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Proprioceptive control of extensor activity during fictive scratching and weight support compared to fictive locomotion.

At rest, extensor group I afferents produce oligosynaptic inhibition of extensor motoneurons. During locomotor activity, however, such inhibition is replaced by oligosynaptic excitation. Oligosynaptic excitation from extensor group I afferents plays a crucial role in the regulation of extensor activity during walking. In this study we investigate the possibility that this mechanism also regulates extensor muscle activity during other motor tasks. We show that the reflex pathways responsible for extensor group I oligosynaptic excitation during fictive locomotion can be activated during both fictive scratching and fictive weight support (tonic motor activity induced by contralateral scratching). These observations suggest that the excitatory group I oligosynaptic reflex pathways are open for transmission during several forms of motor activities. We also show that extensor group I input during fictive scratching can affect the amplitude and the timing of extensor activity in a pattern similar to that observed during locomotion. Most likely these effects involve the activation of the excitatory group I oligosynaptic reflex pathways. Accordingly, it is suggested that extensor group I oligosynaptic excitation during motor activities other than locomotion is also used to regulate extensor muscle activity. Furthermore, the similarity of effects from extensor group I input on the rhythmicity during scratching and locomotion supports the hypothesis that both rhythms are generated by a common network.

Animals↗

["Tube scratching" in the trachea on nasotracheal intubation: comparison of Macintosh and McCoy laryngoscopes].

BACKGROUND: "Tube scratching" in the trachea, the intratracheal resistance of a tube, on nasotracheal intubation was evaluated using the Macintosh and the McCoy laryngoscope blade. METHODS: Fifty young patients requiring nasotracheal intubation were studied. Following induction of anesthesia, X-ray was taken before and during the use of two types of laryngoscopes. For analysis of the configuration of the upper airway, we drew three straight lines [axis of pharynx (P), larynx (L) and trachea (T)] on each film. "Tube scratching" was evaluated and graded to four by a supporting anesthesiologists. RESULTS: "Tube scratching" in the trachea was observed in 14/25 patients with McCoy laryngoscope and 4/25 patients with Macintosh laryngoscope (P < 0.05). Intubation with McCoy laryngoscope decreased more the angles formed by P and L, and L and P those that with Macintosh laryngoscope (P < 0.01). These data indicate that the lines of P, L and T tend not to align with McCoy laryngoscope, preventing the tracheal tube to be passed smoothly. CONCLUSION: An excessive lifting of the epiglottis, often observed in using McCoy laryngoscope, causes "Tube scratching" in the trachea on nasotracheal intubation.

Adult↗

[Changes in the efferent activity of the scratching generator evoked by external mechanical force applied to a hindlimb in the decerebrate cat].

Changes in the afferent inflow appeared with application of the external mechanical force to the rhythmically moving hindlimb have been studied for their scratching generator activity in decerebrate adult cats. Phasic relationship between violent hindlimb transference and efferent activity of the scratching generator was opposite to that found earlier during fictitious scratching, which is explained by difference between afferent activity during real scratching movement and passive movement of the hindlimb in the immobilized animal. Maximum redistribution in the relationship between flexor and extensor intensities in response to the stimulation corresponds to maximum rate of the violent hindlimb transference.

Animals↗

[Readjustment of the efferent activity of the scratching generator in response to stimulation of muscle afferents of the hindlimb of the decerebrate immobilized cat].

Rebuildings of the scratching generator activity caused by phasic electrical stimulation of ipsilateral hindlimb muscle nerves during different hindlimb positions were studied in decerebrated immobilized cats. Strong dependence of these rebuildings on the stimulation phase was observed. The character of the "scratch" cycle duration rebuilding was formed by the scratching generator tendency to bring efferent activity into such correlation with the stimulus that the stimulation moment coincided with the moment of efferent activity phase triggering. Phasic altering of the efferent activity intensity rebuilding was observed against a background of "aiming" and "scratching" activity correlation shift in the direction of strengthening activation of muscles innervated by the stimulated nerve. This rebuilding was intensified when the hindlimb deflects from the aimed position in the direction of corresponding muscles stretching. Physiological sense of "rebuilding absence phases" is discussed. It is postulated that absence of the duration and intensity changes can be achieved simultaneously only with definite correlation between phase and intensity of the afferent impulsation burst.

