Towards an objective theory of subjective liking: A first step in understanding the sense of beauty.

The study of the electroencephalogram signals recorded from subjects during an experience is a way to understand the brain processes that underlie their physical and emotional involvement. Such signals have the form of time series, and their analysis could benefit from applying techniques that are specific to this kind of data. Neuroaesthetics, as defined by Zeki in 1999, is the scientific approach to the study of aesthetic perceptions of art, music, or any other experience that can give rise to aesthetic judgments, such as liking or disliking a painting. Starting from a proprietary dataset of 248 trials from 16 subjects exposed to art paintings, using a real ecological context, this paper analyses the application of a novel symbolic machine learning technique, specifically designed to extract information from unstructured data and to express it in form of logical rules. Our purpose is to extract qualitative and quantitative logical rules, to relate the voltage at specific frequencies and in specific electrodes, and that, within the limits of the experiment, may help to understand the brain process that drives liking or disliking experiences in human subjects.

Mesothelioma and asbestos, fifty years of evidence: Chris Wagner and the contribution of the Italian occupational medicine community.

BACKGROUND: One of the first studies that "convincingly" described the relationship between pleural mesothelioma and asbestos was made by Wagner, Sleggs and Marchard in 1960. This article, published fifty years ago, contains much of what we still know to-day about malignant mesothelioma. OBJECTIVES: The aims of this article were to analyze the historical and scientific developments that led to the publication of Wagner's paper, to critically examine its contents and to consider the contribution to the initernational debate on the carcinogenesis of asbestos fibres made by occupational medicine in Italy in that period. METHODS: A thorough analysis ofscientific and historical literature on the relationship between asbestos exposure and tumours was conducted, with special regard to the articles by Italian authors in the 1960's. RESULTS: The decisive role of Wagner's paper in understanding the aetiopathogenetic mechanisms of asbestos-related tumours is inconfutable. In particular, his article clearly demonstrated the existence of a typical cancer of the mesothelium, expressing three fundamental principles of the epidemiology of occupational cancer: association with the carcinogen, latency and individual susceptibility. Enrico Vigliani, then director of the "Clinica del Lavoro" in Milan, made important contributions to this debate, also through the collection of data regarding mortality among Italian asbestos workers. CONCLUSIONS: Wagner's 1960 paper can be considered as a milestone not only in the history of occupational and environmental health, but also in the evolution of other medical disciplines such as epidemiology, pathology and oncology. A re-appraisal of the Italian contributions to the international debate on this subject should be considered.

Antiepileptic drug distribution in cerebral cortex, ammon's horn, and amygdala in man.

Significant correlations in the concentrations of phenobarbital, phenytoin, and carbamazepine in the brain, plasma, and cerebrospinal fluid were found in 12 surgically treated epileptic patients. These findings confirm the clinical reliability of monitoring anticonvulsant drug plasma levels as part of the routine management of epilepsy. Phenobarbital, phenytoin, and carbamazepine are uniformly distributed in the gray and white matter in different brain areas (except for a higher concentration of phenobarbital in the rhinencephalic structures in comparison with the corresponding temporal neocortex) and in normal and scar tissue. In these 12 patients, all of whom were medically resistant, molar cortex concentration of phenobarbital and phenytoin was at "therapeutic" levels or even higher. These data suggest that in therapy-resistant patients, despite cerebral drug concentrations of the same therapeutic level as, or higher than, those present in medically controlled patients, anticonvulsant drugs are pharmacologically ineffective.

Anal protrusion as a complication of ventriculo-peritoneal shunt. Case report and review of the literature.

A case is reported in which the Raimondi peritoneal catheter of a ventriculoperitoneal shunt spontaneously protruded from the anus in an infant. This complication has been previously reported; both pathogenesis and treatment may still represent a problem. From the review of the pertinent literature pathogenesis is mostly related to bowel perforation due to local infective adhesions. Treatment does not imply major abdominal surgery, if after avulsion of the extruded catheter and exteriorization of the shunt no peritoneal signs are present.

