[Gastric perforation in a two-year-old girl].

Gastric perforation is a life-threatening condition and is rarely seen in children. In this case report a two-year-old girl with a two-day history of fever and severe abdominal pain was evaluated in an emergency department. When she was four months old, she had surgery for malrotation.

Optochiasmatic and peripheral neuropathy due to ethambutol overtreatment.

Ethambutol is known to cause optic neuropathy and, more rarely, axonal polyneuropathy. We characterize the clinical, neurophysiological, and neuroimaging findings in a 72-year-old man who developed visual loss and paresthesias after 11 weeks of exposure to a supratherapeutic dose of ethambutol. This case demonstrates the selective vulnerability of the anterior visual pathways and peripheral nerves to ethambutol toxicity.

Sensory-motor assessment in clinical research trials.

The assessment of changes in sensory-motor function in clinical research presents a unique set of difficulties. Clinimetrics is the science of measurement as related to the identification of a clinical disorder, the tracing of the progression of the condition under study, and calculation of its impact. The selection of appropriate measures for clinical studies of sensory-motor function must consider validity, sensitivity, specificity, responsiveness, reliability, and feasibility.

The rat caudal nerves: a model for experimental neuropathies.

This study provides a detailed investigation of the anatomy of the rat caudal nerve along its entire length, as well as correlated nerve conduction measures in both large and small diameter axons. It determines that rodent caudal nerves provide a simple, sensitive experimental model for evaluation of the pathophysiology of degeneration, recovery, and prevention of length-dependent distal axonopathy. After first defining the normal anatomy and electrophysiology of the rat caudal nerves, acrylamide monomer, a reliable axonal toxin, was administered at different doses for escalating time periods.

Severe myeloneuropathy from acute high-dose nitrous oxide (N2O) abuse.

Background: Myeloneuropathy from chronic exposure to nitrous oxide has been described. Nitrous oxide irreversibly alters B(12) activation, causing signs and symptoms of B(12) deficiency.

Objectives: We describe a case of myeloneuropathy secondary to acute use of high-dose nitrous oxide.

Effects of hyperglycemia on rat cavernous nerve axons: a functional and ultrastructural study.

The present study explored parallel changes in the physiology and structure of myelinated (Adelta) and unmyelinated (C) small diameter axons in the cavernous nerve of rats associated with streptozotocin-induced hyperglycemia. Damage to these axons is thought to play a key role in diabetic autonomic neuropathy and erectile dysfunction, but their pathophysiology has been poorly studied. Velocities in slow conducting fibers were measured by applying multiple unit procedures; histopathology was evaluated with both light and electron microscopy.

Hereditary phenotypes in nocturnal enuresis.

Objective: To identify phenotypic characteristics in three large families with autosomal dominant nocturnal enuresis (NE), and to elucidate whether such characteristics persist after cessation of symptoms.

Subjects And Methods: From three unrelated NE kindreds (A-C) we included 98 living members of whom 34 either had active NE (>one wet night/month after the age of 5 years) or a history of NE. The family members were interviewed to identify NE type and severity.

The circadian defect in plasma vasopressin and urine output is related to desmopressin response and enuresis status in children with nocturnal enuresis.

Purpose: We correlated the circadian rhythm of plasma arginine vasopressin and urine output profile to desmopressin response, presence or absence of an enuretic episode, and age and gender in children with nocturnal enuresis.

Materials And Methods: We studied 125 children 6 to 17 years old (mean age 10.4 +/- 3 years) with monosymptomatic nocturnal enuresis.

Structural and functional investigations of the murine cavernosal nerve: a model system for serial spatio-temporal study of autonomic neuropathy.

Objective: To illustrate the ultrastructural fibre composition of the rat cavernosal nerve at serial levels, from its origin in the main pelvic ganglion to its termination in the corpus cavernosum of the distal penile shaft, and to develop a technique that permits repeated electrophysiological recording from the fibres that form the cavernosal nerve distinct from the axons of the dorsal nerve of the penis (DNP).

