Acetylcholinesterase in the fast extraocular muscle of the mouse by light and electron microscope autoradiography.

The distribution of acetylcholinesterase (ACHe) in the twitch fibers of the extraocular muscles of the mouse was examined by light and electron microscope autoradiography after labeling with radioactive diisopropyl fluorophosphate (DFP) with, and without, 2-pyridine aldoxime methiodide (2-PAM) reactivation. The values obtained were compared with those previously reported for the diaphragm and sternomastoid muscles. The extraocular muscles were studied because they differ from the other two muscles in that they are among the fastest of the mammalian muscles, yet their endplates have sparse junctional folds. They could thus provide information on the extent to which ACHe concentration is an invariant feature of endplate morphology and what, if any aspects may be related to their fast speed of response. We found, using light microscope autoradiography, that in the twitch fibers of the extraocular muscle, there is n average of 6.4 +/- 2.1 X 10(7) DFP-binding sites per endplate, of which 29% (1.8 X 10(7)) are reactivated by 2-PAM and are thus AChe. The morphology of the extraocular endplates allowed us to conclude, on statistical grounds, that the AChe site are probably localized not only along the surface area of the postjunctional membrane (PJM) but also along the surface of the presynaptic axonal membrane. Based on this localization, we calculate 7,800 DFP sites and 2,500 2-PAM-reactivated sites/micron 2 of surface area of pre-and postjunctional membrane. This stacking density of DFP-binding sites per surface area of membrane ( probably in the overlying sheets of basal lamina) is very similar to that in the diaphragm and sternomastoid muscles.

Measurement of pupil reactivity using fast pupillometry.

Analysis of human eye pupil reactivity is a very valuable diagnostic method used mainly for evaluation of the condition of the autonomic nervous system and the visual system. The paper presents an experimental pupillometer built in the Institute of Physics of the Wroclaw University of Technology. The apparatus makes it possible to record and analyze pupillary light reflex and spontaneous changes in the pupil diameter during a session in the dark. The detector system used in the pupillometer allows us to record the pupil diameter at a rate of 90 Hz with a linear accuracy of 0.008 mm. In this paper, the proposed detection method, the principle of operation and calibration of the apparatus and the possibilities of the measurement system are presented.

Enhanced lipid peroxidation processes in patients after brain contusion.

Erythrocyte superoxide dismutase (SOD-1) activity and cerebrospinal fluid (CSF), blood plasma low-density lipoprotein (LDL) and erythrocyte thiobarbituric acid reactive substance (TBARS) concentrations were determined in 30 patients with brain contusion and in 37 control patients with low back pain due to noninflammatory degenerative lumbar disc disease. In comparison to controls, during 10-day follow-up patients with brain contusion had significantly increased erythrocyte SOD-1 activity and CSF, blood plasma (LDL), and erythrocyte TBARS concentrations. The highest CSF TBARS concentrations were observed in five patients who died 2, 7, or 8 days following head injury. A significant negative correlation was found between erythrocyte SOD-1 activity or TBARS concentrations, in the blood plasma LDL fraction and erythrocytes, and The Glasgow Coma Scale score. These results suggest that enhanced lipid peroxidation processes, which seem to correlate with the severity of head injury, accompany brain contusion.

Application of twyman-green interferometer for evaluation of in vivo breakup characteristic of the human tear film.

The paper presents an interferometric method of assessing the in vivo stability of the precorneal tear film. To observe dynamic effects on a human cornea the Twyman-Green interferometer with television frame speed digital registration synchronized with a laser flash was used. The instrument was applied to the human cornea in vivo. The results of the experiment, both tear film distribution and its dynamics, are presented. The proposed interferometric setup can be used to evaluate the breakup characteristics of the tear film, its distribution, and to examine its dynamic changes. The breakup profiles and their cross sections calculated from the interferogram analysis are presented. The depth of recorded breakup, calculated on the basis of interferogram analysis, amounts to about 1.5 µm. The proposed method has the advantage of being noncontact and applies only a low-energy laser beam to the eye. This provides noninvasive viewing of human cornea in vivo and makes it possible to observe the kinetics of its tear film deterioration. © 1999 Society of Photo-Optical Instrumentation Engineers.

