Approaches in injections for radicular pain: the transforaminal, epidural and transfacet approaches.

Spinal injections must be carried out adhering to very strict conditions. However, these procedures have almost come to be seen as everyday and may be practised under quite questionable conditions. The recent reports of new and extremely serious neurological complications have changed the attitudes of those making referrals as well as the attitudes of the interventional radiologists carrying out these procedures. The range of indications for transforaminal injections has shrunk in favour of epidural injections. Where the transforaminal approach is still used, the needle must be positioned extremely accurately. A prior radioopaque contrast medium injection is essential from a safety perspective. The transforaminal epidural injection via the transfacet approach looks to be a promising alternative that is strictly avascular.

Impairment of transcallosal inhibition in patients with corticobasal degeneration.

OBJECTIVE: To evaluate the motor function of the transcallosal pathways in patients with clinical diagnosis of corticobasal degeneration (CBD). METHODS: In a group of 7 patients (4 males, 3 females; mean age 70.6 years) with clinical diagnosis of probable CBD (and in 8 age-matched normal controls) we evaluated the suppression of the ongoing voluntary EMG activity in the opponens pollicis muscle induced by focal transcranial magnetic stimulation (TMS) of the ipsilateral hand motor cortex. Such ipsilateral silent period (iSP) is mediated from one motor cortex to the contralateral side via a transcallosal pathway. In addition, CBD patients were investigated with magnetic resonance imaging (MRI) and neuropsychological assessment. RESULTS: iSP was normal in 4 CBD patients, while it was bilaterally disrupted in the other 3. MRI showed an atrophy of the corpus callosum (middle-posterior part of the trunk) in the CBD patients with iSP disruption. Neuropsychological evaluation showed in patients with iSP impairment a decrease of verbal fluencies associated with an impairment of attentive function. CONCLUSIONS: A proportion of CBD patients shows physiological evidence of impaired callosal motor function and atrophy of the corpus callosum on MRI, possibly correlated to dysphasic and cognitive disorders.

Spinal dermoid cysts originating intracranial fat drops causing obstructive hydrocephalus: case reports.

The authors report two cases of spinal dermoid cysts whose rupture originated the migration of free fat drops into the ventricles and intracranial subarachnoid spaces. In both cases the fat drops caused obstructive hydrocephalus, which represents a quite exceptional complication. Moreover, one of the cases is unique, since the finding of intracranial fat causing hydrocephalus considerably preceded the discovery of the spinal neoplasm. The authors suggest that the finding of intracranial fat in the absence of a local source makes the search for a intraspinal dermoid or epidermoid tumor mandatory.

[Convergence and divergence between morphology and karyology in related species of the genus Vicia]. / Convergenza e divergenza fra morfologia e cariologia in specie affini del genere Vicia.

Karyological polymorphism is generally the rule in related species of genus Vicia, as has been frequently shown in many entities of its comprehensive species; therefore a correspondence of phenotypic and karyotypic characters is rather rare. Two cases are described here, in which both external morphological and internal karyological features, are correlated. These data have been obtained through biometric and karyotypic studies, carried out both on the perennials V. onobrychioides and V. altissima, and on the annuals V. villosa ssp. varia and V. benghalensis. In both perennials the chromosomes were rather long, the nucleolar constriction was on the longest couple of chromosomes, and even the satellite was of the same type; in both annuals the chromosomes were short, the nucleolar constriction was on the shortest couple of chromosomes, and the satellite was large in comparison to the arm to which it was connected. These similarities of the karyotypes are important because they may make easier a possible experimental cross-breed of the abovementioned entities.

[Structure of the endosperm in the mature seed of Melilotus alba]. / Struttura dell'endosperma nel seme maturo di Melilotus alba.

The results of the exam at the light, the fluorescence and the scanning electron microscope of the endosperm of Melilotus alba mature impermeable seeds are reported. Cryostat sections, semithin sections and squashes are observed. Melilotus alba endosperm is variable in thickness and envelopes cotyledons and radicle. Its "aleurone" layer is one-cell thick, while the number of layers of its internal cells varies in relation to the location in the seed. In the aleurone cells, the cytoplasm and the outer portion of the wall are autofluorescent; tannic acid-ferric chloride stains the outer portion of the wall and allows to see clearly the inner thickenings, DAPI and haematoxylin demonstrate the presence of the nucleus. The cytoplasm of these cells is coloured by Sudan black b, and its fluorescence is enhanced by auramine and calcofluor white. Calcofluor white enhances the fluorescence of the outer portion of these walls, too, but is without effect on the non-autofluorescent thickening, indicating presence of cellulose only in the first case. Callose is absent. Also the thin autofluorescent walls of the endosperm inner cells react positively to calcofluor. These cells are very large, almost completely filled with "gelatinous" substances--the galactomannans--and very rarely contain a nucleus.

Gadodiamide injection: nonionic gadolinium chelate for MR imaging of the brain and spine--phase II-III clinical trial.

