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Biomedical subjects

H J Wagner

Publications and source records attributed to H J Wagner.

At least 55 records · Page 3Linked to original sources

Xylem conduits of a resurrection plant contain a unique lipid lining and refill following a distinct pattern after desiccation.

The axial and radial refilling with water of cut dry branches (up to 80 cm tall) of the resurrection plant Myrothamnus flabellifolia was studied in both acro- and basipetal directions by using 1H-NMR imaging. NMR measurements showed that the conducting elements were not filled simultaneously. Axial water ascent occurred initially only in a cluster of a very few conducting elements. Refilling of the other conducting elements and of the living cells was mainly achieved by radial extraction of water from these initial conducting elements. With time, xylem elements in a few further regions were apparently refilled axially. Radial water spread through the tissue occurred almost linearly with time, but much faster in the acropetal than in the basipetal direction. Application of hydrostatic pressure (up to 16 kPa) produced similar temporal and spatial radial refilling patterns, except that more conducting elements were refilled axially during the first phase of water rise. The addition of raffinose to the water considerably reduced axial and radial spreading rates. The polarity of water climbing was supported by measurements of the water rise in dry branches using the 'light refraction'(and, sometimes, the 'leaf recurving') method. Basipetal refilling of the xylem conduit exhibited biphasic kinetics; the final rise height did not exceed 20-30 cm. Three-cm-long branch pieces also showed a directionality of water climbing, ruling out the possibility that changes in the conducting area from the base to the apex of the branches were responsible for this effect. The polarity of water ascent was independent of gravity and also did not change when the ambient temperature was raised to c. 40 degrees C. At external pressures of 50-100 kPa the polarity disappeared, with basipetal and acropetal refill times of the xylem conduit of tall branches becoming comparable. Refilling of branches dried horizontally (with a clinostat) or inverted (in the direction of gravity) showed a pronounced reduction of the acropetal water rise to or below basipetal water climbing level (which was unaffected by this treatment). Unlike water, benzene and acetone climbing showed no polarity. In the case of benzene, the rise kinetics (including the final heights) were comparable with those measured acropetally for water, whereas with acetone the rise height was less. Transmission electron microscopy of dry branches demonstrated that the inner surfaces of the conducting tracheids and vessels were lined with a continuous osmiophilic (lipid) layer, as postulated by the kinetic analysis and light microscopy studies. The thickness of the layer varied between 20 and 80 nm. The parenchymal and intervessel pits as well as numerous tracheid corners contained opaque inclusions, presumably also consisting of lipids. Electron microscopy of rehydrated plants showed that the lipid layer was either thinned or had disintegrated and that numerous vesicle-like structures and lipid bodies were formed (together with various intermediate structural elements). These, many other data and the physical-chemical literature imply that several (radial) driving forces (such as capillary condensation, Marangoni forces, capillary, osmotic and turgor pressure forces) operate when a few conducting elements become axially refilled with water. These forces apparently lead to an avalanche-like radial refilling of most of the conducting elements and living cells, and thus to the removal of the 'internal cuticle' and of the hydrophobic inclusions in the pits. The polarity of water movement presumably results from high resistances in the basipetal direction, which are created by local gradients in the thickness of the lipid film as a result of draining under gravity in response to drought. There are striking similarities in morphology and function between the xylem-lining lipid film and the lung surfactant film lining the pulmonary air spaces of mammals.

Acetone↗

Water rise kinetics in refilling xylem after desiccation in a resurrection plant.

