Revealing the biography of a hidden medieval manuscript using synchrotron and conventional imaging techniques.

Reading the content of hidden texts from ancient manuscripts has become an increasingly important endeavor thanks to the variety of non-destructive analytical tools and image processing routines available for this task. In this study, portable macro X-Ray Fluorescence (MA-XRF-tube), Visible Hyperspectral Imaging (HSI) together with Synchrotron based macro X-Ray Fluorescence (MA-XRF-SR) are combined with signal processing methods to reveal the biography of a degraded manuscript recycled as binding material for a 16th century printed edition of Hesiod's Works and Days. The analytical techniques allow visualizing the hidden text, revealing passages from the Institutes Justinian, a 6th century A.D codification of the Roman Law, with further marginal comments on medieval Canon Law. In addition, the identification of the materials (e.g. pigments, inks) part of the original manuscript together with their sequence of use are revealed: i) the preparation of the parchment using a Ca-based preparation layer, ii) drawing of ruled guide lines, using a Pb-based pen or ink, iii) writing of the main text using a rich Fe-gall ink with modulating color pigments (Hg-, Cu- and Pb- based) and iv) addition of two types of comments to the main text, one of the ink used for the comments being a Fe-gall ink rich in Cu.

Characterization of a prolonged regenerative attempt by diffusely injured axons following traumatic brain injury in adult cat: a light and electron microscopic immunocytochemical study.

Traumatic brain injury in animals and humans is well known to cause axonal damage diffusely scattered throughout the brain without evidence of other brain parenchymal change. This observation has prompted some to posit that such damaged axons are well positioned to mount a regenerative attempt. The present study uses an immunocytochemical marker specific for regenerating neurites to explore this issue. Further, in an attempt to expedite and enhance any potential regenerative effort, this study evaluates the efficacy of intrathecally applied nerve growth factor. Three sets of experiments were performed in adult cats. One group of animals was subjected to moderate fluid percussion brain injury and followed for 7 or 14 days post injury, with the continuous intraventricular infusion of nerve growth factor delivered by implanted osmotic pumps. These animals were compared to a second group of time-matched, sham-operated animals receiving artificial cerebrospinal fluid infusion. To assess axonal damage immunohistochemical staining for the low molecular weight neurofilament subunit (NF-L) was carried out using an NR4 monoclonal antibody. To localize axons exhibiting a regenerative response immunohistochemical staining for the growth associated protein GAP43 was employed. In sham controls, at the light microscopic level NF-L-immunoreactive axonal swellings were numerous at 7 days, but by 14 days post injury their frequency declined markedly. In contrast, GAP43-immunoreactive, disconnected reactive axonal swellings were rarely observed at 7 days but were numerous at 14 days. Ultrastructural analysis at 14 days post injury of carefully matched sections revealed reactive axons demonstrating sprouting consistent with a regenerative effort. Analysis of tissue from animals of 14 days of survival indicated that supplementation with nerve growth factor did not appear to enhance the capacity of damaged brain axons to mount a regenerative attempt. Rather, it appears that regenerative efforts seen reflect a spontaneous response. A third group of adult cats, subjected to the same injury but not subjected to osmotic pump implantation, was allowed to survive for 22-28 days. Animals in this group also demonstrated GAP43 immunoreactivity in reactive axonal swellings in the brain stem. This study demonstrates that diffusely injured axons can mount a sustained regenerative attempt that is associated with a reorganization of their cytoskeleton and accompanied by an up-regulation of growth-associated proteins.

Effects of surgically induced weight loss on idiopathic intracranial hypertension in morbid obesity.

BACKGROUND: The effect on CSF pressures and symptoms of weight loss induced by gastric surgery was studied in morbidly obese patients with idiopathic intracranial hypertension (IIH). METHODS: Gastric weight reduction surgery was performed in eight morbidly obese women (49 +/- 3 kg/m2 body mass index) who had IIH and elevated CSF pressures. Each had been treated medically for IIH. Two had ventriculoperitoneal shunts, with occlusion in both and hemorrhage and hemiparesis in one. Post--weight-reduction measurement of CSF pressures, signs and symptoms of IIH, and obesity co-morbidity were evaluated. RESULTS: CSF pressures decreased in all eight patients, from a mean of 353 +/- 35 to a mean of 168 +/- 12 mm H2O (p < 0.001), following mean weight loss of 57 +/- 5 kg (p < 0.001) when measured at 34 +/- 8 months after surgery. At follow-up no patient had papilledema, all eight patients had resolution or marked reduction of headache, and resolution of tinnitus occurred in all six patients with this symptom. Neuroimaging was unchanged at 27 +/- 6 months after surgery in six patients. There was also resolution or clinical improvement of additional obesity-related co-morbidity, including diabetes, hypertension, sleep apnea, obesity hypoventilation, joint pains, stress urinary incontinence, and gastroesophageal reflux. CONCLUSIONS: Although several complications occurred following obesity surgery over the 11 years of this study, the current low morbidity and mortality with gastric bypass make this a primary option in the severely obese patient with IIH.

