[Results of one-year treatment of multiple sclerosis with azathioprine compared with the therapy using small doses of Encorton]. / Wyniki rocznego leczenia stwardnienia rozsianego azatiopryna w porównaniu z terapia malymi dawkami Encortonu.

A group of 21 patients with clinically confirmed multiple sclerosis were treated for one year with azathioprine, Germed, in daily doses of 50 or 75 mg depending on body weight. After two months the treatment was stopped for one month. The control group received prednisone (Encorton, Polfa) 5 or 10 mg daily. The drugs were given in wafers in powdered form. The double blind method was used. After one year the comparison of both groups failed to show any significant differences, and the reduction in the indices of exacerbations and stabilization of the process evaluated by Kurtzke's scale were nearly identical. However, this might have been due to the fact that nearly one-third of the patients dropped out from both groups. During the treatment with azathioprine no significant differences were noted in the surface phenotypes of peripheral blood mononuclear cells.

[Late results of alternate treatment of multiple sclerosis with encorton and decaris]. / Odlegle wyniki leczenia naprzemien-nego stwardnienia rozsianego Encortonem i Decarisem.

A group of 18 patients with clinically definite multiple sclerosis were subjected to alternate treatment with Prednisone (Polfa) and Decaris (Richter). The results were compared with those in a control group of 18 cases treated exclusively with Prednisone during exacerbations of the disease. The results indicate that the alternate treatment has not any significant effect on the course of multiple sclerosis, evaluated by the Kurtzke disability scale. The alternate treatment with a mild immunosuppression Encorton and immunomodulation-Decaris (Levamisole) leads to significant decrease of relapses in comparison with the period before the treatment, as well as in comparison with the control group treated exclusively with Encorton in case of exacerbations.

[Late results of the treatment of the chronic progressive form of multiple sclerosis by intensive immunosuppression]. / Odlegle wyniki leczenia postaci przewlekle postepujacej stwardnienia rozsianego intensywna immunosupresja.

A group of 16 patients with secondary chronic progression of multiple sclerosis treated by short-lasting intensive immunosuppression (cyclophosphamide with ACTH) by the programme of Hausser et al (4) was compared with a clinically similar group of 16 patients treated exclusively with intramuscular ACTH. During 2 years of observation of the patients it was observed that short-lasting intensive immunosuppression induced with simultaneous administration of cyclophosphamide and ACTH had no beneficial effect on the slowly progressing form of multiple sclerosis. The observation leads to the conclusion that cyclophosphamide therapy should not be used in view of absence of favourable effect on the course of multiple sclerosis and the risk of increased frequency of malignant neoplasms which cannot be ruled out in this method.

[Early results of the treatment of chronic progressive forms of multiple sclerosis with cyclophosphamide and ACTH]. / Wczesne wyniki leczenia postaci przewlekle postepujacych stwardnienia rozsianego cyklofosfamidem i ACTH.

A group of 16 patients with chronic-progressing type of multiple sclerosis treated by intense immunosuppression (cyclophosphamide and ACTH) were followed-up for one year after completion of therapy. The results were compared with the observation of a control group of 16 patients with a similar type of multiple sclerosis. The choice of the type of therapy was done at random, and the results were assessed by a doctor who ignored the type of therapy used. In only a part of the observed cases stabilization of the disease process was observed, in a greater number in the cases treated with cyclophosphamide and ACTH than in the those treated with ACTH alone. However, the duration of follow-up is regarded as too short for reaching final conclusions regarding the effect of therapy on the course of this type of multiple sclerosis.

[Early results of alternating treatment of multiple sclerosis with immunosuppressive and immunomodulating drugs]. / Wczesne wyniki leczenia naprzemiennego SM lekami immunosupresyjnymi i immunomodulacyjnymi.

A group of 18 patients with clinically certain diagnosis of multiple sclerosis were treated alternate with prednisone and Decaris (levamisole). The results were compared with those in a control group of 18 cases with similar initial clinical parameters treated exclusively with prednisone during exacerbations of the disease. Alternating treatment with the mild immunosuppressant, prednisone, and with the immunomodulating drug Decaris caused a statistically significant reduction in the number of exacerbations of multiple sclerosis, however, the effect of this treatment on the natural history of the disease could not have been established in view of the short period of follow-up.

[Late results of the treatment of multiple sclerosis with large doses of Enkorton]. / Odlegle wyniki leczenia stwardnienia rozsianego duzymi dawkami Enkortonu.

A group of MS patients treated with large doses of Prednisone (3960 mg over a period of 54 days with initial dose 200 mg per day) was observed during 4 years after the therapy and the results were compared with the control group treated with medium doses of Prednisone (initial dose 60 mg). The difference between two therapeutic groups estimated according to Kurtzke disability scale is statistically not significant. We cannot also conclude, that the large doses of Prednisone decrease the relapse rate. However it should be stressed that in patients treated with megadoses of Prednisone the secondary chronic progressive course of MS, more rarely developed than in cases treated with medium doses.

[A case of multiple neoplasm metastases to the brain with few clinical symptoms]. / Skapoobjawowy przypadek kilkudziesieciu przerzutów nowotworowych do mózgu.

In the reported case 74 malignant metastases were found in the brain. The primary tumour was a bronchogenic carcinoma. The clinical symptoms were scant and were restricted mainly to those produced by involvement of the pons without evidence of intracranial hypertension. In the discussion the only relative value of laboratory investigations is stressed, including computerized tomography. The case deserves publication in view of rare occurrence of such oligosymptomatic course despite a high number of metastases.