Animals↗

[Readjustment of the efferent activity of the scratching generator in response to stimulation of cutaneous afferents of the hindlimb of the decerebrate immobilized cat].

Rebuildings of the scratching generator efferent activity caused by the phasic electrical stimulation of ipsilateral hindlimb skin nerves during different hindlimb positions were studied in decerebrated immobilized cats. Stimulation was followed by short latency inhibition of the efferent activity. Stimulation did not cause correlation shifts in the common "aiming" and "scratching" activity. Changes in the efferent activity cycle duration and intensity depended on the stimulation phase. Inversion of intensity changes occurred with transition from the middle-force to strong stimulation. A functional role of the dependence of the efferent activity rebuilding on the stimulation phase is considered. The scratching generator is supposed to contain a model of the afferent inflow which enters the spinal cord during real scratching.

Animals↗

[Interrelation of the kinematics of hindlimb movement and efferent activity in the decerebrate cat during scratching].

Statistical dependence between parameters of hindlimb scratching movements and muscle electrical activity was studied in decerebrated cat during real scratching. Power of electrical signal to scratching and aiming muscles and duration of aiming muscle activity are determining factors of movement parameters (amplitude, velocity and phase duration). Experiments with limb deafferentation had shown that statistical dependences between movement parameters and muscle electrical activity reflect the peculiarities of the scratch generator functioning. Some investigated statistical dependences change under the afferent signal influence.

Action Potentials↗

Correlation of the modified scratch test with the radioallergosorbent test (RAST) in atopic children.

The usefulness of the modified scratch test in predicting clinical allergy and its correlation with the RAST were studied in 83 atopic children. A total of 423 scratch tests were compared with the same number of RAST. Percentage agreements between the two tests for individual allergens ranged from 87.5% (milk) to 50% (cat epithelium). The RAST showed more positive results only for the house dust allergen. Both RAST and scratch tests were not indicative of clinical allergy in the skin and gastrointestinal tract. It was concluded that the modified scratch test may give useful information and remain as one of the routine investigative procedures in pediatric allergy.

Adolescent↗

[Acute necrotizing cutaneous streptococcal infection following bites or scratch by dog or cat].

INTRODUCTION: Domestic animal bites or scratches are quite frequent. Among banal bacteria isolated from infected bites or scratches, group A streptococcus seems to be frequently associated with severe infections. CASE REPORTS: Three cases of acute necrotizing cutaneous streptococcal infections, following cat or dog bite or scratch are reported. Twice, group A streptococcus was isolated from cutaneous swabs. In the third case, previous antibiotic therapy had sterilised bacteriological samples. Diagnosis was ascertained on the basis of clinical presentation and significant antistreptococcal antibodies elevation. Skin necrosis around the inoculation area was observed in the 3 cases. Cicatrisation required an average of two months under appropriate treatment. DISCUSSION: An evolution towards cutaneous necrosis localized to the initially injured area is common to these three cases. This peculiar evolution is worth to be known in order to choose an effective anti streptococcal antibiotherapy whenever domestic animals bites and scratches are to be treated.

Acute Disease↗

Cat-scratch disease in a child with unique magnetic resonance imaging findings.

OBJECTIVE: To report a patient with cat-scratch disease and the associated radiological findings. PATIENT: A previously health 10-year-old boy presenting with fever and joint pain. RESULTS: The presence of multiple abnormal foci in the bone marrow were noted by magnetic resonance imaging. There was no correlation with either radionuclide or conventional radiographic imaging findings. The patient's condition was diagnosed as cat-scratch disease by the demonstration of elevated antibody titers to the causative organism, Bartonella (formerly Rochalimaea) henselae. CONCLUSION: Magnetic resonance imaging may be more sensitive to the early bone marrow changes that can occur with cat-scratch disease than either radionuclide bone scan or computed tomography.

Antibodies, Bacterial↗

Oculoglandular disease of parinaud. A manifestation of cat-scratch disease.

