Hydrosyringomyelia in demyelinating diseases

Spinal cord cavitation is a frequent finding in optic neuromyelitis (Devic's syndrome) (DS) but it is also, although rarely, observed in patients with multiple sclerosis (MS). The objective of our study was to compare the MRI characteristics of the syringomyelic cavities in 6 patients with DS and 3 patients with MS. All the patients with DS had a relapsing clinical form with normal brain MRI. Spinal MRI revealed unenhanced central cavities which extended more than 3 vertebral bodies and remained unchanged in follow-up studies. Two patients presented multiple cavities.MS patients suffered a relapsing remitting form of the disease, they all had hyperintense T2 enhancing lesions on their spinal MRI. Moreover spinal MRI also revealed non communicating cavities which extended less than 2 vertebral bodies. Follow-up studies in MS patients revealed a reduction of both the spinal lesions and the cavities. It is still debated whether DS represents a distinct clinical entity different from MS. These findings help distinguishing both disorders in cases when spinal cavities are present and also contribute to the therapeutic choice.     

Small supportive treatment units and the problem of recidivism in indigent chronic schizophrenic patients

This is a report of a three and a half-year follow up of uprooted chronic schizophrenics, who had become disposition problems at the time of discharge from a state psychiatric hospital. One group of 14 was discharged to themselves, another in small supporting units to share living quarters with fellow patients. The results are encouraging and may throw some light into the problem of recidivisim. All patients were diagnosed chronic schizophrenic. They had multiple hospitalizations, came from the same catchment area, and were followed by the same therapist in the same hospital setting.Patients who shared living quarters with other patients did better in terms of post hospitalization adjustment, reduced readmission and subsequent time spent in hospital, employment and self-responsibility compared to patients living alone.     

Evidence for the presence of serotonergic perikarya in the fetal rat pancreas as demonstrated by the high affinity uptake of [H]5-HT

Evidence has been obtained for the presence of serotonergic fibers in the adult rat pancreas; however, the location of the serotonergic cell bodies remains unknown. Fetal rat pancreata (18, 20 and 22 days) were demonstrated to possess a high-affinity uptake of serotonin. Radioautography revealed the uptake sites to be similar to those seen in the adult, indicating the presence of serotonergic fibers in early development. In addition, cell bodies, possibly representing primitive neurons, were demonstrated to be heavily labelled. This suggests a possible intra-pancreatic location for the cell bodies of the pancreatic nerves. The preservation of the specific serotonin uptake in 18-day fetal tissue after 4 days in organ culture substantiates this view.     

Gender-specific 5-HT1A receptor changes in BrdU nuclear labeling patterns in neonatal dentate gyrus

The actions of 5-HT1A receptors on cell proliferation in the rat neonatal dentate gyrus are unknown. We injected a 5-HT1A receptor agonist (ipsapirone) or antagonist (Way 100635) 1 h before injections of BrdU in neonates of both genders between days 2-4, a peak time of dentate gyrus granule cell proliferation. The BrdU immunoreactive (IR) nuclei in the granule cell layer and subgranular zone were examined after 2 weeks. The BrdU-IR nuclear staining patterns were classified as being either diffuse (homogenous dark BrdU-staining throughout the nucleus) or punctate (multiple distinct small stained spots within the nucleus). Most BrdU-labeled nuclei with a diffuse pattern were seen in the subgranular zone while the punctate pattern nuclei were seen within the granular cell layer of the dentate gyrus. 5-HT1A antagonist showed no overall change in absolute number or pattern of labeled nuclei compared to control animals. After a 5-HT1A agonist, there was also no differences in the total number of BrdU-IR nuclei (punctate and diffuse pattern). However, in both genders, the proportion of the BrdU-labeled nuclei showing a punctate compared to diffuse pattern increased: 33% in females and 18% in males. In females, the 5-HT1A receptor agonist increased the number of nuclei showing a punctate pattern by 41%, while in males the 5-HT1A receptor agonist decreased the number of nuclei showing a diffuse pattern by 29%. These results indicate gender-specific 5-HT1A receptor action on the state of nuclear DNA in the cells of the dentate gyrus, without increasing the total number of BrdU-labeled nuclei.     

Cement penetration using a tibial punch cement pressurizer in total knee arthroplasty

This study describes a new tibial cement punch pressurizer to enhance cement penetration into the metaphyseal cancellous bone of the tibial plateau. Thirty knees of 15 patients undergoing simultaneous bilateral total knee arthroplasty (TKA) were randomly selected to receive the tibial cement punch pressurizer on one side, with the opposite side serving as control. Using computerized and radiographic evaluation of both knees 2 weeks postoperatively, the punch pressurizer achieved 132 times better penetration of the cement. The tibial punch cement pressurizer offers a simple technique to provide reliable cement penetration and tibial component fixation in TKA.     

