Selective kainic acid lesions in cultured explants of rat hippocampus

Summary The influence of the excitotoxin kainic acid (KA) on cultivated explants of rat hippocampus was investigated. Addition of 3 M KA to the culture medium over 24–48 h induced a destruction of the pyramidal cells in the CA3 region, whereas the CA1 pyramidal cells and the granule cells were left undamaged. Higher concentrations (10–100 M) of KA destroyed also the latter cell groups. The selectivity of the KA lesion at 3 M was further indicated by the fact that the acetylcholinesterase-positive neurons in the hippocampus were not destroyed through KA administration and that the stereoisomer dihydrokainic acid was ineffective in inducing lesions. Application of tetrodotoxin did not protect the CA3 pyramidal cells from KA lesion, whereas -glutamylaminomethylsulphonic acid (GAMS) only offered a very small, statistically not significant, protection. Baclofen protected the cultures slightly from KA lesions but not when added together with GAMS. Possible mechanisms responsible for the KA lesions in these cultures are discussed.Supported in part by a grant from the Swiss National Foundation for Scientific Research (No. 3.528.-0.83)     

早期食管癌的病理形态观察及组织发生学探讨

目的探讨早期食管癌的组织发生学.方法对109例早期食管癌及癌周病变进行病理观察.结果其中20例的一点癌(黄豆大小),3例双原发癌,1例小细胞癌.癌周伴有不同程度的鳞状上皮异形增生和不典型增生.结论早期食管具有多样性生长的特点.提示临床医生在胃镜检查应注意多点取材,以防漏诊;以及正确确定手术范围,防止手术残留.     

Actual all-arthroscopic techniques for the treatment of osteochondral defects of the ankle joint

The treatment of osteochondral lesions of the talus (OCL) is demanding. Matrix associated techniques are used more and more as a standard, suggestion a more reliable healing. Nevertheless, approaching especially central and medial OCL is still demanding. Medial malleolus osteotomies routineously used, can be a source of morbidity and complications. Improving arthroscopic techniques allow an all-arthroscopic treatment of these defects.     

Morel-Lavallée lesion diagnosed 25 years after blunt trauma

IntroductionMorel-Lavallée lesions are closed degloving injuries in which the skin and subcutaneous tissues separate from the underlying fascia secondary to a shearing force. These injuries are uncommon and can be misdiagnosed in acute settings. If treated incorrectly, they can recur, causing complications requiring multiple surgical interventions. Therefore, it is important to discuss the clinical presentation and imaging characteristics in order to improve their diagnosis and management.Presentation of caseThis is the case of a 44-year-old male patient with a Morel-Lavallée lesion of the left thigh that presented 25 years after trauma. He was successfully treated with open surgical excision. The patient underwent multiple surgical interventions before the lesion was accurately diagnosed and treated.DiscussionMorel-Lavallée injuries can lead to chronic symptoms, such as pain and swelling, affecting the patient’s quality of life. Treatment options include minimally invasive procedures, such as compression bandages or percutaneous drainage. However, if diagnosed late, a fibrotic capsule can form, which may require surgical excision. Our patient was diagnosed more than 20 years after the trauma. Earlier noninvasive treatment options were unsuccessful.ConclusionThe patient was treated with open surgical excision of the chronic lesion. There was no report of any recurrence up to 10 months after surgery. Such lesion treatments should be guided based on the chronicity of the injury and the patient’s symptoms. To the best of our knowledge, this is the first case with such delayed presentation.     

Effect of dopamine denervation and dopamine agonist administration on serine phosphorylation of striatal NMDA receptor subunits

