Structure-activity analysis suggests an olfactory function for the unique antennal delta glutathione transferase of Apis mellifera

Glutathione transferases (GST) are detoxification enzymes that conjugate glutathione to a wide array of molecules. In the honey bee Apis mellifera, AmGSTD1 is the sole member of the delta class of GSTs, with expression in antennae. Here, we structurally and biochemically characterized AmGSTD1 to elucidate its function. We showed that AmGSTD1 can efficiently catalyse the glutathione conjugation of classical GST substrates. Additionally, AmGSTD1 exhibits binding properties with a range of odorant compounds. AmGSTD1 has a peculiar interface with a structural motif we propose to call 'sulfur sandwich'. This motif consists of a cysteine disulfide bridge sandwiched between the sulfur atoms of two methionine residues and is stabilized by CH…S hydrogen bonds and S…S sigma-hole interactions. Thermal stability studies confirmed that this motif is important for AmGSTD1 stability and, thus, could facilitate its functions in olfaction.

Role of Insect and Mammal Glutathione Transferases in Chemoperception

Glutathione transferases (GSTs) are ubiquitous key enzymes with different activities as transferases or isomerases. As key detoxifying enzymes, GSTs are expressed in the chemosensory organs. They fulfill an essential protective role because the chemosensory organs are located in the main entry paths of exogenous compounds within the body. In addition to this protective function, they modulate the perception process by metabolizing exogenous molecules, including tastants and odorants. Chemosensory detection involves the interaction of chemosensory molecules with receptors. GST contributes to signal termination by metabolizing these molecules. By reducing the concentration of chemosensory molecules before receptor binding, GST modulates receptor activation and, therefore, the perception of these molecules. The balance of chemoperception by GSTs has been shown in insects as well as in mammals, although their chemosensory systems are not evolutionarily connected. This review will provide knowledge supporting the involvement of GSTs in chemoperception, describing their localization in these systems as well as their enzymatic capacity toward odorants, sapid molecules, and pheromones in insects and mammals. Their different roles in chemosensory organs will be discussed in light of the evolutionary advantage of the coupling of the detoxification system and chemosensory system through GSTs.

The role of congenital malformations of the thoracic egress in the development of the syndrome

Thoracic Outlet Syndrome (TOS) represents a clinical condition caused by compression of the neurovascular structures that cross the thoracic outlet. TOS can be classified in: 1) NTOS (neurogenic TOS), 2) VTOS (venous TOS), 3) ATOS (arterial TOS). Many different causes can determine the Syndrome: Congenital Malformations, Traumas, and Functional Impairments. This manuscript reviews how the congenital malformations play an important role in adult age; however, TOS also affects patients of all ages. Radiological imaging like RX (radiography), MR (Magnetic Resonance) and CT (Computed Tomography) can provide useful information to assess TOS causes and decide a potential surgery.79% of the patientsincluded in the first two stages of NAV staging experienced excellent results with FKT; whereas patients included in the third and fourth stage of NAV staging were subject to surgery.The treatment of acute forms of TOS involves thrombolysis and anticoagulant therapy; surgery is appropriate for true neurogenic TOS, vascular TOS and in some cases when conservative treatment fails.

Arthrogenic human synovial cysts: immunohistochemical profile of interleukin-1beta, interleukin-6, tumour necrosis factor-alpha

BACKGROUND

Synovial cysts are currently classified as degenerative lesions affecting the joint capsule or adjacent structures.

MATERIALS AND METHODS

In our study we describe the results obtained in an immunohistochemical study comprising 18 patients with synovial cysts, performed to evaluate the pathophysiological role of some inflammatory cytokines such as: interleukin (IL)-1β, IL-6 and tumour necrosis factor-alpha (TNF-α).

RESULTS

Results showed an over-expression of TNF-α, IL-1β and IL-6 which appears to be involved in the onset and progression of the disease. At the present time it is not possible to affirm that these molecules play a direct role also due to the absence of further and more specific investigations. The authors therefore hypothesize that inhibition of inflammation may have a significant role in the pathogenesis and regression of synovial cysts.

CONCLUSIONS

Hence, these inflammatory cytokines may be considered potential therapeutic targets. The development of synthetic inhibitors of these inflammatory factors could lead to a reduction in the intensity of inflammation, thus inhibiting the onset and development of the disease.

