Hospital Episode Statistics and trends in ophthalmic surgery 1998 – 2004

Background  

Hospital episode statistics (HES) is a UK national database for the National Health Service (NHS), now available online. The purpose of this study was to observe trends in ophthalmic operations performed during the period from 1998 to 2004, using this data.     

Ultrastructural observations of organelle accumulation in the equine recurrent laryngeal nerve

Summary The left recurrent laryngeal nerves from five horses with sub-clinical neuropathy were examined by light and electron microscopy in a study designed to examine accumulation of axonal organelles at paranodal and internodal locations. Transverse sections of the nerve showed scattered fibres with split myelin sheaths and axonal accumulation of organelles. On longitudinal sections these collections were seen to result from an axonal outpouching in which dense lamellar bodies and mitochondria had accumulated. These paranodal collections, which could be found on both sides of the node, were often associated with infoldings of the terminal loops of myelin and with occasional paranodal demyelination. The fact that many of the organelles in the outpouches were lysosomal in nature was confirmed by their positive staining for cathepsin D activity. Longitudinal sections demonstrated a number of axons which were swollen over a long distance and which contained focal accumulations of similar organelles. In places, however, there was a clear separation between these organelles and the cytoskeletal proteins. In each case these swollen axons were surrounded by Schwann cell nuclei and their processes, forming well-ordered onion bulbs. The possibility that these two types of changes, i.e. the paranodal accumulations and the axonal swellings could result from a disturbance in axonal transport in this distal axonopathy is discussed.     

The immunolocalisation of the neuroendocrine specific protein PGP9.5 during neurogenesis in the rat.

We have examined the immunolocalisation of the protein gene product (PGP) 9.5 during neurogenesis in the rat embryo. PGP9.5 was first present at 11.5 days gestation (E11.5): all morphologically recognisable nerve cell bodies and fibres were immunoreactive. In routinely processed, wax-embedded tissues, using a standard immunocytochemical technique, PGP9.5 polyclonal antibody specifically demonstrated the developing nervous system and primitive adrenal chromaffin cells.     

Prognosis of epilepsy

It has been a widely accepted view that epilepsy is usually a chronic condition in which the prognosis is generally poor and any remissions that do occur are usually temporary. In this article recent studies challenging this view will be considered, other aspects of the long-term prognosis for seizure control in epilepsy reviewed, and the mortality rates and causes of premature death in epilepsy outlined.     

Serotonergic interhemispheric asymmetry: Neurochemical and pharmaco-EEG evidence

1. Postmortem neurochemical investigations revealed interhemispheric asymmetry in the mediofrontal region of human brain. Significantly higher right hemisphere serotonin metabolite (5HIAA) content as well as increased maximal imipramine binding (IB) were found in the right hemisphere than in the left side.

2. IB did not show a gender difference in the mediofrontal area. However, women had higher IB in the right orbital frontal cortex than did men.

3. In vivo pharmaco-EEG results tend to support the postmortem neurochemical data. Intravenous chlorimipramine resulted in an asymmetric topographic distribution of the P300 auditory evoked potential, peak amplitudes were shifted to the right hemisphere.     

Air pollution and daily mortality: a hypothesis concerning the role of impaired homeostasis.

We propose a hypothesis to explain the association between daily fluctuations in ambient air pollution, especially airborne particles, and death rates that can be tested in an experimental model. The association between airborne particulates and mortality has been observed internationally across cities with differing sources of pollution, climates, and demographies and has involved chiefly individuals with advanced chronic illnesses and the elderly. As these individuals lose the capacity to maintain stable, optimal internal environments (i.e., as their homeostatic capacity declines), they become increasingly vulnerable to external stress. To model homeostatic capacity for predicting this vulnerability, a variety of regulated physiologic variables may be monitored prospectively. They include the maintenance of deep body temperature and heart rate, as well as the circadian oscillations around these set-points. Examples are provided of the disruptive changes shown by these variables in inbred mice as the animals approach death. We consider briefly the implications that the hypothesis may hold for several epidemiologic issues, including the degree of prematurity of the deaths, the unlikelihood of a threshold effect, and the role that coarse, noncombustive particles may play in the association.