Kew M; Lancet; 19 February 2000:591-592
(commentary):
Moderately elevated (120-500 U/L) serum concentrations of
the liver enzymes alanine aminotransferase (ALT) and
aspartate aminotransferase (AST) are the most used
indicators of mild or chronic damage by a virus, toxin,
or drug. But ALT/AST levels don't reliably indicate the
degree of cumulative necrosis, which on rare occasion may
lead to fulminant (sudden) liver failure [e.g., four
cases in clinical trials of tolcapone (Tasmar)].
Schrag A et al;
Lancet, 26 February 2000;754-755:
More letters exchange about prevalence of PSP and MSA
(CSR JAN 00, MAR 00). Sorting these conditions from early
PD is difficult because clinical symptoms are imperfectly
defined, and also because cases are so rare that the
ordinary general practitioner is unlikely to become
familiar with them.
Page W, Tanner C; Lancet, 4 March
2000:843:
Unlike the prior study of British WW II POWs (CSR JAN
00), a similar study of American POWs shows higher
prevalence of PD reported as cause of death.
Lancet, 18
March 2000:991 (news item):
Comment on the pig cell transplant trial cited below:
This and the Science News article appear to stem from a
news conference by the Massachusetts firm Diacrin, who
hope to market the embryonic neural tissue if and when
the procedure is approved.
Snow B et al; J Neur N'surg Psych
2000;68:313-316:
The discovery of parkinsonism caused by MPTP from a
botched batch of kitchen-brewed heroin was a unique
windfall for PD researchers, because it allows use of lab
animals instead of human subjects to test all kinds of
drugs and other treatment. Moreover, the original victims
have been carefully followed and studied. High resolution
positron-emission tomography (PET) now shows, however,
that MPTP-induced parkinsonism is distinct from
idiopathic PD, so the study model is imperfect.
Sawle G; J Neur N'surg Psych 2000;68:276
(editorial):
Commentary and history on the item above.
Rivaud-Pechoux S et al; J Neur N'surg
Psych 2000;68:381-384 :
Certain eye movements (saccades) are impaired in PD and
not improved by levodopa. But in 8 PD patients, bilateral
stimulation of the subthalamic nucleus (STN) reduced the
impairment.
Goetz C et al; Neur 2000;54:710-714:
Authors examined 105 early-stage PD patients in the
placebo group of a controlled trial of ropinirole
(Requip) and found that 16% of them experienced objective
improvement of PD symptoms.
Benarroch E et al; Neur 2000;54:963-968:
Autonomic failure, mainly orthostatic hypotension, in
patients with multiple system atrophy (MSA) is
accompanied by loss of certain neurons in part of the
medulla; but in PD patients with similar autonomic
failure, that is not the case.
Schumacher J et al; Neur
2000;54:1042-1050:
To test safety and efficacy of unilateral embryonic pig
cell transplants in PD patients, they followed 12
recipients for a year. They found variable but general
improvement in symptoms, no porcine retrovirus and no
serious adverse effects.
Schmand B et al; Neur 2000;54:1058-1064:
In a controlled neuropsychological study of 35 PD
patients receiving unilateral pallidotomy, they found no
significant effects upon cognition or behavior.
Science News,
18 Mar 2000:180(news item):
Unlike other neurons of the adult central nervous system,
olfactory cells can regenerate naturally, thanks
apparently to protection by special cells called
olfactory ensheathing glia. Spanish researchers cut the
spinal cords of lab rats, then injected those glial cells
at the severed ends, which then regrew enough connections
to restore hindquarters mobility.
Science News,
25 Mar 2000;197(news item):
Some details about the pig cell transplant trial cited
above: In this first trial to establish safety, a
relatively small amount of tissue was used. Nevertheless,
symptom improvement was "dramatic" in 3 of the
10 advanced-PD subjects, moderate in 3 others, while the
remaining 4 were unchanged. A new study with 18 subjects,
using 4 times the former amount of tissue, includes a
control group getting sham transplants (at first).
Jankovic J et al; Arch Neur
2000;57:369-372:
In a followup as long as 12 years of 800 early-PD
subjects of the original Deprenyl And Tocopherol As
Treatment Of Parkinson's (DATATOP) study, they found that
original investigators had altered their diagnosis in
only 65 cases.
Henderson J et al; Ann Neur
2000;47:345-352:
Although degeneration of dopaminergic feedback from the
substantia nigra to the corpus striatum is a defining
feature of PD, glutamatergic inputs to the striatum from
the cerebral cortex and a part of the thalamus* are more
important. Postmortem study of 9 patients and 8 controls
showed significant neural degeneration of that region as
well, and since it is important in movement control, PD
symptoms may be worsened. (*: "centre
median-parafascicular complex")
Di Maria E et al; Ann Neur
2000;15:374-377:
As well as several clinical features, corticobasal
degeneration (CBD, formerly CBGD) and progressive
supranuclear palsy (PSP) are found to share certain
anomalies of the tau protein gene.
Ramaker C et al; Mov Disord
2000;15:56-64
To assess the value of bromocriptine (Parlodel) as
adjunct therapy for levodopa-induced motor complications
of PD, they reviewed 8 different reports of controlled
trials conducted between 1966 and 1999, but complain that
the generally poor trial methodology prevents any
important conclusions.
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