Molecular evidence for multiple introductions of the banded grove snail (Cepaea nemoralis) in North America

Global identification and monitoring programs for invasive species aim to reduce imminent impacts to biodiversity, ecosystem services, agriculture, and human health. This study employs a 658 base pair fragment of the cytochrome c oxidase subunit I (COI) gene to identify and categorize clades of the banded grove snail (Cepaea nemoralis (Linnaeus, 1758)) from native (European) and introduced (North American) ranges using a maximum-likelihood phylogeny and haplotype networks. This work corroborates the existence of eight clades within C. nemoralis and further identified three clades that were common to both Europe and North America (A, D, O). Clades A and D were found in eastern Canada, Ontario (Canada), and British Columbia (Canada), whereas clade O was restricted to Ontario, possibly introduced from Poland or central Europe. Haplotype networks suggest clade A was introduced from northern Europe, whereas clade D was introduced from western and central Europe. Networks contained many private haplotypes and a lack of haplotype sharing, suggesting strong genetic structure in this system, possibly resulting from reduced dispersal in this species. This study describes the contemporary distribution of C. nemoralis in Canada and demonstrates the efficacy of DNA barcoding for monitoring the spread of invasive species, warranting its widespread adoption in management policies.

Difficult diagnosis of atypical kawasaki disease in an infant younger than six months: a case report

Background

Kawasaki disease (KD) is an acute inflammatory vasculitis of unknown origin.

Case presentation

We report the case of a 5-month-old child with an atypical form of KD, characterized by undulating symptoms, who developed an aneurysm of the right coronary artery and an ectasia of the left anterior descending coronary artery.

Conclusion

This case report underlines the difficulties in recognizing incomplete forms of the illness in young infants, who are at higher risk of cardiac complications.

Photochromic Torsional Switch (PTS): a light-driven actuator for the dynamic tuning of π-conjugation extension

The conjugation of a bithiophene was reversibly modulated over several cycles through the isomerization of an azobenzene.

Here we present a molecular architecture that can reversibly change the geometric conformation of its π-system backbone via irradiation with two different wavelengths. The proposed ‘molecular actuator’ consists of a photoswitchable azobenzene orthogonally connected to a π-conjugated bithiophene by both direct and aliphatic linker-assisted bonding. Upon exposure to 350 nm light, the trans azobenzene moiety isomerizes to its cis form, causing the bithiophene to assume a semiplanar anti conformation (extended π-conjugation). Exposure to 254 nm light promotes the isomerization of the azobenzene unit back to its initial extended trans conformation, thus forcing the bithiophene fragment to twist out of coplanarity (restricted π-conjugation). The molecular conformation of the bithiophene was characterized using steady-state UV-vis and nuclear magnetic resonance spectroscopy, as well as ab initio computations. The proposed molecular design could be envisaged as a π-conjugation modulator, which has potential to be incorporated into extended linear π-systems, i.e. via the terminal α-thiophene positions, and used to tune their optical and electronic properties.

Rapid spread of the novel respiratory syncytial virus A ON1 genotype, central Italy, 2011 to 2013

Respiratory infections positive for human respiratory syncytial virus (RSV) subtype A were characterised in children admitted to hospitals in Rome and Ancona (Italy) over the last three epidemic seasons. Different strains of the novel RSV-A genotype ON1, first identified in Ontario (Canada) in December 2010, were detected for the first time in Italy in the following 2011/12 epidemic season. They bear an insertion of 24 amino acids in the G glycoprotein as well as amino acid changes likely to change antigenicity. By early 2013, ON1 strains had spread so efficiently that they had nearly replaced other RSV-A strains. Notably, the RSV peak in the 2012/13 epidemic season occurred earlier and, compared with the previous two seasons, influenza-like illnesses diagnoses were more frequent in younger children; bronchiolitis cases had a less severe clinical course. Nonetheless, the ON1-associated intensive care unit admission rate was similar, if not greater, than that attributable to other RSV-A strains. Improving RSV surveillance would allow timely understanding of the epidemiological and clinicopathological features of the novel RSV-A genotype.

