 or hematoxylin counterstaining. Conclusions: These data suggest that either apoptosis is not involved in cell loss in MTS, or a very slow rate of cell demise may have precluded detecting TUNEL‐positive neurons dying through apoptosis. Increased Bax expression and activation of caspases support the latter possibility.
Myoinositol Abnormalities in Temporal Lobe Epilepsy
Authors: Wellard R. Mark , Briellmann Regula S. , Prichard James W. , Syngeniotis Ari , Jackson Graeme D. 
Published: June 2003

Summary:  Purpose: This study used magnetic resonance spectroscopy (MRS) to examine metabolite abnormalities in the temporal and frontal lobe of patients with temporal lobe epilepsy (TLE) of differing severity. Methods: We investigated myoinositol in TLE by using short‐echo MRS in 34 TLE patients [26 late onset (LO‐TLE), eight hippocampal sclerosis (HS‐TLE)], and 16 controls. Single‐voxel short‐echo (35 ms) MR spectra of temporal and frontal lobes were acquired at 1.5 T and analyzed by using LCModel. Results: The temporal lobe ipsilateral to seizure origin in HS‐TLE, but not LO‐TLE, had reduced N‐acetylaspartate (NA) and elevated myoinositol (MI; HS‐TLE NA, 7.8 ± 1.9 mM, control NA, 9.2 ± 1.3 mM; p < 0.05; HS‐TLE MI, 6.1 ± 1.6 mM, control mI 4.9 ± 0.8 mM, p< 0.05). Frontal lobe MI was low in both patient groups (LO‐TLE, 4.3 ± 0.8 mM; p < 0.05; HS‐TLE, 3.6 ±.05 mM; p < 0.001; controls, 4.8 ± 0.5 mM). Ipsilateral frontal lobes had lower MI (3.8 ± 0.7 mM; p < 0.01) than contralateral frontal lobes (4.3 ± 0.8 mM; p < 0.05). Conclusions: MI changes may distinguish between the seizure focus, where MI is increased, and areas of seizure spread where MI is decreased.
Pregnancy‐related Increases in Sensory Perception Thresholds Are Not Correlated with Serum Progesterone Levels
Authors: Oshima Masayuki , Inagi Toshiichiro , Yokoyama Kenji , Kikutani Takehiko , Sugimoto Kikuzo , Shimada Yoichi , Ogawa Ryo , Menkes Daniel L. 
Published: June 2003

Abstract:Background: Why pregnant women require smaller doses of anesthetic agents still remains speculative. One hypothesis proposes that pregnancy raises sensory perception thresholds, perhaps through a progesterone‐mediated effect. This study was undertaken in order to quantify any changes in sensory perception thresholds after parturition and to correlate these changes with the expected decrease in postpartum serum progesterone levels.Methods: Nineteen gravid women scheduled to undergo an elective Cesarean section consented to participate. Sensory current perception threshold (CPT) testing was performed before and 7 days after an elective Cesarean section. CPT was defined as the minimum amount of constant current stimulation that can be reproducibly detected at a particular frequency. CPT values were determined on the distal phalanx of the nondominant index finger at 2000 Hz, 250 Hz, and 5 Hz monofrequency stimulation. Seven women permitted serum progesterone level determinations at the prepartum and the postpartum CPT testing sessions.Results: Parturition resulted in a statistically significant decrease in the sensory CPT at all 3 frequencies tested, (p < 0.05). However, there was no significant correlation between the postpartum reduction in serum progesterone levels and the observed postpartum decrease in CPT for any frequency, (r < 0.5).Conclusions: CPTs are significantly reduced after parturition. However, this reduction does not appear to be significantly correlated with the reduction in serum progesterone levels.
Safety and Efficacy of Percutaneous Neuromodulation Therapy in the Management of Subacute Radiating Low Back Pain
Authors: Borg‐Stein Joanne , Seroussi Richard E. , Gomba Lorraine , Meleger Alec , Schmitt Susan , Leep Eric , Glassman Jerel H. , Revord John , Condon Joseph , Bensen Elizabeth , Fitzthum Jeffery E. , Fowler Bradford C. , Gliner Bradford E. , Firlik Andrew D. 
Published: June 2003