Analysis of shearing interferograms of tear film using fast fourier transforms.

A new method for evaluating tear film stability on the human eye is reported. The tear film distribution on the cornea is measured by the lateral shearing interference technique. The eye is kept open during approximately a 2-min recording, when blinking has to be prevented. Continuous recording and viewing of interferograms allows the changes in disturbances of the interference fringes to be registered during elapsed time. The changes in fringes are caused by the evaporation of tears from the ocular surface and appearance of the breakups. For precise and repetitive assessment of the tear film breakup time, a fast fourier transform (FFT) is applied to consecutive interferograms. Larger fringe disturbances result in wider Fourier spectra. The tear breakup time can be evaluated noninvasively by comparing the value of the second momentum of Fourier spectra calculated from the consecutive interferograms. © 1998 Society of Photo-Optical Instrumentation Engineers.

[Holographic analysis of displacement of the bovine cornea after disruption of intact structures]. / Holographische Analyse der Auslenkung der Rinderkornea nach Unterbrechung der intakten Strukturen.

Displacement of the surface of the cornea of bovine eyes after disruption of intact structures was investigated by means of holographic interferometry. Double-T-incisions of different depths were made with a diamond knife. Starting at about 80% of the incision depth there is a change in the central holographic interference fringe pattern. These effects can be clearly demonstrated by means of double-exposure holographic interferometry and real-time holographic interferometry. The stability of an existing corneal scar was analyzed by double-exposure holographic interferometry. The region of the scar showed a higher density of holographic interference fringes compared with the non-affected corneal areas, indicating a higher degree of elasticity. All eyes were investigated at an intraocular pressure of 1340 Pa (about 10 mmHg) and an intraocular pressure change of 10 Pa and 20 Pa. Further potential ophthalmic applications of holographic interferometry are discussed.

[Morphological studies of gunshot wounds of the peripheral nerves in rabbits]. / Badania morfologiczne postrzalowych uszkodzen nerwu obwodowego królika.

The author reports the results of morphological investigations in 48 experimental shot wounds of the peripheral nerves of rabbits. In 8 animals the missile hit directly the ischiadic nerve disrupting its continuity (neurotmesis). The microscopic picture of not discupted nerves differed from one animal to another. Three types of microscopic findings were distinguished: 1) normal microscopic appearance, 2) Wallerian degeneration, 3) axonal regeneration. Normal appearance of nervous fibres was observed in all three groups of animals studied at different time intervals after injury (8-10, 18 and 56 days after injury). In the first and second groups Wallerian degeneration prevailed, while axonal regeneration was a typical finding in groups II and III. Microscopic changes in the nerves were very similar to those observed in peripheral nerves subjected to traction injury. It may be assumed that the cause of shot injury was sudden stretching of the nerve trunk in the pulsating shot channel.

[Use of gelatin-resorcinol-formaldehyde glue in the surgical treatment of cerebrospinal rhinorrhea]. / Zastosowanie kleju zelatynoworezorcynowo-formaldehydowego (GRF) w chirurgicznym leczeniu przetok plynu mozgowo-rdzeniowego.

The introduction of tissue adhesives in neurosurgery for treating cerebrospinal fluid fistulas has been a major advance in the operative technique. The authors describe the use of gelatin-resorcin-formaldehyde adhesive (GRF) in the surgical treatment of cerebrospinal fluid fistulas. The method of preparation of GRF, the technique of adhesive application, its clinical use and advantages are described.

[Cases of "delayed" subdural posttraumatic hygromas]. / Przypadki "odroczonych" pourazowych wodniaków podtwardówkowych.

