Chronic alcohol use and first symptomatic epileptic seizures.

OBJECTIVE: To establish whether chronic alcoholism and alcohol consumption are risk factors for developing a first symptomatic epileptic seizure. METHODS: Multicentre case-control study of 293 patients (160 men, 133 women) with a first seizure symptomatic (either acute or remote) of head trauma, stroke, or brain tumour, matched to 444 hospital controls for centre, sex, age (+/-5 years), and underlying pathology. RESULTS: The risk of first seizure in alcoholics was no higher than in non-alcoholics for men (odds ratio 1.2, 95% confidence interval 0.4 to 3.2) or women (1.5, 0.1 to 54.4). The odds ratio (both sexes) was 1.2 (0.8 to 1.7) for an average intake of absolute alcohol of 1-25 g/day, 0.9 (0.5 to 1.5) for 26-50 g/day, 1.6 (0.8 to 3.0) for 51-100 g/day, and 1.4 (0.5 to 3.5) for >100 g/day. CONCLUSIONS: We found no evidence of an association between alcohol use or alcoholism and a first symptomatic seizure.

Mortality trend for multiple sclerosis in Italy (1974-1993).

The prevalence of multiple sclerosis (MS) in Italy is one of the highest in Europe, estimated proportions ranging between 32 and 69 cases per 100,000. An update of mortality time trend analyses can help trace a picture of the evolution of the disease and contribute to the interpretation of differences related to latitude and gender. Standardized mortality ratios (SMR) were computed for the 1974-1993 calendar period, using the pooled data set as standard. World population was the standard used to estimate age-adjusted rates for all Italy, while for selected regions the 1991 Italian population was utilized. Time trend analysis was performed using the Poisson regression model and the variation of mortality rates in time was expressed as mean difference per cent per year. Age-adjusted rates per million inhabitants were 4.1 for males and 5.0 for females. Northern Italian regions showed higher MS mortality rates than Central and Southern regions and Sicily, particularly in females; the effect was less evident in Sardinia. Time trend analysis by area showed a mortality decrease in Northern Italy (-1.15%) that reached statistical significance for men. In central regions a slight increase of borderline statistical significance (+1.03%) was observed only in women. while in the South and Sicily a statistically significant increase was seen in both males (+2.14%) and females (+3.09%). The analysis of the time trend for all Italy did not reveal significant variations in male mortality; by contrast, a slight, but statistically significant, increase (+0.88%) was observed in female mortality. Analysis of age-adjusted MS mortality rates in each region suggested the presence of an effect due to latitude. The occurrence of an increasing trend in Southern Italian regions and Sicily deserves further investigation.

Ossification of the posterior longitudinal ligament (OPLL) in the cervical spine. Clinical, neuroradiological and neurophysiological study on 9 cases.

Ossification of the posterior longitudinal ligament (OPLL) in the cervical spine is considered to be uncommon in western countries, although widely known and studied in Japan. We report on 9 cases of OPLL cervical myelopathy investigated by x-ray films and cervical CT and by somatosensory evoked potentials. The patients reported spastic tetraparesis, sensory disorders of the limbs and, in one case, sphincter incontinence. Neuroradiological examinations showed that the posterior columns of the spinal cord were more affected than the roots. Our data suggest that OPLL is more frequent in the West than has so far been reported and that combined radiological and neurophysiological investigation ensures correct diagnosis and accurate assessment of the cord impairment.

Lacunae and cribriform cavities of the brain. Correlations with pseudobulbar palsy and parkinsonism.

Fifty-one brains showing lacunae and 30 with cribriform cavities have been identified out of 191 examined brains. A histologic and immunohistochemical study with the peroxidase-antiperoxidase method for glial fibrillary acidic protein has been carried out in selected cases. The number, site, associated arterial lesions and the microscopic appearance of lacunae and cribriform cavities are reported. Lacunae are small cavities usually, but not always due to softenings; cribriform cavities are dilatations of the perivascular space. Two types of cribriform cavities have been identified, according to the histological appearance of the surrounding tissue: type 1 with normal and type 2 with rarefied and abnormally gliotic surrounding nervous tissue. Sixteen cases showing a cribriform state in the basal ganglia exhibited a pseudobulbar palsy or extrapyramidal rigidity. Pseudobulbar palsy of striate form or parkinsonism may be ascertained in some cases only by histological and immunohistochemical examination.

[Huntington chorea. Review of the most recent aspects of research]. / Corea di Huntington. Rassegna degli aspetti più attuali delle ricerche.

The authors are presenting a review concerning the most visible aspects of the research directed to emphasize that Huntington's Chorea cannot be compared, either clinically or pathologically, to Parkinson's Disease. It is a hereditary disease in which we can discern an alteration of some neurotransmitters, neuromodulators, neurohormones that are not necessarily opposite in respect to pathophysiological findings of Parkinson disease.

Polyglucosan bodies in the sural nerve of a diabetic patient with polyneuropathy.

In the sural nerve of a 62-year-old woman with impaired glucose tolerance test and polyneuropathy, many intra-axonal polyglucosan bodies were observed. Polyglucosan bodies have been described in spontaneously or alloxan-diabetic rats, but are not usually observed in human diabetic neuropathy. Since intra-axonal polyglucosan bodies can occur in the sural nerve in various diseases and in aging, they are considered as non-specific changes. Their presence is probably related to a primary axonal neuropathy.

Technology advances for continuous compression milling pretreatment of lignocellulosics for enzymatic hydrolysis.

The feasibility of a continuous compression milling pretreatment process for the enzymatic hydrolysis of lignocellulosics has been demonstrated. Pretreatment efficiency was improved significantly by adjustment of feedstock moisture content prior to milling and/or increasing the roll pressure on the feedstock. Optimum moisture contents for newspaper (24%). corn stover (17%), popular (12-20%) were determined. Sugar Yields of 48% were obtained from air-dried newspaper after six passes through even-pressure rolls and the specific energy input was 0.21kW h/lb. The Effect of roll speed on enzymatic hydrolysis improvement was constant over a roll speed range of from 30-110 ft/min (65 rpm). Enzymatic hydrolysis results from commercial-scale pretreatment of moist newspaper processed at 6 tons/h/ correlated well with laboratory mill data while energy consumption was 26% less.

Effect of compression milling on cellulose structure and on enzymatic hydrolysis kinetics.

The changes in the cellulose structure by compression milling were studied and expressed in terms of crystallinity, accessibility, specific surface area, and degree of polymerization. The kinetic parameters, maximum reaction rate, and Michaelis constant were determined experimentally. Based on the experimental results a two-phase model, which is based on the degradation of cellulose by simultaneous actions of the cellulase complex on the crystalline and amorphous phases, is proposed. The relationships between cellulose accessibility and the kinetic parameters were compared with those predicted by the model. A good agreement was found, although the two-phase hypothesis is a simplification of the true state of order in cellulose.

Differential speed two roll mill pretreatment of cellulosic materials for enzymatic hydrolysis.

Differential speed two roll milling is an effective pretreatment for increasing the susceptibility of cellulose to enzymatic hydrolysis. Using mills with three, six, and ten in. diam rolls and processing times of 10 min or less results in the following percent increases in susceptibility over untreated controls: cotton, 1100; maple chips, 1600; white pine chips, 600; newspaper, 125. In comparison, ball milling of newspaper for 24 hr gives only a 62% increase. A further advantage of the roll mill is the increased wet density of the product permitting higher slurry concentrations during hydrolysis. Important parameters of mill effectiveness are roll clearance and processing time