COGNITIVE, NEUROLOGICAL, NEUROPSYCHOLOGICAL AND NEUROPSYCHIATRIC ALTERATIONS IN POST-COVID-19 PATIENTS.

The SARS-CoV-2 virus that causes the COVID-19 disease, reports hundreds of infections daily, the alterations and sequelae of this new pathogen have been reported globally, due to the seriousness of being an older adult and evolving seriously.

Alteraciones cognitivas, neurológicas, neuropsicológicas y neuropsiquiátricas en pacientes post-covid-19. Una revisión sistemática / Cognitive, neurological, neuropsychological and neuropsychiatric alterations. in post-covid-19 patients

Introducción. El virus SARS CoV-2 causante de la enfermedad COVID-19, reporta cientos de contagios diariamente, las alteraciones y secuelas de este nuevo patógeno han sido reportadas a nivel global, por la gravedad que implica ser adulto mayor y evolucionar de manera grave. Metodología. El presente trabajo tiene un enfoque cualitativo, con intenciones exploratorias y descriptivas de las alteraciones a nivel cognitivo, neuropsicológico, neuropsiquiátrico y neurológico. Resultados. En el análisis fueron incluidos 16 artículos que expresan alteraciones en áreas de funcionamiento que comprometen la calidad de vida en pacientes mayores de 18 años, la evidencia científica es fuerte sobre las alteraciones que provoca el nuevo virus SARS Cov-2, desde el deterioro de la cognición, habilidades visuoespaciales y cefaleas constantes entre otros síntomas, que son de atención desde una perspectiva multidisciplinar. Conclusiones. La transmisión del virus en la población adulta supone un riesgo a la salud, este estudio evidencia las alteraciones a nivel cognitivo, motor y neurológico siendo la edad un factor que predispone la aparición de secuelas. (AU)

Introduction. The SARS-CoV-2 virus that causes theCOVID-19 disease, reports hundreds of infections daily,the alterations and sequelae of this new pathogen have been reported globally, due to the seriousness of being anolder adult and evolving seriously. Methodology. The present work has a qualitative approach, with exploratory and descriptive intentions of the alterations at a cognitive, neuropsychological, neuropsychiatric and neurological level. Results. In the analysis, 16 articles were included that express alterations in areas of functioning that compromise the quality of life in patients over 18 years of age, the scientific evidence is strong on the alterations caused by the new SARS-CoV-2 virus, from the deterioration of cognition, visuospatial abilities and constant headachesamong other symptoms, which are of attention from amultidisciplinary perspective. Conclusions. The transmission of the virus in the adult population poses a risk to health, this study shows alterations at the cognitive, motor and neurological level, agebeing a factor that predisposes the appearance of sequelae. (AU)

A v-transformed copula-based simulation model for lithological classification in an Indian copper deposit.

Copula functions are widely used for modeling multivariate dependence. Since the multivariate data may not necessarily be linear and Gaussian, the copula model is very often brought into the picture for modeling such multivariate phenomena. The lithological classification in spatial domain is a class of problems dealing with categorical variables. A generalized class of copula model is effective for such classification tasks. In this paper, a non-Gaussian copula (v-transformed copula) model has been used for lithotype classification of an Indian copper deposit. Coupling of Markov chain Monte Carlo (MCMC) simulation and copula discriminant function is performed for this purpose. Specifically, four lithotypes, e.g., granite, quartz, basic, and aplite are simulated in the case study deposit. The efficacy of v-transformed copula discriminant function-based simulation is compared with those of Gaussian copula, t copula, and sequential indicator simulations. Finally, the classification accuracy of all the approaches is examined with ground-truth lithological classes obtained from blast hole information. The results show that the v-transformed copula simulation has a relatively higher classification accuracy (76%) than those of Gaussian copula (70%), t copula (69%), and sequential indicator (70%) simulations.

Impact of plasma glucose and duration of type 2 diabetes mellitus on SYNTAX Score II in patients suffering from non ST-elevation myocardial infarction.

