摘要:

&NA;The historical events in the evolution of Alzheimer's disease are reviewed, including the initial description by Alois Alzheimer and the subsequent controversy regarding the nosological specificity of this entity. The similarity of senile dementia and Alzheimer's disease is emphasized. The basis for the modern concept of Alzheimer's disease as premature or accelerated aging is included in the review. The pathological correlates of the major categories of adult dementia have been described. The traditional criteria of neurofibrillary tangles and senile plaques have been re‐evaluated using the current insight into these changes afforded by electron microscopy and biochemistry. The significance of amyloid has been described because it occurs within the senile plaque and also as the essential component of congophilic angiopathy. The new information regarding neuronal cell counts and the loss of choline acetyltransferase has been evaluated in terms of an indication of a pathogenic mechanism of Alzheimer's disease. The current understanding of normal pressure hydrocephalus, Creutzfeldt‐Jakob disease, and multi‐infarct dementia has been described. Brain biopsy in dementia has been described as having diagnostic, research, pathogenic, and prognostic value. The precautions involving the performance and handling of the biopsy have been stressed, particularly because these procedures involve conditions of possible slow virus etiology. The polemic for Alzheimer's disease as aging or slow virus infection has been summarized. At this time a consideration seems justified that Alzheimer's disease is an age‐related, slow virus disease due to a hitherto unknown immune defect. Aging as an etiological agent must be clarified before Alzheimer's disease, in any form, can be considered to be an inevitable consequence of longevity.

ISSN:0148-396X    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

&NA;The dorsal rhizotomy was one of the earliest operations used for the treatment of chronic, intractable, segmental pain. The theoretical basis underlying the use of this procedure was the law of separation of function of the spinal roots that implies, among other things, that sensory fibers are located in the dorsal root and motor fibers are located in the ventral roots. On this basis, it should be possible by cutting the appropriate dorsal roots to relieve pain for any particular part of the body at the cost of making that part of the body anesthetic. Unfortunately, however, the dorsal rhizotomy seems to have a relatively low success rate in that the pain is often not relieved or is relieved for a variable period of time and then returns. Many different reasons may account for these failures, but one reason that is not often considered is that the law of separation of function of the spinal roots may not be accurate. This is pertinent at the present time, because large numbers of ventral root afferent fibers have recently been discovered. This review summarizes the work, both old and new, on ventral root afferents with particular emphasis on possible clinical applications. In particular, it is pointed out that the ventral root afferent fibers are probably present in humans and, if so, they may be involved in explanations for the failure of dorsal rhizotomy to relieve chronic pain. If these fibers are important, then they can be removed by a dorsal root ganglionectomy, which would remove both the dorsal and ventral root afferent fibers, as opposed to a dorsal rhizotomy, which would remove only the dorsal root afferent fibers.

ISSN:0148-396X    

出版商:OVID    

年代:1979

数据来源: OVID

ISSN:0148-396X    

出版商:OVID    

年代:1979

数据来源: OVID

ISSN:0148-396X    

出版商:OVID    

年代:1979

数据来源: OVID

ISSN:0148-396X    

出版商:OVID    

年代:1979

数据来源: OVID