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PubMed1999

Decrements in cognitive performance in metal inert gas welders exposed to aluminium.

OBJECTIVES: Often little has been discovered of the cognitive functions affected by occupational toxins because many functions cooperate to produce the single performance scores typically reported from neuropsychological tests. To facilitate the interpretation of neuropsychological scores, the issue of occupational exposure to aluminium was examined with an approach intended to increase understanding of those cognitive processes that may be affected. METHODS: The investigation was a cross sectional study of asymptomatic aluminium welders and a reference group of mild steel welders. Based on urinary aluminium concentrations, welders were classified into a reference (n = 28), low (n = 27), and high (n = 24) exposure group. The mean urinary aluminium concentrations were 0.46, 2.25, and 9.98 mumol/l, respectively. A comprehensive neuropsychological examination was undertaken to assess psychomotor function, simple visual reaction time, attention related tasks, verbal and visual or visuospatial abilities as well as verbal and visual learning and memory. RESULTS: Aluminium welders showed no impairment on the finger tapping, Santa Ana dexterity, simple visual reaction times, any of the verbal memory tasks, the similarities subtest of Wechsler adult intelligence scale, or the Stroop task. However, the low exposed group performed poorer on the memory for designs and on more difficult block design items demanding preliminary visuospatial analysis. The time limited synonym task, embedded figures, digit symbol speed, and the backward counting component of the divided attention task showed exposure-response relations. CONCLUSIONS: The impairments found were circumscribed. When the neuropsychological tasks were scored to show some of the underlying theoretical cognitive structures, the results indicated that performance difficulties were mainly detected in tasks requiring working memory, particularly that relating to processing of visuospatial information. There was also evidence that such impairments are more readily found in time limited tasks involving visually presented material, in which effective visual scanning combined with control of working memory is demanded.

Adult↗

PubMed2006

Local cold acclimation during exercise and its effect on neuromuscular function of the hand.

Most acclimation research is performed on resting individuals, whereas in real life, cold exposure is often accompanied by physical activity. We examined the effects of 2 weeks of repeated cold exposure of the hand with or without an elevated core temperature from exercise on neuromuscular function of the first dorsal interosseus (FDI) muscle and manual performance of the hand. The experimental group (4 female, 6 male; age, 25.1 +/- 6.9 y) cooled their hands in 8 degrees C water for 30 min daily while cycling (50% of heart rate reserve); the control group (4 female, 4 male; age, 25.1 +/- 5.7 y) remained still. Manual function testing consisted of tactile sensitivity, grip strength, manual dexterity, and evoked twitch force in a custom-made myograph. Thermal sensation, skin temperature of index finger (Tif) and hand (Tfdi), as well as rectal temperature (Tre), were recorded daily. Tre increased significantly during bicycling, by 0.6 +/- 0.2 degrees C. Minimal Tif and Tfdi of the groups combined increased significantly during exposure days from 8.7 +/- 0.7 degrees C and 12.4 +/- 2.8 degrees C to 10.1 +/- 1.3 degrees C and 15.0 +/- 3.0 degrees C, respectively (p=0.04), with no significant difference between groups. Thermal ratings improved significantly on exposure days. Manual function was impaired with cooling, but with no significant difference between groups or across time. Deterioration of twitch characteristics with cooling did not change with repeated cold exposure. Although the increasing core temperature during cold water immersion changed the acute temperature response and thermal ratings, it had no effect on local cold acclimation or manual function.

Acclimatization↗

PubMed1975

A new medical trend in China.

Chinese biomedical scientists are now developing a new approach to medicine by combining traditional Chinese medicine and Western biomedical science. This is the current medical trend in China. Some significant results have already been achieved. For instance, in treating fractures the traditional dexterity in coaxing broken ends of bones into alignment has been successfully adopted, and x-ray has been used to check whether there was accurate bone union. Heart diseases are treated with Western drugs in combination with Chinese herbal medicine, and the results are encouraging. Ancient theories such as Fu Chen Pei Ben (to strengthen the patient's vitality) are applied, for instance, in cancer therapy, i.e., to stimulate the patient's appetite and to improve his general condition with herbs while being treated with Western anti-cancer remedies. However, the Chinese admit that this process has only just begun.

