摘要:

ABSTRACTVisual acuity in five multiple sclerosis (MS) patients was quantitatively monitored during the induction of hyperthermia and the subsequent spontaneous return of body temperature to base line (“cooling”). During heating acuity decreased monotonically. During “cooling” acuity was restored but, in three of the five patients, along a different temperature‐acuity trajectory; that is, acuity at any temperature during “cooling” tended to be better than acuity at the same temperature reached during heating. In two patients acuity upon return to base‐line temperature was significantly better than it had been before the induction of hyperthermia; in one case the difference was striking and significant at the .001 level. The difference in the second case was smaller but also significant (p<0.02). The significance of these findings in helping to better understand the physiologic basis of temperature effects in

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1973.tb01286.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

ABSTRACTThe fibrinolytic activity of human brain was studied with the “fibrin slide technique” for the localisation of tissue plasminogen activators. The material consisted of brains obtained at autopsy of 25 adults without demonstrable intracranial disorders. Measured as the “focal lysis time” the fibrinolytic activity of gray as well as of white matter was found to be low and that of the leptomeninges high. The areas of lysis were situated along small blood vessels scattered over the section. This fibrinolytic activity was found to be localised to the advential layer of the vessel. The concentration of plasminogen activators in various parts of the brain was fairly uniform and relatively low. Major cerebral arteries, such as the internal carotid and basilar arteries, showed active centres of lysis in the intimal layer of the vessels. The ependymal cells lining the floor of the fourth ventricle showed very little or no activity. The choroid plexus was rich in plasminogen activators. One might imagine that large amounts of fibrinolytic activators in the leptomeninges may be released into the CSF after vascular damage and/or haemorrhage and thereby interfere with the first stages of vascular repair and premature dissolution of the clot formed after a haem

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1973.tb01287.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

ABSTRACTThe purpose of the present study was to investigate the incidence of early recurrent haemorrhage and the survival rate in a series of 34 patients with aneurysmal subarachnoid haemorrhage treated with an antifibrinolytic drug (AMCA) for three weeks. The fibrinolytic activity in blood and CSF from these patients was determined before and at regular intervals during the treatment. The invariably high levels of fibrin degradation products in CSF noted before treatment showed that fibrinolysis was already increased, a finding also made in our previous investigations. Although the present clinical material was relatively small, the data obtained suggest that inhibition of fibrinolysis reduces the incidence of early recurrences during the preoperative period of patients eligible for surgical treatment and those conservatively treated. There were six recurrences in the series, but two of them occurred after the third week of treatment. In both cases the recurrence was ascribed to the fibrinolysis that had started again as soon as AMCA in the CSF was no longer demonstrable. In one patient the recurrence was not associated with increased FDP in CSF, and in the remaining three, the recurrence was presumably due to insufficient inhibition of local fibrinolysis in addition to hypertension. The fact that rebleeding occurred after the third week of treatment suggests the necessity of prolonging the prophylactic antifibrinolytic therapy to six weeks with gradual reduction of the dose of AMCA. During such reduction, however, it is imperative to examine the CSF repeatedly to check that complete inhibition of the local fibrinolysis is maintained. Such prophylactic treatment is useful in the management of cases in which operation must be postponed owing to the patient's poor general condition and in cases allocated to conservative treatment.

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1973.tb01288.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

ABSTRACTSMethylprednisolone acetate was administered intrathecally 83 times to 23 patients who had 46 separate exacerbations of multiple sclerosis. Four patients improved, 7 worsened, and 12 were unchanged during treatment and follow‐up. Serious side effects occurred in 3 patients; adhesive arachnoiditis in 2, and aseptic meningitis in one. Three other patients had severe exacerbations within 24 hours of treatment, followed by slow improvement, or no improvement. When the clinical response of this patient group was evaluated and compared with other series, it was found that improvement occurred with chance frequency. Exacerbations continued to occur with natural frequency. These findings suggest that there is no rationale for this mode of therapy, as there are dangers from these intrathecal injections, and the treatment does not alter the course of the diseas

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1973.tb01289.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

ABSTRACTFollowing systemic injection of protein tracers (albumin labelled with Evan's blue and horseradish peroxidase) in immature mice, cells along cerebral and spinal cord vessels accumulated significant amounts of these proteins as revealed by fluorescence microscopy and enzyme histochemistry. These cells most probably correspond to pericytes which in adult animals contain lipofuscin granules and lysosomal enzymes. This accumulation could be revealed only in animals taken 24 h or later after the injection. No tracers were seen in the surrounding neuropile, in glial cells or in neurons. Our observation must imply (1) that small amounts of systematically injected protein tracers can actually pass from the blood into the brain in immature mice and (2) that pericytes of the normal immature brain have the capacity to engulf such tracers from their immediate surroundings.

