Contribution of perceptual motor dysfunction to construction and tracing disturbances in Parkinson's disease

Patients with Parkinson's disease and controls traced patterns of increasing complexity presented on a vertical transparent screen. Some patterns were presented with missing segments which subjects were required to fill in. Digitising equipment quantitated movements for computer analysis. Subjects also completed a brief test of general intellectual function, a construction test and an assessment for depression, and the severity of patients' Parkinsonian signs and symptoms was rated. Patients performed more poorly than controls on complete patterns, and their errors increased more sharply than controls on patterns with missing segments. Patients' errors, but not those of controls, in filling in missing segments were uniquely related to performance on construction tasks. Other aspects of patients' tracing performance correlated with the severity of their Parkinsonian symptoms. These findings suggest that there is an underlying perceptual motor deficit in Parkinson's disease that affects performance on both tracing and construction tasks.

Free microvascular transfer of second toe ray and serratus anterior muscle for management of thumb loss at the carpometacarpal joint level

A 50-year-old machine operator suffered traumatic amputation of the thumb, ring, and small fingers. The thumb had been amputated at the carpometacarpal joint and was reconstructed 6 months later by microneurovascular transplantation of the second toe including the second metatarsal. Opposition was provided and the first web space was released at a second stage by reconstruction with the lowest two digitations of the serratus anterior muscle covered with a split-thickness skin graft.

Platelet alpha 2-adrenergic receptors in schizophrenic patients before and after phenothiazine treatment

The specific binding to isolated platelet membranes of 3H-clonidine, an alpha 2-adrenergic receptor partial agonist, and 3H-yohimbine, an alpha 2-adrenergic receptor antagonist, was measured in male, drug-free schizophrenic patients. The maximum number of binding sites (Bmax) for 3H-yohimbine was significantly lower in these patients than in normal subjects. Treatment with chlorpromazine (CPZ) for 2 weeks further decreased the Bmax for both ligands. Plasma catecholamine levels were determined before and after treatment. Before treatment, levels of dopamine and norepinephrine (NE) were within a normal range, while epinephrine (E) levels were significantly elevated. CPZ treatment significantly increased plasma NE levels, but decreased E levels to a normal range. These observations suggest that schizophrenia might be associated with abnormal noradrenergic function that is reflected by a decreased number of platelet alpha 2-adrenergic receptors.

Evidence for differentiation of right hemisphere visual-perceptual functions

Performance on tasks sensitive to right hemisphere dysfunction (facial discrimination and perceptual closure) are reported in eight patients with right hemisphere lesions. Patients demonstrated an apparent double dissociation of performance on the two measures. Site-by-task specificity for the closure task was strongly suggested. Implications for right hemisphere organization and underlying psychological processes are considered.

Temperature-sensitive mutants of Mycoplasma gallisepticum

Mycoplasma gallisepticum (MG) S6 strain was treated with nitrosoguanidine to obtain temperature-sensitive mutants. Of the 101 colonies screened, 4 were found to be temperature sensitive. These mutants and the wild type organisms were serologically and morphologically identical. Three of the 4 mutants failed to produce air sac lesions when inoculated directly into air sacs of the chicken.

Mimicking the alloantigenicity of proteins with chemically synthesized peptides differing in single amino acids

Recent studies have shown that short chemically synthesized peptides very often induce antibodies which react with the cognate sequence in the intact folded protein. Since such antibodies react with known regions of proteins, they are of predetermined specificity and offer a precision not previously possible with immunological probes. A basic concept emerging from the use of such antibodies in viral systems is that the differential immunogenicity of closely related proteins can be mimicked by short peptides which span the regions of sequence variation. To generalize this concept, we have studied the two Thy-1 proteins which vary by only a single amino acid. Chemically synthesized peptides differing in only one out of 19 amino acids were able to induce allospecific antisera. Thus, single amino acid changes have similar effects on the immunogenicity of proteins and small peptides, even though the latter are free from constraints provided by neighbouring structures in the tertiary configuration of the intact folded proteins.

Is "subcortical dementia" a recognizable clinical entity?

The concept of "subcortical dementia" is controversial, lacking clinical validation and having only a questionable pathological basis. Over 100 patients with Alzheimer's, Parkinson's or Huntington's disease, subdivided into three functional disability stages, were given a brief quantitative neuropsychological assessment. Patients with Huntington's or Parkinson's disease were less intellectually impaired than those with Alzheimer's disease at each functional stage. Criteria for dementia were present in all of the Alzheimer's patients but in only half of the Huntington's and Parkinson's disease groups. Patients with similar overall intellectual function scores had no distinct pattern of neuropsychological test performance. Depression, absent in patients with Alzheimer's disease, was present in half the patients with Huntington's and Parkinson's disease and was correlated with intellectual decline. The concept of subcortical dementia is misleading. The pattern of neuropsychological impairment is not distinct, and the neuropathological basis of dementia in these diseases may result from a combination of cortical and subcortical degeneration.

