RESUMO
Necrotizing fasciitis is a fulminant infection of the deeper layers of skin and subcutaneous tissues characterized by progressive soft tissue necrosis and high mortality. It rarely occurs in the head and neck area. The clinical picture includes non-specific but typical local and systemic symptoms. The treatment is a complex, multidisciplinary task which includes radical surgical exploration, debridement and drainage, empirically started and then targeted intravenous antibiotics and supportive therapy. Authors report a case of necrotizing fasciitis localized on the right side of the face which caused multi-organ failure and phlegmone of the neck.
Assuntos
Antibacterianos/uso terapêutico , Fasciite Necrosante/terapia , Mediastinite/diagnóstico , Mediastinite/patologia , Tomografia Computadorizada por Raios X/métodos , Desbridamento/métodos , Drenagem/métodos , Fasciite Necrosante/diagnóstico , Fasciite Necrosante/patologia , Feminino , Humanos , Masculino , Mediastinite/tratamento farmacológico , Mediastinite/cirurgia , Pessoa de Meia-Idade , Pescoço , Necrose , Sepse/epidemiologia , Sepse/etiologia , Resultado do TratamentoRESUMO
To uncover the functional topography of layer 6 neurons, optical imaging was combined with three-dimensional neuronal reconstruction. Apical dendrite morphology of 23 neurons revealed three distinct types. Type Aa possessed a short apical dendrite with many oblique branches, Type Ab was characterized by a short and less branched apical dendrite, whereas Type B had a long apical dendrite with tufts in layer 2. Each type had a similar number of boutons, yet their spatial distribution differed from each other in both radial and horizontal extent. Boutons of Type Aa and Ab were almost restricted to the column of the parent soma with a laminar preference to layer 4 and 5/6, respectively. Only Type B contributed to long horizontal connections (up to 1.5 mm) mostly in deep layers. For all types, bouton distribution on orientation map showed an almost equal occurrence at iso- (52.6 ± 18.8 %) and non-iso-orientation (oblique, 27.7 ± 14.9 % and cross-orientation 19.7 ± 10.9 %) sites. Spatial convergence of axons of nearby layer 6 spiny neurons depended on soma separation of the parent cells, but only weakly on orientation preference, contrary to orientation dependence of converging axons of layer 4 spiny cells. The results show that layer 6 connections have only a weak dependence on orientation preference compared with those of layers 2/3 (Buzás et al., J Comp Neurol 499:861-881, 2006) and 4 (Karube and Kisvárday, Cereb Cortex 21:1443-1458, 2011).
Assuntos
Axônios/fisiologia , Mapeamento Encefálico , Dendritos/fisiologia , Neurônios/citologia , Orientação/fisiologia , Córtex Visual/citologia , Análise de Variância , Animais , Biotina/análogos & derivados , Biotina/metabolismo , Gatos , Dendritos/ultraestrutura , Dextranos/metabolismo , Processamento de Imagem Assistida por Computador , Neurônios/classificação , Proteína Vesicular 2 de Transporte de Glutamato/metabolismoRESUMO
In the primary visual cortex (V1), Simple and Complex receptive fields (RFs) are usually characterized on the basis of the linearity of the cell spiking response to stimuli of opposite contrast. Whether or not this classification reflects a functional dichotomy in the synaptic inputs to Simple and Complex cells is still an open issue. Here we combined intracellular membrane potential recordings in cat V1 with 2D dense noise stimulation to decompose the Simple-like and Complex-like components of the subthreshold RF into a parallel set of functionally distinct subunits. Results show that both Simple and Complex RFs exhibit a remarkable diversity of excitatory and inhibitory Complex-like contributions, which differ in orientation and spatial frequency selectivity from the linear RF, even in layer 4 and layer 6 Simple cells. We further show that the diversity of Complex-like contributions recovered at the subthreshold level is expressed in the cell spiking output. These results demonstrate that the Simple or Complex nature of V1 RFs does not rely on the diversity of Complex-like components received by the cell from its synaptic afferents but on the imbalance between the weights of the Simple-like and Complex-like synaptic contributions.