摘要:

On the basis of a reliable steady state phenytoin serum concentration on one (lower) dose, the serum concentration on a second (higher) dose was predicted in 28 patients (32 levels) by two previously reported nomograms and 3 physicians who had clinical experience with phenytoin therapy. Both nomograms and all 3 physicians on the average underestimated the serum concentration on the higher dose. Except for 1 physician, this bias was statistically significant (p < 0.05). The mean and SD of the prediction errors (difference between predicted and measured serum concentration) were –2.2 ± 4.2 and –3.1 ± 3.6 for the two nomograms and –1.0 ± 4.0, – 2.1 ±4.1 and –1.8 ± 4.2 for the 3 physicians, respectively. Thus, independent of the method used, there was a large uncertainty in the prediction; the approximate 68% confidence interval of the prediction error (mean ± SD) was almost as large as the therapeutic range of the drug. Because prediction of phenytoin serum levels based on one serum concentration measurement was found unreliable in this study, it is proposed that every patient whose dose had been increased should be under close observation until a new steady state has

ISSN:0014-3022    

DOI:10.1159/000115174

出版商:S. Karger AG    

年代:1980

数据来源: Karger

摘要:

In 28 patients the dose-plasma concentration relationship of phenytoin was studied by stepwise varying of the dose of phenytoin and observing the effect on the plasma concentration after an equilibration period of 4 weeks. Plasma concentrations were determined by two laboratories independently. Comedication (only phenobarbital) was fixed. It appeared that after nonconsecutive 4-week equilibration periods, equal doses could yield substantiallw different plasma concentrations. It is suggested that an equilibration period of at least 4 weeks must be observed between a dose decrement in the high dose range and a check of the resulting steady state plasma concentration. The slow decrement of phenytoin plasma concentration after decreasing the dose cannot be explained by the Michaelis-Menten concept.In this study the maximum safe dose for never exceeding a phenytoin plasma concentration of 15 ) µg/ml was 200 mg/24 h. For phenobarbital a ratio of about 1:10 or more between dose (in mg/kg/24 h) and plasma concentration (in µg/ml) was nearly always observed in 27 of 28 patient

ISSN:0014-3022    

DOI:10.1159/000115175

出版商:S. Karger AG    

年代:1980

数据来源: Karger

摘要:

Pneumoencephalographic (PEG) findings of 37 patients referred to the Institute of Occupational Health, Helsinki, because of suspected chronic organic solvent intoxication showed changes suggesting brain atrophy in 64% of the patients. Slight asymmetric central and slight local cortical atrophy were the most common findings. There were no significant difference between those considered having heavy exposure and those with less significant exposure either in regards to PEG findings or other neurological findings. Thus, lack of dose-response relationship in this study suggests nonspecificity of the slight PEG findings and possibly also individual susceptibility to neurotoxic agents.

ISSN:0014-3022    

DOI:10.1159/000115176

出版商:S. Karger AG    

年代:1980

数据来源: Karger

摘要:

Reviewing the angiograms of 100 patients with RIA or stroke we found intracranial lesions in 67%, extracranial lesions in 64%, and normal angiograms in 13% of the cases. Risk factors occurred more often as the angiographic lesions were more extensive. These findings confirm the importance of angiographic examination of the intracranial vessels in patients with cerebral ischaemia.

ISSN:0014-3022    

DOI:10.1159/000115177

出版商:S. Karger AG    

年代:1980

数据来源: Karger

摘要:

In vascular hemiplegia, motricity of the upper and lower limbs can be assessed from the examination of a limited number of movements which have been selected by a statistical procedure. For these movements the scores may be weighted on the basis of progress achieved over 2, 4 and 6 months. From the weighted, summed and averaged scores, a motricity index may be derived. This index gives a rapid overall indication of a patient’s progress in motor recovery, permits comparisons between different patients and the establishment of correlations with other clinical data and the values obtained by paraclinical technique

ISSN:0014-3022    

DOI:10.1159/000115178

出版商:S. Karger AG    

年代:1980

数据来源: Karger

摘要:

A female patient with Adie’s syndrome died from unrelated disease at the age of 62. Both ciliary ganglia were seen to be severely depleted of nerve cells and still ongoing degeneration was seen in lumbar spinal ganglia, as well as in the posterior funiculi. This confirms earlier reports that primary pathological changes in Adie’s syndrome are localized in the ciliary and spinal ganglia. Furthermore, it indicates that the underlying disease is still progressive after ye

ISSN:0014-3022    

DOI:10.1159/000115179

出版商:S. Karger AG    

年代:1980

数据来源: Karger

摘要:

Auditory brain stem evoked potentials (ABEPs) were investigated in 54 patients with the definite or presumed diagnosis of multiple sclerosis and compared with the results of 42 controls. All patients but one had no hearing impairment on clinical examinations. Investigation of ABEPs have shown to be useful when the diagnosis of multiple sclerosis is uncertain.

ISSN:0014-3022    

DOI:10.1159/000115180

出版商:S. Karger AG    

年代:1980

数据来源: Karger

摘要:

Cervical and cortical somatosensory evoked potentials were recorded in 42 patients with suspected and certain multiple sclerosis. Absolute peak latencies as well as latency differences between the cervical components N9, N11 and N13 and between N13 and cortical N20 were measured. In addition, the right/left differences of these values were analyzed. It was demonstrated that the central conduction times (inter-peak differences) were more sensitive diagnostic indicators than the absolute peak latencies of the same components. Thus we conclude that conduction time measurement has a complementary role in investigating functional disturbances in multiple sclerosis.

ISSN:0014-3022    

DOI:10.1159/000115181

出版商:S. Karger AG    

年代:1980

数据来源: Karger

摘要:

The electrospinogram was investigated in 18 adult rabbits before and after acute spinal lesions of variable entity. The first positive wave is widely distributed from L7 to Th11–12 and seems to be generated by a dipole placed within the cauda. The following ‘M’-shaped complex is propagated up to the cervical segments probably along the primary afferent pathways in the dorsal columns ipsilateral to the stimulated side. Local reflexes of mono- and polysynaptic loops are also present. Standardized seriate clinical observations did not provide reliable data on level and extension of the lesion until 16–24 h, while the electrospinogram showed a ‘killed end’ potential already within the first 60 min. Furthermore, this noninvasive test furnishes early tools about the width of the anatom

ISSN:0014-3022    

DOI:10.1159/000115182

出版商:S. Karger AG    

年代:1980

数据来源: Karger

摘要:

5 cases of late motor neuron degeneration following poliomyelitis are presented. CPK, CSF, EMG and spine radiology were studied. In all cases, muscle biopsy evidenced neurogenic alterations both in previously affected limbs and in newly affected ones. Mitochondrial abnormalities were found in 1 case. The findings are discussed in the light of the literature with particular regard to the pathogenesis of the disease. The case with abnormal mitochondria is stressed for the possible relationship of this pathology with systemic degenerative diseases.

ISSN:0014-3022    

DOI:10.1159/000115183

出版商:S. Karger AG    

年代:1980

数据来源: Karger