bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Role of Brain Computed Tomography in Evaluating Children with New Onset of Seizures in the Emergency Department
Authors: Maytal Joseph , Krauss Joel M. , Novak Gerald , Nagelberg Joy , Patel Mahindra 
Published: August 2005

Summary: Background: The purpose of neuroimaging of a patient with new onset of seizures is to demonstrate cause and explore the prognosis. It was recently recommended that emergency brain computed tomography (CT) be performed only in adult seizure patients with an increased likelihood of life‐threatening lesions, i.e., those with new focal deficits, persistent altered mental status, fever, recent trauma, persistent headaches, history of cancer, history of anticoagulation, or suspicion of acquired immunodeficiency syndrome. The objective of this study was to determine the diagnostic utility of emergency brain CT in children who present to the emergency department with new onset of seizures. Methods: A 1‐year retrospective chart review of all children who presented to the emergency department of the Schneider Children's Hospital with a new onset of seizures and who underwent CT of the brain, excluding children with simple febrile seizures. Results: Sixty‐six patients, 34 boys and 32 girls with a mean age of 4.9 years, qualified for inclusion in the study. Fifty‐two patients (78.8%) had normal CT results and 14 patients (21.2%) had abnormal CT results. Seizure cause was considered cryptogenic in 33 patients, of whom 2 (6%) had abnormal CT results; neither patient required intervention. Seizure cause was considered symptomatic in 20 patients, of whom 12 (60%) had abnormal CT results (p < 0.0001). In two patients with abnormal CT scans (both acute symptomatic), the imaging findings were of immediate therapeutic significance and were predictable from the clinical history and the physcial examination. None of the 13 patients with complex febrile seizure cause had an abnormal CT scan. Patients with partial convulsive seizures were more likely to have abnormal CT scans than patients with generalized convulsive seizures, but the difference was not statistically significant. Conclusions: The routine practice in many pediatric emergency Department of obtaining brain CT scans for all patients with new onset of nonfebrile seizures is unjustified. History and physical examination are sufficient to identify those patients for whom such studies are likely to be appropriate. Emergent CT is not indicated for patients with no known seizure risk factors, normal neurological examinations, no acute symptomatic cause other than fever, and reliable neurological follow‐up. For these patients, referral to a pediatric neurologist for further workup, including electroencephalography and the more diagnostically valuable magnetic resonance imaging, would be more appropriate.
Comparative Stereoselective Pharmacokinetic Analysis of 10‐Hydroxycarbazepine After Oral Administration of its Individual Enantiomers and the Racemic Mixture to Dogs
Authors: Volosov Andrew , Yagen Boris , Bialer Meir 
Published: August 2005

Summary: Purpose: 10‐hydroxycarbazepine (MHD) is the active metabolite of the new antiepileptic drug oxcarbazepine. MHD is a chiral molecule with an asymmetric carbon at position 10. The purpose of this study was to evaluate the stereoselectivity in the pharmacokinetics of the enantiomers of MHD after oral administration of the individual MHD enantiomers and the racemic mixture to dogs. Methods: A racemic mixture of MHD and the individual MHD enantiomers were administered to six dogs in a crossover design. Plasma and urine concentrations of R(−)‐ and S(+)‐MHD were determined by a stereoselective high‐performance liquid chromatography assay. Results: The area under the concentration‐time curve of R(−)‐MHD was significantly greater than that of S(+)‐MHD after the administration of the individual enantiomers but not after the administration of MHD in a racemic form. The formation clearance of the S(+)‐MHD glucuronide was approximately three times greater than that of R(−)‐MHD glucuronide. No difference was found in the renal clearance and protein binding of R(−)‐ and S(+)‐MHD enantiomers. Conclusions: The pharmacokinetics of the MHD enantiomers was found to be stereoselective, mainly as a result of the stereoselectivity in the glucuronidation process. The difference in the pharmacokinetic parameters found after administration of individual MHD enantiomers compared with the administration of MHD in a racemic form suggests the possibility of interaction between the two enantiomers. Stereoselective pharmacokinetic and pharmacodynamic studies are needed to evaluate the rationale of developing MHD as a new antiepileptic drug, either in a stereospecific or racemic form.
Interictal Cardiovascular Autonomic Responses in Patients with Temporal Lobe Epilepsy
Authors: Ansakorpi Hanna , Korpelainen Juha T. , Suominen Kalervo , Tolonen Uolevi , Myllylä Vilho V. , Isojärvi Jouko I. T. 
Published: August 2005

