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Purpose: To evaluate the magnetic characteristics, artifact formation, and implant safety of titanium aneurysm clips for use in MR imaging., Methods: Aneurysm clips made of titanium alloy TiAl6V4 were tested in a magnetometer to determine their magnetic susceptibility and in a 1.5-T MR imager using both a geometric phantom and an animal model. A commercially available alpha-Phynox clip served as the reference standard., Results: We found minimal magnetization and a significant reduction in image artifacts with the titanium clip as compared with the Phynox clip., Conclusion: The titanium clips improve image quality, biocompatibility, and patient safety in medical MR applications.

The techniques, results, and problems of three types of selective temporal lobe (TL) amobarbital procedures (balloon technique with temporary occlusion of the internal carotid artery distal to the origin of the anterior choroidal artery (acha) [n = 19]; selective anterior catheterization of the acha [n = 20]; and selective catheterization of the peduncular P2-segment of the posterior cerebral artery [n = 5]) are described in a group of 40 patients with medically refractory complex partial seizures of mesial TL origin. Selective amobarbital tests were carried out before surgery to predict the memory deficit after an intended selective amygdalohippocampectomy. The effects of selective anaesthetization of TL were correlated with clinical data, pattern and duration of amobarbital induced EEG changes, and performance on verbal and nonverbal memory tasks measured during the test. In 4 patients the effect of selective amobarbital injection on regional and global metabolism was studied with 18F-FDG-PET, with the PET tracer being injected intravenously immediately after amobarbital. More recently in 2 patients the vascular territory perfused by amobarbital in the acha test was studied with SPECT using 99m Tc ECD injected immediately prior to the amobarbital into the acha. Whereas the PET studies showed a rather widespread and bilateral amobarbital-induced decrease of metabolism, the SPECT studies confirmed the selective distribution of the tracer in the vascular territory of the acha, i.e., in amygdala and hippocampus. The comparison of selective TL amobarbital test performance with postoperative neuropsychological performance showed that the predictive value of this test is rather good for the postoperative verbal memory but underestimates postoperative nonverbal ("figural") memory performance.

Of 204 patients who underwent a selective amygdalohippocampectomy at our hospital, we studied 30 in whom special pre- and postoperative MR imaging was carried out and who were followed up for at least 1 year postoperatively. We measured the total size of the resection and the extent to which the following specific mediobasal temporal lobe structures had been removed: amygdala, hippocampus, pes hippocampi, dentate gyrus, parahippocampal gyrus, uncus and subiculum. Postoperative seizure control was correlated with the overall size of the resection as well as with the resection scores of the above mentioned limbic subcompartments. The mean size of the removed tissue was 7.2 cm3 (range: 2.1-17.7). The mean resection scores of the limbic subcompartments (in percentages) are: amygdala 92%, hippocampus 46%, pes hippocampi 92%, dentate gyrus 45%, parahippocampal gyrus 32%, uncus 92%, subiculum 40%. Although a small resection did not exclude a good outcome, the general tendency was that a better outcome was obtained from a larger resection. With regard to the resection scores of the limbic subcompartments, a positive correlation emerged between good postoperative outcome and the radicality of the removal of the parahippocampal gyrus (and the subiculum, which has been evaluated separately). These findings support our previously formulated amplifier hypothesis for the parahippocampal gyrus.

Strikingly localized ring-like constrictions (other than sphincters, cushions and offshoot furrows) have appeared on the casted vessels of some of our preparations. Morphology of the phenomena reveals diverse degree of active contraction of the vessel wall, ranging from corrugation of the luminal surface to near severance of the acrylic cast. Distribution of the vasospastic phenomena reveals as particularly affected the arteries in the diameter range between 25 and 75 micron, that belong either to intra-arterial anastomoses between the branches of each of the three major cerebral arteries or to their terminal junctions in the border zones (inter-arterial anastomoses). Among the possible causes for the occurrence of the observed vasospasms, we indicate the susceptibility to raised intraluminal pressure during injection, producing contraction of the smooth muscle cell. Reactivity appears heightened in the anastomotic districts of the circulation. The evidence of so-called "plastic strips" clinging to constricted sections of affected vessels prompts re-examination of their proposed origin as "plastic wrapping". Rather, they appear to be remnants of dynamic elements of the vascular wall (smooth muscle cells) that resisted corrosion.