Acupuncture Therapy↗

PubMed1986

The double puncture: an effective percutaneous technique for removing complex, multiple renal calculi.

Percutaneous nephrostolithotomy, which can require a double puncture, is presently the method of choice in our institution for the removal of renal stones. Patients that underwent this procedure were evaluated to identify the possible reasons for the double puncture. Of 200 patients evaluated, 14 needed a second tract. The three variables that determined whether a second puncture was needed, in order of importance, were number and size of the stones, with second tracts needed in patients with multiple stones and staghorn calculi; anatomical variations of the renal collecting system itself, with bifid systems the most significant anatomic variation; and the dexterity of the radiologist in performing the puncture and the ability of the urologist to extract the stone. Second tracts were needed more frequently in patients who presented with stones in both the lower and middle poles of the collecting systems.

Humans↗

PubMed1987

Systemic arterial blood supply to the trachea and lung in sheep.

We studied the systemic arterial blood supply to the trachea and lung in adult sheep. After anesthesia, sheep were exsanguinated and then studied by intra-arterial injection of one of the following materials: saline containing dyes of various colors (n = 24), Microfil (n = 8), or Batson's solution (n = 6). The systemic blood supply to the cervical trachea originated from the two common carotid arteries via three to four small branches (rami tracheales cervicales) on each side. A segment of the thoracic trachea between the thoracic inlet and the origin of the tracheal bronchus (bronchus trachealis) and the bronchial tree of the right cranial lobe (lobus cranialis dexter) were supplied by the tracheal bronchial branch (ramus bronchalis trachealis), which originated from the brachiocephalic trunk (truncus brachiocephalicus). A portion of thoracic trachea between the origin of the tracheal bronchus and the tracheal carina was supplied by the thoracic tracheal branch (ramus trachealis thoracica), arising from the bronchoesophageal artery (arteria bronchoesophagea) or directly from the thoracic aorta. The bronchial branch (ramus bronchalis) originated from the bronchoesophageal artery, and its branches supplied the remainder of the bronchial tree. At 120 cmH2O pressure (n = 8), the bronchial branch contributed approximately 50% and the other two approximately 25% each of the total tracheobronchial blood flow. These three branches also supplied the visceral pleura. Additionally, several small vessels (rami pleurales pulmonales) originated from the esophageal branch (ramus esophagea) of the bronchoesophageal artery, traversed the pulmonary ligaments, and supplied the visceral pleura.

Animals↗

PubMed1996

Wet-cold exposure and hypothermia: thermal and metabolic responses to prolonged exercise in rain.

Simulated conditions of hiking in rain, wind, and cold, without protective rainwear, were used to investigate wet-cold hypothermia in 18 male subjects. Thermal, metabolic, and motor responses were monitored during an attempted 5-h walk (5.1 km/h) at 5 degrees C, with continuous exposure to rain (7.4 cm/h) and wind (8.0 km/h) over the final 4 h. The majority of subjects (11) could not complete the protocol because of intolerance of wet-cold conditions during the last 2 h. Therefore, data from 5 subjects who completed the protocol in rain and control conditions were used to describe the general pattern of response. During the 1st h of walking, core temperature rose 1 degree C to 38.1 degrees C. The subsequent 2 h of rain caused substantial cold stress, indicated by a 40% increase in heat production due to shivering and significant loss of strength and manual dexterity. However, core temperature only decreased to 37.1 degrees C, merely eliminating the initial exercise hyperthermia. Over the last 2 h of rain, core temperature remained relatively stable at 36.8 degrees C, decreasing slightly to 36.4 degrees C by 5 h. Two other subjects developed significant hypothermia (35 degrees C). One demonstrated fatigue of shivering after 2.5 h of rain, confirming the exhaustion hypothesis of wet-cold hypothermia. The older cooled rapidly when he failed to maintain the walking pace. We conclude that if a person can tolerate the intense discomfort of prolonged wet-cold exposure, he or she has the potential to resist significant core hypothermia for at least 4 h of walking under the conditions of this experiment. Exceptions to this generalization occur, making exposure of < 4 h a hypothermia risk for some individuals. Exposures > 4 h would involve increasing probability of rapid decline into hypothermia, associated with exhaustion of shivering and exercise heat production.