Indications of anticonvulsant plasma levels monitoring in medical and surgical treatment of epilepsy.

The results of long-term (19-21 months) intensive anticonvulsant plasma levels monitoring in two patients with partial complex epilepsy resistant to therapy are reported. In the first case the qualitative and quantitative therapeutic adjustment based on the monitoring data caused the disappearance of the seizures. In the second case, in which a right mid-temporal calcification (abscess) was demonstrated by CT-scan, the attacks were not controlled by different drugs. The patient became seizure-free after a right temporal lobectomy. The importance of long-term anticonvulsant plasma levels monitoring in partial complex epilepsies unresponsive to pharmacological therapy is discussed in detail in view of possible surgical treatment.

CT-scan and EEG findings in professional pugilists: early detection of cerebral atrophy in young boxers.

In order to evaluate the possibility of early detection of minimal cerebral damages in the professional boxers, ten young pugilists were submitted to complete neurological examination, EEG recording and CT-scan. Neuroradiological data, electrical patterns and neurological aspects were examined in connection with sporting career of each boxer. Neurological examination was normal in all cases. EEG patterns were considered normal in 3 cases, borderline in 4 cases and pathological in 3 cases. CT-scan was considered normal in 4 cases, borderline in 4 and pathological (showing signs of cerebral atrophy) in 2 cases. A good correlation was found between CT-scan pictures, EEG patterns and sporting career of the boxers: the pugilistis who suffered knockouts had pathological and/or borderline CT-scan and EEGs, while the pugilists who did not experience knockouts during their career showed a normal CT-scan and EEG, independently of the years of activity and number of matches.

The disease of the moon: the linguistic and pathological evolution of the English term "lunatic".

The public opinion and the scientific community incorrectly believe that the English term "lunatic" was originally related only to insanity, but it also referred to epileptic people. The aim of this article is to clarify the original meaning of the English word "lunatic" by analyzing the evolution of the relationship between psychiatric and neurological diseases and by pointing out the influence of the moon in the history of medicine, in popular traditions, and in English literature. The article also contains a detailed and accurate review of the modern scientific literature on the relationship between moon and epilepsy/psychiatric disorders.

[Deep cerebral electrical activity during the hypnotic state in man: neurologic considerations in hypnosis]. / Attività elettrica cerebrale profonda durante lo stato ipnotico nell'uomo: considerazioni neurofisiologiche sull'ipnosi.

To the authors' knowledge hypnosis has never been induced in epileptic patients during depth EEG study. This neurosurgical diagnostic procedure (that has been routinely used in medically resistant epileptic patients for the preoperative exact delimitation of the epileptogenic lesion) offers a unique opportunity of obtaining fundamental information on the possible neurophysiological mechanisms implied in human hypnosis. Observations were carried out on 3 consecutive patients affected by medically resistant partial seizures with elementary and/or complex symptomatology. A chronic deep electrode study explored rhinencephalic structures as well as specific target areas of the cerebral cortex. Background electrical activity during the hypnotic state showed a significant decrease of slow waves and an increase of alpha and beta rhythms, with constant increase of amplitude, as compared with the nonhypnotic state. Focal interictal abnormalities were drammatically reduced by hypnotic trance. Moreover, depth EEG study during sleep in one patient indicated that the EEG patterns during hypnosis and sleep are basically different, confirming that there is no convincing evidence of physiological similarities between the 2 states.

Interictal acute psychoses in temporal lobe epilepsy during withdrawal of anticonvulsant therapy.

