Binocular differences in cortical receptive fields of kittens after rotationally disparate binocular experience.

Kittens were afforded visual experience only while wearing goggles fitted with prisms that rotated the inputs to the two eyes equally but in opposite directions about the visual axes (16 degrees for experimental subjects, 0 degrees for control subjects). Subsequently, receptive-field organization of the visual cortex was studied, special attention being given to the preferred orientation centered about the prism rotation experienced during early development. Thus, for moderate amounts of relative rotation, the development of interocular matching of orientation specificity in binocular cells of the visual cortex reflects the correspondence of early visual input between the two eyes.

Operant conditioning of single-unit response patterns in visual cortex.

Unit responses to photic stimuli were studied in cat visual cortex. After the baseline response pattern of a cell was determined, conditioning trials were given during which reinforcement was contingent upon increased firing during a selected segment of the poststimulus interval. Density of reinforcement increased substantially in about half the cells studied; significant increases in firing occurred within, but not outside, the criterion segment.

Intracardiac measurement of pre-ejection myocardial velocities estimates the transmural extent of viable myocardium early after reperfusion in acute myocardial infarction.

OBJECTIVES: We hypothesized that wall motion velocity during pre-ejection is proportional to the regional content of viable myocardium after reperfusion for acute myocardial infarction (AMI). BACKGROUND: Pre-ejection wall motion consists of short and fast inward and outward movement towards and away from the center of the left ventricle (LV) and is altered during regional ischemia. This short-lived event can be accurately quantified by Doppler myocardial imaging (DMI). METHODS: Fourteen open-chest pigs underwent 60 to 120 min of left anterior descending coronary artery occlusion followed by 30 min of reperfusion. The DMI data were collected using a phased-array intracardiac catheter (LV cavity) from ischemic and nonischemic myocardium encompassed within a plane passing through two epicardial bead markers. Peak tissue velocities during isovolumic contraction (IVC) (peak positive and peak negative), ejection (S) and early filling (E) were measured. The cardiac specimen was sliced through the epicardial markers in a plane approximating the ultrasound imaging plane. The transmural extent of necrosis (TEN) (%) was measured by triphenyltetrazolium chloride staining. RESULTS: During ischemia, positive IVC velocity was zero in ischemic walls with TEN >20%. At reperfusion, positive IVC velocity correlated better with TEN (r = -0.94, p < 0.0001) than it did S (r = -0.70, p < 0.01) and E (r = -0.81, p < 0.01). Differential IVC (the difference between peak positive and peak negative velocity) highly correlated with TEN, during ischemia (r = -0.78, p < 0.001) and during reperfusion (r = -0.93, p < 0.0001). CONCLUSIONS: Pre-ejection tissue velocity, as measured by intracardiac ultrasound, allows rapid estimation of the transmural extent of viable myocardium after reperfusion for AMI.

Application of a continuous regression model of restenosis to saphenous vein grafts after successful percutaneous transluminal coronary angioplasty or directional coronary atherectomy.

OBJECTIVES: To evaluate a quantitative model of restenosis in patients with vein graft disease undergoing percutaneous transluminal coronary angioplasty (PTCA) or directional coronary atherectomy (DCA). BACKGROUND: A quantitative relationship between acute gain and late loss has been developed to describe the late changes in lumen dimension after native vessel coronary intervention. This same relationship may also be seen after treatment of saphenous vein graft disease. METHODS: Patients with native coronary artery stenoses (CAVEAT-I) or saphenous vein graft lesions (CAVEAT-II) were randomized to either DCA or PTCA, and data from these trials were analyzed retrospectively. Angiographic results of the target lesions were reviewed, and each lesion was assessed for vessel caliber and reference diameter, absolute minimal lumen diameter, percent diameter stenosis, percent stenosis of the cross-sectional area, acute gain and late loss. Linear regression models were used to determine late loss and to detect differences in angiographic outcomes. RESULTS: Vein grafts had significantly larger reference vessel diameters than native coronary arteries; they also had significantly more acute gain and more late loss. Directional coronary atherectomy was associated with a larger acute gain in both studies. Patients undergoing DCA also experienced greater late loss although the effect was statistically significant only in the CAVEAT-I study. After adjusting for the acute gain, the treatment effect on late loss became nonsignificant in both studies. CONCLUSIONS: In patients undergoing DCA or PTCA of saphenous vein graft narrowings, the relationship between late loss and acute gain is also demonstrated, similar to the device-independent relationships seen in native coronary lesions. In CAVEAT-II, larger degrees of acute gain were also associated with higher degrees of late lumen loss.

