Metachromatic leukodystrophy: a scoring system for brain MR imaging observations.

BACKGROUND AND PURPOSE: Metachromatic leukodystrophy (MLD) is a devastating demyelinating disease for which novel therapies are being tested. We hypothesized that MR imaging of brain lesion involvement in MLD could be quantified along a scale. MATERIALS AND METHODS: Thirty-four brain MR images in 28 patients with proved biochemical and genetic defects for MLD were reviewed: 10 patients with late infantile, 16 patients with juvenile, and 2 patients with adult MLD. All MR images were reviewed by experienced neuroradiologists and neurologists (2 readers in Germany, 2 readers in the United States) for global disease burden, as seen on the T2 and fluid-attenuated inversion recovery images. A visual scoring method was based on a point system (range, 0-34) derived from the location of white matter involvement and the presence of global atrophy, analogous to the scoring system developed for adrenoleukodystrophy. The readers were blinded to the neurologic findings. RESULTS: Thirty-three of 34 MR images showed confluent T2 hyperintensities of white matter. The inter-rater reliability coefficient was 0.988. Scores between readers were within 2 points of each other. Serial MR imaging studies in 6 patients showed significant progressive disease in 3 patients (initial score average, 4; mean follow-up, 24.3) and no change or 1 point progression in 3 patients (initial score average, 12; mean follow-up, 12.66). Projection fibers and the cerebellum tended to be involved only in advanced stages of disease. CONCLUSIONS: The MLD MR severity scoring method can be used to provide a measure of brain MR imaging involvement in MLD patients.

Incidence of sexual dysfunction in healthy volunteers on fluvoxamine therapy.

BACKGROUND: Current literature suggests that the incidence of sexual dysfunction secondary to fluvoxamine therapy is 1% to 8%, while other selective serotonin reuptake inhibitors may have rates as high as 75%. The objective of this study was to determine the incidence of sexual dysfunction secondary to fluvoxamine in healthy volunteers. METHOD: 20 healthy volunteers (10 men, 10 premenopausal women) had adverse effects assessed at 6 visits while not receiving fluvoxamine, then twice while taking 150 mg fluvoxamine daily. Assessments occurred at 2-week intervals. Incidence rates for sexual dysfunction were calculated. RESULTS: No sexual dysfunction was reported prior to fluvoxamine therapy. After 2 weeks and 4 weeks of therapy respectively, sexual dysfunction occurred in 20% (N = 4) and 35% (N = 7) of the healthy volunteers. CONCLUSION: The incidence of sexual dysfunction during fluvoxamine therapy in healthy volunteers is 35%. This incidence is higher than previously reported and similar to that of other selective serotonin reuptake inhibitors.

Serological and virological markers of human parvovirus B19 infection in sera of hemophiliacs.

It is known that parvovirus B19 (B19) is transmitted to hemophiliacs by clotting factors prepared from human plasma. However, it is not clear whether B19 is also transmitted by the more recently used inactivated clotting factor preparations. Therefore, we investigated 69 hemophiliacs, mostly children, receiving only virus-inactivated clotting factors. 49 of them (71%) were B19 IgG-positive and 18 of the IgG-positive hemophiliacs (37%) were also B19 IgM-positive. In contrast, out of 73 age-matched controls only 10 (14%) were IgG-positive, two of them being also IgM-positive. In hemophiliacs treated before 1984 with non-inactivated clotting factors, seroprevalence was very similar: 94/136 (69%) presented B19 IgG antibodies as compared to their age-matched controls with 16/50 (32%). Out of the 94 IgG-positive patients 24 (26%) were IgM-positive, whereas IgM antibodies were never found in 16 sera of 16 IgG-positive controls. In 4 out of 24 IgM positive hemophiliacs, B19 DNA was detected in the sera by using the polymerase chain reaction. However, B19 DNA was also found in 3/69 anti-B19 IgM-negative, HIV-infected hemophiliacs (all three patients in CDC stage IV). Since it seems unlikely that the results only represent passive acquisition of B19 DNA from blood products and induction of antibodies by immunization with inactivated antigen, the observations rather suggest that infection with B19 is transmitted by clotting factors, including those treated for virus inactivation.

[The influence of an amine fluoride/stannous fluoride-containing gel on the oral microorganisms]. / Einfluss eines amin-zinnfluridhaltigen Gels auf den Stoffwechsel der Mundhöhlenmikroflora.

We examined the influence of an aminefluoride/stannous fluoride-containing gel (250 ppm F-) on the anaerobic metabolism of oral microorganisms in saliva specimens of 22 adult probands. A long lasting inhibition of the bacterial metabolism could be demonstrated.