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A 50-year-old man with acute myelogenous leukemia underwent allogeneic bone-marrow transplantation (BMT). He presented with severe diarrhoea 86 days post BMT and was diagnosed with graft-versus-host disease (GVHD) based on skin and rectal biopsies. He complained of numbness and weakness in the distal extremities at 114 days after BMT. His symptoms rapidly deteriorated and he required mechanical ventilation for respiratory failure. His clinical course and the findings of a nerve conduction study fulfilled the criteria for diagnosis of Guillain–Barré syndrome (GBS). Sural nerve biopsy revealed active demyelination and infiltration of macrophages and CD8+ T-cells. After three cycles of intravenous immunoglobulin therapy, his symptoms gradually improved, and he could eventually walk unassisted. Although GBS has been known to develop after allogeneic BMT, the pathogenesis remains unclear, and specific treatment regimens have not been well established. Here, we report a case of GBS, caused by an immune-mediated mechanism related to GVHD, which was successfully treated using intravenous immunoglobulin therapy.

Isopropenyl methyl ketone was polymerized with y-ray radiation and with phenylmagnesium iodide in toluene. The polymers obtained with phenylmagnesium iodide as catalyst were separated into methyl ethyl ketone-soluble and -insoluble p a t s . The soluble parts were amorphoas, while the insoluble parts were crystalline.Treatment of the polymers by heat, alkali and chlorinated solvents induced aldol condensation. It was confirmed by infrared and ultraviolet spectrometry that the crystalline polymer underwent aldol condensation between adjacent units more easily than the amorphous polymer a t temperatures lower than 180 "C, forming monocyclic structures predominantly, whereas the amorphous polymer resisted in the earlier stage of heating but w a s mole rapidly degraded between 180-263 "C than the crystalline polymer. The length of the conjugated double bond sequences produced in the amorphous polymer showed random distribution. ZUSAMMENFASSUNG:Isopropenylmethylketon wurde mit y-Strahlen oder mit Phenylmagnesiumbromid in Toluol polymerisiert. Die mit Phenylmagnesiumbromid als Katalysator erhaltenen Polymeren wurden in Anteile, die in Methylathylketon Ioslich, und in Anteile, die in Methylathylketon unloslich sind, zerlegt. Die loslichen Anteile waren amorph, die unloslichen kristallin.Eine Behandlung der Polymeren mit Wtirme, Alkali und chlorierten Losungsmitteln fiihrt zu Aldolkondensationen. Durch Ultrarot-und Ultraviolettspektralanalyse wurde nachgewiesen, da13 die Aldolkondensation zwischen benachbarten Gruppen bei dem kristallinen Polymeren bei Temperaturen unter 180 "C leichter eintritt als bei dem amorphen Polymeren, wobei sich vorwiegend monocyclische Strukturen bilden; das amorphe Polymere hingegen blieb bei dem Erhitzen anfangs unverandert, wurde aber zwischen 180 und 260°C rascher abgebaut als das kristalline Polymere. Der Abstand in der Folge der konjugierten Doppelbindungen, die sich bei dem amorphen Polymeren bilden, ist >tatistisch verteilt.

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