The acropetal water refilling kinetics of the dry xylem of branches (up to 80 cm tall) of the resurrection plant Myrothamnus flabellifolia were determined with high temporal resolution by observation of light refraction at the advancing water front and the associated recurving of the folded leaves. To study the effect of gravity on water rise, data were acquired for cut upright, horizontal and inverted branches. Water rise kinetics were also determined with hydrostatic and osmotic pressure as well as at elevated temperatures (up to 100 degrees C) under laboratory conditions and compared with those obtained with intact (rooted) and cut branches under field conditions. Experiments in which water climbed under its capillary pressure alone, showed that the axial flow occurred only in a very few conducting elements at a much higher rate than in many of the other ones. The onset of transpiration of the unfolded and green leaves did not affect the rise kinetics in the 'prominent' conducting elements. Application of pressure apparently increased the number of elements making a major contribution to axial xylem flow. Analysis of these data in terms of capillary-pressure-driven water ascent in leaky capillaries demonstrated that root pressure, not capillary pressure, is the dominant force for rehydration of rooted, dry plants. The main reasons for the failure of capillary forces in xylem refilling were the small, rate-limiting effective radii of the conducting elements for axial water ascent (c. 1 micrometer compared with radii of the vessels and tracheids of c. 18 micrometers and 3 micrometers, respectively) and the very poor wetting of the dry walls. The contact (wetting) angles were of the order of 80 degrees and decreased on root or externally applied hydrostatic pressure. This supported our previous assumption that the inner walls of the dry conducting elements are covered with a lipid layer that is removed or disintegrates upon wetting. Consistent with this, potassium chloride and, particularly, sugars exerted an osmotic pressure effect on axial water climbing (reflection coefficients > zero, but small). Although the osmotically active solutes apparently suppressed radial water spread through the tissue to the leaf cells, they reduced the axial water ascent rather than accelerating it as predicted by the theory of capillary-driven water rise in leaky capillaries. Killing cells by heat treatment and removal of the bark, phelloderm, cortex and phloem also resulted in a reduction of the axial rise rate and final height. These observations demonstrated that radial water movement driven by the developing osmotic and turgor pressure in the living cells was important for the removal of the lipid layer from the walls of those conducting elements that were primarily not involved in water rise. There is some evidence from field measurements of the axial temperature gradients along rooted branches that interfacial (Marangoni) streaming facilitated lipid removal (under formation of vesicle-like structures and lipid bodies) upon wetting. Grant numbers: 50WB 9643, Zi 99/9-1.

Biological Transport, Active↗

Altered prevalence and reactivity of anti-Epstein-Barr virus antibodies in patients with multiple sclerosis.

In this study, the prevalence and reactivity of anti-Epstein-Barr virus (EBV) antibodies were investigated in 107 patients with multiple sclerosis (MS) in comparison to age- and gender-matched healthy controls from a north German state. We found a significant 100% EBV-seropositivity and a significant lack of primary EBV infections in the MS group, indicating that all MS patients are infected with EBV before the development of MS. Although there were no differences in reactivities of EBV-specific anti-early antigen (EA)-immunoglobulin G (IgG), -IgM, and -IgA antibodies between each group, MS patients had significant lower anti-Epstein-Barr nuclear antigen (EBNA)1-IgG antibody titers as a possible serological sign for a defective control of the persistent latent EBV carrier state and EBV reactivations. Longitudinal studies of MS patients are necessary to further determine the implications of EBV reactivations on the course and disease activity of MS.

Adult↗

Rheolytic hydrodynamic thrombectomy for percutaneous treatment of acutely occluded infra-aortic native arteries and bypass grafts: midterm follow-up results.

RATIONALE AND OBJECTIVES: To evaluate the efficacy of a rheolytic thrombectomy catheter (RTC) for treatment of acutely occluded infra-aortic native arteries and bypass grafts and to determine midterm primary patency, death, and amputation-free survival rates. METHODS: From March 1995 to September 1997, 112 patients with occluded arteries or bypass grafts were primarily treated with RTC at two centers. Thrombus removal was evaluated by two angiographers. RESULTS: More than 75% of the thromboembolic material could be removed with RTC alone. Mean activation time of RTC was 280 +/- 163 seconds. Residual mural or organized thrombi (29%) required adjunctive fibrinolytic therapy or aspiration thrombectomy. Remaining stenoses were treated with percutaneous transluminal angioplasty and additional stent implantation. For acute reocclusions, surgical intervention was required. Technical success after the entire procedure was 88.4%. RTC-associated complications included distal embolization, dissection, vessel perforation, and technical failure of RTC. Mean follow-up time was 14.8 months +/- 11.5, rates of primary patency, secondary patency, death, and amputation-free survival were 60%, 84%, 16%, and 75% after 2 years, respectively. CONCLUSIONS: RTC is a rapid and efficient technique for mechanical thrombectomy of acutely thrombosed native leg arteries and bypass grafts. Midterm results are comparable to the results of alternative treatment modalities such as Fogarty balloon thromboembolectomy or local fibrinolysis.

Aged↗

Magnetic resonance colonography and virtual magnetic resonance colonoscopy with the 1.0-T system: a feasibility study.