The tensile strength of the anterior talofibular ligament

Cadaveric anterior talofibular ligaments, with their associated bone attachments, were tensile tested to destruction. The ligament ruptured by either bone avulsion from the talus or midsubstance failure. The values of tensile strength varied from 58 to 556 newtons with a mean strength of 206 newtons.

Perceptual motor dysfunction in Parkinson's disease: a deficit in sequential and predictive voluntary movement

We studied the ability of Parkinsonian patients and controls to generate voluntary movements on a tracing task. Subjects were videotaped while tracing designs of increasing complexity, presented on a vertical, transparent screen. Some designs were presented in a degraded form and subjects filled in their missing sections. Subjects also received a constructional task and a test of general intellectual ability. The quality of errors on the tracing task differed in the Parkinsonian and control groups. Parkinsonian patients made two distinct types of errors. One probably related to the motor disorders of the disease, but another seemed to be related to a higher level of control over sequential and predictive movements. The latter correlated with performance on the constructional and general intellectual tasks. These results suggest that Parkinson's disease may affect basal ganglia structures that are necessary for voluntary movements which require sequencing or planning. Clinically this may be observed in perceptual motor tasks since they require both voluntary movement and sequential organisation of behaviour.

Polymer-membrane electrode-based potentiometric sensing of ammonia and carbon dioxide in physiological fluids

Several new electrochemical devices designed for detecting ammonia and carbon dioxide in physiological samples have in common the elimination of the fragile glass pH internal electrode used in the conventional Severinghaus-design potentiometric gas sensors. In one new approach, the pH glass electrode can be replaced with a neutral carrier-based polymer-membrane pH electrode. Alternatively, to improve response characteristics and selectivity, we have used ion-selective polymer membranes responsive to ammonium and carbonate as internal sensing elements in conjunction with appropriate internal buffer reagents. The use of inner polymer membranes rather than glass membranes enables the fabrication of essentially disposable devices having rapid response times. In addition, we have constructed automated continuous-flow NH3- and CO2-sensing systems involving novel tubular forms of the polymer-membrane electrodes and a simple flow-through gas dialysis arrangement. The polymer electrode-based systems described offer many unique and practical advantages over existing gas-sensing units.

Polymer-membrane electrode-based potentiometric sensing of ammonia and carbon dioxide in physiological fluids

Several new electrochemical devices designed for detecting ammonia and carbon dioxide in physiological samples have in common the elimination of the fragile glass pH internal electrode used in the conventional Severinghaus-design potentiometric gas sensors. In one new approach, the pH glass electrode can be replaced with a neutral carrier-based polymer-membrane pH electrode. Alternatively, to improve response characteristics and selectivity, we have used ion-selective polymer membranes responsive to ammonium and carbonate as internal sensing elements in conjunction with appropriate internal buffer reagents. The use of inner polymer membranes rather than glass membranes enables the fabrication of essentially disposable devices having rapid response times. In addition, we have constructed automated continuous-flow NH3- and CO2-sensing systems involving novel tubular forms of the polymer-membrane electrodes and a simple flow-through gas dialysis arrangement. The polymer electrode-based systems described offer many unique and practical advantages over existing gas-sensing units.

"Tip-of-the-tongue" phenomenon in Parkinson disease

Articulatory disturbances are frequently described in Parkinson disease, but language disorders are not. We have occasionally encountered parkinsonian patients with word-finding difficulty unrelated to memory loss, intellectual impairment, or dysarthria. To examine this, 22 medically stable parkinsonian patients were given the vocabulary subtest of the WAIS, the Boston Naming Test, measures of verbal fluency, and sentence repetition. Signs and symptoms of parkinsonism were rated. WAIS vocabulary subtest scores were above the mean for normal aged subjects, but confrontation naming was one standard deviation below norms for age and education. Naming was facilitated by cues in most patients. Only sentence repetition correlated with dysarthria. Category naming was impaired and correlated significantly with the severity of parkinsonism, especially bradykinesia. This suggests that a type of anomia may occur in Parkinson disease. it shares the clinical characteristics of the "tip-of-the-tongue" phenomenon and "word production anomia" seen in some aphasics.