Adult↗

PubMed1998

Influence of localized auxiliary heating on hand comfort during cold exposure.

There is a need for a hand-heating system that will keep the hands warm during cold exposure without hampering finger dexterity. The purpose of this study was to examine the effects of torso heating on the vasodilative responses and comfort levels of cooled extremities during a 3-h exposure to -15 degreesC air. Subjects were insulated, but their upper extremities were left exposed to the cold ambient air. The effect of heating the torso [torso-heating test (THT)] on hand comfort was compared with a control condition in which no torso heating was applied, but Arctic mitts were worn [control test (CT)]. The results indicate that mean finger temperature, mean finger blood flow, mean toe temperature, mean body skin temperature, body thermal comfort, mean finger thermal comfort, and rate of body heat storage were all significantly (P < 0.05) higher on average (n = 6) during THT. Mean body heat flow was significantly (P < 0.05) lower during THT. There were no significant differences (P >/= 0.05) in rectal temperature between CT and THT. Mean unheated body skin temperature and mean unheated body heat flow (both of which did not include the torso area in the calculation of mean body skin temperature and mean body heat flow) were also calculated. There were no significant differences (P >/= 0.05) in mean unheated body skin temperature and mean unheated body heat flow between CT and THT. It is concluded that the application of heat to the torso can maintain finger and toe comfort for an extended period of time during cold exposure.

Adult↗

PubMed2006

Influence of body heat content on hand function during prolonged cold exposures.

We examined the influence of 1) prior increase [preheating (PHT)], 2) increase throughout [heating (HT)], and 3) no increase [control (Con)] of body heat content (H(b)) on neuromuscular function and manual dexterity of the hands during a 130-min exposure to -20 degrees C (coldEx). Ten volunteers randomly underwent three passive coldEx, incorporating a 10-min moderate-exercise period at the 65th min while wearing a liquid conditioning garment (LCG) and military arctic clothing. In PHT, 50 degrees C water was circulated in the LCG before coldEx until core temperature was increased by 0.5 degrees C. In HT, participants regulated the inlet LCG water temperature throughout coldEx to subjective comfort, while the LCG was not operating in Con. Thermal comfort, rectal temperature, mean skin temperature, mean finger temperature (T(fing)), change in H(b) (DeltaH(b)), rate of body heat storage, Purdue pegboard test, finger tapping, handgrip, maximum voluntary contraction, and evoked twitch force of the first dorsal interosseus muscle were recorded. Results demonstrated that, unlike in HT and PHT, thermal comfort, rectal temperature, mean skin temperature, twitch force, maximum voluntary contraction, and finger tapping declined significantly in Con. In contrast, T(fing) and Purdue pegboard test remained constant only in HT. Generalized estimating equations demonstrated that DeltaH(b) and T(fing) were associated over time with hand function, whereas no significant association was detected for rate of body heat storage. It is concluded that increasing H(b) not only throughout but also before a coldEx is effective in maintaining hand function. In addition, we found that the best indicator of hand function is DeltaH(b) followed by T(fing).

Adaptation, Physiological↗

PubMed2004

Reproducibility of the cold-induced vasodilation response in the human finger.

