Cryopreservation of rat peripheral nerve segments later used for transplantation.

Segments of the sciatic nerve of adult rats were stored in liquid nitrogen for three weeks before being used to repair transected sciatic nerves of four other adult rats of the same strain. Eight months later the animals that had received the cryopreserved segments were sacrificed and compared with two animals that had received fresh autografts. The muscular innervation by the repaired nerves was evaluated by histological methods and electromyographic recordings. No differences between fresh transplanted grafts and cryopreserved grafts were found. This indicates that cryopreserved mature peripheral nerve segments can be used to repair peripheral nerve damage in the rat.

Spinal epidural hematomas.

During the period 1943-1985 six patients were operated for spinal epidural hematomas at the department of neurosurgery of the University Hospital of Arhus. It is essential to perform acute laminectomy in case of rapidly increasing neurological symptoms. In the case of slowly increasing symptoms operation may provide a good result even if it is performed a week after the onset of symptoms. It is important to watch patients with fracture/dislocations of the spine closely during the first weeks after a trauma. If they develop neurological symptoms the patients should immediately be transferred to the department of neurosurgery with a view of

Antibiotic prophylaxis in cerebrospinal fluid shunting: a prospective randomized trial in 152 hydrocephalic patients.

The authors report a prospective, randomized 18-month study on the effect of prophylactic antibiotic treatment in 152 hydrocephalic patients in whom clean shunt operations or revisions were done. The treated group received methicillin (totally 200 mg/kg) divided into six i.v. doses during 24 hours starting at the induction of anesthesia. Patients allergic to penicillin received erythromycin instead. Seventy-nine patients received antibiotics, and 73 (the control group) received none. All patients were followed at least 6 months after operation or to their death. Eleven patients developed signs of infection, giving an overall infection rate of 7.2%; however, the infection occurred less than 1 month after the operation in only half of these. Six of the patients had septicemia, 4 had peritonitis, and 1 had meningitis. In the treated group, the infection rate was 8.9%; in the control group, the rate was 5.5%. There was no statistically significant difference. The prophylactic antibiotic regimen in this investigation did not reduce the infection rate connected with cerebrospinal fluid shunting procedures.

Severe headache as the only symptom of long-standing shunt dysfunction in hydrocephalic children with normal or slit ventricles revealed by computed tomography.

Four patients aged 11, 11, 8 and 18 years, shunted in early childhood for hydrocephalus, were followed in the outpatient clinic for severe headache from 3 months to 2 years. The headache lasted for days and up to a week, was usually severe, and was often followed by screaming attacks or aggressive behavior. In all patients repeated computed tomography disclosed a normal ventricular system or slit ventricles. The intracranial pressure (ICP) was measured in all four patients and showed an increased intracranial steady-state pressure between 20-50 mmHg, plateau waves and, in two of the patients, a very high intracranial pulse-pressure amplitude. At operation all patients had dysfunction of the shunt (most often of the distal end). In three patients ICP monitoring post-operatively showed normal intracranial pressure without any abnormal increments from the normal steady-state pressure. Thus, severe headache can be the only symptom of long-standing shunt dysfunction, even without ventricular dilation. In shunted hydrocephalic children complaining of headaches, ICP measurement is highly recommended.

The carpal tunnel syndrome and amyloidosis. A clinical and histological study.

Twenty-six non-randomized patients with carpal tunnel syndrome are presented. It is documented that three out of four patients may be diagnosed pre-operatively by five or more clinical parameters. All patients were screened for amyloidosis in biopsies from the carpal tunnel. One patient presented amyloid deposits in the transversal carpal ligament. The importance of macro- and microscopic findings in the carpal tunnel inclusive local amyloidosis for the pathogenesis of the carpal tunnel is discussed. It is concluded that provided systemic amyloidosis is not suspected, screening for amyloidosis may have diagnostic interest, however without therapeutic consequences and therefore unnecessary.

The incidence of lactose malabsorption in ulcerative colitis.

120 Danish patients with ulcerative colitis, admitted consecutively to a Department of Gastroenterology, were investigated for lactose malabsorption. The prevalence was 9.2 percent, which is not significantly higher than that in a mixed Danish gastroenterological material, There was no difference in distribution according to age and sex, and the incidence was not correlated to the severity of the ulcerative colitis. The possible reasons for the wide variation in the incidence of lactose malabsorption in materials of patients with ulcerative colitis are discussed, and it is concluded that the main cause must be that the materials with the highest incidence include patients of races and ethnic groups in which lactose malabsorption is a common finding.