Depression, intellectual impairment, and Parkinson disease

To determine the prevalence of depression in Parkinson disease (PD) we evaluated 55 consecutive patients without dementia and 31 of their spouses. All subjects completed the Beck depression inventory and a quantitative mini-mental state examination. Using the Beck criteria, 47% of the patients and 12% of the spouses rated themselves as significantly depressed. Mental state scores were significantly lower in the patients. There was a correlation between the severity of depression and cognitive impairment, particularly for calculation, digit span, and visuomotor skills. The severity of parkinsonism, particularly bradykinesia, also paralleled cognition. There was a slight but significant relationship between parkinsonism and depression. These results confirm the high incidence of depression in PD, and suggest that depression in Parkinson patients may be accompanied by mild intellectual impairment and inattention which is independent of the severity of the illness.

Role of RNA transcripts in replication incompatibility and copy number control in antibiotic resistance plasmid derivatives

The genes required for autonomous replication and incompatibility in the antibiotic resistance plasmids R100 and R1 have been located within a 2.5-kilobase region of the 90-kilobase genome, within which the incompatibility gene occupies a 1.3-kilobase region excluding the replication origin. We now report that three RNA species are synthesized in vitro from the 2.5-kilobase region, which R100 and R1 have in common. One, a long RNA molecule which is transcribed in the direction of DNA replication, probably acts as a messenger or a protein required for plasmid replication. The second RNA species, only 91 nucleotides long, is transcribed in the opposite direction, from a region of the DNA entirely contained within the first and known to specify incompatibility and copy control functions. The third RNA species, 150 bases long, is transcribed from a region including the replication origin; it may be a primer of DNA synthesis or, in conjunction with the second of the three RNA species, an influence in the control of replication.

Genes and sites involved in replication and incompatibility of an R100 plasmid derivative based on nucleotide sequence analysis

The nucleotide sequence of the entire region required for autonomous replication and incompatibility of an R100 plasmid derivative, pSM1, has been determined. This region includes the replication region and all plasmid encoded information required for replication. Numerous reading frames for possible proteins can be found in this region. The existence of one of these proteins called RepA1 (285 amino acids; 33,000 daltons) which is encoded within the region known by cloning analysis to be required for replication is supported by several lines of evidence. These include an examination of the characteristic sequences on the proximal and distal ends of the coding region, a comparison of the sequence of the replication regions of pSM1 and the highly related R1 plasmid derivative Rsc13 as well as other biochemical and genetic evidence. The existence of two other proteins, RepA3 (64 amino acis; 7000 daltons) and RepA2 (103 amino acids; 11,400 daltons) is also consistent with most of the criteria mentioned above. However, the region encoding RepA3, which by cloning analysis is within the region responsible for both replication and incompatibility, has never been demonstrated to produce a 7,000 dalton polypeptide. Since a large secondary structure can be constructed in this region, it is possible that the region contains structure or other information that is responsible for incompatibility. RepA2, encoded entirely within the region identified by cloning analysis to be responsible for incompatibility but not for replication can be visualized in vivo and in vitro. However, the nucleotide sequence of the region encoding RepA2 is completely different in mutually incompatible plasmid derivatives of R1 and R100. It is therefore unlikely that RepA2 plays a major role in incompatibility. Thus, we predict that RepA2 is required to initiate DNA synthesis at the replication origin and that the region proximal to RepA2 either encodes a gene product or structure information that is responsible for incompatibility.

Effect of route on inoculation on host resistance to Nocardia

Virulent strains of Nocardia asteroides and Nocardia caviae were injected into mice by five different routes. When these organisms were grown to the same stage of growth in the same medium and otherwise prepared identically, it was found that they differed significantly in their ability to infect and kill the host, depending entirely upon the route of inoculation. Thus, N. caviae 112 was 30 times more virulent than N. asteroides GUH-2 when administered intranasally, whereas N. asteroides was at least 10 times more pathogenic than N. caviae when injected intravenously. They had similar degrees of virulence when given intraperitoneally. N. asteroides GUH-2 induced a more persistent and progressive infection than N. caviae 112 when injected into the footpads of mice; however, the latter strain was more lethal for the animals when given by this route. Different routes of infecting mice indicate a compartmentalization of the host response to different strains of nocardia. Therefore, the use of different strains of nocardia under carefully controlled and defined conditions should make it possible to dissect the nocardia-host interactions at the cellular levels.

Interictal memory and language impairment in temporal lobe epilepsy

Memory and language were evaluated in patients with temporal lobe epilepsy and generalized epilepsy. Subjects were matched for age, duration of illness, and seizure frequency, and grouped according to the electroencephalographic results and seizure type into right temporal, left temporal, and generalized. In formal tests of intelligence, auditory and visual memory, and language, a significant difference was noted only on a confrontation naming test. The mean score on this test was considerably lower in the left temporal group; right temporal and generalized groups scored in the normal range. This correlated with impairment on many verbal subtests of intelligence and memory. These results suggest that the interictal memory impairment of temporal lobe epilepsy may be an anomia and that the anomia may contribute to impairment of verbal learning and memory; both circumlocution and circumstantiality may compensate for anomia.

