Urinary N-acetyl-beta-D-glucosaminidase activity in acute pyelonephritis patients with spinal cord injuries

The urinary N-acetyl-beta-D-glucosaminidase (NAG) activities were determined in acute pyelonephritis patients with spinal cord injuries. The urinary NAG activity was significantly elevated in 23 of 31 cases (74%) compared with normal controls. Out of 7 acute pyelonephritis patients without spinal cord injuries, 4 patients (57%) showed significantly elevated urinary NAG activities. The urinary NAG activities were within normal range in 20 patients with acute simple cystitis and 11 patients with chronic complicated cystitis. Out of 6 patients with urethritis, only one case (17%) showed a significantly higher level of urinary NAG activity. Significantly higher levels in urinary NAG activities were observed in 6 of 9 patients (67%) with acute prostatitis and 5 of 9 patients (56%) with acute epididymitis. In patients with spinal cord injuries, having frequent urinary tract infections and complicated pathophysiological conditions, urinary NAG is one of the helpful laboratory findings for the diagnosis of acute pyelonephritis.     

A case of childhood epilepsy with occipital paroxysms (CEOP) presenting particular EEG findings]

We reported a case of an eight-year-old boy with CEOP. His parents and sibling were in good health. There was no family history of epileptic and neurological disease. He had his first attack of unconsciousness with fixation of eye movement for a few minutes at the age of 7 years. After six months, he experienced attacks of vomiting followed by loss of consciousness and elementary visual hallucinations consisting of red and blue colors. Sometimes he complained of contraction of visual field for 10 to 20 seconds, as if a curtain had fallen following the visual hallucination of a bright light spot. At the age of eight years, he was admitted to our hospital for evaluation and therapy. Investigations included neurological examination, IQ, CT findings were normal. Visual evoked potential revealed more reduced amplitude in the left side than in the right. The EEG findings during the waking state showed continuous bilateral 1-2 c/s spike and wave complex discharges in occipital and posterior temporal areas. These discharges were immediately suppressed by eyes-opening in an illuminated room, but not in a dark room. However, during the light sleep stage, diffuse irregular spike and wave discharges appeared frequently with left side dominance. From the clinico-electrophysiological findings we diagnosed him as CEOP. In order to investigate the changes of the occipital spike and wave discharges by photic stimulation, we administered intermittent photic stimulation (IPS) for 10 seconds at each frequency between 1-30 flashes/sec (f/s) in a dark room.(ABSTRACT TRUNCATED AT 250 WORDS)     

Marked cerebrospinal fluid collection associated with hepatic failure

We report two cases with abnormal CSF accumulation in the cranium. One case had marked dilatation of the ventricular system, for which a ventriculoperitoneal shunt was carried out. The shunt was not beneficial and it turned out that the patient was suffering from ornithine transcarbamylase deficiency. The second case developed marked subdural effusion after fulminating hepatic failure and septicemia, for which drainage of the subdural space and subsequent insertion of Ommaya reservoirs were carried out. In spite of successful CSF control, the outcome was bad, both cases being incapacitated due to severe encephalopathy probably caused by hyperammonemia. The results of serial computed tomographic follow-up are presented.