The assessment of serum concentration of adiponectin, leptin and serum carbohydrate antigen-19.9 in patients with pancreatic cancer and chronic pancreatitis

Pancreatic cancer and chronic pancreatitis are still significant diagnostic and clinical problems. The clinical impact of preoperative serum carbohydrate antygen 19-9 (CA 19-9) levels have been disscussed. The aim of this study was a comparative analysis of the concentrations in serum of adipocytokines: adiponectin and leptin and CA 19-9 in patients with pancreatic cancer (PC), chronic pancreatitis (CP) and control group (CG). The study was performed in a group of 90 patients. Group 1 consisted of 30 patients with PC, group 2 consisted of 30 patients with CP. There was no coincidence of pancreatic cancer in CP group. Group 3 (CG) consisted of 30 persons and were recruited among patients operated for cholelithiasis. The serum samples were taken from patients and the concentration of adiponectin, leptin, CA 19-9 and CEA were evaluated. The revealed concentrations levels of the adiponectin were significantly higher in the PC serum samples compared to the CP and CG. There was no significant correlation between increased adiponectin concentration and body fat mass in the PC group. The concentration of leptin was significantly lower in CP serum samples compared to PC and CG. The concentration of leptin was similar in the PC and CG. The concentration of leptin was mainly dependent on body fat mass and fat distribution. Additionally, measurement of waist circumference and body composition was recorded using bioelectrical impedance analysis.

CONCLUSIONS

significantly higher concentration levels of adiponectin in the PC group, independent of body fat mass, may play a potential role as a new tumor marker in PC and might be useful in the differential diagnosis between PC and CP, but this statement needs further investigation. To our knowledge, this was the first study evaluating not only body mass index but also the content and distribution of body fat in patients with PC and CP.

Quantitative evaluation of intranuclear inclusions in SSPE: correlation with disease duration

Three types of intranuclear inclusions in neurones, oligodendrocytes and astrocytes were quantitatively evaluated by electron microscopy in the autopsy material derived from six cases of subacute sclerosing panencephalitis (SSPE) with different duration of disease. Viral nucleocapsids were found in neurones and oligodendrocytes with the highest incidence (about 38% of nuclei) in two acute cases (adolescent), whereas in two subacute cases only 10% of nuclei of these cells contained nucleocapsids. However, in one acute case (child) and one chronic case, no nucleocapsids were detected at all, despite very intensive study. Two other types of intranuclear inclusions--nuclear bodies (NBs) and granulofilamentous inclusions (GFs) were present in astrocytic nuclei in all cases. Nuclear bodies were found the most frequently (about 66%) in cases of a several-week-long duration, and their incidence decreased with the extended duration of the disease. In the case of a seven-year-long duration, about 31% of nuclei contained NBs. The incidence of certain types of NBs varied also in individual groups of cases, and the same applied to the occurrence of cellular nuclei with different numbers of NBs. Nuclear bodies types IVand V occurred with similar frequency, regardless of the disease duration. The highest incidence of nucleocapsids and NBs was accompanied by the highest (about 25%) frequency of GF in astrocytic nuclei. The incidence of the latter declined with the prolonged duration of the disease, and in the chronic case it was about 16 times lower than in acute cases. In some acute and subacute cases, GF occurred together with NBs. Astrocytic nuclei with both types of inclusions occurred with a similar frequency (about 1.6-1.8%).

Ultrastructural changes in neuronal and glial cells in subacute sclerosing panencephalitis: correlation with disease duration

This paper presents ultrastructural changes in neuronal and glial cells with special reference to intranuclear inclusion bodies in subacute sclerosing panencephalitis (SSPE) with different duration (from several weeks to seven years). Brain autopsy at ultrastructural level revealed the nucleocapsids of paramyxovirus in neuronal and oligodendroglial nuclei in 4 of 6 SSPE cases under study. Nucleocapsids of measles virus were present in two cases of disease lasting several weeks and in two cases with disease duration of two years, while abundant nuclear bodies and granulofilamentous inclusions in astrocytic nuclei were found in all cases. Occasionally, both granulofilamentous inclusions and complex nuclear bodies occurred in the same astrocytic nucleus. Only in the case lasting seven years they were not observed. It is likely that there is a structural and morphological relationship between these two types of inclusions present in astrocytic nuclei. Nuclear bodies and granulofilamentous inclusions were common and independent of the presence or absence of virus nucleocapsids. In the case of SSPE with a seven-year duration but without viral nucleocapsids in neuronal and oligodendroglial nuclei, neuronal tangles were observed.