Among patients with cat-scratch disease, the oculoglandular form is the most common unusual manifestation. This condition, seen in 14 of 585 patients with the infection encountered in a private pediatric practice over a span of 23 years, belongs in the syndrome of the oculoglandular disease of Parinaud. Most of the 14 patients described were only mildly ill and had but little discomfort. All patients recovered without residuals. Diagnosis is based on four criteria: exposure to a cat, usually an immature one; the presence of a localized granuloma of the eye; the presence of preauricular lymphadenopathy; and a positive skin test to cat-scratch antigen of known potency. Several unusual features, never before described, of oculoglandular disease due to cat-scratch disease are submitted.

Adolescent↗

Granulomatous hepatitis in three children due to cat-scratch disease without peripheral adenopathy. An unrecognized cause of fever of unknown origin.

OBJECTIVE: To report the clinical experience of three patients with fever of unknown origin ultimately diagnosed as having cat-scratch granulomatous hepatitis in the absence of peripheral adenopathy. DESIGN: Case-control study. SETTING: Referral center at university-based referral practice. PATIENTS: Three children with fever of unknown origin. Follow-up following presentation was 6 months for each patient. MEASUREMENT AND RESULTS: All three patients with fever of unknown origin were diagnosed radiographically to have multiple hepatic defects. The defects were shown histologically to be granulomatous. Two of the three patients had Warthin-Starry staining bacilli in the granulomas consistent with a diagnosis of Afipia felis. All three had positive cat-scratch skin test results. CONCLUSIONS: Cat-scratch disease in the absence of peripheral adenopathy is a heretofore unrecognized cause of fever of undetermined origin and may account for a small, but significant, percentage of children presenting with it.

Biopsy, Needle↗

Cat-scratch disease. Isolation and culture of the bacterial agent.

A gram-negative bacterium or its cell wall-defective variants were isolated from lymph nodes of ten patients with cat-scratch disease. Cultured bacteria were morphologically identical to vegetative and wall-defective forms seen in human tissues. Three of seven patients with recent cat-scratch disease had fourfold or greater rises in antibody titer against the cultured bacteria; the remaining four patients had maximum titers of 1:32 to 1:128. Rabbit antiserum to cultured bacilli reacted in immunoperoxidase stains with vegetative and wall-defective cat-scratch disease bacilli in lymph node, skin, or conjunctiva and with vegetative or wall-defective bacteria isolated from ten patients. Vegetative bacteria produced lesions in the skin of an armadillo identical to early lesions in human skin. Vegetative bacteria were recovered from the lesions in the armadillo.

Adult↗

Lymphadenopathy at the medial epitrochlear region in cat-scratch disease.

Our objective was to describe the imaging features of lymphadenopathy at the medial epitrochlear region as frequently seen in cat-scratch disease (CSD) and to compare these features with those seen in non-CSD. Ten patients (four males and six females) presented with a subcutaneous soft tissue mass at the medial epitrochlear region. Three patients were younger than 15 years. Magnetic resonance imaging was performed in all patients. All lesions turned out to be regional lymphadenopathy instead of soft tissue neoplasm. They were caused by benign disorders in eight cases, including seven CSD and one other infection, and in two cases by metastatic disease. All lesions, except for three benign ones, were solitary. On MRI, high signal intensity (SI) strands in the surrounding soft tissue on T2-weighted images (WI) were present in all cases. Three cases of CSD showed homogeneous SI on both T1- and T2WI. After contrast administration, a moderate, homogeneous enhancement was seen. The other seven lesions, except for one metastasis, had both solid and liquid components. Liquid components showed high SI on T2WI without enhancement, whereas solid components had intermediate SI on T2WI and marked enhancement after contrast administration. Pathological findings in seven patients, including four with CSD, supported the tentative diagnosis made on MRI. One of two patients with CSD had positive serological test. Cat-scratch disease is a major cause of a soft tissue swelling at the medial epitrochlear region. Identification of lymphadenopathy and its presentation on MRI may be helpful in eliciting an animal-scratch history and achieving diagnostic and therapeutic aims in patients without primary cancer.

Adolescent↗

An ocular cat-scratch disease patient positive for cytoplasmic anti-neutrophil cytoplasmic antibody.