The authors present 6 cases of uni- or bilateral subdural hygromas that appeared a few weeks following severe head injury. Such hygromas were named by the authors as "delayed" ones. Surgical evacuation of hygroma resulted in patient's status improvement in all 6 cases, based on well-known theories of posttraumatic hygromas origin, the authors try to explain patomechanism of the "delayed" hygromas.

[Epidural hematoma with unilateral exophthalmos]. / Krwiak nadtwardówkowy z jednostronnym wytrzeszczem.

A case of epidural haematoma in the fronto-temporo-parietal region with ipsilateral exophthalmus is presented. In the light of 10 cases reported in literature and one own case, and on the basis of neuroanatomical data the possible causes of this rare sign are discussed. The aetiology of this exophthalmus is still unclear and subject to discussion.

[Microsurgical method of transplantation of peripheral nerves]. / Technika mikrochirurgiczna przeszczepów nerwów obwodowych.

The authors present the microsurgical technique of grafting thin cutaneous nerves at the site of peripheral nerve defect. The application of grafts in place of end-to-end suture makes possible elimination of nerve stretching at the time of suturing and at the time of rehabilitation. The use of cutaneous nerves makes possible good revascularization of grafts and their correct regeneration. The use of the microsurgical technique makes possible a good evaluation of the fascicular structure of nerve trunks, their adequate resection, and good adaptation of nerve stumps and grafts connecting the corresponding nerve fascicles. The use of the technique of nerve gluing with autologous plasma enables a stable connection of grafts and stumps to be obtained, with simultaneous elimination of foreign material (threads) from the area of connection.

[Cases of cavernous hemangioma discovered in patients with post traumatic intracerebral hematoma]. / Przypadki haemangioma cavernosum ujawnione u chorych z pourazowym krwiakiem sródmózgowym.

Cavernous haemangioma has various forms. The cases with spontaneous intracerebral haemorrhage are most common, but post-traumatic intracerebral haematoma was not reported. The aim of this report is to present cases of cavernous haemangioma with unusual clinical course. In seven patients with post-traumatic intracerebral haematoma, fragments of histologically confirmed cavernous haemangioma tissue situated in the place of haematoma were found. In one case, delayed intracerebral haematoma twenty four hours after trauma and initial CT-scan was observed. On the initial CT-scan in this patient only traumatic changes in the brain without haematoma or tumour were present. In our cases, cavernous haemangioma was situated most frequently in frontal and temporal region, shown as haematoma usually 24 hours after trauma, mainly in men in age range 30-44 years with disorders of consciousness (GCS 11). As the result of operation, the majority of patients (6 out of 7) were discharged as self-independent. The authors reviewed the literature for cavernous haemangioma. The tumour may be present in any region of the brain including infratentorial region. The lesion is disclosed most frequently in children as spontaneous brain haemorrhage and rarely as seizures or intracranial hypertension. Final diagnosis is based on cerebral angiography or MRI. CT-scans are not typical and before the appearance of haematoma do not suggest the presence of tumour. Surgical removal of haematoma with tumour fragments is the main method of therapy, but radiation is possible in order to diminish the mass. The authors conclude that in each patient with post-traumatic intracerebral haematoma, the presence of cavernous haemangioma is possible.

[Surgical transposition of the ulnar nerve in progressive paralysis]. / Operacyjne przemieszczenie nerwu lokciowego w przypadku postepujacego jego niedowladu.

The authors present a method of surgical treatment of progressive paresis of the ulnar nerve by means of transposition of this nerve to the anterior aspect of the cubital fossa. This method was used in 35 cases. The most frequent cause of the paresis was old fracture or contusion of the region of the cubital joint. In all cases the therapeutic result was good.

[Surgical treatment of Horton's headache or neuralgia of the greater superficial petrosal nerve]. / Leczenie chirurgiczne bólów glowy Hortona czyli neuralgii nerwu skalistego powierzchownego wiekszego.