[Sequence of clinical changes and evolution of MR images in a case of chronic SSPE]

Slow course case of subacute sclerosing panencephalitis is reported. The onset was at the age of 16 years and death followed after 5 years. He was observed during nine successive hospitalizations and the authors describe the changing clinical symptomatology parallelly with successive EEG records and brain MR imaging evolution. Successive phases of the disease were associated with hyperintense changes in T2-weighted.images, and were situated initially in occipital lobes, and involved later on periventricular areas and finally the whole white matter of both cerebral hemispheres. Subcortical brain atrophy developed parallelly.

[The evaluation of the use of antineoplaston AS2-1 treatment in subacute sclerosing panencephalitis]

A follow-up study was carried out of 16 SSPE patients two years after completion of 6-month treatment with Antineoplaston. The study was based on an inquiry sent to the families of the patients and on control examinations at the clinic. In the period of follow-up 6 patients died, all had the downhill type of disease course and their mean survival was 18 months. Out of the remaining 10 patients 4 are in stationary condition and the remaining ones had minimal worsening. A more detailed clinical analysis showed that half the patients were in contact with and general orientation in the environment, but impairment of motor functions made difficult in most cases self-care and self-dependent functioning. All patients had evident changes in brain MRI. The survival time of the patients has been as yet from 2.5 to 5.5 years (mean 3.9 years). The results of the treatment with Antineoplaston AS2-1 + isoprinosine are comparable with those observed during isoprinosine alone treatment but significantly worse than those after administration of Propionibacterium granulosum with isoprinosine. This suggests that Antineoplaston AS2-1 fails to modify importantly the natural course of SSPE.

[The evaluation of humoral immunity response in subacute sclerosing panencephalitis (SSPE)]

The purpose of the study was the assessment of humoral response markers in 20 patients with SSPE in phase I, II and III of the disease during immunomodulating treatment. In the CSF IgG levels were determined by nephalometric method, with its share in the total protein level, and with determination of the local IgG synthesis in CNS by Reiber method, 24-hour IgG synthesis by Tourtellotte-Boce method, IgG index by Link-Tibbling method and albumin index. Oligoclonal IgG was determined by isoelectrofocusing. All mathematical tests indicating IgG synthesis in CSF were abnormal in all cases, and also in all cases oligoclonal IgG was found (type 3 of electrophoresis separation pattern). The results point to far reaching changes of the humoral immune response in SSPE persisting also during immunomodulating treatment independently of disease phase and duration. In only 10% of cases abnormal values of the albumin index suggested damage to the blood-brain barrier.

[Epileptic seizures in relation to the age of SSPE onset]

The aim of this study is a clinical and electroencelographic analysis of those SSPE patients who suffered epileptic seizures in course of the disease. The material is based on an analysis of a computed database including 1180 case histories from multiple hospitalizations of 248 SSPE patients (141 males, 107 females) in years 1978-1995. The analysis was made using computer system EPI-INFO 6. The average age of SSPE onset was 12.3 +/- 4.5 (range 4-27.5). 74.2% of patients developed the disease before the age of 15. Epileptic seizures occurred in 43.5% (N = 108) of all SSPE patients in different stages of the disease. In 47 patients (M-21; F-26) they were observed among first SSPE symptoms, in 41 of those the seizures had the form of GTCS. Epileptic seizures were more frequent in patients with SSPE onset before the age of 15 (50.5%) than in patients with later onset (23.4%). More frequent occurrence of epileptic seizures and epileptiform changes in EEG in children under 15 can be associated with specificity of developmental age: immaturity of nervous and endocrine system and decreased convulsant threshold.

[Assessment of early treatment results with antineoplaston AS2-1 in subacute sclerosing panencephalitis]

A tentative treatment with Antineoplaston AS2-1 was carried out in a group of 16 patients with subacute sclerosing panencephalitis (SSPE). Most patients were in phase II of SSPE (after Jabbour) with mean disease duration 6.4 months. Their age ranged from 13 to 28 years. They were given for 6 months 15 capsules of Antineoplaston AS2-1 and 6 tablets of isoprinosine daily. Despite that treatment progression was observed of the disturbances of higher nervous functions, less so of motor functions. The treatment had no effect on MRI results, EEG and antimeasles antibodies levels. No adverse effects were observed.

