Age-related shrinkage of cortically projecting cholinergic neurons: A selective effect

The number and size of basal forebrain neurons that provide the cholinergic innervation for the cerebral cortex, amygdala, and hippocampus were studied in young and aged mice. The results showed that these neurons became substantially smaller with increasing age. This effect was relatively selective, since the immediately adjacent cholinergic neurons in the striatum did not show a change of similar magnitude. The shrinkage of these basal forebrain neurons may account for the decline of cholinergic innervation that occurs with age. In the material that we examined, aging did not influence the number of cholinergic neurons in the basal forebrain, only their size. It seems, therefore, that the age-related changes in cholinergic function (and their putative behavioral consequences) are not associated with a substantial component of irreversible cell death.     

Measurement of concentrations of the histamine H1 receptor antagonist temelastine in biological fluids

A high-performance liquid chromatographic analysis of temelastine in biological fluids with UV detection at 229 nm is presented. The method involves ether extraction followed by re-extraction into phosphoric acid and chromatography on a reversed-phase column. The method has a lower limit of detection of 0.05 mg L-1 and is adequate for use in pharmacokinetic studies following oral administration.     

Improvement in the quality and fertilization potential of a human sperm population using the rise technique

Semen from 63 individuals participating in an in vitro fertilization program was processed using a modified rise technique. Overall normal morphology was significantly improved in the rise (79.2%) as compared with the unprocessed sample (57.8%), and six of seven specific morphologic abnormalities were significantly reduced. Motility was significantly enhanced from 51.8% in the unprocessed samples to 89.1% in the rise samples. Spermatozoa recovered in the rise portion of the sample represented 5.9% of the total sample. Ultrastructural morphometry revealed that the rise was relatively free of abnormal sperm forms, acellular debris and non-sperm cellular elements as compared with the non-rise portion of the sample or a typical unprocessed sample. Volume density measurements demonstrated that only 18.1% of the volume of the non-rise sample was composed of normal spermatozoa compared with 83.4% of the volume of the rise. In a separate set of experiments utilizing 21 samples, the penetration of hamster eggs was significantly enhanced from 37.9% to 67.2% using spermatozoa from the initial washed sample and those from the rise, respectively. These data demonstrate the qualitative and quantitative improvements, as well as the increase in fertilizing potential, of the rise portion of the semen sample.     

Hemorrhagic complications of varicella

Although normally a benign illness, varicella can be accompanied by purpuric syndromes. While thrombocytopoiesis is normal, a shortened platelet survival time has been demonstrated with no increase in splenic sequestration. Various mechanisms have been suggested, including an autoimmune mechanism, direct interaction between virus and platelets, and vascular damage resulting in platelet removal on nonendothelialized surfaces.     

'Pulling down churches': accounting for the British Mental Health Users' Movement

Abstract A study of the British Mental Health Users' Movement (MHUM) is reported, based upon interviews with some of its participants. These accounts are analysed in terms of three main themes: ideology and policy; relationships between users and non-patients; and relationships between the movement and statutory and voluntary agencies. The data are discussed in relation to international comparisons and with regard to preceding opposition to traditional psychiatric theory and practice in Britain. The emergence of the MHUM is accounted for within the context of existing theoretical analyses of new social movements. Strengths and weaknesses of the movement are highlighted and prospects for its future discussed.     

John Orlando Roe--not Jacques Joseph--the father of aesthetic rhinoplasty

By a careful analysis of numerous medical articles, this article emphasizes that John Orlando Roe (1848-1915), an otolaryngologist from Rochester, New York, was the true father of aesthetic rhinoplasty--in contrast to the claims that incorrectly assign this role to Jacques Joseph of Berlin.     

Bronchobiliary fistula due to acute cholecystitis in a suprahepatic gall bladder

We describe a patient presenting with painless jaundice, anorexia and pruritus. The gall bladder was found to be lying above and behind a hypoplastic right lobe of liver. There was no evidence of cholangitis or biliary obstruction. The patient subsequently developed a bronchobiliary fistula with severe wheeze, cough and bile-stained sputum. Emergency percutaneous drainage of the gall bladder led to immediate cessation of bronchospasm and biloptysis, rendering the patient fit for definitive surgery.     

Longer hospitalization at Veterans Administration hospitals than private hospitals. Verification and additional insights

Utilizing 1,297 male patients under the primary care of an identical group of house officers and under treatment between 1985 and 1987 for ten common medical diagnoses, length of hospitalization was compared between a private sector (n = 481) and Veterans Administration (VA) (n = 816) facility, both affiliated with the same medical school. All patients were rated by the Horn Severity of Illness Index. After researchers controlled for diagnosis, severity of illness, age, race, and physician, results in this study indicate that an additional 3.2 days of hospitalization were associated with the VA facility. This finding is consistent with earlier reports of inappropriate hospitalization at the VA hospital and suggests that VA facility planners need to evaluate whether longer lengths of stay (LOS) are merited.     

Comparison of thermal clearance measurement of regional cerebral blood flow with radiolabelled microspheres

A thermal clearance technique for measuring cerebral blood flow is described and compared with the radiolabelled microsphere technique. The thermal technique involves measurement of the rewarming curve generated after bolus infusion of 4-5 ml of ice-cold saline into the common carotid artery with a subdural thermistor placed on the parietal cortex. Evaluation of the biexponential decay curves obtained with this technique demonstrated a close correlation with total hemispheric, parietal, and parietal gray blood flow determined by simultaneous microsphere measurement. Despite significant correlations (p less than 0.001), scatter in the data produced a broad 95% confidence interval, thus making interpretation of blood flow with the thermal clearance technique impossible. Furthermore, instrumentation with the thermal probe, which required opening of the dura, blunted the cerebral blood flow response to hypercapnia. We conclude that the major limitations of the thermal clearance technique include: nonhomogeneous clearance function, significant variability, and depression of CO2 reactivity. These limitations must be addressed before this technique can be used reliably in the laboratory.