The authors report two cases of Horton's neuralgia treated surgically. In one patient the result is very good, in the other one it is poor. The pathophysiological mechanisms and anatomical-functional basis of this type of headache are discussed stressing the contribution to the knowledge of these mechanisms made by Professor Jerzy Choróbski. It seems that more patients should be referred for this treatment that it is done presently. The operation with sectioning of this nerve is not particularly troublesome and it may be a good supplementation of pharmacological treatment.

[Cerebral aneurysms and current methods of treatment]. / Tetniaki tetnic mózgowych i nowoczesne metody ich zaopatrywania.

The authors discuss briefly aneurysms cerebral arteries. In the light of the pertinent literature the hypotheses of their development are reviewed. These aneurysms are probably lesions acquired by individuals with special predispositions, acquired or inborn. The problems of aneurysm diagnosis are reviewed and the methods are discussed of their management, both surgical and intravascular (embolization). Both methods are tentatively compared. In certain cases each method may be an excellent alternative for the other, and in other cases they are mutually complementary extending thus the range of therapeutic possibilities.

[Surgical treatment of radial nerve injuries]. / Chirurgiczne leczenie uszkodzen nerwu promieniowego.

The results are presented of treatment of 16 patients with radial nerve injuries. In only 3 cases the injury was an isolated lesion while in 13 cases it was secondary to humeral fractures or surgical interventions. In 7 cases autotransplantation was done, and in the remaining cases the interventions were limited to external and internal neurolysis because of the nerve trunk showed continuity without losing normal thickness. The therapeutic results were regarded as good.

[Injury of the deep branch of the ulnar nerve]. / Uszkodzenie gallezi Gleebokiej nerwu lokciowego.

The authors report the clinical material from the Department of Neurosurgery, WAM in Lódz from the last 11 years including cases of damage to the deep branch of the ulnar nerve. In view of the importance of this branch for the function of the hand, damage to it requires very careful surgical management with autogenous graft. Sometimes this is technically difficult in view of the topographic conditions in this area. Damage to the deep branch of this nerve is usually associated with damage to the sensory part of the ulnar nerve, to the median nerve and tendons of finger flexors.

[Results of surgical treatment of intracranial aneurysms]. / Wyniki leczenia operacyjnego tetniaków sródczaszkowych.

In the years 1986-1990 in the Department of Neurosurgery Military Hospital in Bydgoszcz 61 patients were treated surgically for intracranial aneurysms. Good results were obtained in 60.7% of cases and bad in 21.3%. Death from extracranial causes occurred in 6 cases. The number of past bleedings from the aneurysms, the clinical state of the patients, the timing of the operation, intraoperative rupture of the aneurysms were factors having a significant unfavourable influence on the early postoperative results.

[Cases of posterior inferior cerebellar artery aneurysms]. / Przypadki tetniaków tetnicy mózdzkowej tylnej dolnej.

The authors described two cases of aneurysms of the posterior inferior cerebellar artery (PICA) successfully operated on. The possibilities of surgical approaches and methods of obliteration of the aneurysm and review of PICA aneurysms in the literature are presented.

[Nerve transplants in the reconstruction of damaged nerve trunks]. / Przeszczepy nerwowe w rekonstrukcji uszkodzonych pni nerwowych.

The authors present the first in the Polish literature group of 320 cases of autogenic nerve cable grafts. The overall results of this treatment are: very good and good in 43.3%, satisfactory in 29.1%, poor in 18.2%, bad in 9.4%. Nearly all bad results were obtained in grafting nerves in the lower extremity. A comparison of the results obtained with the classic nerve suture and short cable grafts shows a decidedly evident superiority of grafts over the classic suture. The advantages of grafts are discussed, particularly with respect to nerve blood supply. The importance of early surgical treatment and prolonged heat treatment is stressed.