Characterization and distribution of cholinesterase activity in mouse uterine horns: changes in estrous cycle

1. Both butyrylcholinesterase (BChE) and acetylcholinesterase (AChE) are present in the mouse uterus, BChE being more abundant. 2. Their molecular forms were sequentially solubilized by different extraction media obtaining three ChE fractions whose specific activity was different, depending on the stage of the estrous cycle: hydrosoluble (estrous: 75.5 +/- 6.6 and diestrous: 47.9 +/- 8.7 mU/mg prot); detergent-soluble or amphiphilic (estrous 26.6 +/- 2.4 and diestrous 14.7 +/- 3.3 mU/mg prot.), and high ionic strength-soluble (estrous: 18.7 +/- 4.2 and diestrous 12.8 +/- 1.2 mU/mg prot.). 3. Histochemical procedures demonstrated a different distribution for both ChE activities. AChE was found in nerves next to smooth muscle cells of the circular layer and blood vessels, while BChE was concentrated in the longitudinal stratum surrounding the smooth muscle cells. Under the predominance of progesterone, BChE was also found in the endometrial glands. 4. Maximal contractions evoked by the addition of ACh to the isolated organ bath were concentration dependent and greater in estrous than in diestrous. Nevertheless the difference at the two stages of the estrous cycle disappeared when contractions were normalized to smooth muscle cross-sectional area. 5. BChE but not AChE inhibition augmented maximal contractions elicited by ACh in longitudinal but not in circular smooth muscle. 6. The effect of BChE inhibition on the contractile force developed was greater at lower concentrations of ACh and did not depend on the stage of the estrous cycle.

Nicotine stimulates adrenergic terminals and inhibits contractions of mouse uterine horns

1. Nicotine (1-100 microM) stimulated both basal and electrically evoked release of 3H-norepinephrine and also caused a transient inhibition of contractions in an in vitro preparation of mouse uterine horns. 2. The inhibitory effect of nicotine on electrically evoked contractions was potentiated by aminophylline (89 micrograms/ml), and overcome by both propranolol (1 microM) and by omitting magnesium from the physiological solution. Acetylcholine (10 microM), in the presence of atropine (10 microM) was able to reproduce the inhibitory effect of nicotine. 3. These pharmacological findings suggest that the inhibitory action of nicotine on electrically evoked contractions in mouse uterus could be indirect, i.e. mediated through the action of this compound on presynaptic nicotine receptors located on adrenergic terminals.

Efficacy of an individualized outpatient program in the treatment of chronic post-traumatic headache

Twenty patients disabled for work because of chronic post-traumatic headaches were treated: 13 men, and seven women. Their ages ranged between 26 and 69 years (mean = 40.3). Their accidents occurred three months to eight years prior to the initial visit (mean = 1.5 yrs). Thirteen patients had concurrent spinal injuries. They were assigned to an individualized program with emphasis on doctor-patient relationship. All patients received medications, biofeedback, and educational sessions. Thirteen patients with concurrent spinal injuries received additionally therapeutic exercises and transcutaneous nerve stimulation. Five patients needed neuromuscular re-education, and three, stress management. All sessions were individualized. Patients attended the Center one to three times a week for three to 12 weeks (average = 9 weeks). The number of treatment days ranged from six to 37 (average = 18.8 days). The average cost of the program for patients with headache alone was $3849.00; and for those with additional spinal injuries, $7030.00. All patients improved: markedly, 14; moderately, four; and slightly, two patients. The improvement occurred within seven to 150 days (average = 48.7 days). Seventeen out of the 20 patients, (85%) returned to work within 21-224 days (average = 111 days). An individualized outpatient program is very successful in the treatment of post-traumatic headache.

Organic headaches mimicking chronic paroxysmal hemicrania

The article describes two women who had headaches that mimicked chronic paroxysmal hemicrania (CPH). The first patient had a collagen vascular disorder; and the second one, a large malignant tumor in the right frontal lobe. The similarity of the headaches of the first patient to CPH included an absolute response to indomethacin. The existence of these cases may lead to a better understanding of the pathophysiology of CPH. At the same time, their existence also calls for caution in the diagnosis of CPH.

