Primary motor cortex involvement in Alzheimer disease.

In Alzheimer disease (AD) the involvement of entorhinal cortex, hippocampus, and associative cortical areas is well established. Regarding the involvement of the primary motor cortex the reported data are contradictory. In order to determine whether the primary motor cortex is involved in AD, the brains of 29 autopsy cases were studied, including, 17 cases with severe cortical AD-type changes with definite diagnoses of AD, 7 age-matched cases with discrete to moderate cortical AD-type changes, and 5 control cases without any AD-type cortical changes. Morphometric analysis of the cortical surface occupied by senile plaques (SPs) on beta-amyloid-immunostained sections and quantitative analysis of neurofibrillary tangles (NFTs) on Gallyas-stained sections was performed in 5 different cortical areas including the primary motor cortex. The percentage of cortical surface occupied by SPs was similar in all cortical areas, without significant difference and corresponded to 16.7% in entorhinal cortex, 21.3% in frontal associative, 16% in parietal associative, and 15.8% in primary motor cortex. The number of NFTs in the entorhinal cortex was significantly higher (41 per 0.4 mm2), compared with those in other cortical areas (20.5 in frontal, 17.9 in parietal and 11.5 in the primary motor cortex). Our findings indicate that the primary motor cortex is significantly involved in AD and suggest the appearance of motor dysfunction in late and terminal stages of the disease.

Motor conduction block and high titres of anti-GM1 ganglioside antibodies: pathological evidence of a motor neuropathy in a patient with lower motor neuron syndrome.

A patient with a progressive lower motor neuron syndrome and neurophysiological evidence of motor axon loss, multifocal proximal motor nerve conduction block, and high titres of anti-ganglioside GM1 antibodies. Neuropathological findings included a predominantly proximal motor radiculoneuropathy with multifocal IgG and IgM deposits on nerve fibres associated with a loss of spinal motor neurons. These findings support an autoimmune origin of this lower motor neuron syndrome with retrograde degeneration of spinal motor neurons and severe neurogenic muscular atrophy.

Coronary artery rupture during transluminal coronary recanalization and angioplasty in a case of acute myocardial infarction and shock.

Percutaneous transluminal coronary angioplasty (PTCA) is a widely performed and effective therapy for coronary artery disease. Evolution of the dilatation instruments during the last decade has led to an increased success rate of PTCA and to the development of newer techniques such as recanalization of totally occluded coronary arteries. We report a case of coronary artery recanalization complicated by fatal coronary artery rupture.

[Psychotherapy of neurotic disorders in older adults: a new doorway to life]. / Psychotherapie neurotischer Störungen beim alten Menschen: Eine neue Offnung ins Leben.

The general concept of neurosis in old age includes the classical forms as well as the ones specific to this particular community and, also, the reactions to social circumstances. This point of view practically covers the greatest part of the behavior that the ones we call "elders" usually show and almost drives us to give a psychological definition of this state. Etiology of these disorders is plural. It involves the role of the emotional past, of the medicosocial implications of ageing, especially regarding affectivity. Psychotherapeutic intervention needs a great pliancy allowing to interfere both on the pragmatic and the interpretative levels. The freudian prejudice build up on the impediment of psycho-affective rigidity hides the unconscious fears of the therapist towards his own old age as well as the fear of being questioned about his efficiency. A restriction in the means as well as in the therapeutic ambition is not underrating but rather valorizing his action in which he must show self-control and suppleness. This psychotherapy must catalyze the energy that the elderly displays in his quest of unity. It trends to give back the individual an unlimited opening on life.