Heartbeat perception and panic disorder: possible explanations for discrepant findings.

Results on cardiac awareness in panic disorder are inconsistent. The present study attempted to clarify whether differences in instructions or the inclusion of patients taking antidepressant medication could account for these inconsistencies. 112 patients with panic disorder with agoraphobia were compared to 40 normal controls on the heartbeat perception task developed by Schandry (1981) [Schandry, R.

Metabolites of [3-13C]1,2-dibromo-3-chloropropane in male rats studied by 13C and 1H-13C correlated two-dimensional NMR spectroscopy.

Metabolism of 1,2-dibromo-3-chloropropane (DBCP) was examined by direct 13C and 1H-13C correlated two-dimensional NMR spectroscopy of bile and urine of male albino rats treated intraperitoneally with [3-13C]DBCP at 81 mg/kg. The 3-13C label was introduced at 99% enrichment by coupling [13C]paraformaldehyde with vinyllithium to give [1-13C]allyl alcohol which was converted to allyl chloride with carbon tetrachloride/triphenylphosphine and then brominated. Fifteen 13C NMR signals were observed for biliary metabolites and twelve for urinary metabolites.

Biosynthesis and biotransformation of glutathione S-conjugates to toxic metabolites.

The material presented in this review deals with the hypothesis that the nephrotoxicity of certain halogenated alkanes and alkenes is associated with hepatic biosynthesis of glutathione S-conjugates, which are further metabolized to the corresponding cysteine S-conjugates. Some glutathione or cysteine S-conjugates may be direct-acting nephrotoxins, but most cysteine S-conjugates require bioactivation by renal, pyridoxal phosphate-dependent enzymes, such as cysteine conjugate beta-lyase (beta-lyase). The biosynthesis of glutathione S-conjugates is catalyzed by both the cytosolic and the microsomal glutathione S-transferases, although the latter enzyme is a better catalyst for the reaction of haloalkenes with glutathione.

Spinal neurofibromas: a report of 66 cases and a comparison with meningiomas.

A series of 66 spinal cord neurofibromas was analyzed for history, signs, surgical approach, and outcome. The tumors presented primarily with sensory symptoms. Plain films were abnormal in 1/2 of cases and 1/2 had a complete block.

Nephrotoxicity of S-(2-chloro-1,1,2-trifluoroethyl)glutathione and S-(2-chloro-1,1,2-trifluoroethyl)-L-cysteine, the glutathione and cysteine conjugates of chlorotrifluoroethene.

The glutathione and cysteine conjugates of the nephrotoxin chlorotrifluoroethene, S-(2-chloro-1,1,2-trifluoroethyl)glutathione (CTFG) and S-(2-chloro-1,1,2-trifluoroethyl)cysteine (CTFC), are potent nephrotoxins in male rats. Morphological changes in the kidneys were observed 1.5 hr after giving 100 mumol/kg of CTFG (i.

3-Substituted 2-halopropenals: mutagenicity, detoxification and formation from 3-substituted 2,3-dihalopropanal promutagens.

The mutagenicity of halopropenals for Salmonella typhimurium strain TA100 is as follows (revertants/nmole): 2-halopropenals [H2C = C(X)CHO], F = less than 0.6, Cl = 135, Br = 1140 and I = less than 2.4; 3-substituted-2-halopropenals [CH3CH = C(X)CHO], Cl = 68 and Br = 108; [C6H5CH = C(X)CHO], Cl = less than 1 and Br = 5; [ClCH = C(Cl)CHO], 91; [CH3(CH2)2CH = C(Br)CHO], less than 1; [(CH3)2C = C(Br)CHO], less than 0.

Enzymatic reaction of chlorotrifluoroethene with glutathione: 19F NMR evidence for stereochemical control of the reaction.

Chlorotrifluoroethene, a potent nephrotoxin, is a substrate for the glutathione S-transferases present in the cytosolic and microsomal fractions of rat liver. The glutathione conjugate formed by both subcellular fractions has been identified as S-(2-chloro-1,1,2-trifluoroethyl)glutathione by 1H and 19F NMR and by secondary ion mass spectrometry. The conjugate formed by the cytosolic fraction is an equimolar mixture of two diastereomers, whereas the conjugate formed by the microsomal fraction is predominantly one diastereomer, as judged by the 19F NMR spectra.

N-demethylation of p-chloro-N-methylaniline catalyzed by subcellular fractions from the avocado pear (Persea americana).

