From 1972 to 1991, 7 patients with advanced cancer of the head and neck and nodal metastasis with capsular rupture underwent radical neck dissection and sacrifice of the carotid artery. Vascular reconstruction was performed with either an autologous venous (8 cases) or arterial (1 case) graft. In all patients, the postoperative course was uneventful without neurologic complications. One patient is alive 4 years after the procedure. Six patients expired after a mean survival of 20 months. The indications for vascular reconstruction are discussed.

Adult↗

PubMedDate not supplied

Palatal mucoperiosteal free graft: another reconstruction option for oral defects.

Traditional methods of repair for medium-size (3-5 cm) oral defects include allowing granulation, primary closure, skin grafts, and buccal mucosal grafts. Each of these methods has several disadvantages, and all tend to result in significant scar contracture and often lack sufficient bulk. In 10 patients, the defect left by resection of cancer lesions was reconstructed with a free palatal mucoperiosteal graft. In all patients, the grafts survived with little contracture, allowing for adequate tongue mobility. Because of the thickness of the palatal mucoperiosteum, local depressions typically associated with floor of the mouth defects could be avoided. The palatal donor site was left to granulate and recovered in 2-3 weeks with little residual deformity. In 4 patients a through-and-through resection of a floor of the mouth cancer was performed in continuity with a neck dissection. A palatal mucoperiosteal free graft was utilized exclusively in the reconstruction, without the development of salivary fistula.

Carcinoma, Squamous Cell↗

PubMedDate not supplied

Treatment of Alzheimer's disease with clioquinol.

As heavy metal ions may be implicated in the formation of senile plaques in Alzheimer-afflicted brains, treatment with clioquinol was tested in 20 patients with Alzheimer's disease. Clioquinol is a chelator that crosses the blood-brain barrier and has greater affinity for zinc and copper ions than for calcium and magnesium ions. Treatment was given for 21 days at doses of 20 mg/day to 10 patients and 80 mg/day to another 10 patients. The study was blind to the dosages but included no controls. Cerebrospinal fluid (CSF) investigations revealed a significant increase at day 7 and a decrease at day 21 in Tau protein and growth-associated protein (GAP43). These proteins are increased in Alzheimer's disease and considered as rather stable markers. The initial increase may indicate a temporary cytotoxicity to the brain and/or an increased release into the CSF from stores in the tissue, possibly from senile plaques where the proteins are accumulated. The levels of CSF-Tau protein correlated positively and significantly with the serum levels of copper and also with the serum copper/zinc ratio. Clinical ratings showed slight improvement after 3 weeks treatment with clioquinol in this open study.

Aged↗

PubMedDate not supplied

Intracerebroventricular administration of GM1 ganglioside to presenile Alzheimer patients.

We have conducted a preliminary study of the optimum conditions for a therapeutic effect of ganglioside GM1 in Alzheimer's disease. Five patients with the early onset form of Alzheimer's disease (AD type I) received the ganglioside by intracerebroventricular administration for 12 months. Bilateral stereotactic punction of the frontal horns of the ventricular system was performed, and shunt catheters were implanted and connected to a programmable pump. The optimum GM1 dose varied between 20 and 30 mg/24 h. Neurological neuropsychological, psychiatric and neurochemical examinations were performed 7 days before surgery and on days 30, 90, 180 and 360. No patient found the surgery difficult and no patient or relative regretted that they participated in the study. The patients became more active and safer in relation to others and to performance of various activities from day 90. The cerebrospinal fluid level of the monoamine metabolites homovanillic acid and 5-hydroxyindoleacetic acid and the neuropeptide somatostatin increased.

Aged↗

PubMedDate not supplied

Comparative study of the rotatory vestibular nystagmus thresholds obtained by means of constant or sinusoidal angular acceleration. Preliminary report.

Explore the source record for details and available documents.

Acceleration↗

PubMedDate not supplied

[Dexamethasone suppression test in endogenous depression and schizophrenia in male and female patients].

Dexamethasone Suppression Test was performed during an acute phase in 81 patients with endogenous depression and 105 schizophrenic patients. The lack of suppression of cortisol was found in 1/3 if those ill with depression and 1/3 of those ill with schizophrenia. A relationship between those results and age was shown in female schizophrenic patients. In both groups a yearly rhythm was observed, however female patients differed from male patients.

Adult↗

PubMedDate not supplied

[Diagnosis and therapy of geriatric aphasia patients following cerebrovascular stroke].

Aphasia is common in elderly patients with stroke. This paper presents some results of aphasia therapy within the activation phase (acute aphasia) and the syndrome-specific learning phase (until the 24th week of treatment). A phase-specific therapeutic concept was developed to connect stimulation and cirumvention method and compensatory techniques. The results attest to the success early after stroke regarding development of speech pathology logopedic diagnosis and therapy.

Aged↗

PubMedDate not supplied

Changes in carbamazepine plasma concentrations in psychiatric patients during treatment.

Plasma concentrations of carbamazepine (CBZ) were studied in 24 psychiatric patients who were given 400 mg of CBZ every 12 h. The assays were performed on the 1st, 3rd, 8th, 15th, 22th and 29th day of the therapy. The highest minimum 12h plasma CBZ concentrations occurred on the 3rd day of therapy, then decreased up to the 15th day and remained stable thereafter. The CBZ half-time values also diminished up to the 15th day of therapy and then stabilized. This may suggest that the enzymatic autoinduction of CBZ is completed within the first 1-2 weeks of therapy. CBZ plasma levels were slightly but insignificantly higher in patients taking CBZ alone than in patients in which CBZ was added to other psychotropic drugs. A significant correlation was found between the minimum CBZ plasma concentration after the first dose and that at steady state. A dosing schedule for CBZ administration has been proposed with administration of 75% of the maintenance dose during the first week and the full CBZ maintenance dose from the beginning of the second week of CBZ therapy.

Adolescent↗