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A method of examination of the cervical spine and cord
ABSTRACTS OF ANNUAL SCIENTIFIC MEETING
1971
65
T h e brains showed conspicuous generalized cortical atrophy, less marked in the occipital regions, and dilatation of the ventricular system. Microscopically there was considerable nerve cell loss with fibrous glial reaction in the frontal, temporal and parietal cortex and less marked changes in the occipital lobe. T h e most conspicuous feature was neurofibrillary change, most prominent in the cerebral cortex, hippocampus, hypothalamus, substantia nigra, mid-brain tegmcntal region and the pontine and medullary periventricular regions. No senile plaques were evident. Granulo-vacuolar change was demonstrated in occasional degenerate nerve cells. Conditions in which neurofibrially change has been described include Alzheimer’s disease, senile dementia, post-encephalitic Parkinsonism, Pick’s disease, sporadic motor neurone disease, infantile neuroaxonal dystrophy, vincristine neuropathy, Down’s syndrome, Steel-Richardson-Olszewski syndrome, olivary hypertrophy, various experimental conditions, and Guam-Parkinsonian dementia. T h e distribution of the pathological findings in these cases most closely resembled that in Guam-Parkinsonian dementia although clinically our patients did not show Parkinsonian features. In most of the above diseases neurofibrillary change is considered to be due to intraneuronal masses of closely packed twisted tubules which displace normal cell organelles. T h e mechanism by which thcse twisted tubules develop is not known. Electron microscopy was not performed in the authors’ cases. It has been postulated that the Guam-Parkinsonian dementia is caused by a viral infection in a person who is genetically susceptible and the authors considered a similar aetiology possible in their cases.
A METHOD OF EXAMINATION OF T H E CERVICAL SPINE A N D CORD
TAITSMITH,A.
Tht. P r i m e HerirJi Hospital, Sydizey, A’ew South W a l e s
Examination of cervical spinal cord in relation to the vertebral canal, vertebral bodies and intervertebral discs is obligatory in hone and joint disease of the neck, neurological syndromes involving the upper limbs, and in deaths due to motor vehicles. Such examination is carried out by removal en bloc of the cervical spinc and cord. The author removes the brain from the cranial cavity in the usual way, taking care to cut between the lower border of medulla oblongata and the site of emergence of the 1st cervical (sub-occipital) nerve. A quadrangular piece of the basi-occiput is cut so as to include on its under surface the atlanto-occipital articulations and the vertebral arteries as they enter the posterior cranial fossa. A strong knifc is then used to divide the disc between C7-T,, the zygapophyscal joints are easily disarticulated, and the muscle and soft tissue is cut away from the block of the cervical vertebrae to the base of’ the skull. T h e block is then easily lifted out. T h e whole block is frozen in absolute ethanol chilled with dry ice. It is hard enough in 15 min. to be cut in sagittal or coronal slices of 0.5-1.0 cm. thickness. Specimens are suitable for photography or museum preparations.
ELASTIC TISSUE IN LARGE BRONCHI JELIHOVSKY, T A T l A N A .
A’ez:) S o u t h W u l e s
K o j d I’rime A l j r e d Hospital, Sydnev,
Biopsies of bronchial mucosa frequently show a thick layer of amorphous eosinophilic material lying in the superficial portion of thc lamina propria. They resemble deposits of amploid or solar changes in the dermis of skin. Orccin stains show this layer to have the same staining properties as elastica. At first it seemed that the amount of elastica was greatest in elderly patients with cancer of the lung, but examination of infants’ tracheas and bronchi has shown a thick layer of elastic fibres to be present even at birth. T h e fibres are most prominent in the posterior wall of the trachea and large bronchi whcre they are unsupported by cartilage. In these areas the fibres are arranged in longitudinal bundles which form ridges visible to the naked eye. Gland ducts open into the grooves between the ridges. At the carinae and in several divisions of the large bronchi some of the ridges turn into one division and some into the other. T h e author is now studying these elastic fibres to determine the influence upon them of age and disease.
