A post mortem study on neurochemical markers of dopaminergic, GABA-ergic and glutamatergic neurons in basal ganglia-thalamocortical circuits in Parkinson syndrome.

Functional models of the circuitry of the basal ganglia have recently been proposed to account for the vast spectrum of motor disorders associated with the loss of anatomical or neurochemical integrity within the basal ganglia. On the basis of these hypothetical models, hypokinetic disorders such as Parkinson's disease, are thought to be associated with excessive tonic and phasic inhibition of the output from the basal ganglia to the thalamus. In the present study we have attempted to determine the validity of the proposed model by measuring neurochemical markers of inhibitory and excitatory neurotransmission in post mortem human brain tissue. We have determined the concentrations of the excitatory neurotransmitters aspartate/glutamate and of the inhibitory neurotransmitter GABA in 18 relevant regions of the thalamocortical circuits of the basal ganglia of patients who had manifested Parkinsonian symptoms, and compared them with controls of individuals who had died without any history of neurological or psychiatric disorders and had no neuropathological abnormalities. Additionally, the receptor subtype for the excitatory amino acid N-methyl-D-aspartate (NMDA) was studied in the same brain tissue in which neurotransmitter concentrations had been analysed as neurochemical markers of post-synaptic excitatory neurotransmission. In patients who had manifested Parkinsonian symptoms, glutamate and aspartate levels were found to be unchanged in all examined brain regions. In contrast, the binding of [3H]MK-801, which identifies the NMDA receptor, was reduced in the head (-42%) and body (-38%) of the caudate nucleus. In parkinsonian patients, GABA levels were diminished by 36% in the centromedial thalamus, compared to control values. These results do not confirm the changes in neurotransmitter concentrations predicted according to the model, although we cannot rule out that the predicted changes might have been observed if the Parkinsonian group had been further subdivided into groups diagnosed on the basis of the patients' clinical picture (akinetic-rigid, tremor-dominant, equivalent type) and compared with the control group.

Unaltered aconitase activity, but decreased complex I activity in substantia nigra pars compacta of patients with Parkinson's disease.

Substantia nigra pars compacta of seven patients who had died of Parkinson's disease, has been investigated for the iron-depending aconitase (reactions I and II). In addition we analysed respiratory chain enzymes. While complex I activity of the respiratory chain was significantly reduced, other enzymes of this pathway were unaltered. The citric acid cycle enzyme aconitase (reactions I and II) showed no difference between patients and controls. Thus this ferrous iron dependent and oxidatively sensitive enzyme is not affected by the unphysiological high amount of ferric iron and the 'oxidative stress' present in substantia nigra of parkinsonian patients.

Quantification of mRNA of tyrosine hydroxylase and aromatic L-amino acid decarboxylase in the substantia nigra in Parkinson's disease and schizophrenia.

Using the reverse transcription-polymerase chain reaction (RT-PCR), we developed a sensitive and quantitative method to detect all four types of human tyrosine hydroxylase (TH) mRNAs in the human brain (substantia nigra). All four types of TH mRNAs were found in the substantia nigra in the control brains examined, and the ratio of type-1, type-2, type-3, and type-4 mRNAs to the total amount of TH was 45, 52, 1.4, and 2.1%, respectively. The average amount of total TH mRNA in the normal brain (substantia nigra) was 5.5 amol of TH mRNA per microgram of total RNA. The ratios of four TH isoforms were not altered significantly in Parkinson's disease or schizophrenia. Further we measured the relative amount of aromatic L-amino acid decarboxylase (AADC) and beta-actin mRNAs in the brain samples. TH and AADC mRNAs were highly correlated in the control cases. We found that parkinsonian brains had very low levels of all four TH isoforms and AADC mRNAs in the substantia nigra compared with control brains, while no significant differences were found between schizophrenic brains and normal ones. Since the decrease in AADC mRNA was comparable to that in TH mRNA, the alteration of TH in Parkinson's disease would not be a primary event, but it would reflect the degeneration of dopaminergic neurons in the substantia nigra. This is the first reported measurement of mRNA contents of TH isoforms and AADC in Parkinson's disease and schizophrenia.

Imbalance of the Gs and Gi/o function in post-mortem human brain of depressed patients.

The amounts of various G protein subunits in postmortem brain samples from the parietal and temporal cortices were the same in controls and depressive patients as demonstrated by immunoblotting. However, photoaffinity GTP labeling (AAGTP) of Gi/o alpha, but not Gs alpha, was significantly increased in depressives in both cortex regions. Furthermore, the ratio of Gs/Gi/o AAGTP incorporation revealed a significant reduction in depressives in these regions. The present findings suggest that an imbalance of second messengers via G protein function may be involved in the pathophysiology of depression.

