Journal of the neurological sciences
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The development of neutralizing antibodies (NAbs) to interferon (IFN) is a common phenomenon of IFN beta therapy for relapsing-remitting multiple sclerosis (RRMS) patients. Here we examine the specificity of NAbs developed during therapy for RRMS with recombinant interferon (rIFN) beta-1a or rIFN beta-1b, and study the effect of switching from rIFN beta-1a to rIFN beta-1b on the incidence and specificity of NAbs. ⋯ The results show that all positive sera, independent of the source, may recognize both forms of rIFN beta and that a further year of treatment does not significantly affect the incidence and specificity of the NAbs developed during the first two years of treatment even if treatment is switched to a different type of IFN beta. The data then suggests that it is unlikely that the administration of rIFN beta-1b to anti-rIFN beta-1a NAbs-positive patients can overcome the inhibitory effect exerted by the serum antibodies (and vice versa), and that a further period of treatment with IFN beta-1b in patients previously treated with rIFN beta-1a does not significantly change the pattern of antibody response to IFN beta.
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The pattern of neuronal loss in the rat hippocampus following 10-min-long cardiac arrest-induced global ischemia was analyzed using the unbiased, dissector morphometric technique and hierarchical sampling. On the third day after ischemia, the pyramidal layer of sector CA1 demonstrated significant (27%) neuronal loss (P<0.05). At this time, no neuronal loss was observed in other cornu Ammonis sectors or the granular layer of the dentate gyrus. ⋯ However, the hippocampus has a unique, unidirectional system of intrinsic connections, whereby the majority of dentate granular neuron projections target the sector CA3 pyramidal neurons, which in turn project mostly to sector CA1. As a result, the early neuronal dropout in sector CA1 may result in retrograde transynaptic degeneration of neurons in other areas. The lack of neuronal loss in sector CA2 can be explained by the resistance of this sector to ischemia/hypoxia and the fact that this sector is not included in the major chain of intrahippocampal connections and hence is not affected by retrograde changes.
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Stereotaxtic surgery is an effective therapeutic maneuver in the management of advanced Parkinson's disease (PD). Thalamotomy is an effective measure to control tremor but other PD symptoms are not changed. Bilateral operations are associated with a risk of severe speech impairment. ⋯ This procedure may control all PD symptoms, and the dose of levodopa can often be dramatically reduced. Neurotransplantation is a promising surgical approach to PD. However, further investigation is needed to optimize this approach.
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We aimed to study in-hospital mortality after a first-ever stroke (brain infarction or parenchymatous hemorrhage) and to determine its predictors using easily obtainable variables. The main outcome measure was vital status at hospital discharge. Clinical features and type of stroke, with a particular emphasis on age, stroke topography and presumed causes of stroke, were studied in 3362 consecutive patients from the Lausanne Stroke Registry. ⋯ Age was not an independent predictor of stroke mortality, but for brain infarction the number of cumulative factors considered in the model increased with age. Our study shows that several factors associated with death risk are available during the first few hours after onset of stroke. Age alone is not critical, although its interaction with other factors should be considered.
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Case Reports
Brain MRI in peripartum seizures: usefulness of combined T2 and diffusion weighted MR imaging.
Peripartum seizure is a serious disease with significant morbidity and mortality for women and their unborn children. The underlying etiologies are varied, with eclampsia and venous stroke being the most common causes. ⋯ We report three cases of eclampsia with abnormal T2 weighted images, but normal DWI. Diffusion weighted MR images in association with T2 weighted MR images can be extremely helpful in evaluation of women with new onset peripartum seizures.