Topography of projections to posterior cortical areas from the macaque frontal eye fields.

Frontal eye field (FEF) projections to posterior cortical areas were mapped by autoradiography of tritiated amino acids (Leu, Pro) in six macaque monkeys. In three monkeys, the large saccade part of the FEF (IFEF) was identified by microstimulation and injected with tracers. In a fourth monkey, the small saccade part of the FEF (sFEF) was identified by microstimulation and injected with tracer. Tracer injections were placed into the sFEF region of two other monkeys using anatomical landmarks. The IFEF and sFEF generally had distinct and largely segregated projections to posterior cortical areas, and the overall pattern of labeling in visual areas with established topology indicates that IFEF neurons preferentially project to areas having large and eccentric receptive fields, whereas sFEF neurons project to areas having smaller, more centrally located fields. The terminal fields from the sFEF were more widespread than those from IFEF. Projections from sFEF terminated in the lateral intraparietal area (LIP), the ventral intraparietal area (VIP), and the parietal part of visual area V3A, in the fundus of the superior temporal visual area (FST), the middle temporal area (MT), the medial superior temporal area (MST), the temporal part of visual area V4, the inferior temporal area (IT), and the temporal-occipital area (TEO) and in occipital visual areas V2, V3, and V4. Projections from IFEF terminated in parietal areas 7a, LIP, and VIP and the medial part of parietal area PE; in temporal areas MST and the superior temporal polysensory area (STP); and in occipital area V2 and posterior cingulate area 23b. Projections from IFEF and sFEF appeared to terminate in different parts of common target areas in MST, LIP, and V2. The topography of IFEF and sFEF projections to LIP suggests that this posterior eye field may also be organized by saccade amplitude. Most terminal labeling from FEF injections was bilaminar to layers I and V/VI, but labeling in area LIP, area MT, the medial part of area PE, and area 23b was columnar-form to all layers.

Frontal eye field efferents in the macaque monkey: I. Subcortical pathways and topography of striatal and thalamic terminal fields.

Anterograde tracers (tritiated leucine, proline, fucose; WGA-HRP) were injected into sites within the frontal eye fields (FEF) of nine macaque monkeys. Low thresholds (less than or equal to 50 microA) for electrically evoking saccadic eye movements were used to locate injection sites in four monkeys. Cases were grouped according to the amplitude of saccades evoked or predicted at the injection site. Dorsomedial prearcuate injection sites where large saccades were elicited were classified as lFEF cases, whereas ventrolateral prearcuate sites where small saccades were evoked were designated sFEF cases. One control case was injected in the medial postarcuate area 6. We found five descending fiber bundles from FEF; fibers to the striatum, which enter the caudate nucleus at or just rostral to the genu of the internal capsule; fibers to the claustrum, which travel in the external capsule; and transthalamic, subthalamic, and pedunculopontine fibers. Our results indicate that transthalamic and subthalamic pathways supply all terminal sites in the thalamus, subthalamus, and tegmentum of the midbrain and pons, whereas pedunculopontine fibers appear to terminate in the pontine and reticularis tegmenti pontis nucleus exclusively. Frontal eye field terminal fields in the striatum were topographically organized: lFEF projections terminated dorsal and rostral to sFEF projections. Thus, lFEF terminal fields were located centrally in the head and body of the caudate nucleus and a small dorsomedial portion of the putamen, whereas sFEF terminal fields were located in ventrolateral parts of the caudate body and ventromedial parts of the putamen. In the claustrum, lFEF projections terminated dorsal and rostral to sFEF projections. Projections from FEF terminated in ventral and caudal parts of the subthalamic nucleus without a clear topography. By comparison, terminal fields from medial postarcuate area 6 were located more caudally and laterally in the striatum and claustrum than projections from FEF, and more centrally in the subthalamic nucleus. In the thalamus, FEF terminal patches in some thalamic nuclei were also topographically organized. Projections from lFEF terminated in dorsal area X, dorsolateral medial dorsal nucleus, pars parvicellularis (MDpc), and the caudal pole of MDpc, whereas projections from sFEF terminated in ventral area X, medial dorsal nucleus, pars multiformis, and caudal medial dorsal nucleus pars densocellularis.(ABSTRACT TRUNCATED AT 400 WORDS)

Frontal eye field efferents in the macaque monkey: II. Topography of terminal fields in midbrain and pons.

