Tears as the best practical indicator of the unbound fraction of an anticonvulsant drug.

Phenobarbital and carbamazepine concentrations were determined by the EMIT technique in tears, saliva, cerebrospinal fluid (CSF), and plasma of patients with epilepsy. Closer correlation was shown between tear/plasma and tear/CSF ratios than between saliva/plasma and saliva/CSF ratios for the two agents. The phenobarbital CSF/serum ratio was in good agreement with data in the literature, and the higher ratio found for carbamazepine may be caused by an EMIT assay cross-reaction for the free fraction of carbamazepine-10,11-epoxide.

Plasma and cerebrospinal fluid tryptophan in multiple sclerosis and degenerative diseases.

Tryptophan and competing neutral amino acid levels were found to be diminished in the plasma of patients with multiple sclerosis and degenerative diseases, the greatest decrease being of tryptophan. Cerebrospinal fluid tryptophan was decreased in multiple sclerosis and motor neurone disease, while leucine and valine were increased. These changes might lead to decreased synthesis of brain serotonin and brain proteins.

Post-convulsive spinal epidural haematoma in ankylosing spondylitis.

A case of post-convulsive spinal spidural haematoma in a patient with ankylosing spondylitis is presented. As acute tetraplegia developed, surgery was performed with finding of blood clots in the extradural space from C6 to D8. Lethal evolution due to late referral to medical care stresses the need for prompt decompression of the injured spine.

A month-by-month long-term study on carbamazepine:clinical, EEG and pharmacological evaluation.

Carbamazephine plasma levels were monitored for a twelve-month period in twenty epileptic patients. Seizure frequency decreased remarkably on inclusion of the drug in the therapy and attainment of plasma levels of 7-9 microgram/ml. A faster breakdown rate in children was confirmed, while carbamazepine-10, 11-epoxide was present for carbamazepine levels above 4-5 microgram/ml.

Complicated optic atrophy (Bher's disease) associated with epilepsy and amino acid imbalance.

A case of Behr's disease (complicated optic atrophy) associated with epilepsy and with imbalance of the free amino acid pool in plasma and cerebrospinal fluid, quite similar to that identified in patients with hereditary ataxias, is reported. The latter finding stands for a closer correlation between the two clinical entities.

Effects of levodopa alone and in combination with dopa-decarboxylase inhibitors on plasma renin activity in patients with Parkinson's disease.

Plasma renin activity (PRA) of patients with Parkinson's disease was measured in recumbency, upright position, and after frusemide administration. The results show that the renin responses to both stimuli are significantly reduced as compared with those obtained in a group of normal subjects, while recumbent PRA levels of Parkinsonism patients are not significantly lower than those found in recumbent normal subjects. Levodopa treatment, alone or in combination with two different dopa-decarboxylase inhibitors, benserazide and carbidopa, does not modify the renin response to posture or to frusemide.

[Optokynetic and ocular dysmetria tests in the diagnosis of atypical internuclear ophthalmoplegia (author's transl)].

In a patient with atypical bilateral internuclear ophthalmoplegia the optokynetic test and the ocular dysmetria test detected an infraclinical bilateral lag of adduction. The optokinetic test showed amplitude asymmetry of nystagmus, which was larger in both eyes when the fast phase was in abduction. The ocular dysmetria test showed in both eyes that saccades were slower in adducting than abducting saccades: the latters overshooted and showed transient nystagmus.

Resorption of the zygomatic arch after elevation of a depressed fracture and subsequent osteomyelitis: report of case.

A case of osteomyelitis of the zygomatic arch with complete resorption has been presented. The cause of osteomyelitis of the facial bones was discussed. Infection of the soft tissue after intraoral elevation of fractured zygomas does occur, but rarely leads to osteomyelitis and subsequent bony resorption of the underlying bone.

Benign intracranial hypertension after minocycline therapy.

A case is reported of a young girl who developed benign intracranial hypertension, with severe bilateral papiledema and a left sixth cranial nerve palsy, after minocylcine therapy. This drug is a semisynthetic tetracycline which has proven to pass into the CSF more effectively and to have a greater lipoid solubility than the other antibiotics of the same group.

Thyroglobulin biosynthesis in a larval (ammocoete) and adult freshwater lamprey (Lampetra planeri Bl.).

1. The biosynthesis of 18-19S thyroglobulin has been studied in a larval and adult freshwater lamprey (Lampetra planeri Bl.).

[Effect of carbamazepine on free and protein-bound tryptophan in the blood of epileptic patients and healthy volunteers].

The Authors estimated the influence of carbamazepine on both free and linked albumin triptofane in the plasma of 6 epileptic patients and of 6 healthy volunteers, during a period of observation lasting 7 days. The relation free/linked triptofane decreased significantly in the epileptic patients after the first day of treatment, while an analogous phenomenon was observed in healthy people only after the seventh day. Part of triptofane disappeared from plasma thus suggesting a cerebral uptake of the synthesis of serotonin.

Longitudinal changes of brain amino acid content occurring before, during and after epileptic activity.

In cats affected with cortical epileptogenic foci induced by penicillin application to and cobalt implantation into the pericruciate area, the brain amino acids contents were determined in the focus as well as in extrafocal areas. In different groups of animals, brain removal for biochemical determinations was performed at different times before, during and after epilepsy and the values compared to controls. The only amino acid to show a significant change before appearance of spikes in both types of epilepsy was taurine, which decreased.

[Biosynthesis of thyroglobulin in the endostyle of larva (ammocoetes) of a fresh water lamprey, Lampetra planeri B1].

The biosynthesis of thyroglobulin (Tg) in larva of a fresh-water lamprey, Lampetra planeri B1. has been established. This glycoprotein presents the same characters as in thyroid follicles of adult lampreys, as shown by its 18-19 S sedimentation coefficient and by the incorporation (in vivo and in vitro experiments of 4, 12, 72 h) of 125I, 3H-leucine and 3H-galactose.

Further observations on carbamazepine plasma levels in epileptic patients. Relationships with therapeutic and side effects.

Plasma levels of carbamazepine, phenytoin and phenobarbital were monitored weekly over a period of 9 weeks in 20 epileptic patients unresponsive to treatment. No attempts were made to modify phenytoin and/or phenobarbital plasma levels; emphasis was on achieving carbamazepine plasma levels of 4 to 10 mug per milliliter. A remarkable drop in seizure frequency was attained within 2 to 3 weeks of monitoring, with carbamazepine plasma and concentrations within the desired range.