Abnormalities of cerebral lateralization in schizophrenia patients

Initial lateral eye movements (LEMs) have been shown to be associated with activation of the contralateral frontal lobes. Using LEM as a criterion measure of activation, schizophrenics were compared to normals with respect to the processing of four types of stimuli: verbal nonemotional (VNE), verbal emotional (VE), spatial nonemotional (SNE), and spatial emotional (SE). Our results indicate that schizophrenics initiate thought in their left hemisphere significantly more often than controls when one compares all test conditions and on VNE, VE, and SE material. Neither medication nor level of education had an appreciable effect on LEM in either group. However, sex was a significant variable; women irrespective of diagnosis consistently used the left hemisphere more often than men. The inappropriate initiation of thought on SE material as well as the overall increase in left hemisphere activity suggest left hemisphere disorder. This is consistent with other findings that suggest a left hemisphere locus of disturbance in schizophrenia.     

Pseudocaloric nystagmus

Pseudocaloric nystagmus (PCN) is an appropriately beating nystagmus induced by cold caloric irrigation of an ear with abolished vestibular function. The nystagmus is not the result of endolymph flow but probably represents unmasking a latent nystagmus by altering the patient in this case, through tactile (caloric) stimulation. Pseudocaloric nystagmus has the following characteristics: (1) mild intensity (eyes closed-slow phase velocity usually less than 8 degrees/sec), it has not been observed with the eyes open, (2) always beats away from the diseased ear; therefore, any nystagmus induced by cold irrigation will be appropriately (contralateral) beating while that induced by warm irrigation will be inappropriately (contralateral beating; 3) the induced nystagmus will not reverse direction after inverting the ampulla. Establishing bidirectional sensitivity of the cupula by demonstrating appropriately beating nystagmus to ampullopetal and ampullofugal flow of endolymph not only assures that the lateral semicircular canal (SCC) is functionally intact to caloric stimulation but will avoid errors in electronystagmorgraphic (ENG) interpretation.     

Transantral sphenopalatine artery ligation

Posterior epistnxis from branches of the sphenopalatine artery can be rapidly and effectively controlled by a new ligation technique. The sphenopalatine artery or its branches arc directly ligated as they exit the sphenopalatine foramen to enter the nose, completely avoiding the pterygomaxillary fossa. The vessels are exposed via a transantral approach, through the posterior portion of the medial antral wall. The mucoperiosteum of the lateral wall of the nose (medial antral wall) is preserved, elevated medially and posteriorly and used to tense the sphenopalatine vessels, bringing them into view and accessible for ligation at the foramen. Advantages of this technique include direct, specific ligation of the end vessels; ease and speed of operation; and avoidance of complications associated with the pterygomaxillary space. The technique was defined in multiple dissections of anatomic specimens and has been successful to date in 14 cases of severe posterior epistaxis.     

Fractures of the proximal tibial epiphysis

Fractures of the upper tibial epiphysis are rare. We report on three cases classified according to the Salter and Harris method. Case one, a Type III injury, was associated with a neurovascular lesion. Case two, a Type II injury, was associated with rupture of the medial collateral ligament of the knee, which was treated by internal fixation of the fracture and repair of the ligament. Case three was an unusual fracture, which has not previously been reported in the literature, a Type II injury with an accompanying fracture of the tibial tubercle.     

Neurotoxic esterase in rooster testis

Neurotoxic esterase (NTE) is the putative target protein in the nervous system for the initiation of organophosphorus-induced delayed neuropathy. Here it is reported that NTE activity is present in rooster testis. Complete titration of rooster testis phenyl valerate esterases with paraoxon shows that about 15% of the enzymic activity is resistant to paraoxon. NTE activity after complete mipafox titration accounts for 30% of paraoxon-resistant phenyl valerate esterases and corresponds to 7.93 +/- 0.39 nmol/min/mg of protein (mean +/- SD, n = 7). Testis NTE is inhibited in vitro similarly to brain NTE by several organophosphorus compounds. Subcellular fractionation studies of the testis indicate that most NTE activity is particle bound. Testis NTE is also inhibited in vivo by several organophosphorus esters but to a lesser extent than brain NTE. Birds doses with organophosphorus compounds, causing delayed neuropathy, became grossly ataxic, but no testicular pathology was noted by light microscopy in roosters killed 15 days after administration. Serum testosterone levels also measured 15 days after dosing were not different from those of a control group. Recovery of NTE activity was faster in testis than in brain (4 days vs 6 days to recover to 50% of initial activity) in animals that received a high dose of an organophosphorus ester which cause delayed neuropathy.     

Hallervorden-Spatz syndrome.

Two siblings with Hallervorden-Spatz syndrome showed striking homotypism and homochronism. Neuropathologic examination and electron microscopic studies were done; neutron activation analysis showed an increase in the uptake of iron in the basal ganglia. Of particular relevance is the application of radioactive iron studies in the clinical course of this syndrome. These studies disclosed an increase in the uptake of iron in the area of the basal ganglia in one sibling and in another isolated patient. This procedure will be helpful toward the clinical diagnosis.