Effect of thymopentin on peripheral blood T-lymphocytes subsets and on the clinical course of the disease in patients affected by multiple sclerosis.

The effect on peripheral T-lymphocytes of Thymopentin (TP-5), asynthetic pentapeptide reproducing the biological activity of Thymopoietin, is known in Herpes Simplex infections and in Rheumatoid Arthritis. The aim of this study was to observe the effect of TP-5 on the OKT4 and OKT8 lymphocytes in Multiple Sclerosis. The AA. have studied this effect in two patients affected by definite MS, whose lymphocytes subpopulation, observed for 33 and 13.5 months respectively, showed a constant OKT4/OKT8 ratio greater than 2.5 in peripheral blood and whose clinical course was chronically progressive. TP-5 was administered during a period of one month. A decrease of the OKT4/OKT8 ratio in both patients (significant in one, p less than 0.01) due to the increase of OKT8 was observed. Also the clinical symptomatology improved in one patient.

Single photon emission computed tomography with 99mTc HM-PAO in the study of focal epilepsy.

We used 99mTc HM-PAO SPECT to study 50 patients with partial epilepsy: 47 interictally and 3 during a seizure. All 3 patients studied during a seizure presented an area of increased tracer uptake. Of those in whom recordings were taken during seizure-free intervals 35 (74%) showed perfusion asymmetries: 27 (57%) with decreased and 8 (17%) with increased uptake. We discuss the findings and compare them with those of similar studies using SPECT and positron emission tomography.

[Frequency of risk factors in cerebrovascular disease and their effect on the course and outcome. Study on 423 hospitalized patients]. / Frequenza dei fattori di rischio nella malattia cerebro-vascolare e loro influenza su decorso ed esito. Studio su 423 pazienti ospedalizzati.

In a group of 423 patients with cerebrovascular accident (CVA) the so-called risk factors have been studied and correlated with course and outcome of the disease. High levels of glycemia, seric lipids and uric acids, high blood pressure and cardiopathy are the most often observed abnormalities, but age is anyhow strictly correlated with the frequency of the disease and in old patients with diabetes bad outcome of the cerebrovascular accident is to be expected. The EEG, often a valid tool to evaluate the gravity of the cerebral lesion, can give clear information about the prognosis: bioelectrical signs of diffuse suffering of the brain are supporting a bad prognosis. The nature (ischaemic and haemorrhagic) of the CVA remains the most important factor influencing the course of the disease and death is very predictable in haemorrhagic accidents of diabetic patients.

[Long-term study of 34 cases of subarachnoid hemorrhage not subjected to surgical intervention]. / Studio a lungo termine di 34 casi di emorragia subaracnoidea non sottoposti ad intervento chirurgico.

The prognosis of subarachnoid haemorrhage is still a matter of debate. Reference is made to a long-term study of 34 patients not subjected to surgical management. Four recurrences (11.8%), with 3 deaths (8.8%), were noted over a 1-5 yr observation period. A crippling neurological deficiency was noted in 11 subjects (32.2%). The influence of the neurological state in the acute stage on prognosis is discussed.

[Plasma levels of anti-epileptic drugs. Evaluation of determinations carried out in the years 1978-1979]. / Il dosaggio plasmatico dei farmaci antiepilettici. Valutazione delle determinazioni eseguite negli anni 1978-1979.

The results of 701 determinations of antiepileptic drug plasma concentrations administered to 190 patients are described. It has been possible to reduce the number of prescribed drugs to 1.55 per patient, so that only 8.1% of subjects takes three or more drugs while 53% is on monotherapy. The use of the measurement of AEDs plasma concentrations resulted very useful: a) when Phenytoin (PHT) is prescribed; b) in epileptic children; c) when the patient takes two or more drugs; d) to evaluate the compliance. A significant increase (p less than 0.01) of the level/dose ratio of Phenobarbital (PB) when PHT is in, or over, the therapeutic range was observed, while at plasma concentrations of PHT below 10 micrograms/ml it does not influence the metabolism of PB.

[Albumin and IGG in the CSF as demonstration of blood-brain barrier damage and of immune response within the CNS (author's transl)]. / Albumina e immunoglobuline G liquorali, espressione di danno di barriera emato-encefalica e di risposta immunitaria nel sistema nervoso centrale.

The Cerebrospinal Fluid (CSF) and the serum of 102 neurological patients was studied in subgroups according to diagnostic criteria. The Blood-Brain-Barrier (BBB) is more severely damaged in cases of cerebral tumors and haemorragic cerebral diseases; synthesis of IgG within the CNS is more pronounced in Multiple Sclerosis (MS) patients in comparison with patients of other groups. The ratio IgG/PT in CSF is very high in MS patients. Considering the degree of increase of the IgG Index and of the ratio IgG/PT in CSF the Authors found the highest values in MS and this is typical of such disease. The degree of increase of the ratio CSF albumin/serum albumin showed highest values in patients with tumors or with haemorragic cerebral diseases.

[Steinert's myotonic dystrophy and Thomsen's congenital myotonia. Observation of a family (author's transl)]. / Distrofia miotonica di Steinert e miotonia congenita di Thomsen. Osservazione di una famiglia.