RATIONALE AND OBJECTIVES: An ex vivo study and a clinical, prospective, patient study were undertaken to evaluate the feasibility of magnetic resonance (MR) colonography with a 1.0-T system. METHODS: An ex vivo colon model was scanned. A cleaned pig colon was prepared with six simulated sessile polyps (diameters of 4-12 mm) and one simulated pedunculated polyp (diameter of 5 mm). Subsequently, five patients (aged 39-81 years; four women, one man) were examined with MR colonography, immediately followed by endoscopic colonoscopy. After preparation for colonoscopy, the colon was filled with a Gd-DTPA/water solution (1:100). A breath-hold 3D gradient-echo sequence was acquired in both the prone and supine positions and after intravenous Gd-DTPA administration. Images were analyzed interactively by using multiplanar projections, maximum-intensity projection, and a virtual endoscopic view. The MR results were compared with the findings of the fiberoptic endoscopy. RESULTS: All seven simulated lesions of the colon model could be detected by MR imaging. In one patient, an advanced colon cancer as well as an additional small polyp was depicted. In the other four patients, single polyps with a diameter of 1 to 2.5 cm and a large adenoma were visualized by MR colonography. Contrast enhancement of the polyps was noted only after subtraction. CONCLUSIONS: The 1.0-T system is feasible for MR colonography. Reduced requirements for hardware could contribute to establish the novel technique as a screening method for colorectal polyps.

Adenoma↗

Agonist-induced cytoplasmic volume changes in cultured rabbit parietal cells.

Concomitant Na(+)/H(+) and Cl(-)/HCO(3)(-) exchange activation occurs during stimulation of acid secretion in cultured rabbit parietal cells, possibly related to a necessity for volume regulation during the secretory process. We investigated whether cytoplasmic volume changes occur during secretagogue stimulation of cultured rabbit parietal cells. Cells were loaded with the fluorescent dye calcein, and the calcein concentration within a defined cytoplasmic volume was recorded by confocal microscopy. Forskolin at 10(-5) M, carbachol at 10(-4) M, and hyperosmolarity (400 mosmol) resulted in a rapid increase in the cytoplasmic dye concentration by 21 +/- 6, 9 +/- 4, and 23 +/- 5%, respectively, indicative of cell shrinkage, followed by recovery to baseline within several minutes, indicative of regulatory volume increase (RVI). Depolarization by 5 mM barium resulted in a decrease of the cytoplasmic dye concentration by 10 +/- 2%, indicative of cell swelling, with recovery within 15 min, and completely prevented forskolin- or carbachol-induced cytoplasmic shrinkage. Na(+)/H(+) exchange inhibitors slightly reduced the initial cell shrinkage and significantly slowed the RVI, whereas 100 microM bumetanide had no significant effect on either parameter. We conclude that acid secretagoguges induce a rapid loss of parietal cell cytoplasmic volume, followed by RVI, which is predominantly mediated by Na(+)/H(+) and Cl(-)/HCO(3)(-) exchange.

Amiloride↗

[Expert-assessment of suitability for a driving license in otorhinolaryngology].

An absolute requirement for acquiring a driving license according to German law consists in the suitability for driving a motor vehicle. The "driving license decree" defines these requirements; in case of doubt the administrative authority may demand a medical certificate. According to law (enactment: 1.1.99) these medical certificates must be refunded by either appropriate medical specialists, company doctors or public health officers. The criterions for appraisal are set down in the guidelines for driving ability which are edited by the advisory board for traffic medicine; a new edition will be published soon. Concerning otorhinolaryngology hearing impairment and dizziness are the most relevant diseases. Bilateral deafness is no general exception for conferring a driving license for the classes A and B; for classes C and DE hearing loss, established from the pure tone audiogram must not exceed 60%; an exceptional case is a three year demonstration of reliability in class B. Permanent dizziness or vertigo attacks are in most cases incompatible with conferring driving licenses. The most important issue for medical appraisal is to determine the amount of compensation of the impaired sense organ. Therefore in cases of multiple disabilities more stringent criterions must be established.

Automobile Driving↗

Multifocal lenses compensate for chromatic defocus in vertebrate eyes.

