Alfonso M. Albanese

Inversion of the hemispheric laterality of the anterior cingulate gyrus in schizophrenics

The anterior cingulate gyrus (acg) is involved in mechanisms of attention and emotion, where the right hemisphere is considered to be dominant. One of the models for neuropsychological dysfunction in schizophrenia suggests an impairment in the balance of lateralized functions. Fourteen adult human female brains, having no macroscopic lesions, were used in this study. Seven brains came from female patients with clinical diagnoses of residual schizophrenia (DSM-III-R; APA 1987). Seven female brains were used as controls. Thirteen male brains were also studied, with the sole purpose of establishing the typicality of the female controls. All schizophrenic brains were age matched with control brains. Right laterality for weight (71.4%) and surface (85.7%) was observed in the acg of female control brains. The inversion of this laterality in a significant number of the schizophrenic cases was the most relevant finding in this study.

Lateral Subdermic Varicose Vein System of the Legs: Its Surgical Treatment By the Chiseling Tube Method

Shermanl mentions a secondary type of varicose veins in the anterolateral area of the legs. Myers2~ 3 mentions that besides the great saphenous vein there is another venous system running along the thigh and leg. It is closely related to the great saphenous system. Luke4 mentions that stripping is not useful for certain superficial tortuous and fragile varicose veins. Despite the fact that Luke is an enthusiastic proponent of sclerotherapy, he says: &dquo;There are many branch veins which be stripped because of the tortuosity of the vein and the thinness of the varices. The distal ends of the medial and lateral descending branches are of this nature. However, these should be dealt with at time of operation and not left for post-operative injection therapy. Our method in this type of varix is to fragment these branches through a series of small step-ladder incisions along the course of the branch about 12&dquo; apart. A thin long-handled pair of scissors is inserted along the course of the branch and the varices are macerated by rapid cutting with the scissors. This macerated veins are obliterated by thrombus and later by scar tissue; any bleeding at operation is easily stopped by pressure.&dquo; In Argentina, Benchimol5 and Buzzi6 did something similar. We had also used the same approach before studying the problem more closely in its anatomical, clinical and surgical aspects, but our own first impression was that this was a totally special system of varicose veins, not or slightly related with both saphenae in one adolescent I operated on in 1951. He had a long varicose vein in italic S-shape which ran from the dorsal aspect of the foot, passing laterally on the knee to the subgluteal fold. It was very superficial and

COMPENSACIÓN: UN NUEVO CONCEPTO RELACIONADO CON LA LATERALIDAD CEREBRAL. SU APLICACIÓN A REGIONES DEL LÓBULO FRONTAL, INCLUIDA EL ÁREA MOTORA DEL LENGUAJE (DE BROCA)

: Cuando se determina la asimetria de una estructura bilateral formada por subregiones asimetricas con lateralidades opuestas, queda enmascarada (compensada), total o parcialmente, la existencia de las diferencias interhemisfericas de tales subregiones. Para cuantificar esta realidad, hemos establecido un nuevo parametro: la compensacion. El objetivo del presente trabajo, realizado en cerebros humanos postmortem, esta dirigido a determinar los porcentajes de compensacion, de asimetria de peso y de superficie cortical, de tres regiones cerebrales pertenecientes al lobulo frontal: 1. El area de motora del lenguaje (de Broca). 2. La porcion anterior del giro frontal inferior. 3. El giro frontal inferior en su totalidad. Para valores de peso y de superficie cortical para el area motora del lenguaje los porcentajes de casos con compensacion parcial o total son, respectivamente, 50 y 42%; para la porcion anterior del giro frontal inferior 70 y 67%; y para el giro frontal inferior en su totalidad 96 y 96%. En este ultimo el porcentaje de casos con compensacion es significativamente mayor que en las otras dos regiones (Chi2). Similares valores porcentuales de asimetria pueden darse en casos con muy diferentes valores porcentuales de compensacion. Esto demuestra que con el solo calculo de la asimetria se enmascaran aspectos de las diferencias interhemisfericas. De ahi que ambos valores son complementarios

CUERPO CALLOSO EN EL PLANO MEDIANO DE IMÁGENES DE RESONANCIA MAGNÉTICA: PERÍMETRO, SUPERFICIE Y FORMA EN RELACIÓN A EDAD Y SEXO

Numerosas publicaciones sobre aspectos morfologicos del cuerpo calloso (cc) evidencian el interes, a la vez que la necesidad de aclarar discrepancias sobre la influencia de la edad y sexo. Abundante bibliografia se refiere a su superficie en el plano mediano del cerebro, pero pocas citas hacen referencia a su perimetro. El objetivo de este trabajo fue determinar perimetro y superficie del cuerpo calloso como tambien, establecer relaciones entredichos valores y el sexo, tamano cerebral y edad (rango15-82 anos y sub-rangos). En imagenes de resonancia magnetica digitalizadas, de 194 sujetos normales de ambos sexos, se midieron, mediante el programa Scion Image for Windows, perimetro y superficie del cc en el plano mediano del cerebro y superficies cerebrales para sagitales. Los valores obtenidos se procesaron estadisticamente (ANOVA) y se correlacionaron (r de Pearson) con la edad. En ambos sexos, entre 15 y 40 anos, la superficie aumenta significativamente (r: 0.33 y 0.60) y, despues de los 60 anos, disminuye (r:-0.72 y-0.78) pero no se modifica significativamente entre 41 y 60 anos. Entre 15 y 82 anos el perimetro aumenta leve y significativamente (r: 0.22 y 0.35). La superficie es mayor en la mujer solamente en relacion al tamano del cerebro. El trabajo aporta valores de perimetro y superficie del cc, los que varian significativamente con la edad pero no con el sexo. La relacion entre ambos indica variaciones de la forma del cc con la edad. Se evidencia que si solo se analizan amplios rangos de edades pueden obtenerse falsas conclusiones.