Summary:Purpose: To measure interictal cardiovascular autonomic functions in patients with either refractory or well‐controlled temporal lobe epilepsy (TLE).Methods: For autonomic assessment, heart rate variation during normal and deep breathing, Valsalva maneuver, and tilting were measured in 19 patients with chronic refractory TLE, 19 patients with well‐controlled TLE, and 38 age‐ and sex‐matched healthy control subjects. Blood pressure responses to tilting and isometric work also were evaluated.Results: Heart‐rate (HR) variation during normal breathing (p = 0.006) and tilting (p = 0.043) was lower in patients with refractory TLE than in control subjects. Heart‐rate response to tilting (p = 0.036) was also lower in patients with well‐controlled TLE than in control subjects. Blood‐pressure responses showed no differences between the patients and the control subjects. Patients taking carbamazepine (CBZ) medication had decreased HR responses to deep breathing (p = 0.046) and to tilting (p = 0.014) compared with the control subjects.Conclusions: Refractory TLE seems to be associated with dysfunction of the cardiovascular autonomic regulation, manifesting as impaired HR responses to certain stimuli. Interictal autonomic dysfunction is seen in patients with well‐controlled TLE as well, but it may be more evident in patients with refractory epilepsy. CBZ medication may also be associated with altered autonomic cardiac control.
Treatment of Refractory Complex‐Partial Status Epilepticus with Propofol: Case Report
Authors: Begemann Martin , Rowan A. James , Tuhrim Stanley 
Published: August 2005

Summary: Purpose: We report a case of a 65‐year‐old woman who had a subarachnoid and intraventricular hemorrhage secondary to rupture of an anterior communicating artery aneu‐rysm and developed nonconvulsive status epilepticus of the complex‐partial type, refractory to phenytoin (PHT), phenobar‐bital (PB), valproate (VPA), and lorazepam (LZP). Methods: Three weeks after diagnosis of nonconvulsive status epilepticus, general anesthesia was induced with propofol and titrated to burst suppression on the electroencephalogram (EEG). Results: During propofol infusion, the serum VPA level declined markedly, and despite >3 g daily doses, did not return to the therapeutic range, until several days after propofol was discontinued. Continuous propofol infusion was stopped after 7 days, and the patient recovered consciousness. Despite further complications, she gradually regained normal function and was discharged home 4 months after surgery. Conclusions: This is the first case of nonconvulsive status epilepticus successfully treated with propofol.
Chromogranins in Temporal Lobe Epilepsy
Authors: Kandlhofer Susanne , Hoertnagl Brigitte , Czech Thomas , Baumgartner Christoph , Maier Hans , Novak Klaus , Sperk Günther 
Published: August 2005

Summary: Purpose: Chromogranins are neuropeptide precursors stored in large dense core vesicles. Because physiological functions have been postulated for peptides originating from chromogranins, we investigated the distribution of chromogranins A and B and secretoneurin (a peptide derived from secretogranin II) in the control and epileptic hippocampus of humans and rats. Methods: Chromogranin immunoreactivity (IR) was investigated in paraformaldehyde‐fixed hippocampal specimens from 24 temporal lobe epilepsy patients with intractable seizures, postmortem from 15 patients deceased from nonneurological disorders, in rats 30 days after kainate‐induced limbic seizures, and in control rats. Results: In control rats and in humans, chromogranin A and B IR and secretoneurin IR were present in mossy fibers. In addition, chromogranin B IR was found in granule cells, and chromogranin A IR was found in granule and CA2 pyramidal cells in the human hippocampus. In both species, chromogranin B and secretoneurin were unevenly distributed in the molecular layer of the dentate gyrus. The most intriguing change seen in human temporal lobe epilepsy specimens and in the kainic acid model of the rat was the prominent staining of the inner molecular layer, indicating storage of chromogranins A and B and secretoneurin in terminals of reorganized mossy fibers, from which they may be released upon nerve stimulation. Conclusion: Chromogranins A and B and secretoneurin are valid markers for hippocampal neurons and delineate epilepsy‐induced reorganization of mossy fibers.
Topiramate as an Inhibitor of Carbonic Anhydrase Isoenzymes
Authors: Dodgson Susanna J. , Shank Richard P. , Maryanoff Bruce E. 
Published: August 2005