Viral bronchiolitis in children: a common condition with few therapeutic options

Even though bronchiolitis is a disease that has been recognized for many years, there are still few therapeutic strategies beyond supportive therapies. Bronchiolitis is the most frequent cause of hospital admission in children less than 1 year of age. The incidence is estimated to be about 150° million cases a year worldwide, and 2-3% of these cases require hospitalization. It is acknowledged that viruses cause bronchiolitis, but most of the studies focus on RSV. The RSV causes a more severe form of bronchiolitis in children with risk factors including prematurity, cardiovascular disease and immunodeficiency. Other viruses involved in causing bronchiolitis include RV, hMPV, hBoV and co-infections. The RV seems to be associated with a less severe acute disease, but there is a correlation between the early infection and subsequent wheezing bronchitis and asthma in later childhood and adulthood. The supportive therapies used are intravenous fluids and oxygen supplement administered by nasal cannula or CPAP in most complicated patients. Additional pharmacological therapies include epinephrine, 3% hypertonic saline and corticosteroids. The Epinephrine seems to have the greatest short-term benefits and reduces the need of hospital admission, whereas hypertonic saline and corticosteroids seem to reduce the length of hospital stay. As bronchiolitis is such a prevalent disease in children and RV seems to play an important role, perhaps more studies should center around the RV's contribution to the initial disease and following pathology.

Measurement of Interrupter Respiratory Resistance and Spirometry in Preschool Children: Influence of Respiratory Symptoms

Pulmonary function tests play an important role in the diagnosis and management of respiratory diseases in children. The purpose of the study was to evaluate lung function using the interrupter resistance technique (Rint) and spirometry (flow-volume and volume-time) in preschool children and to correlate the findings with respiratory symptoms. We studied 103 children (65 males, 38 females; mean age 5.2±0.7 years; range 3.6–5.8). For each child we collected family history concerning: respiratory diseases, skin prick tests, smoking during maternal pregnancy, history of gestational and neonatal period. All children performed lung function tests (Rint and spirometry) and skin prick test for inhalant and food allergens. Twenty-eight subjects (27.2%) had respiratory symptoms (RS). Expiratory Rint were performed in all subjects and spirometry was carried out on 76 children (73.8%). Spirometric indices were not statistically different between subjects without respiratory symptoms (controls) and RS children except for FEF25–75 expressed as a percentage of the predicted value (RS: 81.5±13.7% vs controls: 94.5±15.8%; p <0.001). Rint mean values were significantly higher in RS children than in controls (RS: 135.6 ±24.8% vs controls: 102.4 ±21.7%; p< 0.0001). We found a statistically negative correlation between Rint and the following Spirometric indices: FEV0.5 (R= −0.696; p < 0.0001), FEV, (R= − 0.728; p < 0.0001) and FEF25–75 (R= −0.681; p < 0.0001). In preschool children with respiratory disease we found significantly higher mean values of Rint and lower FEF25-75 than in the control group and a significant negative relationship between Rint and Spirometric indices.

Seasonally contrasting life-history strategies in the land snail Cornu aspersum: physiological and ecological implications

When a life history is characterized by both seasonality in reproduction and seasonality in offspring fitness, trade-offs in reproductive traits might be adjustments to seasonal time constraints to optimize reproductive success. Therefore, we compared in the laboratory the trade-offs in reproductive traits between early (after maturity) and delayed (after dormancy) reproduction in young land snails Cornu aspersum (Müller, 1774) (syn. Helix aspersa ), depending on food energy content. We also investigated the maternal investment in reproductive output in both breeding periods. After attaining maturity, snails produced single clutches with many small eggs, which resulted, in contrast to previous studies, in large offspring with a low hatching rate owing to high within-clutch cannibalism. The young cannibals may have a higher survival probability in the following hibernation. Snails starting to reproduce after hibernation had smaller clutches of larger eggs, resulting in high quantity of lighter offspring. The clutch mass was positively correlated with maternal mass in snails reproducing after having attained maturity and negatively correlated in snails reproducing after hibernation. Multiple oviposition occurred only after hibernation, thereby enhancing reproductive success. An energy-rich diet did not affect reproductive strategies. Further studies should focus on seasonal plasticity of reproductive strategies in natural populations of C. aspersum and investigate survival probabilities of breeders and juveniles in an evolutionary context.

Do ice nucleating agents limit the supercooling ability of the land snail Cornu aspersum?

