The goldfish nervus terminalis: a luteinizing hormone-releasing hormone and molluscan cardioexcitatory peptide immunoreactive olfactoretinal pathway.

Antisera to two putative neurotransmitters, luteinizing hormone-releasing hormone (LHRH) and molluscan cardioexcitatory tetrapeptide (H-Phe-Met-Arg-Phe-NH2; FMRF-amide), bind specifically to neurites in the inner nuclear and inner plexiform layers of the goldfish retina. Retrograde labeling showed that intraocular axon terminals originate from the nervus terminalis, whose cell bodies are located in the olfactory nerves. Double immunocytochemical and retrograde labeling showed that some terminalis neurons project to the retina; others may project only within the brain. All terminalis neurons having proven retinal projections were both LHRH- and FMRF-amide-immunoreactive. The activity of retinal ganglion cells was recorded with microelectrodes in isolated superfused goldfish retinas. In ON- and OFF-center double-color-opponent cells, micromolar FMRF-amide and salmon brain gonadotropin-releasing factor ( [Trp7, Leu8] LHRH) caused increased spontaneous activity in the dark, loss of light-induced inhibition, and increased incidence of light-entrained pulsatile response. The nervus terminalis is therefore a putatively peptidergic retinopetal projection. Sex-related olfactory stimuli may act through it, thereby modulating the output of ganglion cells responsive to color contrast.     

Peptidergic modulation of patterned motor activity in identified neurons of Helisoma

The neuroactive peptides SCP_B (small cardioactive peptide B) and FMRFamide (Phe-Met-Arg-Phe-NH₂), both originally isolated from molluscs, have potent modulatory effects upon the production of patterned motor activity in identified neurons (e.g., B5 and B19) in the buccal ganglia of the snail Helisoma. Such patterned motor activity has previously been shown to underlie feeding behavior. Micromolar concentrations of SCP_B initiate patterned motor activity in quiescent ganglia and increase the rate of activity in ganglia that are spontaneously active. Micromolar concentrations of FMRFamide inhibit patterned motor activity in Helisoma buccal ganglia, and 10 μM FMRFamide completely suppresses such activity. In addition, there are both anti-SCP_B-and anti-FMRFamide-immunoreactive neurons in Helisoma buccal ganglia. Our results suggest that peptides may play a prominent role in the regulation of feeding behavior in Helisoma.     

Light- and focus-dependent expression of the transcription factor ZENK in the chick retina.

Ocular growth and refraction are regulated by visual processing in the retina. We identified candidate regulatory neurons by immunocytochemistry for immediate-early gene products, ZENK (zif268, Egr-1) and Fos, after appropriate visual stimulation. ZENK synthesis was enhanced by conditions that suppress ocular elongation (plus defocus, termination of form deprivation) and suppressed by conditions that enhance ocular elongation (minus defocus, form deprivation), particularly in glucagon-containing amacrine cells. Fos synthesis was enhanced by termination of visual deprivation, but not by defocus and not in glucagon-containing amacrine cells. We conclude that glucagon-containing amacrine cells respond differentially to the sign of defocus and may mediate lens-induced changes in ocular growth and refraction.     

Motor cortex reorganisation in Parkinson's disease.

Transcranial magnetic stimulation mapping of the motor cortical projection to the hand was performed in a group of patients with Parkinson's disease (PD) of variable duration to determine whether there is evidence of cortical reorganisation. Map shifts were found in the majority of PD cases (12/15), in untreated early cases as well as treated cases of longer duration, and there was a correlation between inter-side difference in the severity of PD symptoms (Unified Parkinson's Disease Rating Scale) and interhemispheric map displacement (r=0.60; P=0.018). These findings indicate that there is reorganisation of the corticomotor representation of the hand in PD, even at a relatively early stage of the disease, and suggest a dynamic process of reorganisation in the motor cortex due to an increase in the pallidal inhibitory inputs to the thalamo-cortical projections.     