Frontal eye field (FEF) projections to the midbrain and pons were studied in nine macaque monkeys that were used to study FEF projections to the striatum and thalamus (Stanton et al.: J. Comp. Neurol. 271:473-492, '88). Injections of tritiated amino acids or WGA-HRP were made into FEF cortical locations where low-level microstimulation (less than or equal to 50 microA) elicited saccadic eye movements, and anterograde axonal labeling was mapped. The injections were made into the anterior bank of the arcuate sulcus from dorsomedial sites where large saccades were evoked (lFEF) to ventrolateral sites where small saccades were evoked (sFEF). The largest terminal fields of FEF fibers were located in the ipsilateral superior colliculus (SC). Projections to SC were topographically organized: lFEF sites projected to intermediate and deep layers of caudal SC, sFEF sites projected to intermediate and superficial layers of rostral SC, and FEF sites between these extremes projected to intermediate locations in SC. Patches of terminal labeling were located ipsilaterally in the lateral mesencephalic reticular formation near the parabigeminal nucleus and the ventrolateral pontine reticular formation. These patches were larger from lFEF injections. Small, dense terminal patches were seen in the ipsilateral pontine gray, mostly along the medial and dorsal borders of these nuclei but occasionally in central and dorsolateral regions. Patches of label like those in the pontine nuclei were located ipsilaterally in the reticularis tegmenti pontis nucleus in lFEF cases and bilaterally in sFEF cases. Small terminal patches were found in the nucleus of Darkschewitsch and dorsal and medial parts of the parvicellular red nucleus in most FEF cases. In the pretectal region, labeled terminal patches were consistently found in the nucleus limitans of the posterior thalamus, but we could not determine if label in the nucleus of the pretectal area and dorsal parts of the nucleus of the posterior commissure marked axon terminals or fibers of passage. We found small, lightly labeled terminal patches in the pontine raphe between the rootlets of the abducens nerve (three cases) or in the adjacent paramedian pontine reticular formation (one case). Omnipauser cells in this region are important in initiating saccades. In one sFEF case, very small patches of label were located in the supragenual nuclei anterior to the abducens nuclei and in the ipsilateral nucleus prepositus hypoglossi posterior to the abducens nucleus. Presaccadic burster neurons in the periabducens region are known to fire immediately before horizontal saccades.(ABSTRACT TRUNCATED AT 400 WORDS)

Topography of projections to the frontal lobe from the macaque frontal eye fields.

Efferents from the frontal eye fields (FEF) to the ipsilateral frontal lobe were studied by autoradiography of tritiated tracers (leucine, proline, and fucose) in seven macaque monkeys that were used previously to describe subcortical connections. In four of the cases, tracer injection sites were confirmed by low thresholds for the electrical elicitation of saccadic eye movements. Cases were grouped as lFEF of sFEF cases according to large or small saccades that were characteristic of the injection site. Projections from the FEF terminated in five frontal regions: 1) area FD on the dorsomedial convexity; 2) area FC (containing SEF) medial to the upper limb of the arcuate sulcus; 3) areas FD and FD delta along the walls of the principal sulcus; 4) area FCBm on the deep, posterior wall of the arcuate sulcus inferior to the sulcal spur; and 5) the inferolateral cortex (area FDi) on the convexity and lateral two thirds of the anterior wall of the arcuate sulcus. Projections in sFEF cases tended to be confined to medial parts of dorsomedial FD and FC and the lateral wall of the principal sulcus and inferolateral convexity. Neither lFEF nor sFEF appeared to project to the SMA or pericingulate cortex. Label in these areas was found only in the cases in which tracer spread into non-FEF areas. FEF projections terminated in column-like patches of about 500-600 microns in diameter. Labeled axons and terminals were seen in all cortical layers regardless of location in the frontal lobe.