Aim    The objective was to assess the correlation of fasting plasma glucose (FPG), HbA1c, and the duration of type 2 diabetes mellitus (T2DM) with SYNTAX score (SS) II in patients with non-ST elevation myocardial infarction (NSTEMI).Material and methods    FPG and HbA1C were measured in 398 patients presenting with NSTEMI at admission. SS II was calculated using an online calculator. Patients were stratified according to SS II (≤21.5, 21.5-30.6, and ≥30.6), defined as SS II low, mid, and high, respectively.Results    37.7 % of subjects were diabetic. Correlations of FPG (R=0.402, R2=0.162, p<0.001) and HbA1c (R=0.359, R2=0.129, p<0.001) with SS II were weak in the overall population. Duration of T2DM showed very strong correlation with SS II (R=0.827, R2=0.347). For the prediction of high SS II in the study population, FPG≥98.5 mg / dl demonstrated a sensitivity of 58 % and a specificity of 60 %, and HbA1c ≥6.05 demonstrated a sensitivity of 63 % and a specificity of 69 %. Duration of T2DM (adjusted odds ratio (OR): 1.182; 95 % confidence interval (CI): 1.185-2.773) and FPG (OR: 0.987; 95 % CI: 0.976-0.9959) were significantly associated with high SS II after controlling for other risk factors. Duration of T2DM (Beta=0.439) contributed strongly to variance of SS II, whereas HbA1c (Beta=0.063) contributed weakly.Conclusion    Duration of T2DM is a very important risk factor for severity of coronary artery disease.

Primary photodissociation mechanisms of pyruvic acid on S1: observation of methylhydroxycarbene and its chemical reaction in the gas phase.

Pyruvic acid, a representative alpha-keto carboxylic acid, is one of the few organic molecules destroyed in the troposphere by solar radiation rather than by reactions with free radicals. To date, only its stable final products were identified, often with contribution from secondary chemistry, making it difficult to elucidate photodissociation mechanisms following excitation to the lowest singlet excited-state (S1) and the role of the internal hydrogen bond in the most-stable Tc conformer. Using multiplexed photoionization mass spectrometry we report the first direct experimental evidence, via the observation of singlet methylhydroxycarbene (MHC) following 351 nm excitation, supporting the decarboxylation mechanism previously proposed. Decarboxylation to MHC + CO2 represents 97-100% of product branching at 351 nm. We observe vinyl alcohol and acetaldehyde, which we attribute to isomerization of MHC. We also observe a 3 ± 2% yield of the Norrish Type I photoproducts CH3CO + DOCO, but only from d1-pyruvic acid. At 4 Torr pressure, we measure a photodissociation quantum yield of 1.0+0-0.4, consistent with IUPAC recommendations. However, our measured product branching fractions disagree with IUPAC. In light of previous calculations, these results support a mechanism in which hydrogen transfer on the S1 excited state occurs at least partially by tunneling, in competition with intersystem crossing to the T1 state. We present the first evidence of a bimolecular reaction of MHC in the gas phase, where MHC reacts with pyruvic acid to produce a C4H8O2 product. This observation implies that some MHC produced from pyruvic acid in Earth's troposphere will be stabilized and participate in chemical reactions with O2 and H2O, and should be considered in atmospheric modeling.

Looking at the bigger picture: Identifying the photoproducts of pyruvic acid at 193 nm.

