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PubMed2007

Irritable bowel syndrome in the 21st century: perspectives from Asia or South-east Asia.

Asian irritable bowel syndrome (IBS) studies not only confirm the truth of this functional disorder but also describe the current disease situation of this continent, with its variable socioeconomic backgrounds. Most Asian community IBS prevalence is within 5-10%, regardless of gender or ethnic character. As well as meeting the main Rome II criteria, Asian IBS subjects also have many minor symptoms. Thus this recommendation remains useful to diagnose Asian IBS. Also, female patients commonly express constipation-predominant (C-) symptoms. Extra-colonic symptoms are common in Asia, for example dyspepsia, insomnia and irritable urinary bladder. Asian IBS subjects do experience psychological disturbances including anxiety, depression, agoraphobia and neuroticism. Accordingly, their quality of life is poor and there is absenteeism leading to excessive physician visits. Abnormal gut motor and sensory functions have been indicated among the Asian IBS subjects. Now, there is evidence of altered colonic neuroimmune function leading to gut hypersensitivity and dysmotility. An Asia-Pacific trial also confirmed tegaserod efficacy on female C-IBS subjects. More than 90% of nurses have very limited IBS knowledge, and are unable even to explain it clearly. In conclusion, Western recommended criteria clearly diagnose Asian IBS and many factors are mutual leading to IBS. Current IBS treatments remain useful but additional reeducation for medical professionals appears to be needed.

Asia↗

PubMed1981

[Critical backward glance at the development of the science of immunity].

Premunition, infection immunity and virus persistence are notions of the theory of immunity, which, on account of their communities lead to the conclusion that the intracellular inclusion of the living agent is the basis of every acquired immunity. The antibodies of the vertebratae have an exclusively sensory function. They are no immune bodies. Acquired immunity is the ability to prevent a repetition of the same disease. But it does not protect from a local infection with the same agent. Local infections arise by the fact that specific antibodies were acquired already before the infection or were preformed in the genome of the host cells and may be called at once. Their germs lead to an inflammation at the entrance. Cyclic infectious diseases with particularly reliable immunity are certain virus diseases, such as measles, poliomyelitis and yellow fever. The viruses increase in the intracellular space may persist there and may later on evoke local recidivations, like the viruses of the herpes group. As a purely sensory substrate antibodies only evoke the inflammatory disease, but they are not carriers of the acquired immunity, but in certain cases only a mediator for these. Only in a prophylactic dosage antibodies may have an effect preventing disease. The gradual change of the contents of the notion of immunity in the course of this century has led the theoretical research to large difficulties, even to contradictions, respectively. Their correction by retroreflection to the original contents of the notion is necessary, in order to create clear fundaments for the future.

Allergy and Immunology↗

PubMed2002

Bone-lengthening for symbrachydactyly of the hand with the technique of callus distraction.

BACKGROUND: Bone-lengthening in the hand and foot is a relatively new application for distraction osteogenesis. We present the operative treatment and postoperative outcome for four patients with M ller type-D symbrachydactyly of the hand who underwent metacarpal lengthening with use of a distraction device to establish pinch function. METHODS: Four patients who underwent distraction osteogenesis for the treatment of congenital symbrachydactyly of the hand were evaluated over a thirteen-year period. The nondominant right hand was treated in two patients, and the nondominant left hand was treated in the other two. The patients included three boys and one girl; all patients had the operation between the ages of five and eleven years. Distraction osteogenesis was performed on the fifth metacarpal in one patient and on the fourth and fifth metacarpals in the remaining three, in whom both bones were lengthened simultaneously with use of a single device. Postoperative bone elongation was analyzed with radiographs made at the time of removal of the distractor. The sensory function of the treated fingers and any growth disturbance of the distracted bones were evaluated. RESULTS: The mean duration of distraction was 37.3 days (range, thirty-two to forty-nine days), and the distractor was removed at a mean of eighty-four days after surgery. The bones were lengthened by a mean of 22.3 mm (81.6% of their original length) at a rate of 0.6 mm/day. Pinch function was improved in all patients. CONCLUSIONS: On the basis of our limited experience, we found that distraction osteogenesis of the metacarpals was an effective technique for the establishment of pinch function. We also found that an intramedullary Kirschner wire could maintain the alignment of the osteotomized bone. Although distraction requires a longer treatment period, it is apparently more effective than bone-grafting in terms of achieving adequate bone length. Simultaneous lengthening of two metacarpals also was found to be an effective technique.