Intracardiac Doppler hemodynamics and flow: new vector, phased-array ultrasound-tipped catheter.

Comprehensive intracardiac Doppler examination under simultaneous direct ultrasound visualization has not been previously possible. This human feasibility study demonstrates that a new 10Fr, 3.2-mm diameter, 5.5- to 10-MHz frequency agile, phased, vector array, ultrasound-tipped catheter with 4-way tip articulation provides diagnostic, high-quality, intracardiac Doppler signals using pulsed and continuous-wave, color flow, and tissue Doppler.

Determinants of infarct size after thrombolytic treatment in acute myocardial infarction.

Both experimental and single-center clinical studies have shown that myocardium at risk, residual collateral flow, and duration of coronary occlusion are important determinants of final infarct size. The purpose of this study was to replicate these results on a multicenter basis to demonstrate that perfusion imaging using different camera and computer systems can provide reliable assessments of myocardium at risk and collateral flow. Sequential tomographic myocardial perfusion imaging with technetium-99 (Tc-99m) sestamibi was performed in 74 patients with first time myocardial infarction, who were enrolled in a multicenter, randomized, double-blind, placebo-controlled pilot study of poloxamer 188 as ancillary therapy to thrombolysis. All patients underwent thrombolysis within 6 hours of the onset of chest pain. Tc-99m sestamibi was injected intravenously at the initiation of thrombolytic therapy, and tomographic imaging was performed 1 to 6 hours later to assess myocardium at risk. Collateral flow was estimated noninvasively from the acute sestamibi images by 3 methods that assess the severity of the perfusion defect. Final infarct size was determined at hospital discharge by a second sestamibi study. Myocardium at risk (r = 0.61, p <0.0001) and radionuclide estimates of collateral flow (r = 0.58 to 0.66, all p <0.0001) were significantly associated with final infarct size. These associations were independent of the treatment center. On a multivariate basis, myocardium at risk (p = 0.003), the radionuclide estimate of collateral flow (p = 0.03), and treatment arm (p = 0.04) were all independent determinants of infarct size. Time to thrombolytic therapy showed only a trend (p = 0.10). The treatment center was not significant (p = 0.42). Myocardium at risk and collateral flow are important determinants of infarct size that are independent of treatment center. Tomographic imaging with Tc-99m sestamibi can provide noninvasive assessments of these parameters in multicenter trials of thrombolytic therapy.

Newer advances in the diagnosis and treatment of mitral stenosis.

There have been significant changes in presentation, diagnosis, and therapy of patients with mitral stenosis. Both the prevalence of mitral stenosis, as well as the type of patient now with mitral stenosis, have changed significantly over the past few decades. In patients with mitral stenosis two-dimensional and Doppler echocardiography have become the diagnostic modalities of choice. The advent of percutaneous mitral balloon valvotomy now provides a nonsurgical approach for the treatment of selected patients with mitral stenosis.

A comparison of survival at different degrees of hemorrhagic shock in germ-free and germ-bearing rats.

We have previously reported superior survival after one level of hemorrhagic shock in germ-free (GF) rats compared with germ-bearing (GB) rats. The objective of this study was to determine the effect of the GF state on survival at different degrees of hemorrhagic shock. GF and GB rats were bled to a mean arterial blood pressure of 30 mmHg. Shock was terminated after 10, 20, 40, or 80% of the maximum shed blood volume was reabsorbed spontaneously. Both shock time and time to decompensation were significantly longer in GF rats (p < .05). Comparative survival was greater for GF rats at most levels of shock (p < .01). This superiority in survival was greatest at moderate shock levels and decreased at severe shock levels. There may be several reasons for the increased tolerance of GF animals to hemorrhagic shock such as metabolic or immunologic variations. It is hard to avoid the fact, however, that the most notable difference between the GF and GB rat is the presence or absence of bacteria.

The effect of cocaine on the physiologic response to hemorrhagic shock.

