bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sulindac in Established Experimental Diabetes: a Follow-up Study
Authors: van der Sloot Paul , Mizisin Andrew , Zochodne Douglas 
Published: February 2016

AbstractBackgroundIn two previous studies we have demonstrated prevention of electrophysiological abnormalities of nerve in experimental STZ (streptozotocin)-induced diabetes (ED) of rats using nonsteroidal anti-inflammatory agents: indomethacin and sulindac. Sulindac might benefit ED because it inhibits both cyclo-oxygenase and aldose reductase.MethodsIn this work, we examined whether 1 month of sulindac treatment reversed or improved established biochemical and electrophysiological abnormalities in experimental diabetes of 3 months duration. Sulindac-treated diabetic rats (6.0 mg/kg 5/7 days weekly by gavage) were compared to untreated diabetics, nondiabetic controls and sulindac treated control rats.ResultsDiabetic rats developed slowing of conduction velocity in caudal sensory, sural sensory, caudal motor and sciatic tibial motor fibers. Sulindac improved caudal motor and, to a lesser extent sural sensory conduction but not caudal sensory or sciatic tibial motor conduction. Sulindac did not alter sciatic sugars or polyols.ConclusionsSulindac provided modest improvement in some indices of experimental neuropathy in this reversal study, but there was less efficacy than in the preventative study. Reversal paradigms should be examined in all experimental therapies for diabetic neuropathy.
Environmental Exposures in Elderly Canadians With Parkinson’s Disease
Authors: Chaturvedi S. , Østbye T. , Stoessl A.J. , Merskey H. , Hachinski V. 
Published: February 2016

AbstractBackgroundEtiologic hypotheses for Parkinson’s disease have implicated environmental factors, genetic factors, or a combination of the two.MethodsData from a survey of elderly Canadians (n = 10,263) with regard to their history of Parkinson’s disease and previous environmental exposures were analyzed. Exposure to various environmental factors was compared between 87 patients with Parkinson’s disease and 2070 elderly controls without Parkinson’s disease.ResultsExposure to plastic resins (OR (odd ratio) = 8.79), epoxy resins (OR = 6.94), glues (OR = 4.26), paints (OR = 3.84), and petroleum (OR = 2.30) products was significantly (p < 0.05) associated with Parkinson’s disease.ConclusionThese substances deserve further exploration with respect to the possible development of parkinsonism.
Long Term Treatment of Intractable Reflex Sympathetic Dystrophy With Intrathecal Morphine
Authors: Becker W.J. , Ablett D.P. , Harris C.J. , Dold O.N. 
Published: February 2016

AbstractBackground:Some patients with reflex sympathetic dystrophy (RD) develop intractable symptoms unresponsive to conventional therapy. Recently, intrathecal morphine therapy has been used with some success in such patients.Methods:The clinical course of two patients with intractable reflex sympathetic dystrophy (RSD) is described. Both patients developed intractable leg pain, swelling and autonomic changes after a leg injury. Numerous medical treatments and surgical sympathectomies failed to provide long term relief.Results:Relatively satisfactory symptom control was achieved only with the use of long term intrathecal morphine therapy delivered by subcutaneously implanted infusion pumps. Exacerbations of the RSD continued to occur, at times in association with further leg trauma, but these could be controlled by a temporary escalation of the intrathecal morphine dose. Complications of morphine therapy were relatively minor. A red rash appearing over the pump site was the first sign that a drug catheter break had occurred, necessitating surgical catheter revision.Conclusion:Long term intrathecal morphine therapy is a useful treatment option for patients with intractable severe RSD who have failed other therapies and remain markedly disabled.
Vertebral Ligament Amyloid Deposits in Spinal Stenosis
Authors: Gagné François 
Published: February 2016