The treatment of early (T1) glottic and supra-glottic carcinoma: does partial laryngectomy have a place?

A series of 900 patients with laryngeal carcinoma is described. Patients with glottic T1N0 tumours were treated by radiotherapy with a 5-year survival of 92%. Seven per cent of patients suffered recurrence and most were salvaged by surgery: vertical hemilaryngectomy was occasionally useful as a salvage procedure. Patients with supra-glottic T1N0 tumours were treated for the first 7 years by supra-glottic laryngectomy and prophylactic neck dissection and thereafter by radiotherapy. The results were equally good in both series: a 5-year survival of 75-80%. Salvage surgery for failed radiotherapy or surgery for supra-glottic carcinoma gave poor results.     

Early histogenesis of the teleostean retina: studies using a novel immunochemical marker, proliferating cell nuclear antigen (PCNA/cyclin)

Immunoreactive proliferating cell nuclear antigen or cyclin (ir-PCNA), detected by immunofluorescence using a human autoantibody, was used as a marker for proliferating neuroblasts during early development of the teleostean retina. In a killifish (Medaka) and a cyprinid (goldfish), ir-PCNA was present in all retinal cells at the monolayer stage (embryonic day 2 in Medaka, days 3-4 in goldfish). Subsequently ir-PCNA was lost, as neuroblasts became postmitotic in a centre-to-periphery and proximal-to-distal (ganglion cells first, photoreceptors last) sequence. In late larvae and adults, neuronal ir-PCNA was confined to the ring of proliferating neuroblasts at the retinal margin and scattered rod precursors in the outer nuclear layer. The changes in localization of ir-PCNA during development parallel closely the changes in localization of [3H]thymidine incorporation, reported previously.     

Alternating cisplatinum and VAC ineffective in end stage squamous cell carcinoma of the head and neck

Sixteen patients with end stage squamous cell carcinoma of the head and neck were admitted to a phase II study of alternating courses of cisplatinum (100 mg/m2) and VAC (vincristine 1.4 mg/m2, adriamycin 50 mg/m2, cyclophosphamide 750 mg/m2) given at three weekly intervals. Only two patients achieved a response (12 per cent). The median survival time was 62 days which is much the same as that of a similar group of patients who received no chemotherapy in a previous trial (70 days).     

Improving patient meal satisfaction with room service meal delivery

Cancer and cancer therapies cause side effects that prevent patients from consuming adequate amounts of food. As evidenced by patient meal consumption studies conducted at patients' bedside, only 39 percent of patients surveyed consumed greater than 50 percent of their main entree. The Food and Nutrition Services Department at Memorial Sloan-Kettering Cancer Center used the organization's performance improvement process, STRAIGHT-A, to develop and execute a room service program designed to increase patient meal consumption and improve patient meal satisfaction A multidisciplinary task force developed policies and procedures and tested new menu items as part of the room service plan. After program implementation, 88 percent of patients surveyed consumed greater than 50 percent of their main entree.     

Sequential chemotherapy and radiotherapy in advanced head and neck cancer

Eighty-six previously untreated patients with advanced squamous-cell carcinoma of the head and neck were entered into a prospective randomised controlled trial to evaluate whether the addition of a kinetically based chemotherapy regimen before and after radiotherapy would improve survival compared with radiotherapy alone. Survival at 30 months showed there was no evidence that the addition of chemotherapy to radiotherapy improved survival and that the chance of obtaining a significant result in favour of adjuvant chemotherapy was remote. We make a strong plea that all chemotherapy regimens for the treatment of squamous-cell carcinoma of the head and neck regions should be subjected to controlled prospective trials before they are widely adopted.     

Chemoprophylaxis in major head and neck surgery

Wound infections are a significant complication following major oncological head and neck surgery. In view of the controversy surrounding the use of chemoprophylaxis a controlled trial was designed. Intravenous Augmentin (amoxycillin and clavulanic acid) was shown to reduce significantly (P less than 0.025) the incidence of postoperative sepsis.