Antonio Carolei

Imaging of leukocytic infiltration in human cerebral infarcts.

The circulating white blood cells of patients with brain infarction were labelled in vitro with Indium-111 tropolonate; the cells were reinjected to study the inflammatory process by gamma camera imaging. Eight patients with acute cerebral ischemic infarct were studied during the first two weeks after the onset of neurological symptoms. In seven cases a well defined area of increased radioactivity was revealed in the infarcted hemisphere indicating active migration and tracking of labelled leukocytes in cerebral infarct. This method allows monitoring of the cellular inflammatory response in human cerebral infarcts and adds another imaging technique.

Changing prognosis of primary intracerebral hemorrhage: results of a clinical and computed tomographic follow-up study of 104 patients.

One hundred four consecutive cases of primary intracerebral hemorrhage hospitalized at the time of stroke were followed until death or for 1 year. All were treated nonsurgically. The 30-day mortality rate was 30%. Good clinical outcome and complete resolution of the lesion on computed tomography were observed in 49 and 13% of patients, respectively. Age, state of consciousness, and size of the hemorrhage on computed tomography scan were reliable prognostic indicators. The long-term survival rate, 66%, was higher than that previously reported and should be considered in future trials evaluating medical and surgical treatment of intracerebral hemorrhage.

Early treatment of stroke with monosialoganglioside GM-1. Efficacy and safety results of the Early Stroke Trial.

Background and Purpose The Early Stroke Trial (EST) is a randomized, double-blind, placebo-controlled trial to assess the effect of monosialoganglioside GM-1 in improving recovery in patients who experienced an ischemic supratentorial stroke. Methods Sixteen clinical centers recruited 805 patients, of whom 792 were confirmed to be eligible. Treatment, consisting of a first dose of either 200 mg GM-1 or placebo, was initiated within 5 hours of the onset of stroke; a second dose of either 100 mg GM-1 or placebo was administered 12 hours later. Thereafter, patients received a daily injection of 100 mg GM-1 or placebo intravenously from day 2 through 10 and intramuscularly from day 11 through 21. Patients were followed up for a total of 4 months. Results Survival was similar in the two treatment groups. Improvement in neurological status, as measured by the change in Canadian Neurological Scale score between baseline and 4-month assessments, was greater in the group receiving GM-1; the observed difference between treatment groups was 0.22 (P=.06). A post hoc analysis in the subgroup of patients treated within 4 hours showed a statistically significant difference, with Canadian Neurological Scale mean improvement of 0.41 (P=.016). GM-1 use was not associated with differences in frequency, nature, or severity of adverse experiences. Conclusions These findings suggest that GM-1 is safe in the dose and treatment schedule used and that its efficacy in ischemic stroke is greater when given soon after onset of stroke.

Proposal of a New Model with Dopaminergic-Cholinergic Interactions for Neuropharmacological Investigations

The motor system of Dugesia gonocephala shows a striking similarity with the extrapyramidal system of high vertebrates and of man with the evidence of correlations between dopaminergic and cholinergic neurons. The utilization of this model seems to be useful in testing drugs which presumably act on dopaminergic or cholinergic transmission. In this model, the quantification of animal behaviour seems considerably easier when compared with the difficulties met in other animal models commonly employed. Besides, it might be anticipated that this model, if correctly used, can display interesting perspectives also in neuroendocrinological investigations.

Effects of dopaminergic agents on monoamine levels and motor behaviour in planaria

1. Dopamine, serotonin and, in lesser amounts, norepinephrine were detected in Dugesia gonocephala using electrochemical detection coupled with liquid chromatography (LCED). 2. Treatment with L-dopa induced hyperkinesias, and a rise in dopamine, serotonin and norepinephrine content, whereas reserpine reduced motor activity and the concentrations of all three monoamines. 3. Haloperidol reduced motor activity and dopamine and norepinephrine levels. 4. Apomorphine induced hyperkinesias without altering monoamine levels.

Radioimmunological and immunocytochemical demonstration of Met-enkephalin in planaria.

1. An anti-Met-enkephalin serum has been used for radioimmunological and immunocyto-chemical demonstration of Met-enkephalin in planaria. 2. The serum showed a high degree of sensitivity and specificity. 3. Radioimmunoassay demonstrated in planaria extracts a considerable concentration of Met-enkephalin. 4. Met-enkephalin was localized by immunocytochemical methods in neurons and neuropil.

Design and baseline results of the monosialoganglioside early stroke trial. The EST Study Group.

The Early Stroke Trial is a randomized, placebo-controlled, double-masked, multicenter study to assess the safety and efficacy of monosialoganglioside in patients who have suffered an ischemic stroke of the cerebral hemispheres. Methods Only patients who could be evaluated and treated within 5 hours after the onset of stroke were considered; within each center, subjects were stratified by age, sex, and clinical severity. Patients were randomly allocated to receive a specified sequence of intravenous and intramuscular doses of either monosialoganglioside or identical-appearing placebo for 21 days. Patients were followed up for 4 months after randomization. Neurological status was measured primarily by using the Canadian Neurological Scale. After assessing the effect of treatment on survival, the principal measure of efficacy will be the change in neurological status between baseline and the 4-month follow-up among survivors. Results Sixteen clinical centers, I5 in Europe and one in North America, entered a total of 792 eligible patients during a 36-month recruitment period (from May 1987 to April 1990). In our series there were more men than women, and the relative frequency of patients increased with advancing age. The most frequently associated cardiovascular conditions were hypertension, atrial fibrillation, and peripheral vascular disease. Approximately 46% of the patients were admitted to a hospital within 1 hour and 81%, within 2 hours after the onset of stroke. About 22% first received the study treatment within 3 hours and 57%, within 4 hours. Conclusions This study demonstrates the feasibility of large-scale trials with the onset of treatment within 5 hours after an ischemic stroke.

The pigmentary system of planaria

SummaryThe pigmentary system of the planaria, Dugesia gonocephala s.l. (Platyhelminthes, Turbellaria, Tricladida), has been studied by light and electron microscopy. The system consists of granules contained in chromatophore-like cells embedded in the parenchyma. The cell processes penetrate between the muscle layers and extend to the sub-epidermal basal lamina. The nature of the pigment and the comparative anatomical significance of the chromatophore structure is discussed.

Ouabain insensitive ATPase in planaria

Abstract 1. 1. Ouabain, up to 8·10−3 M is virtually non-toxic for planaria (Dugesia gonocephala). 2. 2. No behavioural changes are observed during ouabain treatment. 3. 3. Regeneration of sectioned specimens occurs normally in ouabain solutions. 4. 4. Planaria homogenates show a Mg2+ dependent ATPase, not activated by Na + + K + and ouabain insensitive. 5. 5. K+ stimulates, whereas Na+ (or Na + + K + ) inhibits Mg2+ dependent ATPase.

Sequential Computed Tomography and 123I-HIPDM Scans in Multiple Sclerosis with Large Plaque

We report a case of acute multiple sclerosis in whom computed tomography (CT) scan suggested the presence of a large plaque. The anatomical and functional recovery of the brain tissue was followed by means of repeated CT scan and 123I-HIPDM studies. Single photon emission CT may be successfully employed to monitor the pathophysiological changes associated with the demyelinating process.