By using a cube-copying task, visuospatial impairment in patients with Parkinson's disease was identified and studied in relation to the performance IQ, neuropsychological symptoms, and activities of daily living. In addition, a quantitative assessment of the performance IQ was also attempted by establishing a scoring guideline for the copying task. The results indicated that the subjects' performances in the copying task correlated to motor function, visuospatial impairment, and the results from the mobility and social cognition subtests of the Functional Independence Measure. The quantitative evaluation of the results from the copying task also showed a high correlation to the patients' constructional ability, assessed by the Block design and the Object assembly tasks from the Wechsler Adult Intelligence Scale-Revised. This study demonstrated that visuospatial deficits in Parkinson's disease patients were associated with impairments in both activities of daily living and motor function. In addition, quantitative assessment of the copying task suggested that this test may be predictive of the nonverbal IQ. Therefore, we concluded that the copying task is a useful tool for the assessment of visuospatial impairment in patients with Parkinson's disease; these deficits may be associated with an increased risk of motor dysfunction such as difficulties in the activities of daily living.

Activities of Daily Living↗

PubMedDate not supplied

Microangioarchitecture of rat parietal cortex with special reference to vascular "sphincters". Scanning electron microscopic and dark field microscopic study.

Microangioarchitecture of the rat parietal cortex was studied by means of scanning electron microscopy and dark field microscopy. The richest supply of blood vessels in the parietal cortex was found in layer III + IV and layer V, where 2 isolated plexuses of microvessels were prominent. The appearance of the plexuses was quite different between motor and sensory areas. In the motor area the capillary plexuses were narrow and compact, while in sensory area the plexuses were wide and diffuse. Characteristic ring formations, called ring-shaped-compressions in the present study, were frequently observed at branching sites of arterioles. The ring-shaped-compression probably corresponds to the precapillary sphincter. A similar structure was also seen in capillaries and venules and, therefore, it is likely that not only arterioles, but also capillaries and even venules, can actively change diameter to control cerebral blood flow.

Animals↗

PubMedDate not supplied

Central dual innervation of arterioles and capillaries in the brain.

Fluorescence-and electron-microscopic studies were performed on nerve terminals close to intracerebral blood vessels in the rat. For the electron microscope subdural perfusion fixation with potassium permanganate was used. In the rat cerebral cortex deprived of the bilateral superior cervical ganglion some aminergic terminal boutons containing large and small core vesicles were observed contiguous to blood vessels. These terminals abutted on the capillary basement membrane. Since these terminals are found in the rat after bilateral superior cervical ganglion exision, they probably originate from central catecholaminergic neurons in the brain stem. These findings suggest that central aminergic neurons might play some role in cerebral blood flow regulation. In addition to aminergic terminal boutons, non-aminergic nerve terminals containing non-core vesicles also ended in the capillaries. Cerebral capillaries also have central dual innervation, aminergic and cholinergic, and dual peripheral innervation by sympathetic and parasympathetic fibers.

Adrenergic Fibers↗

PubMedDate not supplied

Urinary excretion of 3-methylhistidine in patients receiving parenteral nutrition.

In an attempt to investigate the kinetics of the muscle protein during parenteral nutrition (PN) and surgical stress, the urinary output of 3-methylhistidine (3-Mehis) was measured in patients receiving PN, then the validity of urinary 3-Mehis excretion as an index for the patient's status of protein nutrition was examined. The amounts of 3-Mehis excreted in 24 hr urine in the 19 healthy males and 10 healthy females were 74.8 +/- 17.1 mg/day and 46.3 +/- 12.4 mg/day, respectively. The changes of daily urinary 3-Mehis output in 6 cases receiving PN for more than 4 weeks were also examined. The average urinary 3-Mehis excretion increased gradually during the course of PN, and by the third week was nearly twice as high as the level before PN. In a further study the influence of surgery upon the urinary excretion of 3-Mehis was examined in 9 patients. Finally, a comparison was made of the nutritional status before and 4 wks after PN in the 6 patients without surgical stress. Urinary 3-Mehis was found to be a good index of both the status of protein nutrition and the fluctuation of muscle protein catabolism.

Adolescent↗

PubMedDate not supplied

Clinical studies on zinc metabolism during total parenteral nutrition as related to zinc deficiency.

In 99 adult patients receiving controlled total parenteral nutrition (TPN), a study was made on the time course of concentrations of zinc in plasma, erythrocyte and urine in relation to the development of zinc deficiency. Zinc deficiency developed in 11 cases receiving TPN solutions not containing zinc. The plasma zinc level was significantly lower at the time of onset of zinc deficiency than in normal subjects, before the procedure of TPN, or at the time of symptomatic relief achieved by administration of zinc. The erythrocyte zinc level was slightly but not significantly lower at time of onset of zinc deficiency than in normal subjects, before TPN or at time of symptomatic relief. The urinary zinc level at time of onset of zinc deficiency was significantly lower than that in normal subjects or at the time of symptomatic relief but not significantly lower than that before TPN. A comparison between patients developing and those not developing zinc deficiency within 4 wk of the outset of TPN showed that only the plasma zinc level was significantly lower in the former than the latter group. The urinary zinc level also tended to be lower, although not significantly, in the former than the latter group but varied widely. No difference was present between the groups as to the erythrocyte zinc level. Zinc deficiency developed in none of those patients who had a plasma zinc level of 50 micrograms/dl or more but in five of 10 (50%) patients with less than 50 micrograms/dl and in all three with less than 30 micrograms/dl of zinc in plasma.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMedDate not supplied

Effects of alternate and simultaneous administrations of calcium and phosphorus on calcium metabolism in children receiving total parenteral nutrition.

