Biomedical subjects
Publications and source records attributed to W Koehler.
Human fascioliasis is distributed worldwide with several foci of high endemicity. Being a rare disease in Europe, we describe here a case in the initial hepatic phase of the disease. Therapeutic and, with reference to the 2 distinct stages of disease, diagnostic standards are discussed.
An accidental high dose of intraventricular mezlocillin was given during antibiotic treatment for pneumonia in a patient admitted because of severe traumatic brain injury and occlusive hydrocephalus. Because of serial epileptic seizures not responsive to antiepileptic drug treatment, CSF exchange was performed. The CSF was drained through a ventricular catheter, while mock CSF was infused into the lumbar subarachnoid space. The patient soon recovered to her clinical status previous to intraventricular mezlocillin application. Side effects of CSF exchange were not seen. Under continued antiepileptic medication no more seizures occurred. It is concluded that high doses of intraventricular mezlocillin have proconvulsive effects. In this patient CSF exchange was a suitable means of preventing putatively permanent impairment of brain function caused by serial epileptic seizures due to intraventricular mezlocillin application.
Implications of the Baby Boomers upon the American society are well known. However, the effects of its successor generation, the Baby Busters, have not been as well documented nor reviewed. The next twenty years (1990-2010) will see the fabric of American society unfolded and rewoven as this phenomenon undergoes its place in history. It is not too early to examine the implications of the Baby Bust phenomenon. This study examines the implications and consequences of the Baby Bust for Health Care Marketers.
Vasoactive intestinal peptide (VIP) is a 28-amino acid peptide that has been demonstrated to reside in cells ( = VIP+ cells) of the retinae of various vertebrate species. In an attempt to study the morphology and distribution of VIP+ cells in the retina of the rhesus monkey in more detail, we subjected VIP+ cells observed in cryostat sections or wholemounts rhesus monkey retinae to a quantitative analysis. VIP+ cells were found to reside in the innermost row of the inner nuclear layer (INL) and in the ganglion cell layer (GCL) in similar numbers (estimate: 50 cells/mm2 at 6-10 mm eccentricity each) and only on rare occasions (12% of all VIP+ cells) in varying positions within the inner plexiform layer (IPL). Somata of VIP+ cells were circular and had a mean diameter of 9.1 microns. They gave rise to 1-3 main dendrites, which were usually oriented toward the IPL. Main dendrites ramified widely into thin fibers (dendritic field diameter less than = 1 mm), carrying varicose swellings. The fibers that contributed to one and the same plexus of VIP+ fibers preferred the middle third of the IPL, independent of the positions of the parent somata. A quantitative analysis of nearest-neighbour distances in the retinal wholemount preparation suggested that VIP+ cells in the GCL and in the INL might be distributed according to 2 independent mosaics. A comparison with Golgi-stained material leads to the tentative equation of VIP+ cells with the "spiny" A12 amacrine cell of Mariani ('90). Whereas the low density and large dendritic field size of VIP+ cells might suggest a more widespread function, the varicose dendritic morphology seems to be more compatible with functionally independent dendritic subunits mediating localized effects.
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Single unit recordings from two alert cats were used in an attempt to further elucidate the function of the lateral mesencephalic tegmental region (LTR), a part of the mesencephalon forming a link between the superior colliculus and the lower brain stem. A total of 155 units recorded from the LTR were tested with visual, vestibular and acoustic stimuli. Of these, 54 cells (36%) were characterized as either visually (n = 33) or vestibularly (n = 21) responsive and an additional 13 cells were driven by complex acoustic stimuli. Visually responsive cells typically were directionally selective with large, mainly contralateral receptive fields. Vestibularly responsive cells were modulated by stimulation of either the horizontal canals (yaw stimulation; n = 16) or of both pairs of vertical canals (pitch stimulation; n = 5). About half of the cells with activity modulated by rotation about the yaw axis increased discharge during ipsiversive (Type I), the other half during contraversive rotation (Type II). Of the 5 cells with activity modulated by pitch stimulation, 4 preferred the nose-down and only 1 the nose-up direction. Although the discharge of units responsive to yaw stimulation was roughly in phase with head velocity (mean phase lag with respect to head velocity: 10.6 deg), none of the vestibular cells had activity correlated with eye position, eye velocity or movement of visual stimuli. Our observations suggest that the LTR might introduce visual and vestibular signals into the tecto- facial pathway which may be used to adjust the size of pinna movements with respect to the size of ongoing head- or body movements.