LAS RELACIONES DE DOMINANCIA EN EL LÓBULO LÍMBICO

La dominancia morfologica de regiones cerebrales suele expresarse en funcion del numero o porcentaje significativo de casos que presenta una misma lateralidad hemisferica. Estimamos que la evaluacion de la dominancia debiera complementarse mediante una expresion relacionada con la magnitud relativa de los valores de las asimetrias de los casos con lateralidades opuestas, con significacion estadistica, util para comparar la dominancia de diferentes regiones cerebrales. Para tal fin, hemos desarrollado una nueva expresion, que presentamos en el 250 Congreso Argentino de Neurociencias (2000), a la que denominamos relacion de dominancia (rD). El objetivo del presente estudio fue determinar las rD con su significacion estadistica, de pesos y superficies corticales expuestas y profundas del lobulo limbico (LL) y de sus giros -giro del cingulo anterior (CA), giro del cingulo posterior (CP) y giro parahipocampal (PH)- en 20 cerebros humanos adultos, postmortem, procesados segun nuestro metodo (Arch. Neurol. 46: 307-310, 1989; Rev. Chil. Anat. 17:175-81, 1999). La rD esta basada en la correlacion no parametrica de Spearman. Las variables que se enfrentan en la correlacion corresponden a la lateralidad con su signo (negativo si es izquierda y positivo si es derecha) y al valor absoluto de lateralidad. Su rango esta comprendido entre - 1 y +1. Su signo resulta negativo si la dominancia es izquierda y positivo si es derecha. Son estadisticamentre significativas (p<0.001) las rD de peso y de superficie cortical del CA ( 0.97 y 0.99) y del LL (0.88 y 0.94). La diferencia entre ellas es significativa (p<0.05). Las rD, cuantificando las lateralidades relativas del CA y del LL, complementan las expresiones de dominancia derecha de ambas estructuras, basadas en el porcentaje significativo de casos que comparten dicha lateralidad hemisferica y muestran ausencia de significacion estadistica de dominancia en el resto de giros del lobulo

Los giros del lóbulo frontal: estudio postmortem

The objective of the present work was to study the lobus frontalis in postmortem human brains in order to obtain weight as well as superficial and deep cortex values of the lobus and its gyri and quantitative ratios among these values. Twelve brains obtained from right-handed subjects aged between 30 and 55 years having no visible macroscopic neurologic lesions were fixed in formaldehyde (5%) and processed using a method developed in our laboratory (Arch. Neurol., 46:307; 1989). Absolute and percent values, as well as weight/cortical surface ratios and correlations of the gyri of the lobus frontalis - regio orbitalis, cinguli, superior+medium, inferior and precentralis - were obtained. The cortical surface of the right gyrus cinguli is significantly larger than the contralateral one. The statistically lower weight/cortical surface ratio corresponds to the regio orbitalis and the higher one to the gyrus precentralis. The regio orbitalis supplies a higher percentage in cortical surface than in weight to its respective lobus frontalis; the opposite occurs with the gyrus precentralis. The right gyrus cinguli supplies a higher percentage in weight than in cortical surface than the left one. The Pearson coefficient of correlation between the values (absolute and percent) corresponding to weight and cortical surface between homologous gyri of both hemispheres are positive.The correlations between weight absolute as well as percent values and those of the respective cortical surface are positive, excellent and highly significant. The higher percentage of cases with right laterality corresponds to the gyrus cinguli and that with left laterality to the gyrus frontalis inferior. Modifications that could occur in brains from psychiatric and neurologic patients could alter some of these values and relationships, as for example in schizophrenia in which we found an inversion of the gyrus cinguli anterior laterality (ALBANSE et al., 1995)

Radical and Esthetic Surgery for Varicose Veins of the Legs

1. The affluent accessory vein system of the saphena magna in the legs collects the superficial venous blood in the area from the ankle to the knee (fig. 1). Three accessory affluent veins are ventral and the other three are dorsal to the saphena magna, connecting them with this vein at the pes anserinus area. They have an almost constant pattern, but sometimes not all of them may be present. This distribution was found by us in personal anatomical investigations and was clinically and surgically substantiated. These six afHuent accessory veins connect at the other end with perforating communicating veins (fig. 2) which, through the deep fascial holes (fig. 3), connect later with the deep venous systems. The affluent accessory veins have many more perforating communicants than both saphenous veins. The subdermic lateral vein system is a particularly tortuous vein system located very superficially on the lateral aspect of the thigh and leg. It has a X pattern with the branches meeting at the lateral aspect of the knee. This system connects with the affluent accessory, the nonperforating communicants (see below), the dermic web and the saphenous systems. Besides, it connects with the deep venous system by thin and long perforants (see below). The nonperforating subcutaneous communicating vein system (subcutane-