bluuebunny/crossref_metadata_2025_split huggingface dataset:
Focal Functional Deficits in Temporal Lobe Epilepsy on PET Scans and the Intracarotid Amobarbital Procedure: Comparison of Patients with Unitemporal Epilepsy with Those Requiring Intracranial Recordings
Authors: Salanova V. , Markand O. , Worth R. 
Published: May 2003

Summary Purpose: To analyze the relationship between the intracarotid amobarbital procedure (IAP) and positron emission tomography (PET) and study the lateralizing value of these tests in patients with unitemporal epilepsy and those requiring intracranial recordings. Methods: We compared 51 patients with unitemporal epilepsy (group 1) with 26 patients in whom surface recordings failed to reveal a distinct unitemporal focus, necessitating invasive recordings (group 2). Results: The brain magnetic resonance imaging (MRI) scans for group 1 showed mesial temporal sclerosis in 70.5% of the patients. PET showed unilateral temporal hypometabolism in 88%. In addition, 74.5% of the patients in group 1 had impaired memory on the epileptogenic side on the IAP, and 89.4% of those patients also had ipsilateral temporal hypometabolism on PET scans. All the group 1 patients underwent temporal resections. The pathologic examination showed hippocampal sclerosis in 72% of the patients. Eighty percent of group 1 patients became seizure free, and 16% had rare seizures (follow‐up, 2–7 years). MRIs for group 2 showed mesial temporal sclerosis in 31% of the patients; PET scans showed temporal hypometabolism in 39%. The IAP was lateralized in 47.8%. Sixty‐nine percent had temporal lobe resections. The pathologic examination showed hippocampal sclerosis in 44% of the patients. Forty‐four percent of group 2 patients became seizure free, and 27.7% had rare seizures (follow‐up, 2–8 years). Conclusions: Ninety‐six percent of the patients with unitemporal foci had focal functional deficits on the epileptogenic side on 18‐fluorodeoxyglucose‐(FDG) PET scans, the IAP, or both. The results of the FDG‐PET were predictive of impaired memory on the IAP. Memory impairment contralateral to the temporal hypometabolism found on the PET scans was never seen. These patients had an excellent outcome. In contrast, < 50% of the patients requiring intracranial recordings had focal functional deficits, suggesting that more a diffuse pathology may account for their less favorable outcome.
Genetic Predisposition to Severe Myoclonic Epilepsy in Infancy
Authors: Benlounis A. , Nabbout R. , Feingold J. , Parmeggiani A. , Guerrini R. , Kaminska A. , Dulac O. 
Published: May 2003

Summary Purpose: To address genetic predisposition to febrile convulsions (FCs) and epilepsy as an etiologic back‐ground of severe myoclonic epilepsy in infancy (SMEI). Methods: Familial antecedents of epilepsy and FCs were analyzed in four groups of patients with SMEI (65 cases), FCs (57 cases), childhood absences (67 cases), and a control group of patients with no neurologic problems (64 cases). Results: Patients with SMEI and those with FCs had significantly increased incidence of FCs in their relatives compared with those with absence epilepsy and with the control group. The incidence of epilepsy in relatives of patients with SMEI and absence epilepsy was increased compared with that in the control group and reached statistical significance. Epilepsy in relatives with SMEI had the characteristics of idiopathic generalized epilepsy. Conclusions: A genetic predisposition could determine three types of epileptic syndromes: FCs, idiopathic generalized epilepsy, and SMEI.
Circulating Levels of Allopregnanolone, an Anticonvulsant Metabolite of Progesterone, in Women with Partial Epilepsy in the Postcritical Phase
Authors: Galli Renato , Luisi Michele , Pizzanelli Chiara , Monteleone Patrizia , Casarosa Elena , Iudice Alfonso , Murri Luigi 
Published: May 2003

