Clinical restitution following cerebral ischemia in hypo‐, normo‐ and hyperglycemic ratsSiemkowicz, Eugeniusz; Hansen, Anker Jon
doi: 10.1111/j.1600-0404.1978.tb02855.xpmid: N/A
Rats with different levels of blood glucose concentration were exposed to 10 min of complete brain ischemia achieved by compression of neck vessels by a pneumatic cuff. All normoglycemic rats survived the ischemic period and made the best clinical recovery. Hyperglycemic rats died within 12 h. Seizure activity was observed in all animals in this group. Three of eight hypo‐glycemic rats died between 3 and 16 days. The clinical recovery was less complete than in the control group. Thus, recovery from cerebral ischemia depends upon preischemic blood glucose concentration. Hyper‐ and hypoglycemia hamper the clinical recovery after transient cerebral ischemia.
Ophthalmoplegia‐plus, a real nosological entityBastiaensen, L. A. K.; Joosten, E. M. G.; Rooij, J. A. M.; Hommes, O. R.; Stadhouders, A. M.; Jaspar, H. H. J.; Veerkamp, J. H.; Bookelman, H.; Hinsbergh, V. W. M.
doi: 10.1111/j.1600-0404.1978.tb02856.xpmid: 212920
Four patients with chronic progressive external ophthalmoplegia (c.p.e.o.), retinal, neurological, endocrine and auditory anomalies, three of whom showed signs of cardio‐myopathy, are described. On biochemical examination signs of disturbed pyruvate and lactate metabolism were found and there were indications of loss of respiratory control with loosely coupling of phosphorylation (from oxidation). In the muscle biopsy specimens from all four patients aggregates of abnormal mitochondria were seen, compatible with the diagnosis of a mitochondrial myopathy. A cardiac biopsy was performed once also showing abnormalities. The great similarity in the clinical, biochemical and morphological findings justifies one comprehensive diagnosis. The term “ophthalmoplegia‐plus”, although it has recently fallen into some discredit as a nosological entity, is the most obvious choice. The pathogenesis of ophthalmoplegia‐plus is a widespread general disturbance of mitochondrial function, affecting various organs and systems. This distinguishes it only gradually from true ocular myopathy, and descending ocular myopathy, where only the ocular muscles and skeletal muscles, are affected by the mitochondrial anomaly (at least there is no obvious clinical involvement of other organs). Within the nosological entity of ophthalmoplegia‐plus a subdivision can be made for the Kearns‐Sayre syndrome, in which the clinical picture suggests that the most severe and widespread mitochondrial lesions are to be found.
Guillain‐Barré syndrome: Demonstration of antibodies to peripheral nerve tissueNyland, Harald; Aarli, Johan A.
doi: 10.1111/j.1600-0404.1978.tb02857.xpmid: 707033
Sera from 30 patients with acute Guillain‐Barré syndrome were tested for the presence of antibodies to peripheral nerve tissue using the antiglobulin consumption test. An increased binding of IgG was observed in 15 out of 30 sera and in these sera F(ab')2 fragments prepared from IgG retained the capacity to combine with peripheral nerve tissue, suggesting an antigen‐antibody interaction. The specificity for peripheral nerve tissue was demonstrated by absorption experiments. F(ab')2 fragments prepared from IgG of normal sera, however, failed to react with the tissue, suggesting a non‐specific binding through the Fc part of the molecule. In sera from patients fully recovered from the Guillain‐Barré syndrome and from patients with other neuropathies, no increased binding of IgG was observed.
Anterior spinal artery syndromeO'Moore, Brian
doi: 10.1111/j.1600-0404.1978.tb02860.xpmid: 707036
Three patients are presented, each showing clinical and electrophysio‐logical findings indicative of the anterior spinal artery syndrome: sudden onset of nonprogressive weakness and spasticity of one or both legs, associated in one patient with pain and in all three patients with selective impairment of temperature sensation, radiological evidence of aortic calcification, normal sensory and motor conduction velocities and normal amplitude of sensory potentials, but diminshed amplitude of evoked motor responses. Electromyography showed widespread fibrillation in muscles of the leg in two patients and evidence of marked loss of motor units in all three patients.
Dopaminergic agonist Ro 8–4650 in Parkinson's diseaseBirket‐Smith, Erik; BØttcher, Jette; Dupont, Erik; Holm, Per; Jensen, John P. A.; Kristensen, Ole; KØhler, Ole; Mikkelsen, Bent
doi: 10.1111/j.1600-0404.1978.tb02862.xpmid: 360759
An isoquinoline derivative Ro 8–4650 (rac‐4‐(3,4‐dichlorophenyl)‐1,2,3,4‐tetrahydro‐7‐methoxy‐2‐methylisoquinoline hydrochloride) with dopamin‐ergic properties was studied in a randomized crossover trial. The group studied comprised 37 patients with idiopathic parkinsonism and persistent symptoms, despite levodopa treatment. Median Webster rating before allocation was 11.5. The trial drug did not differ significantly from placebo as regards effect and involuntary movements. It led to more frequent minor side effects. Levodopa is not sufficiently effective in all parkinsonians and side effects are frequent. The isoquinoline derivative Ro 8–4650 (rac‐4‐(3,4‐dichlorophenyl)‐1,2,3,4‐tetrahydro‐7‐methoxy‐2‐methylisoquinoline hydrochloride) has shown dopaminergic activity (Haefely 1977) and was accordingly assessed in a randomized clinical trial.