Papillitis and vasculitis of the arteria spinalis anterior as complications of hepatitis C reinfection after liver transplantation.

It is well known that hepatitis C virus (HCV)-related chronic liver disease may be associated with various immunological disorders including mixed cryoglobulinemia, which is accompanied by cutaneous vasculitis, arthralgias, membrano-proliferative glomerulonephritis, and neuropathy in association with cryoprecipitable immune complexes in serum. We describe here the first case of central nervous system HCV infection with evidence of the virus in the cerebrospinal fluid in association with cryoglobulinemia in a patient who developed recurrent episodes of papillitis and vasculitis of the arteria spinalis anterior after liver transplantation.

[Can muscle transposition of an antagonist modify regeneration of the peroneal nerve?]. / Kann die Muskelverlagerung eines Antagonisten die Regeneration des N. peronaeus beeinflussen?

The prognosis after injury and microsurgical repair of the peroneal nerve is poor. However, clinical experience seems to indicate better results if nerve repair or neurolysis is combined with transposition of the tibialis posterior muscle. This hypothesis was tested in 20 rabbits by severing the peroneal nerve of one lower extremity. Nerve repair with muscle transposition was performed in ten rabbits and nerve repair without muscle transposition in the remaining ten animals. Six to twelve months later, histological and histochemical studies of nerve and muscle tissue were performed. No significant differences between the two groups could be determined.

Direct subclavian-carotid anastomosis for the subclavian steal syndrome.

Between 1984 and 1986, 38 patients--25 males and 13 females--underwent treatment for proximal subclavian arteriosclerotic lesions. All of these patients presented with symptoms of the subclavian steal syndrome and 13 (34.2%) had additional claudication of the arm. Preoperative angiography showed distal filling of the subclavian artery via retrograde flow in the vertebral artery. 31 patients (81.5%) had total occlusion of the proximal subclavian artery and 7 (18.5%) presented with severe stenosis. 34 of these lesions were on the left (89.5%) and 4 on the right side (10.5%). Complete cerebral angiography was performed in each patient with emphasis on visualisation of the carotid bifurcation and selective opacification of the aortic arch vessels if indicated. Doppler ultrasound flow measurement in the vertebral artery yielded the basic data which were then used for comparative postoperative evaluation. The operation was performed under general anaesthesia and heparinisation. A shunt was not required while performing the direct end-to-side anastomosis between the transected subclavian and the common carotid artery. Arteriosclerotic plaques in the distal stump of the transected subclavian artery and occasionally the origin of the vertebral artery were dealt with by simple eversion endarterectomy. There was no operative mortality; the postoperative complication rate was 13.1% including palsy of the recurrent nerve in 3 patients, a lymphatic cyst of the neck in one patient and bleeding requiring re-exploration in another. Occlusion of the reconstructed artery or neurologic deficit did not occur. Post operatively all patients were treated with platelet inhibitors. The average follow-up period was 13 months, when the reconstructed arteries were found to be patent in 37 patients (97.4%).(ABSTRACT TRUNCATED AT 250 WORDS)

The rigid spine syndrome--a myopathy of uncertain nosological position.

Four patients meeting the clinical criteria of the rigid spine syndrome are presented; they are one girl with a positive family history and three boys. Clinical and histological findings are discussed in relation to the 14 cases of rigid spine syndrome reported in the literature. The delineations of the syndrome from other benign myopathies with early contractures are discussed suggesting that the rigid spine syndrome probably does not represent a single nosological entity.