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1973.tb01290.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

ABSTRACTThree cases of progressive weakness of the external ocular muscles are described. Although there were many common factors, each seemed to represent a distinct clinical entity. Several associations such as cardiac conduction defects, malabsorption, athetosis, myopathy, peripheral neuropathy, optic atrophy, posterior column dysfunction and cerebellar ataxia were noted in different cases. Although muscle biopsies were done, the paper illustrates the difficulty in establishing the cause of the muscle atrophy. In this context the term progressive external ophthalmoplegia is appropriate, as it implies a clinical state and does not presume the underlying pathological change. In view of the absence of a clear genetic basis for disease processes under scrutiny, I wondered whether this progressive assault on the anatomy could be the result of an infection with some slow virus. There was nothing to support an infective basis for the illness in any of the investigations. It is of interest that the C.S.F. protein was 92 mg/100 ml in one case. The mechanism of an attack by slow viruses is still a matter of conjecture.

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1973.tb01291.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

ABSTRACTIt has been shown, that on monocular registration of evoked nystagmus in patients with the cerebral form of multiple sclerosis, latent anterior internuclear ophthalmoplegia is present which appears as a dissociation of provoked nystagmus between the right and the left eye. Nystagmus was induced by rotation at an angular velocity of 100°/sec, lasting for three minutes. Latent anterior internuclear ophthalmoplegia was manifested using this method in 35 patients out of a group of 50 patients suspected of multiple sclerosis. In another 15 patients the evoked nystagmus was abnormal but without symptoms of dissociation. After a follow‐up period, lasting for six years the diagnosis of multiple sclerosis was confirmed in 29 out of 35 patients. Six patients did not come for control examination. In the above 15 patients the clinical symptomatology eliminated multiple sclerosis. These results proved that the monocular electronystagmographic registration of evoked nystagmus can reveal latent, early stages of cerebral form of multiple sclerosis. The negative results are important because they exclude damage of the medial longitudinalis fascicul

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1973.tb01292.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

ABSTRACTThe activity of acetylcholinesterase was studied in various autopsy brain samples of nine parkinsonian patients and eight control subjects without extrapyramidal disorders. Putamen and caudate nucleus showed the highest activities of acetylcholinesterase when different brain areas were compared. Acetylcholinesterase values expressed per wet weight or protein were somewhat lower in the extrapyramidal brain regions of parkinsonian patients than in those of controls. When values were calculated per desoxyribonucleic acid (DNA) it was found that extrapyramidal brain regions, especially substantia nigra, showed higher activities in parkinsonian material than in controls. This difference is due to the decrease of DNA which in the substantia nigra mainly reflects the loss of dopaminergic substantia nigra neurons. Furthermore, analyses of dopamine from the same tissue samples showed many times increased acetylcholinesterase‐dopamine ratio in parkinsonian brain than in controls. Levodopa alone or combined with a decarboxylase inhibitor did not have any significant effect on the activity of acetylcholinesterase. It is concluded that the cholinergic mechanisms in the extrapyramidal system of parkinsonian brain are not so severely affected as the dopaminergic ones leading to relative and functional cholinergic dominanc

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1973.tb01293.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

ABSTRACTCertain features of the slow leg tremor observed in chronic alcoholic ataxia were established by electromyographic recordings. In standing (Romberg's test) the recordings from the flexor and extensor muscles of the feet showed a 3 Hz regular, alternating tremor of high intensity. The tremor activity was synchronous in the right and left legs. A similar slow tremor could also, in certain attitudes, be recorded from other muscle groups in the legs and, rarely, in the upper limbs.

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1973.tb01294.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

ABSTRACTIncomplete apallic syndromeswith (almost total) loss of the telencephalic grey matter, the supratentorial blood flow and oxygen uptake were found to be only about 20 per cent of the normal. Such cases show no signs of higher functions and they have an isoelectric EEG. Due to the retention of brain stem structures they may, however, show clear‐cut signs of arousability with lively brain stem reflexes and primitive motor reactions. In a permanently comatose case—also without higher functions—due to aselective reticular brain stem infarction, but with retained telencephalic morphology on the whole, extremely low values (about 20 per cent of normal) for the supratentorial oxygen uptake and blood flow were also demonstrated. Other states with a severe reduction, but not a complete loss of higher functions, due to posttraumatic stupor and advanced Alzheimer's disease showed higher cerebral blood flow and metabolic values than those related above. Such cases also showed a retention of an often pathological EEG. Two patients withakinetic mutismshowed relatively high flow values and by and large a normal relative weight of the cortical grey matter, as well as a normal EEG. Both cases showed slight but definite signs of remaining higher functions. It is concluded that measurements of the supratentorial cerebral oxygen uptake and blood flow may be used to quantitate the functional state of the brain in patients with a loss of, or with a severe reduction of higher functions (signs of conscious awareness, voluntary motor activity, speech, and memory). It is emphasized that a complete loss of such functions may be caused by a total loss of the cortical grey matter (the complete apallic state), or by a selective lesion of the reticular system of the brain

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1973.tb01295.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY