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Cerebrospinal fluid (CSF) lymphocytes from two patients with tuberculous meningitis proliferated stronger than the corresponding peripheral blood lymphocytes (PBL) when stimulated with tuberculin purified protein derivative (PPD) in the lymphocyte transformation test after 3 days of culture. This might indicate an accumulation of specifically primed lymphocytes within the central nervous system. CSF lymphocytes and PBL from nine of ten patients with acute aseptic meningitis investigated as controls showed no or low responses when stimulated with. PPD, whereas the remaining patient displayed a significant proliferation of CSF lymphocytes, which was more pronounced than that of PBL. Stimulation with the mitogens phytohaemagglutinin, concanavalin A, and pokeweed mitogen gave lower proliferation of CSF lymphocytes compared with PBL in tuberculous and aseptic meningitis. Evaluation of the proliferative response of CSF lymphocytes compared with PBL on stimulation with PPD might be a useful complement in the diagnosis of tuberculous meningitis. [ABSTRACT FROM AUTHOR]

Eight cryopositive patients with multiple sclerosis used cooling suits for 40 minutes regularly one or more times daily for a six-week period. The patients were given repeated motor and mental tests by a physiotherapist in order to determine whether they had a continuous beneficial effect of cooling during this period. Additionally, selected activities of daily living performed in the patient's homes were evaluated and registered according to Assessment of Motor and Process Skills (AMPS). Six out of eight patients improved in at least one motor test and all patients improved according to AMPS. For one of the patients, who was profoundly handicapped, the effect of cooling was evaluated differently.

The aim of the present study was to determine whether any significant alterations of evoked potentials could be detected after treatment of patients with multiple sclerosis with a cooling suit. All patients had previously experienced a positive effect of this treatment. Six patients were investigated with visual, sensory and motor evoked potentials and six further patients with only motor evoked potentials. All patients had relevant clinical lesions. The mean values for the group of patients were similar before and after cooling, but a few individuals showed a substantial improvement of motor evoked potentials after cooling, with increased amplitude and/or shortened central motor conduction time. There was also a weak, but significant, correlation between temperature decrements and the reduction of central motor conduction time. However, since the central motor conduction times of most patients were only slightly affected, this effect could explain only a small part of the beneficial effect of cooling. Effects on cognition and executive ability or improvement of spasticity may be of greater importance.

The measles-adherent phenomenon described by Levy in multiple sclerosis was investigated by studying the rosetting effect of blood lymphocytes from multiple sclerosis patients and healthy controls on chronically measles infected heteroploid Hela cells (Lu 106). No significant difference in rosetting was observed, irrespective if a lymphocyte/virus infected Lu cell ratio of 10/1 or 50/1 was used. Therefore, the test is not discriminative for multiple sclerosis.

A patient with Mollaret's meningitis with protracted course and a strong immune response within the central nervous system is described. The findings of IgG bands in agarose gel electrophoresis of CSF together with elevated CSF IgG index values are in accordance with intrathecal synthesis of IgG, possibly against an antigen persistent in the CNS. Subgrouping of CSF lymphocytes morphologically (B/T, active T cells) and functionally (stimulation with mitogens) showed that these cells differed from peripheral blood lymphocytes. A defect in the regulatory function of T cells may be responsible for the continuing pathologic process in Mollaret's meningitis.

Cysticercosis is not likely to be the first diagnosis the otologist has in mind when regarding tumors in the head and neck area. The fact that this disease may present a diagnostic and therapeutic problem is illustrated by three cases, appearing in the tongue, buccal mucosa, and midline of the neck, respectively. The local finding of a soft nontender mass, the typical calcifications in the soft tissues visible on roentgenograms, and the histopathological findings are described and illustrated. Attention is drawn to the fact that cerebral cysticercosis, which is a very grave disease, may cause tinnitus, nystagmus, and hearing disturbances.

The leukocyte migration inhibiton test was used in multiple sclerosis patients and in healthy controls for investigation of sensitization of blood lymphocytes against preparations of measles virus, mumps, NDV virus, and PPD. Regardless of antigen used, no significant differences were found between the groups. There was a strong correlation between the leukocyte migration inhibition obtained with measles virus antigen and with PPD. The leukocytes from MS patients as well as from healthy controls showed a significantly more pronounced inhibiton when a Tween 80 and ether-treated preparation of measles virus was used, compared with the whole measles virus antigen. No correlations were found between the degree of leukocyte migration inhibition and the antibody titers against different components of measles virus in individual samples.

Since experimental data strongly suggest a synergistic cytotoxic effect when methotrexate (MTX) and 5-fluorouracil (5-FU) are administered sequentially, we investigated antitumor effects and toxicity with sequential MTX/5-FU followed by leucovorin rescue in 52 patients with carcinoma of the head and neck. MTX (200 mg/m2) was given as an i.v. infusion over 1 hr. At 2 hr, 5-FU (600 mg/m2) was started as an i.v. infusion for 2 hr. At 24 hr, the leucovorin rescue was started. The chemotherapy course was repeated every week until toxicity (mainly gastrointestinal) occurred, after which the interval between courses was prolonged to 2 wk. Toxicity was mild and usually disappeared when the interval between the chemotherapy courses was prolonged to 2 wk. The regression rate was 15% for complete and 48% for partial regression (response rate, 63%). In 31 of the patients not previously treated, the objective response rate was 74%. About the same results were obtained for tumors of different anatomic sites of the head and neck. Radiotherapy could be added sequentially without measurable escalation of toxicity. We conclude that sequential MTX/5-FU treatment, which produces a very mild toxicity to normal tissue, is effective in inducing antitumor response in patients with carcinoma of the head and neck.

Three types of acute obstructive laryngitis in children are distinguished: 1. Acute supraglottic laryngitis (Epiglottitis acuta): The usual causative organism is Hemophilus influenzae, type B. Characteristic findings include a swollen red epiglottis. Treatment is based on Ampicillin, Solucortef (hydrocortisone-sodium succinate) i.m., air humidification, intravenous infusions and airway protection (tracheotomy or intubation). From 1958-1967, 68 children were treated, of whom boys were twice as commonly affected as girls. In about 80% of cases, tracheotomy was still found necessary. 2. Acute subglottic laryngitis: Mucosal swelling in the subglottic space causes a clinical picture which initially is common to several groups of deseases. In allergic subglottic edema, a pale "pillow-shaped" swelling occurs which responds favorably to antiallergenics and cortisone. In contrast, infectious swelling is partially caused by the infiltration of inflammatory cells. Parainfluenzae virus was isolated in 60% of these cases at our hospital. During the period studied, 2,741 cases were treated, of whom boys were 3.3 times more frequently affected than girls. The use of Solu-cortef i.m. has decreased the tracheotomy rate from 12% to 0. 3. Acute laryngotracheobronchitis: In this disease process, the initial infection is attributed to a virus, with the infected mucosa secondarily invaded by bacteria. The clinical course is prolonged when compared to subglottic laryngitis, and the general condition seriously affected. Both expiratory and inspiratory stridors occur. Tracheotomy is usually required, with viscous crusts removed by bronchoscopy. Respirator treatment is also often required. Fourteen children have been treated, of whom two have died.

Acromegalic dysphonia is described in a series of 80 acromegalic patients. Subjective dysphonia was observed in most patients, objective dysphonia, however, wasnoted in only 50% of the cases. The patients with objective dysphonia usually had progenia, moderate to high acromegalic activity and duration of disease of more than five years. The different factors of importance for the development of acromegalic dysphonia are summarized.