The focal length of the vertebrate eye is a function of wavelength, i.e. the eye suffers from longitudinal chromatic aberration. Chromatic defocus is a particularly severe problem in eyes with high light-gathering ability, since depth of field is small due to a pupillary opening that is large in relation to the focal length of the eye. Calculations show that in such eyes only a narrow spectral band of light can be in focus on the retina. For the major part of the visual spectrum, spatial resolution should be limited by the optics of the eye and far lower than the resolving power achievable by the retinal cone photoreceptor mosaic. To solve this problem, fishes with irises unresponsive to light have developed lenses with multiple focal lengths. Well-focused images are created at the wavelengths of maximum absorbance of all spectral cone types. Multifocal lenses also appear to be present in some terrestrial species. In eyes with mobile irises, multifocal lenses are correlated with pupil shapes that allow all zones of the lens, with different refractive powers, to participate in the imaging process, irrespective of the state of pupil constriction.

Animals↗

Effects of retinal dopamine depletion on the growth of the fish eye.

We investigated the suitability of fishes as animal models to study the involvement of the retinal dopaminergic system in the visually guided control of eye growth (emmetropization). Advantages of such a model system are (i) that all dopaminergic cells in the retina can be destroyed without apparent damage to other neurons, (ii) simple optical design and short depth of field of the eye, and (iii) continuous growth throughout life. Depleting the retina of dopamine in Aequidens pulcher (Cichlidae) had no apparent effect on refractive state, since size and focal length of the eye were reduced by the same amount. Furthermore, imposed defocus was compensated at a normal rate in spite of the absence of retinal dopamine. In A. pulcher, the dopaminergic system of the retina trus appears not to have an essential role in emmetropization. Our results furthermore suggest that in eyes of more complicated optical design, manipulation of the retinal dopaminergic system may lead to unrelated effects indistinguishable from direct interference with emmetropization. A major disadvantage of the fish model was that refractive state of the eye could not be measured accurately in vivo with standard methods.

Animals↗

Morphological changes in the retina of Aequidens pulcher (Cichlidae) after rearing in monochromatic light.

We investigate the processing of chromatic information in the outer retina of a cichlid fish, Aequidens pulcher. The colour opponent response characteristics of some classes of cone-specific horizontal cells in the fish retina are the result of feedforward-feedback loops with cone photoreceptors. To interfere with the reciprocal transmissions of signals, animals were reared in monochromatic lights which preferentially stimulated the spectrally different cone types. Here we report the effects on the cones. Their absorbance spectra were largely unaffected, indicating no change in photopigment gene expression. Significant changes were observed in the cone outer segment lengths and the frequencies of spectral cone types. Quantum catch efficiency and survival of cones appear to be controlled in a spectrally selective way. Our results suggest that the retina responds to spectral deprivation in a compensatory fashion aimed at balancing the input from the different cone types to second order neurons.

Animals↗

Effects of nitinol Strecker stent placement on vascular response in normal and stenotic porcine iliac arteries.

PURPOSE: This experimental study was conducted to evaluate neointimal thickness, lumen diameters, and histologic changes in normal and stenotic porcine iliac arteries following placement of self-expanding nitinol Strecker stents. MATERIALS AND METHODS: Neointimal trauma causing slight vascular stenosis was induced unilaterally within external iliac arteries of 12 swines by means of endothelial abrasion and high cholesterol diet. Nitinol Strecker stents were placed within the stenotic and the normal contralateral vascular segments. For histopathologic evaluation, the pigs were killed 12 or 24 weeks after stent placement and luminal diamters were evaluated angiographically. RESULTS: Excluding one occlusion, 15% narrowing of the lumen diameter was induced unilaterally (P = .002). Initial luminal gain after stent placement was greater for stenotic than for normal arteries. The amount of neointima thickness was not different between stenotic and normal vessels (P > .05). Comparing vascular diameters before stent placement and at follow-up, luminal loss due to neointima proliferation was 22% within normal arteries (P = .0002), while a luminal gain by 15% was found within the stenotic arteries (P = .008). Maturation of neointima and endothelial coverage were complete after 24 weeks. CONCLUSIONS: Even though nitinol Strecker stents induce excessive neointimal proliferation, stenotic arteries seem to profit from great early luminal gain resulting in 15% of vascular expansion at follow-up while slight stenosis is induced within normal iliac arteries.

Alloys↗

Analysis of Epstein-Barr virus (EBV) receptor CD21 on peripheral B lymphocytes of long-term EBV- adults.

