Two phases of the contingent negative variation in humans: association with motor and mental functions.

The question of the relationship between contingent negative variation and the mechanisms controlling motor and mental functions has received inadequate study. The aims of the present work were to investigate the relationship between the early and late phases of contingent negative variation and the state of motor and mental functions in patients with Parkinson's disease and to study the effects of levodopa on contingent negative variation. Patients with Parkinson's disease showed significant decreases in the amplitudes and areas of both phases of contingent negative variation as compared with subjects of similar age. Correlation analysis demonstrated a negative relationship between the extent of impairment of coordinatory muscle interactions and the amplitudes of both phases of this variation (p < 0.01). There was a positive relationship between the magnitudes of both phases and the state of mental functions, particularly memory (p < 0.05). Treatment of patients with Parkinson's disease with levodopa was followed by a significant increase in the late phase (p < 0.05). The results obtained here provide evidence for the important role of structures supporting both direct motor control and mental functions in forming both phases of contingent negative variation. The greater effect of levodopa on the late phase of contingent negative variation suggests that the efferent system of the basal ganglia has a greater role in generating the late phase than in organizing the early phase of the variation.

[Two phases of the contingent negative variation in humans: connection with motor and mental functions].

The question of dependence of the contingent negative variation (CNV) on the regulating mechanisms of motor and mental functions is not sufficiently studied. The tasks of the present work were: to investigate the dependence of the CNV early and late phases on the state of motor and mental functions in patients with Parkinson's disease (PD), and to elucidate the levodopa influence on the CNV parameters. 18 healthy subjects and 56 patients with PD were studied. In PD patients, significant reductions of amplitudes and squares of two CNV phases were observed. A negative correlation of the degree of coordinating muscle relationships disturbance with amplitudes of two CNV phases was found (p < 0.01). A positive interdependence between values of the both CNV phases and the state of mental functions was established, memory in particular (p < 0.05). After levodopa administration in PD patients, the early CNV phase did not significantly change, whereas the late CNV phase significantly increased (p < 0.05). Results of the investigation suggest an important role of the structures ensuring both direct motor control and mental functions in two CNV phases formation. A more obvious levodopa influence on the late CNV phase suggest participation of the basal ganglia efferent system in generation of the late CNV phase rather than in organization of the early CNV phase.

[Effect of cerebrolysin on the electroencephalographic indices of brain activity in Parkinson's disease]. / Elektroéntsefalograficheskie pokazateli deiatel'nosti mozga pri lechenii tserebrolizinom bolezni Parkinsona.

Cerebrolysin is a brain-derived peptide drug that increases the BBB-GLUT1 and MAP2 genes expression, thus exerting a neuroprotective effect. The present study aimed at investigating in patients with Parkinson's disease (PD) influence of Cerebrolysin infusions (intravenously, 10 ml during 10 days) combined with levodopa treatment on the electroencephalographic (EEG) indices of brain activity: P300 potential, contingent negative variation (CNV) and recovery functions of the cortical auditory evoked potentials, which reflect the postexcitatory inhibition at the paired stimulation. Nineteen PD patients, mean age 61.4 +/- 1.7 years; disease stage according to M.M. Hoehn and M.D. Yahr, 1967-2.2 +/- 0.1) and 18 age-matched healthy controls were studied. In the patients with essential differences of the EEG indices, comparing to the normal values, statistically significant changes were revealed: a decrease of P300 latency from 419.4 +/- 23.5 to 356.3 +/- 18.4 ms (8 patients, 42%); an increase of CNV duration from 423.1 +/- 93.3 to 600.6 +/- 38.5 ms; 2-fold increase of CNV mean amplitude and 3-fold increase of CNV square (8 patients, 42%) and strengthening of postexcitatory inhibition in auditory system at the paired stimulation (13 patients, 68%). In conclusion, Cerebrolysin may be recommended as an additional neuroprotective drug for brain functions improvement in the complex pathogenetic therapy of earlier PD stages.

Corneal crystalline deposits and drusenosis associated with IgA-kappa chain monoclonal gammopathy.

An unusual case is presented in which corneal deposits in mid-to-deep stroma with Doyne's posterior pole drusenosis are the initial signs of an IgA-kappa monoclonal gammopathy. The case has several unique features. Corneal deposits have been described previously with IgG and IgM-kappa light chain gammopathies, but to our knowledge have not been described before with IgA-kappa monoclonal gammopathy. Corneal stromal deposits and associated macular drusen have been described with IgM monoclonal gammopathy, but not previously with IgA monoclonal gammopathy. Bietti described superficial perilimbal corneal deposits with fundus albipunctatus, whereas the present case shows diffuse central deep corneal deposits with macular drusen.

The pattern and incidence of nasolacrimal injury in naso-orbital-ethmoid fractures: the role of delayed assessment and dacryocystorhinostomy.

A detailed review of forty-six patients with severe naso-orbital-ethmoid injury confirms that naso-lacrimal system injury is less common than originally suspected. Post-operative epiphora is more frequently due to eyelid malposition than naso-lacrimal obstruction. Eight patients (17.4%) required eventual dacryocystorhinostomy. Three out of five patients (60%), treated with closed reduction and external splint fixation, needed dacryocystorhinostomy. This treatment predisposes to external compression of the naso-lacrimal system by malpositioned bone fragments and segments. Open reduction and internal fixation of all fractures provides optimal repair and minimizes the incidence of post-operative epiphora. During fracture repair, the naso-lacrimal sac should be identified, but not probed or intubated unless obviously lacerated. The upper lacrimal pathway is protected by the medial canthal ligament. Obstruction usually occurs in the bony naso-lacrimal canal. Telecanthus invariably accompanies severe naso-orbital-ethmoid injuries and subsequent naso-lacrimal obstruction. Dacryocystography is useful in the investigation of naso-lacrimal function. When dacryocystorhinostomy is necessary, it should be performed at least 3 months after the primary repair.

Mechanism of tear flow after dacryocystorhinostomy and Jones' tube surgery.

In the 42 patients (84 eyes) in this study, 32 eyes had dacryocystorhinostomy (DCR), 15 had Jones' tube insertions, and the remaining 37 were considered controls. All patients were studied using nuclear scanning with computer interfacing quantitative lacrimal scintillography to determine the effects of blinking, respiration, and gravity on their functioning. Tears flowed through DCR openings faster than through the systems of normal patients. Patients with Jones' tubes demonstrated slower flow than in normal patients. The effect of respiration on tear flow was minimal, but blinking and lid function were important. Patients with eyelid laxity may show decreased flow even if the DCR and Jones' tubes are functional.

Malignant melanoma of the choroid in the nevus of Ota of a black patient.

To our knowledge, this report is the first description of an association of a choroidal melanoma in the nevus of Ota in a black patient. While white patients who have the nevus of Ota appear to be predisposed to the development of a malignant melanoma, this complication is rare in all nonwhite racial groups. Nevertheless, it should be realized that regardless of the patient's race, there is a greater than normal chance that a patient with the nevus of Ota might have a malignant melanoma develop within one of the affected tissues.

Diffuse iris nevus manifested by unilateral open angle glaucoma.

Uncontrolled unilateral glaucoma developed in the right eye of a 24-year-old woman. It was caused by the diffuse growth of a nonpigmented nevus of the iris into the anterior chamber angle. Histologically, the nonpigmented nevus cells in the angle were distinguishable from a proliferation of corneal endothelium. Clinically, there was no heterochromia, and a tumor was not suspected as the cause of the glaucoma.