Summary: Purpose: This study investigated the effectiveness of topiramate (TPM) as an inhibitor of six isozymes of carbonic anhydrase (CA). Methods: The inhibition constants (Ki) of TPM and acetazolamide (AZM) for CA I, CA II, CA III, CA IV, CA V, and CA VI were determined for human (HCA), rat (RCA), or mouse (MCA). The activity of CA was studied by using purified isozymes, erythrocytes, subcellular fractions of kidney or brain, and saliva, and was assayed at 37°C or 25°C by 18O mass spectrometry and/or by measuring the pH shift at 0°C. Results: Topiramate Ki values for HCA I, HCA II, HCA IV, and HCA VI were ∼100, 7, 10, and >100 μM, respectively. TPM Ki values for RCA I, RCA II, RCA III, RCA IV, and RCA V were ∼180, 0·1 to 1, >100, 0·2 to 10 and 18 μM, respectively. For RCA II and RCA IV, the Ki values were temperature dependent. TPM Ki values for MCA II and MCA IV ranged between 1 and 20 μM. Conclusions: These results indicate that TPM is more potent as an inhibitor of CA II and CA IV than of CA I, CA III, and CA VI. In all three species, AZM was usually 10 to 100 times more potent than TPM as an inhibitor of CA isozymes.
Effects of Topiramate on Sustained Repetitive Firing and Spontaneous Recurrent Seizure Discharges in Cultured Hippocampal Neurons
Authors: DeLorenzo Robert J. , Sombati Sompong , Coulter Douglas A. 
Published: August 2005

Summary: Purpose: In this study, we examined the effects of topiramate (TPM) on the electrophysiologic properties of cultured rat hippocampal pyramidal neurons. Methods: Whole‐cell current‐clamp recording techniques were used to determine the effects of TPM on sustained repetitive firing (SRF), spontaneous epileptiform‐burst firing, and spontaneous recurrent seizures (SRS). Results: Topiramate at therapeutic concentrations (10–100 μM) significantly decreased or abolished SRF in a dose‐dependent and partially reversible manner. When transiently exposed to a medium in which Mg2+ is omitted, hippocampal neurons in culture develop SRS (“epilepsy”) and epileptiform discharges. Application of TPM at concentrations ranging from 10 to 100 μM to cells displaying seizure activity caused a concentration‐dependent decrease in the number of action potentials within a burst and in the average duration of epileptiform activity. Both effects were partially reversed during a 5‐ to 30‐min drug washout period. Conclusions: These effects on the electrophysiologic properties of cultured neurons are consistent with the concept that TPM exerts modulatory effects on voltage‐dependent Na+ and/ or Ca2+ conductances responsible for the generation and propagation of action potentials. Topiramate also may inhibit synaptic conductances responsible for transmission of epileptiform discharges.
Epilepsy in the Elderly
Authors: Hiyoshi Toshio , Yagi Kazuichi 
Published: August 2005

Summary: Purpose: The aim of this study was to evaluate the clinical characteristics of elderly patients with epilepsy. Methods: We retrospectively reviewed the clinical records of 190 patients (104 males and 86 females) aged 60 years or older at the time of study. Results: Epilepsies were classified as generalized in 33 patients (17.4%), partial in 145 (76.3%), and undetermined in 12 (6.3%). Twenty‐nine of 33 patients with generalized epilepsy were idiopathic, whereas all patients with partial epilepsy were symptomatic. Symptomatic partial epilepsy (SPE) began at all ages (2 to 81 years). Patients with early onset (< 20 years) showed the most unfavorable course in both seizure control and social adaptability. Patients with late onset (50 years or older) had no family history of epilepsy, and half of them had a past history of ccrebrovascular disease or head injury as a presumed etiology. In patients with idiopathie generalized epilepsy (IGE), 25 of 29 had early onset, and a family history of epilepsy was found in 31%. Nineteen patients continued to have seizures after 50 years of age, albeit infrequently. Furthermore, 10 of them showed exacerbation around the age of 50. Conclusions: Most of the late onset epilepsies were SPE with a relatively good prognosis. General belief has held that seizure outcome in IGE is favorable, but some IGE patients show an increased seizure propensity in old age.
Assessment of the correlation of platelet morphology with in vivo recovery and survival
Authors: Mintz Paul D. , Anderson Garth , Avery Nancy , Clark Pamela , Bonner Robert F. 
Published: July 2005