Primary infections with EBV are rarely observed after the age of 20. Some individuals even remain seronegative all their lives. Previously, a lack of EBV receptors on B cells of persistently EBV- adults was described as a reason for long-term EBV-seronegativity. The present study examined the CD21 receptor status of 20 repeatedly EBV- healthy adults and 32 EBV+ volunteers by means of flow cytometry. CD21 molecules on the surface of CD19+ B cells were quantified using anti-IgG-coated microbeads. The percentage of CD19+/CD21+ B lymphocytes was slightly lower in the peripheral blood of EBV- donors, but the CD21 antibody binding capacity on CD19+ B cells showed no significant differences between EBV- and EBV+ adults. In vitro studies showed an equally good EBV transformability of peripheral B lymphocytes of EBV- and EBV+ donors. Since HLA-DR was recently described as a co-receptor for EBV infection of B cells, we also determined HLA-DRB1 alleles in the EBV- group. We found a significant negative association of EBV-seronegativity with HLA-DR13 in comparison with 111 healthy blood donors. In summary, a biologically significant lack of the EBV receptor CD21 on peripheral B lymphocytes of persistently EBV- adults was excluded as a reason for long-term EBV-seronegativity.

Adult↗

Immunolocalization of protein kinase C isoenzymes alpha, beta1 and betaII in rat kidney.

Protein kinase C (PKC) significantly contributes to the control of renal function, but little is known about the renal function or localization of PKC isoenzymes. Therefore, the localization of PKC isoenzymes alpha, betaI, and betaII was studied in rat kidney. Immunoblot analysis identified immunoreactive bands corresponding to PKC a, betaI, and betaII in total cell extracts of both renal cortex and medulla. Immunohistochemistry using confocal laser scanning microscopy revealed immunostaining for PKC alpha within the glomerulus including podocytes and mesangial cells. PKC betaI was detected in mesangial cells, whereas anti-PKC betaII labeled neither podocytes nor mesangial cells. PKC betaII, however, was detected in cells within the mesangial area, which expressed MHC II, a marker for antigen-presenting cells. None of the three isoforms was detected in glomerular endothelial cells. A prominent immunostaining with anti-PKC alpha and betaI was localized to the brush border of S2 and S3 segments of proximal tubule, whereas S 1 segments were not stained. Along the loop of Henle, both PKC a and PKC betaI were found in the luminal membrane of cortical and medullary thick ascending limb. In addition, anti-PKC betaI labeled the luminal membrane of thin limbs. In the cortical collecting duct (CCD), immunofluorescence for PKC alpha was observed at the apical membrane of both peanut agglutinin (PNA)-negative cells and part of PNA-positive cells, whereas in the medullary collecting duct (MCD), PKC a was detected at the basolateral membrane. In comparison, PKC betaI was localized at the luminal membrane of PNA-positive cells only in CCD and at the luminal membrane of MCD. Unlike PKC a or betaI, there was (1) no detectable immunostaining with anti-PKC betaII in the proximal tubule, the loop of Henle, or the CCD and (2) a distinct staining for PKC betaII of interstitial cells in cortex and medulla (including MHC II-positive dendritic cells). Furthermore, PKC betaII was detected in the luminal membrane of MCD. In summary, a distinct and differential expression pattern for PKC alpha, betaI, and betaII was shown in rat kidney, which may contribute to a better understanding of the specific role of these isoenzymes in the control of renal function.

Animals↗

[Angiography detection of closed palmar arcs].

PURPOSE: Angiographic evaluation of the prevalence of an anastomosis between the superficial and deep palmer arcs in our patients. MATERIALS AND METHODS: Between January 1st 1991 and December 31st 1997, all selectively performed angiographies of the upper extremities were evaluated retrospectively with special focus on an anastomosis between the superficial palmer arc (SPA) and the deep palmer arc (DPA). The indications for performing a selective angiography of the upper extremity were presurgical planning of a skin/muscle transplantation (n = 42), creation of a hemodialysis fistula (n = 4) and evaluation of vascular diseases such as vasculitis (n = 9), peripheral occlusive disease (n = 3) and M. Winiwarter-Buerger (n = 8). RESULTS: 66 selective angiographies of the palm of 60 patients (39 male, 21 female, mean age 52 years old) could be used for evaluation. Angiographies of both hands were performed in 6 patients. Closed superficial palmar arcs and closed deep palmar arcs were detected in 31.8% and 84.8% of the patients, respectively. CONCLUSIONS: The rates of anastomosed superficial and deep palmar arcs in our study are comparable with those of former angiographic investigations, but they are considerably lower than the rates based on anatomical or sonographical studies. Reasons for the discrepancy are discussed.

