The sizes of Brodmann's areas 44 and 45 (Broca's speech region) and their extent in relation to macroscopic landmarks and surrounding areas differ considerably among the available cytoarchitectonic maps. Such variability may be due to intersubject differences in anatomy, observer-dependent discrepancies in cytoarchitectonic mapping, or both. Because a reliable definition of cytoarchitectonic borders is important for interpreting functional imaging data, we mapped areas 44 and 45 by means of an observer-independent technique. In 10 human brains, the laminar distributions of cell densities were measured vertical to the cortical surface in serial coronal sections stained for perikarya. Thousands of density profiles were obtained. Cytoarchitectonic borders were defined as statistically significant changes in laminar patterns. The analysis of the three-dimensional reconstructed brains and the two areas showed that cytoarchitectonic borders did not consistently coincide with sulcal contours. Therefore, macroscopic features are not reliable landmarks of cytoarchitectonic borders. Intersubject variability in the cytoarchitecture of areas 44 and 45 was significantly greater than cytoarchitectonic differences between these areas in individual brains. Although the volumes of area 44 differed across subjects by up to a factor of 10, area 44 but not area 45 was left-over-right asymmetrical in all brains. All five male but only three of five female brains had significantly higher cell densities on the left than on the right side. Such hemispheric and gender differences were not detected in area 45. These morphologic asymmetries of area 44 provide a putative correlate of the functional lateralization of speech production. J. Comp. Neurol. 412:319–341, 1999. © 1999 Wiley-Liss, Inc.

Broca's region revisited: cytoarchitecture and intersubject variability.

Méthodes : Sur une série de 31 femmes présentant des varices périnéales d’origine extrasaphéniennes ayant bénéficié d’une exploration radiologique veineuse pelvienne et de l’embolisation des veines incontinentes nous avons étudié les résultats et les corrélations anatomo-clinique entre les varices et les signes cliniques de l’insuffisance veineuse pelvienne. Un sous-groupe B de 23 patientes présentant une insuffisance veineuse pelvienne et des signes cliniques a été comparé à un groupe A de 4 patientes qui ne présentaient pas d’insuffisance veineuse pelvienne à l’exploration. Nous avons choisi d’étudier 3 signes cliniques : la douleur pelvienne et la douleur des membres inférieurs survenant au début ou pendant les règles ainsi que la dyspareunie. La symptomatologie a été évaluée sur une échelle analogique de 0 à 10 et un score clinique (de 0 à 30) a été établi en ajoutant ces 3 chiffres.

http://link.springer.com/content/pdf/10.1007/BF02973687.pdf

Références bibliographiques: La fibroscopie bronchique

Regulation of affect by the lateral septum: implications for neuropsychiatry

Substantial evidence indicates that the lateral septum (LS) plays a critical role in regulating processes related to mood and motivation. This review presents findings from the basic neuroscience literature and from some clinically oriented research, drawing from behavioral, neuroanatomical, electrophysiological, and molecular studies in support of such a role, and articulates models and hypotheses intended to advance our understanding of these functions. Neuroanatomically, the LS is connected with numerous regions known to regulate affect, such as the hippocampus, amygdala, and hypothalamus. Through its connections with the mesocorticolimbic dopamine system, the LS regulates motivation, both by stimulating the activity of midbrain dopamine neurons and regulating the consequences of this activity on the ventral striatum. Evidence that LS function could impact processes related to schizophrenia and other psychotic spectrum disorders, such as alterations in LS function following administration of antipsychotics and psychotomimetics in animals, will also be presented. The LS can also diminish or enable fear responding when its neural activity is stimulated or inhibited, respectively, perhaps through its projections to the hypothalamus. It also regulates behavioral manifestations of depression, with antidepressants stimulating the activity of LS neurons, and depression-like phenotypes corresponding to blunted activity of LS neurons; serotonin likely plays a key role in modulating these functions by influencing the responsiveness of the LS to hippocampal input. In conclusion, a better understanding of the LS may provide important and useful information in the pursuit of better treatments for a wide range of psychiatric conditions typified by disregulation of affective functions.

Research report Regulation of affect by the lateral septum: implications for neuropsychiatry

We describe a system of parcellation of the human brain that is based on the functional anatomy of the cerebral cortex and that is applied to the analysis of magnetic resonance images. This system is designed to support investigations of hemispheric asymmetries and quantitative lesion localization studies in cognitive neuroscience. The system of cortical subdivision is a neural systems oriented model that approximates subdivisions supported by previous architectonic and functional analyses. It is based primarily on boundaries determined by "limiting fissures." It is completed by a set of coronal planes, keyed to visible anatomic landmarks, which "close" the borders of the parcellation subdivisions. The method depends on computational reconstruction of the primary image data in multiple planes so as to allow the observed pattern of limiting fissures in a given brain to be digitized. In this presentation, the method is applied in order to define the surface anatomy of the cerebral hemispheres in a normal subject. Volumetric measurements of individual cortical regions are compared as hemispheric percentiles to areal perceniiles derived from the analysis of Jouandet et al. 1989, a conceptually related though methodologically different approach. We specifically address the approach to the study of interhemispheric differences and interindividual variations in cortical anatomy.

