Varicella-zoster infection in adult cancer patients. A population study.

In a retrospective review of varicella-zoster (V-Z) Infections in adult cancer patients, 766 episodes of V-Z Infection were studied among 740 patients seen at a large comprehensive cancer center from 1972 to 1980. The highest risk of infection was present among patients with lymphoma and leukemia. The risk of dissemination of V-Z Infection was significantly associated with the presence of active tumor at the time of Infection. The site of the primary tumor correlated with the site of subsequent zoster Infection among patients with breast cancer, cancer of the respiratory tract, and gynecologic cancer. Pain attributable to V-Z Infection was present in a large majority of episodes. The median time from the completion of therapy to the onset of Infection was seven months for patients receiving radiotherapy and less than one month for those receiving chemotherapy. Various attributes of this study group were compared with those of previously studied cancer and noncancer populations.

Intravenous radionuclide angioscintigraphy and computer tomography in cerebral arteriovenous malformations.

In 25 patients with cerebral arteriovenous malformation (AVM) computer tomography (CT) was compared with dynamic and static intravenous radionuclide angioscintigraphy (99mTc-labelled red blood cells). The diagnosis was verified by arteriography performed 2-20 years prior to this study. Scintigrams and CT-scans were evaluated 'blindly' by independent observers after pooling of the patient studies with 20 and 20 control studies, respectively. Only images strictly characteristic of AVM were classified as positive. The nosographic sensitivity of both methods was about 70%, in a few patients they were supplementary. Neither CT nor scintigraphy were able to detect lesions of less than 2 cm diameter. The methods seem to be of equal and rather high specificity, and are both well suited as screening procedures. CT provides additional information as to other intracranial abnormalities. The screening method of first choice when AVM is suspected may be CT or angioscintigraphy, depending on availability of equipment and expertise.

GH4ZD10 cells expressing rat 5-HT1A receptors coupled to adenylyl cyclase are a model for the postsynaptic receptors in the rat hippocampus.

1. Vasoactive intestinal polypeptide (VIP) stimulated adenosine 3':5'-cyclic monophosphate (cyclic AMP) production by cultured GH4ZD10 cells with an EC50 value of about 7 nM. The extracellularly recovered cyclic AMP predominated, and was reduced by co-incubation with 8-hydroxy-2-(di-n-propyl-amino) tetralin (8-OH-DPAT) and 5-hydroxytryptamine (5-HT), whereas dopamine (0.1-30 microM) did not reduce VIP-stimulated cyclic AMP production. 2. The responses to 5-HT and 8-OH-DPAT were blocked by (-)-alprenolol and NAN 190. The antagonism by (-)-alprenolol was competitive in nature with a pA2 value of 7.0. 3. The responsiveness of the cells to 5-HT agonists was highly dependent upon the culturing conditions used. Thus, 8-OH-DPAT inhibition of VIP (30 nM)-stimulated cyclic AMP production decreased with increasing passage number of the cells. Reduction of the zinc concentration used to promote expression of the 5-HT1A receptor gene produced a greater sensitivity of the cells to 5-HT agonists. 4. Under such conditions, the following efficacies (5-HT = 100) were found: lisuride 106, (+)-lysergic-acid diethylamide 100, 5-methoxy-N,N-dimethyltryptamine 98, RU 24949 98, 5-carboxamidotryptamine 97, (+/-)-8-OH-DPAT 90, (+)-8-OH-DPAT 87, 1-[2-(4-aminophenyl)ethyl]-4-(3-trifluoromethylphenyl)-piperazine 86, flesinoxan 79/88, (-)-8-OH-DPAT 62, buspirone 43/50, ipsapirone 46. Spiroxatrine and spiperone had a low intrinsic activity, but reduced the response to 5-HT. These efficacies are similar to those reported in the literature for post-synaptically localized 5-HT1A receptors in the rat hippocampus. Thus, the GH4ZD10 cells serve as a useful in vitro model system for these receptors.

