ATPase activity was investigated in sciatic and optic nerves of female mutant diabetic C57Bl/Ks (db/db) mice and age-matched control mice (db/m and m/m). Nerves from animals aged 50, 70, 125, 180 and 280 days were assayed in vitro for ATPase activity in the presence or absence of ouabain: the ouabain-sensitive fraction contained Na+,K(+)-ATPase. Enzymatic activity was compared within and between age-matched groups. No significant difference in Na+,K(+)-ATPase activity was detected between the diabetic and control mice, whether expressed as mumol Pi/h-1 formed per gramme wet weight or per nerve (protein content). The activity decreased by about 25% in both the sciatic and optic nerves of the oldest animals. These results were strikingly similar in all groups, regardless of the type of nerve examined, confirming that the development of neuropathy in this animal model is unrelated to the postulated derangement of Na+,K(+)-ATPase activity. Among possible explanations, a lack of polyol pathway activation was investigated by staining the sciatic nerves of animals from all groups with the peroxidase-antiperoxidase procedure using a polyclonal antiserum raised against the enzyme aldose reductase. Histological sections of all nerves were consistently negative, suggesting that these animals actually lack the enzyme involved in activating the self-perpetuating metabolic cycle leading to deranged nerve function. The db/db mouse appears to present particular biochemical changes which merit attention with a view to clarifying the pathogenesis of diabetic neuropathy.

Adenosine Triphosphatases↗

PubMed1990

[Definite colostomy using a circular stapler: a technique to be reconsidered].

Personal experience on a particular utilization of circular stapler is reported. At the beginning the fast and easy execution emphasized its use. However, the constant appearance of a late complication was observed, i.e. the progressive stenosis of the stoma. This event occurred even when maximal size of the instrument was used and it reappeared after repeated procedures of instrumental or surgical dilatation. The effective validity of this technique was evaluated by the Authors. On the other hand, the Burk alternative technique, with a second purse-string on the cutaneous ring seems to prevent the stenosis. However, it is slow and difficult as traditional procedure. The causes of the neostoma stenosis performed by circular stapler, reported by the Authors in 100% of cases, are easily explained with the absence of biological barrier of colonic mucosa that normally prevents excessive tissue growth.

Colostomy↗

PubMed1990

[Critical considerations on circular staplers].

After a careful review of the literature and a critical evaluation of personal experience on stapling technics in visceral anastomoses, some critical considerations on circular devices are reported. The Authors emphasize the well known qualities of staplers which brought to their routine use in digestive surgery. Some complications exclusively due to an "imperfect" firing of the instrument are then reported. Personal experience on a particular utilization of circular stapler for definitive colostomy is also reported. The Authors finally suggest some simple technical improvements.

Anastomosis, Surgical↗

PubMed1990

[Incidence and clinical significance of rhythm disorders in the elderly].

The goal of this study was the evaluation of cardiac arrhythmias in an unselected population of elderly patients by 24-hour Holter electrocardiography. An elevated incidence of hyperkinetic (62%) and hypokinetic arrhythmias (22.7%) were detected. Following a critical review of the literature, the Authors conclude that even in hyperkinetic arrhythmias a conservative approach is advisable without indiscriminate therapeutic treatment. This review also confirmed the clinical utility of ambulatory monitoring in the detection of arrhythmias, otherwise underestimated, mainly in asymptomatic patients.

Aged↗

PubMed1989

A parkinsonian kindred.

We report 8 cases of clinical idiopathic Parkinson disease in one kindred. None of the patients presented anomalous symptoms and all responded normally to routine L-Dopa therapy. On the basis of these findings we analyse the possible etiological role of heredity in Parkinson disease.

Aged↗

PubMed1989

Abnormalities of mitochondrial enzymes in hereditary ataxias.

