The RECIST criteria compared to conventional response evaluation after peptide receptor radionuclide therapy in patients with neuroendocrine neoplasms

Annals of Nuclear Medicine - The Response Evaluation Criteria In Solid Tumors (RECIST) is the most used radiological method for evaluating response after peptide receptor radionuclide therapy...     

Cerebellar nuclear afferents--where do they originate? A re-evaluation of the projections from some lower brain stem nuclei

Summary Cerebellar nuclear afferents from some caudal brain stem nuclei in the cat were studied by means of retrograde transport after implantation of the wheat germ agglutinin-horseradish peroxidase complex in crystalline form in the cerebellar nuclei. The findings give evidence that projections to the cerebellar nuclei from certain nuclei of the reticular formation proper (e.g., from the gigantocellular reticular nucleus) are very modest, while there appears to be no or extremely few cerebellar nuclear afferents from the paramedian reticular, spinal trigeminal, gracile, cuneate and external cuneate nuclei. Previous tracer studies have given evidence that also the pontine and red nuclei send very few, if any, fibres to the cerebellar nuclei. All these brain stem regions are known to project to the cerebellar cortex. This relative lack of mossy fibre collaterals to the cerebellar nuclei is discussed with references to previous literature on the distribution of cerebellar nuclear afferents, and the problem of how the cerebellar nuclei are facilitated is considered.Abbreviations Br.c. superior cerebellar peduncle (brachium conjunctivum) - Br.p. middle cerebellar peduncle (brachium pontis) - C.r. interior cerebellar peduncle (restiform body) - HRP horseradish peroxidase - L left - N.c. cuneate nucleus - N.c.e. external cuneate nucleus - N.c.t. nucleus of corpus trapezoideum - NIA anterior interposed nucleus - NIP posterior interposed nucleus - NL lateral (dentate) nucleus - N.l.l. nuclei of lateral lemniscus - NM medial (fastigial) nucleus - N.m.X. dorsal motor vagal nucleus - N.mes. mesencephalic trigeminal nucleus - N.r.l. lateral reticular nucleus (nucleus of the lateral funiculus) - N.r.p. paramedian reticular nucleus - N.r.t. reticular tegmental pontine nucleus - N V, VI, VII, XII root fibres of cranial nerves - Ol.s. superior olive - P.h. nucleus praepositus hypoglossi - Py pyramid - R right - R.gc. gigantocellular reticular nucleus - R.l. lateral reticular nucleus of Meessen and Olszewski - R.p.c. caudal pontine reticular nucleus - R.pc. parvicellular reticular nucleus - R.v. ventral reticular nucleus - Tr.sp.V. spinal tract of the trigeminal nerve - T.s. solitary tract surrounded by nucleus of solitary tract - V.m. medial vestibular nucleus - WGA wheat germ agglutinin - WGA-HRP wheat germ agglutinin-horseradish peroxidase conjugate - V, VI, VII, X, XII motor nuclei of cranial nerves     

Microvascular decompression for hemifacial spasm: postoperative neurologic follow-up and evaluation of life quality

Microvascular decompression (MVD) is an effective and safe treatment in hemifacial spasm (HFS). Postoperative evaluations are usually made by neurosurgeons. Follow-up studies performed by neurologists and postoperative quality of life (QoL) investigations are lacking. All 25 HFS patients operated with MVD in our centre between 2000 and 2004 were evaluated with the recently validated HFS-7 scheme, extended with the item 'sleep disturbance due to HFS' (HFS-8). The patients underwent a careful neurological examination median 3 years after the operation. The evaluation focused on clinical aspects, changes in blood pressure and time until observable effect of MVD. The evaluation of HFS-7 questionnaire and the extended form (HFS-8) showed significant improvement in QoL after MVD. Neurological outcome was in almost all cases excellent or good. Eleven (44%) patients had no neurological deficits at all. Only one patient had serious complications with ipsilateral facial palsy, deafness, balance problems and vertigo. The other patients had minor neurological findings or symptoms. Eighteen (72%) patients experienced early effect within 3 months after MVD; seven (28%) patients had late effect between 6 and 14 months. Median age of the patients with late effect (62.6 years) was significantly higher than in those with early effect (52.7 years).     

Interleukin 1 receptor antagonist (IL1RA) in acute leukaemia: IL1RA is both secreted spontaneously by myelogenous leukaemia blasts and is a part of the acute phase reaction in patients with chemotherapy- induced leucopenia

Abstract: Blast cells derived from peripheral blood of patients with acute myelogenous leukaemia (AML) were cultured in vitro and interleukin 1 receptor antagonist (IL1RA) concentrations determined in culture supernatants. AML blasts derived from patients classified as AML-M4 and AML-M5 subtype showed an increased release of IL1RA. IL1α and IL1β caused a similar increase in AML blast release of IL1RA, and addition of anti-ILl antibodies decreased IL1RA release. IL1RA release from AML blasts was also increased by stem cell factor, tumour necrosis factor α (TNFα), granulocyte-macrophage colony-stimulating factor and macrophage colony-stimulating factor, whereas interleukin 3, interleukin 6, leukaemia inhibitory factor and granulocyte colony- stimulating factor did not significantly alter IL1RA release. When investigating IL1RA serum levels, serum concentrations were decreased in acute leukaemia patients with chemotherapy-induced cytopenia compared with healthy controls. Serum levels of both IL1RA as well as IL1β and soluble TNFα receptors increased when the leucopenic patients developed complicating bacterial infections.     