Summary Purpose: Several lines of evidence indicate that there exists a relation between ovarian hormones and epilepsy. Estrogens decrease seizure threshold and increase brain excitability, whereas progesterone has an inhibitory effect and reduces epileptiform activity. Recently considerable interest has turned to neuroactive steriods, a group of progesterone metabolites, as endogenous modulators of excitability of the central nervous system (CNS). Their ability to alter neuronal firing rapidly occurs through interaction with γ‐aminobutyric acid (GABA) A receptor complex. In a previous experience, serum allopregnanolone (3α‐OH‐5α‐pregnan‐20‐one) levels were measured in 15 women with partial epilepsy in the intercritical phase, and no significant differences were found between patients and control subjects. Methods: To find out if there are changes in serum allopregnanolone levels after epileptic seizure, blood samples were drawn immediately, 15 min, and 6 h after a seizure in seven fertile females with partial epilepsy. Results: The most interesting finding is that allopregnanolone increases in serum during the first 15 min after partial seizures (p <0.05) and decreases after 6 h. Conclusions: These data are consistent with a role for allopregnanolone in the control of neuronal excitability and seizures.
Alfentanil‐Induced Epileptiform Activity: A Simultaneous Surface and Depth Electroencephalographic Study in Complex Partial Epilepsy
Authors: Ross J. , Kearse L. A. , Barlow M. K. , Houghton K. J. , Cosgrove G. R. 
Published: May 2003

Summary Purpose: Alfentanil is a high potency mu opiate receptor agonist commonly used during presurgical induction of anesthesia. This and other opiate receptor agonists have demonstrated proconvulsant effects in animals, but these properties have been less consistently demonstrated in humans. Most human scalp EEG studies have failed to demonstrate induction of epileptiform activity with these agents, which is inconsistent with findings using intracranial EEG. Simultaneous scalp and depth EEG recordings have yet to be performed in this setting. The relationship between opiate dose and proconvulsant activity is unclear. Methods: Simultaneous scalp and depth electrode recordings were performed on five patients with complex partial epilepsy (CPE) who underwent alfentanil anesthesia induction before depth electrode removal. Consecutive equal bolus doses of alfentanil were administered to each patient according to strict time intervals so as to assess their correlation with any induced epileptiform activity. Results: Epileptiform activity was induced by alfentanil in three of five patients. Two of these patients had electrographic seizures. Epileptiform activity was only detected from the depth electrodes, occurring within 2 min of the first bolus dose in all three cases. Further increase or spread of epileptiform activity did not occur despite cumulative bolus doses of alfentanil. Conclusions: Alfentanil is proconvulsant in patients with CPE. Induced seizures may be subclinical and lack a scalp EEG correlate. There is a complex dose—response relationship. Alfentanil induction of anesthesia should be approached with caution in patients with CPE.
Antiepileptic Drug Withdrawal in Patients with Temporal Lobe Epilepsy Undergoing Presurgical Video‐EEG Monitoring
Authors: Yen Der‐Jen , Chen Chien , Shih Yang‐Hsin , Guo Yuh‐Cherng , Liu Li‐Ting , Yu Hsiang‐Yu , Kwan Shang‐Yeong , Yiu Chun‐Hing 
Published: May 2003

Summary Purpose: To investigate antiepileptic drug (AED) withdrawal during video‐EEG monitoring in adult patients with temporal lobe epilepsy (TLE). Methods: Between 1995 and 1997, 102 consecutive patients with refractory TLE were admitted to the epilepsy monitoring unit for presurgical evaluation. Patients were monitored with ongoing AEDs being rapidly decreased and discontinued in 4–6 days. The monitoring was continued until sufficient numbers of seizures were recorded. Serum AED levels were checked at admission and after the first complex partial seizure (CPS). Results: In all, 89 patients had 429 CPSs (mean, 4.8 per patient), including 156 (36.4%) secondarily generalized. A mean of 153.8 h (16–451 h) was required for completing the monitoring in each patient. Forty‐three (48.3%) patients experienced seizure clusters, and eight (9.0%) had generalized seizures that had never occurred or had been absent for years. However, none evolved to status epilepticus. Carbamazepine was the most commonly used AED in 71.9% of patients, followed by valproate and phenytoin. When the first CPS occurred, mean 77.2 h since the beginning of the monitoring, serum levels of these three AEDs were mostly subtherapeutic rather than minimal. Conclusions: Acute AED withdrawal effectively provoked seizures in TLE patients undergoing presurgical video‐EEG monitoring. However, nearly 50% of patients had seizure clusters or secondarily generalized seizures. Serum AED levels were mostly subtherapeutic when the first CPS occurred.
Visual Field Loss Associated with Vigabatrin: Quantification and Relation to Dosage
Authors: Hardus P. , Verduin W. M. , Engelsman M. , Edelbroek P. M. , Segers J. P. , Berendschot T. T. J. M. , Stilma J. S. 
Published: May 2003

