A round robin exercise in archaeometry: analysis of a blind sample reproducing a seventeenth century pharmaceutical ointment.

Chemical analysis of ancient residues of pharmaceutical or cosmetic preparations such as balms or ointments is made problematic by the high complexity of these mixtures, composed of organic and inorganic materials. Consequently, a multi-analytical approach and special caution in the interpretation of the results are necessary. In order to contribute to the improvement of analytical strategies for the characterization of complex residues and to reconstruct ancient medical practices, a replica of a pharmaceutical formulation of the seventeenth century was prepared in the laboratory according to a historically documented recipe. In a round robin exercise, a portion of the preparation was analysed as a blind sample by 11 laboratories using various analytical techniques. These included spectroscopic, chromatographic and mass spectrometric methods. None of the laboratories was able to completely reconstruct the complex formulation, but each of them gave partial positive results. The round robin exercise has demonstrated that the application of a multi-analytical approach can permit a complete and reliable reconstruction of the composition. Finally, on the basis of the results, an analytical protocol for the study of residues of ancient medical and pharmaceutical preparations has been outlined.

TENS is harmful in primary writing tremor.

OBJECTIVE: It is unclear whether primary writing tremor (PWT) is a tremulous form of dystonia or a tremor per se. Transcutaneous electrical nerve stimulation (TENS) at 50 Hz applied for 2 weeks was reported to improve the writing capabilities of patients with writer's cramp (WC). We explored whether such a beneficial effect can be obtained in patients with a PWT. METHODS: In a cross-over, double-blinded randomized study we tested whether 2-week periods of 5, 25 or 50 Hz TENS applied to wrist flexor muscles, improved the score of the Fahn-Tolosa-Marin scale of nine patients with PWT. Excitability of neurons and of various intracortical circuits in the motor cortex were also tested before and after TENS by using transcranial magnetic stimulation. RESULTS: TENS at 5 and 25 Hz did not have any effect while TENS at 50 Hz worsened the clinical condition and the cortical excitability. CONCLUSIONS: TENS is not a new treatment alternative for PWT. SIGNIFICANCE: The beneficial effect in WC and the harmful one in PWT of TENS stresses that the two disorders are likely different nosological entities.

Physiotherapy of focal dystonia: a physiotherapist's personal experience.

The approach of the physiotherapist to each form of dystonia is individual and has to be specific. There is not one single method but several strategies related to the different clinical forms. Although there is no standard programme applicable to all forms of cervical dystonia, we can distinguish a number of guidelines for the different clinical forms. In the myoclonic form, emphasis is placed on seeking to immobilize the head, and for the tonic form, on rehabilitating corrector muscles. Physiotherapy and botulinum toxin injections mutually interact in order to reduce the symptoms. Recent studies have shown the clinical benefits of physiotherapy. The physiotherapy of writer's cramp is designed as a re-learning process. The first step is to perform exercises to improve independence and precision of fingers and wrist movements. Then, the muscles involved in the correction of dystonic postures are trained by drawing loops, curves and arabesques. The aim of rehabilitation is not to enable patients with writer's cramp to write as they used to, but to help their dysgraphia evolve towards a fast, fluid and effortless handwriting. A reshaping of the sensory cortical hand representation appears to be associated with clinical improvement in patients with dystonia after rehabilitation.

Case-control study of writer's cramp.

Task-specific focal dystonias are thought to be due to a combination of individual vulnerability and environmental factors. There are no case-control studies of risk factors for writer's cramp. We undertook a case-control study of 104 consecutive patients and matched controls to identify risk factors for the condition. We collected detailed data on medical history and writing history as part of hobbies or occupation. Cases had a college or university degree more frequently than controls [OR = 4.6 (1.3-20.5), P = 0.01]. The risk of writer's cramp increased with the time spent writing each day (P-trend = 0.001) and was also associated with an abrupt increase in the writing time during the year before onset (OR = 5.7, 95% CI = 1.3-33.9, P = 0.02). Head trauma with loss of consciousness [OR = 3.5 (1.0-15.7), P = 0.05] and myopia [OR = 4.1 (1.7-12.0), P = 0.0009] were both associated with the condition but it was not significantly associated with peripheral trauma, left-handedness, constrained writing, writing in stressful situations or the choice of writing tool. The dose-effect relationship between writer's cramp and the time spent handwriting each day, and the additional burden of acute triggers such as an abrupt increase in the writing time in the year before onset, point to a disruptive phenomenon in predisposed subjects. Homeostatic regulation of cortical plasticity may be overwhelmed, resulting in dystonia.