Sensitization of striatal N-methyl-d-aspartate (NMDA) receptors has been implicated in the pathogenesis of the response alterations associated with dopaminomimetic treatment of parkinsonian animals and patients. To determine whether serine phosphorylation of NMDA receptor subunits by activation of Ca2+/calmodulin-dependent protein-kinase II (CaMKII) contributes to this process, we examined the effects of unilateral nigrostriatal ablation with 6-hydroxydopamine and subsequent treatment with levodopa, SKF 38393 (D1-preferring dopamine agonist), or quinpirole (D2-preferring agonist) on motor responses and phosphorylation states. Three weeks of twice-daily levodopa administration to rats shortened the duration of their rotational response to levodopa or SKF 38393 challenge, but prolonged the duration of quinpirole-induced rotation. At the same time, levodopa treatment elevated serine phosphorylation of striatal NR2A (p<0.02), but not that of NR2B subunits, without associated changes in subunit protein levels. Chronic treatment with SKF 38393 increased NR2A (p<0.0001) but decreased NR2B (p<0.004) serine phosphorylation. In contrast, chronic quinpirole treatment had no effect on NR2A but increased NR2B phosphorylation (p<0.0001). The acute intrastriatal injection of the CaMKII inhibitor KN93 (1.0 micrograms) not only normalized the levodopa-induced motor response alterations but also attenuated the D1 and D2 receptor-mediated serine phosphorylation of NR2A and NR2B subunits, respectively (p<0.02). These results suggest that a CaMKII-mediated rise in serine phosphorylation of NMDA receptor subunits induced by intermittent stimulation of D1 or D2 dopaminergic receptors contributes to the apparent enhancement in striatal NMDA receptor sensitivity and thus to the dopaminergic response plasticity in levodopa-treated parkinsonian rats.     

Neurological prognosis correlated with variations over time in the number of subependymal nodules in tuberous sclerosis

In tuberous sclerosis (TS), brain CT reveals subependymal nodules, cortical tubers and white matter lesions. This study is a retrospective analysis of the relationship between the variations over time in the number of subependymal nodules and the clinical course in cases of tuberous sclerosis. Twenty-four children with tuberous sclerosis, who attended the National Children's Hospital as outpatients, were followed by means of brain CT examinations for 7 years and 1 month on average. Cranial MRI was also performed in 22 cases. Brain CT disclosed subependymal nodules already in early infancy. In almost all cases, the number of subependymal nodules gradually increased with age, especially around the frontal horn of the lateral ventricle. The increase stopped at around age 10. The cases with five or more subependymal nodules at the initial or subsequent CT examination (17 patients; Group A) exhibited a significantly greater number of cortical tubers than those with less than five (five patients; Group B) and had white matter lesions unlike Group B. In addition, the number of cases with either infantile spasms or mental retardation was significantly higher in Group A than Group B (P<0.005). In conclusion, the number of ventricular subependymal nodules may allow prediction of the severity of the cerebral dysfunction in TS. Our results suggest that its variation may reflect the degree of the embryologic disorder when neuronal cells grow in the early gestational period.     

Selective drawing disorders after right subcortical stroke: a neuropsychological premorbid and follow-up case study

We report the case of a patient affected by a subcortical lesion of the right non-dominant hemisphere, and demonstrate that he had selective constructional disorders by comparing his post-stroke performances with those assessed 18 months before the stroke. A detailed analysis was made of the visuospatial, perceptual, representational and executive competences involved in drawing tasks at one, two and six months post-stroke. Neuropsychological follow-up revealed the progressive recovery of all visuospatial abilities. This study provides some interpretative elements for constructional disorders and, in particular, for the closing-in phenomenon observed only during the subacute phase.

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Sommario Descriviamo un paziente affetto da una lesione sottocorticale dell'emisfero destro. Le prestazioni del paziente dopo l'ictus cerebrale, confrontate con quelle osservate prima dell'evento patologico, hanno dimostrato la presenza di selettivi disturbi costruttivi. Abbiamo effettuato un approfondito esame delle prestazioni costruttive, con prove visuospaziali che esplorano i livelli percettivo, rappresentazionale ed esecutivo, esaminando il paziente fino a sei mesi dopo l'ictus. Il follow-up neuropsicologico ha dimostrato un progressivo recupero di tutte le competenze visuospaziali. Questo studio fornisce dunque alcuni elementi interpretativi per i disordini costruttivi ed, in particolare, per il fenomeno del closing-in osservato nelle prime fasi dello studio longitudinale.

     

Primary cranial vault lymphoma mimicking meningioma

Primary lymphomas of the cranial vault are rare; only six patients have been described in the literature. We report a 75-year-old woman who was admitted to our hospital after a focal seizure. CT showed a homogeneous mass which, on contrast enhancement, was similar to a meningioma. The tumour was excised and found to be a centroblastic, centrocytic non-Hodgkin's lymphoma. Treatment was completed with radiotherapy and chemotherapy.     

Suprasellar arachnoid cysts in children report of three cases

Summary Three cases of suprasellar arachnoid cysts in children are reported. Incidence, aetiology, pathogenesis, symptomatology, diagnosis, treatment, and other problems of these uncommon lesions are discussed.Communication presented at the XXXIst Meeting of the Portuguese-Spanish Neurosurgical Society. Santiago de Compostela, Spain. May 1979.