Acute interictal psychotic attacks during withdrawal of medication are described in two patients with temporal lobe epilepsy submitted to depth EEG study with a view to surgical treatment. The patients were on chronic treatment with clonazepam associated in one with phenobarbitone and in the other with phenobarbitone plus carbamazepine. Our observations suggest that the acute withdrawal of clonazepam, the plasma levels of which were monitored may play a part in producing psychotic attacks characterised by dysphoric manifestations, irritability, aggressiveness, anxiety, and hallucinations. These symptoms could be interpreted as a withdrawal syndrome.

Simultaneous EEG/ECG recordings during prolonged status syncopus. Physiopathological considerations on a case.

Report of a case of status syncopus in which only simultaneous EEG/ECG recordings permitted the correct diagnosis and a study of the feed-back mechanisms between brain and heart.

[Interruption of antiepileptic therapy in seizure-free patients following surgery to remove the epileptogenic lesion]. / Interruzione della terapia antiepilettica nei pazienti liberi da crisi dopo intervento per la rimozione della lesione epilettogena.

This paper presents a series of 20 epileptic patients operated on at our Institute, with a clinical, EEG and drug plasma level follow-up, for periods from 48 to 60 months. Following surgery a group of 12 patients were seizure-free in a 3 year period of follow-up, and anticonvulsant medication was gradually withdrawn. While in 8 of these patients drug interruption uneventful, in 4 cases drug withdrawal caused the seizure to reappear. These 4 patients became seizure-free again, following a reintroduction of pharmacological therapy, which appeared to be effective also at low doses. Another group of 8 patients continued to have seizure also after surgery. Following quantitative and qualitative adjustments of their anticonvulsant medication, 5 patients became again seizure-free, while 3 continued to have seizures. Our experience suggests that in patients in whom the epileptogenic lesions have been surgically removed, anticonvulsant therapy can be safely withdrawn and removed after a seizure-free period of 3 years. Reappearance of seizures after drug withdrawal has a good prognosis, since a simple readjustment of medical therapy is usually effective in preventing further seizures to occur.

Differences between the concentrations of antiepileptic drugs in normal and pathological human brain.

The concentrations of antiepileptic drugs in histologically normal and pathological brain tissues were investigated in 6 patients submitted to surgery. No significant difference for phenobarbital and phenytoin was found between normal and scar tissue, whereas there was a trend to concentration in tumour tissue (meningioma and glioma) of phenobarbital, phenytoin and carbamazepine. Alteration in the vascular supply and pathological changes at cellular and subcellular levels could be responsible for the differences in the distribution of the drugs. The possible clinical relevance of the preferential concentration of the drugs in tumour tissue is discussed.

Stereo-EEG and surgery in partial epilepsy with temporo-parieto-occipital foci.

Six cases of partial epilepsy operated on for lesions at the temporo-parieto-occipital junction are presented. Three cases had signs of enlargement of one lateral ventricle at the temporo-parieto-occipital carrefour, three had a lateral homonymous hemianopsia and all showed lateralizing interictal EEG abnormalities. The manifold features of the seizures could not be related to the involvement of one or more definite cortical areas. Since clinical, radiological, scalp EEG investigations provided no sufficient data to map the epileptogenic lesion to be excised, stereo-EEG studies with chronic depth electrodes were performed. Besides permitting the exact delimitation of the epileptogenic lesion, depth EEG gave the clue for interpreting physiopathological mechanisms underlying the electroclinical seizures in each case.

Late results of stereotactic radiofrequency lesions in epilepsy.

Thirty-five patients with partial complex seizures and two patients with generalized epilepsy were treated by stereotactic radiofrequency lesions. Follow-up from 2 to 13 years was available in 30 patients. The stereotactic targets in patients with partial complex seizures were: a) Amygdala; b) Ammon's horns; c) parahippocampal gyrus; d) Fornix. Depending on scalp EEG and depth electrode studies, each patient had one or more target coagulated, unilaterally or bilaterally. In the 2 cases of generalized epilepsy, bilateral Forel field lesions were performed. Late surgical results are discussed in relation to the depth EEG studies and the number and site of stereotactic lesions.