Levetiracetam: treatment in epilepsy.

A large number of new antiepileptic drugs (AEDs) have become available over the last 10 years. Results from placebo-controlled clinical trials and community-based practice have demonstrated that levetiracetam has a broad spectrum of activity in suppressing seizures as add-on treatment and monotherapy and that it is safe and well-tolerated. Levetiracetam also has a favourable pharmacokinetic profile characterised by rapid and nearly complete absorption, very low potential for drug interactions and a prolonged pharmacodynamic effect that permits twice-daily dosing.

Preliminary efficacy of levetiracetam in monotherapy.

The standard of care for prescribing antiepileptic drugs (AEDs) has come to favor the use of monotherapy when possible; i.e., when compa-rable efficacy can be achieved with fewer risks of adverse events and drug interactions.

Thin fibre territories of nerves innervating hairs in the human forearm estimated from axon reflex vasodilatations.

1. To study the territories of thin nerve fibres innervating hair follicles, we extracted single hairs from forearm skin. Scanning laser Doppler methodology was used to measure the evoked local increase of skin perfusion, the underlying assumption being that axon reflex vasodilatation would be evoked within the territory of extraction-activated thin nerve fibres.

Two sites for modulation of human sympathetic activity by arterial baroreceptors?

1. Peroneal muscle sympathetic nerve activity (MSA), finger blood pressure and cardiac intervals were recorded at rest in 60 healthy subjects, aged 18-71 years. Arterial baroreflex control of MSA was analysed by relating each spontaneous sympathetic burst to the diastolic blood pressure and the cardiac interval of the heart beat during which the burst was generated.

Conceivable mechanisms by which Helicobacter pylori provokes duodenal ulcer disease.

A conceivable concept for the development of duodenal ulcers in Helicobacter pylori (H. pylori) infected subjects is presented in this chapter. The concept includes an explanation of the fact that only a minority of all H.

Two neural mechanisms for respiration-induced cutaneous vasodilatation in humans?

1. In humans, a deep breath is known to induce cutaneous vasoconstriction in the warm state, and vasodilatation in the cold state. To investigate whether vasodilatation in the cold state is related to reduction of sympathetic vasoconstrictor nerve traffic, we studied the effect of a deep breath on vascular resistance in a skin area on the dorsum of the hand, in which release of noradrenaline from sympathetic nerves was blocked by iontophoretic pretreatment with bretylium tosylate.

An in-vivo method for biomechanical characterization of bone-anchored implants.

Experimental equipment for in-vivo registrations of pull-out load vs displacement, applied torque vs angle of rotation, and lateral load vs lateral displacement has been developed. The set-up is designed for testing three implants inserted in a row and osseointegrated in, for instance, the proximal tibia of the beagle dog. The details of the set-up are described and considerations of the stress distributions are reported.

Longitudinal EEG findings in dementia related to the parietal brain syndrome and the degree of dementia.

EEG slow-wave activity was correlated with the regional brain syndrome profile in 74 patients with dementia. The EEGs were visually assessed using a semiquantitative rating scale. The intensities of four regional brain syndromes (parietal, frontal, subcortical, global) and the degree of dementia were rated.

Biomechanical characterization of osseointegration: an experimental in vivo investigation in the beagle dog.

This study reports the results of torsion tests, pull-out tests, and lateral loading tests on osseointegrated commercially pure titanium fixtures. The tests were performed in vivo on six beagle dogs. Three fixtures, each with a diameter of 3.

Selection of collimator for rCBF studies and evaluation of triple-headed SPET using noise-resolution plots.

We investigated the effect of collimator selection on image quality in regional cerebral blood flow (rCBF) studies of the brain performed with 99Tc(m)-HMPAO. A triple-headed SPET system (GE/CGR Neurocam) was used, together with three sets of parallel-hole collimators - general-purpose (GP), high-resolution (HR) and ultra-high-resolution (UHR). Two image quality parameters were used to describe the image quality, namely, noise and resolution.

Biomechanical characterization of osseointegration during healing: an experimental in vivo study in the rat.

This study reports torsion tests and pull-out tests on osseointegrated commercially pure titanium fixtures. The tests were performed in vivo on a total of 26 rats. Three fixtures with a diameter of 2.

The triplane fracture: four years of follow-up of 21 cases and review of the literature.

The triplane fracture of the distal tibia consists of several anatomic types, including two to four principal fracture fragments. According to previous calculations, 7% of all ankle fractures in girls and 15% in boys birth to 18 years old who have open growth plates are triplane fractures. In this update of a previous study and literature review of 209 cases (108 boys and 101 girls), the mean ages in boys and girls were 14.

Influence of topical rectal application of drugs on dextran sulfate-induced colitis in rats.

A rat model of colitis [dextran sulfate (DSS)] was used to study the permeation of Evans blue (EB) from the lumen into the wall of proximal and distal colonic loops after exposure to the dye for 2 hr. Topical application of drugs used in human ulcerative colitis (lidocaine, mesalazine, prednisolone, or sucralfate) was given daily during induction of colitis to protect the mucosa. The mucosal changes were evaluated with special regard to peptidergic innervation [substance P (SP) and neuropeptide Y (NPY)], invasion of antigen-presenting polydendritic cells, and mucin-containing goblet cells.

