Hypertrophic neuropathy — neurosurgical and neuropathological aspects

Summary Three cases of hypertrophic peripheral neuropathy are presented and their different aetiology is discussed. Hypertrophic peripheral neuropathy involving spinal nerve roots may act as a space occupying lesion mimicking tumors especially neurinomas. Therefore the neurosurgical approach may have a therapeutic as well as a diagnostic value.

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Zusammenfassung Drei Fälle von hypertrophischer peripherer Neuropathie werden beschrieben und ihre unterschiedliche Aetiologie wird diskutiert. Bei Beteiligung spinaler Nervenwurzeln an der hypertrophischen peripheren Neuropathie kann eine Raumforderung entstehen, die einen Tumor, insbesondere ein Neurinom, vortäuschen kann. Ein neurochirurgisches Vorgehen kann in diesem Falle neben der diagnostischen Bedeutung auch von therapeutischem Nutzen sein.

     

Studies on the quality of breast milk during 23 months of lactation in a rural community of the Ivory Coast.

Milk samples from 33 women from a rural area of the Ivory Coast were analyzed once a month. In two longitudinal studies covering 23 months of breast feeding, analyses of lipid components and protein were performed. The compositions remained virtually constant over 23 months of lactation except for a decrease of protein concentration during the first 6 months, a rising trend of myristic acid (14:0) and a falling trend of oleic acid (18:1). Infants were growing well on breast milk with nothing else for the first 5 months, but thereafter their growth curves were no longer satisfactory as judged by Western standards: weight for age (percentage of Harvard standards) decreased from 5 to 10 months of age to level off thereafter at a value of 80%. The mothers' weight for height remained constant. In a cross-sectional study, additional determinations were performed: aminograms, lactose, calories, iron, copper, manganese, zinc, and vitamin E. All data were compared with those of the literature. Lauric (12:0) and myristic (14:0) acids were higher, total lipids and polyunsaturated fatty acids lower than those published for Western countries. Plasma composition of the mothers showed lower levels of albumin, lipids, and polyunsaturated fatty acids as well as blood hemoglobin. Possible correlations between various variables such as milk composition, plasma levels, and anthropometry were calculated and discussed.     

The mentally ill in nursing homes. New back wards in the community.

The reduction in state hospital populations in the last two decades is most often attributed to psychotropic medication and community mental health centers. The role the proprietary nursing home has played in this reduction has not been adequately studied. Using data routinely collected for Medicaid utilization review, we studied characteristics of psychiatric nursing home patients in Utah. One third of the nursing home patients had a psychiatric diagnosis; more than half of this group were classified as psychotic. Most psychotic patients were significantly younger than their nonpsychiatric counterparts. Nonpsychiatric patients received a higher mean number of psychoactive drugs than did psychiatric or mentally retarded patients. Over time, all groups of patients showed an increase in prescribed psychoactive medication and a decrease in activity. The consequence of this pattern of care raise serious questions about our current reliance on nursing homes for the care of the psychiatric patient.     

Plasma catecholamines and pituitary adrenal hormones in response to noise exposure

Summary To evaluate the immediate effect of exposure to a high level of noise on the sympatho-adrenal and pituitary-adrenal systems, measurements were made of circulating catecholamines, growth hormone, ACTH, and cortisol in seven normal male subjects. They were studied on two random experimental days: a control day and a noise-exposure day with an intermittent noise alternating between 99 dB (A) and 45 dB (A) for 2 h.Analysis did not reveal any variation in the plasma levels of norepinephrine (NE), epinephrine (E) or dopamine (D), measured every 20 min, which might have been related to noise exposure. Similarly, analysis of the 2-h urine samples collected from 8 a.m. to 2 p.m. revealed no significant changes in urinary catecholamine excretion. Plasma levels of GH and ACTH did not differ significantly from those for control days, but cortisol showed a brief, significant levelling-off in its pattern during the exposure period.The data demonstrate that exposure to a high level of noise, although considered as unpleasant, does not induce any important endocrinological changes in man. These conclusions differ from those for studies on animals where reactions to noise may be related to a more general stressing situation.     

Acid etch bonded cast orthodontic retainers.

We have described a technique which involves the use of a cast orthodontic retaining appliance bonded by the acid etch technique and composite resin for semipermanent retention. The technique provides an alternative form of treatment which offers some unique advantages over previous retentive techniques.     

Tc-99m labelled anti CD 66 antigranulocyte antibody imaging for assessment of bone marrow reserve

Patients with metastatic disease to the bone marrow are at risk of significant hematologic toxicity, if they undergo myelotoxic chemotherapy. Tc-99m labelled Anti CD 66 monoclonal antibody imaging is a useful, noninvasive approach to the assessment of bone marrow reserve under such circumstances.