[Clinical analysis of diagnosis and treatment of 44 cases with intraspinal lipoma]

44 cases of intraspinal lipoma were confirmed by pathologic examination. We excised the lipomas totally or partly. After surgery, 8 cases improved greatly, 19 cases improved, 18 not improved. CT scan and MRI are the key methods for diagnosis of intraspinal lipoma, most of intraspinal lipomas are adherent to the spine and root of nerves tightly and difficult to be dissected. So it's not easy to excise the lipoma entirely. But if we use microsurgery we can get better results.

The prevalence of dementia in Down syndrome

The prevalence of clinical dementia was assessed in three age groups of patients with Down syndrome in the county of Aarhus, Denmark: Group I: 14-16 years (n = 13), group 2: 23-29 years (n = 34), group 3: 50-60 years (n = 25). Seventy-two (85%) of 85 patients participated. Caregivers were interviewed and a neurological examination was performed. An EEG was recorded in 50 patients. Definite clinical dementia was defined as an acquired and progressive decline in 4 or more out of 17 items that are considered to indicate dementia in Down syndrome. Possible dementia was considered when 1-3 items were affected. Six (24%) in group 3 had definite clinical dementia. A further 6 patients in group 3 and 2 (6%) in group 2 had possible dementia. This is the first population-based study with a clinical assessment of the prevalence of dementia in Down syndrome.

Epilepsy in Down syndrome--prevalence in three age groups

A prevalence study of epilepsy in patients with Down syndrome (n = 85) in three age-groups (14-16 years, 23-29 years, 50-60 years) was conducted in the county of Aarhus, Denmark. Seventy-two patients (85%) participated. An interview and a neurological examination were performed. An EEG was recorded in 50 patients. Twelve patients (17%) had epilepsy. ILAE-1981-classification: two with partial seizures, seven with primary generalized and three with unclassifiable generalized seizures. Two patients with epilepsy had a normal EEG and 13 patients without epilepsy had an abnormal EEG.

[Alzheimer-type dementia and Down syndrome]

Dementia is seen earlier and more often in patients with Down syndrome (DS) than in the general population. Patients with DS develop neuropathological changes similar to the changes seen in dementia of Alzheimer's type (DAT). The literature concerning DAT in DS is reviewed. The clinical course and differential diagnoses are discussed. Before the diagnosis of DAT is made, treatable causes of dementia should be excluded.

Lymphocyte glutathione peroxidase activity during exacerbations in multiple sclerosis

Glutathione peroxidase, one of the major antioxidants in the human brain, has been found to have decreased activity in patients suffering from multiple sclerosis (MS). This study compares the activity of lymphocyte glutathione peroxidase (L-GSH-px) in MS patients suffering from acute relapses with clinically stable MS patients and with control patients referred with nondemyelinating neurological diseases. All three groups showed an increase of mean enzymatic activity (MEA) during the observation period. The highest MEA in this study was observed in the MS groups. However, there were no significant differences in the L-GSH-px activity in the three groups. These results are not in accordance with previous investigations, and the need for further research in this field is emphasized.

Glutathione peroxidase in early and advanced Parkinson's disease

A defective antioxidant scavenging system plays a major role in one of the theories of the pathogenesis of Parkinson's disease. The aim of this study was to investigate whether there is a general difference in antioxidant activity between early and advanced cases of Parkinson's disease. Twenty five recently diagnosed patients, without any clinical fluctuations (group A), and 25 patients in a late phase of the disease with severe fluctuations in response to levodopa therapy (group B) were included in the study. Erythrocyte glutathione peroxidase was determined as a measure of antioxidant activity and significantly lower values were found in group B than in group A. Regression analyses in groups A and B showed significant correlation between glutathione peroxidase and duration of disease, but not between glutathione peroxidase and age of patients.

Intermittent prophylaxis in febrile convulsions: diazepam or valproic acid?

In an open, prospective, randomized, and hospital-based study, comprising 219 consecutive children, 169 were given intermittent prophylaxis for one year, receiving either diazepam or valproic acid after their first febrile convulsion. Children admitted on odd dates (n = 89) were given rectal diazepam in solution every 12 h, whenever the temperature was 38.5 degrees C or more. Children admitted on even dates (n = 80) were given valproic acid as suppositories at times of fever. Twenty-three children in the diazepam group had a recurrence within 1 year versus 14 in the valproic acid group. On an intention-to-treat basis the 12-month recurrence rates in the 2 groups were similar, 27% vs 20%. The latter is well below figures for untreated controls from Denmark (32%), suggesting that intermittent valproic acid at times of fever may be effective, but further studies are needed. The number of complex recurrences, however, were significantly higher in the valproic acid group than in the diazepam group. Parental non-compliance was a major problem, and in the 2 study groups only 5 and 12 children, respectively, with recurrences were treated adequately. Sixty-nine children receiving diazepam had side-effects vs 37 receiving valproic acid. None were serious.

High dose antioxidant supplementation to MS patients. Effects on glutathione peroxidase, clinical safety, and absorption of selenium

High-dose antioxidant supplementation has recently been recommended for multiple sclerosis (MS) patients. This study tests the clinical safety, the glutathione peroxidase (GSH-px) activity, and the absorption of selenium during such supplementation. Eighteen MS patients were given 6 tablets especially made for this study, equivalent to 6 mg sodium selenite, 2 g vitamin C, and 480 mg vitamin E a day for five wk. GSH-px, which was lower than in non-MS controls before the start of treatment, increased fivefold during 5 wk of treatment. Side effects were scarce. Ten MS patients were subjected to a 24-h selenium absorption study after ingestion of 2 active tablets, equivalent to 2 mg sodium selenite. Selenium, which was low initially, increased 24% during the first 3 h and then stabilized. It is concluded that the tested antioxidant treatment seems to be safe and that MS patients have low GSH-px, which may be increased by the tested antioxidant treatment.

[Results of thoracoscopy in localized lung and chest wall diseases]

On the basis of 109 thoracoscopic examinations--out of a total number of 1,014 thoracoscopies performed between 1981 and 1986 at our Department--carried out to investigate localised disorders of the lungs and wall of the chest, the diagnostic effectiveness of the method for this indication has been examined. The lesions involved were 59 pulmonary foci, and 50 localised changes involving the wall of the chest, thoracic spine or diaphragm. With the aid of thoracoscopy, the diagnosis proved possible in 83% of the disorders of the chest wall, in comparison with only 46% in the case of the pulmonary lesions, since the focus is often not sufficiently sub-pleural in location, or else pleural adhesions that presented impaired the view. On the basis of the high diagnostic yield in localised diseases of the thoracic wall, thoracoscopy should be considered for this indication in particular, when clarification of the situation is not possible with radiological procedures, and surgery appears unnecessary or not feasible.