Materials And Methods: For the light microscope and ultrastructural studies, Sprague-Dawley rats were anaesthetized and the pelvic organs and lower limbs were perfused with glutaraldehyde through the distal aorta. Tissue samples were embedded in epoxy resin and prepared for light and electron microscopy.

Occupational manganese neurotoxicity provoked by hepatitis C.

Manganese neurotoxicity developed in a highly exposed worker after asymptomatic, moderate hepatic dysfunction from hepatitis C infection. Antiviral therapy was accompanied by resolution of increased blood manganese levels and neurologic improvement. Even asymptomatic hepatic dysfunction may impair manganese clearance and place highly exposed persons at risk for toxicity.

Methyl bromide intoxication causes reversible symmetric brainstem and cerebellar MRI lesions.

Methyl bromide is toxic to the central and peripheral nervous systems. A patient with occupational exposure to this agent is described. MRI showed strikingly symmetric brainstem and cerebellar lesions.

Peripheral neuropathy in young-old and old-old patients.

Diabetes is said to account for most cases of neuropathy in the elderly. We reviewed records of 223 young-old (65-79 years) and 77 old-old (>or=80 years) patients referred for evaluation of neuropathic symptoms over a 9-year period. We prospectively validated our findings in 102 consecutive elderly (77 young-old) patients receiving intensive evaluation for neuropathy.

Intra-individual variability in nighttime urine production and functional bladder capacity estimated by home recordings in patients with nocturnal enuresis.

Purpose: We evaluated the intra-individual variability and reproducibility of nighttime urine production on wet nights and functional bladder capacity estimated by long-term home recordings of monosymptomatic nocturnal enuresis. In particular, the intention was to evaluate the validity of 1 versus 2 weeks of recording when estimating urine volume on wet nights and 1 versus 2 weekends of recording when estimating functional bladder capacity.

Materials And Methods: We analyzed 120, 2-week home recordings of nighttime urine volume from patients with monosymptomatic nocturnal enuresis 6 to 16 years old (mean age 9.

The genetics of enuresis: a review.

Purpose: Formal studies of the genetics of enuresis have been performed since the 1930s and molecular genetics since 1995, both highlighting the importance of hereditary factors in the etiology of nocturnal enuresis. We summarize the current state of knowledge with respect to the genetics of nocturnal enuresis and its genotype-phenotype interactions.

Materials And Methods: A comprehensive review of the published data available on the genetic basis of enuresis was performed.

No relationship between family history of enuresis and response to desmopressin.

Purpose: We determined the prevalence of positive family history of nocturnal enuresis in relation to response to desmopressin.

Materials And Methods: A total of 328 children with nocturnal enuresis and 53 normal children were interviewed to determine the presence of family history of nocturnal enuresis. Response to desmopressin was confirmed in some cases by home recordings of enuresis episodes during 2 baseline weeks and 2 weeks of 20 to 40 microg.

Classification of neurotoxic responses based on vulnerability of cellular sites.

An ideal classification of neurotoxic substances should link the vulnerable target of chemical attack to alterations in neural function. There is little basis for classifying agents based on their common use or physico-chemical properties. Outlined in this article are the principal cellular targets of substances that perturb the nervous system structure and function.

Occupational exposure to methyl isobutyl ketone causes lasting impairment in working memory.

The authors describe serial evaluations of a 44-year-old man who became cognitively impaired during a 6-year period of repeated exposure to high levels of methyl isobutyl ketone (MIBK). Neuropsychological tests administered six times over 10 years demonstrated a stable pattern of cognitive impairment. Dynamic imaging studies suggested persistent CNS dysfunction.

Prevalence of peripheral neuropathy in injection drug users.

Background: Nucleoside analogue reverse transcriptase inhibitors are a critical component of antiretroviral therapy in HIV-infected persons. Several of these medications cause painful, dose-limiting peripheral neuropathy (PN), which may develop earlier and more intensely in persons with preexisting neuropathy. The prevalence of baseline peripheral neuropathy in injection drug users (IDUs), one of the largest populations of HIV-infected persons, has not been described, yet has important implications for the selection of antiretroviral therapy.