Pediatric chest trauma

Blunt and penetrating chest trauma in children results from many causes but the major cause is motor vehicle accidents. The trauma induces a variety of injuries to the bony thorax, the pulmonary parenchyma, and mediastinal structures. In recent years, a disturbing increase in iatrogenic chest trauma has occurred in patients, particularly small infants, receiving intensive hospital care. Radiologic evaluation plays an important role in documenting and diagnosing these traumatic and iatrogenic injuries. The various radiologic manifestations of these injuries are described and discussed.

Cluster headache variant. Spectrum of a new headache syndrome

The syndrome of cluster headache variant is characterized by the occurrence of three combined symptoms: atypical cluster headaches, multiple jabs, and background vascular headaches. Atypical cluster headaches are localized headaches that occur several times daily, usually without any headache-free periods. They differ from the typical chronic cluster headache in their location, duration, frequent shifting, and frequency. Multiple jabs are short-lasting, sharp pains of variable severity and location. Background vascular headache is a chronic, continuous often unilateral headache of variable severity that throbs at rest or begins to throb during exertion. We have studied 54 patients between the ages of 14 and 78 years (average age, 40.5 years). Forty-five (83%) patients responded to indomethacin. Complete control was achieved in 50% of the patients. The nine patients who did not respond to indomethacin were depressed. These nine patients responded well to tricyclic antidepressants.

Cyclical migraine

We have observed 27 migraineurs whose headaches occurred in groups separated by headache-free periods. Twenty-one of the patients were women. The headaches occurred on either side in most patients. The headaches were severe lasting for an average of 25.5 hours, often preceded by scintillating scotomas, and often associated with nausea, vomiting, and photophobia. The attacks occurred in cycles that lasted an average of six weeks. The cycles recurred an average of five times per year; during the cycles, severe migraine occurred several times per week. In many patients, the cycles were often accompanied by a constant, low-grade headaches and depression. Twenty-two patients were treated with lithium carbonate. Complete or partial control of the headaches was achieved in 19 patients.

Lithium carbonate therapy for cluster headache. Changes in number of platelets, and serotonin and histamine levels

Three groups of patients were studied: Group A consisted of 12 patients with cluster headache that was treated with lithium carbonate. Group B consisted of six patients with cluster headache that was managed with other drugs. Group C consisted of five patients with muscle contraction headache who received lithium. Serum lithium levels, platelet count, platelet serotonin levels, and platelet-rich plasma histamine levels were determined before and during therapy. The frequency of the headache and levels of serotonin and histamine tended to follow a parallel course in groups A and B: as the headache frequency dropped, serotonin and histamine levels fell. The stable period was characterized by little change in serotonin and histamine levels. Recurrences of headaches were accompanied by a return of serotonin and histamine to pretreatment levels. The course of cluster headache is related to changes in serotonin and histamine levels. Lithium, by modifying the headache course, changes serotonin and histamine levels.

Syndrome of agitated delirium and visual impairment: a manifestation of medial temporo-occipital infarction

Three patients presented with sudden visual impairment followed by agitated delirium one to three days later. Examination revealed marked agitation, dementia, and loss of vision. Computerised axial tomography demonstrated temporo-occipital infarctions. All recovered from the agitated state in four days to two months, but their visual impairment and dementia persisted one to four years later.

The clinical link between migraine and cluster headaches

We describe seven patients with vascular headaches. Five of them had cluster headaches, which were preceded by migrainous scotamata (two patients), weakness contralateral to the pain (one), accompanied by ipsilateral photopsias (one), or by contralateral paresthesias (one). The other two patients had "clusters" of daily common migraine headaches separated by long free intervals. The symptoms of these patients suggest a common root for cluster and migraine headaches.

Localized myokymia caused by peripheral nerve injury

One year after a gunshot wound in the popliteal fossa, a 30-year-old man began to experience cramps and myokymia in the left gastrocnemius muscle. Myokymia was characterized by vermicular fibrillary movements localized to the gastrocnemius muscle and accompanied by plantarflexion and dorsiflexion of the toes. Neurologic examination, nerve conduction velocities, electromyograms, and muscle biopsy findings showed affection of left common peroneal and posterior tibial nerves. The myokymia disappeared during sleep, spinal anesthesia, and treatment with carbamazepine.