AbstractObjective:We have searched for amyloid substance in 41 consecutive samples of tissue taken during laminectomies performed to relieve spinal canal stenoses. We also evaluated the relation between the occurrence of deposits and the age of patients.Methods:Tissue sections were stained with Congo red; positive areas had to show green dichroism under polarized light.Results:Small amyloid deposits were found in fibrous and fibro-elastic (ligamentum flavum) tissues in 14 subjects (34%). After age 60, the frequency was close to 50%. It reached 58% in those aged 70 or over. Our 3 patients aged 80 or more all had deposits. There was also a relation between age and importance of the infiltration. Both sexes appeared evenly involved. Systemic amyloidosis (multiple myeloma) was demonstrated in a single patient. In this case infiltration was slightly more abundant and exceeded ligamentary structures, also involving vascular walls.Conclusions:Small amyloid deposits were frequent in our material. Their presence and their abundance were closely related to the age of patients. Rarely, a more important infiltration, exceeding ligamentary structures will perhaps suggest a systemic form of amyloidosis. A few other rare amyloid conditions (amyloidosis associated with prolonged dialysis, amyloid tumour) have been reported to induce spinal canal stenosis. The occurrence of amyloid in vertebral ligaments of non-stenosed elderly persons is not documented; it may represent a new localization of senile amyloidosis.
Intrathecal Baclofen Therapy for Adults with Spinal Spasticity: Therapeutic Efficacy and Effect on Hospital Admissions
Authors: Nance Patricia , Schryvers Orpha , Schmidt Brian , Dubo Hy , Loveridge Brenda , Fewer Derek 
Published: February 2016

ABSTRACT:A prospective trial to demonstrate the efficacy of intrathecal baclofen therapy by implanted pump for adults with spasticity due to spinal cord injury or multiple sclerosis was initiated in our hospital. Of the 140 patients assessed, 7 met the following criteria for inclusion in the study: a modified Ashworth score > 3, a spasm frequency score > 2, and an inadequate response to oral antispasticity drugs, (i.e., baclofen, clonidine and cyproheptadine). All patients responded to intrathecal bolus injection of baclofen in the double blind, placebo-controlled screening phase (mean bolus dose = 42.8 μg). Programmable Medtronic pumps were implanted in 4 patients while 3 patients received nonprogrammable Infusaid pumps. Post-implantation, a marked decrease in spasticity occurred with a significant reduction of the Ashworth score (mean = 1.8, p < .005), a reduced spasm score (mean = 0.8, p < .005), and an improved leg swing in the pendulum test. These effects were maintained during a follow-up of 24 – 41 months (average infusion dose = 218.7 μg/day). The gross cost-savings due to reduced hospitalizations related to spasticity was calculated by comparing the cost for the two year period before pump implantation to the same period after treatment for 6 of the 7 patients. The cost of in-hospital implantation as well as the cost of the pumps were deducted from the gross savings. There was a net cost-saving of $153,120. Our findings agree with the reported efficacy and safety of intrathecal baclofen treatment, and illustrate the cost-effectiveness of this treatment.
Role of Electrophysiological Studies in Diabetic Neuropathy
Authors: Bril Vera 
Published: February 2016

Abstract:Electrophysiological studies are a reproducible and noninvasive method of assessing peripheral nerve function. The sensitivity of these methods has been validated in population-based and clinical studies, and the variability of test results is typically lower than with other noninvasive tests of nerve function. It has been recommended that standardized procedures including temperature control and equipment calibration be utilized with electrophysiological testing. The failure to detect significant changes in nerve conduction studies from clinical studies may be due to poor standardization of technique and inadequate sample size to detect differences. Baseline results from a multicenter, randomized trial indicate that different electrophysiological measures are highly correlated and reproducible. This and future studies that incorporate standardized techniques and an adequate sample size should be able to detect significant differences between treatments and identify effective therapeutic interventions for diabetic neuropathy.
Traitement Medico-chirurgical du Mal de Pott de L’adulte. Notre Attitude au Gabon
Authors: Loembe Paul-Marie 
Published: February 2016

Abstract:Twenty-six of 95 adults treated for tuberculous spondylitis, between 1982 and 1993, underwent surgery. Twenty-one exhibited neurological deficits: radicular deficits: 4, and progressive spinal cord syndromes: 17 (incomplete: 13, complete, of acute onset: 4). Vertebral body compression fracture was the most prominent finding. Indications for surgery were neurologic: 11, mechanical: I, etiologic: 1, and mixed: 13. Twelve patients had vertebrectomies, 3 laminotomies and 11 laminectomies. The average follow-up was 23 months. The neurological recovery was complete in 16 cases, partial in 4 cases and unchanged in one case. Bony consolidation occurred after 3–5 months. The medicosurgical treatment produced a very high cure rate, so rapidly, that it became the treatment of choice in our setting. Moreover, that allows to specify the diagnosis. Anterior decompression and fusion is recommended in the cervical and lumbar spine. In the thoracic segment, significant kyphosis is infrequent, so that surgical correction is rarely necessary. Laminotomy may occasionally be indicated for posterior decompression for abscess. Laminectomy is now preferred for uncommon cases of thoracolumbar posterior compression by tuberculous arachnoiditis or associated posterior vertebral tuberculosis. Indications for open biopsy are discussed.
NMDA Receptor Blockade and Spinal Cord Ischemia Due to Aortic Crossclamping in the Rat Model
Authors: Follis F. , Miller K. , Scremin O. U. , Pett S. , Kessler R. , Wernly J. 
Published: February 2016