Compound muscle action potentials (CMAPs) were recorded from anterior tibial (TA) and soleus (SOL) muscles following transcranial magnetic stimulation of motor cortex in 10 healthy subjects: (1) while standing upright without support, (2) while sitting, and (3) while lying supine. The results of this study demonstrate a significant influence of posture upon the amplitudes of CMAPs. Postural facilitation presented itself, firstly, in terms of a higher incidence of bilateral activation of distal leg muscles during stance and, secondly, as significant enhancement of the amplitude of CMAPs while standing as compared to lying supine. The onset latency, however, did not disclose a significant shortening during stance. To assess the effects of preinnervation subjects voluntarily adjusted the level of TA activity to 5%, 10% and 20% of maximum isometric force respectively before cortex stimulation. Voluntary background contraction resulted in a significant increase of amplitude of CMAPs but, in contrast to postural facilitation, concomitant with a significant decrease in onset latency. These results point to a somewhat different mechanism of facilitation during stance as compared to voluntary preinnervation. But it cannot be decided whether cortical mechanisms, different descending systems, the spinal circuitry or a combination of these factors is responsible for the observed effects.
The dorsolateral basilar pontine grey is assumed to play an essential role in a cortico-ponto-cerebello-pontine pathway subserving smooth-pursuit eye movements. The dorsolateral basilar pontine grey interconnects those cerebral and cerebellar cortical areas known to be involved in the generation of smooth-pursuit eye movements. In the present study three categories of neurons presumably contributing to smooth pursuit eye movements were recorded: visual-only neurons, visual-tracking neurons, and neurons combining both properties. Preference for directions of visual stimulation could be either iso- or antidirectional.
The activity of neurons in the dorsolateral pontine nucleus (dlpn) was studied in two awake rhesus monkeys trained to participate in a variety of visual and oculomotor tests. The visual and eye movement related responses of 73 neurons encountered in the more caudal part of the dlpn were analyzed. Thirty eight of these could be assigned to one of the three following groups. Visual-only neurons (Type 1, n = 10) responded to movement of a broad range of visual stimuli in certain preferred directions. Their receptive fields were usually large, not restricted to the contralateral visual field and always included the fovea. Visual-tracking (VT) neurons (n = 28) discharged in relation to smooth pursuit of a small target in particular preferred directions. Nine of these (Type 2) did not respond to visual stimulation during stationary fixation. Nineteen VT-cells (Type 3) discharged in relation to both visual tracking and visual stimulation. In 9 of the Type 3 neurons, the preferred directions for visual stimulation and tracking were opposite, whereas they were the same in the other 10. Visual responses of Type 3 neurons were indistinguishable from those of Type 1 neurons. Testing of an additional 9 neurons driven by either visual-tracking or pattern movement was not sufficient to allow a definite assignment to one of the groups 1, 2 or 3. The distribution of preferred directions for both visual stimulation and visual tracking was widely scattered between 0 and 360 deg. Our results suggest that the dlpn is a constituent in a cerebro-cerebellar loop important for the generation of smooth pursuit eye movements.
