1,720,970 research outputs found
Tacrine improves Huntington's chorea
No full textSince hyperkinesia in Huntington's disease (HD) is at least in part due to a degeneration of the cholinergic system, we undertook an open pilot trial testing the effect of the cholinesterase inhibitor Tacrine in patients with genetically proven Huntington's disease. The extent of hyperkinesia was assessed while the patient was (i) off medication, (ii) on Tacrine alone and, in 3 patients, (II) on Tacrine and Perphenacine. Tacrine significantly reduced hyperkinesias, with only a slight additional benefit for the combined therapy. We conclude that there is a potential benefit of cholinesterase inhibitors in HD that should be evaluated in randomised, double-blind clinical trials
Quantitative reduction of saliva production in two ALS patients with intraglandular injections of botulinum toxin.
No full textA quantitative reduction of saliva production to less than 10% of original flow rate could be achieved by intraglandular injections of a total of 300 units of botulinum toxin (type DysportR) in two amyotrophic lateral sclerosis (ALS) patients. The treatment effect lasted for at least 8 weeks and increased after repeated injections. All major salivary glands were injected. Masseter strength did not decrease intolerably. This treatment can therefore be recommended even in ALS patients with paresis of the bulbar musculature
Tacrine improves Huntington's chorea
No full textSince hyperkinesia in Huntington's disease (HD) is at least in part due to a degeneration of the cholinergic system, we undertook an open pilot trial testing the effect of the cholinesterase inhibitor Tacrine in patients with genetically proven Huntington's disease. The extent of hyperkinesia was assessed while the patient was (i) off medication, (ii) on Tacrine alone and, in 3 patients, (II) on Tacrine and Perphenacine. Tacrine significantly reduced hyperkinesias, with only a slight additional benefit for the combined therapy. We conclude that there is a potential benefit of cholinesterase inhibitors in HD that should be evaluated in randomised, double-blind clinical trials
Quantitative reduction of saliva production in two ALS patients with intraglandular injections of botulinum toxin.
No full textA quantitative reduction of saliva production to less than 10% of original flow rate could be achieved by intraglandular injections of a total of 300 units of botulinum toxin (type DysportR) in two amyotrophic lateral sclerosis (ALS) patients. The treatment effect lasted for at least 8 weeks and increased after repeated injections. All major salivary glands were injected. Masseter strength did not decrease intolerably. This treatment can therefore be recommended even in ALS patients with paresis of the bulbar musculature
Blocking of secretion in exocrine glands of the head and neck area with botulinum toxin A. Therapeutic option in the treatment of rare diseases
No full textBackground. Hypersecretion disorders of the exocrine glands of the head and neck area are a therapeutic problem in the field of otorhinolaryngology. In the present study, we demonstrate the effectiveness of local injections of botulinum toxin A to block secretions of exocrine glands of the head and neck area. Patients and methods. Four patients suffering from hypersecretion disorders received local injections of botulinum toxin A to patients suffered from disorders of the salivary glands: one presented an idiopathic hypersialorrhea and another a salivary fistula after parotidectomy. A third patient suffered from epiphora and a further patient presented severe hyperhidrosis on the pilose head region. In a retrospective clinical study, the outcome of therapy was evaluated by clinical examination and chemical parameters. Results. Clear blocking of secretion in the treated glands could be demonstrated in all four cases. Possible side effects of the treatment could not be observed. Conclusions. The present study was able to demonstrate a clear blocking of secretion of the exocrine glands of the head and neck region through botulinum toxin A, offering an improvement in therapy especially for the innovative indication of blocking the salivary glands of the head
Migration of human granulocytes through reconstituted basement membrane is not dependent on matrix metalloproteinase-9 (MMP-9)
No full textTransmigration of human granulocytes across a basal lamina equivalent was studied in vitro. Transwell(R) inserts were coated with Matrigel(R), a reconstituted basement membrane. Granulocytes (2 x 10(6)) were applied to the upper chamber. As chemoattractant interleukin-8 (IL-8; 25 ng/ml) was added to the lower chamber. After 1 h of migration, cells were counted in the lower chamber. Specific hydroxamate inhibitors of MMPs (BB-3103, Ro 31-9790) or of serine proteases (Pefabloc(R), leupeptin) were added at various concentrations to both chambers before the start of migration. Additional experiments were performed with alpha (2)-macroglobulin, a natural inhibitor of MMPs and a monoclonal antibody which specifically blocks the activity of MMP-9. Migration of granulocytes through Matrigel could not be reduced significantly by any of the MMP inhibitors. A dose-dependent impairment of transmigration was only found with Pefabloc, however, this substance also induced severe morphological changes of the cells. The other inhibitor of serine proteases, leupeptin, did not influence migration at all. (C) 2001 Elsevier Science B.V. All rights reserved