[Computerized analysis of the database of SSPE patients treated at the 1st Neurological Clinic of the Institute of Psychiatry and Neurology in Warsaw in 1978-1995]

Computer-assisted analysis was done of database containing 1180 records of 249 patients with SSPE hospitalized repeatedly at the I Dept. of Neurology using the EPI INFO 6 computer system recommended by the WHO. Boys were slightly prevalent in these cases (58%). The results of the analysis showed a falling incidence of SSPE among children born after 1976 (increased mean age of onset and death with successive years and hospitalization period, but without correlation between the mean age at onset and the birth year, decreased number of patients born after 1978 and absence of new admissions of those born after 1984). The falling incidence of SSPE can be a result of the introduction in 1976 of routine measles vaccination. 80.5% of the patients had measles, and 70.5% had it in the first two years of life (mean age to onset 2.34 +/- 2.32). Only 29 patients (11.6%) had had measles vaccination, and 15 of them (6%) had had measles.

[Leukotrienes B4 and C4 in cerebrospinal of patients with multiple sclerosis]

Leukotrienes B4 and C4 have been assayed in CSF of 24 patients with the attacks or slowing-progressing course of multiple sclerosis, and in 23 patients with other noninflammatory diseases. Leukotrienes concentrations have been assayed with RIA technique with the use of commercially available kits manufactured by Amersham. Leukotrienes B4 and C4 levels in CSF of patients with multiple sclerosis have been 91.8 +/- 5.6, and 88.6 +/- 7.5 pg, and have been significantly higher than those in other neurological disorders (p < 0.01). Mean LTB4 and LTC4 levels have been significantly lower in patients with atherosclerotic dementia (69, 12.2 and 63, 02.9 pg/ml) or in patients with headache (72.7 +/- 2.8 and 64.5 +/- 8.2 pg/ml). Higher LTB4 and LTC4 levels in patients with multiple sclerosis is probably due to both increased penetration through blood-brain barrier and their synthesis in blood-brain barrier, and cerebral nervous tissue. Further investigations are necessary to show whether LTB4 and LTC4 levels may indicate a stage of inflammatory process activity and enable to draw any conclusions on efficacy of anti-inflammatory therapy.

Successful double bypass grafting in a child with coronary artery obstruction due to Kawasaki disease

We describe the clinical evaluation and surgical treatment of a 7-year-old child who had severe coronary artery obstructions that occurred as a sequela of previously diagnosed Kawasaki disease.

Health Promotion Schools of Excellence: a model program for Kentucky and the nation

This article reviews the development and progress of an innovative, comprehensive school health project in the Jefferson County school district known as the Health Promotion Schools of Excellence (HPSE). This project features unique working relationships between public and private entities seeking a common goal: "A Healthier Community." The goals and development of HPSE have been formulated to coincide with the emerging directives of the Kentucky Education Reform Act (KERA) as well as the growing pressures to control health care costs through effective preventive measures. The results of testing following the first and second years of the project show an encouraging trend of improved physical fitness levels for all students (grades K-12) and improving levels of health knowledge and attitudes in elementary level children (grades 4-8) as well as school faculty and staff. These initial results, although encouraging, will only be meaningful if they translate over time into a healthier, more responsible cohort of adolescents and young adults when compared to their peers not involved in the project. The project, while only in its third year of development, has already been recognized at regional and national levels as a successful model of a comprehensive school health program. As the project continues and grows, the authors anticipate developing one of the nation's largest and most comprehensive longitudinal data bases of childhood and adolescent health information.

Group B streptococcal endocarditis involving the tricuspid valve in a 7-month-old infant

To our knowledge, we report the first case of group B streptococcal endocarditis that occurred in an infant after the neonatal period. A large, friable vegetation had destroyed the tricuspid valve and resulted in pulmonary emboli. Surgical resection of the valve was needed to achieve clinical cure of the patient. A review of the English-language literature on older patients with group B streptococcal endocarditis revealed a mortality rate of 60% among patients treated with antimicrobial drugs alone and a mortality rate of 29% among those whose treatment included both surgery and therapy with antimicrobial drugs. Surgical debridement of the valve may be necessary for children with large vegetations, which tend to embolize and thus contribute to the morbidity and mortality associated with group B streptococcal endocarditis.

