Sudden cervical pain: spontaneous cervical epidural hematoma

Three cases of cervical epidural hematoma are reported. Acute neck pain usually associated with a mild effort, closely followed by radicular pain and a neurologic deficit below the lesion is the typical presentation of this extremely rare and difficult diagnosis. As prognosis depends on preoperative neurologic state, the authors emphasize the importance of prompt identification of this lesion. The diagnosis is confirmed by computed tomography, and emergency neurosurgical laminectomy is mandatory.     

CONGENITAL DISLOCATION OF THE KNEE AS A CONSEQUENCE OF PERSISTENT AMNIOTIC FLUID LEAKAGE

SUMMARY A case congenital dislocation of both knees and dislocation of the left hip in an infant whose mother had a chronic amniotic fluid leakage after mid-trimester amniocentesis.     

(S)-emopamil, a novel calcium and serotonin antagonist for the treatment of cerebrovascular disorders. 1st communication: pharmacological profile

(S)-Emopamil ((2S)-2-isopropyl-5-(methylphenethylamino)-2-phenylvaleronitril e hydrochloride) is a novel compound of the phenylalkylamine group of calcium antagonists. (S)-Emopamil was tested in comparison to verapamil and gallopamil for calcium and serotonin antagonism and for cerebroprotective activity in acute hypoxia/ischemia. In receptor binding studies with (S)-3H-devapamil, (S)-emopamil exhibited distinct affinity to the verapamil binding site of the calcium channel. In rat cerebrocortical membranes, its affinity (Ki = 38 nmol/l) equalled that of verapamil and gallopamil (Ki = 49 and 27 nmol/l, respectively), whereas it was somewhat weaker in guinea pig skeletal muscle membranes. Comparing (S)-emopamil to its (R)-enantiomer, there was no clear stereoselectivity. Additionally, (S)-emopamil showed very high affinity to the cerebral serotonin S2 receptor; its Ki value (4.4 nmol/l) for 3H-ketanserin displacement being substantially lower than that of verapamil and gallopamil (Ki = 177 and 242 nmol/l, respectively). This feature is clearly stereoselective; (S)-emopamil's affinity was distinctly higher than that of the (R)-enantiomer (Ki = 58 nmol/l). The functional significance of (S)-emopamil's receptor affinity was tested in rat aortic strips. (S)-Emopamil's serotonin antagonistic efficacy (EC50 = 4.5 nmol/l) was an order of magnitude higher than that of verapamil and gallopamil. (S)-Emopamil has a less potent calcium antagonistic effect (EC50 = 270 nmol/l) on the aorta than verapamil and gallopamil (EC50 = 35 and 14 nmol/l, respectively). In isolated electrically driven (1 Hz) left atria of guinea pigs, (S)-emopamil inhibited contractile force at a much higher concentration (EC50 = 29 mumol/l) than verapamil and gallopamil (EC50 = 1.1 and 0.19 mumol/l, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)     

Imaging of activated microglia with PET and [11C]PK 11195 in corticobasal degeneration.

Positron emission tomography (PET) using [(11)C]PK 11195, a ligand for peripheral benzodiazepine receptor binding sites, offers the opportunity to image activated microglia in vivo. This tool may therefore be used to display the occurrence of microglial activation in the course of neurodegeneration. A patient with the clinical diagnosis of corticobasal degeneration (CBD) and left-sided symptoms was studied using fluorodeoxyglucose (FDG) and [(11)C]PK 11195 PET. We found a marked right hemispheric hypometabolism and asymmetric microglial activation in corresponding areas of the basal ganglia and right temporal and parietal cortex. [(11)C]PK 11195 PET suggests involvement of microglial activation in the pathogenesis of CBD.     

Partner and grandmother contact in black and white teen parent families.

Contact of teen mothers with grandmothers and partners was studied as a predictor of maternal and middle childhood developmental outcomes. Mothers were interviewed yearly beginning in 1979 until 1986. Each child was given a developmental assessment in 1986. Black teens lived longer with their parents after the child's birth and white teens married earlier and had more disruptions in their relationships. Grandmother assistance with childcare was positively associated with the mother's ability to pursue her education. The findings suggested, however, that child developmental problems may occur when mothers routinely rely upon grandmother assistance into middle childhood, particularly for white families. In general, a male partner who had regular contact with the mother's child, more stimulation and support in the home environment, and higher educational level of the mother were associated with better child developmental outcomes.