Cold-induced vasodilation (CIVD) is a cyclic oscillation in blood flow that occurs in the extremities on cold exposure and that is likely associated with reduced risk of cold injury (e.g., frostbite) as well as improved manual dexterity and less pain while working in the cold. The CIVD response varies between individuals, but the within-subject reproducibility has not been adequately described. The purpose of this study was to quantify the within-subject variability in the CIVD response under standardized conditions. Twenty-one volunteers resting in a controlled environment (27 degrees C) immersed the middle finger in warm water (42 degrees C) for 15 min to standardize initial finger temperature and then in cold water (4 degrees C; CWI) for 30 min, on five separate occasions. Skin temperature (Tf) and blood flow (laser-Doppler; expressed as percent change from warm-water peak) responses that describe CIVD were identified, including initial nadir reached during CWI, onset time of CIVD, initial apex during CIVD, time of that apex, and overall mean during CWI. Within-subject coefficient of variation for Tf across the five tests for the nail bed and pad, respectively, were as follows: nadir, 9 and 21%; onset, 18 and 19%; apex, 12 and 17%; apex time, 23 and 24%; mean 10 and 15%. For blood flow, these values were as follows: nadir 52 and 64%; onset, 6 and 5%; apex, 33 and 31%; apex time 9 and 8%; and mean 43 and 34%. Greater variability was found in the temperature response of the finger pad than the nail bed, but for blood flow the variability was similar between locations. Variability in onset and apex time between sites was similar for both temperature and blood flow responses. The reproducibility of the time course of CIVD suggests this methodology may be of value for further studies examining the mechanism of the response.

Blood Flow Velocity↗

PubMed2003

Neuromotor noise limits motor performance, but not motor adaptation, in children.

Children do not typically appear to move with the same skill and dexterity as adults, although they can still improve their motor performance in specific tasks with practice. One possible explanation is that their motor performance is limited by an inherently higher level of movement variability, but that their motor adaptive ability is robust to this variability. To test this hypothesis, we examined motor adaptation of 43 children (ages 6-17) and 12 adults as they reached while holding the tip of a lightweight robot. The robot applied either a predictable, velocity-dependent field (the "mean field") or a similar field that incorporated stochastic variation (the "noise field"), thereby further enhancing the variability of the subjects' movements. We found that children exhibited greater initial trial-to-trial variability in their unperturbed movements but were still able to adapt comparably to adults in both the mean and noise fields. Furthermore, the youngest children (ages 6-8) were able to reduce their variability with practice to levels comparable to the remaining children groups although not as low as adults. These results indicate that children as young as age 6 possess adult-like neural systems for motor adaptation and internal model formation that allow them to adapt to novel dynamic environments as well as adults on average despite increased neuromotor or environmental noise. Performance after adaptation is still more variable than adults, however, indicating that movement inconsistency, not motor adaptation inability, ultimately limits motor performance by children and may thus account for their appearance of incoordination and more frequent motor accidents (e.g., spilling, tripping). The results of this study also suggest that movement variability in young children may arise from two sources--a relatively constant, intrinsic source related to fundamental physiological constraints of the developing motor system and a more rapidly modifiable source that is modulated depending on the current motor context.

Adaptation, Physiological↗

PubMed1984

Experiments on functional role of peripheral input to motor cortex during voluntary movements in the monkey.

The functional role of sensory input to the motor cortex was studied by interrupting two major input pathways. One was the dorsal column, which sends the input directly through the thalamus to the motor cortex, and the other was the sensory cortex, which transfers its input through association fibers. Removal of the sensory cortex produced very little motor disturbances and the function recovered within a week. Section of the dorsal column produced some motor deficit, but the deficit was not severe and the animals recovered nearly completely within 2 wk. Combination of dorsal column section and sensory cortex removal produced severe motor deficits. These consisted of loss of orientation within extrapersonal space and loss of dexterity of individual fingers. These deficits never recovered within the duration of observation, which lasted 4-5 wk. It is concluded that the direct sensory input from the thalamus plays an important role in the control of voluntary movements, but loss of its function can be compensated by the input from the sensory cortex. The possible neuronal basis for the observed motor deficits is discussed and it is proposed that the sensory input functions by selectively changing the excitability of cortical efferent zones before and during the execution of voluntary movements. Recovery of motor function following dorsal column section occurred in parallel with the recovery of sensory input to the motor cortex. The recovered function and sensory input disappeared again following section of the association fibers from the sensory cortex. Neuronal mechanism for this observation is also discussed.