The activity of 7 mitochondrial enzymes, fumarase, NAD-malate dehydrogenase (MDH), citrate synthase (CS), valine dehydrogenase (VDH), succinate dehydrogenase (SDH), glutamate dehydrogenase (GDH), pyruvate dehydrogenase complex (PDHC) has been measured in platelet preparations from patients affected by Friedreich's ataxia (FA), dominant and non-dominant olivopontocerebellar atrophy (DOPCA, NDOPCA) and normal individuals. Significant decreases of GDH (P less than 0.01), PDHC (P less than 0.01), VDH (P less than 0.05) and SDH (P less than 0.05) activities were observed in FA patients. Significant decreases of GDH (P less than 0.01), PDHC (P less than 0.01), VDH (P less than 0.05), SDH (P less than 0.05) and CS (P less than 0.05) activities were Observed in ND-OPCA patients, whereas in DOPCA patients only GDH activity was significantly (P less than 0.05) decreased. In 8 of 10 patients with FA and in all patients with NDOPCA the activity of one or more of 4 enzymes, i.e. GDH, VDH, SDH, PDHC, was lower than the lowest of control values. Four of 6 patients with DOPCA had GDH activity lower than the lowest of control values. These results indicate that abnormalities of mitochondrial metabolism is a constant element in hereditary ataxia and suggest that the alteration primary leading to the different types of ataxias should be related to mitochondrial oxidative metabolism, at least at a regulatory level.

Adolescent↗

PubMed1989

Histopathological correlates of leuko-araiosis in patients with ischemic stroke.

A neuropathological study was carried out in 4 cases of ischemic stroke with leuko-araiosis (LA), 3 cases of clinically suspected Binswanger's subcortical arteriosclerotic encephalopathy (SAE) also showing LA, and 3 cases without LA. Unlike the SAE cases, in 3 of the cases in the first group the white matter changes corresponding to LA could not be explained by ischemic mechanisms related to small vessel changes.

Aged↗

PubMed1989

Ganglioside treatment and improved axonal regeneration capacity in experimental diabetic neuropathy.

The efficacy of gangliosides in enhancing axonal regeneration and maturation in the early stages of diabetic neuropathy was assessed by quantitative analysis of immunostained serial sections of the sciatic nerve. Sprague-Dawley rats were made diabetic with a single injection of alloxan (100 mg/kg). One week later they were injected daily intraperitoneally with either a highly purified ganglioside mixture (10 mg/kg) or sterile saline for 4 wk. At the end of the treatment, sciatic nerves were crushed and allowed to regenerate for 1 wk without ganglioside treatment. The animals were then killed, and the nerves were frozen and processed for immunohistochemistry and electron microscopy. The number of regrowing axons was counted with a computerized image-analysis system on cross sections taken at predefined distances along the regenerating stump and stained with monoclonal antibody iC8 specific for the 145,000-Mr subunit of the neurofilaments. In untreated diabetic animals the number of axons able to regenerate and sustain elongation for greater than or equal to 13 mm from the crush point was reduced by 40% with respect to control rats. Ganglioside treatment was effective in compensating almost completely for this dramatic reduction. Electron microscopy confirmed that the immunofluorescence counts corresponded to regenerating axons containing neurofilaments. These results suggest that gangliosides are able to compensate for the derangements of axonal transport of cytoskeletal proteins reported in experimental diabetic neuropathy.

Alloxan↗

PubMed1988

Acute and subacute akinetic-rigid parkinsonian syndrome mimicking a meningoencephalitis.

Four cases of acute and subacute akinetic-rigid parkinsonian syndrome are described. The clinical picture initially simulated a meningoencephalitis, which was escluded by the negative CSF findings and the aspecific electroencephalogram. In the first case the parkinsonism was attributable, also on the basis of the autoptic findings, to the prolonged neuroleptic therapy; in the other cases a toxic-infectious condition, through a damage on liver function, revealed a subclinical latent parkinsonian syndrome.

Acute Disease↗

PubMed1988

General toxicity and peripheral nerve alterations induced by chronic vincristine treatment in the rabbit.