The supercooling ability of adults and eggs of the partially freezing tolerant land snail Cornu aspersum remains limited to high subzero temperatures (ca. -5 degree C) whatever the conditions, suggesting the presence of ice nucleating agents (INAs). In this study, we investigated the nucleation activity of the digestive tract of adult snails, eggs and their direct environment: food, faeces and soil. The mucous ribbon always present in the distal intestine of adults exhibited a heat-sensitive (i.e. organic) nucleation activity, close to that of the entire snails during dormant states (aestivation and hibernation). However, a microbial nature of these INAs could not be established in inactive snails. The food provided to active snails contained ice nucleating bacteria, which followed the digestive tract to be found in the intestine and in the faeces, but with a decreasing concentration along the transit. Eggshells also presented a heat-sensitive nucleation activity, which could be related to its structure. Moreover, eggs are laid directly in the soil which contained both organic and mineral INAs. This study is the first to demonstrate the implication of organic INAs in the cold hardiness of a terrestrial gastropod.

Gastric emptying and intragastric balloon in obese patients

BACKGROUND

Intragastric balloons have been proposed to induce weight loss in obese subjects. The consequences of the balloon on gastric physiology remain poorly studied. We studied the influence of an intragastric balloon on gastric emptying in obese patients.

PATIENTS AND METHODS

12 patients were included in the study, with BMI (mean +/- SD) of 38.51 +/- 4.32 kg/m2. The balloon was inserted under light anaesthesia and endoscopic control, inflated with 700 ml saline, and removed 6 months later. Body weight and gastric emptying (T1/2 and T lag) using 13C-octanoic acid breath test were monitored before balloon placement, during its permanence and 2 months after removal.

RESULTS

Mean weight loss was: 6.2 +/- 2.3 kg after one month; 12.4 +/- 5.8 kg after 3 months; 14.4 +/- 6.6 kg after 6 months and 10.1 +/- 4.3 kg two months after BIB removal. Gastric emptying rates were significantly decreased in the first periods with balloon in place, and returned to pre-implantation values after balloon removal. T1/2 was: 87 +/- 32 min before BIB positioning, 181 +/- 91 min after 1 month, 145 +/- 99 min after 3 months, 104 +/- 50 min after 6 months and 90 +/- 43 min 2 months after removal. T lag was 36 +/- 18 min before BIB positioning, 102 +/- 82 min after 1 month, 77 +/- 53 min after 3 months, 59 +/- 28 min after 6 months and 40 +/- 21 min. 2 months after removal.

CONCLUSIONS

BIB in obese patients seems to be a good help in following the hypo caloric diet, especially during the first three months when the gastric emptying is slower and the sense of repletion is higher. After this period gastric emptying starts to return to normal and the stomach adapts to BIB loosing efficacy in weight loss.

Toroidal plasma rotation induced by the dynamic ergodic divertor in the TEXTOR tokamak

The first results of the Dynamic Ergodic Divertor in TEXTOR, when operating in the m/n=3/1 mode configuration, are presented. The deeply penetrating external magnetic field perturbation of this configuration increases the toroidal plasma rotation. Staying below the excitation threshold for the m/n=2/1 tearing mode, this toroidal rotation is always in the direction of the plasma current, even if the toroidal projection of the rotating magnetic field perturbation is in the opposite direction. The observed toroidal rotation direction is consistent with a radial electric field, generated by an enhanced electron transport in the ergodic layers near the resonances of the perturbation. This is an effect different from theoretical predictions, which assume a direct coupling between rotating perturbation and plasma to be the dominant effect of momentum transfer.

Immunoscintigraphy of venous thrombi: clinical effectiveness of a new antifibrin D-dimer monoclonal antibody

