Cisplatin neurotoxicity in the treatment of metastatic germ cell tumour: time course and prognosis

In order to ascertain the incidence and prognosis of cisplatin-induced neurotoxicity in testis cancer patients undergoing combination chemotherapy, 29 patients with metastatic disease were studied prospectively. Assessments included enquiry into neurological symptoms, measurement of sural nerve sensory action potential and conduction velocity, and vibration threshold in the left big toe. At the end of chemotherapy (3 to 4 cycles) only 3 out of 26 (11%) patients had paraesthesiae, but 3 months later the proportion rose to 65%. Resolution occurred in the majority over the ensuing 12 months so that only 17% had persistent symptoms. None of the 11 patients treated with 3 cycles of chemotherapy had persisting symptoms. Vibration thresholds showed a significant deterioration during chemotherapy (P = 0.032), further deterioration in the 3 months following chemotherapy (P = 0.009) and significant improvement between 3 and 12 months after chemotherapy (P = 0.038). Sural nerve sensory action potentials and conduction velocities were unhelpful.© 2001 Cancer Research Campaignhttp://www.bjcancer.co

A new approach for the evaluation of recovery after peripheral nerve damage

The major caudal nerves of the rat provide an excellent model for longitudinal evaluation of nerve repair following a crush lesion. The surgical procedure and the method for testing sensory recovery are described in detail. Using this technique a clear, positive effect of ORG.2766 (an ACTH (4–9) analog) on the regeneration of sensory nerves could be shown. Results support the suggestion that ORG.2766 enhances the initial sprouting response, rather than exerting an effect on the growth rate of newly developed sprouts

Hand-assisted laparoscopic surgery (HALS) - A report of 150 procedures

Background: This study was performed to evaluate the (long-term) morbidity associated with hand-assisted laparoscopic surgery (HALS) for various indications. Methods: HALS procedures for various indications were evaluated prospectively from 1995 to 2002. The primary outcome parameters were postsurgical complications and the development of incisional hernias. Results: Twenty-six splenectomies, 51 hand-assisted laparoscopic donor nephrectomics (HLDN), 34 segmental bowel resections, 29 proctocolectomies, and 10 emergency colectomies were evaluated. A Kustner or Pfannenstiel incision was used for handport placement. Minor complications (i.e., wound complications, urinary tract infection) occurred in 15%, 12%, 26%, 7%, and 33% of the patients after, respectively, splenectomy, HLDN, bowel resection, proctocolectomy, and emergency colectomy. Major complications (i.e., hemorrhage, anastomotic leakage) occurred in 15% and 12% of the patients after, respectively, bowel resection and proctocolectomy. Incisional hernias occurred in six patients (4%), all after a wound complication in the Kustner incision. Conclusion: HALS is fast, safe, and feasible for various indications, especially HLDN and (procto-)colectomies. Little advantage can be expected when HALS is applied in splenectomy and segmental bowel (sigmoid) resectio

A new approach for the evaluation of recovery after peripheral nerve damage

The major caudal nerves of the rat provide an excellent model for longitudinal evaluation of nerve repair following a crush lesion. The surgical procedure and the method for testing sensory recovery are described in detail. Using this technique a clear, positive effect of ORG.2766 (an ACTH (4–9) analog) on the regeneration of sensory nerves could be shown. Results support the suggestion that ORG.2766 enhances the initial sprouting response, rather than exerting an effect on the growth rate of newly developed sprouts