Similar effects on infants of n-3 and n-6 fatty acids supplementation to pregnant and lactating women.

Objective: There have been indications that high intake of n-3 long-chain polyunsaturated fatty acids (PUFAs) during pregnancy may increase birth weight and gestational length. In addition, n-3 long-chain PUFAs may be important for the neurobiological development of the infants. High levels of docosahexaenoic acid (DHA, 22:6 n-3) are found in the gray matter of the cerebral cortex and in the retina, and it seems as if the availability of long-chain PUFAs may be limiting cerebral development.

[Acute respiratory failure caused by myotonic dystrophy].

Background: Respiratory insufficiency is not always caused by pulmonary diseases or diseases involving the pulmonary vasculature.

Material And Method: We present a case history of a 29-year-old patient with acute respiratory insufficiency following a gynaecological operation.

Results: Ventilation/perfusion scintigraphy and spiral-CT of thorax excluded pulmonary embolism.

Childhood autism: the need for physical investigations.

In this paper the results of an extensive medical investigation of 25 children with childhood autism are presented and compared with those found in a group of non-autistic individuals matched for sex, age and intellectual level, all referred for developmental deviancy of unknown etiology. The examination included a psychiatric assessment and a neurological examination in addition to neurophysiological, chromosomal, metabolic and neuroimaging evaluation. In the clinical examination macrocephaly was found only among the autistic individuals, while the frequency of pathological cerebral CT and clinical parameters such as tendon reflexes and mobility problems was significantly greater in the control group.

Hypoxemic resuscitation in newborn piglets: recovery of somatosensory evoked potentials, hypoxanthine, and acid-base balance.

We tested the hypothesis that hypoxic newborn piglets can be successfully resuscitated with lower O2 concentrations than 21%. Severely hypoxic, 2-4-d-old, anesthetized piglets were randomly divided into five resuscitation groups: 21% O2 (n = 10), 18% O2 (n = 9), 15% O2 (n = 9), 12% O2 (n = 8), all normoventilated, and a hypoventilated 21% O2 group (PaCO2; 7.0-8.

Fibre density in idiopathic ano-rectal incontinence.

Fibre density (FD) was measured in the external anal sphincter (EAS) in 54 patients with idiopathic anal incontinence and compared to normative data from a control group of 18 patients. The aim of the study was primarily to establish a diagnostic tool which could give an objective analysis of the anal sphincter muscles. Secondly, to examine whether or not FD was correlated to clinical symptoms of incontinence and manometric measurements from the anal canal.

[Treatment of paracetamol poisoning. An indication for liver transplantation?].

Development of metabolic acidosis (pH < 7.30) or the combination of encephalopathy grade III-IV, coagulopathy (PT > 100s) and oliguric renal failure are associated with a poor prognosis in paracetamol-induced fulminant liver failure. It is important to administer N-acetylcysteine as soon as possible after the overdose, but N-acetyl-cysteine also seems to improve survival when given 36-80h following ingestion.

Cerebral blood flow and evoked potentials during reoxygenation with 21 or 100% O2 in newborn pigs.

The effects of resuscitation with 21 or 100% O2 on cerebral blood flow (CBF) and somatosensory evoked potentials (SEPs) were studied in 19 newborn pigs anesthetized with pentobarbital sodium. They were ventilated with 8% O2 until base excess reached -20 mmol/l and then were randomly reoxygenated with 21% O2 (n = 10) or 100% O2 (n = 9) for 25 min followed by 21% O2. Mean duration of hypoxemia in the two groups was 57 +/- 6 (SE) and 59 +/- 6 min, respectively.

[Botulinum toxin. A new therapeutic alternative in spastic dysphonia (laryngeal abductor dystonia)].

Laryngeal dystonia is a condition characterized by involuntary spasms of the laryngeal muscles. In most patients this involves the adductor laryngeal muscles (adductor laryngeal dystonia). Treatment with a variety of therapies, including speech therapy and pharmacotherapy, have led to minimal improvement.

Complete ulnar innervation of the thenar muscles combined with normal sensory fibres in a subject with no peripheral nerve lesion.

A complete ulnar innervation of all thenar muscles, including the opponens, have to our knowledge been described only in patients with severe traumatic lesions of the median nerve. The present study reports a subject with exclusive ulnar innervation of the thenar muscles in the right hand. The patient had no anamnestic or objective signs of peripheral nerve lesions.

[Neurointensive monitoring. Experiences with neurophysiological examinations].

Multimodal-evoked responses and EEG are used as a routine in many intensive care units and have proved their diagnostic and prognostic significance in a series of studies on comatose patients and patients with severe head injuries. The article includes a brief description of the methods, and of their use and interpretation in neurointensive medical care.

Long-term metabolic control in recipients of combined pancreas and kidney transplants.

Metabolic glucose control was followed in 36 patients at 12-month intervals for up to 5 years after a successful combined kidney and segmental duct-occluded pancreas transplantation. All recipients had normal blood glucose levels at each examination. HbA1 values, intravenous glucose tolerance test, C-peptide levels and C-peptide responses to glucagon stimulation were also, on average, within the normal range.

[Liver transplantation in fulminant hepatic failure].