Safety and thrombus imaging capabilities of the 99mTc-labeled form of a new F(ab')2 monoclonal antibody (MoAb) against fragment D dimers from cross-linked human fibrin, previously shown to be effective labeled to 131I in detecting venous thrombi in the rabbit, were investigated. Sixteen patients (seven men, mean age: 60+/-7 years) with deep (n = three) and superficial (n = 13) venous thromboses of the lower limbs documented at echo-Doppler study underwent, 24 hours before saphenous vein stripping, a scintigraphic study after IV injection of the 99mTc-MoAb (1,129+/-275 MBq/mL), acquiring dynamic images, as well as early and delayed static images of lower limbs. Tracer activity was compared in normal and pathologic areas. At the operation, vessel wall including the thrombotic lesion was isolated, weighed, and counted. Blood radioactivity and MoAb concentration were also measured. No adverse reaction was observed after MoAb administration. Thrombus site appeared as a focal area (hot spot) of asymmetrically increased tracer uptake, already detectable at early images in all patients. All thrombi detected at echo-Doppler study (n=25) were confirmed at scintigraphic study, which showed four additional hot spots subsequently confirmed to represent thrombi at operation. Average percent ratio between pathologic and normal regions was 1.51+/-1.34 (p < 0.05) at time-activity curves, 2.27+/-1.1 (p < 0.05) at early static images, and 2.15+/-1.2 (p < 0.05) at delayed images, respectively. Thrombus-to-blood uptake ratio was 4.3+/-0.9 (p < 0.01). The F(ab')2 MoAb proved to be safe, and low levels of antimouse antibodies were detected in response, although further studies are needed to assess tolerance and effectiveness in case of a second administration in the same patient. The 99mTc-labeled MoAb was very effective in identifying venous thromboses both at deep and superficial localizations, although its sensitivity and specificity need be evaluated in a more numerous group, including also patients with different and clinically more relevant localizations, such as caval thromboses. However, the possibility of obtaining high-quality images within 4 hours of MoAb administration is clinically relevant, and carries also therapeutic implications, especially in pulmonary thromboembolism.

Large striatocapsular infarcts: clinical features and risk factors

We defined large striatocapsular infarcts as subcortical softenings of more than 20 mm in diameter involving the territories of the lateral and medial groups of lenticulostriate arteries. The aim of this study of 56 patients was to compare the clinical features and risk factors of these infarcts with those of cortical and lacunar infarcts. On the whole, our data suggest that both the clinical features and risk factors of large striatocapsular infarcts are similar to those of cortical infarcts, but significantly different from those of lacunar infarcts. The clinical manifestations of large striatocapsular infarcts with a maximum diameter of less than 50 mm may sometimes resemble those of lacunar infarcts because neuropsychological disorders are less frequent; however, our study indicates that, even in these cases, cardioembolic sources and artery-to-artery embolism are significantly more frequent in large striatocapsular than in lacunar infarcts, thus suggesting a different pathogenesis.

Peripheral nerve vasculitis: a clinico-pathological study

The clinico-pathological findings of 20 nerve biopsies consecutively performed at the neuropathological laboratory of Verona University Hospital were reviewed in order to establish the most important clinical manifestations of peripheral nerve vasculitis and to determine the role of biopsy in corroborating the diagnosis. Dystal sensori motor polyneuropathy was the most frequent clinical manifestation, confirming previous clinico-pathological studies and suggesting a more widespread pathological process than usually supposed. The biopsy was the basis of the diagnosis since it established or substantially modified the clinical diagnosis. Therefore we suggest that in cases with suspected vasculitis of the peripheral nerve the biopsy makes a useful contribution to diagnosis.

Paraballism associated with anterior opercular syndrome: a case report

We describe the combination of acute bilateral ballism and anterior opercular syndrome in a 75-year-old female hypertensive patient with bilateral multiple small infarcts involving the basal ganglia, the subcortical white matter and the area of the subthalamic nucleus, detected by CT scan and MRI. These clinical manifestations were accompanied by apathy, somnolence and cognitive changes usually observed in cortical involvement. Pathogenetic mechanisms for this unusual clinical picture are discussed on the basis of CT, MRI, and SPECT findings.

Peripheral nervous system involvement as the only neurological manifestation of infective endocarditis

We report a case of acute endocarditis with the unusual presentation of mononeuritis multiplex at onset. Mononeuropathy was the only detected neurological sign. The presence of muscular abscesses compressing the peripheral nervous system could lie at the basis of the pathophysiological mechanism responsible for acute mononeuropathy.