BACKGROUND: We report a case of ocular cat-scratch disease with permanent vision reduction in a patient who was cytoplasmic anti-neutrophil cytoplasmic antibody (C-ANCA) positive. METHODS: Case report and review of the literature. RESULTS: While taking steroids and antibiotics, a 52-year-old man with uveitis associated with cat-scratch disease developed retinal vein occlusion and a macular exudate. His final visual acuity was poor because of residual macular degeneration and optic atrophy. Serum C-ANCA increased and decreased in parallel with ocular inflammatory activity. CONCLUSION: C-ANCA is an indicator of vasculitis and may be useful as an indicator of severe cat-scratch disease.

Ampicillin↗

Cell-mediated immunity in cat-scratch disease.

The importance of cell-mediated immunity in cat-scratch disease (CSD) is suggested by the positive skin test reactions and granulomatous histopathology noted in patients with this disease. However, an earlier investigation found that lymphocytes from patients with CSD and control subjects were equally unresponsive in vitro to cat-scratch antigen. In contrast, we found that 16 patients with CSD had significantly increased lymphocyte transformation responses to cat-scratch antigen when patients were compared to control subjects. This cell-mediated immune response may be directed against nonviable bacteria in the involved lymph nodes and may be the major mechanism responsible for the granulomatous reaction and clinical features of CSD.

Adolescent↗

An unusual presentation of cat scratch encephalitis.

Cat scratch disease is an infectious illness that has been recognized since the 1880s; however, our understanding and knowledge of it is still evolving (1). It was not until 1991 that the etiologic species, Rochalimaea, was finally confirmed (2,3). Only recently have the breadth of its clinical spectrum and the population at risk been appreciated. We now realize that signs and symptoms that had been considered cardinal for diagnosis may be absent. Cat scratch disease was known to afflict primarily children and adolescent; however, the incidence of CSD is increasing in immunocompromised groups, such as AIDS and transplant patients (3,4). The recent discovery of the infectious agent and improved understanding of the disease process have led to new approaches in diagnosis and treatment. We present a report of a patient with cat scratch disease who presented with seizure and altered mental status secondary to encephalitis.

Bartonella henselae↗

[A little known cause of persistent fever and granulomatous hepatitis in children: cat scratch disease].

BACKGROUND: Extensive hepatic and splenic involvement in cat-scratch disease has rarely been reported. CASE REPORT: A 2 1/2 year-old boy suffered for 2 weeks from high-grade fever, abdominal pain and alteration of his general condition. Ultrasonography revealed multiple hypoechogenic nodules in liver and spleen. The CT scan also showed hypodense lesions. An open liver biopsy was performed 5 weeks after the onset of illness. Histopathology of a resected nodule demonstrated neutrophilic granulomatous inflammation with central abscess formation. Recent cat exposure, suppurated epitrochlear lymph node 15 days before admission were also consistent with cat-scratch disease which was confirmed by elevated anti-Rochalimaea antibody titers. Follow-up showed complete resolution of all hepatic and splenic lesions within 6 months and emergence of splenic calcifications. CONCLUSION: Cat-scratch disease should be considered in the diagnosis of fever of unknown origin and hepatosplenic abscesses in children.

Cat-Scratch Disease↗

Macular hole in cat scratch disease.

PURPOSE: To report the development of a macular hole as a complication of cat scratch disease. DESIGN: Case report. METHODS: A 10-year-old girl was seen with unilateral neuroretinitis from serologically confirmed cat scratch disease. Twelve days later, she developed a macular hole in the involved eye. Fundus photography and optical coherence tomography (OCT) were obtained at presentation and after the development of a macular hole. RESULTS: Fundus photography and OCT on presentation revealed a nasal neurosensory detachment and multiple inflammatory foci throughout the macula, including a subfoveal lesion. Fundus photography and OCT 12 days later revealed the development of a partial posterior vitreous detachment and a full thickness macular hole. CONCLUSIONS: Macular hole should be included among posterior segment complications of cat scratch disease. In this case, the macular hole was associated with partial vitreous detachment and a preexisting subfoveal lesion, likely representing an inflammatory focus.

Antibodies, Bacterial↗