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A procedure for the ultrastructural cytochemical localization of cytochrome oxidase via cytochrome c in the cerebral cortex is described. Vascular perfusion fixation by formaldehyde and glutaraldehyde of different concentrations and mixtures of the two gave varying results. A mixture of 4% formaldehyde and 0.5% glutaraldehyde gave the best combination of ultrastructural preservation and retention of enzyme activity. Histochemical methods were examined for optimum incubation conditions, based on the oxidative polymerization of 3,3'-diaminobenzidine (DAB) to an osmiophilic product. The reaction product was discretely localized within intercristate and the intermembrane space of mitochondria. The staining pattern was the same in nerve cells and in neuroglia and their processed. The DAB reaction product was also found in mitochondria of the endothelial cells.

The reported prevalence of type 2 diabetes among the Kuwaiti population varied from one source to another. This study was undertaken to define the magnitude of the problem and to suggest plans for future diabetic care. All type 2 Kuwaiti diabetic subjects registered and continuing to attend regularly in two health areas Mubarak Health Area (MHA) and Farwania Health Area (FHA)] were selected for the study. There were 3222 in MHA and 5114 in FHA among the Kuwaiti population aged 20 years and above, accounting for a total crude prevalance of 7.6% in both health areas and for a prevalence rate of 5.6% in MHA and 10.0% in FHA. The age-specific prevalence of type 2 diabetes in both areas combined rose from 2.639 per 100 population in the age group 20–39 years to 15.350% and 26.252% in the age groups 40–59 and 60 and above, respectively. The female to male ratio was 1.7, 1.6, 1.1, respectively, in MHA and 1.7, 2.0, 0.9 in FHA for the age groups 20–39, 40–59, and 60 and above. This study shows that type 2 diabetes is a major public health problem in Kuwait, with a female preponderance. Obesity is a characteristic feature of the population studied, with a mean body mass index of 31.8±6.3 and 28.5±5.1 in women and men, respectively. A positive family history of diabetes mellitus was reported in 63% of the diabetic subjects. There is a need to standardize methods of reporting and to plan a national screening survey.

Techniques for the ultrastructural demonstration of dehydrogenases in cerebral cortex are described. The best fixation for good fine structural preservation and retension of LDH and NADH-diaphorase was obtained by perfusion with a mixture of formaldehyde and glutaraldehyde and for SDH by perfusion with formaldehyde. Comparison of incubation conditions showed that consistent results were obtained using enzyme markers NBT and DS-NBT for LDH and NADH-diaphorase; DS-NBT was more satisfactory than NBT and BSPT for SDH. Penetration of incubation media was improved by Triton X-100; DMSO and ultrasonic treatment were less effective. The techniques enabled the first electron cytochemical demonstration of dehydrogenases in different elements of prefixed cerebral cortex. Ultrastructural sites of enzyme activities were localized within cristae and intermembrane spaces of mitochondria in nerve cell cytoplasm and its processes, oligodendrocytes and astrocytes. Authenticity of the ultrastructural sites was confirmed by four different control experiments.

A two-stage fixation technique has been developed to obtain morphological preservation and retention of glucose 6-phosphatase (G6-Pase) activity for its demonstration in rat cerebral cortex. The technique was then employed to localize the enzyme in the cortex where it produced a dense reaction over the well developed granular endoplasmic reticulum cisternae in nerve cells and oligodendrocytes which contrasted with a thin reaction in astrocytes. Other membranous organelles showed no reaction.

Enzymes in reactive astrocytes of the corebral cortex were examined at the ultrastructural level in an attempt to resolve some conflicting aspects of astrocytic activity. Correlations between morphological and enzyme changes after injury established that the apparent increase in oxidative enzyme activity was exclusively mitochondrial and not an artefactual reaction product resulting from anoxic cellular damage. Pronounced glucose-6-phosphatase activity within cisternae of an increased amount of the granular endoplasnie reticulum was related to increased glycogen. Further evidence from acid phosphatase activity indieated that astrocytes played a minimal role in phagocytosis.

A needle wound was made in the adult rat cerebral cortex. Responses of neurons and oligodendrocytes at the site of injury were followed over a period of 450 days and correlations made between morphological and enzyme cytochemical changes to clarify some phenomena previously unresolved. Evidence from acid phosphatase activity in degenerating neurons showed no increase in the number of cytochemically stained lysosomal profiles nor changes in the subcellular localization of the acid phosphatase reaction product. Our observations indicated that the majority of dying neurons were not digested by their own acid phosphatase ‘autodigestion’ but by the process of heterodigestion. The time-course study revealed that not all the traumatized neurons were eliminated but some persisted permanently in an attenuated ‘atrophic’ state. The atrophic neurons were small in size with low cytoplasmic-nuclear ratios and exhibited low levels of glucose-6-phosphatase and cytochrome oxidase activities. The acid phosphatase activity was slightly increased as evidenced by cytochemically stained hypertrophic Golgi cisternae and a slight increase in the number of lysosomes. The low level of enzyme activities, concerned with carbohydrate metabolism reflected the low metabolic activity in atrophic neurons whilst an increase in Golgi-lysosomal enzyme activity suggested some anabolic process necessary for their survival. Oligodendrocytes displayed only minor changes in morphology, and their glucose-6-phosphatase and cytochrome oxidase activities were normal, suggesting that these cells have little or no involvement in the repair of a cerebral wound. The absence of significant changes in lysosomal acid phosphatase activity indicated a minimal role, if any, of oligodendrocytes in the process of phagocytosis.