Matrix metalloproteinase-9 is elevated in serum of patients with amyotrophic lateral sclerosis
No full textMatrix metalloproteinase-9 (MMP-9) and its specific inhibitor, tissue inhibitor of matrix metalloproteinase-1 (TIMP-1), were analysed by enzyme-linked immunosorbent assay (ELISA) and by zymography in serum and cerebrospinal fluid (CSF) of patients with amyotrophic lateral sclerosis (ALS). In contrast to patients with inflammatory diseases, MMP-9 levels were not elevated in CSF of ALS patients. In serum, however, compared to healthy donors, MMP-9 was significantly (p=0.0003) increased up to levels as high as those of viral meningoencephalitis (VM) or bacterial meningitis. (BM) patients. MMP-9 levels remained elevated during long-term observation of ALS patients. In the absence of an inflammatory response, the results indicate that the increase of MMP-9 in serum of ALS patients might be caused by upregulation of MMP-9 in denervated muscles or in degenerating peripheral nerves following motor neurone loss. NeuroReport 11:3419-3422 (C) 2000 Lippincott Williams & Wilkins
Intracortical excitability in the hand motor representation in hand dystonia and blepharospasm
No full textWe sought to determine the activity of inhibiting and facilitating cortical circuits in areas surrounding a hand muscle motor representation in focal dystonia and in controls. In 15 patients with hand dystonia, 16 patients with blepharospasm, and age-matched controls, we applied suprathreshold transcranial magnetic stimuli with a figure-eight coil over the optimal representation of the relaxed abductor digiti minimi muscle of the dominant hand. Additional conditioning stimuli were given through a second figure-eight coil that was held either above the test coil or 2 cm or 4 cm apart in the anterior, posterior, lateral, or medial direction. We measured intracortical excitability in each of the nine positions of the conditioning coil. Intracortical inhibition was reduced in both patient groups at all conditioning coil positions. With both coils centered, the intracortical facilitation did not differ between patients and controls. After shifting the conditioning coil, the intracortical facilitation tended to be less diminished in patients than in controls, this difference between patients and controls was significant for the anterior, posterior, and medial 4-cm conditioning coil shift. Our results demonstrate decreased intracortical inhibition in the cortical hand muscle representation not only in patients with hand dystonia, but also in patients with blepharospasm. In addition, our findings in both patient groups show a trend toward a relatively increased intracortical facilitation in surrounding motor areas. (C) 2002 Movement Disorder Society
Botulinum toxin to reduce saliva flow: Selected indications for ultrasound-guided toxin application into salivary glands
No full textObjectives/Hypothesis: The study investigates the effect of local injections of botulinum. toxin type A (Botox) into the major salivary glands of the head in various states of hypersalivation. In particular, we studied pathological states with permanent as well as passing hypersalivation disorders and present new indications for local application of botulinum. toxin to the salivary glands. Study Design: Retrospective clinical investigation. Methods: A total of 55 to 65 units of Botox were injected under sonographic control into the left and right parotid and submandibular glands of four patients with hypersalivation resulting from head and neck carcinoma, tracheostomy, and "idiopathic" hypersalivation disorder. At defined time intervals following injection, flow rate, total protein and immunoglobulin A content, and the enzymatic activities of amylase, acid phosphatase, and kallikrein were determined in the saliva. The patients were clinically examined to assess the severity of their symptoms, including sonographic control of the major salivary glands. Results: All four patients reported distinct improvement of their symptoms within 1 week after injection. Salivary flow rate had considerably dropped, whereas the concentrations of the salivary components were much increased. Sonography did not reveal any changes of the salivary gland parenchyma. Therapeutic side effects were absent. Conclusions: Treatment of hypersalivation by local injections of Botox into the salivary glands of the head is a reliable and efficient therapy without side effects for certain otolaryngological diseases, especially if injections are performed under sonographic control. Extension of this therapeutic concept to other indications is suggested
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