Human cerebral cortex: Localization, parcellation, and morphometry with magnetic resonance imaging

• Results of this work show, in the inferior frontal gyrus and in the different portions into which it was divided, asymmetry of weight and cortical surface and left predominance in the posterior portion, which is concerned with language. In spite of the difference among the absolute individual values, the correlation between weight and surface values is excellent in all cases, and the weight and surface ratio is the same for the portions related to language and different for the remainder of the inferior frontal gyrus.

Anterior speech region. Asymmetry and weight-surface correlation.

Obstructive urinary symptoms due to chronic non-bacterial prostatitis are due to incomplete relaxation of the bladder neck or inappropriate contraction of the external urethral sphincter during voiding. Patients may respond to adrenergic blocking drugs; if effective, treatment may need to be continued indefinitely. Botulinum toxin has been used to weaken striated and smooth muscles. Toxin injections into the external urethral sphincter to relieve urethral obstruction were described by Dykstra and Sidi. Apart from treatment of detrusor-sphincter dyssynergia, we have found no reports in the literature on the treatment of voiding dysfunction in non-bacterial prostatitis. Four consecutive men (mean age 30·7 [SD 5·7] years) with chronic non-bacterial prostatitis and poor bladder emptying because of spastic external urethral sphincter (mean duration of symptoms 18 [3] months), who failed to respond to tamsulosin 0·4 mg once daily for more than 4 months were enrolled. All the patients were examined, had uroflowmetric studies to assess times of urinary flow (TQ) and maximum urinary flow (TQmax), maximum flow (Qmax), average flow (Qave), and total urinary volume (Vcomp), and had anorectal manometry at rest (RT) and after maximum contraction (MC). An increased value of TQ and TQmax with a normal value of Qmax was taken to be indicative of incomplete relaxation of bladder neck. 1, 4, and 8 weeks after treatment, patients underwent the same assessments. With the patient lying on his left side, a 26-gauge monopolar needle electrode was inserted in the perineum in the anterior midline, about 1·5–2·0 cm from the anus and directed toward the prostatic apex, without sedation or local anaesthesia. 30 U of type A botulinum toxin were injected. No local complications or systemic side-effects were seen. Within 1 week of injection all patients had a striking improvement in their voiding; none complained of urinary incontinence. At 4 weeks, three patients showed a continuing improvement. At 8 weeks, the same three patients were satisfied with the therapy and none of them complained of urinary incontinence. The patients were followed up for a mean of 12 months. No relapse occurred in the three patients who improved. 6 weeks after treatment, the fourth patient reported worsening voiding. He was also depressed and required fluoxetine. He was re-treated with 50 U of botulinum toxin and the urinary symptoms improved. Uroflowmetric study showed a decrease in TQ and TQmax values at 1, 4, and 8 weeks compared with baseline values (table). Other variables were not changed.

Relief by botulinum toxin of voiding dysfunction due to

Thirty-two female (mean age=52.9 years [SD=9.2]) patients with a diagnosis of residual schizophrenia and 19 female (mean age=51.1 years [SD=12.7]) control subjects were studied through cerebral Magnetic Resonance Imaging. Along the entire surface of the septum pellucidum, 1-mm coronal slices were performed in all subjects. The authors classified the cavum septum pellucidum into three types based on embryological development. The prevalence of a cavum was significantly higher in the patients with schizophrenia (Chi square 6.112. p < 0.05). No other significant associations with previously described morphological brain changes were found. Although this result was found in previous reports (DeGreef et al., 1992; DeLisi et al., 1993), our discussion focused on the neurodevelopmental theory of the septum pellucidum and its possible association with schizophrenia.

Cavum septum pellucidum and its increased prevalence in schizophrenia: a neuroembryological classification.

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

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

Alfonso M. Albanese

Papers

Anterior speech region. Asymmetry and weight-surface correlation.

Relief by botulinum toxin of voiding dysfunction due to

Cavum septum pellucidum and its increased prevalence in schizophrenia: a neuroembryological classification.

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

Lateral subdermic varicose vein system of the legs. Its surgical treatment by the chiseling tube method.