Indirect hypothalamo-cerebellar pathway? Demonstration of hypothalamic efferents to the lateral reticular nucleus

Summary Hypothalamic efferents to the lateral reticular nucleus (NRL) have been demonstrated in the cat by means of anterograde and retrograde axonal transport of the wheat germ agglutinin — horseradish peroxidase (WGA-HRP) complex. Pressure injections of the WGA-HRP complex into the hypothalamus resulted in anterograde labelling of branching terminal axons both in the NRL and in an adjacent area, presumably the ventrolateral catecholaminergic cell group (A1). After microiontophoretical ejections of the WGA-HRP complex into the NRL from a ventral approach, retrogradely labelled neurons were found in the lateral, dorsal, posterior and anterior hypothalamic areas and in the tubero-mammillary, dorsomedial and periventricular nuclei. The projection is bilateral with a clear ipsilateral predominance and has its main origin in the lateral hypothalamic area. The locations of hypothalamic cells projecting to the NRL are somewhat different from those giving rise to hypothalamo-cerebellar and hypothalamo-spinal connections. The present demonstration of a hypothalamic input to one of the major precerebellar relay nuclei introduces a new possible indirect route through which the cerebellum may be influenced by the hypothalamus. The different indirect and direct hypothalamo-cerebellar pathways and their potential functional importance are discussed.     

Divergent axon collaterals to cerebellum and amygdala from neurons in the parabrachial nucleus, the nucleus locus coeruleus and some adjacent nuclei

Summary After injections in the cat of Rhodamine labelled latex microspheres in the amygdala and of Fast Blue in the cerebellum neurons labelled with one of these tracers as well as some double labelled neurons were found in the parabrachial nucleus, the nucleus locus coeruleus and some adjacent nuclei (the nucleus subcoeruleus and the pontine tegmental reticular formation). All double labelled cells were located on the ipsilateral side. A few double labelled neurons were also found bilaterally in the dorsal raphe nucleus. It therefore appears that a certain number of cerebellar projecting neurons in these brain stem nuclei by means of divergent axon collaterals also project to the amygdala. The location of the double labelled cells found in this study suggests that at least some of the neurons are catecholaminergic. The findings are related to previous reports on the distribution of catecholaminergic neurons and on the amygdaloid and cerebellar projections from this part of the brain stem, and the possible involvement of these connections in cerebellar non-somatic responses are discussed. Some comments are made concerning the use of fluorescent latex microspheres for double labelling studies in combination with another fluorescent tracer.     

The medullary projection from the mesencephalic trigeminal nucleus. An experimental study with comments on the intrinsic trigeminal connections

Summary The medullary projection from the mesencephalic trigeminal nucleus has been studied in cats where the wheat germ agglutinin-horseradish peroxidase complex has been used as a retrograde and anterograde tracer. All injections were made at the level of the caudal pole of the inferior olive and show that it is especially the lateral part of nucleus parvicellularis of the reticular formation which is the main area for termination of the fibres. In addition, it can not be excluded that the descending fibres also reach the medialmost part of the spinal trigeminal sensory nucleus (pars magnocellularis and the adjoining pars gelatinosa). All three cell types of the mesencephalic trigeminal nucleus are labelled, the large globular, the small globular and the polygonal cells. Some of these cells are only faintly labelled. The observations confirm previous studies of the intrinsic trigeminal connections, but show that when the wheat germ agglutinin-horseradish peroxidase complex is used as a tracer, the origin as well as the termination for the intrinsic fibres (also the commissural) can be studied in the same section. The use of this sensitive tracer also shows new details within the intrinsic connections. The findings are discussed with special reference to the recent observations by Ruggiero et al. (1982). These authors found that in rabbit and rat there is a more restricted termination for the descending mesencephalic trigeminal fibres. The discrepancies between the observations seem to indicate that there are species differences as regards the connections between the mesencephalic trigeminal nucleus and the nuclei in the lower part of the brain stem.     

The cerebellar corticonuclear and nucleocortical projections in the cat as studied with anterograde and retrograde transport of horseradish peroxidase

Summary The cerebellar parafloccular corticonuclear and nucleocortical connections were studied in the cat by means of anterograde and retrograde transport of horseradish peroxidase.Previous investigations have given evidence that the cortex of the paraflocculus can be subdivided into three zones. These zones are recognized as C₂, D₁ and D₂. The material presented is compatible with the findings from previous reports with other methods that each of these zones sends its Purkinje axons to separate regions within the cerebellar nuclei. These terminal fields are the lateral part of nucleus interpositus posterior (the alleged nuclear zone C₂) and the dentate nucleus and its transition area with nucleus interpositus anterior (the supposed nuclear D zones). The parafloccular corticonuclear fibres appear to terminate along a continuous mediolateral band extending from the NL through the NL-NIA transition area into the lateral NIP. This observation is in concordance with our previous findings concerning the termination of the cerebellar corticonuclear fibres (Dietrichs and Walberg 1979, 1980; Dietrichs 1981). Within the NL and NL-NIA transition area the Purkinje axons from the ventral paraflocculus terminate ventral to those from the dorsal paraflocculus.The nucleocortical projection shows the same zonal arrangement as the corticonuclear connection, indicating the presence of a corticonuclear-nucleocortical reciprocity.The findings are discussed with reference to previous studies on the parafloccular corticonuclear and nucleocortical connections, and some comments are made concerning the cerebellar zonal subdivision of this cortical area.