Cytomegalovirus infection and Guillain-Barré syndrome: the clinical, electrophysiologic, and prognostic features. Dutch Guillain-Barré Study Group.

Guillain-Barré syndrome (GBS) is usually preceded by infections, in particular cytomegalovirus (CMV) and Campylobacter jejuni infection. We studied the clinical and electrophysiologic features of 20 CMV-associated GBS patients and compared the findings with earlier established data of C. jejuni-related GBS patients (n = 43) and of GBS patients without these infections (n = 71).

Sequential involvement of NMDA receptor-dependent processes in hippocampus, amygdala, entorhinal cortex and parietal cortex in memory processing.

Rats bilaterally implanted with cannulae in the CA1 region of the dorsal hippocampus and/or in the amygdaloid nucleus, in the entorhinal cortex, and in the posterior parietal cortex, were trained in a step-down inhibitory avoidance task. At various times after training (immediately, 30, 60 or 90min) they received, through the cannulae, 0.5µl microinfusions of saline or of 5.

Campylobacter jejuni infections and anti-GM1 antibodies in Guillain-Barré syndrome.

The group of patients with Guillain-Barr'e syndrome (GBS) is very heterogenous with regard to antecedent infections, immunological parameters, clinical manifestations, and response to treatment. In this study, the presumed pathogenic factors anti-GM1 antibodies and Campylobacter jejuni infections were related to the clinical characteristics. Serum from 154 patients with GBS, 63 patients with other neurological diseases (OND), and 50 normal controls (NC) were tested for the presence of antibodies against GM1 and C.

Relationship between the exposure to cisplatin, DNA-adduct formation in leucocytes and tumour response in patients with solid tumours.

The study was designed to investigate possible relationships between tumour response and exposure to cisplatin (area under the curve of unbound cisplatin in plasma, AUC) and DNA-adduct formation in leucocytes (WBC) in patients with solid tumours. Patients were treated with six weekly courses of cisplatin at a dose of 70 or 80 mg m-2. The AUC was determined during the first course and DNA-adduct levels in WBC during all courses at baseline, 1 h (A(max)) and 15 h after a 3 h infusion of cisplatin.

Self-expanding metal stents for palliative treatment of superior vena caval syndrome.

Purpose: Two stent types (a new Wallstent and a Z-stent) were investigated in 30 patients with recurrent malignant superior vena caval syndrome (SVCS).

Methods: Eligibility requirements were that the patient had recurrent symptoms after appropriate radiation therapy, chemotherapy, or both; >/= 75% of the vessel was occluded; and there was collateral flow. Because of the limited availability of stents, it was not possible to perform a prospectively randomized study.

Detection of liver metastases from colorectal carcinoma: is there a place for routine computed tomography arteriography?

Background: A prospective evaluation of the liver by preoperative ultrasonography, conventional computed tomography (CT), and continuous CT angiography (CCTA) was performed in 60 patients with primary or secondary colorectal carcinoma.

Methods: The standards of reference were palpation of the liver and intraoperative ultrasonography. The imaging techniques were assessed independently of each other.

Surgical treatment of lung metastases: The European Organization for Research and Treatment of Cancer-Soft Tissue and Bone Sarcoma Group study of 255 patients.

Background: Several reports have shown a prolonged survival after surgical treatment of pulmonary metastases from soft tissue sarcomas. However, it is still unclear which prognostic factors predict a favorable outcome. Series are not comparable and the data are conflicting.

Analysis of cumulative probabilities shows that the efficacy of 5HT3 antagonist prophylaxis is not maintained.

Purpose: Several investigators have reported that the efficacy of 5HT3 receptor antagonists is maintained over repeated cycles of chemotherapy. These investigators presented conditional probabilities of protection. Because conditional analyses by definition only include patients with protection in previous cycles, the results are flattered.

Hippocampal cGMP and cAMP are differentially involved in memory processing of inhibitory avoidance learning.

Cyclic GMP (cGMP) and cyclic AMP (cAMP) have been proposed to participate in the early and late stages of long-term potentiation (LTP), respectively. Here we report on the effect of post-training intrahippocampal infusion of membrane-permeable analogues of these cyclic nucleotides on the consolidation of inhibitory avoidance learning in rats and on the effect of this task on hippocampal cGMP and cAMP levels. Bilateral intrahippocampal microinjection of 8 Br-cGMP (1.

