Poster Abstracts Friday, November 11, 2005 $525

then using image analysis system, we made the comparison of diaphragm shapes between DM and controls. Results: In respiratory movement, anterior-posterior diameter of thoracic cage had moved more than lateral. All patients with MD had raised diaphragm in both inspiration and expiration movement. Control had raised diaphragm only in expiration and not in inspiration. There were not almost differences between diaphragm shapes in D M patients during respiratory movement. In contrast, controls had convexity shape in expiration and flat shape in inspiration. Therefore, diaphragms in MD almost did not contract and had weakness. Conclnsion: Diaphragm elevations have seen and diaphragm shape did not change during respiratory movement. Diaphragm weaknesses have been noted in all DM cases.

1676 Subderulal Wile Electrodes vs. Collodion-Applied Disk Electrodes for long-term ICU UlOtdtoring

Young B l, Ires J~, Chapman M 2, Mirsattari S a. 1University of Western Ontario, London, Ontario, Canada," 2University of Toronto, Toronto, Ontario, Canada

The reliability of long-term EEG monitoring (LTM) primarily depends on tile integrity of scalp electrodes. We sinmltaneously studied subdermal wire scalp electrodes (SWE) and standard, collodion- applied disk electrodes (CADE) for long term monitoring (LTM) of 10 patients in the neuro-ICU. Records were read without knowledge of which electrode system was being used. In 8 patients CADE began to fail between 3-6 hours in a characteristic manner: 60 Hz artifact, then low voltage rhytlmfic waves followed by high voltage artifact at various frequencies. No scalp elearode position was more likely than others to fail. In contrast, SWE showed artifacts after 10 hours in 5 patients; these were transient in 4 and did not interfere with EEG interpretation. SWE recordings were more susceptible to movement artifact, e.g., during physiotherapy. Initial minor scalp bleeding occurred in all SWE but in no CADE patients. SWE rims provide stable recordings for 24-48 hours and are superior to CADE. This has potential usefulness for application to LTM in the ICU, especially when EEG technologists are not always available for servicing, for reliable interpretation and for constructing automated systems for LTM.

1677 Sex differences in mortality with gram negative Bacteremia

B. Young ~, A. Fraser a, Z. Hussain a, Z. Hutchinson ~ and J. Wilson ~. 1University of Western Ontario, London, Ontario, Canada

Prefiminary studies suggest that women with sepsis and its attendant encephalopathy have a higher mortality than men. In a survey we found that men and women under age 50 years with Gram-negative bacteremia had similar outcomes. We therefore examined patients over age 50 years with blood cultures positive for Gram-negative bacteria as this would explore tile sex difference in mortality in more vulnerable patients and such cultures would unlikely contain false-positives. We obtained names of all patients over 50 years of age with positive Gram-negative blood cultures in our hospital from the years 2000 and 2001. Charts were retrieved and the following data tabulated: name, age, gender, micro-organism, co-morbidities, antibiotics and outcome (lived to be discharged or died) during that adnfission. Of 59 men 20 (34%) died; of 41 women 6 (15%) died (Clfi-Square - 4.7; p - 0.031). There was a nonsignificant trend for males who died to have more serious c.omorbidities (heart disease, renal failure, diabetes mellitus, cancer, chronic lung disease, alcoholism, stroke or dementia) than men who lived or women who lived or died. Men over 50 years had a higher incidence of Gram-negative bacteremia and a proportionately higher in-hospital mortality than women over age 50 years; comorbidities may contribute to the increased mortality.

1678 Construction of neuron specific expression vector for human Noggin gene

Zhou, C 1, Wei, X 1, Liu, L 2, Jiang, H 1 . 1Department o/Neurology, Qilu Hospital of Shandong University, Yinan, China; 2 Shandong University of Traditional Chinese Medicine, Yinan, China

Background: Noggin gene is known to have an important role in the development and maturation of nerve system. A neuron specific expression vector for human Noggin Gene was constructed for for further study. Method: Human Noggin gene was cloned from human fetus with a pair of specific, primers by mean of RT-PCR. The purified product of RT- PCR was ligated into the pMD18 simple T clone vector, hich was confirmed by DNA sequence analysis. The pCS2+ [Tod]-GFP plasrnid contained tire alphal-tubulin promoter, a neuron specific promoter. Tile right fragnrents recycled from the two plasnfids, which contained tire full length of human Noggin eDNA and tile tissue-specific pro- moter, was ligated with T4 DNA ligase. The recombinant pCS2 + [Tad]- Noggin plasmid was also identified by DNA sequence analysis. Results: Human Noggin gene was under the control of the alphal- tubulin promoter in the recombinant pCS2+ [Tzd]-Noggin plasmid. Conclusion: An expression vector was successfully constructed which expressed human Noggin gene specifically in tile neurons.