[Leukotrienes in cerebrospinal fluid of patients with subacute sclerosing panencephalitis]

In the cerebrospinal fluid of two groups of patients with subacute sclerosing panencephalitis (SSPE), the determinations of LTB4 and LTC4 leukotriene concentrations were performed by radioimmunoassay (RIA). In the first group of 10 patients with chronic SSPE (from 2 to 11 years), the LTB4 and LTC4 levels were 94.8 +/- 17.0 and 97.4 +/- 16.8 pg/ml respectively, and were significantly higher than those in six patients with discopathy, epilepsy and headache (p < 0.01). In the second group of 10 patients with beginning SSPE (disease duration from 1 to 11 months) LTB4 level was lower (was not different from that in the control group), while LTC4 concentration was 97.6 +/- 10.8 pg/ml and again was significantly raised. Higher LTB4 and LTC4 levels in the cerebrospinal fluid of patients with SSPE indicate that these compounds participate in chronic inflammatory reaction around cerebral veins.

[Changes of cognitive and emotional processes during immunostimulatory treatment in subacute sclerosing panencephalitis]

In 35 cases of SSPE sensibilized neuropsychological testing was done before and after 6 months of immunostimulatory and virostatic treatment. Three groups of patients were studied. All groups received isoprinosine, one group was given additionally TFX-thymus extract Polfa, and another group received additionally Propionibacterium granulosum KP-45. A tendency for improvement of verbal function and emotional status was observed only in the group receiving isoprinosine with propionibacterium. In both remaining groups, receiving only isoprinosine or isoprinosine with TFX worsening was noted, particularly in the isoprinosine-only group. This was particularly evident in the visuospatial orientation. Prolongation of survival time in SSPE owing to specific treatment increases the need for psychoreactive and therapeutic influences for stimulation of cognitive processes.

[Early signs of cognition disorders in children with subacute sclerosing panencephalitis in initial stage]

The purpose of the study was to find some characteristic features of cortical defects in the neuropsychological examination of children with SSPE. These findings could be very useful in early differential diagnosis. We analysed the results of the neuropsychological assessment of 13 children selected from a group of 100 patients. The most frequent defects were found in the visuo-spatial functions. The clinical analysis of the obtained results was studied in view to establish, whether there are the signs of the dysfunction of the right or both cerebral hemispheres.

Increased levels of beta 2-microglobulin, soluble interleukin-2 receptor, and soluble CD8 in patients with subacute sclerosing panencephalitis

We measured beta 2-microglobulin (beta 2-M), soluble interleukin-2 receptor (sIL-2R), and soluble CD8 (sCD8) antigen levels in paired cerebrospinal fluid (CSF) and sera from patients with subacute sclerosing panencephalitis (SSPE), multiple sclerosis (MS), and other neurological diseases (OND) using enzyme-linked immunosorbent assay. beta 2-M was significantly increased in CSF of the SSPE group compared to the MS or the OND group. Similarly, beta 2-M in the MS versus OND group was significantly increased in CSF. Although serum levels of beta 2-M were similar in the three groups, the CSF/serum ratios were higher in SSPE versus the MS group and in the MS versus the OND group. Levels of sIL-2R and sCD8 were higher in SSPE CSF than OND CSF; however, there were no differences between levels in SSPE and MS CSF. The levels of sIL-2R were increased in SSPE sera compared to those of MS or the OND group, whereas levels of sCD8 in serum from the three groups were similar. The findings of increased CSF/serum ratio of beta 2-M and higher levels of serum sIL-2R and CSF sCD8 in SSPE patients are consistent with those seen in patients with acute and chronic viral infections. When the levels between the initial and follow-up CSF and serum samples from SSPE patients were compared, the data showed that CSF levels of sCD8 elevated during periods of clinical worsening and decreased during clinical improvement. In contrast, serum beta 2-M decreased during periods of worsening and increased during improvement. The measurement of serum beta 2-M and CSF sCD8 may be useful in SSPE patients as markers to monitor disease activity.

