[Chronic subdural hematoma. A comparison of bore hole trepanation and craniotomy]. / Das chronische Subduralhämatom. Ein Vergleich zwischen Bohrlochtrepanation und Kraniotomie.

Within the period from 1981 to 1986 a total of 65 patients with 74 (9 bilateral) chronic subdural haematomas (CSH) were operated on. First symptoms, preceding diseases, accompanying factors and neurological findings were listed and evaluated retrospectively. Preoperative CT criteria and postoperative CT controls of the course were put in relation to the clinical development of the findings obtained with different surgical techniques. The comparison of borehole trepanation (37 haematomas) and large craniotomy (37 heamatomas) shows advantages with respect to the retrogression of the haematomas (CT), the postoperative clinical course and the complications in favour of the patients subjected to borehole trepanation.

Quantitative and morphological studies on the plasticity of mixed synapses as exemplified by clear, spherical vesicles.

Large mixed axosomatic synapses (synaptic membrane with chemically "active zones" and electric "gap-junction" parts) within the region of the oculomotor nucleus of the trout were stimulated for a prolonged period of time (14 days) under physiological conditions. Concerning the great number of clear vesicles that are found in the presynaptic part of this type of synapse it can be said that they can be subdivided morphometrically into two classes with respect to the special membrane complexes of the mixed synapse (active zone, gap junction). This paper is designed to find out to what an extent the proven adaptability of the "mixed synapse" system does reflect the quantitative changes in the population of these organelles. For this purpose the number (numerical density of vesicles NVv) as well as the size (vesicular volume Vv) of the vesicles were determined by stereologic methods from segments of vesicles that were visible in the electron microscopic picture. Stimulation of the contact caused an accumulation of vesicles in the presynaptic area of the active zone as well as in the region of the terminal axonal cylinder (myelin-free presynaptic part of the axon--"marginal zone"). At the gap junctions the number of vesicles remained unchanged, but their size diminished significantly. On the one hand, the findings obtained are discussed as an expression of potential compensatory mechanisms involved in vesicle supply or formation (axonal transport, recycling) for chemical transmission, and, on the other, as indicating possible interactions between vesicles and gap junctions for electric transmission. They suggest that the behaviour of the vesicle population of mixed synapses is governed by laws of its own.

[Quantitative morphologic examination of the vesicle population of mixed synapses--method and significance]. / Quantitativ-morphologische Untersuchung der Vesikelpopulation gemischter Synapsen--Methodik und Aussage.

Quantitative electron microscopic investigations have been performed regarding the population of clear round vesicles within the axosomatic mixed contacts between secondary vestibular and oculomotor neurons of the trout. The measurements are based on a subdivision of the axon terminal area into single fields which topographically belong to different synaptic types (active zone, gap junction) of this mixed contact. Furthermore, areas between active zones and gap junctions ("intermediate zones") and areas along the lateral membranes of the axon terminal ("border zones") have been analyzed. The following vesicle parameters have been estimated stereologically: volume density (Vvv), surface density (Svv), numerical vesicle density (Nvv) mean vesicle volume (Vv) and mean vesicle surface (Sv). In this connection, aspects of the homogeneous distribution, of number and size of the organelles hae been investigated. The results obtained show a characteristic distribution in number and size of vesicles inthe presynaptic areas of the different membrane specializations of this mixed synapses. The results further indicate that two different pools of clear round vesicles exist in this mixed synapse, clear synaptic vesicles for chemical transmission and gap junction vesicles. In relation to the synaptic vesicles, a recycling mechanism is suggested. Gap-junction vesicles may function as Ca++ transport organelles to regulate gap junction permeability. A possible role in trophic tasks of the gap junction is also discussed.

[Evidence of the recycling of vesicle membranes by means of morphometric measurement of the vesicle density (author's transl)]. / Beitrag zum Nachweis des Recycling von Vesikelmembranen mittels morphometrischer Bestimmung der Vesikeldichte.

Quantitative-electron microscopic investigations have been performed on large morphologically mixed synapses in the oculomotor nucleus of the trout with the aim to get some hints at recycling processes of vesicle membranes. For this reason vesicle density of the presynaptic area and number of vesicle attachment sites of the presynaptic membrane of the active zones within these mixed contacts have been estimated in two different experimental groups. Furthermore, vesicle density near the unmyelinated axolemma of the axon terminal has been measured in both groups. The results obtained support the view that a recycling of vesicle membranes occurs in morphologically mixed synapses, probably also over the axolemma of the so-called extended extracellular spaces, which are interrupting the contact area between the two neuronal elements. The question of a recycling of gap-junction-vesicles has not been answered.