Spastic paraparesis associated with portal-systemic venous shunting due to congenital hepatic fibrosis.

We report a case of progressive spastic paraparesis in a 45-year-old man with total portal-systemic shunting, which developed spontaneously due to congenital hepatic fibrosis. Cellular functions of the liver, except for an elevated blood ammonia level, were within normal limits, as is usual in congenital hepatic fibrosis. This case shows that spastic paraparesis following portal-systemic shunting may occur without liver failure.     

Pulsed dye laser (577 nm) treatment of portwine stains: ultrastructural evidence of neovascularization and mast cell degranulation in healed lesions

Portwine stains were examined before, immediately after, and 1 yr after successful clearance by a pulsed dye laser (577 nm) using ultrastructural techniques. Dilated vascular channels and mast cell hypoplasia characterized lesional skin before treatment. Immediately after treatment, widespread selective vessel necrosis, similar to changes previously described, was observed. One year after laser irradiation, the abnormally ectatic portwine stain vessels had been replaced by small venules and arterioles, similar in number and diameter to blood vessels in normal skin; the only difference noted was that these new vessels were surrounded by easily identifiable mast cells. Many of these mast cells exhibited evidence of activation and degranulation. We conclude that mast cells may play an important role in the neovascularization of portwine stains treated by 577-nm dye laser irradiation.     

Penicillin treatment for gonorrhoea in relation to early syphilis in prostitutes.

A retrospective study of prostitutes in Singapore showed that they had received less antigonorrhoeal treatment with penicillin derivatives during the three month period before early syphilis was diagnosed than in other three month periods when they had not developed syphilis. This suggests that penicillin derivatives in doses sufficient to treat gonorrhoea will abort coincidental early syphilis.     

Muscarinic nature of cholinergic receptors in the cerebellar flocculus involved in the enhancement of the rabbit''s optokinetic response

Intrafloccular micro-injection of the aselective cholinergic agonist carbachol enhances the optokinetic reflex (OKR)17. Histochemical and physiological studies have identified cholinergic receptors of the muscarinic as well as nicotinic type in the cerebellar cortex, and both have been implicated in cholinergic transmission. The present study was undertaken to elucidate the receptor type involved in the control of OKR. For that purpose, effects of injections of the nicotinic N1 agonist DMPP on the OKR and vestibulo-ocular reflex (VOR) were compared with injections of the muscarinic agonist betanechol and the aselective cholinergic agonist carbachol. Injection of betanechol mimicked the enhancement of the OKR by carbachol, while DMPP had no effect. We conclude that muscarinic receptors are involved in the positive modulatory action of the cholinergic system in the cerebellar flocculus.     

Trephine craniotomy in neurosurgery]

For three years, we have performed craniotomy with a 5 cm diameter trephine through a linear incision. 53 craniotomies were done in 49 patients. This simple and time-saving method produced little bleeding and slight injury to the brain. The technique allowed the surgeon to spend most of his time at the management of lesion. Healing of wound was rapid and brain edema was minimal.