The effects of alternate and simultaneous administrations of calcium (Ca) and phosphorus (P) on Ca metabolism in children receiving total parenteral nutrition (TPN) were examined. Eight children, aged 2 to 36 months, were studied. The following three solutions were administered: solution 1 contains Ca (533 mg/liter); solution 2 contains P (413 mg/liter); and solution 3 contains Ca (267 mg/liter) and P (207 mg/liter). Solutions 1 and 2 were administered alternately for 24-hr periods. (Results) I. During administration of solution 1, significant hypophosphatemia (4.39 +/- 0.26 mg/dl) and hypercalcemia (9.96 +/- 0.15 mg/dl) were observed and, conversely, during administration of solution 2, significant hypocalcemia (8.36 +/- 0.18 mg/dl) and hyperphosphatemia (6.16 +/- 0.27 mg/dl) were observed. During administration of solution 3, the serum levels of both minerals were maintained within the normal ranges (Ca 9.46 +/- 0.12 mg/dl, P 5.65 +/- 0.21 mg/dl). II. The urinary excretion of cyclic AMP was significantly lower during administration of solution 1 (6.67 +/- 0.45 nmol/mg creatinine (Cr] as compared with solution 3 (7.50 +/- 0.61 nmol/mg of Cr). On the other hand, the excretion was significantly higher during administration of solution 2 (11.55 +/- 1.58 nmol/mg of Cr) as compared with solution 3, indicating the existence of secondary hyperparathyroidism. III. The Ca and P retention rates were significantly higher with solution 3 (Ca 79.0 +/- 5.5%, P 73.2 +/- 7.2% of the intake) than with solutions 1 and 2 alternately (Ca 62.7 +/- 4.5%, P 49.2 +/- 9.3%). (Conclusions) Simultaneous administrations of Ca and P are preferable to their alternate administrations for Ca metabolism in children receiving TPN.

Bone and Bones↗

PubMedDate not supplied

Urinary excretion of 3-methylhistidine as an index of protein nutrition in total parenteral nutrition.

In 39 healthy adult volunteers and nine patients receiving total parenteral nutrition (TPN), determinations were made of the urinary excretion of 3-methylhistidine (3-Mehis) to estimate the degree to which the urinary output of 3-Mehis reflects the status of protein nutrition. In 19 males and 10 females of the former group, measurements were made of the amount of 3-Mehis and of creatinine (Cr) in 24-hr urine samples. The urinary output of 3-Mehis was also measured in two subgroups of five healthy adult male subjects who were fed one of the two different diets prescribed: meat (M) and meat-free (F) diet. Furthermore, in one of these subgroups which was fed on F diet, the urinary output of 3-Mehis was measured both while the subject was kept at bed rest and while the subject was allowed to live a normal life. From these measurements the standard value was determined for the urine 3-Mehis level and the 3-Mehis/Cr ratio in 24-hr urine in healthy adult human subjects of both sexes. In nine patients maintained on TPN these indices of nutritional status were measured before and at 4 weeks of TPN. The time course of the indices was also investigated. The results obtained suggest that both the urinary output of 3-Mehis and the 3-Mehis/Cr ratio can provide a sensitive index of the status of protein nutrition.

Adult↗

PubMedDate not supplied

Branched-chain amino acids metabolic support in surgical patients: a randomized, controlled trial in patients with subtotal or total gastrectomy in 16 Japanese institutions.

A prospective, randomized, controlled trial of nutritional effects of branched-chain-enriched amino acid (BCAA) solution was undertaken in 173 surgical patients with gastric cancer. Eighty-six and 87 patients underwent subtotal and total gastrectomy, respectively. The effects were evaluated in total parenteral nutrition (TPN) in an isocaloric/isonitrogenous setting where the major difference between the group was the amount of BCAA received. Each 80 patients in the control and the BCAA groups completed the trial. The group receiving BCAA-enriched amino acid solution demonstrated a statistically significant improvement on days 2 and 3 in nitrogen balance in patients with total gastrectomy. Three-methyl-histidine excretion gradually decreased after day 1, and the values on day 7 were significantly lower than those on day 1 in the BCAA group in both those receiving subtotal and total gastrectomy. There were no significant differences of serum albumin and rapid turnover proteins between the control and BCAA groups in both those receiving subtotal and total gastrectomy. Plasma BCAA level and BCAA to aromatic amino acid (AAA) ratio were significantly higher, and AAA level was significantly lower in the BCAA group than in the control group. There were no serious complications encountered during the observation period in both groups. These results indicated that a BCAA-enriched amino acid solution can improve metabolism and maintains good nitrogen retention without increasing side effects as compared with a conventional amino acid solution for nutritional support of patients who have received subtotal or total gastrectomy.

Adolescent↗

PubMedDate not supplied

Copper deficiency during total parenteral nutrition: clinical analysis of three cases.

Three adult cases in which copper deficiency developed during long-term total parenteral nutrition (TPN) without copper supplementation have been described, together with a brief review of the literature. All three patients were suffering from malabsorption when TPN was instituted, and overt symptoms of copper deficiency developed an average of 5.8 months after the start of TPN. Clinically, leukopenia with neutropenia and low plasma levels of copper and ceruloplasmin were seen in all cases. The dosage of copper administration in these cases was 0.3 to 7.2 mg of copper/day, or 5.3 to 133 micrograms of copper/kg/day, with total doses of 7 to 176 mg of copper.

Adolescent↗

PubMedDate not supplied

Electron microscopic alteration of synaptic vesicles after alpha-methyl-p-tyrosine administration in sympathetic nerve terminals demonstrated by potassium permanganate fixation.

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Animals↗

PubMedDate not supplied

Skin lesions during intravenous hyperalimentation: zinc deficiency. 1976.

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History, 20th Century↗