Abstract:Recent brain research proposes that, during ischemia, synaptically released excitatory amino acid neurotransmitters accumulate at toxic concentrations with ensuing neuronal death. Their action is mediated by the receptor subtype N-methyl-D-aspartate (NMDA). The protective effect of NMDA receptor blockade with intrathecal MgS04 and MK-801 was investigated during spinal cord ischemia induced by aortic occlusion of 12 minutes. Male Sprague-Dawley rats, 250-300g, underwent intrathecal administration of 20 μL of normal saline (SA n = 16), MgS04 1M (MG n = 16), or MK-801, 25 mM solutions (MK n = 16) in a randomized order. After 2 hours, the animals underwent occlusion of the thoracic aorta and subclavian arteries for 12 min. An additional control group (CO n = 16) underwent occlusion for 12 minutes, without intrathecal injection. The animals were scored according to their functional performance (LS = lesion score) each day for four days by a blinded observer. Mean LS were calculated for each group at a given day. Treatment and control groups were not different at day 1 (P = 0.302). Group MG was improved from groups SA (P = < 0.0039) and CO (P = < 0.0048) at day 4. This study demonstrates that although intrathecal NMDA receptor blockade with MgS04 or MK-801 does not prevent paraplegia due to spinal cord ischemia in the rat, it could however influence the rate of recovery after ischemic injury.
Large Unresponsive Zones Appear in Cat Somatosensory Cortex Immediately After Ulnar Nerve Cut
Authors: Li Cheng-Xiang , Waters Robert S. , Oladehin Akinniran , Johnson Eldridge F. , McCandlish Carl A. , Dykes Robert W. 
Published: February 2016

Abstract:The organization of the primary somatosensory cortex innervated by the ulnar nerve was studied before and immediately after ulnar nerve transection in 11 cats electrophysiologically mapped under Nembutal or Ketamine anesthesia. The cortex was reexamined a second time beginning 42 hr after nerve transection in four cats anesthetized with Nembutal. One additional sham-operated control was also mapped. The region of cortex formerly served by the ulnar nerve remained largely unresponsive to somatic stimulation independent of the type of anesthetic used during recording. Nonetheless, animals anesthetized with Ketamine had more new responsive sites in deafferented cortex following nerve cut than cats anesthetized with Nembutal. New responses, when observed, were evoked by stimulation of a region of skin adjacent to the region served by the ulnar nerve. These findings suggest that the immediate response to deafferentation of somatosensory cortex is a limited acquisition of novel responses restricted to a region immediately adjacent to cortex containing normal afferent input.
Assessment of Genetic Polymorphisms in DNA from Formalin Fixed Neurological Tissues
Authors: Mordila M. , Vaula G. , St George-Hyslop P.H. 
Published: February 2016

Abstract:The ability to analyze the genotype of deceased affected members of pedigrees segregating inherited neurological diseases considerably augments the informativeness of such pedigrees. This information has direct application in attempts to isolate disease genes by positional cloning strategies, and for genetic counselling. We show that the genotype at polymorphic simple sequence repeat loci can be determined from genomic DNA isolated from 10 micron thick paraffin embedded, formalin fixed neurological tissues. The critical constraint on this method is the size of the template target bearing the simple sequence repeat, which should ideally be less than 165 base pairs.
Fluoxetine and Selegiline – Lack of Significant Interaction
Authors: Waters C.H. 
Published: February 2016

Abstract:The use of the combination of fluoxetine, an anti-depressant serotonin uptake inhibitor, and selegiline, a monoamine oxidase -B inhibitor, was reviewed in a large population of patients with Parkinson’s disease. All records were reviewed from a Parkinson’s disease clinic to determine how many patients were treated simultaneously with selegiline and fluoxetine. Patient characteristics, duration and dose of treatment, side effects and reasons for discontinuation were noted. Twenty-three patients received both medications at the same time. No additional side effects were noted with the combination therapy that had not already been reported with each medication alone. No serious side effects were found. In this clinic population, fluoxetine and selegiline were used in combination without major side effects, but further observation is warranted.
A Controlled Trial of Mitoxantrone in Multiple Sclerosis: Serial MRI Evaluation at One Year
Authors: Bastianello S. , Pozzilli C. , D’Andrea F. , Millefiorini E. , Trojano M. , Morino S. , Gasperini C. , Bozzao A. , Gallucci M. , Andreula C. , Bozzao L. , Gambi D. , Prencipe M. 
Published: February 2016