Seventy-three patients with clinically suspected central nervous system abnormalities (44 intracranial, 29 medullospinal) were studied with magnetic resonance (MR) imaging before and after administration of nonionic gadodiamide injection. MR imaging showed intracranial lesions in 37 patients. Eight patients had spinal tumors, and 21 had disk disease. Structural abnormalities were shown in 37 of 44 head studies and in all 29 spine studies. Lesions enhancement was seen in 31 head studies and 28 spine studies, and distinction of lesion(s) from associated edema was possible in 10 head studies and in one study of intrinsic cord tumor. Administration of gadodiamide injection provided improved definition of lesion borders in 19 of 44 head studies and 26 of 29 spine studies. The use of the contrast agent changed the diagnosis that was based on the unenhanced images in nine head studies and 13 spine studies. Early postcontrast, T1-weighted spin-echo images of postoperative spines were adequate in distinguishing epidural scar (enhancing) from herniated disk (nonenhancing). The contrast agent was well tolerated, and no drug-related adverse events occurred.

[Dormancy in Vicia loiseleurii seeds. Observations of the seminal tegument]. / Dormienza in semi di Vicia loiseleurii. Osservazioni sul tegumento seminale.

Seed coat structure has been examined in Vicia loiseleurii (M. Bieb.) Litw. on sections and phytoglyphs. The structure is the typical one of the Papilionaceae, with malpighian (= palisade) layer, hour-glass cell layer and hypodermis. An apparently non-cellular thick strip separates the seed coat from the cotyledons of the embryo. The malpighian cell of V. loiseleurii, with its cone-shaped cap or dome, is very similar to the well studied one of the Melilotus alba seed. Histochemical tests reveal the hydrophobic nature of the cap, which is stained by Sudan Blck B, Nile Blue and rendered highly fluorescent in its basal part by Auramine O. Aniline blue evidentiates callose in the wall below the cap. It is suggested that the impermeability of the coat, cause of the dormancy of the V. loiseleurii seed, is dependent on both the hydrophobic caps and the callose-containing radial walls of its malpighian cells.

[Variability in the dormancy of seeds of Securigera securidaca (L.) Deg. et Dorfl. Preliminary note]. / Variabilita' di dormienza nei semi di Securigera securidaca (L.) Deg. et Dorfl. Nota preliminare.

The germination rate of seeds of Securigera securidaca varied abruptly from 0% to 100% in different years of maturation, and this variability did not seem to be due to climatic differences during the period of seed maturation. These seeds showed also polymorphism in colour, which appeared to be related with varying depths of dormancy. This last one seemed to be increased by a short ageing of the seeds.

Pituitary hormone concentrations in cerebrospinal fluid in patients with prolactin and growth hormone-secreting tumors.

GH, PRL, LH, FSH and TSH were measured in serum and in cerebrospinal fluid (CSF) in 16 patients with chromophobe adenomas, in 8 with acromegaly and in 18 subjects with neurological diseases without endocrine troubles. Elevated mean GH and PRL levels in serum and in CSF were found in patients with chromophobe adenomas and with acromegaly. No constant correlation was observed between serum and CSF values. The highest hormonal levels in CSF were usually observed in adenomas with suprasellar extension, but this finding was inconstant. The determination of hormonal levels in CSF does not seem to supply any reliable information about the characteristics of pituitary tumors.

[Effect of aqueous extracts of Tamus communis L. leaves on the germination of seeds of various species]. / Azione di estratti acquosi di foglie di Tamus Communis L. su semi germinanti di specie diverse.

The different influence of germination and growth inhibitors in aqueous extracts, at the same concentration, of Tamus communis L. leaves, on germinating seeds and seedlings of nigra L., Lactuca sativa L., Medicago sativa L., has been shown. This action, very marked at the experimental concentrations, is not toxic, as the seeds and seedlings, if immersed in deionized water after treatments, recover their germination and growth. This recovery occurs however differently in the plants investigated.

[Anatomical and cytohistological changes caused by aqueous extracts of Tamus communis L. leaves]. / Modificazioni anatomiche e cariologiche indotte da estratti acquosi di foglie di Tamus communis L.

Aqueous extracts of Tamus communis leaves induce root tip swelling of Medicago seedlings and disrupt the mitotic process of Allium root tips. The cells of the swollen roots of Medicago treated seedlings are much wider an shorter than the homologous control cells. In the treated roots of Allium prophases prevail and some cells contain vacuolated nuclei or micronuclei.

[The subclavian approach as an alternative to the femoral approach in selective cervicocephalic phlebography (author's transl)]. / L'abord sous-clavier comme alternative de la voie fémorale dans la phlébographie sélective cervico-céphalique.

The authors describe the technique employed for selective catheterization of the main mediastinal trunks and the veins of the brachiocephalic and cervicocephalic regions by means of the subclavian approach. The importance and advantages of this procedure as an alternative to the femoral approach, especially if this is contra-indicated, are emphasized.

Traumatic intracerebral hematomas. 72 cases surgically treated.

This report concerns 72 patients who underwent surgery for postraumatic intracerebral hematoma. The clinical findings of this pathology have been delineated as well as the diagnostic and therapeutic characteristics.

[Selective catheterization of cervical and mediastinic veins by subclavian approach (author's transl)]. / Tecnica della flebografia selettiva cervico-mediastinica per via succlavia.

The authors present the selective catheterization of the veins of the neck and mediastinum via the subclavian vein. Benefits and complications of the technique are discussed. The subclavian approach is very helpfull and technique of choice when the femoral route is not available.