Focal ischemia due to traumatic contusions documented by stable xenon-CT and ultrastructural studies.

A traumatic cerebral contusion causes a zone of perifocal neuronal necrosis, the cause of which is not known; the surgical management of these lesions remains controversial. To determine the pathophysiological mechanisms responsible for brain damage after contusions, the authors performed cerebral blood flow (CBF) mapping studies and related these to change in local cerebral blood volume (CBV) and ultrastructure. In 11 severely head injured patients with contusion, CBF and CBV were measured in pericontusional areas using stable xenon-computerized tomography (CT). These studies demonstrated a profound reduction in perilesional CBF (mean 17.5 +/- 4 ml/100 g/min), which was always accompanied by a zone of edema defined by CT density measurements. Mean CBV in these regions was 2.3 +/- 0.4 ml/100 g, a reduction to approximately one-half the value of 4.8 ml/100 g found in the nonedematous regions, and to approximately 35% of the value of 6.0 ml/100 g found in normal volunteers. Ultrastructural analysis of the pericontusional tissue, taken at surgery in four patients with high intracranial pressure showed glial swelling with narrowing of the microvascular lumina due to massive podocytic process swelling. Additionally, some suggestion of vascular occlusion due to erythrocyte and leukocyte stasis was seen. These data support the conclusion that microvascular compromise by compression and/or occlusion is a major event associated with profound perilesional hypoperfusion, which is a uniform finding within edematous pericontusional tissue.

Giant intrasacral schwannoma: an unusual cause of lumbrosacral radiculopathy.

Sacral schwannoma is a rare lesion (23 reported cases) with a tendency to reach large proportions. Symptoms are back and leg pain, leg weakness, hypoesthesias, paresthesias, constipation, and incontinence. The peak incidence is between ages 30 and 50. Radiographs of the sacrum are abnormal in nearly all cases. Computed tomography and magnetic resonance imaging may reveal large lesions with bony erosion and involvement of the soft tissues. The treatment of this lesion is complete removal, which is curative.

Changes in cerebral blood flow and metabolism related to the presence of subdural hematoma.

Acute subdural hematoma (SDH) remains an important factor in head injury. The early effects of SDH on cerebral blood flow (CBF) and cerebral metabolic rate of oxygen consumption (CMRO2) in humans have not been clearly demonstrated. Patients admitted to the Medical College of Virginia with severe closed-head injury between 1982 and 1990 were studied with Xenon-133 regional CBF measurement. Data were reviewed retrospectively with regard to the presence of SDH (n = 54). A comparison group consisted of patients with head injuries without mass lesions or midline shift on admission computed tomographic scans (n = 76). CBF measurements made in patients less than 16 years of age, with concurrent administrations of mannitol or vasopressors, or with cerebral perfusion pressure under 50 mm Hg were excluded. CBF measurements were made on multiple occasions during the first 6 days after injury, and in many instances, simultaneous determinations of cerebral arteriovenous oxygen difference (AVDO2) were made through sampling of jugular bulb and arterial oxygen content. Not all patients underwent CBF measurements on each day. Differences in mean CBF, CMRO2, and AVDO2 were evaluated on each day after injury with the application of Student's t-test for independent groups. Significant reductions in CBF were demonstrated in patients with SDH on Days 1 (P < 0.0005) and 2 (P < 0.01). CMRO2 differed notably on Days 1 (P < 0.005) and 2 (P < 0.05) in patients with SDH, but when corrected for the lower Glasgow Coma Score in patients with SDH, the P values were only 0.07 and 0.12, respectively (analysis of covariance).(ABSTRACT TRUNCATED AT 250 WORDS)

Desmoplastic cerebral astrocytoma of infancy. A case report with immunohistochemical, ultrastructural and proliferation studies.

We present a case of desmoplastic cerebral astrocytoma of infancy (DCAI) in a 7 1/2-month-old girl and include immunohistochemical, ultrastructural and proliferative activity studies. The dural-based cystic tumor showed a biphasic pattern consisting of glial fibrillary acidic protein (GFAP)-positive astrocytes embedded in a desmoplastic stroma. The astrocytic processes were lined with basal lamina at their surface contacting the collagen. Scattered islands of undifferentiated small cells were seen acquiring GFAP positivity at their peripheral zone facing the collagen. Studies with silver nucleolar organizer region and proliferating cell nuclear antigen disclosed a high proliferative activity. Flow cytometric study showed an elevated S phase and 15% hypertetraploid cell population. These findings contrast the favorable prognosis of the tumor at 26 months follow-up. Probably, extracellular-matrix-induced maturation of the undifferentiated cells with the formation of basal lamina may account for this unique disparity.