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This preliminary study investigated Myrhaug's neuromuscular hypothesis by means of audiological and electromyographic assessment. After a clinical examination of the TMJ system, the activity of the tensor veli palatini muscles in the state of rest and during swallowing was investigated in 16 patients with the help of an EMG recording, and the tube-opening function was evaluated endoscopically. Results showed that 6.25% of the patients suffered from mild joint-dysfunction (group I), 81.25% from a moderate dysfunction (group II), and 12.5% from severe dysfunction (group III). Although five patients suffered from tinnitus and 11 from fullness in the ear, both the audio- and tympanogram performed on 15 patients displayed normal recordings. Only one patient suffered from moderate sensorineural hearing loss. In the EMG recording, 11 of the 16 subjects displayed normal EMG patterns in state of rest and during swallowing contraction. In two cases, abnormal EMG recordings were obtained due to incorrect insertion of the EMG needle. The study's results indicate that spasm in the masticatory muscles of TMJ patients neither seems to cause reflex spasm of the tensor palatini muscles nor to effect significant alterations in Eustachian tube function.

Cerebrovascular disease (CVD) is associated with high fibrinogen levels and lipid fractions leading to an increase of both plasma and whole blood viscosity as well as raised aggregability of blood cells. One important goal in the treatment of cerebral multiinfarct dementia (MID) therefore should be to reduce fibrinogen and lipoproteins and thereby to improve the haemorheological state. The effect of heparin-induced extracorporeal LDL precipitation (H.E.L.P.), a method for safe and immediate reduction of parameters relevant to haemorheology, such as plasma fibrinogen and the lipoproteins, was investigated in 98 patients with MID. All the patients underwent two H.E.L.P. applications within 8 days. The impact of H.E.L.P. on CVD was studied by changes of laboratory data and by evaluation of clinical symptoms before and after treatment. Each H.E.L.P. session caused an immediate, safe and significant reduction of important rheological parameters such as fibrinogen (P < 0.001), whole blood viscosity at high and low shear rate, plasma viscosity and red cell transit time (P < 0.01 each). Also total cholesterol and low density lipoprotein (P < 0.0001 each), lipoprotein (a) (P < 0.003) and the triglycerides (P < 0.0001) had been reduced. The results in laboratory measurement were followed by a statistically significant improved neurologic recovery, represented in the values of the Mathew Scale, the Mini Mental State Examination and the Activities-of-Daily-Living-Test. These results can indicate the importance and influence of haemorheology on clinical symptoms in CVD.

Objective: To study the long-term effects of vaginal dissection on the innervation of the striated urethral sphincter., Methods: Perineal nerve terminal motor latency was measured before and 8 weeks and 1 year after anterior colporrhaphy, colpoperineoplasty, and vaginal hysterectomy in 33 women, 19 of whom also underwent endoscopic suspension of the bladder neck., Results: In the entire series, the mean perineal nerve terminal motor latency was prolonged before surgery over that in normal continent women and further prolonged 8 weeks and 1 year postoperatively. In the subjects who underwent vaginal hysterectomy and anterior colporrhaphy, perineal motor latencies were not significantly prolonged at the 8-week postoperative follow-up and had almost returned to preoperative values 1 year later. However, in those who underwent additional endoscopic bladder neck suspension, perineal motor latencies were prolonged at both postoperative follow-up examinations. Perineal motor latencies were unchanged 1 year postoperatively in continent patients (N = 19) but were prolonged in incontinent patients (N = 14)., Conclusion: Vaginal dissection, especially during endoscopic bladder neck suspension, can worsen preexisting perineal neuropathy in patients with pelvic relaxation and stress incontinence.

Background and Purpose: High fibrinogen levels have been assessed in cerebrovascular disease with a direct relation to both plasma and whole-blood viscosity, as well as cerebral blood flow. Heparin-induced extracorporeal low density lipoprotein precipitation (HELP) is a new method that safely and effectively reduces fibrinogen and plasma lipoproteins and improves blood flow properties., Methods: We studied 26 patients with acute embolic stroke and 22 with multi-infarct dementia. Each received two treatments with HELP within 8 days. Each patient had measurement of the important blood constituents and evaluation of changes in clinical signs and symptoms related to their cerebrovascular disease., Results: Each HELP treatment safely produced an immediate and significant reduction in rheological measures, including fibrinogen (P < .001), whole-blood viscosity at high and low shear rates, plasma viscosity, and red cell transit time (P < .01 each). Total cholesterol, low density lipoprotein (P < .0001 each), lipoprotein(a) (P < .003), and triglycerides (P < .0001) were also reduced. The treated group in both the acute stroke group and the multi-infarct group showed improvement relative to the untreated control subjects in Mathew scale, Mini-Mental State Examination, and activities of daily living test scores. These uniform improvements persisted at least 3 days past the second HELP treatment., Conclusions: These results support the hypothesis that the improved hemorheologic property of blood is an important factor in clinical recovery as well as basic neurological function.

Syntheses of steroid-linked N-[N'-(2-chloroethyl)-N'-nitrosocarbamoyl]-(CNC-) amino acid esters and -amides with potential antineoplastic activity are described. The esters are prepared by reaction of CNC-amino acids with steroids using N,N'-carbonyldiimidazole and N,N'-dicyclohexylcarbodiimide. The corresponding amides are prepared by reaction of 1-(CNC-amino acyloxy)-pyrrolidine-2,5-diones with 17 beta-amino-3-hydroxy-1,3,5(10)-estratriene or 17 beta-O-[4-(6-aminohexylamino)-1,4-dioxo-butyl]-estradiol. Estradiol-17 beta-hemisuccinate is esterified with N-(2-hydroxyethyl)-N'-(2-chloro-ethyl)-N'-nitrosourea (HECNU). Spectroscopic characteristics and relative binding affinities to steroid receptors are given.