1971
65
T h e brains showed conspicuous generalized cortical atrophy, less marked in the occipital regions, and dilatation of the ventricular system. Microscopically there was considerable nerve cell loss with fibrous glial reaction in the frontal, temporal and parietal cortex and less marked changes in the occipital lobe. T h e most conspicuous feature was neurofibrillary change, most prominent in the cerebral cortex, hippocampus, hypothalamus, substantia nigra, mid-brain tegmcntal region and the pontine and medullary periventricular regions. No senile plaques were evident. Granulo-vacuolar change was demonstrated in occasional degenerate nerve cells. Conditions in which neurofibrially change has been described include Alzheimer’s disease, senile dementia, post-encephalitic Parkinsonism, Pick’s disease, sporadic motor neurone disease, infantile neuroaxonal dystrophy, vincristine neuropathy, Down’s syndrome, Steel-Richardson-Olszewski syndrome, olivary hypertrophy, various experimental conditions, and Guam-Parkinsonian dementia. T h e distribution of the pathological findings in these cases most closely resembled that in Guam-Parkinsonian dementia although clinically our patients did not show Parkinsonian features. In most of the above diseases neurofibrillary change is considered to be due to intraneuronal masses of closely packed twisted tubules which displace normal cell organelles. T h e mechanism by which thcse twisted tubules develop is not known. Electron microscopy was not performed in the authors’ cases. It has been postulated that the Guam-Parkinsonian dementia is caused by a viral infection in a person who is genetically susceptible and the authors considered a similar aetiology possible in their cases.
A METHOD OF EXAMINATION OF T H E CERVICAL SPINE A N D CORD
TAITSMITH,A.
Tht. P r i m e HerirJi Hospital, Sydizey, A’ew South W a l e s
Examination of cervical spinal cord in relation to the vertebral canal, vertebral bodies and intervertebral discs is obligatory in hone and joint disease of the neck, neurological syndromes involving the upper limbs, and in deaths due to motor vehicles. Such examination is carried out by removal en bloc of the cervical spinc and cord. The author removes the brain from the cranial cavity in the usual way, taking care to cut between the lower border of medulla oblongata and the site of emergence of the 1st cervical (sub-occipital) nerve. A quadrangular piece of the basi-occiput is cut so as to include on its under surface the atlanto-occipital articulations and the vertebral arteries as they enter the posterior cranial fossa. A strong knifc is then used to divide the disc between C7-T,, the zygapophyscal joints are easily disarticulated, and the muscle and soft tissue is cut away from the block of the cervical vertebrae to the base of’ the skull. T h e block is then easily lifted out. T h e whole block is frozen in absolute ethanol chilled with dry ice. It is hard enough in 15 min. to be cut in sagittal or coronal slices of 0.5-1.0 cm. thickness. Specimens are suitable for photography or museum preparations.
ELASTIC TISSUE IN LARGE BRONCHI JELIHOVSKY, T A T l A N A .
A’ez:) S o u t h W u l e s
K o j d I’rime A l j r e d Hospital, Sydnev,
Biopsies of bronchial mucosa frequently show a thick layer of amorphous eosinophilic material lying in the superficial portion of thc lamina propria. They resemble deposits of amploid or solar changes in the dermis of skin. Orccin stains show this layer to have the same staining properties as elastica. At first it seemed that the amount of elastica was greatest in elderly patients with cancer of the lung, but examination of infants’ tracheas and bronchi has shown a thick layer of elastic fibres to be present even at birth. T h e fibres are most prominent in the posterior wall of the trachea and large bronchi whcre they are unsupported by cartilage. In these areas the fibres are arranged in longitudinal bundles which form ridges visible to the naked eye. Gland ducts open into the grooves between the ridges. At the carinae and in several divisions of the large bronchi some of the ridges turn into one division and some into the other. T h e author is now studying these elastic fibres to determine the influence upon them of age and disease.