Child↗

PubMed2005

Functional MRI activation of somatosensory and motor cortices in a hand-grafted patient with early clinical sensorimotor recovery.

The aim of this study was to investigate somatosensory and motor cortical activity with functional MRI (fMRI) in a hand-grafted patient with early clinical recovery. The patient had motor fMRI examinations before transplantation, and motor and passive tactile stimulations after surgery. His normal hand and a normal group were studied for comparison. A patient with complete brachial plexus palsy was studied to assess the lack of a fMRI signal in somatosensory areas in the case of total axonal disconnection. Stimulating the grafted hand revealed significant activation in the contralateral somatosensory cortical areas in all fMRI examinations. The activation was seen as early as 10 days after surgery; this effect cannot be explained by the known physiological mechanisms of nerve regeneration. Although an imagination effect cannot be excluded, the objective clinical recovery of sensory function led us to formulate the hypothesis that a connection to the somatosensory cortex was rapidly established. Additional cases and fundamental studies are needed to assess this hypothesis, but several observations were compatible with this explanation. Before surgery, imaginary motion of the amputated hand produced less intense responses than executed movements of the intact hand, whereas the normal activation pattern for right-handed subjects was found after surgery, in agreement with the good clinical motor recovery.

Adult↗

PubMed1983

Characterization of the peptide and sensory neurotoxic effects of capsaicin in the guinea pig.

The effects of capsaicin, the major pungent ingredient of hot peppers, were assessed on sensory neuron neuropeptide levels and on sensory function in the adult guinea pig. Systemic doses of capsaicin as low as 2.5 mg/kg depleted substance P (SP) in dorsal roots plus ganglia (DRG) whereas a 10-mg/kg dose depleted the peptide maximally in DRG and in the dorsal spinal cord. High doses of capsaicin had no consistent effects on levels of cholecystokinin (CCK), vasoactive intestinal polypeptide, or somatostatin, although a transient decrease in CCK levels was observed 4 days after dosing. A single 5-mg/kg dose of capsaicin rendered animals completely insensitive to chemical irritation of the cornea without affecting sensitivity to noxious heat. Higher doses of capsaicin produced a marked insensitivity to nociceptive and non-nociceptive heat as well as to chemical irritation without affecting other sensory modalities. The SP depletion and sensory deficits produced by a single 50-mg/kg dose of capsaicin were still evident 10 weeks later. The pattern of selectivity of the sensory deficits produced by capsaicin differed from that produced by morphine which was active against all forms of nociceptive stimuli. The results indicate that in the guinea pig capsaicin is potent at producing a unique, long-lasting syndrome of peripheral sensory deficits that may result from an effect of the agent on SP-containing primary afferent neurons.

Animals↗

PubMed1994

[Taste disorders in forensic medicine].

Taste disorders can a rise from lesions of peripheral receptors, taste control pathways or cortical area involvement. Among peripheral lesions, trauma of the tongue and oropharynx are the most common. Iatrogenic lesions of facial and glossopharingeal nerves are very important in Forensic Medicine, while there are different opinions about taste alterations due to head injuries; hypogeusia associated to smell disorders are found in 0.4-0.5% of patient after head trauma with good prognosis (90% healing) while qualitative disorders are more common (30%). The Authors describe clinical methodologies for taste evaluation and their application in Forensic Medicine. Forensic estimation of taste disorders con be classified by two main groups: study of cause relation between the occurrence and damage and quantitative valuation of the damage in three different juridical ambits: Penal, Civil, Insurance and foresight. In Penal Right taste damages could be classified among personal lesion crimes and can be classified as serious (permanent injury of taste) ore very serious (complete lost of taste function). Italian Legislation equipare the 5 sense organs. In Civil Right evaluation the so-called "biologic damage" and working ability are considered; this means very different evaluations. In the most recent baremes, generic damage is estimated by different Authors from 0 to 10% while with regard to specific working capacity, common evaluation criteria does not exist. In Insurance taste disorders evaluation is based only on working ability and not on biologic damage. In the previdenzial ambit, taste disorders are not even included in the most recent tables of permanent invalidity estimation. The Authors propose new and more efficacious valutation criteria for taste disorders in all ambits, hoping for more interest in the Forensic aspects of taste, a too often forgotten sensory function.