BACKGROUND: Bradycardia is thought to be an uncommon and abnormal response to acute blood loss. A review of trauma patients (n = 84) admitted during a 1-year period with a systolic blood pressure of less than 100 mm Hg revealed that 45% had relative bradycardia (heart rate < 100 beats/minute). Cocaine use was recorded more often in this group (76% versus 26%; p < 0.05) compared with patients with tachycardia (heart rate > or = 100 beats/minute). We investigated the effect of cocaine use on the response to acute blood loss in an animal model of hemorrhagic shock. METHODS: Rats were given intraperitoneal cocaine 20 mg/kg/day for 14 days (n = 10) or saline solution (n = 10). The rats were bled until 30% of their blood volume was shed; they were resuscitated 30 minutes later. RESULTS: Cocaine-treated rats showed a decreased 24-hour survival rate (50% versus 100%; p < 0.05), a relative bradycardic response compared to baseline heart rate (-8.9% +/- 6.4% versus 7.5% +/- 3.5%; p < 0.05), and a greater drop in mean arterial blood pressure (-55.5% +/- 4.8% versus -37.0% +/- 5.5%; p < 0.05) by 5 minutes of shock. Cocaine-treated rats were more acidotic after shock compared to controls (pH 7.36 +/- 0.03 versus 7.44 +/- 0.02; p < 0.05). CONCLUSIONS: Cocaine had a deleterious effect on experimental hemorrhage. The bradycardic response observed in our trauma patients may be due, in part, to cocaine abuse, and we postulate that chronic cocaine use alters the normal adrenergic response to blood loss.

Fixed left ventricular outflow tract obstruction in presumed hypertrophic obstructive cardiomyopathy: implications for therapy.

BACKGROUND: A subset of patients presenting with a presumed diagnosis of hypertrophic obstructive cardiomyopathy (HOCM) have a fixed left ventricular outflow tract (LVOT) obstruction. Recognition of this pathophysiologic abnormality is important in choosing therapy. METHODS: Of patients referred for treatment of HOCM, 4 had fixed LVOT obstruction. Clinical and echocardiographic data and surgical findings were reviewed. RESULTS: In the 4 patients with clinical features consistent with HOCM or HOCM-like conditions, echocardiography showed fixed LVOT obstruction with an early-peaking LVOT Doppler signal or absence of severe systolic anterior motion of the mitral valve. The causes of fixed obstruction included accessory mitral tissue with associated fibrous ring (1 patient), fixed subaortic tunnel stenosis (2 patients), and a discreet subaortic ridge (1 patient). After surgical relief of the fixed LVOT obstruction, all patients had relief of the ventricular outflow tract gradient. CONCLUSIONS: Not all patients with a presumed diagnosis of HOCM have isolated dynamic LVOT obstruction but may have isolated or additional fixed obstruction. Careful two-dimensional and Doppler echocardiography are needed to identify this subset of patients who are best treated surgically.

Somatosensory cortex in macaque monkeys: laminar differences in receptive field size in areas 3b and 1.

We have examined receptive field sizes of neurons in granular, supragranular and infragranular layers within somatosensory cortical areas 3b and 1 in macaque monkeys. Receptive fields of neurons in layer 4 are smaller than receptive fields of neurons above or below layer 4. In addition, neurons in area 1 have larger receptive fields than neurons in corresponding layers of area 3b.

Intracardiac echocardiography: newest technology.

Intracardiac echocardiography, defined as ultra-sonographic navigation and visualization within large blood-filled cavities or vessels of the cardio-vascular system, has recently undergone refinement as a clinical tool through technologic advances in transducer miniaturization. Intra-cardiac ultra-sound catheters image at lower frequencies than current conventional intravascular ultrasound catheters used for intracoronary imaging. The lower imaging frequency enables greater tissue penetration, permitting whole-heart evaluation from a right-sided catheter position. Newer devices are steerable, have variable imaging frequency (5.5 to 10 MHz), and full Doppler capability (pulsed, continuous wave, and tissue Doppler). These advances have made intracardiac high-resolution imaging as well as hemodynamic assessment possible. A historical perspective, current capabilities and limitations, and potential clinical and research applications of this new imaging technique are discussed.

Feasibility study: transesophageal echocardiography with a 10F (3.2-mm), multifrequency (5.5- to 10-MHz) ultrasound catheter in a small rabbit model.