Treatment of superficial basal cell carcinomas using topically applied delta-aminolaevulinic acid and a filtered xenon lamp.

Objective: To evaluate the treatment of superficial basal cell carcinomas (SBCC) using photodynamic therapy with topically applied delta-aminolaevulinic acid (ALA) and a filtered short arc xenon lamp as a light source.

Method: An oil-in-water emulsion containing 20% ALA was applied topically to the lesion sites which were then occluded for 3 h. Irradiation was performed in a single session of 10 min using 125 or 166 mW/cm2 in the wavelength range (620-670 nm, giving a radiation dose of 75 or 100 J/cm2, respectively.

Quantitative EEG analysis as a supplement to the clinical coma scale RLS85.

Background: The aim of the study was to investigate the correlation between EEG indicators and clinical scores based on the RLS85 (Reaction Level Scale 85) in comatose patients. The results of a simple visual assessment of the EEG, using an arbitrary scale with typical EEG patterns, were compared with those obtained by quantitative electroencephalography (qEEG).

Method: The RLS85 scores were examined in 34 patients with impaired consciousness due to brain tumours, vascular lesions or head injuries.

Lumbar disc disease with discogenic pain. What surgical treatment is most effective?

The diagnosis and treatment of painful degenerative disc disease remains one of the most controversial topics in the spine literature. The debate continues as to whether surgical treatment should be attempted, and if so, which surgical approach is optimal. Surgical options include the following general types of spinal fusions: posterolateral (instrumented or noninstrumented), anterior lumbar interbody, posterior lumbar interbody, and transarticular facet joint screws.

Ultrastructural changes in spinal nerve roots induced by autologous nucleus pulposus.

Study Design: Ultrastructural changes were analyzed by transmission electron microscopy in nerve roots exposed to autologous nucleus pulposus experimentally.

Objectives: To assess if ultrastructural changes were present in areas with no light microscopic changes in nerve roots exposed to autologous nucleus pulposus in a pig model.

Summary Of Background Data: Previous analyses have shown that there is focal nerve fiber damage in nerve roots exposed to autologous nucleus pulposus in the pig.

Hepatitis and cancer: genetic aspects.

Hepatocellular carcinoma (HCC) is one of the most common tumours in the world. It is the seventh most common cancer in men and the ninth in women with an estimated 500,000 to 1,000,000 new HHC cases per year. However, there are considerable variations in the incidence of HCC throughout the world, related to geographical areas, socioeconomic factors, sex and age-specific incidence rates, suggesting genetic differences in susceptibility to HCC.

Expanding antiepileptic drug options: clinical efficacy of new therapeutic agents.

Results of double-blind, placebo-controlled, add-on trials of topiramate (TPM), lamotrigine (LTG), and vigabatrin (VGB) in refractory partial epilepsy were reviewed. In three European multicenter studies of TPM, the clinical efficacy of 400-, 600-, and 800-mg/day target dosages was demonstrated. In a similarly designed United States trial, LTG was significantly superior to placebo at a 500-mg/day dosage but not at a 300-mg/day dosage.

Central blood volume influences sympathetic sudomotor nerve traffic in warm humans.

The objective of this study was to test whether changes in central blood volume can induce reflex effects on sweating. Multi-unit skin sympathetic nerve activity (SSA) was recorded from the posterior cutaneous nerve of the forearm or radial nerve branches in 11 healthy volunteers. Skin electrical resistance and skin blood flow were recorded in the area innervated by the impaled nerve fascicle.

Autonomic and thermal sensory symptoms and dysfunction after stroke.

Background And Purpose: Symptoms interpreted as unilateral disturbances of autonomic function, such as coldness, dryness, sweating, and trophic changes, are well known but incompletely understood clinical problems after stroke. The present study provides data related to the incidence and mechanisms behind such symptoms.

Methods: Temperature perception thresholds, skin temperatures, evaporation rates, and skin blood flow responses were measured bilaterally in 37 stroke patients aged 58 +/- 13 years (mean +/- SD) and in a control group of 15 patients aged 64 +/- 15 years with a single transient ischemic attack.

Chondroid lipoma: an ultrastructural and immunohistochemical analysis with further observations regarding its differentiation.

Chondroid lipoma was recently described as a unique, benign, pseudosarcomatous lipomatous tumor with chondroid features, often simulating liposarcoma and myxoid chondrosarcoma. An extended histochemical and immunohistochemical analysis of 13 cases, including the proliferation markers, proliferating cell nuclear antigen (PCNA) and Ki67, as well as ultrastructural studies of eight cases were performed with the intent of further elucidating its differentiation. Staining with toluidine blue and alcian blue at controlled pHs indicated the presence of chondroitin sulfates within the myxohyaline matrix.