Projections of the dorsolateral anterior complex and adjacent thalamic nuclei upon the visual Wulst in the pigeon

The distinctive patterns of thalamic input to the rostral (R), intermediate (I) and caudal (C) divisions of the pigeon Wulst were determined using the retrograde multiple label technique following concomitant injections of various fluorescent tracers into different Wulst loci. The results showed topographical projections from components of the visual thalamic n. dorsolateralis anterior complex. Major ipsilateral and contralateral projections upon the R and I Wulst stem from the pars lateralis ventralis and dorsalis nuclei, respectively. The nuclei pars lateralis rostralis, pars magnocellularis and n. suprarotundus provide weak bilateral projections to all of the Wulst divisions sampled. Lastly, bilateral connections from the n. superficialis parvocellularis upon I and C, and from n. dorsolateralis posterior upon the posterior C Wulst were also demonstrated. Based upon their patterns of terminal distribution upon the Wulst, some of these thalamic nuclei are compared to specific components of the mammalian geniculate and extrageniculate visual systems.

The evolution of a unit for the cognitively impaired elderly

The MDE unit has filled a significant gap in the care of the psychogeriatric patient. Prior to its existence, the aggressive demented patient was generally managed by physical or chemical restraints. As community needs increase and require changes in the type of institutional care provided, the program will continue to respond with adaptive programs and expanded staff expertise. In the future the program may play a larger role. Due to gaps in the health care system, this type of program may have to admit more psychogeriatric patients. Also, this unique patient population could provide material for scientific research on dementia and its treatment. The MDE program depends not only on physicians and medications but also on a dedicated interdisciplinary team to manage this interesting and exceptional population.

Scintigraphic evaluation of renal function after extracorporeal shock-wave lithotripsy

We evaluated renal function within 48 hours after extracorporeal shock-wave lithotripsy (ESWL) as well as 1 month and up to 6 months later employing technetium-99m dimercaptosuccinic acid and iodine-131-labelled ortho-iodohippurate. All 17 patients displayed abnormal renal function immediately after ESWL. The abnormalities identified included focal cortical lesions, diffuse reduction of renal function, increased kidney volume, and diffusely and focally increased parenchymal transit times. The follow-up scintigraphic studies indicated that the great majority of the lesions had been temporary.

Fate of alpha-1,4-glucosidases and cathepsin D in the rat epididymis after vasectomy

Short-term vasectomy was studied in adult male rats in order to ascertain whether cytosolic or lysosomal hydrolases were differently affected 100 days after vas ligation. The secretory form of alpha-1,4-glucosidase remained unchanged while the lysosomal form of the enzyme and also cathepsin D increased in the cytosol of both caput and cauda epididymis. This set of data demonstrates for the first time that a triggering mechanism which stimulates lysosomal activity is present all along the rat epididymis. Disposal of the continuous influx of spermatozoa from the testis could therefore require both an active and a passive process.

Acute effect of protein or carbohydrate breakfasts on human cerebrospinal fluid monoamine precursor and metabolite levels

Patients with normal pressure hydrocephalus who had three lumbar punctures during 1 week ingested either water, a protein breakfast, or a carbohydrate breakfast 2.5 h before each of the lumbar punctures. The CSF was analyzed for biogenic amine precursors and metabolites. The protein meal raised CSF tyrosine levels, a finding consistent with animal data, but did not alter those of tryptophan or any of the biogenic amine metabolites. The carbohydrate meal increased CSF 3-methoxy-4-hydroxyphenylethylene glycol, an unexplained finding. The carbohydrate meal did not affect CSF tryptophan, tyrosine, 5-hydroxyindoleacetic acid, or homovanillic acid. Our results support the idea that in humans protein or carbohydrate meals do not alter plasma amino acid levels sufficiently to cause appreciable changes in CNS tryptophan levels or 5-hydroxytryptamine synthesis.

A reproducible radionuclide procedure for measurement of cerebrospinal fluid shunt flow

A radionuclide technique was developed to obtain reproducible measurements of cerebrospinal fluid flow in Rickham-Holter type shunt systems. In attempting to reproduce previously described radionuclide procedures, we found that different flow rate measurements can be obtained simply by changing the radiotracer injection technique or the method of analysis of the time activity curves which are generated. The importance of these technical pitfalls cannot be over-emphasized, since there is no gold standard to evaluate cerebrospinal fluid flow in vivo. An experimental model with a calibrated Harvard pump and a shunt system filled with normal saline was constructed. Aliquots of 500 microCi of pertechnetate in 0.05 ml of saline were injected serially into the center of Rickham reservoir using a size 28 needle. Time-activity curves were obtained after waiting five min to reach equilibrium, and standard curves of radiotracer clearance vs actual flow for each system used clinically in our institution were generated. In addition, a technique to quantify and thus correct for the small but significant leak of radiotracer which occurs at the site of injection in the reservoir is described. Excellent correlation was obtained between our results and the clinical and radiological findings in a preliminary clinical evaluation.

Neuropathy and mitochondrial myopathy

It has been stated that peripheral neuropathy can be a feature of so-called ophthalmoplegia-plus syndrome, but to date only one case of hypertrophic neuropathy has been reported. This study is concerned with the clinical, electrophysiological, and pathological observations in a 37-year-old man with progressive external ophthalmoplegia and a ragged-red fiber myopathy associated with severe sensorimotor neuropathy. Histological and morphometric studies of the sural nerve revealed a marked loss of large myelinated fibers and an occasional degenerating axon. Residual fibers had disproportionately thin myelin sheaths in relation to axon calibers. In contrast to the muscle biopsy findings, no mitochondrial paracrystalline inclusions were observed in the nerve. However, the number of mitochondria per square micron of Schwann cell cytoplasm was elevated when compared with values obtained from normal subjects and a patient with a chronic neuropathy. These findings may indicate an alteration of mitochondrial function common to muscle fibers and Schwann cells which, in nerves, could lead to axon loss and abnormality of myelination.

Sensory neuropathy associated with primary biliary cirrhosis. Histologic and morphometric studies

Sensory symptoms can develop in the course of primary biliary cirrhosis. They have been attributed to xanthomatous infiltrates of the nerves. We report a case of a young woman suffering from pure sensory neuropathy starting at a time when evidence of liver disease was minimal. Histologic and morphometric studies of sural nerve biopsy specimens obtained from calf and ankle showed a dying-back type of axonal degeneration predominantly affecting large myelinated fibers. No lipid-containing cells were seen, which raises the possibility that other mechanisms related to primary biliary cirrhosis are involved in the pathogenesis of the neuropathy.

Parkinsonism--dementia complex, hydrocephalus and Paget's disease

A 65-year-old female patient with Paget's disease displayed dementia, a bilateral Parkinsonian syndrome, gait ataxia, bilateral grasp reflex of the feet, urinary incontinence and a left hemicerebellar syndrome. She had a marked basilar impression; the radionuclide cisternogram was suggestive of a communicating hydrocephalus with ventricular dilatation. After a shunting procedure there was improvement in both neurological and mental function.