Abstract:We present the results of a randomized double-blinded placebo controlled, multicenter trial, of low-dose mitoxantrone (MX), after one year, in 25 patients with relapsing-remitting multiple sclerosis, who had serial enhanced magnetic resonance imaging (MRI). Treatment groups were balanced for age, gender, duration of illness and neurological disability. Five of the 13 MX patients and 10 of the 12 placebo patients had exacerbations during treatment (p < 0.02). The mean change in the extended disability status scale was not significantly different between the MX and placebo treatment groups. Serial Gadolinium-DTPA enhancedMRIdetected no significant difference between the MX treated and placebo groups in the mean total number of new, enlarging, or Gadolinium-DTPA enhancing lesions; there was a trend toward a reduction of new, enlarging and Gadolinium-DTPA enhancing lesions in MX patients. Despite this ameliorating effect, the results indicate that serial Gadolinium-DTPA enhanced MRI, performed over one year in a limited number of patients, could not provide conclusive evidence for a role of MX therapy in relapsing-remitting multiple sclerosis.
Intractable Hiccup Due to Multiple Sclerosis: MR Imaging of Medullary Plaque
Authors: Chang Yung-Yee , Wu Hsiu-Shen , Tsai Tsung-Chia , Liu Jia-Shou 
Published: February 2016

Abstract:We describe a 31-year-old man with clinically definite multiple sclerosis who presented with intractable hiccup for one month prior to admission. The responsible lesion was confirmed by magnetic resonance imaging to be a plaque in the ventral paramedian portion of the medulla oblongata.
A Double-Blind Cross-over Trial of Amantadine Hydrochloride in Friedreich's Ataxia
Authors: Filla A. , De Michele G. , Orefice G. , Santarelli F. , Trombetta L. , Banfi S. , Squitieri F. , Napolitano G. , Puma D. , Campanella G. 
Published: February 2016

ABSTRACT:We performed a double-blind cross-over study with amantadine hydrochloride in 12 patients with Friedreich's disease and 2 with autosomal dominant cerebellar ataxia. Patients were randomly assigned to a placebo-amantadine or amantadine-placebo sequence. The interval between the treatments was two weeks. Patients were graded according to a functional ataxia scoring scale and videotaped in basal conditions and 90 min after a single oral dose of 100 mg amantadine or placebo. Three evaluators independently scored the videotapes. Statistical analysis showed no significant effect of amantadine in Friedreich's disease.
Epidemiology and Clinical Features of Vestibular Schwannoma in Manitoba, Canada
Authors: Frohlich Arnold M. , Sutherland Garnette R. 
Published: February 2016

ABSTRACT:The incidence of vestibular schwannoma (acoustic neuroma) in Manitoba, Canada was reviewed. From 1987 through 1991, 71 tumors were diagnosed in 69 patients. The overall annual incidence rate for both sexes was 1.27/100,000 with male and female annual incidences of 1.31/100,000 and 1.24/100,000 respectively. For males, there was an early peak in the age group 30 - 39 years (2.1/100,000). Following the fifth decade, the incidence for males plateaued (2.7 - 3.6/100,000). For females, the incidence increased with age up to age 60 - 69 years (4.1/100,000). This was followed by a progressive decline in the incidence. Although the incidence of vestibular schwannoma was relatively high, the clinical features were not unlike those previously reported in the literature.
Serum Lipoprotein Fatty Acid Profile in Hereditary Ataxias
Authors: Iorio L. , De Michele G. , Filla A. , Di Martino L. , Postiglione A. , Patti L. , Campanella G. 
Published: February 2016

ABSTRACT:We investigated the serum fatty acid profiles of cholesterol esters, phospholipids and triglycerides in 24 patients with Friedreich's disease and 16 patients with other forms of spinocerebellar degeneration. In 8 patients with Friedreich's disease we also analyzed the fatty acid profile of the lipoprotein fractions. We found no major differences in fatty acid profiles between ataxic patients and sex and age-matched controls; in particular there was no decrease of linoleic acid in Friedreich's disease. The level of linoleic acid in serum cholesterol esters decreased with increasing disability of patients.
Dural Cavernous Hemangioma: An Under-recognized Lesion Mimicking Meningioma
Authors: James R. Perry , William S. Tucker , Mario Chui , Juan M. Bilbao 
Published: February 2016