Effect of treatment on oligoclonal IgG bands and intrathecal IgG synthesis in sequential cerebrospinal fluid and serum from patients with subacute sclerosing panencephalitis

Oligoclonal IgG bands were analyzed in matching pairs of cerebrospinal fluid (CSF) and serum from 12 subacute sclerosing panencephalitis (SSPE) patients, using isoelectric focusing and immunofixation. Each patient was given isoprinosine, and four of the 12 patients were given alpha-interferon in addition. Two to 4 serial CSF and serum samples were collected from each SSPE patient during periods ranging from 1 to 16 months. In 3 SSPE patients a small number of new oligoclonal bands were seen in the follow-up CSF samples. In the other 9 SSPE patients there was no change in CSF band patterns between initial and follow-up specimens. Band patterns in serum remained unchanged between initial and follow-up samples. Although all 12 SSPE cases had higher IgG indices and increased rate of intra blood-brain barrier (BBB) IgG synthesis in comparison to patients with other neurological diseases, the values did not significantly differ between the first and follow-up specimens. We conclude that treatment of SSPE patients with isoprinosine or with isoprinosine and alpha-interferon had no significant effect on the CSF oligoclonal band profiles or IgG synthesis within the central nervous system.

[Subacute sclerosing panencephalitis (SSPE) in women during pregnancy]

Four women with SSPE during pregnancy were observed. The influence of pregnancy on the course of illness was in all patients unfavourable: the disease exacerbated, what could be explained by physiological immunosuppression connected with gestation. Delivery (in three cases by sectio caesarea) had no beneficial influence on the fatal course of SSPE. In two cases intrauterine necrosis of foetus took place in the 8th and 20th week from the beginning of SSPE. In other two cases healthy children were born. One of them does not exhibit any neurological abnormalities during the first 5 years of life.

[Evaluation of cerebrospinal fluid proteins in patients with subacute sclerosing panencephalitis (SSPE)]

CSF proteins of 62 patients with SSPE aged 6 to 26 years were analysed by polyacrylamide gel electrophoresis. The total IgG concentration in the CSF was increased to 16.8 +/- 10 mg/dl and the IgG index was raised to from 2.7 +/- 0.5 to 3.6 +/- 3.0. All SSPE patients had pathological subfractions gamma 4 and gamma 5. The per cent proportion of the gamma 1 subfraction was raised only in the youngest patients. A tendency was observed for higher values of the prealbumin:albumin index and the prealbumin: transferrin index. The youngest SSPE patients had a tendency for greater total protein concentration, lower prealbumin concentration, and highest IgG index values (3.6 +/- 3.0). In early disease period a tendency was noted for higher concentration of total protein, higher total IgG level and higher IgG index. These results suggest that SSPE patients have a constant stimulation of B-cells and variable increase of blood-brain barrier permeability.

[Comparison of the results of the treatment of patients with SSPE using various immunomodulating preparations]

The authors analysed the results of controlled treatment by three methods of patients in the 1st or 2nd phase of SSPE in a randomized group. The groups received: I. Propionibacterium granulosum KP-45 (interferon inducer) + isoprinosine, II--TFX (thymus extract) + isoprinosine, III--only isoprinosine. In all groups the treatment was continued during 6 months. The analysis of the clinical results of these methods failed to demonstrate a statistically significant superiority of any of these methods (among others, due to small number of cases) but an evident statistical tendency was revealed suggesting a better effectiveness of combined treatment (immunostimulator + isoprinosine) in relation to treatment with isoprinosine only. The final evaluation of the results requires further observations of these patients.

Measles virus-specific immunoglobulin D antibody in cerebrospinal fluid and serum from patients with subacute sclerosing panencephalitis and multiple sclerosis

Quantitation of measles-specific immunoglobulin D (IgD) antibody was carried out in cerebrospinal fluid (CSF) and serum samples from 18 patients with subacute sclerosing panencephalitis (SSPE), 12 patients with multiple sclerosis (MS) and seven normal controls with high measles antibody titers in serum, using polyclonal and monoclonal antibodies specific for human IgD and enzyme-linked immunosorbent assay. Measles-specific IgD activity was significantly higher in CSF and serum from SSPE patients compared to that found in patients with MS or normal controls. The IgD antibody to measles virus was not due to high levels of measles-specific IgG since significant measles IgD activity was found after eluting IgG from SSPE serum. The increased level of measles-specific IgD found in SSPE sera is consistent with the levels observed in patients with acute and chronic viral infections.