Subcellular fractions from the avocado pear ( Persea americana) catalyzed formation of p-chloroaniline from p-chloro-N-methylaniline. Fractions prepared by centrifugation of avocado homogenates at 20, 000g for 20 min formed p-chloroaniline (2900 +/- 500 pmol min-1 mg protein-1) with an NADPH-generating system. p-Chloroaniline formation required reduced pyridine nucleotide (NADPH was 6-7 times more effective than NADH) and O2.

Spinal cord meningioma.

The authors present a retrospective analysis of 97 cases of spinal meningioma. Age, sex, tumor location, and clinical presentation are similar to that reported by others. Importantly, even among paraplegic patients, one-third eventually walked.

Central cord syndrome as a delayed postoperative complication of decompressive laminectomy.

We report five cases of a central cord syndrome that appeared as a delayed surgical complication several days after decompressive laminectomy with the patient in the sitting position. Some episode of abnormal positioning of the neck or hypotension seems to have triggered the central cord syndrome. The patients improved slowly, but did not return to their immediate postoperative status.

Recurrence of lumbar canal stenosis a decade after decompressive laminectomy.

Lumbar canal stenosis is treated by decompressive laminectomy with a high rate of success, but patients may experience late recurrence of pain. We report on 3 patients with return of symptoms years after their original decompression. CT scanning showed reformation by bone; their symptoms were relieved by decompression.

Giant fusiform aneurysm of the cerebral arteries.

Giant fusiform aneurysm of the cerebral arteries was found in 11 patients during a 20-year period. The 7 males and 4 females ranged in age from 9 to 68 years (mean: 49 years). The supraclinoid segment of the internal carotid artery (ICA) and the M-1 segment of the middle cerebral artery (MCA) were the most frequently involved arteries.

Neuroendocrinological aspects of histiocytosis X of the central nervous system.

Detailed neuroendocrine studies were carried out in a patient with histiocytosis X involving the hypothalamus. She presented with amenorrhea, galactorrhea, and diabetes insipidus. The diagnosis was established through needle biopsy with the aid of a computerized tomography (CT) scanner.

Effect of hyaluronidase on acute spinal cord injury.

Three control and five experimental dogs were subjected to 500 gm-cm injury of the midthoracic spinal cord by the weight dropping technique. Five hundred units per kilogram of hyaluronidase injected intravenously 20 minutes after injury in the experimental animals did not alter the loss of dorsal column evoked potentials (nonaveraged) or improve the pathological results up to three hours. These results imply that hyaluronidase will not significantly alter the functional outcome of trauma of the spinal cord in dogs.

Arterial occlusion following anastomosis of the superficial temporal artery to middle cerebral artery.

Symptoms of cerebral ischemia following superficial temporal artery (STA) to middle cerebral artery (MCA) anastomosis are uncommon and are usually related to impaired flow through the anastomosis or occlusion of the cortical receptor artery. In this report, 3 patients are described who developed symptoms of cerebral ischemia after surgery despite a widely patent anastomosis. In each patient, postoperative angiography revealed occlusion of a previously demonstrated high-grade stenosis of the intracranial internal carotid artery (ICA) or MCA.

Surgical problems of the base of the skull. An interdisciplinary approach.

Lesions of the clivus, upper cervical vertebrae, and the cervicomedullary junction often present difficulties to the neurologic surgeon. Currently available surgical approaches often provide less than optimal exposure, for both removal of the primary lesion and repair of the dura. A transoral approach that combines a median labiomandibular glossotomy, soft palate "split," and hard palate resection has been used in illustrative cases.

Neurosurgery at the crossroads: leadership role of the American Association of Neurological Surgeons. The 1979 AANS presidential address.

The President of the American Association of Neurological Surgeons (AANS) reviews the formative history of the major neurosurgical societies, together with their agreement to consolidate their efforts in the joint AANS. As a united group, the Association has been effective in carrying out relations with other professional organizations and with government. Long-range planning is being pursued steadily to increase the role of organized neurosurgery in maintenance of, and improvement in, patient care, education, and research.

Recurrent subarachnoid hemorrhage associated with aminocaproic acid therapy and acute renal artery thrombosis. Case report.

Epsilon aminocaproic acid (EACA) has been used to prevent rebleeding in patients with subarachnoid hemorrhage (SAH). Although this agent does decrease the frequency of rebleeding, several reports have described thrombotic complications of EACA therapy. These complications have included clinical deterioration and intracranial vascular thrombosis in patients with SAH, arteriolar and capillary fibrin thrombi in patients with fibrinolytic syndromes treated with EACA, or other thromboembolic phenomena.