[Pulmonary alveolar microlithiasis (author's transl)]. / Mikrolithiasis alveolaris pulmonum.

The Pulmonary alveolar microlithiasis is a rare disease of unknown etiology with chronic course. Clinical symptoms are not characteristic or missing completely. The disease is diagnosed by X-ray examination and histologic examination from biopsy specimen of the lung. A report on the first case in Austria is given.

[Dysgerminoma of the ovary during pregnancy (author's transl)]. / Dysgerminom des Ovars und Schwangerschaft.

A report presented of a case of giant dysgerminoma which initiated an acute abdomen necessitating surgical intervention during the mid-trimester of pregnancy. Two months later the patient was delivered of a healthy baby by Caesarean section. Repeated follow-up examinations of the patient have so far confirmed the favourable prognosis based on the pathological findings and intra-operative assessment.

[Case report of a Gartner's duct carcinoma of the vagina (author's transl)]. / Fallbericht eines Gartner-Gang-Karzinoms der Scheide

A case report is presented of a malignant tumour of the vagina arising from the mesonephric duct (Gartner's duct) in a 34-year-old woman. The diagnostic difficulties are illustrated on the basis of the course, clinical findings and cytological and histological reports. In an attempt to classify the histological picture amongst the great diversity of forms of mesonephric tumours it would appear advantageous to distinguish between a mesonephric tubulopapillary "Gartner's duct type" and a metamesonephric "clear-cell type". Management by extended radical operation and subsequent combination chemotherapy, as carried out in this patients, appears promising.

[Angiography, scintigraphy and ultra sound in the diagnosis of splenic or hepatic disease in Hodgkin's disease (author's transl)]. / Angiographie, Szintigraphie und Ultraschall zum Nachweis von Milz- oder Leberbefall bei Morbus Hodgkin

The combined use of selective angiography, scintigraphy and ultra-sound is not reliable enough for the certain exclusion of visceral involvement in Hodgkin's disease. Since this is of importance in the planning of treatment, it confirms the recommendation made by Wagenknechts, Glatsteins and others that a diagnostic splenectomy be carried out in order to determine the presence of visceral involvement.

Gilbert's syndrome and HL-A. Preliminary report.

HL-A antigens were determined in 18 unrelated patients with Gilbert's syndrome and 3 families where this condition occurred in 2 generations. The data obtained do not point out an association between HL-A antigens and Gilbert's syndrome.

[Pneumocystis carinii infections following kidney transplantation]. / Pneumocystis-Carinii-Infektion nach Nierentransplantation

Four adult recipients of cadaveric renal homografts acquired Pneumocystis carinii infections from which they subsequently died. The disease in adults under immunosuppressive therapy runs a course different from the disease observed in newborns. The clinical course is rapidly progressive and early diagnosis by means of aggressive diagnostic procedures is mandatory. To prevent a fatal outcome, treatment even on suspicion is suggested. Epidemiologically, a person-to-person spread seems possible and isolation of the patient is necessary.

Investigation of cell-vitality in tumor specimen after cryosurgical operations.

Carcinomas of the gastro-intestinal tract were resected in 6 patients either by cryosurgery or in the usual, conventional manner without freezing the tumor. Cells from the tumorsections in each case were isolated by the use of enzymes and were examined for vitality following trypan-blue vital staining. In 5 out of 6 cryosurgical cases fewer than 10% of the cells were vital compared with sections from nonfrozen specimen. In one case the freezing method (cryosurgery) did not have any influence on the cell vitality. The cell-damaging effect of cryosurgical procedures proven in vitro suggests possible additional therapeutic effects in tumor-patients. Cryosurgery has proven useful in the treatment of hypertrophic prostates, when an unusual risk was involved. Recently it has also been used in the surgical treatment of carcinomas of the skin, the bladder and the cervix (1; 2, 3, 6). Approximately a year ago we started to use cryosurgery in our hospital in inoperable abdominal tumors. After freezing the primary tumor or its metastases a massive breakdown of the remaining tumor in-situ occurs, which might produce a palliative effect. As a result of freezing the tumor before resection, we expect a decrease in the spread of tumor cells during surgery and a stimulation and mobilization of specific immune response against the tumor (5). In order to increase our knowledge of the biological behaviour of cryosurgically treated tumors, we investigated in the present study teh cell-vitality in tumor tissues before and after cryosurgery.

[A primary retroperitoneal mesodermal mixed-cell tumor? (author's transl)]. / Ein primäres retroperitoneales Malignon. Variante eines Müllerschen Mischtumors?

A primary retroperitoneal tumor is reported. Histologically the tumor consists of epithelial and mesenchymal compartments. By reason of the positive SRCA-reaction the tumor was classified as a mesodermal mixed-cell tumor.