Adult↗

PubMed2002

Compliance, tone and sensitivity of the rectum in different subtypes of irritable bowel syndrome.

Irritable bowel syndrome (IBS) consists of various subtypes. It is not known whether these subtypes share a common pathophysiology. Evaluation of motor and sensory function of the rectum using a barostat may help to explore a common pathophysiological background or differences in pathophysiology in subtypes of IBS. We have evaluated compliance, tone and sensitivity of the rectum, in both fasting state and postprandially, using a computerized barostat in 15 patients with diarrhoea-predominant IBS (IBS-D), 14 patients with constipation-predominant IBS (IBS-C) and compared the results with those obtained in 12 healthy controls. Rectal compliance as calculated over the steep part of the pressure-volume curve (17-23 mmHg) was decreased in both IBS groups (IBS-D 8.0 +/- 1.4 mL mmHg-1; IBS-C 5.6 +/- 1.1 mL mmHg-1) compared with controls (24.7 +/- 3.5 mL mmHg-1). The perception of urge was increased only in IBS-D patients, whereas pain perception was significantly increased in both IBS groups. Spontaneous adaptive relaxation was decreased in IBS-D patients. Postprandially, rectal volume decreased significantly in the controls and in IBS-D patients, but not in IBS-C patients. In conclusion, both rectal motor and sensory characteristics are different between IBS-D and IBS-C patients. Therefore, testing of rectal visceroperception, adaptive relaxation and the rectal response to a meal may help distinguish groups of patients with different subtypes of irritable bowel syndrome.

Adult↗

PubMed2006

False negative in spinal cord monitoring using spinal cord-evoked potentials following spinal cord stimulation during surgery for thoracic OPLL and OLF.

Several electrophysiologic methods have been used for intraoperative monitoring of spinal cord functions. Recently, muscle responses following transcranial electric stimulation have also been widely used. However, in patients with severe myelopathy, only the spinal cord responses following spinal cord stimulation can be recorded. We report a false-negative case in monitoring using spinal cord responses following spinal cord stimulation. The patient presented with severe thoracic myelopathy due to ossification of the posterior longitudinal ligament (OPLL) and ligamentum flavum. Spinal cord responses following spinal cord stimulation were recorded during laminectomy and partial removal of the OPLL. Although the amplitude of those responses decreased transiently to within 50% of control data during decompression, it had recovered to the control level by the end of surgery. Just after surgery, the patient showed complete motor paralysis with preserved sensory function. Spinal cord responses following spinal cord stimulation can be recorded in patients with severe myelopathy. However, motor problems may occur when surgery is continued in the false belief that responses are accurate.

Electric Stimulation↗

PubMed2004

Environmental enrichment prevents effects of dark-rearing in the rat visual cortex.

Environmental enrichment potentiates neural plasticity, enhancing acquisition and consolidation of memory traces. In the sensory cortices, after cortical circuit maturation and sensory function acquisition are completed, neural plasticity declines and the critical period 'closes'. In the visual cortex, this process can be prevented by dark-rearing, and here we show that environmental enrichment can promote physiological maturation and consolidation of visual cortical connections in dark-reared rats, leading to critical period closure.

Animals↗

PubMedDate not supplied

Nutrients and behaviour: research strategies for the investigation of taste characteristics, food preferences, hunger sensations and eating patterns in man.

