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Radiation therapy for benign central nervous system disease.

The most common indication for the use of radiation therapy in the treatment of benign central nervous system disease is for the treatment of benign brain tumors, such as meningioma, pituitary adenoma, acoustic neuroma, arteriovenous malformation, and craniopharyngioma. Other less common benign intracranial tumors treated with radiation include chordoma, pilocytic astrocytoma, pineocytoma, choroid-plexus papilloma, hemangioblastoma, and temporal bone chemodectomas. Benign conditions, such as histiocytosis X, trigeminal neuralgia, and epilepsy, are also amenable to radiation treatment. There have also been reports of radiosurgery being used for the treatment of movement disorders and psychiatric disturbances, such as obsessive-compulsive and anxiety disorders. For benign brain tumors, radiation therapy as either primary or adjuvant therapy plays an integral role in improving local control. In the treatment of trigeminal neuralgia, epilepsy, tremor, and some psychiatric disturbances, radiosurgery may help ameliorate or eliminate some symptoms. Patients with benign central nervous system disease are expected to live a long time. As such, treatment should be highly conformal and based on three-dimensional planning using magnetic resonance imaging, computed tomography, or both. It is critical that damage to normal brain be minimized.

Brain Neoplasms↗

Exposure to electromagnetic fields and risk of central nervous system disease in utility workers.

Occupational exposure to electromagnetic fields has been associated with neurological diseases such as amyotrophic lateral sclerosis, senile dementia, Parkinson disease, and Alzheimer disease. I studied the incidence of central nervous system diseases in 30,631 persons employed in Danish utility companies between 1900 and 1993. I linked the cohort to the nationwide, population-based Danish National Register of Patients and compared the numbers of cases of these diseases observed between 1978 and 1993 with the corresponding rates in the general population. In addition I fit to the data on utility workers a multiplicative Poisson regression model in relation to estimated levels of exposure to 50-Hz electromagnetic fields. Overall, there was an increase in risk for senile dementia and motor neuron diseases combined. The incidences of Parkinson disease, Alzheimer disease, and other diseases of the central nervous system were essentially unrelated to exposure to electromagnetic fields. A decreased risk of epilepsy compared with the general population probably reflects a healthy worker effect; I observed an increased risk of epilepsy based on internal comparisons. The increased risk for senile dementia and motorneuron diseases may be associated with above-average levels of exposure to electromagnetic fields.

Adult↗

Do endogenous retroviruses have etiological implications in inflammatory and degenerative nervous system diseases?

Vertebrates carry large numbers of endogenous retroviruses (ERVs) and related sequences in their genomes. These retroviral elements are inherited as Mendelian traits. Generally, ERVs are defective without the ability of being expressed as viral particles. However, ERV sequences often have a potential for expression of at least some proteins. So far, the possible biological significance of ERVs is not clear. Nonetheless, there are observations suggesting a connection between ERVs and various diseases. This is the case with murine lupus and a spinal cord disease of certain mouse strains. In the present review, we discuss possible mechanisms by which ERVs could contribute to the development of human degenerative and inflammatory nervous system diseases, including direct effects on nervous system cells and immune cells. Interactions between ERVs and infectious viruses are also discussed. Finally, we review a possible retroviral etiology of multiple sclerosis.

Animals↗

[Absence of anal reflex in patients with central nervous system diseases].

The anal reflex was examined electromyographically in 336 patients with central nervous system disease. The absence of anal reflex was found in a total of 78 patients. The incidence of the absence of anal reflex was 31 over 132 (23.7%) in the patients with pyramidal signs in lower extremities, 7 over 41 (17.0%) in patients with extrapyramidal signs in lower extremities, 12 over 50 (24.0%) in patients with both signs and 28 over 113 (24.8%) in patients without both signs. Further incidence of the absence of anal reflex was 6 over 26 (23.1%) in patients with unilateral pyramidal signs, 24 over 106 (22.6%) in patients with bilateral pyramidal signs, 3 over 13 (23.1%) in patients with unilateral extrapyramidal signs and 4 over 28 (14.3%) in patients with bilateral extrapyramidal signs. There was no statistical difference among the above groups, therefore the absence of anal reflex appeared to have no specific relationship to pyramidal or extrapyramidal signs. On the other hand, the incidence of the absence of anal reflex was 33 over 81 (40.7%) in patients with and 45 over 255 (17.6%) in patients without disturbance of light touch and/or pinprick in sacral area. The incidence of the former is statistically higher than that of the latter. Therefore we may conclude that the central afferent arch of the anal reflex has a strong relationship to superficial sensory tract, but the central efferent arch has almost no connection with pyramidal or extrapyramidal tracts.

Adolescent↗

Sjögren's syndrome. Association of cutaneous vasculitis with central nervous system disease.

We describe a group of patients with Sjögren's syndrome, who commonly present to dermatologists with cutaneous manifestations of vasculitis. Two specific clinically recognizable forms of cutaneous vasculitis predominate: palpable purpura of the lower extremities (Waldenström's benign hypergammaglobulinemic purpura) and urticarialike vasculitis. Two pathologic types of cutaneous vasculopathy are demonstrated, one leukocytoclastic and the other mononuclear. The leukocytoclastic vasculopathy is associated with high titers of Ro(SS-A) and La(SS-B) autoantibodies (detected by gel double-diffusion techniques) and general serohyperreactivity. In marked contrast, the mononuclear vasculopathy is associated with low titers of Ro(SS-A) and La(SS-B) autoantibodies (detected by enzyme-linked immunosorbent assay but not gel double-diffusion techniques) and general serohyporeactivity. Approximately 70% of patients with Sjögren's syndrome and cutaneous vasculitis have also developed peripheral and/or central nervous system disease. The pathogenesis of the nervous system disease is unknown, but preliminary data suggest a vasculopathy.

Autoantibodies↗

[The role of metalloprotease in pathogenesis of nervous system diseases].

Matrix Metalloproteases (MMPs) comprise a big family of proteolytic enzymes secreted into extracellular matrix and involved in remodelling of many tissues. The MMPs' activity is regulated on many levels. It is also determined by specific inhibitors known as tissue inhibitors of metalloproteases (TIMPs). Several studies revealed that MMPs have a role not only in physiological processes but also in pathophysiology of nervous system diseases, such as multiplex sclerosis, Guillan-Barré syndrome and strokes. Concerning demyelination MMPs are responsible for degradation of myelin components and facilitation of immune cells migration into inflammatory sites by degrading vascular basement membrane. We still investigate substances with positive clinical effect on the nervous system diseases due to MMPs inactivation.

Animals↗

[Statistical data on hereditary nervous system diseases in Ashkhabad and Krasnovodsk Provinces, the Turkmen SSR].

Epidemiology and the clinical course of hereditary diseases of the nervous system were studied in the Ashkhabad and Krasnovodsk Provinces of the Turkmen SSR versus the data from other regions of the country. A detailed analysis was made of 236 cases of hereditary neural pathology. The intensity rate (21.6 X 10(-5)) of the pathology in the studied area turned to be significantly higher in the other regions considered. Such a high incidence rate was attributed to the existence of isolated communities, marriages between close relatives and a high rate of birth.

Consanguinity↗