Mandibular atrophy and metabolic bone loss. Mandibular ridge augmentation by combined sandwich-visor osteotomy and resorption related to metabolic bone state. A 5-year follow-up

92 patients, 31 with and 61 without signs of metabolic bone loss, were treated with a combined sandwich-visor osteotomy. A 5-year follow-up showed a significantly higher rate of resorption in patients with radiographic signs of metabolic bone loss. The analysis was based upon lateral cephalometry.     

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.     

Are complex partial seizures an uncommon withdrawal sign in the elderly?

An elderly female alcohol and benzodiazepine addict presented with an atypical amnestic episode. Five days later she showed several complex partial seizures as main signs of a withdrawal state. The value of the EEG in the differential diagnosis of amnestic syndromes is emphasized. Temporolimbic involvement in withdrawal states is discussed and our ignorance regarding drug dependence and withdrawal in the elderly is stressed. It is suggested that late-onset partial seizures with unknown etiology in the elderly might be more often related to drug dependence than generally accepted.     

Pharmacokinetics and hemodynamic effects of long-term nisoldipine treatment in hypertensive patients

In six patients with essential hypertension, the pharmacokinetics of nisoldipine were investigated before, during, and after 4 weeks of treatment. On day 1, nisoldipine was infused intravenously (i.v. 2 mg in 2 h); on day 2, oral nisoldipine treatment (10-mg tablets twice daily) was started for 4 weeks. During this period, patients came to the hospital six times, on which occasions blood samples were taken for the determination of trough and peak concentrations of nisoldipine. After 4-week treatment, the infusion experiment was repeated. In the first infusion experiment, systemic clearance was 1.02 +/- 0.23 L/min (mean +/- SD), terminal half-life (t1/2) was 15.4 +/- 6.7 h, and volume of distribution was 5.9 +/- 1.8 L/kg. After 4 weeks, these parameters had not changed significantly. Nisoldipine lowered blood pressure (BP) in all patients, whereas forearm blood flow and heart rate (HR) increased. Neither were the hemodynamic changes different after the oral treatment period, although basal BP was lower than before oral treatment. No accumulation of nisoldipine occurred during the 4-weeks treatment period.     

The influence of diet and dimethylhydrazine on the large intestine of vervet monkeys: scanning and transmission electron microscope studies

The study was designed to identify diet and carcinogen-dependent ultrastructural changes in the epithelium of macroscopically normal colonic mucosa in primates. Seventy adult female vervet monkeys were divided into seven equal treatment groups. Four received a Western high-fat low fibre diet (WD), two a prudent low-fat higher fibre diet (PD) and one a control low-fat high fibre diet (CD). Three groups (2 WD, 1 PD) received dimethylhydrazine intramuscularly at 14 day intervals. After 18 months, monkeys of two groups on the WD were transferred to the PD (WD----PD) and 30 months later all were killed. Mucosae of caecum, colon transversum and rectum were examined by scanning and transmission electron microscopy and showed close similarity to that of humans. Rectal mucosae showed increased surface goblet cell secretory activity, mucin production and microvillar changes related to WD and WD----PD. The enhancing effect of a carcinogen on ultrastructural changes such as cellular pleomorphism, cytoplasmic interbridging, nuclear and nucleolar irregularities and appearance of argentaffin cells in the free surface epithelium were noted predominantly in high-fat treated animals. Such changes observed in the upper part of crypt, orifice and free surface epithelium can be characteristic for precancerous change and could be utilised practically in the detection of precursor lesions of the colon.