Background and Purpose: Hitherto, treatment of acute cerebral hemorrhage with intravenous glycerol has not been evaluated in rigorous clinical studies with sufficient patient numbers.Methods: We undertook a double-blind, stratified and randomized, placebo-controlled clinical trial. Only patients with a first stroke admitted to the hospital within 24 hours after onset of symptoms were recruited, provided computed tomography confirmed hemorrhage and informed consent was obtained. After stratification into alert, semicoma, and coma subgroups using the Glasgow Coma Scale, 107 patients received active treatment (500 ml of 10% glycerol in saline by intravenous infusion over 4 hours on 6 consecutive days) and 109 were given corresponding saline treatment. Using a variety of objective scoring systems, patients were followed up for up to 6 months.Results: At follow-up, all measures of outcome in the treated and control groups were very similar. At 6 months, respective mortality rates were 37 of 107 and 33 of 109. Corresponding mean±SD improvements in Scandinavian Stroke Study Group scores were 8.35±16.9 versus 11.55±15.6 (long-term) and 0.64±7.3 versus 2.40±6.9 (prognostic), and improvements in the Barthel Index ratings were 10.72±24.7 versus 13.95 ±23.3, respectively. Glasgow Coma Scale score improvements in the survivors were 0.81 ±1.5 and 1.16±1.7 in the treated and control groups, respectively. Hemolysis (generally subclinical) was the only adverse effect of glycerol noted.Conclusions: In the absence of any clinically or statistically significant difference in outcome between the treated and control groups, this trial provides no justification for glycerol therapy following acute cerebral hemorrhage. (Stroke 1992;23:967-971) KEY WORDS • cerebral hemorrhage • clinical trials • glycerin

Our prospective study of cerebrovascular disease in Hong Kong confirms a previous clinical impression that stroke in the Chinese has a pattern different from that in Caucasians. We studied 540 patients (aged 20-70 years) with stroke. Computed tomography or autopsy was obtained in 86.1% and showed an increase in the proportion with lacunar infarction, striatocapsular infarction, and parenchyma! hemorrhage relative to the frequencies in Caucasians. This increase in the incidence of cerebral hemorrhage occurs not only in semicomatose and comatose patients but also in alert patients (16.9%) and those with a lacunar syndrome (12.5%). Our findings suggest that cerebrovascular disease in the Chinese selectively affects small vessels, causing lacunes and hemorrhages. In future community studies on stroke prevalence, researchers should be cautious about interpreting similar prevalence rates as reflecting similar risk factors or pathologies. (Stroke 1990^1:230-235)

In an offset printing factory with 56 workers, 20 (36%) developed symptomatic peripheral neuropathy due to exposure to n-hexane. Another 26 workers (46%) were found to have subclinical neuropathy. The initial change in the nerve conduction study was N-hexane, present in many commonly used organic solvents, is known to cause peripheral neuropathy.' Outbreaks have been reported in laminating,2 3 pharmaceutical,4 sandal and shoe making,'9 furniture production'0 and adhesive bandage manufacturing" industries.In the printing industry, n-hexane is used to remove residual colouring agents on the roller and has caused two outbreaks of neuropathy in the past.'2 13 We report our investigation on the clinical, electrophysiological and pathological features of n-hexane neuropathy in a printing factory. ResultsThe factory was situated on a multi-storey building with a floor area of 2000 m2 and a floor height of 4 m. There were 17 offset printing machines placed on two floors.There were no MSDS sheets on substances available in the factory, as the law did not require it. Cleaning solvents, such as, petroleum spirit and white gasoline were stored in large containers. They were used for manual cleaning of ink stains and dirts on rubber roller blankets, ink rollers, ink containers and zinc plates. The word n-hexane, a symbol for harmful substance, and a brief description on general precautions were printed on the container labels but the percentage of n-hexane was not specified. Analysis by gas chromatography revealed that they contained 14-20% nhexane. These solvents and the emusifying oil, kerosene, diesel and solvent blend also contained a variable percentage of toluene but no methyl n-butyl ketone (MBK) or methyl ethyl ketone (MEK). The moistening solutions contained only trace amounts of phosphate at 42 ppm. The printing inks contained 0-68-2 pg/g lead, <0 05-0 95 pg/g mercury and no volatile organic compound.Dilution ventilation was provided by air distribution ducts of air conditioning units. These were recycling units wth limited fresh 538 on 10 May 2018 by guest. Protected by copyright.