Summary Purpose: To describe the correlation between visual field loss and the duration, dosage, and total amount of vigabatrin (VGB) medication in a group of patients with epilepsy. Co‐medication of antiepileptic drugs (AEDs) and compliance were also studied. Methods: Ninety‐two patients (53 male and 39 female) taking VGB medication in the past or the present, attending the Outpatient Epilepsy Clinic in Utrecht, were examined with the Goldmann perimeter. The amount of visual field loss was calculated by the Esterman grid method and by a new method, with which the percentage surface loss of the visual field is measured. A complete drug history was compiled, specifying the amount and duration of VGB medication. Concomitant AED medication was noted. Serum levels of AEDs were determined. Results: Linear regression showed the total amount of VGB as the most significant parameter to predict visual field loss (p <0.001). Further, men were more affected than women (p = 0.026). Compliance was good, and other AEDs did not influence the results. Conclusions: Because prolonged use of VGB medication is correlated with the amount of visual field loss, VGB should be prescribed only when there are no alternatives. In such cases, we recommend an examination of the peripheral visual field before starting therapy and a repeated examination every 6 months.
Mental Retardation in Pediatric Candidates for Epilepsy Surgery: The Role of Early Seizure Onset
Authors: Vasconcellos Elza , Wyllie Elaine , Sullivan Shawn , Stanford Lisa , Bulacio Juan , Kotagal Prakash , Bingaman William 
Published: May 2003

Summary Purpose: We sought to determine whether early age at seizure onset is a risk factor for mental retardation, independent of etiology. Assessment of risk for mental retardation with continued uncontrolled seizures plays a role in considerations of timing for epilepsy surgery. Previous studies have indicated that onset of seizures in the first years of life may be a risk factor for mental retardation, but the etiologies of the epilepsies were not included in the analyses. Methods: Intellectual function was assessed at ages 2–20 years during presurgical evaluation in 100 patients with intractable epilepsy due to focal lesions limited to part of one lobe of the brain. Mental retardation (MR) was defined as Full‐Scale Intelligence Quotient (FSIQ) ≤70. The age at seizure onset and the seizure frequency were obtained retrospectively. Results: Younger ages at seizure onset were associated with lower FSIQ scores, and mean FSIQ was also significantly lower for patients with onset of epilepsy at ≤24 months of age (74.0 ± 21.5) versus that in patients with onset of epilepsy later in life (87.8 ± 18.8: p = 0.005). The frequency of patients with MR was significantly higher for patients with seizure onset at ≤24 months of age (15 of 33, 46%) than for patients with seizure onset later in life (eight of 67, 12%; p <0.001). This difference persisted within etiologic subgroups. For patients with focal malformation of cortical development, MR was seen in eight (50%) of 16 patients with seizure onset at ≤24 months versus two (10%) of 20 patients with seizure onset at >24 months (p > 0.001); for patients with tumor, MR was seen in four (50%) of eight patients with seizure onset at >24 months versus four (13%) of 30 patients with seizure onset at >24 months (p = 0.003); and for patients with hippocampal sclerosis, MR was seen in two (28%) of seven patients with seizure onset at ≤24 months versus none of 30 patients with seizure onset at >24 months (NS). Within the subgroup with daily seizures. MR was present in 13 (65%) of 20 patients with seizure onset at >24 months versus five (17%) of 29 patients with seizure onset later in life (p =0.001). Conclusions: These results indicate that onset of intractable epilepsy within the first 24 months of life is a significant risk factor for MR, especially if seizures occur daily. The risk based on early age at seizure onset appeared independent of etiology and persisted within subgroups of patients with focal malformation of cortical development, tumor, or hippocampal sclerosis. Prospective studies will be important to clarify whether early surgical intervention may reduce the risk for subsequent MR in carefully selected infants.
Ictal Perfusion Changes During Occipital Lobe Seizures in Infancy: Report of Two Serial Ictal Observations
Authors: Hollo Andras , Kaminska Anna , Véra Pierre , Cieuta Cecile , Ville Dorothée , Bulteau Christine , Dulac Olivire , Chiron Catherine 
Published: May 2003