Photodissociation of pyruvic acid (PA) was studied in the gas-phase at 193 nm using two complementary techniques. The time-sliced velocity map imaging arrangement was used to determine kinetic energy release distributions of fragments and estimate dissociation timescales. The multiplexed photoionization mass spectrometer setup was used to identify and quantify photoproducts, including isomers and free radicals, by their mass-to-charge ratios, photoionization spectra, and kinetic time profiles. Using these two techniques, it is possible to observe the major dissociation products of PA photodissociation: CO2, CO, H, OH, HCO, CH2CO, CH3CO, and CH3. Acetaldehyde and vinyl alcohol are minor primary photoproducts at 193 nm, but products that are known to arise from their unimolecular dissociation, such as HCO, H2CO, and CH4, are identified and quantified. A multivariate analysis that takes into account the yields of the observed products and assumes a set of feasible primary dissociation reactions provides a reasonable description of the photoinitiated chemistry of PA despite the necessary simplifications caused by the complexity of the dissociation. These experiments offer the first comprehensive description of the dissociation pathways of PA initiated on the S3 excited state. Most of the observed products and yields are rationalized on the basis of three reaction mechanisms: (i) decarboxylation terminating in CO2 + other primary products (∼50%); (ii) Norrish type I dissociation typical of carbonyls (∼30%); and (iii) O-H and C-H bond fission reactions generating the H atom (∼10%). The analysis shows that most of the dissociation reactions create more than two products. This observation is not surprising considering the high excitation energy (∼51 800 cm-1) and fairly low energy required for dissociation of PA. We find that two-body fragmentation processes yielding CO2 are minor, and the expected, unstable primary co-fragment, methylhydroxycarbene, is not observed because it probably undergoes fast secondary dissociation and/or isomerization. Norrish type I dissociation pathways generate OH and only small yields of CH3CO and HOCO, which have low dissociation energies and further decompose via three-body fragmentation processes. Experiments with d1-PA (CH3COCOOD) support the interpretations. The dissociation on S3 is fast, as indicated by the products' recoil angular anisotropy, but the roles of internal conversion and intersystem crossing to lower states are yet to be determined.

Temperature dependence of the photodissociation of CO2 from high vibrational levels: 205-230 nm imaging studies of CO(X1Σ+) and O(3P, 1D) products.

The 205-230 nm photodissociation of vibrationally excited CO2 at temperatures up to 1800 K was studied using Resonance Enhanced Multiphoton Ionization (REMPI) and time-sliced Velocity Map Imaging (VMI). CO2 molecules seeded in He were heated in an SiC tube attached to a pulsed valve and supersonically expanded to create a molecular beam of rotationally cooled but vibrationally hot CO2. Photodissociation was observed from vibrationally excited CO2 with internal energies up to about 20 000 cm-1, and CO(X1Σ+), O(3P), and O(1D) products were detected by REMPI. The large enhancement in the absorption cross section with increasing CO2 vibrational excitation made this investigation feasible. The internal energies of heated CO2 molecules that absorbed 230 nm radiation were estimated from the kinetic energy release (KER) distributions of CO(X1Σ+) products in v″ = 0. At 230 nm, CO2 needs to have at least 4000 cm-1 of rovibrational energy to absorb the UV radiation and produce CO(X1Σ+) + O(3P). CO2 internal energies in excess of 16 000 cm-1 were confirmed by observing O(1D) products. It is likely that initial absorption from levels with high bending excitation accesses both the A1B2 and B1A2 states, explaining the nearly isotropic angular distributions of the products. CO(X1Σ+) product internal energies were estimated from REMPI spectroscopy, and the KER distributions of the CO(X1Σ+), O(3P), and O(1D) products were obtained by VMI. The CO product internal energy distributions change with increasing CO2 temperature, suggesting that more than one dynamical pathway is involved when the internal energy of CO2 (and the corresponding available energy) increases. The KER distributions of O(1D) and O(3P) show broad internal energy distributions in the CO(X1Σ+) cofragment, extending up to the maximum allowed by energy but peaking at low KER values. Although not all the observations can be explained at this time, with the aid of available theoretical studies of CO2 VUV photodissociation and O + CO recombination, it is proposed that following UV absorption, the two lowest lying triplet states, a3B2 and b3A2, and the ground electronic state are involved in the dynamical pathways that lead to product formation.

Alternative nitrogenase and pseudogenes: unique features of the Paenibacillus riograndensis nitrogen fixation system.