BACKGROUND:  There is continuing interest in the development of in vitro tests evaluating the in vivo function, recovery, and survival of platelets stored for transfusion. A recent forum concluded that no completely reliable test exists, although discoid morphology indicates a platelet's good health. We evaluated a novel device, the NAPSAC (Noninvasive Assessment of Platelet Shape and Concentration), designed to determine noninvasively the proportion of discoid platelets in a stored concentrate, as well as platelet concentration.STUDY DESIGN AND METHODS:  Twenty‐eight plateletapheresis concentrates stored 24 hours in PL‐146 were evaluated. Percent discoid platelet results were correlated with radiolabeled autologous recovery and survival performed using 111Indium oxyquinoline and calculated using linear (L) and multiple‐hit (M) models. pH of 8 concentrates was raised at the end of storage with 6N NaOH. Platelet concentration measured by NAPSAC and Coulter Thrombocounter C was compared in 256 plateletapheresis products.RESULTS:  Percent discoid platelets at 24 hours did not correlate significantly with platelet recovery or survival (recovery L = 0.29, M = 0.28; survival L = 0.16, M = 0.03). Raising the pH (mean 6.38 to 6.94) resulted in a significant increase in percent discoid platelets (21% to 41%). Platelet concentration values for both methods studied were linearly correlated with a slope of 1.01 ± 0.03, r = 0.81.CONCLUSION:  Percent discoid platelets was not predictive of posttransfusion platelet recovery or survival. The results suggest that non‐discoid platelets may survive posttransfusion and even revert to discoid shape, since raising the pH approximately doubled the percent of discoid platelets. The NAPSAC was shown to be a reliable instrument for noninvasively determining platelet concentration in PL‐146 concentrates.
The effect of immunization on the response to P. gingivalis infection in mice is adjuvant‐dependent
Authors: Houri‐Haddad Yael , Soskolne W. Aubrey , Halabi Amal , Shapira Lior 
Published: August 2005

AbstractAim: Studies on vaccines against the periodontal pathogen Porphyromonas gingivalis have produced conflicting results, but no consideration has been given to the role of different adjuvants in these vaccines. We have previously shown that an intra‐chamber challenge with heat‐killed P. gingivalis was modified by immunization with different adjuvants. This study tested the hypothesis that different adjuvants in P. gingivalis vaccines would differentially modify the host response to a live P. gingivalis infection.Results: Using P. gingivalis‐infected subcutaneous chambers in mice, we show that vaccination with P. gingivalis in alum attenuated the pro‐inflammatory cytokine levels at the site of infection, while the vaccine containing incomplete Freund's adjuvant did the opposite. Although both vaccines induced a similar humoral IgG response, P. gingivalis‐induced abscesses were significantly smaller in the alum‐adjuvant group.Conclusions: The results suggest that the immune response and the resultant protection to a P. gingivalis infection, in P. gingivalis‐vaccinated mice, are adjuvant‐dependent.
A Decomposed Negative Binomial Model of Structural Change: A Theoretical and Empirical Application to U.S. Agriculture
Authors: Kim C. S. , Schluter G. , Schaible G. , Mishra A. , Hallahan C. 
Published: July 2005

We developed a single‐equation decomposed negative binomial regression model (NBRM) of the U.S. farm sector to simultaneously evaluate structural changes in the U.S. agricultural sector and the strength of several economic forces that influenced the changes in farm structure during the 1960–96 period. We found all these forces reinforced economic incentives to increase the size and decrease the number of small farms. Only agricultural programs and machinery prices countered these forces. Nous avons élaboré un modèle de régression binomiale négative (NBRM) décomposéàéquation unique pour le secteur agricole des États‐Unis afin d'évaluer simultanément les changements structurels de ce secteur ainsi que la puissance de plusieurs forces économiques qui ont influencé les changements de structure des exploitations agricoles au cours de la période 1960–96. Nous avons conclu que toutes ces forces ont renforcé les stimulants économiques en faveur d'une augmentation de la taille des exploitations et d'une diminution du nombre de petites exploitations. Seuls les programmes agricoles et le prix de la machinerie ont contrecarré ces forces.
Multi-Operational Machining Processes Modeling for Sequential Root
Cause Identification and Measurement Reduction
Authors: Wang Hui , Huang Qiang , Katz Reuven 
Published: August 2005