1679 European PLAATO (Percutaneous Left Atrial Appendage Transcath- eter Occlusion) Registry Trial: preventing Stroke in patients with Atrial Fibrillation

Fischer, E l, Omran, H 2, Thuesen, L s, Pichler, M 4, Rowland, E 5, Bartoell, A 6, Leetz, M 1, Bayard, y1, Sievert, H 1. 2CardioVascular Center Frankfi~rt, Sankt R~tharinen RYankenhaus, German},; 2St. Marien Krankenhaus Bonn, Bonn, Germany.." SSkejby Sygehus, Aarhus, Denmark; 4Landesk-rankenhaus Salzburg, Salzburg, Austria; sSt Georges Hospital, London, United Kingdom; 6Centro Cardiologico S.p.A., Milan, Italy

Background: Patients with atrial fibrillation have a high risk of experiencing a cardioembolio stroke emerging from the left atrial appendage (LAA). Closing the LAA with the PLAATO T M (Perouna- neous Left Atrial Appendage Transcatheter Occlusion) device has proved to be feasible and safe. However, the effectiveness concerning stroke prevention is still to be discussed. Methods: The European PLAATO T M Registry Trial is designed for 176 patients. Inclusion criteria were atrial fibrillation with inability to take warfarin, prior cerebral ischemia and/or two clinical risk factors for stroke. The patients were followed by x-ray, TEE and NIH stroke scale in regular intervals. Results: 99 patients with a mean age of 70 ± 10 years were enrolled so far. The mean procedure time was 73 d- 34 minutes. All patients were successfully implanted. They were followed for a total of 83 patient years. During follow up two patients developed a perioardial effusion, three patients suffered pericardial tamponade and underwent pericar- diocentesis. One occluder was chosen too small and embolized after being released. It was retrieved successfully and another device was implanted during the same procedure. Three patients had a thrombus formation on the occluder which resolved without sequelae. One patient suffered a stroke six months post implant. According to the CHADS2 score the expected annual risk of stroke was 6.7% for our patients. The annual stroke rate after implantation was 1.2%. That leads to a risk reduction by PLAATO T M of 82.1%. Conclusions: As far as follow up test show, the occlusion of the LAA with the PLAATO T M device seems to reduce the inddence of stroke in patients with atrial fibrillation.

1680 Evaluation of Anfioxidant potential of vitamin E Anti M Rna Synthesis hi Cyclophosphainide treated rat brain

$526 Friday, November 11, 2005 Poster Abstracts

Revnic, C l, Revnic, F a, Botea, S ~. 1UMF Carol Davila, Bucharest, Romania; 2NIGG Aria Asian, Bucharest, Romania; 3 tz Babes Institute, Bucharest, Romania

Objective: evaluaton of the effects of vitanfin E upon m R N A synthesis and lipid peroxidation and catalase activity in cerebral cortex, hypocampus and hypothalamus of Wistar rats following i.p. admin- istration of Cyclophosphamide (Cy) Material and Method: 21 adult Wistar rats aged 18 months old ,were divided into three groups of 7 rats each: group A (controls), group B which received CY for 5 days consecutively 35mg/kg body weight Group C which received Cy and vitamin E for 5 days (12nrg/kg body weight) with one hour before the administration of CFA. Cerebral cortex, hypocampus and hypothalamus (100mg from each biological sample have been processed for radioisotope uptake (3H Uridine The activity of catalase has been deterimend in all brain regions The rate of lipid peroxidation has been detet~fined by Wilbur method expressed in rmroli MDA/hour. Our data have pointed out immediate and long term effects of chemical stress induced by Cy administration upon bio- chemical and oxidative parameters from brain cortex, hypocampus and hypothalamus. Cy has a negative effect upon m R N A synthesis and catalase activity which significantly decreases in all brain regions under study Lipid peroxidant potential is modified following CY treatment decreasing below the normal limits esspecialy in cerebral cortex and hypocampus. Vitamin E has a positive effect upon m RNA synthesis, lipid peroxidation rate in brain cortex and esspecialy in hypothalamus but no effect on hypochampus. The positive effect of vitamin E was noticed also on catalase by attenuating the inhibitory effects of Cy esspecialy in hypochampus and brain cortex but not in hypothalamus.