SummarySerial‐ictal single‐photon‐emission computed to mography (SPECT) examinations are presented in two infants (ages 1 and 2 years), with early ictal and ictal in one, and ictal and late ictal images in the other. Both had pharmacoresistant occipital epilepsy, due to focal cortical dysplasia. In the first case, size of ictal hyperperfusion increased in the course of the seizure from early ictal to ictal state. A concomitant ictal hypoperfusion was observed around the hyperperfused area. In the second patient, there was a dramatic difference between ictal and late ictal images. In the late ictal state, the previous occipital ictal hyperperfusion and extraoccipital ictal hypoperfusion disappeared, together with homolateral posterotemporal and contralateral occipital hyperperfusion, corresponding to seizure propagation. Ictal extratemporal blood‐flow changes are therefore highly dynamic, particularly in very young children.
Generalized Convulsions After Consuming a Large Amount of Gingko Nuts
Authors: Miwa Hideto , Iijima Makiko , Tanaka Shigeki , Mizuno Yoshikuni 
Published: May 2003

SummaryWe report a 36‐year‐old woman, without any past or family histories of epilepsy, who presented frequent vomiting and generalized convulsions. About 4 h before the convulsion, she had consumed ∼70–80 gingko nuts, seeds of Gingko biloba, in an attempt to improve her health. It is important to know that conculsion may be induced if a large amount of gingko nuts is consumed. The neurotoxicity of gingko nuts, particularly their convulsion‐inducing effect, should be recognized.
Advancing Age and Cervical Cancer Screening and Prognosis
Authors: Sawaya George F. , Sung Hai‐Yen , Kearney Kathleen A. , Miller Marie , Kinney Walter , Hiatt Robert A. , Mandelblatt Jeanne 
Published: May 2003

OBJECTIVES:To determine associations between advancing age and screening behavior and prognosis in long‐term members of a prepaid health plan diagnosed with invasive cervical cancer (ICC).DESIGN:Case series.SETTING:Prepaid health plan.PARTICIPANTS:All women diagnosed with ICC at Kaiser Permanente Medical Care Program—Northern California health plan from 1988 to 1994.MEASUREMENTS:From medical records, we recorded participants' age, stage at diagnosis, tumor histology, and results of and reasons for all previous cervical smears. We limited our analysis to women who had been members of the health plan for at least 30 of the 36 months preceding diagnosis (n = 455).RESULTS:Women in older age groups were less likely than younger women to have been screened within the 3 years before diagnosis (P = .005 for trend). Nonadherence to follow‐up of abnormal cervical smears was uncommon (17/455, 3.7%) and not age related (P = .932 for trend). The proportions of ICC that were interval cancers, defined as ICC diagnosed within 3 years of a negative screening smear, were highest in women under age 30 (P = .004 for trend). In multivariate analyses controlling for stage at diagnosis, women age 60 and older were not more likely to die of ICC within 3 years of diagnosis than were women younger than age 60 (odds ratio 1.30, 95% confidence interval 0.75–2.28).CONCLUSION:The disproportionate burden of cervical cancer observed in older women appears to be largely attributable to lack of screening within the 3 years before diagnosis. J Am Geriatr Soc 49:1499–1504, 2001.
Voices from the Top of the Pile: Elite Perceptions of Poverty and the Poor in the Philippines
Authors: Clarke Gerard , Sison Marites 
Published: May 2003

AbstractHow do elites perceive poverty and the poor? In this article, we present the results of interviews with eighty members of the Filipino elite, undertaken as part of a larger six‐country study of elite perceptions of poverty and the poor. Poverty, we argue, is a highly subjective phenomenon. People's perceptions of poverty, of who is and who is not poor, of how poverty affects them and others, and of how poverty can be effectively tackled, vary enormously between different types of people (defined in terms of class, status, occupation, nationality, ethnicity, gender or a myriad of other social identities). Wherever people cohere as groups, classes or other social constructs, perceptions of poverty are aggregated and refined and then embedded in social dynamics. The study of elite perceptions of poverty and the poor, we conclude, can both add to our understanding of the social dynamics of poverty and inequality and inform pro‐poor public policy.
Whose Modernity? Indigenous Modernities and Land Claims after Apartheid
Authors: Robins Steven 
Published: May 2003