[Propionibacterium granulosum KP-45 in the treatment of subacute sclerosing panencephalitis]

3 groups of patients, who suffered on SSPE (without treatment, with isoprinosine therapy, combined treatment with propionibacterium granulosum and isoprinosine) are compared. The results show a favourable effect of the combined treatment in a part of the patients. They are discussed in detail.

[Epileptic attacks in subacute sclerosing panencephalitis (SSPE)]

The analysis is reported of the frequency of epileptic seizures in 125 cases of subacute sclerosing panencephalitis (SSPE). Sporadic, periodic and recurrent seizures were isolated. Seizures developed in 42% of cases, mostly in the II phase of the disease. The most serious clinical problem are difficulties in the differentiation between involuntary movements of the type of complex moyclonia and atonic-myoclonic seizures. In the electrophysiological evaluation of use may be finding in EEG of triphasic sharp waves and spike-wave complexes, apart from generalized periodic discharges characteristic for SSPE. A greater possibility of differentiation between epileptic seizures and involuntary movements is opened by monitoring examination or 24-hour EEG recording.

Immunoglobulin G subclass antibodies to measles virus in patients with subacute sclerosing panencephalitis or multiple sclerosis

Mouse monoclonal antibodies specific for human immunoglobulin G (IgG) subclasses and a sensitive immunoassay were used to evaluate the IgG subclass antibody response to measles virus antigens in cerebrospinal fluid and serum samples from 20 patients with subacute sclerosing panencephalitis (SSPE), 12 patients with multiple sclerosis (MS), and 11 controls with high measles virus antibody titers in serum. In patients with SSPE, measles virus-specific antibodies were found mainly in the IgG1 subclass and the IgG subclass distribution remained unchanged, irrespective of the clinical stage or duration of the disease. In patients with MS and in controls, measles virus activity was also associated mainly with IgG1. However, the activity was significantly lower than that found in patients with SSPE. The results suggest that there is no primary abnormality in humoral immune response to measles virus in patients with MS. The disproportionately high levels of the measles virus-specific IgG1 subclass found in patients with SSPE may be due to persistent antigenic stimulation or reflect a defect in immunoregulatory mechanisms in response to viral infection.

[Intrathecal administration of interferon in the treatment of SSPE]

Seven patients with SSPE aged from 10 to 19 years received beta interferon intrathecally one million units every second day during one month (in all, 15 million units for one course of treatment. During the treatment signs were observed of irritation of the meninges which regressed after treatment completion. The neurological status of the patients was not significantly changed during the treatment. Control investigations carried out 3 to 10 months after the treatment demonstrated worsening with progression to a further phase of SSPE in 4 cases, and evidence of disease progression within the previous phase in 3 cases.

[Changes in the cerebrospinal fluid in patients with subacute sclerosing panencephalitis during intrathecal administration of interferon beta]

Changes were observed in the cerebrospinal fluid in SSPE cases during administration of beta-interferon 1 million units in 3.3 ml of normal saline intrathecally every second day for one month. During and after the treatment the cell count rose to a mean value of 277/mm3, with prevalence of monocytes initially and then lymphocytes. The total protein level increased by a mean threefold value, with a particular increase in the gamma-globulin and IgG fractions. In control investigations 3-10 months after completion of treatment the cell count became normal and the total protein level was slightly above the normal one, while the electrophoretically demonstrated changes regressed. The changes in the cerebrospinal fluid during intrathecal administration of beta-interferon are due probably to a non-specific irritative action of the drug on the reticulo-histiocytic system of the leptomeninx and the effect of interferon on the immune system.

[Gamma globulin subfractions and immunoglobulin G in the cerebrospinal fluid of patients with multiple sclerosis, subacute sclerosing panencephalitis and other diseases of the nervous system]