1681 Radical diet revealing Dracul's Disease

Tournier, M 1, Trevisol-Bittencourt p1,2,3,4, Pioner, L 1"3, Bittencourt, F 2'4, Collares, C 1'2"3"4'5, Tomaselli, p1,3. 1Universidade Federal de Santa Catarina, Florian@olis/SC, Brasil," 2Hospital Santa Teresa, Sdo Pedro de Aledntara/SC, Brasil," 3Hospital Universitdrio/ UFSC, Florian@olis/SC, Brasil," 4Cliniea Nterdiseiplinar de Epilepsia do Estado de SC, Florian@olis/SC, Brasil," 5Centro de Controle de IntoxicaeJes de Sdo Paulo, Brasil

Backgroumh Acute intermittent pot-phyria (ALP) is characterized by the deficiency of enzymes in the heine biopathway. [t has an autossomic dominant genetic inheritance. The symptoms are habi- tually triggered by various conditions such starvation or low- carbohydrate diets, illicit drugs and a huge variety of medications. The diagnosis can be performed through clinical and laboratory evidence. The nrythological Romanian character Dracul was the most famous sufferer of this disease. Methods: To describe a young woman presenting AIP secondary to radical protein based diet.

Results: OBL, 20 years old, became habitually admitted to the emergency room with complaints of weakness and recurrent abdom- inal pain. The doctor recomendation was..." you nmst look for psychological assistance". She said that 15 days before had started a high-protein-based diet for losing weight The neurological exanrination showed mfiversal diminished deep reflexes and muscular weakness mainly in the extremities. Her urine presented urobilinogen (++). Exposed to the light, the color of the urine became different - "Port wine" urine. OBL had typical symptoms such recurrent abdominal pain, polineuropathy and behavioral changes. The strong recurrent abdominal pain and the acute peripheral neuropathy can be misdiagnosed as acute surgical abdomen and Guillain-Barre syndrome respectively. Canelnsions: These patients must be oriented about their condition and to avoid low carbohydrate diets and dangerous drugs as well. Most of people suffering from AIP can have a perfectly normal life by properly avoiding its precipitant factors.

1682 Kluver-Bucy syndrome in children of hypox[c [scheIn[c eneephalopathy

Ilia S. Department o/Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India

Background: Khiver-Bucy syndrome (KBS) includes hyperorality, pladdity, indiscriminate hyper sexuality and altered dietary habits, reported to develop following insult to temporal lobes. Psychic blindness (inabifity to recognize fanfiliar objects) and hyper metamor- phosis (over reaction to visual stimulus) are its other constituents. Method: We encountered 16 children in age range of 6-16 years between 1993-2005 (12 years) with features of KBS. They were selected from cases of cerebral birth anoxia consequent to hypoxic ischemic encephalopathy (HIE). Only children having documentary evidence of HIE (standard criteria) were selected. This was based on birth records of pediatrician, history by mother and clinico-radiological features. Presence of hyperorality, sexual hyperactivity and abnornml behavior suggested the presence of KBS. Results: Hyperorality and abnormal behavior were common manifes- tations in all 16 (1100%) patients. Hypersexuality was evident in 7 (43%) children. Psychic blindness and hypetmetanrorphosis were present in 4 (25%). Violent behavior was present in 6, while 4 patients had a placid behavior. Bulimia and coprophagia were observed in 3 patients. Seizures were present in 9 (56%), among whom, they were well controlled (more than 60% decline in frequency) in 5 children by sodium valproate or carbamazepine. Following seizure control, significant improvement in behavior was observed in 4 cases, hr other patients, behavior was unaltered. Conclusion: It appears that KBS may be more common in children of HIE than suspected previously and may manifest with a wide clinical spectrum. Seizures are commonly associated and their control may help in improving behavior.