Modulation of immune parameters in patients with metastatic renal-cell cancer receiving combination immunotherapy (IL-2, IFN alpha and autologous IL-2-activated lymphocytes).

We treated 72 patients with metastatic renal-cell cancer according to 2 protocols consisting of two 5-week induction cycles of continuous i.v. high-dose interleukin-2 (IL-2), i.

Serum bicarbonate is an independent determinant of protein catabolic rate in chronic hemodialysis.

Serum bicarbonate is an independent determinant of protein catabolic rate in chronic hemodialysis. Recent biochemical studies suggest that metabolic acidosis induces an increase in protein catabolic rate. Therefore, we retrospectively examined the relationship between serum total CO2, normalized protein catabolic rate (NPCR), midweek BUN, KT/V, and serum albumin in 70 chronic hemodialysis patients over a period of 4-6 months (total of 270 determinations).

Upper airway patency and nocturnal desaturation in habitual snoring and obstructive sleep apnea: pathogenesis of sleep-related breathing disorders.

Sixty patients, 53 men and 7 women, referred for excessive snoring or suspected sleep apnea syndrome were analyzed by polysomnography, Mueller maneuver, cephalometric roentgenography, and pulmonary function testing, to evaluate the contribution of static and dynamic upper airway obstruction in the pathogenesis of sleep-related breathing disorders and OSAS. Desaturation index and maximal desaturation were used in the analysis as indicators of severity of sleep-related breathing disorders. Body Mass Index, increased collapsibility at the base of the tongue by the Mueller maneuver, increased distance between hyoid and mandibular plane, and increased soft palate diameters by cephalometry as well as a decreased peak inspiratory flow by pulmonary function testing were found to be related to increased oxygen desaturation parameters.

Prognostic value of electrodiagnosis in the Dutch Guillain-Barré study.

In the Dutch Guillain-Barré trial, three EMGs were performed according to a rigid protocol at early stages of the disease in 147 Guillain-Barré patients who were unable to walk independently. Independent locomotion 8 weeks and 6 months after entry were considered to be the outcome measures of most clinical value. Electrodiagnostic data obtained 1 week after entry were concluded to be most important for studying prognostic value.

Omega-3 fatty acids attenuate glomerular capillary hydraulic pressure in rats with renal ablation.

To clarify the emerging role of omega-3 fatty acids (FAs) in the regulation of the renal microcirculation, we recently performed micropuncture studies in normal rats maintained on diets enriched with omega-3 FAs. Although those studies suggested that omega-3 FAs alter the renal microcirculation in normal rats, it was not apparent whether this dietary maneuver could modulate intrarenal hemodynamics in the setting of renal disease. Therefore, the present renal micropuncture studies were performed in nephrectomized rats maintained on control diets or diets enriched with omega-3 FAs.

Acute myeloid leukemia: lack of predictive value of sequential quantitative MR imaging during treatment.

Purpose: To assess the use of magnetic resonance (MR) imaging in monitoring treatment response in patients with acute myeloid leukemia (AML).

Materials And Methods: Bulk T1 and T2 were determined with at least four MR imaging examinations (strictly timed) during the first 6 weeks of treatment in 29 patients with AML (age range, 16-75 years; 15 female, and 14 male). Bulk T1 and T2 in responder (n = 22) and nonresponder (n = 7) patients were compared.

Patient participation in clinical decision-making for treatment of T3 laryngeal cancer: a comparison of state and process utilities.

Purpose: To study the use of two different approaches, and feasibility of four commonly used utility assessment methods to assess preferences for treatment of T3-laryngeal cancer by surgery or radiation therapy (RT).

Methods: Utility assessment methods, namely, time trade-off (TTO), standard reference gamble (SRG), rating scale (RS), and direct comparison (DC), were used to assess utilities in two groups of former cancer patients (n = 10 for both), a group of clinicians (n = 9), and a group from the general population (n = 10). For the treatment modalities, ie, surgery and RT, two types of scenarios were developed and used: the state scenario, which describes a stable health state after treatment, and the process scenario, which describes a dynamic process.

Absence of vacuolar H(+)-ATPase pump in the collecting duct of a patient with hypokalemic distal renal tubular acidosis and Sjögren's syndrome.

