Paraneoplastic Syndromes of the Central Nervous System

In recent years a continuous stream of new information on clinical, pathological and immunological aspects of paraneoplastic neurological syndromes has been published. In this survey, we will discuss current opinions on the value of anti-neuronal antibody detection for establishing a diagnosis of one of the paraneoplastic syndromes of the central nervous system

Effect of an ACTH(4-9) analogue on cisplatin neuropathy of longstanding duration: A phase II study

The efficacy of Org 2766, an ACTH(4–9) analogue, on the recovery of cisplatin neuropathy of longstanding duration was investigated in a phase II study. Twenty-two patients were treated with Org 2766 during a period of 4 months and vibration perception threshold (VPT) and sum scores for neuropathic symptoms and signs were compared with pre-treatment values. No change in VPT could be detected. Although there was a small improvement of clinical measures for neuropathy, no clear evidence for repair could be obtained. These results indicate no beneficial effect of Org 2766 on recovery of a longstanding cisplatin neuropathy

Self-reported work productivity in people with multiple sclerosis and its association with mental and physical health

Purpose This study aimed to identify mental health, physical health, demographic and disease characteristics relating to work productivity in people with multiple sclerosis (MS). Methods In this cross-sectional study, 236 employed people with MS (median age = 42 years, 78.8% female) underwent neurological and neuropsychological assessments. Additionally, they completed questionnaires inquiring about work productivity (presenteeism: reduced productivity while working, and absenteeism: loss of productivity due to absence from work), mental and physical health, demographic and disease characteristics. Multiple linear and logistic regression analyses were performed with presenteeism and absenteeism as dependent variables, respectively. Results A model with mental and physical health factors significantly predicted presenteeism F(11,202) = 11.33, p < 0.001, R-2 = 0.38; a higher cognitive (p < 0.001) and physical impact (p = 0.042) of fatigue were associated with more presenteeism. A model with only mental health factors significantly predicted absenteeism; chi(2)(11)=37.72, p < 0.001, with R-2 = 0.27 (Nagelkerke) and R-2 = 0.16 (Cox and Snell). Specifically, we observed that more symptoms of depression (p = 0.041) and a higher cognitive impact of fatigue (p = 0.011) were significantly associated with more absenteeism. Conclusions In people with MS, both cognitive and physical impact of fatigue are positively related to presenteeism, while symptoms of depression and cognitive impact of fatigue are positively related to absenteeism.Neurological Motor Disorder

A study of antimicrobial activities of local anesthetics, and conbined effects of anesthetics/antibiotics on clinical isolates from oral and maxillofacial infections

局麻薬の臨床分離株に対する抗菌力, ヒト抜歯創における局麻薬停滞性および抗菌薬との併用効果について検討し, 以下の結果を得た。1) Streptococcus sp., S. aureus およびP. aeruginosa に対する lidocaine と prilocaine のMICを測定したところ, それぞれ2500～7500μg/ml以上で抗菌力が確認された。2) 抜歯創における lidocaine 濃度は, 注射後1～45分で8.4～2590μg/mlに分布し, 全症例 (182例) の平均値は426.3μg/mlであった。3) 下顎第三大臼歯の135例では, 80%が10～15分で抜歯されており, 平均188.9～283.2μg/mlの lidocaine 濃度が認められたが, MICから判断すると lidocaine 単独での抗菌力は臨床的に期待できない結果であった。4) CCL, ABPCおよびOFLXの抗菌力について, 250μg/mlの lidocaine を添加してMICを測定した結果, 一部の菌株では1～2管程度のMICの低下がみられたが, なかでも Streptococcus sp. に感受性の改善した菌株が多かった。5) Streptococcus sp. に対するCCL, ABPCおよびOFLXの抗菌力について, lidocaine を25, 250, 500μg/mlに調整して添加したが, 感受性の変化はlidocaine 濃度に関係なくみられた。以上, 一部の菌株では低濃度の局麻薬存在下に抗菌薬の感受性が増強され, 術前から抗菌薬を投与した場合にはさらに感染予防効果が高くなる可能性が示唆された。 / Antimicrobial activities of the local anesthetics against clinical isolates from oral and maxillofacial infections, ledocaine levels of tooth extraction wounds in human, and the combined antimicrobial effects of lidocaine with antibiotisc were determined. The folloewing results were obtained. 1) The MICs of lidocaine and prilocaine against Streptococcus sp., S. aureus and P. aeruginosa were 2500 to 7500μg /ml. 2) Lidocaine levels of tooth extraction wounds ranged from 8.4 to 2590μg /ml in 1 to 45 minutes after injection, and the mean lidocaine level was 426.3μg /ml. 3) Lidocaine levels of the third molars in 135 cases showed 188.9 to 283.2μg /ml in 10 to 15 minutes after injection, however, it was thought that these lidocaine concentrations would not be able to act as antimicrobial agency according to the MICs of lidocaine. 4 ) When the MICs of CCL, ABPC and OFLX in combination with lidocaine of 250μg /ml were determined, some strains especially in Streptococcus sp. showed 2 to 4 fold greater antimicrobial activities than those of antibiotics alone. 5) The MICs of CCL, ABPC and OFLX against Streptococcus sp. in combination with different lidocaine levels (25, 250, 500μg /ml) , were not changed in sensitive strains with no relation to the concentration of lidocaine in this study. From the above results, antimicrobial activities of antibiotics against some strains may be improved with low dose local anesthetics, so it was suggested that preoperative administration of antbiotics would be helpfull to get greater antimicrobial actimicrobial activities and prophylactic effects with local anesthetics