Early and late side effects of water-soluble contrast media for myelography and cisternography: a short review.

Acute and chronic neurotoxicities of the ionic contrast media Conray, Dimer X, Dimer X and a steroid, and a nonionic contrast medium metrizamide (Amipaque) are reviewed. All ionic media induced late arachnoiditis potentiated by intrathecal steroids. Amipaque did not induce late arachnoiditis, but it produced a number of acute side effects. Myelography in patients given a phenothiazine (levomepromazine) was associated with a decreased incidence of side effects compared with a nonmedicated group.

Ataxia and cerebellar atrophy in chronic alcoholics.

Forty-five alcoholics were examined clinically and by CT scanning in order to evaluate the relationship between ataxia, cerebellar atrophy and peripheral neuropathy. A significant relationship was found between ataxia and cerebellar atrophy as well as between ataxia and peripheral neuropathy.

Neuroendocrine tests in depressive stroke patients.

1. In the present study 63 stroke patients and 23 control patients participated. The presence and degree of depression was defined by the Hamilton Rating Scale for Depression and the Research Diagnostic Criteria. 2. The TRH stimulation test was performed in all the patients. 3. No difference in Delta Max TSH was found between stroke patients and control patients. 4. No difference in Delta Max TSH was found between patients with the lesion in the right or left hemisphere. 5. No correlation was found between the frequency of blunted response to the TRH stimulation test and the presence of depression. 6. No difference in Delta Max TSH was found between suppressors and non-suppressors to the DST.

Antagonism by 8-hydroxy-2(di-n-propylamino)tetraline and other serotonin agonists of muscarinic M1-type receptors coupled to inositol phospholipid breakdown in human IMR-32 and SK-N-MC neuroblastoma cells.

IMR-32 and SK-N-MC cells were found to contain [3H]quinuclidinyl benzilate specific binding sites inhibited by pirenzepine in a manner suggesting the presence of both M1-type and M2-type muscarinic receptor recognition sites. Neither cell had detectable [3H]8-OH-DPAT binding sites. Carbachol stimulated the rate of inositol phospholipid breakdown in IMR-32 and SK-N-MC human neuroblastoma cells with an EC50 value of about 50 microM in both cases. Pirenzepine inhibited the carbachol (100 microM)-stimulated inositol phospholipid breakdown in both cells with Hill slopes of unity and IC50 values of 15 nM (IMR-32) and 12 nM (SK-N-MC). The 5-HT1A receptor agonist 8-OH-DPAT competitively inhibited carbachol-stimulated inositol phospholipid breakdown with pA2 values of 5.78 (IMR-32) and 5.61 (SK-N-MC). These values are consistent with the inhibitory potency of 8-OH-DPAT towards [3H]quinuclidinyl benzilate binding in these cells. The 5-HT agonists 5-MeODMT and buspirone at micromolar concentrations inhibited carbachol-stimulated breakdown in IMR-32 cells. The inhibition by 8-OH-DPAT and 5-MeODMT was not affected by preincubation with (-)alprenolol. 5-HT (10-100 microM) was without effect on either basal or carbachol-stimulated breakdown. It is concluded that IMR-32 and SK-N-MC neuroblastoma cells express muscarinic M1-type but not serotoninergic receptors coupled to phosphoinositide-specific phospholipase C. 8-OH-DPAT acts as a weak antagonist at these muscarinic receptors.

Reaction to contrast media in contrast-enhanced CT of the brain. A comparative investigation of non-ionic ultravist and ionic urografin-meglumin.

A comparison has been made of contrast medium reactions in contrast-enhanced CT of the cerebrum using Urografin-meglumin and a new non-ionic, low-osmolality radiologic contrast medium, Ultravist. The number of contrast medium reactions was significantly less with Ultravist, but many mild reactions were observed with both contrast media. Regardless of the contrast used, the incidence of contrast reactions was independent of the CT diagnoses.