Although, as described elsewhere in this report, the consumption of particular nutrients can modify behaviors that are not directly related to eating, it seems highly likely that the main function of nutrient-induced changes in neurotransmitter synthesis is to provide the brain with information about what has been eaten, which the brain can then utilize in deciding what to eat next. This chapter summarizes research strategies and techniques which have been used to assess the effects of drugs and diseases on appetite and food consumption, and which might also be useful in exploring the effects of particular nutrients. Crude measures of total food intake and of global hunger ratings are probably too insensitive to reveal the subtle effects of many nutrients. Some alternative procedures allow the assessment of particular aspects of feeding behaviour, (e.g. food or nutrient choice), and of the relationships between such behaviour and the individual's metabolic and physiological state, sensory functions, taste hedonics, and affective response to foods.

Behavior↗

PubMed2001

Early binocular visual experience may improve binocular sensory outcomes in children after surgery for congenital unilateral cataract.

PURPOSE: To compare the effect of intensive and reduced occlusion therapy regimens on binocular sensory outcomes, visual acuity, and the prevalence of strabismus in children after surgery for congenital unilateral cataract. METHODS: Two nonrandomized groups of patients were studied prospectively: (1) an intensive occlusion group (n = 29) patched 80% of waking hours were followed for a median 6.9 years and (2) a reduced occlusion group (n = 8) patched 25% to 50% of waking hours were followed for a median 4.3 years. Six subjects in the intensive group and 4 in the reduced occlusion group had secondary intraocular lenses. Two subjects in the intensive group had epikeratophakia surgery. Binocular sensory function was assessed with random dot and contour stereoacuity tests and the Worth 4-dot test. The prevalence and age at onset of strabismus were determined from the patients' charts. RESULTS: A higher proportion of subjects in the reduced occlusion group (50%) had stereoacuity or fusion compared with the intensive occlusion group (14%), a borderline significant difference (P =.08). No significant difference (P =.55) was found in median visual acuity between the intensive (20/50) and the reduced occlusion (20/55) groups. The 90% prevalence of strabismus in the intensive occlusion group was slightly higher than the 63% prevalence in the reduced occlusion group, although this difference was not significant (P =.18). CONCLUSIONS: These results suggest that a reduced occlusion protocol may be associated with better binocular sensory outcomes and a reduced prevalence of strabismus without compromising good visual acuity in children treated for congenital unilateral cataract.

Cataract↗

PubMed2003

Impact of rectal distention on the results of evaluations of lower urinary tract sensation.

PURPOSE: To our knowledge no systematic studies have been performed in humans to test the interaction of normal bladder and rectal sensory function. However, symptoms affecting the different pelvic viscera often coexist. MATERIALS AND METHODS: In 15 healthy female volunteers sensations of bladder filling were evaluated during 2 consecutive cystometric studies, including 1 with an empty rectum and 1 with a full rectum. Similarly the electrical perception threshold was determined in the bladder when the rectum was empty and again when the rectum was full. RESULTS: Rectal distention did not change bladder compliance during filling. When the rectum was distended, sensations of bladder filling were reported at smaller volumes. On the other hand, electrical perception thresholds in the bladder were higher when the rectum was full. CONCLUSIONS: The state of the rectum significantly influences the sensations of bladder filling and electrical bladder stimulation. These results show that before sensory testing of the bladder rectal fullness should be examined and if necessary the rectum should be emptied. The different effect of rectal distention on filling and electrical sensations represents an additional argument for different innervation of the 2 sensations in the lower urinary tract.

Adolescent↗

PubMed2001

Highly activated CD8(+) T cells in the brain correlate with early central nervous system dysfunction in simian immunodeficiency virus infection.