Afferent Pathways↗

PubMed1991

Behavioral deficits induced by local injection of bicuculline and muscimol into the primate motor and premotor cortex.

1. The role of intracortical GABAergic inhibition in the performance of hand movements was studied in macaque monkeys while they performed two behavioral tasks: a raisin pick-up test and a visual reaction-time task. A gamma-aminobutyric acid (GABA) agonist, muscimol (MUS; 1-5 microgram), and an antagonist, bicuculline methiodide (BMI, 1-10 micrograms), were injected at various sites in the precentral motor cortex (MC), at which single-unit activity was related to the manual aspects of the performance of the reaction-time task. 2. Manual dexterity in the raisin pick-up task was severely disturbed by injections of either MUS or BMI into the hand MC. The effect was less severe after injections into the postarcuate premotor cortex (PM). 3. Performance of the reaction-time task was unstable after injection of BMI. The instability was caused by increased electromyogram (EMG) activity and by cocontractions of agonistic and antagonistic muscles of the arm during the pressing or release of the lever. 4. Reaction time was increased by injection of MUS, although the effect was temporary and decayed within 60 min. These deficits were consistent with the time course of the decrease in the total amount of EMG activity of hand muscles related to the task. As in the case of the raisin pick-up task, performance deficits were greater when MUS and BMI were injected into the hand MC and smaller when they were injected into the PM. 5. After injection of BMI, the animals gradually began to display muscle activity in response to a green warning signal that did not require a behavioral response. The muscle activity accelerated to spontaneous muscle twitches without any external stimulus, and the animals were unable to continue the task. These BMI-induced twitches were eliminated by injection of barbiturate. 6. Appropriate levels of GABAergic inhibition in the MC appear, therefore, to be important for the regulation of spatiotemporally organized ensembles of muscle activity, in particular for reciprocal contraction at the task-related joints.

Animals↗

PubMed2000

Striking differences in transmission of corticospinal excitation to upper limb motoneurons in two primate species.

There is considerable debate as to the relative importance, for cortical control of upper limb movements, of direct cortico-motoneuronal (CM) versus indirect, propriospinal transmission of corticospinal excitation to cervical motoneurons. In the cat, which has no CM connections, a significant proportion of corticospinal excitation reaches forelimb motoneurons via a system of C(3)-C(4) propriospinal neurons (PN). In contrast, in the macaque monkey most motoneurons receive direct CM connections, and, under the same experimental conditions as in the cat, there is little evidence for PN transmission. We have investigated corticospinal transmission in the New World squirrel monkey (Saimiri sciureus) because its CM projections are weaker than in the macaque. Intracellular recordings were made from motoneurons identified from the ulnar, median, and deep radial (DR) nerves in four adult squirrel monkeys under chloralose anesthesia and neuromuscular paralysis. Responses to stimulation of the contralateral medullary pyramid were recorded before and after a lesion to the dorsolateral funiculus (DLF) at C(5), designed to interrupt direct corticospinal inputs to the lower cervical segments and unmask PN-mediated effects. This lesion greatly reduced the proportion of motoneurons showing either CM EPSPs or disynaptic IPSPs, but the proportion showing late EPSPs with segmental latencies beyond the monosynaptic range, evoked by repetitive but not single PT stimuli, was unaffected: 23 of 29 motoneurons (79%) before and 32 of 37 (86%) after the lesion; 41% of these late EPSPs had strictly disynaptic latencies after the lesion, only 14% before. These results are in striking contrast to the macaque (late EPSPs in only 18% of motoneurons before a C(5) lesion, 19% after it). Transmission of the late EPSPs via C(3)-C(4) PNs in the squirrel monkey was indicated by their absence after an additional C(2) DLF lesion. Nearly all tested motoneurons also responded with short latency EPSPs to stimulation in the ipsilateral lateral reticular nucleus. By analogy with the cat, these EPSPs probably reflect antidromic activation of ascending collaterals of C(3)-C(4) PNs with monosynaptic connections to motoneurons; the EPSPs were significantly smaller than in the cat but larger than in the macaque. These results suggest that the positive correlation across species between more advanced hand function and the strength of the CM system is accompanied by a negative correlation between hand function and the strength of the PN system. We hypothesize that in primates with more advanced hand function, the CM system effectively replaces PN-mediated control. This would include a contribution to the control of reaching movements, which are said to be specifically under the control of the PN system in the cat, and we speculate that these differences may be related to the degree of dexterity exhibited by the different species. This interpretation of the results predicts that in man, where the CM system is highly developed, the PN system is unlikely to be responsible for significant transmission of cortical commands to upper limb motoneurons.

