Efficacy of nerve growth factor in regeneration of the mandibular nerve: a preliminary report.

An experimental study evaluating the potential utility of nerve growth factor (NGF) on sensory nerve regeneration was conducted in a rabbit mandibular nerve model. In 10 animals, bilateral 7-mm nerve gaps were created and repaired with the placement of 10-mm Silastic (American Scientific Products, McGaw Park, IL) conduits into which NGF (left side) and a control solution (cytochrome C, right side) was instilled. After 90 days, the nerve repairs were removed and the two sides compared by clinical appearance, and histologic and electrophysiologic assessment. The conduits instilled with control solution failed to result in nerve regeneration in any of the animals. The conduits with NGF solution, however, consistently displayed neural connections between the proximal and distal ends with the presence of slowed, but recordable, conduction velocities. The axonal numbers in the NGF repairs were significantly less than those of the normal nerve, but when adjusted for fascicular size, the axonal densities were comparable. In addition, osteoid tissue was observed around many of the NGF-induced nerve regenerates, but not on the control solution side, suggesting a possible influence of this protein on bone formation.     

Carbon disulfide excretion in urine--a biological exposure test for the workplace and environmental concentration ranges

The biological control procedure for carbon disulphide (CS2), the determination of free and bound CS2 in urine--a procedure already applied to hygienic surveillance--were modified by using gas chromatography and sulphide selective detection (FPD). The results obtained by the changed biological monitoring test in workplace and environmental surveillance are present and discussed. For CS2 concentrations at workplaces in the range of 8-54 mg/m3 a correlation coefficient of r = 0.56 (n = 11, p less than 0.07) was calculated for the mathematical connection of CS2 shift exposure and CS2 content in urine. For environmental exposures in the range of the CS2 immision short term threshold value (MIKK) of 0.03 mg/m3 the procedure may discriminate significantly exposure load from naturally occurring CS2 background.     

Porphyria cutanea tarda and chronic renal failure

Bullous dermatosis developed in a patient with renal failure who was on hemodialysis. The results of standard tests for porphyria cutanea tarda--quantitation of urinary and fecal porphyrins by fluorometric assay--were within normal limits or were nondiagnostic. Assay of plasma using high-pressure liquid chromatography, however, revealed that this patient had a porphyrin profile consistent with porphyria cutanea tarda. A porphyria-like bullous eruption may occur in patients with chronic renal failure; however, in only a few cases have laboratory studies confirmed the diagnosis of porphyria cutanea tarda. Our experience suggests that, in patients with renal failure, a plasma assay may be more reliable than tests of the urine and feces in establishing a diagnosis in those patients who actually have disorders of porphyrin metabolism. We also report the results of assay of erythrocyte uroporphyrinogen decarboxylase activity and fecal isocoproporphyrin.     

Restless Legs Syndrome and Other Movement Disorders of Sleep—Treatment Update

Purpose of review

The purpose of this review article is to summarize and discuss the recent advances in the treatment of restless legs syndrome (RLS), as well as REM sleep behavior disorder (RBD), and periodic leg movement disorder (PLMD).

Recent findings

Traditionally, dopaminergic therapy has been considered the sole option for first-line treatment of RLS due to their impressive acute efficacy. Dopamine agonists such as oral pramipexole and ropinirole, as well as transdermal rotigotine are all effective treatment options. However, augmentation of the RLS symptoms is a major limitation of oral dopaminergic therapy. Recently, gabapentinoid agents such as gabapentin enacarbil and pregabalin have shown comparable short-term efficacy to dopaminergics with lower risk of augmentation of the RLS symptoms. Recent evidence on the efficacy of oxycodone-naloxone in treatment-resistant RLS provides an additional therapeutic avenue. The increasing understanding of the role of iron in RLS pathophysiology has led to new options in iron supplementation therapy in RLS, including treatment with ferric carboxymaltose.

Summary

With emerging evidence of augmentation being a side effect specific to dopaminergic treatment, gabapentinoids are considered a safer option as initial treatment. In severe refractory RLS, oxycodone-naloxone can be used. If iron stores are low, IV iron formulations should be the initial treatment choice. New treatment options are needed to address issues with current therapies.

     

Activity of herbicolin A against Mycoplasma, Acholeplasma, Ureaplasma, and Spiroplasma species

Herbicolin A, a novel acyl peptide antibiotic, inhibits the growth of the sterol-requiring Mycoplasma, Ureaplasma, and Spiroplasma species, with MICs varying from 1.5 to 100 micrograms/ml. With the exception of Acholeplasma modicum, all of the non-sterol-requiring species of the family Acholeplasmataceae were totally resistant to herbicolin A when tested on serum-containing medium but were inhibited to some extent on medium devoid of serum and any other source of sterol or fatty acids.     

Traumatische und degenerative Läsionen der Sehnen an der Hand

Tendon lesions are the second most common injury in the hand and therefore an important factor in orthopedic patients. Most injuries are open injuries to the flexor or extensor tendons; nevertheless, also less frequent injuries such as damage to the functional system of tendon sheath and pulley or dull avulsions need to be considered. Besides the clinical examination, ultrasound and MRI have proven to be important diagnostic tools. In the postoperative course of flexor tendon injuries, the principle of early passive movement is important to trigger "intrinsic" tendon healing to guarantee a good outcome.     

Sleep and periodic limb movements in corticobasal degeneration

Corticobasal degeneration (CBD) exhibits distinct features of akinesia, the 'alien limb' sign and cortical myoclonus. We report a 63-year old woman with a history of CBD for 18 months who was studied twice using all-night polysomnography with an interval of 13 months. Both recordings revealed frequent periodic arm and leg movements predominantly during non-REM sleep. To our knowledge this has not been described in a patient with CBD so far. Similar to a previous report we found REM sleep without atonia (RWA) in all REM episodes. However, the patient showed RWA and some non violent movements that fulfilled the diagnosis of subclinical REM sleep behavior disorder only in the second investigation. These observations may be due to the underlying degenerative process that involves not only cortical but also thalamic and brainstem structures.