Serum prolactins in the diagnosis of epilepsy: sensitivity, specificity, and predictive value

Serum prolactin levels rise after generalized tonic-clonic and partial complex seizures, but not after pseudoepileptic seizures. The criteria for a significant elevation in serum prolactin vary with individual investigators. The prevalence of pseudoseizures in the population studied determines the predictive value of serum prolactin determinations. In populations where most patients have epilepsy, a rise in serum prolactin is highly predictive for true epilepsy, but no increase in serum prolactin is not predictive for pseudoseizures.     

Comparison of Grenz rays versus placebo in the treatment of chronic hand eczema

A double-blind trial was performed on 30 patients with bilateral symmetrical constitutional hand eczema, resistant to previous treatment. There was no difference in efficacy between Grenz rays in a total dose of 900 rad (9 Gy) given in three equal doses at 21-day intervals, and placebo therapy given in a similar treatment schedule.     

Non-secretion of ABO blood group antigens as a host susceptibility factor in the spondyloarthropathies

Gram negative bacteria precipitate reactive arthritis and may be concerned in the pathogenesis of ankylosing spondylitis and other spondyloarthropathies. Susceptibility to many infectious agents is associated with ABO blood group or secretor state, or both. The distribution of the ABO blood group or secretor state, or both, was therefore determined in 87 patients with ankylosing spondylitis and 32 with other forms of spondyloarthropathy. The prevalence of non-secretors was significantly increased in the total patient group (54/114; 47%) and in the subgroup with ankylosing spondylitis (41/84; 49%) compared with local controls (89/334; 27%) (p less than 0.001). Other subgroups of patients showed a similarly increased prevalence of non-secretion (33-47%). The distribution of ABO blood groups did not differ between patients and controls. The association between non-secretor state and ankylosing spondylitis strengthens the hypothesis that ankylosing spondylitis is a form of reactive arthritis. It also suggests several pathogenic mechanisms which may be relevant to the initial hostparasite interaction in ankylosing spondylitis.     

Thrombosis of the basilar trunk caused by syphilis

The authors describe a case of cerebrovascular accident by syphilis in a 37 years-old man. The clinical features were headache, right hemiparesis and ptosis of the left eyelid. Blood and spinal fluid tests for syphilis were positive. The angiography showed a basilar trunk occlusion with revascularization of the cerebellar culmen. The autopsy disclosed a sub-total occlusion of the basilar artery and a fresh left cerebellar infarct.     

Ipsilateral blepharospasm and contralateral hemidystonia and parkinsonism in a patient with a unilateral rostral brainstem-thalamic lesion: structural and functional abnormalities studied with CT, MRI, and PET scanning

A patient developed progressive right hemidystonia in childhood. Subsequently, left-sided blepharospasm, slurred and stuttering speech, and right-sided rigidity and bradykinesia, responsive to dopamine agonists, appeared. Investigation with computed tomography and magnetic resonance imaging (MRI) at age 43 years revealed a left-sided calcified rostral brainstem-thalamic lesion of uncertain aetiology. Although no structural lesion was seen in the striatal regions, L-[18F]-fluorodopa uptake was severely diminished in the left striatum but normal on the right. Dopamine receptor binding identified by [11C]-methylspiperone was in the normal range on both sides.     

Growth factors induce actin disruption in cultured human retinal pigment epithelial cells

Exposure of cultured human retinal pigment epithelial cells to platelet-derived growth factor, nerve growth factor or epidermal growth factor resulted in a time- and dose-dependent alteration in the distribution of actin stained by rhodamine-phalloidin. These growth factors (platelet-derived growth factor of 80 ng/ml, nerve growth factor of 10 ng/ml or epidermal growth factor of 10 ng/ml) caused disappearance of actin filaments from the peripheral region of a cell in 1 or 2 h and change of cell configuration to spindle shape in 3 or 4 h. Other growth factors, fibroblast growth factor of 10 ng/ml and insulin of 25 mumol/ml had no effect on actin distribution. The alteration of actin and the change of cellular shape might be associated with stimulation of cell growth and migration of retinal pigment epithelial cells.     

Hepatoma in siblings with progressive familial cholestatic cirrhosis of childhood

This report describes four siblings affected with familial intrahepatic cholestasis detected in early infancy. In the two male siblings, biliary cirrhosis and fatal hepatocellular carcinoma later developed, whereas the female siblings have had persistent hepatomegaly and recurrent episodes of cholestasis. Sequential biopsies show that this rare disorder of unknown etiology must be added to the many causes of giant cell transformation of the liver in infancy. Its oncogenic risk, particularly in males, has not been generally appreciated.