AbstractThis article questions some of the key assumptions of post‐development and anti‐development critics such as Arturo Escobar and Wolfgang Sachs, who tend to prescribe a puritanical and principled rejection of ‘exogenous development’ that does not necessarily reflect the needs and desires of the beneficiaries of development. Drawing on fieldwork research on land claims in Northern Cape and Northern Provinces (South Africa), the author argues that these beneficiaries tend to deploy hybrid and highly selective and situational responses to development interventions. These hybrid responses can be regarded as indigenous modernities. Development packages are resisted, embraced, reshaped or accommodated depending on the specific content and context. The author also questions James Ferguson's conclusion that depoliticizing development discourses inevitably buttresses bureaucratic state power. Rather, the fieldwork findings suggest that state‐led development is often an extremely risky business that can undermine the legitimacy and authority of governments. In addition, in many parts of the developing world, it is the retreat of the neo‐liberal state, rather than ‘the tyranny of development’, that poses the most serious threat to household livelihood strategies and economic survival. The case studies discussed here suggest that responses to development are usually neither wholesale endorsements nor radical rejections of modernity. Even when resisting and subverting development ideas and practices, people do not generally do so on the basis of either radical populist politics or in defence of pristine and authentic local cultural traditions.
Examining the Potential of Indigenous Institutions for Development: A Perspective from Borana, Ethiopia
Authors: Watson Elizabeth E. 
Published: May 2003

AbstractThis article examines an institutional approach to development in which indigenous institutions are viewed as a resource for achieving development. It concentrates on indigenous natural resource management (NRM) institutions which have been seen by some development agencies to be a means to address the needs of people and the environment in a way that is also participatory. Using material from Borana, Ethiopia, the article describes the indigenous NRM institutions and examines the outcome of one attempt to work with them. In the process, it shows that partnerships between development agencies and indigenous NRM institutions are often fragile, and tend to dissolve when they fail to meet the preconceptions of the developers. Through an examination of this approach to development, the article also examines the usefulness of recent broad approaches to institutions.
Selection of Small-Colony Variants of
Salmonella enterica
Serovar Typhimurium in Nonphagocytic Eucaryotic Cells
Authors: Cano David A. , Pucciarelli M. Graciela , Martínez-Moya Marina , Casadesús Josep , García-del Portillo Francisco 
Published: June 2003

ABSTRACT

Salmonella enterica
strains are enteropathogenic bacteria that survive and proliferate within vacuolar compartments of epithelial and phagocytic cells. Recently, it has been reported that fibroblast cells are capable of restricting
S. enterica
serovar Typhimurium intracellular growth. Here, we show that prolonged residence of bacteria in the intracellular environment of fibroblasts results in the appearance of genetically stable small-colony variants (SCV). A total of 103 SCV isolates, obtained from four independent infections, were subjected to phenotypic analysis. The following phenotypes were observed: (i) δ-aminolevulinic acid auxotrophy; (ii) requirement for acetate or succinate for growth in glucose minimal medium; (iii) auxotrophy for aromatic amino acids; and (iv) reduced growth rate under aerobic conditions not linked to nutrient auxotrophy. The exact mutations responsible for the SCV phenotype in three representative isolates were mapped in the
lpd
,
hemL
, and
aroD
genes, which code for dihydrolipoamide dehydrogenase, glutamate-1-semyaldehyde aminotransferase, and 3-dehydroquinate dehydratase, respectively. The
lpd
,
hemL
, and
aroD
mutants had intracellular persistence rates in fibroblasts that were 3 to 4 logs higher than that of the parental strain and decreased susceptibility to aminoglycoside antibiotics. All three of these SCV isolates were attenuated in the BALB/c murine typhoid model. Complementation with

lpd
+

,

hem
+

, and

aroD
+

genes restored the levels of intracellular persistence and antibiotic susceptibility to levels of the wild-type strain. However, virulence was not exhibited by any of the complemented strains. Altogether, our data demonstrate that similar to what it has been reported for SCV isolates of other pathogens,
S. enterica
SCV display enhanced intracellular persistence in eucaryotic cells and are impaired in the ability to cause overt disease. In addition, they also suggest that
S. enterica
SCV may be favored in vivo.