Animals↗

PubMed2001

Changes in muscles and tendons due to neural motor disorders: implications for therapeutic intervention.

Patients with an upper motor neurone syndrome (CP) suffer from many disabling primary symptoms: spasms, weakness, and loss of dexterity. These primary 'neurogenic' symptoms often lead to secondary disabilities, muscle contractures, and tertiary effects, bone deformations. A common symptom of CP is hypertonia, with the consequence that the involved muscles remain in an excessively shortened length for most of the time. As a normal reaction of the muscle tissue, the number of sarcomeres is reduced and the muscle fibers shorten permanently: a contracture develops. A possible second type of contracture is that normal muscle lengthening along with bone growth is affected. Current treatments for the secondary effects include (1) reduction of muscle force, (2) lengthening of the muscle fibers by serial plaster casts, and (3) surgical lengthening of tendons or aponeurosis. The choice of treatment depends on the cause of the functional deficit. Bone tissue also adapts itself to abnormal forces, especially in the growth period. The hypertonias or contractures of CP so may give rise to bone malformations that interfere with function (e.g. femur endorotation) or may reduce the action of muscles by changing the lever arm (e.g. ankle varus). Although prevention should always be preferred, a timely surgical intervention cannot always be avoided. The differences in treatment for the various groups require and justify an extensive laboratory investigation, including EMG recordings in gait, measurement of passive elastic properties, and long-term observation of the hypertonia.

Cerebral Palsy↗

PubMed2002

Impact of selective posterior rhizotomy on fine motor skills. Long-term results using a validated evaluative measure.

Suprasegmental effects following selective posterior rhizotomy have been frequently reported. However, few studies have used validated functional outcome measures to report the surgical results beyond 3 years. The authors analyzed data obtained from the McGill Rhizotomy Database to determine the long-term impact of lumbosacral dorsal rhizotomy on fine motor skills. The study population comprised children with debilitating spasticity who underwent SPR and were evaluated by a multidisciplinary team preoperatively, at 6 months and 1 year postoperatively. Quantitative standardized assessments of upper extremity function were obtained using the fine motor skills section of the Peabody Developmental Motor Scales (PDMS) test. Of 70 patients who met the entry criteria for the study, 45 and 25 completed the 3- and 5-year assessments, respectively. Statistical analysis demonstrated significant improvements in grasping, hand use, eye-hand coordination, and manual dexterity at 1 year after SPR. More importantly, all improvements were maintained at 3 and 5 years following SPR. This study supports that significant improvements in upper extremity fine motor function using the PDMS evaluative measure are present after SPR and that these suprasegmental benefits are durable.

Cerebral Palsy↗

PubMed2001

Telesurgical laparoscopic radical prostatectomy. Initial experience.