Micro-angioarchitecture of the choroid plexus of the lateral ventricles is investigated in microcorrosion casts of animal and human preparations studied with the scanning electron microscope. The capillary bed in the diverse regions of the tissue belongs to one of three patterns: (1)-a network of capillary meshes that envelop the larger arteries and veins predominates in the central segment. (2)-in the villous regions a "leaf-like" organization of sinusoids is found together with (3)-fronds of "glomerular" formations. "Glomeruli" are formed when arterial afferents and venous efferents converge in a quasi hilar structure before branching in arterio-venous loops. Nodular thickenings are observed on glomerular capillaries. The preparations studied (rat, dog, human) are remarkably similar and differ mostly in degree of occurrence of common architectural patterns. Arterio-venous communications are found at the hilus of human glomerular formations.

NPY-containing neuronal structures in the cerebral cortex of surgical tissue samples were compared to those in postmortem material by immunocytochemical methods. However, the quality of preservation of individual neurons and axonal and dendritic plexuses in the neuropil is unusually fine in the surgical specimens. This result is most likely attributable to the excellent fixation that can be regularly achieved by rapid and careful handling of tissue during and after surgical removal. The tissue is suitable for both light and electron microscopy, and the superior preservation also leads to intense, reliable antibody reactions. Postmortem tissue samples can provide good specimens for immunocytochemistry when properly handled as previously described. However the postmortem delays prior to fixation disrupt neuronal integrity in the immunostained structures. Nevertheless, postmortem material from carefully studied subjects of neurological diseases compared with age matched controls can provide valuable information.

Using ultrastructural features as a natural tracer we identified a commissural interneuron in the tench (Tinca tinca L.) spinal cord with the following characteristics: (1) the unipolar cell soma is located 100-150 micron dorsal from the central canal, the frequency of its occurrence being one cell on each side per spinal cord segment; (2) the first node of Ranvier of its axon is connected to a presynaptic branch of the ipsilateral Mauthner axon via gap junctions; (3) its postsynaptic targets are contralateral moto- and interneurons; (4) its terminal boutons contain f-type vesicles and form Gray-type-2 synapses abut on the initial segment or node of Ranvier of these target neurons distal to the input site of monosynaptic excitatory links from the contralateral Mauthner axon. Thus, it appears that this segmental interneuron may provide the structural basis for the well-known mutual crossed inhibition within the spinal circuit of Mauthner axons.

The spiny collaterals of the Mauthner axon were reinvestigated in the tench (Tinca tinca L.) with the electron microscope and special staining procedures. These collaterals, as demonstrated by intraaxonal labelling with lucifer yellow, are more or less regularly spaced (100-300 micrometers) and make synaptic contacts with processes of spinal motoneurons and interneurons. The unmyelinated tips of the collaterals are further characterized by the following structural features: (1) an electron-dense undercoating of the axolemma, (2) a positive Prussian blue reaction of the inner surface of the axolemma following ferric ion-ferrocyanide staining (Waxman and Quick, '78a), (3) expanded extracellular spaces which react specifically to inorganic phosphate, metallic ions, and diaminobenzidine. All these properties are known to be shared by the axolemma of central and peripheral nodes of Ranvier. Previous studies from this laboratory have shown that the nerve impulse is propagated along the Mauthner axon in a saltatory mode. Since classical nodal gaps could not be identified within the myelin sheath of this giant fiber, it is concluded on the basis of the present findings that the unmyelinated tips of the spiny collaterals represent nodal equivalents, and thus provide the morphological substrate for the saltatory propagation of the nerve impulse along the Mauthner axon. The typical latency steps, as demonstrated in the latency plot of the longitudinal current signals (Greeff and Yasargil, '80), and the distances between the identified membrane specializations at the axon collaterals are consistent with this conclusion.

The freeze-etching technique was applied to the tench spinal cord. Replicas of Mauthner axons revealed that the non-junctional axolemma at the tip of axon collaterals alone exhibits intramembranous E-face particles whose size, distribution and overall density are comparable with those at Ranvier nodes. Since typical Ranvier nodes are lacking along the stem of the heavily myelinated Mauthner giant axon, this finding contributes further evidence to our earlier observations suggesting that the spiny Mauthner axon collaterals represent true nodal equivalents and most likely the long-sought substrate of impulse propagation.