Transesophageal echocardiography (TEE) is useful in children with congenital heart defects. However, because of available probe size (>/=7 mm diameter), its use is limited to patients weighing more than 3 kg. The aim of this study was to determine the feasibility of TEE in a small animal model by using a 10F (3.2-mm) intravascular ultrasound tipped catheter with a monoplane (longitudinal) 5.5- to 10-MHz phased vector array transducer. Ten New Zealand White rabbits (400 to 3400 g; mean 1580 g) underwent TEE. With animals under general sedation, the probe was blindly introduced into the esophagus. All intracardiac and extracardiac structures were examined, and the images were stored and independently reviewed. All pertinent intracardiac and extracardiac structures were identified except in the 3 smallest rabbits (400 to 600 g). Doppler hemodynamics and color Doppler were possible in each animal. Frequency agility (5.5 to 10 MHz) facilitated optimization of image resolution and penetration. Certain transgastric, 4-chamber, and short-axis views were limited because of the monoplane array. No overt adverse effects were associated with the procedure. Diagnostic TEE can be performed in a small animal model with a 10F, 5.5- to 10-MHz phased vector array ultrasound catheter. Our study suggests that this system has potential in performing diagnostic TEE safely in small, even premature, neonates.

Personal ultrasound imager: abdominal aortic aneurysm screening.

BACKGROUND: Miniaturized ultrasonographic machines (2.5-MHz curved-array transducer connected to a compact 2.6-kg console), termed personal ultrasound imagers (PUIs), may enable detection of occult abdominal aortic aneurysms (AAAs). OBJECTIVES: Our goals were to determine whether a PUI is capable of screening for AAAs and to compare the results with an established screening examination with standard echocardiography (SE). METHODS: One hundred twenty-five patients (aged >70 years) with hypertension who were referred for transthoracic echocardiography were enrolled. After SE, a focused screening with a PUI examination was performed by a blinded sonographer. An AAA was defined as a focal enlargement of the aorta >30 mm. Results and the length of time to image the aorta were compared for both tests. RESULTS: We studied 64 men and 61 women (aged 76.8 +/- 5 years; mean blood pressures: systolic 145.7 +/- 18 and diastolic 78.6 +/- 10; body surface area 1.9 +/- 0.2 m(2)). The mean time for SE was 2.9 +/- 1.5 minutes and for the PUI examination was 4.6 +/- 2.3 minutes. By using SE as the gold standard, the sensitivity and specificity of the PUI were 91% and 96%, respectively. The positive predictive value of the PUI was 71%, and the negative predictive value was 99%. CONCLUSION: A PUI can be used to screen for occult AAAs as an extension of the physical examination. Results are comparable to an established screening strategy that uses more expensive, nonportable echocardiographic equipment.

Cerebral cortical activity associated with the orientation of visual attention in the rhesus monkey.

Attentional mechanisms in the posterior parietal cortex and the frontal eye fields have been studied in the rhesus monkey. In each of these areas single neurons discharge in response to visual stimuli and the discharge is enhanced when the monkey makes a saccade to the stimulus. In the posterior parietal cortex this enhancement also occurs whenever the monkey attends to the target, regardless of the movement or nonmovement that the monkey might make. Conversely, neurons in the frontal eye fields give enhanced responses only before saccades, and some discharge before purposive saccades made to remembered targets, with no overt current visual guidance. Some cells in the frontal eye fields also anticipate the onset of predictable saccades.

Segmenting high-frequency intracardiac ultrasound images of myocardium into infarcted, ischemic, and normal regions.

Segmenting abnormal from normal myocardium using high-frequency intracardiac echocardiography (ICE) images presents new challenges for image processing. Gray-level intensity and texture features of ICE images of myocardium with the same structural/perfusion properties differ. This significant limitation conflicts with the fundamental assumption on which existing segmentation techniques are based. This paper describes a new seeded region growing method to overcome the limitations of the existing segmentation techniques. Three criteria are used for region growing control: 1) Each pixel is merged into the globally closest region in the multifeature space. 2) "Geographic similarity" is introduced to overcome the problem that myocardial tissue, despite having the same property (i.e., perfusion status), may be segmented into several different regions using existing segmentation methods. 3) "Equal opportunity competence" criterion is employed making results independent of processing order. This novel segmentation method is applied to in vivo intracardiac ultrasound images using pathology as the reference method for the ground truth. The corresponding results demonstrate that this method is reliable and effective.