Abstract:Objective: Percutaneous neuromodulation therapy (PNT) is a new minimally invasive, office‐based treatment for low back pain in which electrical stimulation is delivered to the paraspinal peripheral nerves. The purpose of this study was to determine the safety, tolerability, and clinical efficacy of PNT in a population of patients with subacute low back pain with radiation to the lower extremity.Design: Open label prospective clinical trial.Setting: Multi‐center outpatient setting.Participants: We enrolled 83 patients who had radiating low back pain for 4 weeks to 6 months with a pain intensity of at least 4 on a visual analog scale of 0–10.Interventions: Subjects were treated with PNT 1 to 2 times per week for at least 4 weeks. Based on clinical response patients were treated up to an additional 8 weeks.Main Outcome Measures: We recorded baseline visual analog scale (VAS) scores of radiating pain, low back pain, physical activity, and sleep, as well as the Oswestry Disability Questionnaire. Follow‐up assessments were performed at each session, and at 5 and 12 weeks. Patients benefiting from treatments at 12 weeks were followed‐up at 6 months.Results: Fifty‐nine patients completed the study protocol. Mean VAS scores improved as follows: leg/buttock pain decreased by 37% to 4.0 ± 2.6 from a baseline of 6.6 ± 1.7 (P < 0.001); low back pain decreased by 26% to 3.9 ± 2.4 from a baseline of 5.5 ± 2.2 (P < 0.001); activity levels improved by 38% to 3.6 ± 2.2 from a baseline of 6.0 ± 2.2 (P < 0.001); and sleep improved by 27% to 3.1 ± 2.5 from a baseline of 4.8 ± 3.0 (P < 0.001). The Oswestry Low Back Pain Disability scores improved by 24% to 32 ± 16 from a baseline of 43 ± 15 (P < 0.001). Pain relief was sustained over a 3‐month observation period.Conclusion: For many patients with subacute radiating low back pain, PNT significantly reduced pain and self‐rated disability, and improved sleep quality and activity level. PNT is safe and generally well tolerated.
Management of Chronic Limb Pain with Spinal Cord Stimulation
Authors: Fogel Guy R. , Esses Stephen I. , Calvillo Octavio 
Published: June 2003

Abstract:Background: Spinal Cord Stimulation (SCS) is a treatment option for chronic pain patients. The most common indication for SCS is the failed back syndrome with leg pain. In the last decade, advances in our understanding of appropriate stimulation programming, lead placement and the physiology of SCS, have led to changes in multi‐site stimulation, and stimulation with differing programs. In the past, low back, axial neuropathic type pain was not responsive to SCS. With dual electrode arrays, and dual stimulation with alternating programs of stimulation, steering of stimulation paresthesia, and versatile programmable stimulation parameters, SCS has become a more versatile form of analgesia.Purpose: To describe the current treatment rational for SCS and the results of that treatment.Results: The SCS is most efficient in patients with neuropathic pain of the extremities and less efficacious in patients with axial pain.Conclusion: SCS is the most effective treatment for limb pain not amenable to surgical decompression. The success of SCS in this chronic pain group is 80% successful in treatment of leg pain, and much less effective in treatment of axial pain.
Regulatory Elements of the Floral Homeotic GeneAGAMOUSIdentified by Phylogenetic Footprinting and Shadowing[W]
Authors: Hong Ray L. , Hamaguchi Lynn , Busch Maximilian A. , Weigel Detlef 
Published: June 2003

AbstractIn Arabidopsis thaliana, cis-regulatory sequences of the floral homeotic gene AGAMOUS (AG) are located in the second intron. This 3-kb intron contains binding sites for two direct activators of AG, LEAFY (LFY) and WUSCHEL (WUS), along with other putative regulatory elements. We have used phylogenetic footprinting and the related technique of phylogenetic shadowing to identify putative cis-regulatory elements in this intron. Among 29 Brassicaceae species, several other motifs, but not the LFY and WUS binding sites identified previously, are largely invariant. Using reporter gene analyses, we tested six of these motifs and found that they are all functionally important for the activity of AG regulatory sequences in A. thaliana. Although there is little obvious sequence similarity outside the Brassicaceae, the intron from cucumber AG has at least partial activity in A. thaliana. Our studies underscore the value of the comparative approach as a tool that complements gene-by-gene promoter dissection but also demonstrate that sequence-based studies alone are insufficient for a complete identification of cis-regulatory sites.
Low glutelin content1: A Dominant Mutation That Suppresses the Glutelin Multigene Family via RNA Silencing in Rice[W]
Authors: Kusaba Makoto , Miyahara Kenzo , Iida Shuichi , Fukuoka Hiroyuki , Takano Toshiya , Sassa Hidenori , Nishimura Minoru , Nishio Takeshi 
Published: June 2003

