Pseudoathetosis: report of three patients.

We report on 3 patients with pseudoathetosis, which are involuntary, slow, writhing movements due to loss of proprioception.     

Familial occurrence of testicular cancer

A case of testicular cancer in 2 brothers is reported and a review of the literature about testicular malignancies and etiologic factors in closely related family members is given. The familial incidence of testicular tumor is found to be 3% in twins and 0.6-2.1% in less closely related men. Tumors were of the same histology in 70-77% of the twins, whereas in brothers and in other degrees of relationship tumors of different histology mostly occur. Following the diagnosis of the tumor in the first man, the average interval to presentation of the tumor in the relative was 3.7 years in twins, 7.7 years in nontwin brothers and 13.5 years for less closely related men. The need for a thorough checkup of other family members is advised.     

Transfusion of ABO-incompatible platelets causing severe haemolytic reaction

Not infrequently clinical demand dictates that patients receive transfusions of ABO-incompatible platelets when there is a short supply of group-specific platelets. This carries a risk of causing a haemolytic reaction, as illustrated in the clinical case we report. In discussing this potential complication, we suggest a strategy for avoiding it.     

The effects of literacy and education on the quantitative and qualitative aspects of semantic verbal fluency.

Semantic verbal fluency tasks are commonly used in neuropsychological assessment. Investigations of the influence of level of literacy have not yielded consistent results in the literature. This prompted us to investigate the ecological relevance of task specifics, in particular, the choice of semantic criteria used. Two groups of literate and illiterate subjects were compared on two verbal fluency tasks using different semantic criteria. The performance on a food criterion (supermarket fluency task), considered more ecologically relevant for the two literacy groups, and an animal criterion (animal fluency task) were compared. The data were analysed using both quantitative and qualitative measures. The quantitative analysis indicated that the two literacy groups performed equally well on the supermarket fluency task. In contrast, results differed significantly during the animal fluency task. The qualitative analyses indicated differences between groups related to the strategies used, especially with respect to the animal fluency task. The overall results suggest that there is not a substantial difference between literate and illiterate subjects related to the fundamental workings of semantic memory. However, there is indication that the content of semantic memory reflects differences in shared cultural background--in other words, formal education--, as indicated by the significant interaction between level of literacy and semantic criterion.     

Temporal arteritis presenting with scalp ulceration

We report the case of a 75-year-old-woman who presented with bilateral scalp ulcerations and blindness, accompanied by severe headache and scalp tenderness, due to bilateral temporal arteritis without systemic involvement. A biopsy taken from the border of an ulceration showed evidence of giant cell arteritis. She was treated with oral prednisone, 60 mg per day. The ulcerations healed in a few weeks but the vision loss was irreversible. This case highlights for temporal arteritis the importance of accurate and timely diagnosis as well as the need for prompt therapy with systemic steroids in order to avoid major complications, namely loss of vision. It also demonstrates that scalp necrosis and ulcerations are skin signs associated with a poor prognosis.     

Acetylcholine receptor antibody in myasthenia gravis

Radioimmunoassay techniques were used to detect antibodies to the acetylcholine receptor (AAChR) in 164 patients with adult-onset myasthenia gravis. AAChR levels above 0.6 nM/l were considered pathological and were found in 67% of the patients with an average value of 58.99 +/- 125.02 nM/l (0.6-900.0). Correlation, with clinical functional status, the histopathological thymus alterations and the different therapeutics used did not disclose any statistically significant differences.     

Local and remote microvascular changes in excitotoxin-induced focal brain lesions

We have examined the changes in the microvascular diameter, number/mm2 (NA) and area (AAi%) which occur after local brain lesions by the excitotoxin ibotenic acid (IBO). Rats (n = 18) were anesthetized with halothane. IBO (10 micrograms in 1 microliters of phosphate buffer) or vehicle was microinjected in a target region of the parietal cortex via glass micropipettes stereotaxically placed and animals were allowed to recover. Four 9, 15 and 30 days later rats were sacrificed and their brains removed, sectioned (thickness: 20 microns) and processed for the microvascular marker alkaline phosphatase. AAi%, NA and diameter were measured in the area of the lesion and in the homotopic contralateral cortical area by computer-assisted image analysis. In the lesion, AAi% increased by 83% at day 4, reached its maximum at day 9 (+227%) and then declined. Vascular diameter and NA also increased. However while diameter peaked at day 9 (+75%), Na reached its maximum at day 15 (+50%), at a time when AAi% was declining. In the contralateral cortex diameter increased at day 9 (+21%) but NA decreased (-35%) resulting in unchanged vascular area. Thus, focal brain lesions by excitotoxins produce substantial local and remote microvascular changes which have different patterns and may be mediated by distinct cellular and molecular mechanisms.