The fatty acid pattern of central myelin lipids after transplacental intoxication by ethylnitrosourea.

Porton mice were used in the experiments. Pregnant animals were injected intravenously with a single dose of ethylnitrosourea (ENU). The poison was administered at the 15th day of pregnancy. The cerebral myelin of offsprings of the intoxicated mothers was examined with respect to the fatty acid spectrum of myelin lipids. The results obtained lead to the following conclusions: The fatty acid pattern of the individual myelin lipid fractions has revealed significant differences between the normal myelin and that isolated from brains of mice that had been subjected to transplacental intoxication by ENU. Transplacental intoxication by ENU has not only a carcinogenic effect on the central nervous system, but it obviously also affects the lipid metabolism of membraneous structures of the developing brain. ENU when acting during foetal life induces the formation of deviated myelin, that differs significantly with respect to its lipid and fatty acid composition from that of normally developing animals.

Neuroglia of the developing optic nerve in the course of Wallerian degeneration.

Unilateral enucleation was performed in 8 days rabbits and morphological changes occurring in the degenerating immature optic nerve were evaluated by means of light and electron microscopy and correlated with histoenzymatic changes in the activity of various phosphatases, esterases and oxidoreductases. The results of these experiments have lead to the following conclusions: 1. In contrast to the marked hyperplasia of the astroglia, the cellularity of the neuroglia of the oligodendroglial line suffered a considerable decrease in the course of Wallerian degeneration of the immature optic nerve. 2. Disconnection of axons from their parental perikaryons caused a considerable delay and reduction of differentiation of the immature neuroglia cells into oligodendrocytes. 3. The histoenzymatic pattern of neuroglia in the immature degenerating optic nerve differs from and bears no relation to that of the normally developing nerve. 4. Cells of the oligodendroglia line, when maturing in contact with degenerating axons are incapable of promoting myelinogenesis. 5. The genetic information contained in both the immature and mature oligodendroglia cells is not the sole factor safeguarding the transformation of these cells into myelinating ones.

Enzyme histochemistry of Wallerian degeneration in the immature optic nerve of rabbits.

A histochemical study was performed on the activity of several phosphatases, esterases and oxidoreductases in the immature optic nerve of rabbits undergoing Wallerian degeneration. Unilateral enucleations of the eye bulb were performed on 7 days old animals and the degenerated optic nerves were examined in rabbits, 5, 23, 63 and 173 days afterwards. The following results were obtained: 1. The reactive cells appearing in the immature optic nerve undergoing Wallerian degeneration exhibit distinctly increased activities of many hydrolytic and oxidoreductive enzymes. 2. The histoenzymic pattern of changes displayed by the reactive cells occurring in the immature, degenerating optic nerve is distinct from and bears no relation to that seen in the normally developing optic nerve. 3. The genetic formation contained in the oligodendroglial cells is not the sole factor safeguarding the transformation of immature and mature oligodendroglia into myelinating cells.

The effect of transplacental intoxication with ethylnitrosourea on myelin proteins.

Pregnant mice at the 15th day of gestation were injected with a single intravenous dose of ENU/80 mg/kg of body weight). The protein composition of the myelin fraction isolated by means of differential centrifugation from brains of the offsprings was studied. The results obtained lead to the following conclusions: 1. The myelin protein spectrum of transplacentally intoxicated animals aged 40 days postnatal, shows decreased percentages of the Wolfgram protein and of the low molecular weight basic protein, whereas the proportions of the high molecular weight component of the myelin basic protein as well that of the Agrawal's protein are elevated. 2. The alterations in the profile of myelin proteins obtained from experimental mice aged 70 days postnatal are less severe and consist in a decline of the percentage of Wolfgrams protein and elevation of the Agrawal's protein content. 3. The intraplacental intoxication of mouse fetuses leads to development of animals defective with respect to the protein composition of the central myelin.

Myelin lipids in the brain after transplacental intoxication with ethylnitrosourea.

At day 15 of gestation pregnant mice were injected with a single intravenous dose of ethylnitrosourea (ENU) (80 mg/kg of body weight). The lipid composition of the myelin fraction isolated by means of differential centrifugation from brains of their offsprings was studied. The transplacentally intoxicated mice developed severe changes in the lipid composition of their central myelin sheaths, such as a markedly decreased galactolipid (both cerebroside and sulfatide) as well as plasmalogen contents. The results show, that besides being a well known carcinogenic agent, ENU is capable of affecting the lipid metabolism of the developing central nervous system. The resultant effect is the formation of a chemically defective myelin sheath.

The effect of intoxication with alkylnitrosourea derivatives on cerebral myelin.

Adult BD IX rats were injected with methylnitrosourea and pregnant mice on the 15th day of gestation with a single intravenous dose of ethylnitrosourea and pregnant mice on the 15th day of gestation with a single intravenous dose of ethylnitrosourea. The cerebral myelin fraction of adult BD IX rats and of the mice offsprings was studied. It was found that a part of the rats intoxicated with methylnitrosourea developed spongious changes in the cerebral and cerebellar white matter. The myelin fraction of intoxicated rats also showed severe losses of sphingomyelin with a steady increase in the cholesterol ester content. The myelin fraction from mice intoxicated during the foetal development appeared deficient with respect to galactolipids and plasmalogen. It is concluded that, besides the carcinogenic effect, alkylnitrosourea derivatives effectively disturb the lipid metabolism of membrane structures of the central nervous system.