Acute confusional states secondary to infarctions in the territory of the posterior cerebral artery in elderly patients

Acute confusional states and agitated delirium are among the most common psychopathologic disorders in the elderly. However, they are rarely reported in the course of infarcts in the territory of the posterior cerebral artery. This study involving thirteen patients aged more than 65 years suggests that acute confusional states from posterior cerebral artery infarcts are less rare than usually thought, although the diagnosis may be difficult during the acute phase. The risk factors are no different from those observed for infarcts in other cortical areas, suggesting that this syndrome is due to structural damage of the brain rather than the other, usual causes of confusion in the elderly (intoxications, dysmetabolic diseases or dementia). The recognition of acute confusional states from posterior cerebral artery infarcts and its distinction from other causes of confusion is important in elderly patients because of the different diagnostic, prognostic and therapeutic implications involved.

Dementia syndrome in patients with postsurgical hypoparathyroidism and extensive brain calcifications

The authors report the cases of 2 patients with extensive brain calcifications after thyroidectomy, showing behavioral and cognitive changes suggesting a subcortical dementia syndrome. On the basis of clinical, neuroradiologic and SPECT features they discuss the role of the brain calcifications in the pathophysiology of associated cognitive disorders and the putative mechanisms for the observed neuropsychological disorders.

Lacunar syndromes due to non ischaemic causes: prevalence and clinical findings (study of 19 patients)

137 consecutive patients with Lacunar Syndrome (LS) were studied in order to evaluate the prevalence between ischaemic and not ischaemic forms. The lacunar infarcts (LI) were 118, the not ischaemic ones 19. These latter were caused by primary intracerebral hemorrhages with rapid recovery (12 cases), multiple sclerosis (3 cases) and unruptured top of the basilar aneurysm, chronic subdural haematoma, Arnold-Chiari malformation type 1, multiple metastases (1 case respectively). In this paper we discussed the probable pathogenetic mechanism and the clinical features in the 19 cases of not ischaemic LS. Moreover, FISHER'S opinion that LS are nearly always due to LI is here discussed.

Painful tonic spasms associated with subcortical infarction

The authors describe the case of a patient in whom painful tonic spasms developed as a consequence of a small infarct involving the lateral aspect of the putamen, the external capsule, and the subcortical white matter of the posterior insular region. Possible pathogenetic mechanisms explaining painful tonic spasms are discussed.

Neurotoxicity of idiopathic hypereosinophilia on a case with simultaneous CNS and PNS involvement

We report the case of a patient with idiopathic hypereosinophilia in whom both central and peripheral nervous systems were affected. We discuss possible pathogenetic mechanisms explaining the neurotoxicity of idiopathic hypereosinophilia. Corticosteroid therapy should be given early and continued indefinitely.

Proliferative retinopathy: value of the oscillatory potentials

Oscillatory potentials (OPs) and retinal fluorescein angiography (RFA) were performed in 45 patients with diabetes mellitus. OPs were normal in 28 patients, altered (increased latencies and or inter-peak times) but with normal shape in 9, changes in morphology in 8: none of these patients had normal RFA, 2 had no proliferative retinopathy, 6 proliferative retinopathy (PR). In the authors' opinion OP changes in morphology are nearly always caused by a serious diabetic retinopathy, often by a PR. The authors emphasize the usefulness of OPs for studying the neurophysiologic properties of the retina of diabetic patients, particularly in PR.

Late onset unilateral asterixis secondary to posterior cerebral artery infarction

Unilateral asterixis developed in a 56 year old man, 5 months after an infarct in the posterior cerebral artery territory, involving the posterolateral nuclear complex of the thalamus, documented by CT-scan and MRI. Unilateral asterixis in rarely reported in association with thalamic lesions and usually develops as an immediate postictal phenomenon. We discuss possible physiopathological mechanisms explaining the occurrence and the delayed onset of these involuntary movements.

Opsoclonus in a patient with Guillain-Barré syndrome

A 54 year-old woman showed the unusual association of a Guillain-Barré syndrome and opsoclonus, a rare eye movement characterized by involuntary bursts of jerking, ataxic and multidirectional saccades, without an intersaccadic interval. Since opsoclonus is a phenomenon described exclusively in CNS diseases, the case reported supports the hypothesis of CNS involvement in some cases of Guillain-Barré syndrome. The latter is generally considered an immune-mediated disease and an immune pathogenesis is also supposed in opsoclonus associated with systemic malignancies; besides, in the patient reported, the self-limiting nature of the disturbance and the lack of MRI lesions suggest that opsoclonus may result from an immune-related phenomenon causing a functional and transitory dysfunction of the CNS.