Abnormal spinal interactions from hand afferents to forearm muscles in writer's cramp.

OBJECTIVE: Spinal reflexes from hand to wrist muscles were investigated in writer's cramp. METHODS: Stimulus-triggered rectified EMG averages after ulnar nerve and cutaneous stimulation, in wrist flexors and extensors during tonic contraction, were compared in 18 controls and 19 patients. RESULTS: On the patient dystonic side, ulnar-induced EMG suppression was decreased in wrist extensors, and facilitation in wrist flexors modified dependent on the dystonic wrist posture during writing. No change was found on the patient non-dystonic side. Cutaneous stimulation increased wrist flexor EMG on both sides of the patients with normal wrist posture during writing, but had no effect in controls and patients with abnormal wrist posture. CONCLUSIONS: Comparison between cutaneous and mixed nerve stimuli suggests that spindle afferents from intrinsic hand muscles may mediate patients' ulnar-induced EMG modulations. Abnormal proprioceptive control was only observed on dystonic side, while bilateral unusual cutaneous control was found in patients. Changes in spinal transmission were partly related to the dystonic wrist posture, suggesting that systems involved in sensory processing can be differentially altered in writer's cramp. SIGNIFICANCE: Changes in spinal transmission, probably related to peripheral and/or cortical inputs, might either take part in primary or adaptive mechanisms underlying writer's cramp.

Structural abnormalities in the cerebellum and sensorimotor circuit in writer's cramp.

BACKGROUND: Structural abnormalities were detected in bilateral primary sensorimotor areas in writer's cramp. Evidence in other primary dystonia, including blepharospasm and cervical dystonia, suggest that structural abnormalities may be observed in other brain areas such as the cerebellum in writer's cramp. OBJECTIVE: To test the hypothesis that structural abnormalities are present along the sensorimotor and cerebellar circuits in patients with writer's cramp. METHODS: Using voxel-based morphometry, the authors compared the brain structure of 30 right-handed patients with writer's cramp with that of 30 healthy control subjects matched for gender, age, and handedness. RESULTS: Gray matter decrease was found in the hand area of the left primary sensorimotor cortex, bilateral thalamus, and cerebellum (height threshold p < 0.01, cluster significant at p < 0.05 corrected for multiple comparisons). CONCLUSIONS: These results demonstrate in writer's cramp the presence of structural abnormalities in brain structures interconnected within the sensorimotor network including the cerebellum and the cortical representation of the affected hand. These abnormalities may be related to the pathophysiology of writer's cramp, questioning the role of the cerebellum, or to maladaptive plasticity in a task-related dystonia.

Quantification of deformed peaks in capillary gas chromatography (CGC): application to simultaneous analysis of free fatty acids and less polar compounds in aqueous distillery effluent.

The purpose of this study was to find a simple and rapid method allowing the simultaneous quantification of some alcoholic fermentation inhibitors present in aqueous distillery effluent in order to evaluate its recycling properties. A capillary gas chromatography (CGC) method was tested for the quantification of both short chain fatty acids (acetic to hexanoic) and neutral compounds (butane 2,3-diol, 2-furaldehyde, phenyl-2-ethane1-ol). A polyvalent column coated with trifluoro-propyl-polysiloxane, allowing water injection, was tested and experiments were performed directly on untreated samples. During the development of the method, a deformation of acid peaks was observed; that could be explained by a secondary equilibrium, added to the chromatographic equilibrium. Although the acid peaks were deformed, calibration curves were produced and rigorously validated, proving that quantification is possible even when the best chromatographic conditions have not been achieved. Eventually, the method enabled the concentration of eight major fermentation inhibitors in distillery effluent to be measured.

Atheroprotective effect of adjuvants in apolipoprotein E knockout mice.

Strategies aimed at treating atherosclerosis by immunization protocols are emerging. Such protocols commonly use adjuvants as non-specific stimulators of immune responses. However, adjuvants are known to modify various disease processes. The aim of this study was to determine whether adjuvants alter the development of atherosclerosis. We performed immunization protocols in apolipoprotein E knockout mice (E degrees ) following chronic administration schedules commonly employed in experimental atherosclerosis. Our results point out a dramatic effect of several adjuvants on the development of atherosclerosis; three of the four adjuvants tested reduced lesion size. The Alum adjuvant, which is the adjuvant currently used in most vaccination protocols in humans, displayed a strong atheroprotective effect. Mechanisms accounting for atheroprotective effect of Freund's adjuvants included their capacity to increase both Th2 responses and anti-MDA-LDL IgM titers, and/or to impose atheroprotective lipoprotein profiles. The present study indicates that adjuvants have potent atheromodulating capabilities, and thus, implies that the choice of adjuvant is crucial in long-term immunization protocols in experimental atherosclerosis.