The prognosis for patients suffering from fulminant hepatic failure is still poor. The possibility of performing liver transplantation has improved the outcome for the patient. The article presents three cases illustrating some of the difficulties in selecting patients for transplantation, and discusses clinical and laboratory monitoring of patients with fulminant hepatic failure and criteria for selecting patients for liver transplantation.

Iopentol compared with iohexol in carotid angiography. A double blind crossover test of a new non-ionic contrast medium.

A randomized double blind crossover test with iohexol and the new non-ionic contrast medium iopentol in 12 patients undergoing carotid angiography showed no difference in tolerability, EEG, ECG, neurologic status or image quality. Iopentol seems to be well suited for cerebral angiography.

Failed ileoanal anastomosis: correlations between clinical function and anal canal neurophysiologic and histologic examinations.

Ten patients with an ileoanal anastomosis had conversion to permanent ileostomy 13 (range, 6-29) months after the primary procedure. Causes for reoperation were incontinence in seven patients, unacceptable stool frequency without incontinence in two patients, and atypia in the mucosal remnant with perfect continence in one patient. Stool frequency, continence function, anal canal resting pressure, external anal sphincter (EAS) EMG/pressure relationship (in terms of slope, m), EAS fiber density (FD), and pressure in the distal ileum were registered, and the mucosa and the anal sphincter muscles were examined histologically.

Clinical and electrophysiological abnormalities in the visual system in myotonic dystrophy.

The investigation comprised 16 patients with verified myotonic dystrophy. The patients were examined ophthalmologically, by electroretinography (ERG) and pattern visual-evoked potentials (VEPs). The results were compared to those of a normal control group.

Multimodal evoked potentials, EEG and electroretinography in patients with dystrophia myotonica.

EEG, somatosensory (SEP) and visual evoked potentials (VEP) and electroretinography (ERG) were recorded from 16 patients with clinical and electromyographically verified dystrophia myotonica. The results were compared to an age- and sex- matched control group and revealed statistically significant differences between the group mean values for almost all records. Furthermore, abnormal individual electrophysiological tests were relatively frequent in the patient group.

Visual evoked responses in hereditary motor and sensory neuropathies.

The P2 latency of the pattern reversal visual evoked response was measured in 11 patients with hereditary motor and sensory neuropathy (HMSN). The P2 latency was inversely related to the peripheral nerve conduction velocity, but no significant relation was found between the P2 latency and the age of the patients or the duration of their symptoms. When the whole group was considered the mean P2 latency was longer but not significantly different from a control group.

EEG and evoked potentials in comatose patients with severe brain damage.

EEGs and evoked potentials were recorded in 76 deeply comatose and unresponsive patients with traumatic or non-traumatic cerebral damage. Spontaneous EEG activity was absent in 37 of the patients on the initial examination. The cortical somatosensory evoked potentials were invariably absent in these patients as were the visual evoked potentials.

Effect of near normoglycaemia for two years on progression of early diabetic retinopathy, nephropathy, and neuropathy: the Oslo study.

Forty five insulin dependent diabetics were randomised to treatment with continuous subcutaneous insulin infusion (CSII), multiple insulin injections (five or six daily), or conventional twice daily insulin injections. Near normoglycaemia was obtained with CSII and multiple injections but not with conventional treatment (p less than 0.01).

Multimodal evoked responses and cerebrospinal fluid oligoclonal immunoglobulins in patients with multiple sclerosis.

One hundred patients with possible, probable and definite multiple sclerosis (MS) were examined with somatosensory (SER), visual (VER) and brain stem auditory (BAER) evoked responses. Paired samples of cerebrospinal fluid (CSF) and serum were examined with agarose gel electrophoresis to detect intrathecally synthesized oligoclonal immunoglobin bands. Comparison of the number of abnormal CSF and evoked response tests showed that the CSF examination was slightly more sensitive in all diagnostic groups when compared to the results of multimodal evoked responses but that the two sets of test were in part supplementary.

Functional cervical myelography with iohexol.

Thirty patients underwent functional cervical myelography, i.e. radiographs in the lateral view were obtained in extension as well as in flexion of the neck.

Combined renal and pancreatic transplantation: effects on advanced diabetic neuropathy and retinopathy.

In this study of 24 uremic diabetic patients treated with combined kidney and pancreas transplantation, the one year patient, kidney and pancreas graft survival was 96, 78 and 55%, respectively. In recipients followed for three months or more, a regression of neuropathy was registered in all patients, whereas improvement in visual acuity was seen only in two patients with simplex type retinopathy. The advanced proliferative retinopathy observed in most recipients at the time of transplantation, was not significantly altered after pancreas and kidney transplantation.

Subcomponents of the cervical evoked response in patients with intracerebral circulatory arrest.

The subcomponents of the cervical evoked response, N11, N13, N14, and the following positivity, were studied in 13 patients with full arrest of the intracerebral circulation, isoelectric EEGs and abolished cortical somatosensory evoked responses. The peak negativity (N13) and the following positive wave were present in all patients. Also N11 and N14 could be identified in most patients either at standard stimulation frequency (2 Hz) or by increasing the stimulation rate.

Cervical myelography with iohexol.

An open study with iohexol (Omnipaque) in cervical myelography has been performed in 20 patients to evaluate the properties and neurotoxicity of this new water soluble contrast medium. The image quality was good (30%) or excellent (70%) in all cases. The frequency of headache was 25%.