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We used an antibody raised against the inhibitory transmitter gamma-aminobutyric acid (GABA) in the basilar pontine gray (bpg) of the monkey. Somata, dendrites, and a plexus of probably axonal fibers exhibited GABA-like immunoreactivity. Labeled neurons were small with oval, triangular, or circular soma shape. They gave rise to 2 to 4 dendrites with little branching. No axons were seen issuing from the soma. Occasionally, appendages consisting of spheroidal bodies positioned at the distal end of tenuous stalks and (in 1 cell) axonlike processes were observed to originate from dendrites. According to their morphology, we suggest that these putative GABA-ergic neurons may correspond to the type II neurons observed in Golgi material. The average number of putative GABA-ergic cells in 40-micron sections was about 30/mm2. When compared with Nissl-stained sections, these amounted to about 5% of all cells. There was no substantial variation in average density in different parts of the bpg. However, labeled cells tended to lie in clusters, perhaps related to the well-established input-output compartments of the bpg. The demonstration of a significant population of putative inhibitory neurons challenges the traditional view of the bpg, which suggests that this brainstem cell group functions as a simple relay exchanging signals between cortex and cerebellum.
A method is presented for computing correlation coefficients of two (or more) output spike trains in temporal relation to one (or more) input even trains. These event-related correlation functions are computed by convolving the output spike trains, represented as point processes, with rectangular pulses of selectable width, and by then calculating linear correlation coefficients for the pairs of amplitude values obtained from the two convolved processes in temporal relation to the input events. The merits of this technique are illustrated on stimulus trains delivered to motor units (MUs) and output spike trains recorded from muscle spindle afferents of the same cat hindlimb muscle. The correlation functions obtained show the temporal course of the correlated firings of the two afferents (mostly Ia afferents from primary muscle spindle endings) as a function of time from MU activation; they are compared with the conventional cross-correlation histograms (CCHs) between afferents and with peri-stimulus time histograms (PSTHs) between stimulus and afferent firing patterns. Stimulus-related cross-correlation functions as displayed here can be calculated for any three spike trains. Possible extensions of the method to larger numbers of input and output channels are also discussed.
In anaesthetized cats, medial gastrocnemius motor units (MUs) were electrically stimulated via their ventral-root axons with independent random patterns. Isometric muscle tension and homonymous alpha-motoneuron (MN) membrane-potential fluctuations in response to these stimuli were recorded simultaneously, usually for periods of about 2 min. The tension and membrane potential were averaged with respect to a stimulus train over two disjoint time intervals, one stretching 20-40 s at record beginning, and the other a similar duration at the end of recording. Whereas average MU twitch amplitudes usually decreased between these periods, average membrane potential trajectories did not do so, such that, when normalized to the change in twitch amplitude, the membrane potential trajectories usually increased in size. This suggests that the decline in the mechanical effect of MU activation was accompanied by an increase in the gain of the afferent pathway to homonymous MNs, which was confirmed by gain computations in the frequency domain. This compensation could be a mechanism to maintain the high quality of information about MU contractions transmitted to MNs in the course of MU fatigue.
In anesthetized cats, medial gastrocnemius motor units (MUs) were electrically stimulated via their ventral-root axons with independent random patterns. Muscle tension and homonymous alpha-motoneuron (alpha-MN) membrane potential fluctuations in response to these stimuli were recorded simultaneously. Cross-correlating these two signals in temporal relation to the stimuli showed the covariance of the two signals around their respective means. With moderate to strong MU-MN couplings indicated by clear and large average membrane potential changes (PSP trajectories), the correlation coefficients tended to be positive at times when the PSP hyperpolarized, and vice versa. These relations are probably caused by the non-linear behavior of MUs, muscle receptors and afferent pathways. Thus, the signal transfer from motor efferents back to homonymous alpha-MNs depended upon the level of background tension, upon which MU twitches were superimposed.
