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Autonomic function mediating cardiovascular regulation was evaluated in amyotrophic lateral sclerosis (ALS) in comparison with Shy-Drager syndrome. The subjects were 14 normal controls and 9 patients each with ALS and Shy-Drager syndrome. To evaluate the autonomic function in detail, a new series of quantitative autonomic function tests was conducted, in conjunction with conventional tests. In patients with ALS, the data indicated subclinical sympathetic hyperfunction and parasympathetic (vagal) hypofunction, probably resulting in cardiovascular dysfunction. [ABSTRACT FROM AUTHOR]

Sera were collected from a total of 122 children, comprising 117 cases with undifferentiated fever and 5 cases with dengue hemorrhagic fever (DHF), during June to September 1994 in Karachi, Pakistan. Sera were tested by the IgM-capture ELISA using dengue type 1 (D1), dengue type 2 (D2), West Nile (WN), and Japanese encephalitis (JE) viral antigens. Among 92 single sera from undifferentiated fever cases, IgM antibodies were detected in 5 cases by D1, 8 cases by D2, and 5 cases by WN antigens, respectively. Corresponding number of positives among 25 paired sera from undifferentiated fever cases were 3 by D1, 6 by D2, and 1 by WN antigen. Four out of 5 DHF cases possessed anti-D1 as well as anti-D2 IgM antibodies. Only a single DHF case was positive for anti-WN IgM antibodies. Anti-JE IgM antibodies were not detected in any of the tested serum specimens. Clinical manifestations of undifferentiated fever patients were generally non specific, but the percentage of children with anemia, hepatomegaly and splenomegaly was higher in patients possessing anti-dengue IgM antibodies than those without. Among the groups with anti-dengue IgM antibodies, those possessing only anti-D2 but not anti-D1 IgM antibodies showed higher percentages with cough, edema, and splenomegaly. The results indicated that up to 26% of the undifferentiated fever cases were caused by dengue virus infection in Karachi, Pakistan. [ABSTRACT FROM AUTHOR]

Bilateral striatal necrosis in acute encephalopathy has been reported in a small number of adults with methanol or cyanide intoxication, hypoxic encephalopathy or haemolytic-uraemic syndrome. Acute encephalopathy with bilateral striatal necrosis has been reported in infants and children. However, the pathogenesis of the necrosis remains unclear. This is the first report of serial imaging from the very early to chronic stage in two acute encephalopathic adults with bilateral striatal necrosis. A clinicoradiological study is presented for clarification of the pathological process and pathogenesis. Striatal lesions were not detected in the very early stages, but only thereafter. Serial studies suggested that the lesions were caused by delayed neuronal death. These patients had severe lactic acidosis, near the limit for survival. There have been few reports of adults with acute encephalopathy and bilateral striatal necrosis in whom arterial pH was described; all these exhibited marked acidosis. The common pathophysiological condition among these encephalopathies with bilateral striatal necrosis could be lactic acidosis elicited by impairment of ATP generation through the Krebs cycle. The striatum might represent one of the target areas of Krebs-cycle blockade. [ABSTRACT FROM AUTHOR]

Clinical surveys on 224 patients with liver cirrhosis were made to assess the recent advance in the treatment for liver cirrhosis. These patients consisted of those received treatment in our Department in the years from 1938 to 1965. Of the principal causes of death in cirrhotics studied, hepatic coma has recently decreased and bleeding from the alimentary tract has increased. Cachexia or infection as the cause of death has also decreased. Such an improvement is likely to be attributable to introducing a high protein, high caloric diet. Alternatively, the therapeutic use of potent diuretic drugs has brought success in the treatment of ascites and edema, however, there has been found no betterment in the survival rate of cirrhotics with ascites. Among the abnormal findings which were shown in cirrhotics, icterus index more than 30, bromsulphalein retention exceeding 30 percent in 45 min, albumin/globulin ratio less than 0.5, zinc sulfate test more than 30, and reduced albumin less than 1.5 g/dl were of much omnious significance. The majority of those died within a year. Prothrombin time, total protein values, and transaminase activities in sera were not to be related to the prognosis. Most of deaths without any marked abnormalities in laboratory findings died of massive hemorrhage from the alimentary tract. [ABSTRACT FROM AUTHOR]

The levels of ten elements in the hair of 7 patients with olivopontocerebellar atrophy (OPCA), 10 patients with late cortical cerebellar atrophy (LCCA) and 1489 healthy persons were determined by inductively coupled plasma emission spectrometry. The phosphorus, zinc, selenium, calcium, magnesium, iron, managanese, aluminium and mercury concentrations did not show any statistically significant difference among the three groups. The copper concentration was significantly lower in the patients with LCCA than in the patients with OPCA, and in the healthy controls. The possibility that LCCA is associated with a mild degree of copper deficiency is considered. [ABSTRACT FROM AUTHOR]

We present the unusual case of 16-year-old girl who developed intractable convulsions five days after the onset of a cold. Meningeal signs, lymphopenia, proteinuria, and lupus anticoagulant were also present. Treatment with anticonvulsants, antituberculous agents, and adenine arabinoside were ineffective. The initiation of methylprednisolone pulse therapy immediately resolved convulsions and fever. The diagnosis, suggested by the clinical course and the marked improvement of the meningoencephalitis by pulse therapy, was an encephalitic form of acute disseminated encephalomyelitis. Clinical and laboratory findings indicated that an immune disorder may have triggered an abnormal response to a viral infection leading to this patient's neurologic disorder. [ABSTRACT FROM AUTHOR]

Pontine volume was measured and evaluated by computer tomography (CT) in 37 healthy adults and in 29 adult autopsied brains which did not have chronic neurologic diseases. The pons was cut serially into 5 mm slices in the autopsied brains. In the CT examinations both 5 mm and 2 mm slices were studied. Pontine areas in horizontal planes were measured using an image analyzer, then pontine volume was calculated by accumulation of the mean value of the areas and cranio-caudal length. Pontine volume was approximately 19 cm and pontine atrophy could be defined as less than 12 cm (i.e. the mean - 2 SD) in both methods, which heretofore have not been reported. [ABSTRACT FROM AUTHOR]

4-NQO-C can enter the grey matter parenchyma of the central nervous system of mice after i.v. injection. The level of its uptake by the central grey is higher than that taken up by the central white and by the trigeminal and spinal dorsal root ganglia. This pattern of distribution is strikingly different from that obtained after i.v. injection of 4-HAQO-C, suggesting the possible occurrence of 4-NQO encephalomyelopathy having entirely different sites of lesions from those of 4-HAQO neuropathy. [ABSTRACT FROM AUTHOR]