Abstract
Variation propagation modeling has been proved to be an effective way for variation reduction and design synthesis in multi-operational manufacturing processes. However, previously developed approaches for machining processes did not directly model the process physics regarding how fixture, and datum, and machine tool errors generate the same pattern on part features. Consequently, it is difficult to distinguish error sources at each operation. This paper formulates the variation propagation model using the proposed equivalent fixture error concept. With this concept, datum error and machine tool error are transformed to equivalent fixture locator errors at each operation. As a result, error sources can be grouped and root cause identification can be conducted in a sequential manner. The case studies demonstrate the model validity through a real cutting experiment and model advantage in measurement reduction for root cause identification.
Role of Protein Kinase G in Growth and Glutamine Metabolism of
Mycobacterium bovis
BCG
Authors: Nguyen Liem , Walburger Anne , Houben Edith , Koul Anil , Muller Stefan , Morbitzer Monika , Klebl Bert , Ferrari Giorgio , Pieters Jean 
Published: August 2005

ABSTRACT

The survival of pathogenic mycobacteria in macrophages requires the eukaryotic enzyme-like serine/threonine protein kinase G. This kinase with unknown specificity is secreted into the cytosol of infected macrophages and inhibits phagosome-lysosome fusion. The
pknG
gene is the terminal gene in a putative operon containing
glnH
, encoding a protein potentially involved in glutamine uptake. Here, we report that the deletion of
pknG
did not affect either glutamine uptake or intracellular glutamine concentrations. In vitro growth of
Mycobacterium bovis
BCG lacking
pknG
was identical to that of the wild type. We conclude that in
M. bovis
BCG, glutamine metabolism is not regulated by protein kinase G.
Effect of bronchial thermoplasty on airway distensibility
Authors: Brown R. H. , Wizeman W. , Danek C. , Mitzner W. 
Published: July 2005

Recent studies have reported that the application of thermal energy delivered through a bronchoscope (bronchial thermoplasty) impairs the ability of airways to narrow in response to methacholine. How such altered smooth muscle affects the response of airways to lung inflation may have important clinical implications, particularly as it relates to the abnormal response of asthmatic subjects to lung inflation and deep inspiration. The aim of this study was to examine whether bronchial thermoplasty affected airway distension with lung inflation in relaxed and contracted airways.A total of 230 airways were studied, ranging 2.5–15 mm, in six dogs. These airways were divided into two groups: an untreated (control) population and a bronchial thermoplasty-treated population.Prior to treatment, the airway pressure-area curves in the two groups of airways were identical. In contrast, the relaxed and contracted airway pressure-area curves in treated airways were shifted upward at all points, showing increased airway area at both 3 and 5 weeks post-treatment.In conclusion, these results show that reducing that amount of functional smooth muscle with bronchial thermoplasty leads to increased airway size in both relaxed and contracted states over a normal range of inflation pressures.
A dynamic population model of disease progression in COPD
Authors: Hoogendoorn M. , Rutten-van Mölken M. P. M. H. , Hoogenveen R. T. , van Genugten M. L. L. , Buist A. S. , Wouters E. F. M. , Feenstra T. L. 
Published: July 2005

To contribute to evidence-based policy making, a dynamic Dutch population model of chronic obstructive pulmonary disease (COPD) progression was developed.The model projects incidence, prevalence, mortality, progression and costs of diagnosed COPD by the Global Initiative for Chronic Obstructive Lung Disease-severity stage for 2000–2025, taking into account population dynamics and changes in smoking prevalence over time. It was estimated that of all diagnosed COPD patients in 2000, 27% had mild, 55% moderate, 15% severe and 3% very severe COPD. The severity distribution of COPD incidence was computed to be 40% mild, 55% moderate, 4% severe and 0.1% very severe COPD. Disease progression was modelled as decline in forced expiratory voume in one second (FEV1) % predicted depending on sex, age, smoking and FEV1% pred. The relative mortality risk of a 10-unit decrease in FEV1% pred was estimated at 1.2. Projections of current practice were compared with projections assuming that each year 25% of all COPD patients receive either minimal smoking cessation counselling or intensive counselling plus bupropion.In the projections of current practice, prevalence rates between 2000–2025 changed from 5.1 to 11 per 1,000 inhabitants for mild, 11 to 14 per 1,000 for moderate, 3.0 to 3.9 per 1,000 for severe and from 0.5 to 1.3 per 1,000 for very severe COPD. Costs per inhabitant increased from \#8364;1.40 to 3.10 for mild, \#8364;6.50 to 9.00 for moderate, \#8364;6.20 to 8.50 for severe and from \#8364;3.40 to 9.40 for very severe COPD (price level 2000). Both smoking cessation scenarios were cost-effective with minimal counselling generating net savings.In conclusion, the chronic obstructive pulmonary disease progression model is a useful instrument to give detailed information about the future burden of chronic obstructive pulmonary disease and to assess the long-term impact of interventions on this burden.