One of the consequences of HIV infection is damage to the CNS. To characterize the virologic, immunologic, and functional factors involved in HIV-induced CNS disease, we analyzed the viral loads and T cell infiltrates in the brains of SIV-infected rhesus monkeys whose CNS function (sensory evoked potential) was impaired. Following infection, CNS evoked potentials were abnormal, indicating early CNS disease. Upon autopsy at 11 wk post-SIV inoculation, the brains of infected animals contained over 5-fold more CD8(+) T cells than did uninfected controls. In both infected and uninfected groups, these CD8(+) T cells presented distinct levels of activation markers (CD11a and CD95) at different sites: brain > CSF > spleen = blood > lymph nodes. The CD8(+) cells obtained from the brains of infected monkeys expressed mRNA for cytolytic and proinflammatory molecules, such as granzymes A and B, perforin, and IFN-gamma. Therefore, the neurological dysfunctions correlated with increased numbers of CD8(+) T cells of an activated phenotype in the brain, suggesting that virus-host interactions contributed to the related CNS functional defects.

AIDS Dementia Complex↗

PubMed2003

Inclusion body myositis--sensory dysfunction revealed with quantitative determination of somatosensory thresholds.

In order to evaluate sensory function in inclusion body myositis (IBM), nine patients were subjected to sensibility screening and quantitative determination of somatosensory thresholds. Data were compared with results from electrophysiological examination and muscle biopsy. On sensibility screening all but one of the IBM patients had abnormal findings in hands and/or feet mostly affecting thermal sensibility. Vibratory thresholds were abnormal in five and thermal thresholds in four of the patients. Mean vibratory thresholds were significantly (P < 0.05) higher in the IBM patients when compared with the controls. Significantly increased heat pain thresholds were found in hands and feet when compared with the controls while thermal thresholds were normal. Nerve conduction velocities were decreased in three patients, EMG showed both myopathic and neuropathic abnormalities in six patients. Eight patients had neuropathic abnormalities on muscle biopsy. The sensory dysfunction found suggests an affection of peripheral nerves in IBM mainly affecting large diameter myelinated nerve fibres corroborating earlier findings of a peripheral neuropathy in IBM.

Aged↗

PubMedDate not supplied

[Hormones of the posterior region of the hypophyseal gland].

Arginine vasopressin is the main hormone involved in the regulation of body fluid osmolality. The hormone is released by the posterior pituitary whenever water deprivation causes an increased plasma osmolality or whenever the cardiovascular system is challenged by hypovolaemia and/or hypotension. The main site of action of this hormone is the renal collecting duct, but vasopressin is also a potent vasopressor and neurotransmitter, it has a role in the secretion of corticotrophin, in the regulation of the cardiovascular system, temperature and other visceral functions. Vasopressin also promotes the release of coagulation factors by vascular endothelium and increases platelet aggregability. In addition to its classical contractile effect on uterine myometrial and mammary glandular myoepithelial cells, oxytocin acts as neurotransmitter, stimulates endometrial prostaglandin production, pituitary prolactin secretion, luteolysis, sperm transport and natriuresis, and may play a role in immune function. Sensorial stimuli arising from the cervix and vagina as well as stimulation of the breast can induce secretion of oxytocin from the posterior pituitary. There are many vasopressin and oxytocin analogues (agonists and antagonists) that are synthetized with the goal of increasing duration of action and selectivity for the receptor subtypes, while non-peptide antagonists are orally active. The oxytocin and the vasopressin V1a, V1b and V2 receptors have recently been cloned and shown to form a sub-family within the large superfamily of G-protein-linked receptors. Renal V2 receptors mediate vasopressin-induced water reabsorption via induction of intracellular cAMP production in collecting duct cells. Most remaining actions of vasopressin on blood vessel constriction, liver glycogenolysis, platelet adhesion, adrenal angiotensin II secretion and certain brain functions are mediated via V1a-type receptors that are coupled to a Gq/11 protein. V1 receptor activation leads to stimulation of phospholipases C, D and A2, and an increase in intracellular calcium. Vasopressin stimulates pituitary corticotrophin release via a third vasopressin receptor type (V1b) which is present in corticotrophs. Oxytocin induces myometrial contraction, endometrial prostaglandin F2a production, mammary gland milk ejection, renal natriuresis and specific sexual, affilitative and maternal behaviours via oxytocin receptors which are also coupled to a G1/11 protein. Although only one oxytocin receptor type has been cloned so far, recent binding studies indicate that uterine endometrial oxytocin receptors may constitute a distinct receptor subtype. Expression of oxytocin receptors have relevant up- and down-regulation by oestrogens and progesterone.

