Cerebral blood flow and freezing of gait in Parkinson's disease.

OBJECTIVE: We investigated the relationship between freezing of gait (FOG) severity in Parkinson's disease (PD) and regional cerebral blood flow (rCBF) using single-photon emission computed tomography (SPECT) and evaluated the effect of selegiline therapy. METHOD: We evaluated 54 patients with PD (FOG positive: 21 patients, and FOG negative: 33 patients) with N-isopropyl-p-[I-123] iodoamphetamine ((123) I-IMP) SPECT and the Unified Parkinson's Disease Rating Scale (UPDRS) part III, Mini-Mental State Examination (MMSE), and Beck Depression Inventory. [Correction added on 18 April 2012, after online publication: In the preceding statement, 55 instead of 54 patients with PD were evaluated, and FOG negative consisted of 34 instead of 33 patients] Furthermore, we examined rCBF in FOG-negative patients treated with levodopa with or without selegiline. RESULTS: Z-values of bilateral Brodmann areas (BA) 10 and 11 and left BA32 showed significant increases in the FOG-positive group compared with the FOG-negative group. [Correction added on 18 April 2012, after online publication: In the preceding statement, Z-values was changed to Z-scores] There were significantly positive correlations between Z-values of these areas and FOG score, especially on both sides of BA11. [Correction added on 18 April 2012, after online publication: In the preceding statement, Z-values was changed to Z-scores] An increase in Z-values in bilateral BA10 and 11 and left BA32 in the levodopa-selegiline treatment group after 1 year was significantly inhibited compared with the levodopa treatment group. [Correction added on 18 April 2012, after online publication: In the preceding statement, left BA32 was changed to right BA32, and Z-values was changed to Z-scores] CONCLUSION: There was a close relationship between FOG severity in PD and an increase in rCBF in BA 10, 11 and 32. Furthermore, selegiline's FOG prevention effect may be related to maintaining rCBF in these same areas.

The relationship between depression and regional cerebral blood flow in Parkinson's disease and the effect of selegiline treatment.

OBJECTIVES: We examined the relationship between severity of depression in Parkinson's disease (PD) and regional cerebral blood flow (rCBF) using single photon emission computed tomography (SPECT) and the reaction to levodopa-selegiline combination therapy. MATERIALS AND METHODS: We evaluated 52 patients with PD and nine age-matched controls with SPECT and the Unified Parkinson's Disease Rating Scale (UPDRS) part III, Mini-Mental State Examination (MMSE), and Beck Depression Inventory (BDI) to evaluate depression severity and its connection with rCBF. Furthermore, we examined rCBF in patients with PD treated with levodopa with or without selegiline. RESULTS: A significant fall in rCBF was observed in the bilateral posterior cingulate, hippocampus, and cuneus and the superior parietal and primary visual areas in PD patients with minor depression and in all regions in those with major depression. Elevations in UPDRS part III and BDI scores and falls in MMSE scores were of significantly lower magnitude in the levodopa-selegiline group than in the levodopa group. Whole brain rCBF fell significantly less in the levodopa-selegiline group than in the levodopa group. CONCLUSIONS: These results indicate that selegiline controlled not only worsening of motor function and cognitive function in PD but also aggravation of minor depression, and restrained a fall in whole brain rCBF.

[Measurement of subarachnoid space with a short TR gradient echo method; myelo MRI].

The cerebro-spinal fluid in the subarachnoid space is delineated clearly with gradient field echo technique (TR = 60 ms, TE = 20 ms, flip angle = 20 degrees). Average area, width, depth, and curvature of the subarachnoid space in the cervical region were obtained in ten young normal subjects.

An electron microscopic study of malignant lymphomas; with special reference to undifferentiated type.

Nine cases of malignant lymphomas of undifferentiated type, which is difficult to classify whether they are derived from reticulum cell or lymphocyte by light microscopy, were collected and studied by electron microscopic and histopathological examinations, and calssified into two types from electron microscopic findings. Some characteristic features, including cellular size and shape, and quantity and quality of cytoplasmic and nuclear structures at the electron microscopic level, were compared between the two types of lymphomas with similarity to reticulum cell and to lymphoblastic cell. From the aspects of systemic and synthetic view, it is possible to classify whether these tumor cells correspond to the so-called reticulum cell or to lymphoblastic cell in malignant lymphomas of undifferentiated type, which was previously thought to be indistinguishable. In addition to these results, clinico- and histo-pathological analyses were also made, with short discussion.

Reticulosarcomatosis originating from skin--A clinicopathological study.

The case is that of a 65 year-old male with reticulosarcomatosis originating from the skin. There were multiple tumors composed of reticulum cells located only in the skin, particularly around the large joints. The entire course of illness was three years and five months, during which period regression by irradiation, recurrence, or new formation of tumors were repeatedly seen. At the end systemic tumor spread not only of the skin but also in various visceral organs including lymph nodes occurred. From histological and electron microscopic examinations repeatedly performed with biopsy materials, and finally with autopsy materials it was ascertained that the tumor cells had become smaller in size with less lymphoid cell infiltration at the terminal stage.

Primary thrombocythemia and myocardial infarction in a 26-year-old woman with normal coronary arteriogram.

Acute myocardial infarction occurred in a 26-year-old woman with normal coronary arteriogram and primary thrombocythemia (500,000 approximately 1,500,000/mm3). Hyperaggregability of platelets was also demonstrated by stimulation with adenosine diphosphate, collagen, and epinephrine administration. A stillbirth at the 8th month of gestation in her past history was referred to the complication of primary thrombocythemia, too. Since discharge, the patient has been on 750 mg of aspirin and then free of any thromboembolic symptoms and signs, even during pregnancy and labour.