Distal renal tubular acidosis (dRTA) is a common complication of autoimmune connective tissue diseases. The underlying pathophysiology of renal tubular acidosis in these syndromes is frequently characterized by impaired hydrogen ion secretion, i.e.

[Efficacy of the tumor necrosis factor-alpha (rTNF-alpha) associated with interferon-gamma and chemotherapy in extracorporeal circulation in the limb in inoperable malignant melanoma, soft tissue sarcoma and epidermoid carcinoma. A 4-year experience].

The authors review their experience of 4 years with isolated limb perfusion for the application of high dose TNF-alpha associated to IFN-gamma and melphalan for the treatment of regionally advanced tumours such as malignant melanoma, soft tissue sarcoma and epidermoid carcinoma. In malignant melanoma, the complete remission rate reaches 91%. In irresectable soft tissue sarcoma, this treatment when used as a neoadjuvant treatment saves the limb from amputation in 87.

Memory enhancement by intrahippocampal, intraamygdala, or intraentorhinal infusion of platelet-activating factor measured in an inhibitory avoidance task.

Platelet-activating factor (PAF; 1-O-alkyl-2-acetyl-sn-glycero-3-phosphocholine), which is thought to be a retrograde messenger in long-term potentiation (LTP), enhances glutamate release and LTP through an action on presynaptic nerve endings. The PAF antagonist BN 52021 blocks CA1 LTP in hippocampal slices, and, when infused into rat dorsal hippocampus pre- or posttraining, blocks retention of inhibitory avoidance. Here we report that memory is affected by pre- or posttraining infusion of the PAF analog 1-O-hexadecyl-2-N-methylcarbamoyl-sn-glycerol-3-phosphocholine (mc-PAF) into either rat dorsal hippocampus, amygdala, or entorhinal cortex.

Indices from flow-volume curves in relation to cephalometric, ENT- and sleep-O2 saturation variables in snorers with and without obstructive sleep-apnoea.

In a group of 37 heavy snorers with obstructive sleep apnoea (OSA, Group 1) and a group of 23 heavy snorers without OSA (Group 2) cephalometric indices, ENT indices related to upper airway collapsibility, and nocturnal O2 desaturation indices were related to variables from maximal expiratory and inspiratory flow-volume (MEFV and MIFV) curves. The cephalometric indices used were the length and diameter of the soft palate (spl and spd), the shortest distance between the mandibular plane and the hyoid bone (mph) and the posterior airway space (pas). Collapsibility of the upper airways was observed at the level of the tongue base and soft palate by fibroscopy during a Müller manoeuvre (mtb and msp) and ranked on a five point scale.

Experiments suggesting a role for nitric oxide in the hippocampus in memory processes.

Nitric oxide (NO) has been proposed to be involved in the induction of long-term potentiation (LTP) and in other processes. When coupled with weak tetanic stimulation, NO produces a long-term synaptic enhancement on its own. N-Nitroarginine (NO-Arg) inhibits NO-synthase, the enzyme that produces NO, and blocks LTP in hippocampal slices.

The Rotterdam Daytime Sleepiness Scale: a new daytime sleepiness scale.

A new daytime sleepiness scale was constructed on the basis of interviews with 96 apnea patients (the Rotterdam Daytime Sleepiness Scale) and included three subscales of Global Evaluation, Behavioral Impact, and Affected Life Domains. The scale showed satisfactory convergent and discriminant validity.

Administration of high-dose tumor necrosis factor alpha by isolation perfusion of the limbs. Rationale and results.

Recombinant tumor necrosis factor alpha (rTNF alpha) has potent antitumor activity in experimental studies on human tumor xenografts. However, in humans, the administration of rTNF alpha is hampered by severe systemic side effects. The maximum tolerated dose ranges from 350 to 500 mg/m2, which is at least 10-fold less than the effective dose in animals.

Intrahippocampal, but not intra-amygdala, infusion of an inhibitor of heme oxygenase causes retrograde amnesia in the rat.

Zinc protoporhyrin-9 (ZnPP) is an inhibitor of heme oxygenase, the enzyme involved in the biosynthesis of carbon monoxide (CO). CO regulates the activity of glutamatergic synapses and has been proposed to play a role in the early phases of long-term potentiation. The present paper reports on the effect of ZnPP on memory of inhibitory avoidance and of habituation to a novel environment.