The effects of five 0.3 mg/kg intravenous administrations of vincristine (VCR) at weekly intervals were studied in the rabbit. Body weight gain was impaired starting from the first injection, while gross signs of motor paralysis and hair loss initiated from the third week. At the end of the observation period blood analysis revealed normocytic normochromic anemia, elevated serum creatine kinase, and low serum alkaline phosphatase, whereas all the tested parameters related to liver and kidney functions where within normal limits. The decreased number of red blood cells was the consequence of a complete, although reversible, blockade of staminal hematopoietic activity. Two important indexes of peripheral nerve function were clearly altered at the end of the treatment: (i) the sciatic nerve conduction velocity in vitro was 27% reduced and (ii) the latency between sciatic nerve stimulation and extensor digitorum longus (EDL) twitch in vivo was 34% prolonged. The usefulness of the rabbit as an animal model to study side-effects of VCR treatment is discussed.

Alkaline Phosphatase↗

PubMed1988

Electro-oculographic routine examination in Parkinson's disease.

The authors studied a group of 36 patients with idiopathic Parkinson's disease by electro-oculographic examination in order to evaluate the most frequent vestibular and oculomotor findings. Vestibular alterations were detected mainly in caloric nystagmus (82.9%). Hyperreflectivity was the most frequent evidence, but it does not necessarily represent the sign of a lesion. The occurrence of spontaneous and evoked nystagmus was not significant. Oculomotor findings were more interesting, as they were altered in two-thirds of the cases. Particularly, saccadic eye movements presented a "multiple step" morphology in 58.3% of the series. This saccadic disarrangement was scarcely found in neurological patients with brainstem and/or cerebellum pathology (7.7%). Moreover, in Parkinson's disease patients no other saccadic alterations typical of brainstem or cerebellum involvement were found. Such observations suggest a possible non-cerebellar origin of "multiple step". Vestibular and oculomotor findings were not significantly correlated with the clinical features of the patients.

Adult↗

PubMed1988

Evaluation of Parkinson's disease: reliability of three rating scales.

We studied the three most commonly used rating scales in Parkinson's Disease (Hoehn and Yahr Clinical Staging, Webster Rating Scale, Columbia University Rating Scale) in order to examine the agreement between observers. Six neurologists, experts at using such scales, evaluated 48 patients suffering from the idiopathic form of Parkinson's Disease. Reliability using the K index was moderate, although a slight superiority was found with the Columbia University Rating Scale. Analysis of the various items used has suggested that scales of disability could be a valid alternative to those examined.

Adult↗

PubMed1988

Lack of efficacy of phosphatidylcholine in ataxias.

We gave phosphatidylcholine orally at a daily dosage of 9 grams for 4 years to 20 subjects with Friedreich's ataxia (FA) and 24 with olivopontocerebellar atrophy (OPCA). There was no clinical improvement during the follow-up compared with 12 ataxic patients (six FA and six OPCA) who did not receive any treatment. A 6-month trial at a double dose did not have any significant effect. This study indicates that phosphatidylcholine does not change the natural course of ataxias.

Ataxia↗

PubMed1988

ATPase activity defects in alloxan-induced diabetic sciatic nerve recovered by ganglioside treatment.

ATPase activities were measured in sciatic nerves from rats with alloxan-induced diabetes (ALX-D) of various duration (2 wk, 5 wk, 9 wk, and 6 mo). Our data confirm that sciatic nerve Na+-K+-ATPase abnormalities are present very early in ALX-D rats, similar to results previously described in streptozocin-induced diabetic rats, spontaneously diabetic BB Wistar rats, and ALX-D rabbits. Na+-K+-ATPase activity decreased by 26-47% in ALX-D rats compared with age-matched controls. Ganglioside treatment (10 mg/kg i.p. for 10 or 30 days starting 1 wk after ALX injection) completely impeded the enzyme reduction. The effect observed at the end of either 10 or 30 days of treatment lasted greater than or equal to 1 mo. Chronic diabetic groups treated for 30 days before killing also presented normal ATPase activity at the end of treatment. Therefore, gangliosides are effective on Na+-K+-ATPase even in animals with a longer duration of diabetes. The maintenance of fairly normal ATPase activity by ganglioside treatment could mirror a more general recovery from early metabolic dysfunction and/or late structural abnormalities in diabetic nerve fibers.

Alloxan↗