Adult↗

A fluorescent double stain for visualization of neural tissue by confocal laser scanning microscopy.

We present a fast and simple method for a general, fluorescent double stain that differentially labels various cellular components and visualizes all cells in confocal laser scanning microscopy. The technique is useful for two- and three-dimensional visualization of neural tissue and facilitates quantification of a variety of neuroanatomical parameters. Examples from cerebellum and retina are shown to demonstrate the broad applicability.

Animals↗

Characterization of the novel, pediatric Hodgkin disease-derived cell line HKB-1.

BACKGROUND: A novel Hodgkin disease (HD)-derived cell line, designated HKB-1, was established from pulmonary HD of nodular sclerosing subtype of a 14-year-old-girl. PROCEDURE AND RESULTS: Immunophenotypically, HKB-1 cells are of B cell in phenotype, being also positive for markers CD15, CD25 and CD30. Transformation of the cell line by Epstein-Barr virus (EBV) was excluded by failure to detect EBV antigens and EBV DNA in cultured cells. Chromosome studies of HKB-1 showed a pseudodiploid karyotype with complex clonal structural aberrations. The detection of a monoclonal immunoglobulin heavy chain (IgH) gene rearrangement confirmed the derivation of the HKB-1 from the B cell lineage and its monoclonality. HKB-1 produced high amounts of interleukin (IL)-6 as detected in culture supernatant whereas no secretion of IL-1 beta, IL-2, IL-4, IL-10, IL-12 or interferon (IFN)-gamma was detected. CONCLUSIONS: Our studies indicate that this cell line is of tumor origin.

Adolescent↗

Pre-eruptive varicella encephalitis: case report and review of the literature.

UNLABELLED: Varicella-related neurological complications usually appear after the rash. Pre-eruptive neurological complications of primary varicella zoster virus infections have been rarely described. We report on a 5.5-year-old boy who developed encephalitis 4 days before the onset of a mild vesicular skin rash and 5 days after known exposure. Primary varicella zoster virus infection was confirmed serologically. Cranial magnetic resonance imaging revealed temporary inflammatory oedema in the right cerebellar peduncle. CONCLUSION: Neurological complications of varicella may appear up to 2.5 weeks before the onset of the exanthema. Physicians treating patients with ataxia or encephalitis should inquire about exposure to varicella zoster virus.

Brain↗

Adaptation-dependent plasticity of rod bipolar cell axon terminal morphology in the rat retina.

We chose synaptic terminals of rat rod bipolar cells as a model system to study activity-related changes in the overall morphology and the fine structure of synaptic sites. Using confocal laser scanning microscopy in conjunction with three-dimensional reconstruction and electron microscopy, we examined the effect of light and dark adaptation on axon terminals identified by protein kinase C (PKC) immunoreactivity. Rod bipolar cell axon terminals consisted of 2-3 polymorphic boutons situated close to the ganglion cell layer and a single ovoid swelling located more distally. Both components of the terminal complex showed adaptation-dependent differences in the distribution of PKC immunoreactivity and in their morphology. In light-adapted rod bipolar cell axon terminals, PKC immunoreactivity was homogeneously distributed throughout the cytoplasm, whereas terminals from dark-adapted animals showed PKC immunoreactivity preferentially localised in the submembrane compartment and a reduced staining of the more central cytoplasm. In three-dimensional reconstructions of optical sections and at the ultrastructural level, the shape of light-adapted axon terminals was round and smooth and exhibited more convexly curved synaptic membranes. In contrast, dark-adapted terminals had irregular contours, numerous dimples and a concave synaptic curvature. No spinules of bipolar cell terminals were observed in dark-adapted material. These observations are discussed in the context of activity-related morphological plasticity of central nervous system synapses and of the functions of PKC in the cycle of vesicle fusion and retrieval at the tonically active ribbon synapses of the rod bipolar axon terminal.

Adaptation, Ocular↗