Biological nitrogen fixation (BNF) is a tightly regulated process that is carried out by diazotrophic microorganisms. The regulatory mechanisms of BNF-related genes are well characterized in Gram-negative models, but they are poorly understood in Gram-positive bacteria. Paenibacillus riograndensis SBR5(T) is a Gram-positive, endospore-forming facultative aerobic diazotroph. Three clusters of BNF-related genes with dissimilar phylogenetic histories were identified in the P. riograndensis genome, and no regulatory genes were recognized. P. riograndensis nifH2 was considered inactive based on transcript and promoter analyses, whereas transcripts of nifH1 and anfH were induced upon nitrogen-limited conditions. The functionality of the alternative nitrogenase system was also validated by enzymatic activity analysis. Fragments upstream of the two active clusters seem to harbor primary functional promoter sequences, producing a constitutive expression pattern in Escherichia coli. Sequences upstream of the anf genes were not recognized by this heterologous host, indicating a very distinct promoter pattern. These results shed light upon the evolutionary history of nitrogen fixation genes in this Gram-positive bacterium and highlight the presence of novel regulatory elements that are yet to be described.

Changes in root bacterial communities associated to two different development stages of canola (Brassica napus L. var oleifera) evaluated through next-generation sequencing technology.

Crop production may benefit from plant growth-promoting bacteria. The knowledge on bacterial communities is indispensable in agricultural systems that intend to apply beneficial bacteria to improve plant health and production of crops such as canola. In this work, the diversity of root bacterial communities associated to two different developmental phases of canola (Brassica napus L.) plants was assessed through the application of new generation sequencing technology. Total bacterial DNA was extracted from root samples from two different growth states of canola (rosette and flowering). It could be shown how bacterial communities inside the roots changed with the growing stage of the canola plants. There were differences in the abundance of the genera, family, and even the phyla identified for each sample. While in both root samples Proteobacteria was the most common phylum, at the rosette stage, the most common bacteria belonged to the family Pseudomonadaceae and the genus Pseudomonas, and in the flowering stage, the Xanthomonadaceae family and the genus Xanthomonas dominated the community. This implies in a switch in the predominant bacteria in the different developmental stages of the plant, suggesting that the plant itself interferes with the associated microbial community.

Effects of dietary copper supplementation on production performance and plasma biochemical parameters in broiler chickens.

A study was conducted to estimate the effect of copper (Cu) supplementation on growth performance and biochemical profiles of blood and meat in broiler chickens. A total of 240 d-old broiler chicks (Vencobb-100) were randomly divided into 12 groups, each of 20 chicks (4 treatments x 3 replicates). The basal diet (T1) contained 215 g kg⁻¹ crude protein (CP), 12·76 MJ kg⁻¹ ME, 32 g kg⁻¹ total calcium and 5 g kg⁻¹ total phosphorus. T2, T3 and T4 were formulated to contain an additional 75, 150 and 250 mg Cu kg⁻¹ diet, respectively. Copper sulphate pentahydrate (CuSO4, 5H2O) was used as the source of Cu. Significant reductions in plasma total cholesterol and triglyceride, and an elevated concentration of HDL-cholesterol, were observed in the chickens fed with 250 mg Cu kg⁻¹ (T4) of feed at the 3rd and 6th week of the experiment. Total cholesterol in meat decreased significantly in the birds fed with dietary Cu at 250 mg kg⁻¹ (T4) of feed. Growth performance was measured in terms of live weight gain, cumulative feed intake and feed conversion ratio at the end of d 21 and d 42 of the experiment, and the result was found to be commercially beneficial for the chickens receiving 150 mg Cu kg⁻¹ (T3) of diet. The concentration of Cu in breast muscle and liver increased significantly at the end of experiment. From this study it can be concluded that supplementation with dietary Cu may be beneficial for production performance and plasma biochemical characteristics of broiler chickens.

Morphological processing of physiological signals for feature extraction.

