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PubMed2001

[Peripheral neuropathy in cancer].

Neuropathy is a quite common finding in cancer patients. If the cancer is known, the main clinical problem is often whether the symptoms and signs are caused by metastasis or recurrence, or if the neuropathy can be related to effects of the oncological treatment. In addition to the clinical findings, radiological and neurophysiological examination can often be of considerable diagnostic help. Peripheral neuropathy may also be the first manifestation of the cancer, as in paraneoplastic neuropathies. Detecting the tumor in these cases may improve the oncological prognosis, as the neuropathy often precedes tumor symptoms by several years. A determined approach in searching for an occult cancer is necessary. The neuropathic symptoms are seldom life-threatening. However, the neuropathy may cause distressing symptoms, and symptomatic treatment and rehabilitation is often required.

Antineoplastic Agents↗
PubMed1975

[Intercentral relations in rat spinal cord with local depression of the inhibitory processes].

The changes in certain reflex responses of the rat spinal cord after local depression of inhibitory processes by tetanus toxin (the so-called phenomenon of "determinative dispatch station") were studied. It is shown that the tonic and rhythmic activity generated by this locus in the lumbar part of the spinal cord evokes generalized activity of all spinal motoneurons with similar time characteristics. The depression of its neurons by glycine removes this phenomenon. The excitation of "determinative dispatch station" neurons in cervical segments causes a pathologically enhanced scratch reflex in the ipsilateral hind limb. The enhancing of the scratch reflex is not connected with the depression of inhibitory processes of lumbar motoneurons. The formation of the "determinative dispatch station" in cervical segments produces both excitatory and inhibitory influences on monosynaptic reflexes of the lumbar flexor motoneurons. The role of local inhibitory processes depression in the functioning of the nervous system is discussed.

Animals↗
PubMed2001

Quality of life assessment in patients who undergo sacral neuromodulation implantation for urge incontinence: an additional tool for evaluating outcome.

PURPOSE: We investigated the impact of sacral neuromodulation on quality of life and assessed the importance of quality of life for determining the success of sacral neuromodulation in patients with detrusor hyperactivity, including instability and hyperreflexia. We also compared it with parameters documented in a voiding diary. MATERIALS AND METHODS: From May 1998 to December 2000, 82 female and 31 male patients 17 to 79 years old (mean age 51.1) with urge incontinence (63), urgency/frequency (5), voiding disturbance (41) and pelvic pain (4) resistant to conservative treatment were enrolled in a national prospective registry after showing a positive response to percutaneous nerve evaluation testing. Of the patients 47 who were 32 to 79 years old (mean age 59.2) with urge incontinence due to detrusor instability and 16 who were 27 to 51 years old (mean age 51.5) with hyperreflexia were asked to complete a validated self-reporting incontinence domain specific quality of life questionnaire before, and 3, 6, 9, 12, 18, 24 and 36 months after implantation. RESULTS: Compared with baseline the quality of life index significantly improved at each followup, which strongly correlated with the decrease in the number of incontinence episodes. CONCLUSIONS: Evaluating quality of life may be an additional useful tool for assessing the results of sacral neuromodulation for urge incontinence. Our study confirms that sacral neuromodulation is effective therapy for urge incontinence that can have a positive effect on patient quality of life.

Adolescent↗
PubMed1975

[Effect of some N-alkyl-N-NO-carbamyl esters on leukemia L 5222].

Contrary to N-methyl-N-NO-carbamyl esters, two N-ethyl-N-NO-urethanes have shown, at s.c. application, good chemotherapeutic effectiveness on the monocytic-myelogeneous rat leukaemia L 5222. It was possible to achieve definite healing. Single doses of N-ethyl-N-NO-n-butyl-urethane were equally effective as repeatedly applied smaller doses, the rate of curing amounting in both cases to 80 percent. N-Ethyl-N-NO-ethyl-urethane, however, can be compared to N-ethyl-N-NO-n-butyl-urethane only at repeated application. As suggested by orientative experiments, N-ethyl-N-NO-n-butyl urethane acts directly upon leukaemic cells and does not need any activation in the organism. Whether or not splitting by esterases, which are present in the cells of L 5222, should be decisive for the chemotherapeutic effectiveness of these substances can only be elucidated by further investigation. It is yet too early to form a definite opinion on the carcinogenicity of s.c. applied N-ethyl-N-NO-n-butyl-urethane.

Animals↗
PubMed2002

Sacral neuromodulation and pregnancy.

PURPOSE: Sacral neuromodulation is effective for lower urinary tract dysfunction. However, despite its increasing use and a preponderance of female patients treated to our knowledge its effect in pregnant women and developing fetuses remains unknown. Therefore, we obtained information on patients on sacral neuromodulation who then achieved pregnancy. MATERIALS AND METHODS: Data were obtained using a standard questionnaire from 4 physicians with a total of 6 eligible patients. We recorded patient urological history, indication for neuromodulation, pregnancy course, the mode of delivery and neonatal health. We also noted the timing of implant deactivation and reactivation. RESULTS: In 5 patients the stimulator was deactivated between weeks 3 and 9 of gestation, after which 2 with a history of urinary retention had urinary tract infection. In another case, stimulation was discontinued 2 weeks before conception. The only noted complication developed in a pregnancy in which birth was premature at 34 weeks. Three patients underwent normal vaginal delivery, including 1 in whom subsequent implant reactivation did not resolve voiding dysfunction. In 3 cases elective cesarean section was performed. All neonates were healthy. CONCLUSIONS: When a patient on neuromodulation achieves pregnancy, the stimulation should be deactivated. If implant deactivation leads to urinary related complications that threaten the pregnancy, reactivation should be considered. Elective cesarean section should be discussed since it is possible for sacral lead damage or displacement to occur during vaginal delivery.

Adult↗
PubMed2002

[Footdrop during pregnancy or labor due to obstetric lumbosacral plexopathy].

Two women, aged 27 and 28 years, presented with an isolated dropping foot developed during labour and the third trimester of pregnancy, respectively. Lumbosacral plexopathy was diagnosed in both cases. Of the relatively rare maternal obstetric complications, lumbosacral plexopathy is the most common. It is caused by compression of the truncus lumbosacralis against the sacral ala by the foetal head. Symptoms are often misdiagnosed as peroneal or ischiadic neuropathy or lumbosacral radiculoopathy. Therefore for a correct diagnosis, a consultation with a neurologist is indicated. The prognosis for lumbosacral plexopathy is excellent.

Adult↗
PubMedDate not supplied

Effects of lumbar sympathectomy on thromboangiitis obliterans.

The clinical response to lumbar sympathectomy has been reported. The incidence of improvement was as follows: Coldness 52 percent, ulcer 58 percent, rest pain 64 percent, and claudication 31 percent, respectively. The blood flow in the anterior tibial muscles did not increase within 5 weeks postoperatively. There were correlations between the effects and the clinical stages, the interval from the onset to the operations, the abuse of tobacco, and the degree of reactive hyperemia, but not relation was observed between as to the site of obstruction. In the experiments, the influence of acetylcholine on blood flow increased after the operations and the duration of vasoconstriction following administration of noradrenalin became shorter. On the basis of the clinical and experimental facts, postoperative improvement seems to be due to increased blood flow to the peripheral skin and to relief of vasospasm.

Acetylcholine↗