Pattern of glomerular disease in Saudi Arabia.

Clinical data and renal biopsy study of 186 adult patients found to have nephropathy and seen at the Security Forces Hospital, Riyadh, over a 5-year period (1989 to 1994) were reviewed. Primary glomerular disease accounted for more than three fourths of all patients (79%), and the most common histological lesion was focal segmental glomerulosclerosis (40.8%) associated with a high incidence of hypertension (86.7%), nephrotic syndrome (61.7%), hematuria (48.8%), and renal impairment (33.3%). Mesangioproliferative glomerulonephritis was the second most common lesion (21.1%), followed by membreous glomerulonephritis (13.6%), immunoglobulin A nephropathy (IgAN) (13.6%), membranoproliferative glomerulonephritis (9.5%), and minimal change disease (1.4%). Although not as common as in most other developed countries, IgAN is being increasingly recognized in Saudis. Lupus nephritis remained the commonest cause of secondary glomerulonephritis (48.5%), whereas amyloidosis was conspicuously absent. There is no evidence, at least in this series, that chronic infection such as hepatitis B virus infection has a major role in the development of glomerulonephritis.

Amyotrophic lateral sclerosis in Nova Scotia.

A study of ALS incidence in Nova Scotia for a ten year period was carried out with the cooperation of neurologists, neurosurgeons, physiatrists and major medical hospitals. Over a ten year period 161 cases occurred, an incidence of 1.95 per 100,000 population in a province with a population of 825,000. There was an increase in incidence over the ten year period, with an incidence for the first five years of study of 1.50 per 100,000, and 2.40 per 100,000 for the latter five years. The peak incidence in 1981-1982 was 2.66 per 100,000. Although this is the highest incidence in community studies of ALS (excepting the unusual circumstances in Guam), it may reflect the realistic incidence of ALS rather than an unusual focus, as ascertainment was likely greater than in many other studies. The more significant finding is the suggestion of an increasing incidence, as noted in other studies in the U.S., England and Israel.

Intercostal nerve transfer to lumbar nerve roots. Part I: development of an animal model and cadaver studies.

This is a description of the development of an animal model for intercostal nerve transfer and saphenous nerve grafting to lumbar nerve roots in the dog. Further, the technical feasibility of intercostal nerve transfer and autogenous sural nerve grafting to the lumbar and sacral nerve roots in the adult and infant human cadaaver is demonstrated graphically.

Intercostal nerve transfer to lumbar nerve roots. Part II: Neuropathologic findings in the animal model.

These are the neuropathologic findings in dogs 8-11 months after a unilateral intercostal nerve transfer and anastomosis to a lumbar nerve root were performed. This is a follow-up study of a procedure that was initially carried out in the adult and infant human cadaver and subsequently in an animal model by Malik and Buhr, as reported in this issue of Spine. At the time of sacrifice, the animals in this study had lost the limp that they had postoperatively. The results demonstrate the viability of the intercostal nerve transfer and its anastomosis to the lumbar motor root. There was supplied by a lumbar nerve root that had been operated upon, but the basis of this was not definitely established.

Post-traumatic syringomyelia.

Post-traumatic syringomyelia is uncommon. It is seen predominantly after injury to the thoracic or the lumbar spine and rarely after injury to the cervical spine. In this report, three cases of post-traumatic syringomyelia are presented. The injury was limited to the thoracic spine in one case and to the cervical spine in the rest. The symptoms began after two years in two cases and after fifteen years in the third. The diagnosis was suggested by radiographic examination and was confirmed at operation in each case. Following evacuation and drainage of the cyst, significant improvement occurred in two patients.