Single course versus maintenance bacillus Calmette-Guerin therapy for superficial bladder tumors: a prospective, randomized trial

A total of 42 patients with recurrent superficial bladder tumors or carcinoma in situ entered a prospective, randomized trial to compare the efficacy of bacillus Calmette-Guerin therapy with and without quarterly maintenance instillations of bacillus Calmette-Guerin. Maintenance therapy did not reduce further bladder tumor recurrence rates or the interval to recurrence in patients who responded to the initial course of therapy. However, prolongation of toxicity was observed with maintenance bacillus Calmette-Guerin therapy.     

Severe hypoglycorrhachia after subarachnoid hemorrhage. Two cases with spontaneous recovery in adults

We report two patients with severe hypoglycorrhachia after a subarachnoid hemorrhage. They had no obvious meningeal infection, and they spontaneously recovered within a few weeks. Such cases have previously been reported in neonates, but exceptionally in adults. Contrary to detailed cases from the literature, our patients recovered without antibiotics, and hypoglycorrhachia was very severe.     

Computed tomography of the brain in the Smith-Lemli-Opitz syndrome

Computed tomographic (CT) scans of the brain in a child with Smith-Lemli-Opitz syndrome revealed enlargement of the ventricular system, hypoplasia of the cerebellum, and abnormal thickening of the gray matter, consistent with pachygyria. These findings have been previously noted in autopsies performed on patients with this disorder. We conclude that CT scanning is a valuable tool in the evaluation of children suspected of having the Smith-Lemli-Opitz syndrome.     

Total-body protein turnover in parenterally fed neonates: effects of energy source studied by using [15N]glycine and [1-13C]leucine

The effects of nonprotein energy source (ie, glucose only vs glucose and lipid) on nitrogen retention and total-body protein turnover were studied in 20 parenterally fed newborn infants. All infants received approximately 3 g amino acids and 80-90 kcal.kg body wt.d. Total-body protein synthesis was estimated by using three constant-infusion, end-product methods: enrichment of urinary urea and ammonia in response to a [15N]glycine label and exhaled carbon dioxide enrichment in response to a [1-13C]leucine label. No differences were seen in nitrogen retention between the two energy sources. The estimate of total-body protein turnover obtained from the 13C label was similar to that obtained with the [15N]urea label. No differences in turnover rates were observed between the two diet groups. Use of the glucose-plus-lipid fuel system enhanced energy storage and the reutilization of amino acid for protein synthesis.     

Cervico-arthrotic myelopathies. Treatment and prognosis

The authors present 50 cases of cervical spondylotic myelopathy treated by anterior or posterior approach. To assess the severity of the pre- and postoperative neurological symptoms, they define an original ten-point classification scale taking into account gait and urinary disturbance, ability to manipulate objects and pain. With C2-C7 laminectomy, 60% of the patients are improved, essentially for walk. A few cases only (14%) are upgraded for upper limbs function. The authors conclude that this surgical treatment should be applied only when there is a multi-level narrowed canal and predominant lower limbs deficits. The efficacy of the anterior approach depends on complete removal of osteophytes. In cases with complete osteophytectomy, this surgical treatment can improve both the upper and lower limbs function and 77.8% good results are obtained. In a few cases it may be necessary to use both approach successively. Discriminant analysis applied to 12 factors shows that pre-operative scores of upper and lower limbs and sagittal diameter of spinal canal are the most important factors for neurological prognosis.     

C(3)-cyclopropyl cephems and carbacephems

A series of C(3)-cyclopropyl cephems and carbacephems has been prepared by palladium catalyzed addition of diazomethane to the corresponding C(3)-vinyl derivatives. The phenylglycyl cyclopropyl cephem derivatives exhibit better Gram-positive activity than cephalexin or cefaclor, while the aminothiazole oxime cyclopropyl cephem derivatives were not as active as the corresponding C(3)-vinyl cephems.