Transient pure sensory strokes in patient with aneurysm of rostral basilar artery

Images

[Infarction of the anterior choroidal territory. Clinical and tomodensitometric study of 11 cases]

Clinical features of anterior choroidal artery (ACA) territory infarct are hemiplegia, hemi-anaesthesia and homonymous hemianopia. However this syndrome in its complete form is of rare occurrence, since one or more signs or symptoms may be lacking. The Authors describe 11 patients with CT-documented infarctions in the (ACA) territory in order to establish clinical-CT correlations and possible risk factors. Among the investigated risk factors arterial hypertension is the most frequent in these patients. This finding, and the small size of the ischemic lesions make the ACA territory infarctions similar to Lacunar Infarcts. The Authors, emphasize that, as in lacunar infarcts, a thromboembolic mechanism cannot always be ruled out in ACA infarctions. Therefore a cause other than arterial hypertension should be considered in each patient for a better management of this type of infarcts.

[Femoral neuropathy, diabetes mellitus, reduced glucose tolerance. Possible correlations]

44 cases are reported of definite femoral mononeuropathy, by clinical and neurophysiological criteria. In 11 patients there was diabetes mellitus, in 10 compressions, in 23 no determined etiology was identified. Among these 23 patients, 15 showed glucose intolerance. The value of diabetes mellitus and the glucose intolerance in the etiology of femoral mononeuropathy is discussed.

Acute transient cerebral intoxication induced by low doses of baclofen

We report a case of acute transient encephalopathy with confusion, drowsiness, myoclonic jerks, periodic triphasic sharp wave EEG patterns induced by low doses of baclofen. We discuss the pathogenesis and the differential diagnosis from the subacute spongiform encephalopathy of sudden onset.

Language disturbances from paramedian thalamic infarcts: a CT method for lesion location

The authors describe the case of three patients suffering from language disorder secondary to mesencephalo-thalamic infarcts. One of them showed the clinical features of transcortical motor aphasia, while the other two presented the typical pattern of the so-called "thalamic aphasia". The CT-stereotaxic method for lesion localization disclosed that the dorso-medial was the mostly involved thalamic nucleus in each case. Since this nucleus is connected both with Broca's and Wernike's areas, the authors suggest that the more or less extensive involvement of the fibres connecting these structures may be responsible for the different aphasic features presented in these cases.

Aphonia due to paramedian thalamo-subthalamic infarction. Remarks on two cases

We describe two patients in whom CT brain scans imaged paramedian thalamo-subthalamic infarcts in the territory of the thalamo-mesencephalic arteries. Such infarcts give rise to a complex syndrome marked by disturbances of consciousness and of eye movement and neuropsychological disorders, including attentional, memory and, more rarely, language deficits. A loss of voice volume may accompany aphasic disturbances but is exceedingly rare in isolation. In the cases described the aphonia, total but transient, was the only language disorder. The physiopathological mechanisms involved in aphonia are complex and controversial.

Quadriceps myopathy: report of a late onset sporadic case

The Authors describe the case of a 44 year-old man whose familial and personal histories were negative for muscular diseases. The patient complained slowly progressive wasting and weakness localized to the quadriceps muscles. The bioptic study of the gastrocnemius and the quadriceps showed dystrophic changes, confirming that muscular dystrophy closely localized to quadriceps is of rare occurrence. Muscles other than quadriceps can often be involved by the same pathology even if the clinical signs continue to be localized to the quadriceps muscles for many years.

MRI findings in a patient with a familial form of motor neuron disease

The authors report the case of a 32-year-old woman who developed symptoms and signs possible manifestations of a familial motor neuron disease with left sided pyramidal signs and marked wasting and weakness in the ipsilateral upper girdle, progressively extended to the contralateral upper limb. The CT-scan showed only frontal cortical atrophy. MRI disclosed a restricted area of increased signal intensity in the centrum semiovale of the subcortical white matter of the right prefrontal cortex. This young woman did not disclose any risk factors for cerebrovascular diseases nor other disorders of the CNS; therefore the authors are of the opinion that the white matter changes observed on MRI are not occasional findings, but are related to the pathologic process occurring in consequence of her neurodegenerative disorder (possible ALS).

