AmsterdamI N 1912, Lewy1 described cytoplasmic hyaline inclusions in the substantia innominata and the dorsal vagal nucleus in paralysis agitans. Tr\l=e'\tiakoff2 described these inclusion bodies in the substantia nigra. In a previous paper3 I discussed the significance attached by various authors to these Lewy bodies, demonstrating additionally by a lipid-histochemical study that these Lewy bodies contain sphingomyelin. The next question concerned the relationship between the partial disintegration of such structures as the substantia nigra (in Parkinson's disease) and the disturbed catecholamine metabolism in the basal nuclei on the one hand4 and sphingomyelin storage on the other hand. There is one organ in the body which is a veritable catecholamine plant: the medulla of the adrenal gland. This is why an investigation was made into a possible disturbance of lipid metabolism in the adrenal glands in two patients with Parkinson's disease. As a control the adrenal glands of ten patients not suffering from Parkinson's disease were examined.
Material and MethodsA study was made of the substantia nigra and the adrenal glands of one 72-year-old man (ease 1) and one 65-year-old man (case 2) with Parkinson's disease. A few control sections of the substantia nigra were stained with hema-toxylin-eosin on paraffin. Likewise, a few sec¬ tions of the adrenal glands were stained with hematoxylin-eosin and Masson's trichrome stain on paraffin. Next, formaldehyde solutionfixed frozen sections and paraffin sections of the adrenal gland from patient 1 were submitted to a series of 17 lipid stains. The adrenal gland of patient 2 was stained only on paraffin sections. Five were routine stains with Sudan III, Sudan IV, oil red O, Sudan black B, and luxol-fast blue. The other 12 stains were carried out according to Adams.5 They were Nile blue sulfate, osmium tetroxide-a-naphthylamine (OTAN), sodium hydroxide-, acid hematin modified after Baker, sodium hydroxideacid hematin, gold hydroxamate, osmium tetroxide, performic acid Schiff, plasmai reaction, modified PAS, cresyl violet acetic acid, and copper rubeanic acid.The table of staining methods (Table 1) reviews these stains and the substances identi¬ fied by them. Furthermore, stainings were done on formaldehyde solution-frozen sections with a routine PAS method with and without diastase and Best's carmine staining for glycogen after Pearse.6 In addition, the adrenal glands of ten patients who had died from various diseases or accidents and who were known or considered likely not to have suffered from Parkinson's disease were examined with a modified PAS with and without chloroform methanol extrac¬ tion.
ResultsSince the results obtained in the two pa¬ tients with Parkinson's disease were identi¬ cal, they can be discussed under a single heading.In the hematoxylin-eosin stained control sections of the substantia nigra, Lewy bodies
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