ABSTRACT:We report a 77-year-old woman who presented with partial seizures and was found to have an enhancing dural-based parietal convexity mass. The lesion enlarged on serial examination by computed tomography (CT) over a one year period. The clinical features and radiologic appearance were compatible with a pre-operative diagnosis of meningioma; however, pathologic findings were typical of a dural cavernous hemangioma. Accumulating evidence suggests that these lesions are an uncommon but distinct type of vascular malformation most often arising from the cavernous sinus, tentorium, or cerebello-pontine angle. With CT, magnetic resonance imaging and angiography, these lesions can closely resemble meningioma in terms of signal characteristics, enhancement pattern, and location. This is of importance both in the practical management of meningiomas where the diagnosis is often based on radiologic studies alone, and in clinical trials where incorrect entry diagnosis should be avoided.
Syrinx Extending from Conus Medullaris to Basal Ganglia: A Clinical, Radiological, and Pathological Correlation
Authors: Marc R. Del Bigio , John H.N. Deck , Kerry MacDonald J. 
Published: February 2016

ABSTRACT:A 41-year-old woman with a history of birth injury to the brachial plexus suffered several delayed episodes of neurological deterioration. Magnetic resonance imaging studies revealed a syrinx extending from the conus medullaris into the brainstem and rostrally into both internal capsules. She died of an acute exacerbation of chronic respiratory failure. Autopsy demonstrated syringomyelia and syringobulbia with cavity extension bilaterally along the corticospinal tracts into the internal capsules. Islands of glial tissue in the subarachnoid space around the medulla caused obstruction of the subarachnoid space at the foramen magnum. These were probably the result of birth injury to the cerebellum. A detailed clinico-pathological correlation is provided to explain her neurological deficits. The pathogenesis of syrinx formation is discussed in terms of a late manifestation of birth trauma.
Pathogenic Mechanisms in Sporadic Amyotrophic Lateral Sclerosis
Authors: Andrew Eisen , Charles Krieger 
Published: February 2016

ABSTRACT:In recognition of the 100th anniversary of Charcot’s death we have reviewed possible pathogenic mechanisms in amyotrophic lateral sclerosis (ALS). Advances in the last 5 years in molecular biology and genetics have identified mutations in the cytosolic dismutase (SODI) gene in some patients with familial ALS raising the possibility that oxidative stress may be involved in the pathogenesis. An excitotoxic pathogenesis has been implicated based on elevated plasma and CSF levels of amino acids and altered contents of amino acids in the nervous system of ALS patients and changes in the number of excitatory amino acid receptors. ALS sera containing antibodies to L-type calcium channels and the development of immune mediated lower and upper and lower motor neuron models have revitalized research efforts focusing on an immune basis for ALS. Other pathogenic mechanisms which have been the subject of recent research include elemental toxicity, apoptosis and programmed cell death and possibly a deficiency or abnormality in growth factors. Pathogenic processes for ALS must account for an increasing incidence of ALS, male preponderance, and the selective vulnerability of the corticomotoneuronal system.
Anti-Glutamate Therapy in Amyotrophic Lateral Sclerosis: A Trial Using Lamotrigine
Authors: Andrew Eisen , Heather Stewart , Michael Schulzer , Donald Cameron 
Published: February 2016

ABSTRACT:Glutamate excitotoxicity is implicated in the pathogenesis of amyotrophic lateral sclerosis (ALS). We report the results of a double blind, placebo controlled, trial using 100 mg of oral daily lamotrigine (3,5-diamino-6-(2,3 dichlorophenyl)-l,2,4-triazine) which inhibits glutamate release. 67 patients were entered and at trial termination of 1.5 years 15 had withdrawn (9 active and 6 placebo) and 12 had died (6 active and 6 placebo). Mean age at entry was 57.5 years for the active and 58.6 years for the placebo groups. Patients were seen at 3 monthly intervals and scored according to neurological deficit based upon age of onset, bulbar and respiratory involvement, ambulation and functional disability. The mean change in clinical scores for the active versus placebo groups over the trial period was 7.1 ± 3.3 and 9.0 ± 3.3 respectively (0.05 < p < 0.10). Changes in cortical threshold and MEP/CMAP ratios to magnetic stimulation also did not differ significantly between the two groups. We conclude that lamotrigine in the doses administered does not alter the course of ALS.