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Two young American miniature horses from the same farm were evaluated by a veterinarian due to presence of lethargy, anorexia, and cardiac arrhythmias. Both horses were treated aggressively with IV fluids and other supportive measures. The first horse died approximately 72 hr after the start of clinical signs and the second horse was humanely euthanized due to poor response to treatment. Oleander toxicosis was suspected based on the types of clinical signs present and due to several oleander plants and dried leaves present on the property. Oleander toxicosis was confirmed by the presence of oleandrin in gastrointestinal contents and digoxin in the serum of second horse.

Between February, 1981, and September, 1990, 444 men with erectile dysfunction were implanted with AMS inflatable penile prostheses. Etiology was vascular for 62% and diabetic for 22%. Ninety-three percent had a functional prosthesis at last contact. Overall, 74% of the originally-implanted cylinders were functional at last contact with no revisions; an additional 3% required one or more revisions, though no replacement, to maintain function. Of the sub-group receiving PPS cylinders as the first implant under my care, 35% have required no revision; along with 66% implanted with the thicker-walled PPT; 85% with the PND, designed to reduce stress on the tunica albuginea and prevent aneurysm formation; and 90% with the CX cylinders. This greatly improved reliability can be ascribed to (1) continued improvements by the manufacturer, (2) use of a single prosthesis type leading to improved surgical proficiency, and (3) a modified revision technique when a fluid leak has occurred, making it frequently unnecessary to replace the entire device.

A 19-year-old patient with acute idiopathic polyneuritis is described. Clinically, apart from ophthalmoplegia, areflexia and ataxia, the patient presented a serious bilateral and symmetrical deficiency of the VII-IX-X cranial nerve and hypanapallesthesia of trunk and extremities. Liquor examination showed albumino-cytological dissociation with an increase in liquor IgG; encephalic CT and encephalo-medullary NMR were normal; a neurophysiological study (EMG, PEV, BAER) was indicative of the PNS problems. Combined corticosteroid and plasmaferesis treatment produced complete clinical remission after about 3 months. The primary role of PNS involvement in this clinical entity is discussed.

A clinical and electromyographic study was carried out to assess the therapeutic efficacy and general tolerance of a new mixture of internal ester gangliosides, with retarded neuropathy due to alcoholism. The study included the comparison between treatment for two months with internal ester gangliosides and traditional multi-vitamin treatment; the study was double-blind and randomised, and was performed according to an experimental plan using a double placebo technique. In order to assess damage to the PNS and the therapeutic efficacy of the two treatments, the following EMG tests were carried out: bilateral motory VDC, latency and width of MAP for SPE nerve, bilateral sensory VDC, latency and width of SAP for sural nerve. With regard to the clinical picture, statistical analyses were calculated using Mann-Whitney's test. Statistical evaluations for EMG tests were performed using Student's "t" test for unrelated groups in differences between the basal and final values of the variables taken into consideration. On the basis of results, it is possible to conclude that: a) the clinical variations and symptomatology showed a statistical significance in favour of the new ganglioside in comparison to the group treated with multi-vitamins; b) a statistically significant difference was observed in some electroneurographic parameters, namely VCM and latency of the SPE nerve, which was in favour of the group treated with the new ganglioside.

Two cases of spino-cerebellar heredoataxia are reported. The first patient, aged 18, presented the clinical peculiarities of Friedreich's disease; subjected to encephalic CT and encephalomedullary NMR the proved normal; EMG study and visual, acoustic and somatosensorial evoked potentials were not normal but there was nothing specifically wrong. The second patient, aged 30, followed up for more than 10 years, presented the clinical aspects of Pierre Marie disease; stress is laid on encephalic CT examinations carried out at the age of 20 and 30. These were pathological due to the marked dilatation of the IVth ventricle and the basal cisternae; evoked potential changes were aspecific. The nosography is discussed, especially as regards clinical diagnosis, in the absence of typical neuroradiological or other instrumental aspects and, obviously, in the absence of anatomopathological signs.

A clinical of 37 patients suffering form Guillain-Baré syndrome has been carried out. Because of their unusual onset and clinical course, two of the cases are reported in full. The first case presented atypical onset modalities characterised by dysarthria, dysphonia and dysphagia with subsequent diplegia of the facial nerve and motor involvement of all four extremities; the second was difficult to diagnose and over time it turned out to be disimmune chronic-recurrent polyneuropathy. The clinic instrumental diagnostic and therapeutic course of this case, which was characterised by the poor response to corticosteroid therapy as a result of which use of immunosuppressor (azatioprine) and plasma-feresis were employed with a reaosable improvement, is described in detail. The differential diagnosis and nosologica classification are discussed.

Some remarks on the individual medical and social problem of alcoholism are presented. The most significant epidemiological data are reported and the most frequently observed medical complications, namely liver, pancreatic, gastroenteric impairment, alcohol and cardiovascular diseases, alcohol and pregnancy, are analysed. Some general remarks are then offered regarding the alcoholism phenomenon, the concepts of physical/mental health and alcoholism are examined and the personality of the alcoholic is analysed.

The clinical case and instrumental diagnosis of a patient suffering from sporadic late cerebellar atrophy (Pierre Marie, Foix and Alajouanine's syndrome) is reported. Interesting was the long period of observation and the neurodiagnostic study rounded out by encephalo-medullary N.M.R. The differential diagnosis is discussed.

In 325 patients inflatable penile prostheses were implanted from 1981 to 1987. All patients were diagnosed as organically impotent and subsequently the AMS inflatable penile prosthesis, using the PPS, PPT, or PND cylinders, was implanted. The scrotal approach, utilizing a transverse incision, was used in all 325 cases. The three-year cylinder survival rate was 72 percent for the PPS, 86 percent for the PPT, and 97 percent for the PND. Survival for the PPT and PND cylinders showed a statistically significant improvement when compared with the PPS cylinder. It was concluded that overall success had improved due to modification of the surgical technique and refinements in the components of the prosthesis, particularly the cylinders.