The paper proposes a novel method of extracting features from physiological signals using intrinsic mode decomposition (IMD) and morphological signal processing (MSP). The complex, nonlinear and non-stationary biomedical signals are first decomposed into intrinsic mode functions (IMF). Next each IMF is subjected to MSP for extracting features, namely, pattern spectrum entropy, that characterize the shape-size complexity of the component signals. These along with other features like energy and sample entropy are extracted from the individual IMF as well as the cumulative sums of IMF for characterizing the signals. The procedure is illustrated using heart sound signals digitally recorded during cardiac auscultation representing different cardiac conditions.

Development and in vivo testing of a Nitinol tracheal stent.

This article describes the development of a Nitinol tracheal stent (HCPA NiTi-stent) and its application in a feline animal model. Straight-annealed, bright-polished Nitinol wire (55.8%Ni-44.2%Ti) was weaved around a 40-mm-long metal fixture with 8-mm diameter. The prototypes were submitted to different times of shape-setting heat treatment (530 degrees C), which resulted in stents of different colors and caused some variation in length and diameter. The prototypes were then submitted to compression testing, and the most resistant pieces, requiring the greatest force to achieve a 25% reduction in diameter and presenting the least variation in length and diameter (dark blue, 9 min of heat treatment), were submitted to fatigue testing. After that, only dark blue stents were manufactured and implanted in felines. No migration, tracheal stenosis, or any other type of damage were observed after 40 weeks. The integrity of the tracheal wall in contact with the stent was confirmed by macro and microscopic analyses. The development and in vivo testing of the HCPA NiTi-stent were successful.

Intrapartum transcervical amnioinfusion for meconium-stained amniotic fluid.

OBJECTIVE: To assess the rates of cesarean deliveries and perinatal outcome following intrapartum transcervical amnioinfusion in women with meconium-stained amniotic fluid (MSAF) in a setting with no electronic fetal monitoring or specialized neonatal care. MATERIALS AND METHODS: In this prospective comparative study with 150 women who were in labor and had MSAF, 50 of the women received a transcervical amnioinfusion and the remaining 100 women received standard care. The inclusion criteria were a pregnancy of at least 37 weeks' duration, a single live fetus in cephalic presentation, no major medical or obstetric complications, and no known fetal malformation. The amnioinfusion was performed with 1000 mL of normal saline solution through a red rubber catheter. RESULTS: Amnioinfusion was associated with a significant decrease in the incidence of low Apgar score (<7) at 1 min (12% vs. 47%; relative risk [RR], 0.26; 95% confidence interval [CI], 0.12-0.56); low Apgar score at 5 min (4% vs. 23%; RR, 0.17; 95% CI, 0.04-0.71); and meconium aspiration syndrome (4% vs. 18%; RR, 0.22; 95% CI, 0.05-0.92). There was also a trend towards a lesser incidence of cesarean deliveries (18% vs. 30%; RR, 0.6; 95% CI, 0.31-1.16) and perinatal deaths (4% vs. 13%; RR, 0.31; 95% CI, 0.07-1.31). The incidence of maternal hospital stays longer than 3 days was significantly lower in the amnioinfusion than in the control group (24% vs. 48%; RR, 0.5; 95% CI, 0.29-0.85). There were no major complications related to amnioinfusion. CONCLUSIONS: Intrapartum amnioinfusion for MSAF is a simple, safe, effective, and inexpensive procedure feasible in settings where intrapartum monitoring is limited. It is associated with improved perinatal outcome and could lower cesarean delivery rates in low-resource countries.

[Surgical treatment of temporal lobe epilepsy: a series of forty-three cases analysis]. / Tratamento cirúrgico da epilepsia do lobo temporal: análise de 43 casos consecutivos.

