Polymyositis-dermatomyositis:25 years of follow-up of 50 patients disease course, treatment, prognostic factors

Therapeutic results were analysed in 50 patients, including 17 with polymyositis (PM) and 30 with dermatomyositis (DM). All patients were treated with prednisone (Encorton, Polfa) and 47% of patients with PM and 73% with DM required combined treatment with prednisone and cytostatic agents, mostly with cyclophosphamide (Endoxan G.D.R.). Long-term treatment monitored with the clinical status led to remissions persisting after treatment discontinuation in 17.6% of PM patients and 24.2% of DM patients. In 64.7% of PM patients and 57.6% of DM patients regression of the clinical signs of the disease was achieved but these patients required further treatment. No information was obtained on 5 cases. Four DM patients died. The cumulative 17-year survival rate of PM patients was 100%, and that of DM patients was 78.8% . In 45 follow-up cases, the mortality was 8.9%. Side effects of the combined treatment included most frequently mucosal candidiasis (22.2%), transient leucopenia (14.8%) and recurrent respiratory tract infections (11.1%). In 5 cases liver biopsy was done and histological examination disclosed moderate fatty, glycogen and vacuolar degeneration of the hepatocytes. The statistical analysis of prognostic factors such as the diagnosis of PM or DM, sex, age at disease onset, disease duration till diagnosis establishing and beginning of treatment, fever, dysphagia, circulatory and respiratory changes, leucocytosis nad ESR at the beginning of the disease showed that sex (female), older age at disease onset and respiratory system changes may be accepted as poor prognosis factors.     

Remarks on treatment of unstable fractures of the thoracolumbar spine]

An evaluation of treatment results of unstable spine fractures using the Harrington instruments in 37 patients has been performed. The described method can result in anatomical restoration of the vertebral canal. If vertebral canal lumen is not restored, anterior decompression should be performed making possible removal of posteriorly dislocated bone fragments. The earlier anterior decompression, the greater chance of improvement of neurological conditions. The described procedure is especially useful in fractures with partial palsy. After treatment 70 per cent of the patients with partial palsy resumed their normal lives.     

The value of different methods of treatment of brain abscess in the CT era

Summary 67 cases of brain abscess were analyzed retrospectively. As 2 comatose patients died on admission before any treatment was started, the results are based on 65 treated patients. Different methods of treatment included: total removal in 36 patients, drainage in 14, aspiration in 6 and conservative treatment in 9. Management mortality was 18,5% and was almost not dependent on the method of treatment (except aspiration) being lowest in the drainage group. The mortality was significantly higher in patients with serious impairment of consciousness on admission.Follow-up examination after 1 to 11 years was performed in 47 out of 53 discharged patients and revealed in 25 of them (53%) full recovery. 10 additional cases (21%) are independent. The best early and long term results were obtained in patients by drainage and medical treatment.Chronic epilepsy developed in 34% of patients with supratentorial lesions. The risk of epilepsy was lowest in the group of patients treated by drainage.The authors present the opinion that removal of brain abscess is necessary only in exceptional cases.     

Histamine level and transglutaminase activity may provide indication of the development of spontaneous mammary tumor in C3H mice

Histamine (HA) concentrations and HA metabolizing enzyme activities were measured in macroscopically unchanged mammary glands and in tumor tissue of C3H mice carrying spontaneous mammary tumor as well as im mammary glands of control subjects matched for age.The great fall in HA level and the enzyme activities in tumor tissue was confirmed. In host mammary glands which showed no current evidence of neoplasm, consistently lower than normal HA concentrations and elevated transglutaminase (TG) activity were found, It is suggested, therefore, that HA level and TG activity may provide an early indication of the development of spontaneous mammary tumor.     

Astrocytomas of the cerebellum in children: treatment and results]

Between 1980 and 1987, 113 children with astrocytoma of the cerebellum were treated. The range of the age was 11 months to 15 years. 103 children were treated by surgery only and 10 received surgery and postoperative irradiation. Shunting was necessary in 22% patient with cerebellar astrocytoma. One-year survival for patients with cerebellar astrocytoma was 97%, five-year 89%.     

Gunshot wound of the lumbar spine]

A case of 20 years old patient with the gunshot injury of the spine was presented. The bullet has stuck in the spinal canal at L3-L4 level causing no neurological disturbances. It was removed in our department gunshot wounds to do this in district hospital. No complication occurred in the postoperative course.