CSF samples were obtained from 22 patients with multiple sclerosis, 14 patients with subacute sclerosis panencephalitis, and 10 with neuroses or headaches. Most samples were investigated simultaneously by a sensitive method of electrophoresis in polyacrylamide gel (PE) and radial immunodiffusion (RID). The absolute IgG concentration was in multiple sclerosis 6.8 +/- 3.3 mg/100 ml, and in SSPE 21.4 +/- 16.8 mg/100 ml and it was higher than in control subjects (p less than 0.01). In 84% of MS patients the Bauer index (IgG: total protein) was raised, 72% had relatively raised subfractions gamma 2-gamma 3 in PE, 64% had higher absolute concentration of GG (0.045 g/l or more) and 63% had increased proportion of one of gammaglobulin subfractions (over 4%). Of positive diagnostic importance was a rise of the IgG: total protein index, since 7 patients with SM (31%) with normal per cent gammaglobulin level (less than or equal to 13%) had an evident rise of this index. Raised value of the index IgG: total protein (greater than or equal to 10%) was observed also in 100% of SSPE cases, while in 92% the proportional value of one of gamma globulin subfractions was increased (over 4%), in 92% the subfractions gamma 3-gamma 4 were increased, in 85-86% of patients the relative (over 13%) and absolute (0.045 g/l or more) levels of gammaglobulins were increased. The index beta/gamma in MS and SSPE was 0.85 and 0.57 respectively, and was significantly lower than in patients with headaches. The authors discuss the diagnostic value of these findings.

[Visual evoked potentials and their relation to fundus oculi changes in patients with subacute sclerosing panencephalitis (SSPE)]

The results of 634 determinations of visual evoked potentials in 110 cases of SSPE are presented. The determinations were repeated many times in successive stages of the disease and were compared with findings obtained during eye fundus examinations. A statistically significant correlation was found between these potentials and changes in the fundus involving the optic disc and macula, and increasing abnormalities of the potentials in successive stages of the disease with their complete disappearance in the last stages. Visual evoked potential determination is regarded by the authors as a valuable diagnostic factor in early stages of the disease and as an additional source providing information about the degree of visual system damage with progression of the pathological process.

[Evaluation of the results of the treatment of patients with subacute sclerosing panencephalitis with TFX-Polfa]

The authors report the results of a trial of treatment of patients with SSPE with the preparation TFX-POLFA given together with isoprinosine and amantadine to 13 children for 12 weeks, and to 7 for 6 weeks. The results of clinical and immunological treatment were compared with those in a group of 10 patients with SSPE receiving only isoprinosine and amantadine. In both groups a steady deterioration of the neurological status was observed in about half the cases. No significant effect of TFX was observed on the immune reactivity. During the treatment with TFX the per cent of lymphocytes forming early E rosettes rose.

[Changes in blood lipids after stroke in patients treated with lipanthyl]

The authors analysed the effectiveness of Lipanthyl treatment in 38 patients after stroke undergoing rehabilitation treatment. The effects of the drug were evaluated on the general condition, neurological and psychic status, progression of motor rehabilitation, and on lipid metabolism parameters. A statistically significant improvement was obtained in the subjective and psychic condition, and the results of motor rehabilitation were slightly better than in the compared groups of patients. Lipid metabolism was normalized only in part (cholesterol, chylomicrons). In the conclusions the authors state that it is useful to give this drug to patients with cerebral atherosclerosis only if disturbances of lipid metabolism coexist with this disease and are refractory to dietetic treatment.

Measles antibodies in the saliva of children with subacute sclerosing panencephalitis

Using the method of haemagglutination inhibition, the authors determined the levels of measles antibodies in the saliva of 14 children with subacute sclerosing panencephalitis. In 13 of them these antibodies were found in titres from 1:8 to 1:128. In the control groups, comprising 29 children, these antibodies were found in the saliva in only two cases and in low titres. There appears to be a correlation between the levels of these antibodies in the saliva and cerebrospinal fluid in patients with subacute sclerosing panencephalitis.

[Comparative evaluation of the therapeutic effectiveness of drugs of different mechanisms of action in cerebral atherosclerosis]

The author describes the results of treatment of 299 patients with clinical evidence of cerebral atherosclerosis receiving three groups of antiatherosclerotic agents: improving cerebral blood flow (naftidrofuryl, cinnarazine, pyridinol carbamate, low-molecular dextran), normalizing lipid metabolism (clofibrate, heparinoid, alpha-tocopherol, Procetophen) and improving the metabolism of nerve cells (piracetam, pyritinol). After a statistical analysis of the results of the author evaluated the effectiveness of these drugs in various groups and suggested practical conclusions and treatment schedules in various forms of cerebral atherosclerosis.