Interlaminar astroglia of the cerebral cortex: a marker of the primate brain

Evidence for "cable-like" processes stemming from astroglial cells in the supragranular cerebral cortex has been recently presented. In addition to what could be called the "general mammalian-like" astroglial architecture (the so-called "panglial syncytium") of the cerebral cortex, composed of typical stellate astrocytes (intralaminar astrocytes), the anthropoid species, mostly catarrhines, show a manifest vertical, radial distribution of long (interlaminar) astroglial processes. It can be tentatively proposed that evolutionary pressures resulted in the progressive appearance, in primates, of a new type of glial cell. Its soma has a superficial location and unusually long cellular processes that invade, in a predominant radial fashion, the supragranular region of the cerebral cortex. Their existence has been ignored for more than a century. On the neuronal side, modular (columnar) organization of the cerebral cortex may represent an evolutionary acquisition that could optimize communication and information processing, with the least volume compromise in terms of wiring. Yet, for such columns to be functionally operative, adequate isolation from neighboring units would be required. A "mass" operation of the astroglial architecture would tend to compromise spatial definition and the degrees of freedom of such columnar modules. It is proposed that the presence of a "palisade" of interlaminar glial processes represents a relatively recent evolutionary event, instrumental for the optimization of the modular (columnar) organization of the cerebral cortex. It is interesting that the supragranular cortical region has undergone the largest growth among mammalian species during brain evolution, and has been associated with a crucial role in cortico-cortical interactions.     

Cardiovascular nursing in Israel

Cardiovascular (CV) nursing as an entity in Israel dates back to 1952, when the nurses in Tel-Hashomer hospital took care of postoperative heart surgery patients. The first intensive cardiac care units (ICCUs) were established in 1971. In 1982, the first ICCU course was established in Tel-Hashomer hospital nursing school. Today, most of the nursing staff in Israels ICCUs are graduates of ICCU courses. The nurses professional society, the Society for Nursing of Israel, was established in 1947. In 1989 the Society for Advancement of Cardiac Nursing in Israel (SACN) was established. The main goals of the society were: the exchange of CV nursing knowledge, CV nursing research, CV nursing education in nursing schools, education of nurses in other departments in the care of the cardiac patient, and CV nursing education in the community. The CV nurse takes a large role in the total care of the cardiac patient, which includes rehabilitation within the hospital and in the ambulatory setting and coordination of nursing in national and international multicenter clinical trials. In collaboration with the Ministry of Health Nursing Division, Israeli CV nurses participate in national and international projects to: develop and upgrade nursing education; train new CV nurses; develop, review, and revise nursing protocols and guidelines; and establish new, more advanced ICCUs in underdeveloped areas within Israel and around the world. Our vision for the future development of CV nursing in Israel includes coordination and management roles in the hospital setting, and the establishment and management of home-care programs.     

Inhibition of interleukin-1 but not tumor necrosis factor suppresses neovascularization in rat models of corneal angiogenesis and adjuvant arthritis

OBJECTIVE: To assess the capacities of the cytokine inhibitors interleukin-1 receptor antagonist (IL-1Ra; anakinra) and PEGylated soluble tumor necrosis factor receptor I (PEG sTNFRI; pegsunercept) to suppress neovascularization. METHODS: A corneal angiogenesis assay was performed by implanting nylon discs impregnated with an angiogenic stimulator (basic fibroblast growth factor or vascular endothelial growth factor) into one cornea of female Sprague-Dawley rats. Animals were treated with IL-1Ra or PEG sTNFRI for 7 days, after which new vessels were quantified. In a parallel study, male Lewis rats with mycobacteria-induced adjuvant-induced arthritis were treated with IL-1Ra or PEG sTNFRI for 7 days beginning at disease onset, after which scores for inflammation and bone erosion as well as capillary counts were acquired from sections of arthritic hind paws. RESULTS: Treatment with IL-1Ra yielded a dose-dependent reduction in growth factor-induced corneal angiogenesis, while PEG sTNFRI did not. IL-1Ra, but not PEG sTNFRI, significantly reduced the number of capillaries in arthritic paws, even though both anticytokines reduced inflammation and bone erosion to a similar degree. CONCLUSION: These data support a major role for IL-1, but not TNFalpha, in angiogenesis and suggest that an additional antiarthritic mechanism afforded by IL-1 inhibitors, but not anti-TNF agents, is the suppression of the angiogenic component of pannus.     

Individualized antianginal therapy guided by systemic arterial pressure

All antianginal drugs except nitrates are also first-line antihypertensive drugs. Their antianginal efficacy has not been evaluated in relation to pretreatment blood pressure. They may aggravate ischemia due to excessive reduction in blood pressure. Until the results of direct comparative studies are available, it is advisable to start treatment of angina pectoris in normotensive and hypotensive patients with other drugs that do not primarily decrease blood pressure. Nitrates are a reasonable choice.