Structural analysis of commercial ceramides by gas chromatography-mass spectrometry.

A simple method using gas chromatography-mass spectrometry was applied to analyse structures of ceramides. Identification of trimethylsilylated ceramides were obtained in short analysis times (derivatization of ceramides in 30 min at room temperature and 20 min gas chromatography mass spectrometry run) even for complex mixtures. For example in ceramide Type III, 18 peaks were observed which represent 27 various structures. The coeluted compounds were ceramides containing the same functional groups and the same carbon number but with a different distribution on the two alkyl chains of the molecule. They were accurately differentiated by mass spectrometry. Therefore, 83 structures of trimethylsilylated ceramides were identified in 11 different commercial mixtures. For 52 structures of these, mass spectral data were not described in the literature, neither full mass spectra nor characteristic fragments.

[Role of rehabilitation Parkinson's disease, by disease severity and disability pattern]. / La reeducation de la maladie de Parkinson en fonction des differents stades evolutifs et du profil de handicap.

Physical therapy is recognized as one of the most helpful means of improving the disabling side-effects of Parkinson's disease. Techniques which reduce stiffness, and improve muscle contracture and respiratory function are well established in different fields of rehabilitation including rheumatology and orthopedics. Parkinson's disease patients derive an obvious benefit from such treatments, suitably adapted to each stage of the disease course. New avenues for rehabilitation care include the cognitive approach for learning strategies or mental preparation for a given action in an attempt to reduce the akinesia, one of the main features of parkinsonism. Attractive as this new approach may be, its effectiveness remains to be proven.

Use of relationships between retention behaviors and chemical structures in subcritical fluid chromatography with CO2/modifier mixtures for the identification of triglycerides.

Satisfactory separations of vegetable oil triglycerides (TG) differing in fatty acid composition are obtained by subcritical fluid chromatography (SubFC) with octadecyl packed columns and CO2/modifier mobile phases. However, the identification of TG can be sometimes difficult due to the small retention differences between the compounds. A method of TG identification in SubFC was achieved, which does not require calculation of retention pattern but uses the differences in retention behavior related to TG structure and to the nature of the subcritical mobile phases. These retention differences were produced by the variation of either outlet pressure or modifier percentage or of temperature. Whatever the column aging, this method allows the determination of the triglyceride total chain length and double bond number. Among numerous structures, these two criteria restrict the structural hypothesis at worst to three or four possibilities and sometimes only to one. The validity of this relative identification method was confirmed by electronic impact mass spectrometry of triglyceride fractions collected from the analysis of a peanut oil. The analysis of concentrated fractions is favored by the spontaneous elimination after the pressure regulator of carbon dioxide, the main fluid of the subcritical mobile phase.

Identification of phenolic acids and inositols in balms and tissues from an Egyptian mummy.

A number of samples taken from an Egyptian mummy (ca. 100 B.C.) from the Guimet Museum in Lyon have been analyzed by GC-MS. Derivatives of aromatic acids (hydroxyhydrocinnamic, vanillic, protocatechuic and gallic acids) and inositols (non-methylated and mono-O-methyl) have been found among the constituents of extracts prepared by methanolysis and trimethylsilylation. From the reported electron impact mass spectra, ion sets where proposed for a sensitive and selective profiling of these selected compounds by mass fragmentometry. The source of gallic acid and inositol was found to be a vegetable tannin, an ingredient which was not previously known to be used for mummification in ancient Egypt. The nature and abundance ratios of the detected inositols also appeared to be a promising criterion to further investigate the botanical source of the tannin employed.

[Clinical, electrophysiologic and endocrine effects of the perfusion of high doses of TRH in amyotrophic lateral sclerosis]. / Effets cliniques, électrophysiologiques et endocriniens de la TRH en perfusion à doses élevées dans la sclérose latérale amyotrophique.

Eight patients with amyotrophic lateral sclerosis received 500 mg TRH by IV infusion, at a progressive rate during 3 hours. Only 3 patients noted subjective improvement of strength. Clinical muscular testing and H response study failed to show any change. Moreover modifications of the prolactin, growth hormone, TSH and T3 serum levels raise a question concerning the tolerance with long term utilization of TRH.