A previously presented multi-loop model of the mammalian spinal alpha-motoneurone-Renshaw cell system was extended to incorporate different physiological input patterns: Ia fibres from primary muscle spindle endings, spinal input systems descending in the ventral quadrant and from the nucleus ruber. The main goal of the computer simulation calculations was to present a number of dynamic input-output relations between these inputs which are distributed inhomogeneously to different types of alpha-MNs (that is, S-, FR-, and FF-type MNs) and the outputs of pools of the latter, for the purpose of experimental testing. The main outcome was that the phase relations of the outputs of the different types of MNs depend very much on the overall strength of recurrent inhibition, such that small changes of this strength, which appears to be small anyway, can significantly alter these phase relations. Since this strength is alterable through descending and segmental afferent inputs, this provides a physiological means of phase-decorrelation although it is unlikely to put the discharges of different MN types totally out of phase (by about 180 degrees). Also, the inhomogeneity of recurrent inhibition would help to prevent a strong phase separation of this kind. Yet a decorrelation at the microscopic level could help suppress physiological tremor.
In anaesthetized low-spinal cats, intracellular recordings were made of the Ia excitatory post-synaptic potential (e.p.s.p.) responses of semimembranosus motoneurones to electrical stimulation (Group I range) of nerve branches supplying the anterior and posterior heads of semimembranosus, the anterior and posterior parts of biceps femoris, and the distal part of semitendinosus. Recordings were also made during stimulation of nerves to the gracilis muscle and to the vasti muscle group. Stimulation of the semimembranosus-anterior nerve branch produced Ia e.p.s.p.s. of greater amplitude in semimembranosus-anterior motoneurones than in semimembranosus-posterior cells; likewise, stimulation of the semimembranosus-posterior nerve branch produced larger e.p.s.p.s. in cells which supplied the posterior head than in those which supplied the anterior head. Stimulation of the nerve branches to components of two 'flexor' muscles (Sherrington, 1910), biceps-posterior and semitendinosus-distal, produced larger e.p.s.p.s in semimembranosus-posterior cells than in the anterior motoneurones. A tendency was found for stimulation of the nerve to biceps femoris-anterior (an 'extensor') to produce larger e.p.s.p.s in semimembranosus-anterior than in-posterior motoneurones. However, this effect was of borderline (0.06 greater than P greater than 0.05) significance. The limited monosynaptic input produced by stimulation of the nerves to the gracilis and vasti muscles showed that their Ia axons do not distinguish between the two semimembranosus cell groups. A slight topographic organization of motoneurones within the semimembranosus motor nucleus was found, with anterior cells encountered, on average, at a more rostral level of the spinal cord than posterior cells. A similar topographic arrangement was observed in the rostrocaudal distribution of Group I afferent fibres in the dorsal roots and motor axons from the two sets of motoneurones in the ventral roots. These findings are consistent with 'location specificity' (Scott & Mendell, 1976) being a factor which contributes to the observed pattern of homonymous Ia connexions. A role for 'species specificity' (Scott & Mendell, 1976) in determining the observed pattern of homonymous Ia connexions was indicated by species-dependent differences in e.p.s.p. amplitude in pairs of semimembranosus-anterior and -posterior motoneurones at similar rostrocaudal locations in the spinal cord. The pattern of heteronymous connexions to the semimembranosus motor nucleus also showed evidence for species specificity. However, no clear topographic pattern was evident in these connexions.
In anesthetized cats 3 medial gastrocnemius (MG) motor units (MUs) were electrically activated with independent pseudorandom patterns at physiological mean rates. Recordings of isometric MG tension (T) and membrane potential changes (PSPs) in MG alpha-motoneurons (MNs) were averaged with respect to each stimulus train. The resulting T and PSP trajectories displayed the responses of each MN to the 3 average MU twitches. These responses could vary from no response to a sequence of depolarizing and hyperpolarizing waves in a PSP trajectory. The results are consistent with the known behavior of muscle stretch receptors to muscle and MU twitches and the receptors' connections to homonymous MNs.
An analysis is made of linear and non-linear summation of the motor unit (MU) tension and motoneuron (MN) membrane potential (PSP) trajectories evoked by stimulation of MUs as previously reported. In most cases, summation of both averaged responses was linear. Seldom, PSPs summed non-linearly, then usually coinciding with non-linear summation of the responsible MU twitches. The results suggest that the afferent pathways mediating the mechanical events in muscle to MNs behave rather linearly, at least in the small-signal range of interest here.