Arginine Vasopressin↗

PubMed1998

Reinnervation of split skin grafts in humans: comparison of two different methods of operation.

Studies on the reinnervation of split skin grafts have produced contradictory results. As the difference in sensitivity may be caused by the method of grafting, sensory reinnervation was studied in split skin grafted by two different methods. Thirty-nine patients given split skin grafts after the excision of malignant melanoma took part in the study. In 17 patients, split skin was grafted on to the intact muscle fascia. In another 22 patients the skin was grafted directly on to the muscle after the fascia had been removed. In all patients, sensitivity (to touch, heat/cold, and pain) was tested on the grafts and the skin from the opposite side. Sensory functions on grafted skin were generally reduced. Patients with split skin grafted on to the intact muscle fascia had better reinnervation than the ones in whom the fascia had been removed. However, individual patients from both groups showed surprisingly good reinnervation of transplanted skin. The reasons for this finding are not clear, but it is quite possible that the characteristics of the grafted skin have some influence on the reinnervation.

Adult↗

PubMed1992

Influence of anterior subdiaphragmatic vagotomy and TPN on rat feeding behavior.

Total parenteral nutrition (TPN) inhibits food intake and feeding behavior. Whether caloric sensory function of the liver contributes to this food intake and feeding behavior regulation via vagal-afferent innervation was tested after performing anterior hepatic vagotomy or sham operation in rats infused with a TPN solution providing 100% of daily energy needs, given continuously for 4 days. Food intake, meal number, size, duration, meal and intermeal sniffs, and eating activity were measured using an automated computerized rat eater meter (ACREM). TPN infusion resulted in a significant decrease of food intake and feeding indexes in both groups. The vagotomized rats showed a significantly higher food consumption, achieved by greater meal frequency, larger meal size, and longer meal duration. Thus, vagotomized rats consumed more than their controls by eating larger meals more often and of longer duration. Data suggest that anterior hepatic vagotomy interrupts hepatic caloric sensory feedback loop, diminishing inhibitory vagal effects on food intake with TPN, leading to an overall increase in food intake.

Afferent Pathways↗

PubMed2006

Assessment of regional blood flow in cerebral motor and sensory areas in patients with spinal cord injury.

We assessed the presence and the degree of alteration of the regional blood flow (rCBF) as visualized by Tc-99m HMPAO brain rest SPECT in the sensory motor cortex and subcortical structure in spinal cord injury (SCI) patients, who suffered from various levels of motor and sensory function loss. Twenty-two patients (mean age: 42.1+/-13.4 years, 18 M, 4 F) and 11 control subjects (mean age: 32.2+/-6.4 years, 8 M, 3 F) participated in this study. The spinal cord injury group was consisted of 2 groups (14 paraplegic and 8 tetraplegic patients). The corticocortical rCBF ratios were calculated by using region of interests obtained from 34 cortical areas on coronal slices. Significantly reduced rCBF were measured from 11 cortical areas in tetraplegic patients and 11 cortical areas in paraplegic patients. Some of these areas were different in each group. In the tetraplegic group, significant reduction was observed in the following rCBF areas: left anterior cingulate gyrus, left medial supplementary motor area, bilateral front and back aspects of posterior cingulate gyrus, right lateral primary motor area, right medial primary sensory area, bilateral putamen, and right cerebellum. In the paraplegic group, reduced rCBF areas were as follows: bilateral anterior cingulate gyrus, right lateral supplementary motor area, left front aspect of posterior cingulate gyrus, left lateral primary motor area, bilateral back aspects of posterior cingulate gyrus, right medial primary sensory area, left lateral primary sensory area and bilateral putamen. In conclusion, in some of the movement-cortical and subcortical areas having significantly reduced blood flow in SCI may be helpful to demonstrate the disrupted areas of rCBF by SPECT. We believe that it may be useful if these findings should be considered during the evaluations related to the reorganization in SCI cases.

Adolescent↗