Forty-three patients with epilepsy resistant to drug therapy were submitted to temporal lobe epilepsy surgery at the Instituto de Neurologia de Curitiba, from 1998 to 2003. Thirty-nine patients (90.6%) had mesial temporal sclerosis, and four had brain tumors. According to Engel's rating, 83.7% from 37 patients with complete postoperative evaluation were classified as Class I (free of disabling seizure). Postoperative complications (18.6%) were evaluated, with one case of surgical wound infection, one case of hydrocephalus, one case of cerebrospinal fluid fistula, two cases of transient palsy of the trochlear nerve and one case of transient hemiparesis. No death related to epilepsy surgery was found in our study.

Tratamento cirúrgico da epilepsia do lobo temporal: análise de 43 casos consecutivos / Surgical treatment of temporal lobe epilepsy: a series of forty-three cases analysis

Quarenta e três pacientes com epilepsia refratária ao tratamento medicamentoso foram submetidos à cirurgia de epilepsia do lobo temporal no Instituto de Neurologia de Curitiba, entre os anos de 1998 a 2003. Trinta e nove (90,6 por cento) pacientes apresentavam esclerose mesial temporal, e quatro (9,4 por cento), tumores cerebrais. Dos trinta e sete pacientes que possuíam avaliação pós-operatória completa, 83,7 por cento apresentaram classificação I, segundo Engel (livres de crises incapacitantes). Complicações pós-operatórias ocorreram em 18,6 por cento: uma infecção da ferida operatória, um caso de hidrocefalia, um de fístula liquórica, dois casos de paralisia transitória do IV nervo craniano e um de hemiparesia transitória. Não houve nenhum óbito relacionado à cirurgia de epilepsia no presente estudo.

Efficacy of the phosphorylation of synthetic peptides by purified catalytic subunit of PKA (PKAcat) from bovine lens depends on the amino acid sequence of the peptides.

Protein kinase (PK) A catalytic (PKAcat) subunit was purified to homogeneity from bovine lens using a 100-kDa cut-off membrane filtration followed by different chromatographic procedures. The molecular weight of PKAcat was found to be 41 kDa. The kinase phosphorylates histone IIIs and other synthetic modified peptides of VRKRTLRRL with different amino acid environment. The extent of phosphorylation depends not only on the presence of Ser or Thr (phosphorylating residues) but also on other surrounding amino acid residues. Although some peptides compete in phosphorylating histone, they are not very significant. The result suggests that the extent of phosphorylation depends on the amino acid residue(s) surrounding phosphorylable residue(s) on the peptide.

[4-Bromo-2-[2-(5-bromo-2-oxidobenzylideneaminomethyl)phenyliminomethyl]phenolato-kappa4O,N,N',O']nickel(II).

In the title complex, [Ni(C(21)H(14)Br(2)N(2)O(2))], the Ni(II) atom is coordinated by the two imine N and two phenolate O atoms of the Schiff base ligand in a tetrahedrally distorted square-planar geometry. The Ni-N and Ni-O distances are within the ranges expected for Ni-Schiff base derivatives. Intermolecular C-H...O hydrogen bonds link the molecules into centrosymmetric dimers, forming R(2)(2)(12) (A) and R(2)(2)(10) (B) rings. These dimers combine to form a supramolecular ABAB... aggregate which propagates along the [100] direction.

Can human fetal cortical brain tissue transplant (up to 20 weeks) sustain its metabolic and oxygen requirements in a heterotopic site outside the brain? A study of 12 volunteers with Parkinson's disease.

