PYRUVATE, CITRATE, ALPHAKETOGLUTARATE AND GLUCOSE IN THE CSF AND BLOOD OF NEUROLOGIC PATIENTS

CSF and blood levels of pyruvate, citrate, alphaketoglutarate and glucose were obtained from some 250 neurologic patients with various diagnoses. Statistical comparisons were made between these metabolites from each patient group and normal volunteers. Significantly increased CSF pyruvates occurred in cerebrovascular disease, and they were decreased in pseudotumor cerebri. CSF citrates were elevated in a number of conditions but blood citrates did not accompany this rise. CSF alphaketoglutarates did not change, but blood levels were elevated in cerebrovascular disorders. CSF citrate levels were significantly related to CSF total protein levels. CSF citrate changes seem to have diagnostic value in patients with neurological disorders apart from changes in pyruvates or lactates.     

THE EFFECT OF DANTRIUM®* ON SPASTICITY IN HEMIPLEGIC PATIENTS

The effect of a new peripherally acting muscle relaxant drug, Dantrium®, on spasticity was tested on 11 hemiplegic patients. The effect was evaluated both with regular clinical examination and with electromyographic technique. The latter concerned a quantitative analysis of the patients’voluntary control of fine neuromuscular activity both with and without the drug. The results indicated that spasticity was initially markedly reduced in the majority of the patients without, however, meaningfully increasing the daily-living functions of the patients. After a few months, the medication could be discontinued without any immediate increase in the spasticity. No severe side-effects were noted. In some cases, the medication had to be discontinued due to marked tiredness. Electromyographically, it was found that the ability of the patients to control fine neuromuscular activity with the paretic muscles was increased significantly with Dantrium, indicating that the reduction of the spasticity increased the ability for fine control of the muscles.     

BIPHASIC RESPONSE ON ORAL GLUCOSE TOLERANCE TESTING IN MYOTONIC DYSTROPHY

Oral glucose tolerance tests have been carried out on 40 patients with myotonic dystrophy, and 50 hospitalized control patients. A biphasic response was found in 19 myotonic dystrophy patients (49 per cent), compared with 12 of the control population (24 per cent). In 9 patients with myotonic dystrophy (23 per cent), the height of the second peak was greater than or equal to 20 mg/100 ml, the corresponding figure for the control group being 2 patients (4 per cent) (P less than 0.005).     

COMPARATIVE NEUROPHYSIOLOGICAL STUDY FOR THE DIAGNOSIS OF MILD POLYNEUROPATHY IN PATIENTS WITH DIABETES MELLITUS AND GLUCOSE INTOLERANCE

This article evaluates diagnostic sensitivity of minimal F-wave latency, sural/radial amplitude ratio (SRAR), dorsal sural/radial amplitude ratio (DSRAR), sympathetic skin response (SSR), and R-R interval variability (RRIV) for detecting early polyneuropathy in patients with glucose intolerance and diabetic patients. F-wave latencies were more prolonged in diabetic patients with normal and abnormal nerve conduction studies than control subjects (p < .001). SRAR was lower, SSR latency was more prolonged, and RRIV was lower in diabetic patients with abnormal nerve conduction studies than healty controls (p < .001). SSR latency was more prolonged and RRIV was lower in diabetic patients with normal nerve conduction studies than healty controls (p < .01, p < .05, respectively). DSRAR was lower in diabetic patients with normal and abnormal nerve conduction studies than control subjects (p < .001). DSRAR was also lower in patients with glucose intolerance than control subjects (p < .01). DSRAR was the most sensitive and specific test in either of diabetic patients with normal nerve conduction studies (sensitivity 66%, specificity 90%) and diabetic patients with abnormal nerve conduction studies (sensitivity 100%, specificity 90%). DSRAR is the most reliable method for detection of early nerve pathology. Patients with glucose intolerance might have subclinical neuropathy that can be demonstrated with DSRAR analysis.     

THE EFFECT OF SOCIAL CLASS ON PSYCHIATRIC PSYCHOLOGICAL EVALUATIONS IN PATIENTS WITH PULMONARY TUBERCULOSIS

The present study is a methodological examination in which the social and psychic background factors of 100 tuberculous patients, aged 20 to 45 years, were explored using psychiatric interview and psychological tests (MMPI, Rorschach, and Wartegg). The purpose of the study was to analyse the effect of social background factors on the psychiatric and psychological examination. With the help of correlation coefficients and three-factor factor analysis, the variable indicating the social class of the subject could be proved to correlate significantly to the projective test variables (Rorschach, Wartegg). No such correlation between the social group variable and those obtained in the psychiatric interview or the MMPI test could be demonstrated. On the basis of the projective tests, subjects in the lower social classes were considered more disturbed. It can be supposed that the background factors characteristic of lower social classes would contribute to the unfamiliar test situation, causing reactions disturbing the test performance. This suggests that the mentioned tests should be used with caution in the evaluation of personality disturbances.