Poriomania

Three patients with complex partial seizures experienced prolonged episodes of aimless wandering followed by retrograde amnesia for the experience, a phenomenon called poriomania. Our experience and the literature suggest that this behavior is a prolonged postictal automatism and is not psychogenic. Adjustments of anticonvulsant therapy eliminated this behavior in all three of our patients.

Hemispheric asymmetry of pentamethylenetetrazol-induced wave-spike discharges and motor imbalance in rats

An intrinsic asymmetry of nigrostriatal dopamine system postulated to be responsible for motor imbalance in normal rats (Glick et al., 1976) is believed to create asymmetry of arousal-sensitive wave-spike discharges. In the present study, bilaterally recorded pentamethylenetetrazol (PMZ)-activated wave-spike discharges were correlated with circling behavior in intact rats. Thirteen naive rats (10 male, 3 female) were implanted with electrodes symmetrically placed over the visual cortices, and their rotation directionality was assessed in the rotometer subsequent to administration of d-methamphetamine sul-ate, 1.5 mg/kg, i.p. In 9 rats a PMZ injection, 20 mg/kg, i.p., revealed asymmetric wave-spike bursts. All of them reliably rotated in the dirction opposite to the hemisphere with lower amplitude wave-spike discharges. It is believed that the nigrostriatal dopamine system plays a major role in modulating the asymmetry of wave-spike seizures. The findings are discussed as they relate to asymmetric generalized wave-spike dischanges found in certain petit mal patients.

The nucleotide sequence of the region surrounding the replication origin of an R100 resistance factor derivative

The replication origin of a group of small plasmids derived from R100 was previously determined by electron microscopy (Ohtsubo et al., 1977). This region was subjected to extensive restriction enzyme analysis and the nucleotide sequence of the region containing the replication origin was determined using the Maxam and Gilbert sequencing technique. Various characteristics of this sequence, including a very interesting secondary structure are described and discussed.

Effects of one-stage and serial ablations of the middle third of sulcus principalis on delayed alternation performance in monkeys

Recovery of a spatial delayed alternation habit following partial frontal lesions was investigated in mature rhesus monkeys. All animals subjected to serial ablation of the middle third of sulcus principalis were found to be capable of reacquiring preoperative levels of performance on the task. However, one-stage removal of the mid-principalis region resulted in both more severe and more protracted impairments than were evident after serial surgery. These results in conjunction with previous findings suggest that recovery following serially induced neurological insult may be dependent upon the integrity of neural tissue adjacent to the locus of injury.

Scleral perforation. A complication of the soft contact lens

A large area of conjunctiva and a smaller area of full thickness sclera eroded immediately adjacent to the edge of a soft contact lens. The soft lens was worn to protect the epithelium of a corneal graft in an alkali-burned eye. The conjunctiva-sclera necrosis appears to be a complication of a distorted and tightly fitting lens.

Association of cleft lip and atrial septal defect in mice: a preliminary report

Newborn A/J and CL/Fr mice with congenital cleft lip usually have an atrial septal defect of the secundum type, often associated with cyanosis. Their littermates without cleft lip rarely have a septal defect. The atrial septal defect results from a delay in growth of the atrial septum primum.

Role of visual acuity in tachistoscopic recognition of three-letter words

It has been suggested that a correlation between word recognition and visual acuity would constitute a confounding influence in word-recognition studies within a laterality paradigm. 20 Ss made binary judgments concerning the presence or absence of a spatial gap in a tachistoscopically presented line target positioned at .75°, 1.5°, 3.0°, and 6.0° in either visual field. Gap detection was superior in the right visual field ( p = .02) at the 6.0° position. Word recognition was determined for tachistoscopically presented three-letter words positioned along a 6.0° vertical meridian in either visual field. Visual acuity performance was not related to word recognition either for the group or for individual Ss. The data therefore do not encourage the view that normal variations in acuity significantly affect word recognition in laterality studies.

Recovery of function after serial ablation of prefrontal cortex in the rhesus monkey

Rhesus monkeys with one-stage or serial ablation of sulcus principalis (prefrontal association cortex) were compared on three spatial tasks. On all tests, the serial monkeys made fewer errors than did the monkeys with onestage lesions. These results indicate that partial recovery of function can occur after extensive destruction of association cortex in the mature primate brain if the damage is distributed over a number of operations.