ABSTRACT
The aim of the present study was to determine the significance of different SEP techniques and parameters in clinical evaluation of cases of lumbar and cervical root lesions and stenosis of the spinal canal. Using a qualitative rating scale, 92 cases were analyzed retrospectively whose primary diagnosis was questioned because of conflicting data from clinical, neuroradiological and neurophysiological testing. In conclusion SEP techniques proved to be a useful tool in exclusing other e.g. demyelinating diseases. Except for the time-consuming method of segmental stimulation, the demonstration of the functional deficit itself by SEP techniques in general was frequently disappointing. The contribution of the different SEP parameters to clinical decision making and the clinical consequences are briefly discussed.
Subject(s)
Evoked Potentials, Somatosensory/physiology , Nerve Compression Syndromes/diagnosis , Spinal Nerve Roots/physiopathology , Spinal Stenosis/diagnosis , Cervical Vertebrae/physiopathology , Cervical Vertebrae/surgery , Diagnosis, Differential , Electric Stimulation , Humans , Intervertebral Disc Displacement/diagnosis , Intervertebral Disc Displacement/physiopathology , Intervertebral Disc Displacement/surgery , Lumbar Vertebrae/physiopathology , Lumbar Vertebrae/surgery , Magnetic Resonance Imaging , Nerve Compression Syndromes/physiopathology , Nerve Compression Syndromes/surgery , Peripheral Nerves/physiopathology , Retrospective Studies , Spinal Nerve Roots/surgery , Spinal Stenosis/physiopathology , Spinal Stenosis/surgeryABSTRACT
Eosinophilia-Myalgia-Syndrome (EMS), a newly recognized illness, was described first in October 1989, when it formed an epidemic in the USA and later also in Europe. In the meantime, ingestion of L-tryptophan containing products has been recognized to trigger this syndrome, but the pathophysiological basics are still subject to speculation. Often starting with a flu-like period, the disease is dominated by dermatologic (fasciitis) and neurologic (neuropathy, myopathy) symptoms in the subsequent stages. Reporting on an own case and reviewing the literature, clinicopathological aspects and the problems of treatment are discussed. In contrast with the majority of published cases, which showed predominance of axonal damage, our patient displayed the clinical and electro-physiologic characteristics of demyelinating neuropathy.
Subject(s)
Eosinophilia-Myalgia Syndrome/diagnosis , Fasciitis/diagnosis , Polyneuropathies/diagnosis , Depressive Disorder/drug therapy , Diagnosis, Differential , Eosinophilia-Myalgia Syndrome/physiopathology , Fasciitis/physiopathology , Female , Humans , Middle Aged , Myelin Sheath/physiology , Neurologic Examination , Peripheral Nerves/physiopathology , Polyneuropathies/physiopathology , Reaction Time/physiology , Synaptic Transmission/physiology , Tryptophan/administration & dosage , Tryptophan/adverse effectsABSTRACT
Enzymatic methylation of DNA in mouse L cells has been studied using DNA fibre autoradiography to analyse the distribution of 5-methylcytosine in chromosomal DNA. The autoradiographic pattern of DNA labelled in the 5-methylcytosine is in several respects similar to the pattern of DNA replication. Two mean features are apparent: (1) the silver grains appear in well defined sections, and (2) the labelled sections are arranged in tandem along each DNA double helix. After a short pulse of radioactivity in the rate of growth of labeled sections in the pattern of DNA replication and the enzymatic methylation of DNA are identical. Unlike the replication pattern, DNA labeled during the S phase with L-[Me-3H] methionine is not completely labeled. There are distinct, 8-20 mum intervals in the autoradiographic pattern of this DNA. The length of these intervals may correspond to unmethylated sections of chromosomal DNA of about 23 to 58 kilo base pairs. These unmethylated sections of chromosomal DNA represent about 10% of the total genome.