Radiologic aspects of inverted papilloma.

A series of 42 patients with inverted papilloma is presented. Of these, 38 patients had radiologic examinations. Thirty patients had comparable radiologic examinations in the form of X-ray of the sinuses and/or tomography and/or CT scan. The preoperative findings were compared and related to the extent of the tumor at surgery. Clinical examination combined with CT appears to be the optimal preoperative procedure. Follow-up should include CT in order to allow comparison with postoperative status and, preferably, also with preoperative radiologic findings.

Nervous system damage and nutritional factors in chronic alcoholics.

Dietary habits in 45 chronic alcoholics were assessed by the dietary history method, and plasma albumin and serum transferrin. These variables as well as clinical findings did not indicate general malnutrition, but a moderate deficiency in folate intake was found. There was no correlation between the nutritional variables and central and peripheral nervous system function investigated by neuroradiological, neuropsychological, and neurophysiological methods. Transketolase and thiamine-pyrophosphate effects were measured in a subgroup of alcoholics and compared to a control group. No differences were found and there was no correlation to central nervous system impairment. These findings do not support the hypothesis that nervous system damage found in chronic alcoholics is of nutritional etiology.

Oral health status and treatment needs in long-term medicine patients in a Copenhagen hospital department.

Oral health and dental treatment needs were investigated in 50 randomly selected long-term medicine patients admitted to The Glostrup Hospital, University of Copenhagen, Glostrup, Denmark. All the patients were clinically and radiologically examined. Oral health generally was poor. Two-thirds (66%) of the patients were totally edentulous, 24% partially edentulous. Only 10% were dentate with no dentures. The number of remaining teeth per patient averaged 4.7, that of caries destructed teeth 1.4. All 17 patients with remaining teeth had periodontal disease, and 13 of them suffered from caries. Alveolar ridge atrophy, periapical inflammation, root remnants, impacted teeth and oral mucosal lesions were demonstrated in, respectively, 80, 22, 24, 8, and 26% of the group. In total 82% of the patients needed some kind of treatment, mainly prosthetic and oral surgery. The estimated total treatment time per patient averaged 165 min.

Permanent, skin penetrating, bone-anchored titanium implants. A clinical study of host-reaction in bone and soft tissue.

In 12 patients with a skin penetrating retroauricular titanium-implant (Brånemark) the reaction in bone and soft tissue was studied. Observation time was 6 to 36 months. All implants were "osseointegrated", as assessed by repeated manual test, X-ray examination and 99mTC-scintigraphy. Soft tissue reactions appeared to be slight and clinically insignificant. However, all patients produced crusts around the abutment. When the abutment was removed varying degrees of inflammatory reaction in the skin penetration could be observed in most patients. A theory for the development and cause of the soft tissue reactions is proposed and changes in the operative procedure and the design of the abutment to reduce the host reaction are suggested. It is stressed that the clinical significance of this host reaction is uncertain and above all has to be weighed against the important benefits this implant system offers to a severely handicapped group of patients.

Amipaque myelography. The side effects compared with Dimer X.

In a comparative study between Dimer X and Amipaque (metrizamide) for lumbar myelography it was found that there is a little higher frequency of monor, but unimportant side effects after Amipaque. Amipaque has also been used for thoracocervical myelography with excellent results and without greater discomfort than after myelography in the lumbar region. A new puncture technique was used for the eximation of the cervical region alone: lateral puncture on the neck between the laminae of C1 and C2 under TV control. In more than 75 reinvestigations no arachnoid changes were observed.

Iohexol compared to urografin meglumine in cerebral angiography. A randomized, double blind cross-over study.

In a double blind cross-over study the non ionic, water soluble contrast medium iohexol has been compared to Urografin Meglumine by angiography in common carotid artery and vertebral artery. More subjective adverse effects were generally seen with Urografin than with iohexol and statistically there were significantly less changes in heart rate after iohexol but no significant changes in the intra-arterial recorded blood pressure.