Language disturbances from mesencephalo-thalamic infarcts. Identification of thalamic nuclei by CT-reconstructions

The authors report the cases of two patients with CT-documented paramedian mesencephalo-thalamic infarcts, showing language disturbances. The first patient showed a non fluent, transcortical motor-like aphasia, the other had a fluent but severely paraphasic language disorder. The CT study disclosed that it was the dorso-median thalamic nucleus that was mostly involved in both cases. These findings agree with a few previous pathological studies suggesting that the paramedian thalamic nuclei, particularly the dorso-median nucleus may play some role in language disturbances. However the anatomical basis for thalamic aphasia remains speculative, taking into account the importance of cortical connections in the origin of subcortical neuropsychological disturbances.

Partial Klüver-Bucy syndrome arising from a multicentric glioblastoma: anatomo-clinical study of a case with unusual involvement of CNS

The authors describe the case of a patient showing clinical symptoms consistent with a partial Klüver-Bucy syndrome. CT-scan, macroscopic and histological findings showed the presence of a multicentric glioblastoma with almost exclusive involvement of subcortical gray nuclei and white matter. The possible anatomo-clinical correlations of these unusual locations in KBS are discussed. In addition, the authors emphasize that KBS can arise not only from lesions located in the temporal cortex and/or amygdala, but also from strategically located subcortical lesions particularly involving striatal nuclei and subcortical white matter in the insular area.

[Unilateral cavernous angioma of the thalamus disclosed by transitional disorders in the upward gaze]

We describe a case of a cavernous angioma of the right thalamus, identified by MRI, showing transient vertical diplopia in the upward gaze, present only in protracted recumbency. We consider possible pathogenetic mechanisms in an attempt to explain this peculiar disturbances. In addition we emphasize that MRI is the most sensitive procedure for detection of the cavernous angioma.

Subacute parkinsonism from a single lacunar infarct in the basal ganglia

The authors describe the case of a patient showing a lateralized and subacute parkinsonism with CT-evidence of a single lacunar infarct in the contralateral basal ganglia. The vascular origin of this type of subacute parkinsonism is emphasized.

Day-night differences in effects of cosmetic treatments on facial skin. Effects on facial skin appearance

Two groups of 24 healthy caucasian women, similar with regard to age classes (from 19 to 55) as well as fair and dark complexion of skin and hair, volunteered to use during a 14-day span a conventional facial cream (active placebo: AP) and thereafter, during a 21-day span Noctosome (Noctos). The latter is a new generation of liposome made with non-ionic lipids leading to microspheres which include glycopeptides in the aqueous compartment of the vesicle, alpha-tocopherol ester in the membrane-like structure and sphingo-ceramides at the surface of the microspheres. The aim of the study was to test the beneficial effects of Noctos (vsAP) with respectively morning (7-9-hr) and evening (21-23-hr) applications as facial ointments. Observed differences were validated using several statistical tests: ANOVA, cosinor, etc. Subjects were socially synchronized with a diurnal activity from 7 hr to 23 hr and a nocturnal rest. Each day, at fixed clock hours (7, 10, 20 and 23 hr), each subject used visual analogue scales to self-rate a set of variables characterizing facial aspects. Brilliance of complexion and texture of skin exhibited a circadian rhythm (peak time at 10 hr), both with AP and Noctos. The latter produces a beneficial effect with regard to reference values (AP). The evening application of Noctos is more efficient than the morning one. However, the magnitude of this beneficial effect is related both to age (greater for the age class 25-35 years than for younger and older subjects) and to skin complexion (greater for fair than dark complexioned subjects). Major beneficial effects of Noctos in the evening hours are related neither to fatigue nor to mood of the women since the respective circadian rhythms of these variables appear to vary independently from those of facial skin characteristics.

Intramedullary spinal cord metastasis detected through intrathecal contrast medium computerized tomography

A case of intramedullary spinal cord metastasis is reported in which the diagnosis was possible through intrathecal contrast medium computerized tomography. The case described suggests that this method of radiologic investigation can provide a prompt identification of ISM from other noncompressive complications of systemic cancers. This is very important for radiation treatment which can be effective in the early stages of ISM.