INTRODUCTION: Telepresence surgery offers theoretically to overcome two main problems of laparoscopic surgery, i.e. the limitation to only four degrees of freedom and the lack of stereovision. Since 1998, telesurgical minimally invasive procedures have been performed with the da Vinci system mainly for cardiac bypass surgery. Clinical experience in urology is still very limited. We want to present our initial experience using the device for robot-assisted laparoscopic radical prostatectomy. MATERIAL AND METHODS: The Intuitive surgical system consists of two main components: the surgeon's viewing and control console with 3D imaging and the surgical arm unit that positions and maneuvers detachable surgical instruments. These instruments introduced via two 8-mm trocars allow movements in all 6 degrees of freedom due to the EndoWrist technology. The surgeon performs the procedure seated at the console holding specially designed instruments. Highly specialized computer software and mechanics transfer the surgeon's hand movements exactly to the microsurgical movements of the manipulators at the operative site. We have used a semilunar-shaped 5-trocar arrangement with the robot's arms at the lateral trocars and two assistant trocars medially. A sixth trocar was used in the right suprapubic area for retraction of the gland. The left assistant used different instruments such as bipolar forceps, Ultracision, Endoclip, whereas the right assistant mainly used the suction-irrigation device. Except the first case, the Intuitive System was attached after exposure of Retzius' space. RESULTS: We have treated 6 patients (2 pT2, 4 pT3, median Gleason score 6). The OR time averaged 315 (242-480) min including pelvic lymph node dissection. No intraoperative complications occurred, 1 patient required transfusions. There were no positive margins, median catheter time was 5 days. 3 patients were completely continent after 1 month. CONCLUSION: Telerobotic laparoscopic surgery offers several advantages over all presently available techniques, such as all six degrees of freedom, dexterity enhancement, tremor filtering, and stereovision. There is a learning curve with the device, mainly because of the magnification, the 3D image and the lack of tactile feedback. However, only after a short period of time, the experienced surgeon is able to get familiar with the device. However, there are still concerns with respect to the high investment and running costs of the device as well as regarding the necessity of further developments of instruments for urological procedures.

Aged↗

PubMed2003

Cortical orofacial motor representation in Old World monkeys, great apes, and humans. II. Stereologic analysis of chemoarchitecture.

This study presents a comparative stereologic investigation of neurofilament protein- and calcium-binding protein-immunoreactive neurons within the region of orofacial representation of primary motor cortex (Brodmann's area 4) in several catarrhine primate species (Macaca fascicularis, Papio anubis, Pongo pygmaeus, Gorilla gorilla, Pan troglodytes, and Homo sapiens). Results showed that the density of interneurons involved in vertical interlaminar processing (i.e., calbindin- and calretinin-immunoreactive neurons) as well pyramidal neurons that supply heavily-myelinated projections (i.e., neurofilament protein-immunoreactive neurons) are correlated with overall neuronal density, whereas interneurons making transcolumnar connections (i.e., parvalbumin-immunoreactive neurons) do not exhibit such a relationship. These results suggest that differential scaling rules apply to different neuronal subtypes depending on their functional role in cortical circuitry. For example, cortical columns across catarrhine species appear to involve a similar conserved network of intracolumnar inhibitory interconnections, as represented by the distribution of calbindin- and calretinin-immunoreactive neurons. The subpopulation of horizontally-oriented wide-arbor interneurons, on the other hand, increases in density relative to other interneuron subpopulations in large brains. Due to these scaling trends, the region of orofacial representation of primary motor cortex in great apes and humans is characterized by a greater proportion of neurons enriched in neurofilament protein and parvalbumin compared to the Old World monkeys examined. These modifications might contribute to the voluntary dexterous control of orofacial muscles in great ape and human communication.

Animal Communication↗

PubMed2004

Robotics in colorectal surgery.

Minimally invasive surgery has been shown to offer many advantages to general surgical patients but has not been widely adopted for colorectal disease. Initial fears surrounding the oncological safety of laparoscopic colectomies have largely subsided but the technical challenges still remain. Surgical robots or telemanipulators present the laparoscopic surgeon with unrivaled dexterity and vision, which may allow colonic resections to be completed with greater ease. Although initial studies suggest promising results using currently available systems, it will take further time for patient benefits to be proven, therefore justifying the greater expense of operating with this new technology.

Colonic Diseases↗