[Clinico-electroencephalographic correlates in subacute sclerosing panencephalitis]

The authors studied 30 cases of subacute sclerosing panencephalitis in various stages of the disease. The group comprised 28 children with a mean age of 7.8 years and 2 adults ages 22.5 years on the average, who were in remission. Apart from characteristic EEG findings with rhythmic seizure activity typical of this disease, in several cases other patterns were observed connected with the phase of the disease: in phase II with changes resembling hypsarrhythmia, in phase III generalized slowing down of the rhythm without discharges. Gradual disappearance of discharges with progression of the disease was observed. The authors discuss the possible pathological mechanism of EEG changes and their evolution.

[Antiviral treatment of subacute sclerosing panencephalitis]

The natural outcome of SSPE which is as a rule unfavourable independently of the treatment given, and this indicates the necessity of studies on new methods of treatment. After failures of steroids, immunosuppressants and transfer factor the treatment with virostatic drugs seems to be most safe and justified. The paper contains preliminary results of clinical observations of 34 patients with SSPE treated with amantadine, ITF (a derivative of isothiazole) and isoprinosine. In some cases it was tried to correlate the results of treatment with those of immunological and electrophysiological investigations. The presented data are insufficient for a reliable conclusion to be drawn concerning the effect of various drugs on the course of SSPE, nevertheless, it seems that the best results with slowing down of the progression of the disease were observed in the group treated with isoprinosine.

[Familial EEG abnormalities in children of epileptics]

The purpose of the study was to establish the frequency of EEG abnormalities in mother and child when one of them has epilepsy. The incidence and type of EEG abnormalities were analysed in 2 groups: 33 epileptic children and their 31 healthy mothers, and 28 epileptic mothers with their 46 clinically healthy children. For illustration of data distribution in EEG the examined subjects were divided in both groups into mother-child pairs comparing the features of the records as well as morphological similarity of the curves in mother and child. It was found that the probability of abnormalities in the bioelectric activity of the brain is the same in a healthy child of an epileptic mother (67.3%) as in a healthy mother of an epilepitic child (51.6%). The frequency of EEG pathology was greater in daughters than in sons of epileptic mothers. Similarities in morphological patterns of EEG occurred in only 3 cases in mothers of epileptic children and in 8 children of epileptic mothers.

[Study of children of mothers treated with anticonvulsants during pregnancy]

Forty children of mothers with epilepsy treated with anticonvulsants during pregnancy were investigated. Medical documentation and history data permitted to gain information concerning the course of the disease and treatment during pregnancy, the course of pregnancy and labour and the neonatal condition of the child. The children had medical, psychological and EEG investigations. It was found that in the group studied disturbances in the course of pregnancy occurred much more frequently than in the general population (pregnancy disturbances in 20.5%, premature labour -- 25.6%, complicated labour -- 15.4%). Numerous so-called minor malformation syndromes were found in these children (37.5%) and somatic development was deficient in 52.5% of cases. EEG abnormalities were present in 65.6% of children. No abnormalities were observed in mental development. It seems that these abnormalities were most frequent when the mothers had been treated with derivatives of phenytoin and phenobarbital. The observed group is, however, too small for reaching reliable conclusions.

Clonazepam, baclofen and placebo in the treatment of spasticity

25 patients with multiple sclerosis (MS) and other spastic disorders, 33 MS patients and 10 control patients with MS were given clonazepam, baclofen or placebo over a period of 5 days to 20 weeks. Both clonazepam and baclofen were significantly more effective than placebo in the treatment of spasticity (p less than 0.005 or p less than 0.01). A clinical trial of clonazepam versus baclofen was carried out and this showed no significant difference between the two drugs. However, there was indication that clonazepam influenced with better improvement in patients with slight muscle hypertonia mainly of cerebral origin. Patients with more severe forms, mainly of spinal spasticity, benefited rather from baclofen treatment (Fisher's test, p = 0.003). There was suggestion that combination of the two drugs may be more effective in some patients than than clonazepam or baclofen alone.

[Cerebral blood flow determination with the use of a Standard ZM 703 device]

The authors report a method of determination of regional blood flow in the brain with a Polish ZM 703 apparatus produced by United Nuclear Equipment Works POLON. The authors found that ZM 703 is useful for determination of brain blood flow but it should be equipped with detection crystals and collimators of smaller size for simultaneous examination of greater number of brain regions.