Spermidine: A predictor for neurological outcome and infarct size in focal cerebral ischemia?

BACKGROUND AND PURPOSE: Polyamines are mainly restricted to the intracellular space. During focal cerebral ischemia, polyamines are released from the intracellular compartment. Experimental studies have implicated a marked elevation in brain tissue and blood. The aim of our study was to investigate whether the elevation of polyamines in the blood of patients with focal cerebral ischemia correlates with the clinical outcome and the infarct volume. METHODS: Polyamines were measured in 16 patients with focal cerebral ischemia and in 8 healthy control subjects. Blood samples for polyamine measurement were taken at admission and at fixed time points for the next 28 days. Polyamines were analyzed in red blood cells by a high-pressure liquid chromatography system. Clinical findings were recorded with the NIH Stroke Scale score. Volume of infarction was analyzed from cranial CT at admission and on days 4 to 6 after ischemia. RESULTS: A significant increase of the spermidine level in the peripheral blood could be observed in all patients with focal cerebral ischemia as compared with control subjects (P:<0.01), starting with the admission. Spermidine values correlated positively with the clinical outcome at several time points in the first 48 hours (r=0.90 to 0.40; P:<0.01) and with the infarct volume in cranial CT on days 4 to 6 (r=0.91; P:<0.01). CONCLUSIONS: As hypothesized from experimental data, polyamine levels in blood increase in patients after focal cerebral ischemia. The results indicate that the peripheral spermidine level is closely associated with the clinical outcome as well as with the infarction volume. Therefore, polyamines may be used as a novel predictor for the prognosis of patients with focal cerebral ischemia.

The behaviour of tumour cells of ovarian carcinomata under in vitro conditions and the coincidence with clinical controllability of tumours.

The clinical significance of in vitro cytostatics testing, based on 96 patients with ovarian carcinomata over a 4-year period (1976-1979) is reported. Cell cultivation and short-time incubation are used for the purpose. The cytostatic effect are ascertained by microscopic comparative tests and determination of 3H-thymidine and -cytidine incorporation. The results obtained by in vitro methods coincide to about 70%. Ovarian carcinomata are most frequently sensitive to Adriblastin and least frequently to DTIC. The correlation rate between in vitro test results and clinical reality was 83%. The clinical significance of cytostatics testing in vitro consists in --the individualisation of the tumour chemotherapy, --the possibility of a prognostic estimate, --the ascertainment of causes of chemotherapy failure, --the prevention of useless therapeutic trials on the patient.

[Treatment of pain with psychotropic drugs (author's transl)]. / Ergebnisse psychopharmakologischer Schmerzbehandlung.

30 patients suffering from therapy-resistant chronic pain were divided into three groups according to drive and mood: I. psychomotor inhibition combined with depressive mood, II. agitation and depressive mood, III. agitation combined normal mood. The psychopharmacological treatment of pain showed sufficient results, when the drugs were directed to the target symptoms "agitation", "lack of drive", and "depression". The differentiated administration of activating or sedative antidepressants and neuroleptics caused reduction or absence of pain while the routine administration of neuroleptics (i.e. chlorpromazine) was less effective.