Abstract
Low glutelin content1 (Lgc1) is a dominant mutation that reduces glutelin content in rice grains. Glutelin is a major seed storage protein encoded by a multigene family. RNA gel blot and reverse transcriptase–mediated PCR analyses revealed that Lgc1 acts at the mRNA level in a similarity-dependent manner. In Lgc1 homozygotes, there is a 3.5-kb deletion between two highly similar glutelin genes that forms a tail-to-tail inverted repeat, which might produce a double-stranded RNA molecule, a potent inducer of RNA silencing. The hypothesis that Lgc1 suppresses glutelin expression via RNA silencing is supported by transgenic analysis using this Lgc1 candidate region, by reporter gene analysis, and by the detection of small interfering RNAs. In this context, Lgc1 provides an interesting example of RNA silencing occurring among genes that exhibit various levels of similarity to an RNA-silencing–inducing gene. Possible mechanisms for gene silencing of the glutelin multigene family by Lgc1 are discussed.
Mutation or Drug-Dependent Microtubule Disruption Causes Radial Swelling without Altering Parallel Cellulose Microfibril Deposition in Arabidopsis Root Cells[W]
Authors: Sugimoto Keiko , Himmelspach Regina , Williamson Richard E. , Wasteneys Geoffrey O. 
Published: June 2003

AbstractAs critical determinants of growth anisotropy in plants, cortical microtubules are thought to constrain the movement of cellulose synthase complexes and thus align newly deposited cellulose microfibrils. We tested this cellulose synthase constraint model using the temperature-sensitive mor1-1 mutant of Arabidopsis. Contrary to predictions, the disruption of cortical microtubules in mor1-1 root epidermal cells led to left-handed root twisting and radial swelling but did not alter the transverse orientation of cellulose microfibrils. We also found that drug-dependent disassembly or hyperstabilization of cortical microtubules did not alter the parallel order of cellulose microfibrils. By measuring cellulose content in mor1-1 seedlings, we verified that cellulose synthesis is not reduced at the restrictive temperature. The independence of cortical microtubule organization and cellulose microfibril alignment was supported by the observation that double mutants of mor1-1 and rsw1-1, the cellulose-deficient mutant with misaligned microfibrils, had additive phenotypes. Our results suggest that cortical microtubules regulate growth anisotropy by some mechanism other than cellulose microfibril alignment or synthesis.
CytochromefTranslation in Chlamydomonas Chloroplast Is Autoregulated by its Carboxyl-Terminal Domain[W]
Authors: Choquet Yves , Zito Francesca , Wostrikoff Katia , Wollman Francis-André 
Published: June 2003

AbstractThe rate of synthesis of cytochrome f is decreased ∼10-fold when it does not assemble with the other subunits of the cytochrome b 6 f complex in Chlamydomonas reinhardtii chloroplasts. This assembly-mediated regulation of cytochrome f synthesis corresponds to a regulation of petA mRNA initiation of translation. Here, we demonstrate that cytochrome f translation is autoregulated by its C-terminal domain. Five cytochrome f residues conserved throughout all chloroplast genomes—residue Gln-297 in the transmembrane helix and a cluster of four amino acids, Lys-Gln-Phe-Glu, at positions 305 to 308, in the stromal extension—participate in the formation of a translation repressor motif. By contrast, positively charged residues in the stromal extension have little influence on the autoregulation process. These results do not favor a direct interaction between the repressor motif and the petA 5′ untranslated region but suggest the participation of a membrane-bound ternary effector.
A novel method for automating the checking and correction of digital elevation models using orthophotographs
Authors: Georgopoulos Andreas , Skarlatos Dimitris 
Published: June 2003

AbstractThis article presents a complete mathematical model, which translates discrepancies between two orthophotographs created from different photographs, into precise corrections of the Digital Elevation Model (DEM). These corrections are the differences from the real surface and, if applied over the existing DEM, can produce a more accurate one. The mathematical model is straightforward, and is not approximate, and therefore there is no need for iterations.Possible applications include checking of automatically created DEMs, refinement of existing DEMs using aerial photographs and update of orthophotographs based on the previous DEM and new imagery.