BACKGROUND: Neural and stem cell transplantation is emerging as a potential treatment for neurodegenerative diseases from Parkinson's to Huntington's disease. Stereotactic placement of dopaminergic neurons in the caudate-putamen (striatum), is being attempted in centers of excellence and has proved to be beneficial. Basic research using cell transplantation indicates that structural development mechanisms seen in immature brains, i.e., fetal brains, can also function in the adult brain. The adult brain consumes 15% of the resting cardiac output for its metabolic needs. While most human tissues can sustain an anaerobic assault for a few minutes up to 30 minutes, a sudden total lack of oxygen supply to the brain cells in an adult will render the person unconscious within five to ten seconds. Our team has been working on the problem of human fetal tissue response to antigenic assault for the last two decades. In the present series, 12 patients with prolonged histories of Parkinsonism, who were not responding to anti-Parkinsonian drugs, and could not afford costly stereotactic surgery or deep brain stimulation and other modalities of recent Parkinson's disease treatment, were enrolled in the study. MATERIALS AND METHOD: After obtaining proper informed consents from the patients or their guardians and from the multidisciplinary ethical committee, the patients, varying in age from 45 to 75 years and suffering for many years with Parkinsonism, were enrolled in the heterotopic brain tissue transplant programme. We followed standard antiseptic, aseptic and premedication protocols, after selecting a proposed site of transplantation of the brain in the axillary fold of the skin, under local infiltration anaesthesia. In an adjacent OR, a fetus was collected from a consenting patient undergoing hysterotomy and ligation (before 20 weeks), under general anaesthesia. Within a minute of hysterotomy, the fetal brain tissue was dissected, and under the guidance of the operative microscope, 1 g of fetal cortical brain tissue was dissected and weighed in an electronic machine. The tissue was collected from around 1 cm of the frontal opercula of the developing human fetal brain and grafted in the already dissected and prepared subcutaneous site in the axilla and the skin was closed. Hematological parameters (Hgb; total count, Tc; differential count, Dc; erythocyte sedimentation rate, ESR) were estimated sequentially up to one month. A small portion of the transplanted tissue was retrieved after one to two months, and a serial histological study was done along with a clinical assessment of the disease condition as per the specifications of the Unified Parkinson's Disease Rating Scale. The results were matched with the pre-transplant ratings of the individual cases. Presenting dyskinesia was also rated (0-4), on the basis of objective criteria assessment like walking, putting on a coat, lifting a cup to drink, etc. RESULTS AND ANALYSIS: Initially 30 patients suffering from advanced Parkinson's disease (PD) were approached after getting the necessary clearance from the institutional multidisciplinary ethical committee; however, we have been able to arrange transplantation in only 12 cases so far. These patients were evaluated at the pre- and one month post-transplant period by the Unified Parkinson's Disease Rating Scale (0-108) and the minimum score was 40 in the motor portion of the unified scale at the pre-transplant state. Evaluation of the patients after one month revealed mild improvement of the pre-transplant scoring (up to 33.3%) in 41.6% of the cases, and moderate improvement (up to 66.6%) in another 41.6% of the cases. While 16.8% of the cases did not show any improvement from the basal score, i.e., the pre-transplant score, there was a definite sense of well being and rise in weight (2-4 pounds) noted in each case and there was also a reduction of the L-Dopa dosage in 75% of the cases. There was also a 58.3% improvement in the bradykinesia scoring from the pre-transplant level. What is intriguing is the survival, growth and proliferation of the grafted fetal brain tissue in the HLA- and sex-randomized adult axilla without any immunosuppressive support. Not a single histological study of the fetal brain tissues after removal from the axilla showed any signs of graft vs. host or inflammatory reaction (Figures 1-9) but there were features of growth of the transplanted cortical brain tissue along with its different components like neurogenesis, gliogenesis, early neovascularisation and angiogenesis, etc. There was also no systemic leucocytosis or lymphocytosis. DISCUSSION AND CONCLUSION: Histological evidence at the transplanted tissue site suggests that fetal cortical brain tissue can sustain life in sex-randomized, HLA-randomized adult hosts, without the support of immuno-suppressive drugs and the tacit support of the blood-CSF and blood-brain barrier and other specific requirements of adult brain cells in the skull. Whether the clinical improvement in PD is transient or long lasting is presently under investigation along with basic questions like, is it due to transplanted fetal dopaminergic or non-dopaminergic neurons or is it the growth factors and the cytokine mediated hitherto unknown reactions causing the clinical improvement.