The nosographic relationship between Thomsen's and Steinert's disease is still uncertain. There is not agreement in the literature whether these are two different diseases or just different stages in the evolution of a single one. Four members of a family in two generations have been studied: two have a typical Steinert's, one a Thomsen's disease and one a clinical pattern that cannot be clearly considered neither of the first nor of the second type. In this patient a generalized muscular hypertrophy was followed, at the age of 54, by a generalized impairment of the muscular trophism and evolved into a severe wasting. This may be interpreted as an evolution of Thomsen's into a Steinert's disease. Furthermore, the presence in the same family of cases of both Thomsen's and Steinert's disease supports the hypothesis of a single disease. The present study suggests that Thomsen's and Steinert's diseases could be two clinical varieties of a single disease in different stages of development. This conclusion is supported by the similarity in the electromyographic patterns and in the histological picture from muscle biopsy of all patients examined.

[Preliminary study on immunoglobulins G in the cerebrospinal fluid of neurological patients]. / Studio preliminare sulle immunoglobuline G nel liquido cefalo-rachidiano di malati neurologici

The preliminary data from a study of the cerebrospinal fluid IgG of 76 neurological patients are reported. The radial immunodiffusion method was employed. The absolute and percentage increase of IgG with respect to total proteins in the various diagnostic classes involved in the series was considered. The most significant increases were encountered in M.S., in neuropathies and radiculopathies and in tumor involving the subarachnoid spaces. The high percentage is, however, characteristic of M.S. The method is thus particularly useful in diagnosing M.S. and in differentiating it from other neurological diseases.

[Histochemical demonstration of glial enzyme activity. I. Normal glia]. / Rivista sintetica sull'evidenziazione istochimica di alcune attività enzimatiche nella glia. I. Glia normale.

The literature data for normal glia enzyme activity are reviewed, with special reference to the specific phosphatases and the nucleoside-phosphatases and their relationship to transport mechanisms and the Golgi apparatus. Their demonstration still presents technical difficulties and is also hindered by substrate affinity variations which influence the histochemical picture; greater activity is sometimes observed in the oligodendrocytes and sometimes in the astrocytes and, in the latter, in different cytoplasma or nucleus structures. Using 32ATP, Hyden has shown the importance of this enzyme as a regulator of neuron K availability and of substrate transport from the capillaries to the nerve cells. Several workers have shown the striking positivity of the ATPase reaction in animal glia, as well as its importance in the sodium pump mechanism. Carboanhydrase is also involved in transport mechanisms. Giacobini has demonstrated high cholinesterase values and an absence of AChE in oligodendrocytes and astrocytes. Lysosome has been proved to be an arylsulphatase site. Phosphorylase is important in glial cell metabolism, since high levels indicate increased glycogen metabolism.

[Histochemical demonstration of glial enzyme activity. II. Reagent and neoplastic glia]. / Rivista sintetica sull'evidenziazione istochimica di alcune attività enzimatiche nella glia. II. Glia reattiva e neoplastica.

Enzyme activity changes in reagent and neoplastic glia are examined. In the case of reagent glia, considerably increased ADPase, ATPase and AMPase values have been observed in experimental elective parenchymal necrosis in the rat, in hypertrophic astrocytes from recent plaques in multiple necrosis, in demyelinisation associated with cyanide encephalopathy, and in reagent astrocytes surrounding tumours and arteriosclerosis sites. Depressed ATPase values have been observed in experimental oedema, as compared with increased TPPase in human oedema. BuChE and ChE activity disappears in both oligodendro- and astroglia near old cerebral infarct sites, whereas there is marked BuChE activity peripherally to multiple sclerosis plaques and in areas of phenylpyruvic oligophrenia demyelinisation. In neoplastic glia, ADPase is clearly evident in malignant gliomas, ATPase is related to the extent of the cell body, AMPase is positive in medulloblastoma cell cytoplasm and beta-glucuronidase increases in anaplasia. Above-normal ChE activity has been observed in astrocyte tumors, while BuChE is greater than that of AChE. Phosphorylase reaction is intense in astrocytoma and in glioblastoma giant cells. Phosphoglucomutase values are below-normal in tumours, except in the case of ependymoma, while both phosphohexoisomerase and hexokinase display increased activity in atypical forms.

[A case of Leber's hereditary optical atrophy in a family with evident signs of hereditary degenerative neuropathy]. / Contributo allo studio del morbo di Leber. Presentazione di un caso appartenente ad una famiglia con stigmate di neuropatia degenerativa ereditaria.

Reference is made to a case of Leber's disease in a patient with other slight neurological signs of the type encountered in hereditary ataxias. The importance of the case lies in the following points: (a) very early onset (this is a rare finding: 2.5% of cases, according to Ronne); (b) the presence of nervous abnormalities of the Charcot-Marie-Tooth amyotrophy type and of hereditary spinal of cerebellar ataxia in some of the 35 members of the patient's family, with or without optical atrophy; (c) the prevalence of the disease, though not to the total exclusion of females, suggesting a primarily diagynic multifactorial form of transmission. The main features of the case are compared with those reported in the literature.