Histopathologic and physiologic effects of chronic implantation of microelectrodes in sacral spinal cord of the cat.

Active microelectrodes were implanted for a period of 2 weeks to 3 months into the sacral spinal cord of 10 male cats in order to test the feasibility and the safety of discrete stimulation of the parasympathetic preganglionic nucleus for future clinical applications of microelectrode technology in micturition control. An array of four 50 microns-diameter iridium microelectrodes was inserted beneath the dura in each cat. At weekly intervals, bladder pressure was measured as hydrostatic pressure on an intraluminal catheter. At the end of the period, histopathology was evaluated with serial transverse epoxy sections. Observations included diffuse and focal axonal degeneration in white matter and possible neuronal loss around the electrode in the gray matter, meningeal ensheathment of the shafts, and occasional aseptic inflammation of tissue and apparent movement of the electrodes after implantation. Increased bladder pressure responses to individually pulsed electrodes located within the sacral parasympathetic nucleus were not consistent, and, surprisingly, at least 2 different sites were also effective. As long as 3 months after implantation, in 2 out of 5 animals, pulsing of electrodes consistently produced micturition. We conclude that while microelectrode implants are feasible, further modifications in electrode design are needed to eliminate movement and inflammation.

Severe COPD and acute respiratory failure. Correlates for survival at the time of tracheal intubation.

The recognition of a reversible cause for acute respiratory failure (ARF) is frequently difficult in patients with severe chronic obstructive pulmonary disease (COPD). We sought to identify clinical findings present at the time of tracheal intubation that were associated with successful weaning and short-term survival among a population of male veterans with severe COPD. Over a 5-year period (1987 to 1991), 39 episodes of ARF requiring mechanical ventilation (MV) were identified in 33 men with severe COPD. All the patients had a baseline FEV1 < 1 L. Univariate analysis suggested a higher serum albumin level and absence of pulmonary infiltrates on chest radiography distinguished survivors (weaned from MV for 72 h) from nonsurvivors (died while undergoing MV or within 72 h of weaning). Multivariate analysis revealed the absence of pulmonary infiltrates on initial chest radiography was the strongest correlate for survival. To examine the significance of these correlates in ARF complicating milder COPD, 19 patients with lesser degrees of chronic airways obstruction and ARF were also studied. Unlike patients with severe COPD, the presence or absence of pulmonary infiltrates on chest radiography was not correlated with survival in patients with milder chronic airways obstruction. Analyzing all COPD patients with ARF, the mortality risk associated with the presence of pulmonary infiltrates on chest radiography increased dramatically with declining baseline lung function. Mortality risk ratio analysis revealed the greatest likelihood for survival was predicted by a higher baseline FEV1 and the absence of pulmonary infiltrates on chest radiography. The extent of baseline airways obstruction alone was not correlated with short-term survival in either group. These observations suggest that in the subset of patients with severe COPD and ARF, the presence of pulmonary infiltrates on chest radiography at the time of tracheal intubation may be associated with less likelihood for survival. An exacerbation of COPD may infrequently be the terminal illness in these patients.

Cutaneous blastomycosis as a complication of transthoracic needle aspiration.

A patient with an ill defined density in the left upper lobe underwent transthoracic needle aspiration. A diagnosis of Blastomyces dermatitidis was made from the aspiration. The patient later returned with a cutaneous ulcer at the site of needle aspiration. B dermatitidis was subsequently recovered from the skin lesion.

Subacute disseminated mucormycosis in a diabetic male.

Mucormycosis is an opportunistic invasive infection caused by fungi of the order Mucorales. Rhizopus, Absidia, and Mucor are the most commonly encountered genera. Disease is characterized by vascular invasion, thrombosis, and tissue necrosis. Rhinocerebral disease is the most common manifestation but pulmonary, cutaneous, gastrointestinal, and widely disseminated forms have been reported. Pulmonary and disseminated disease are usually seen in neutropenic patients with leukemia or lymphoma. Both present as fever and unexplained pulmonary infiltrates unresponsive to antibacterials and corticosteroids. Disease is usually fulminant and has a high mortality rate. Diagnosis is most commonly made at autopsy. A single case of disseminated disease is reported that is unusual in its subacute course and its occurrence in an otherwise healthy non-neutropenic diabetic male.

A review of the physiological significance of hypertonic body fluids on feed intake and ruminal function: salivation, motility and microbes.

Mechanisms exist in the ruminant to detect changes in osmolality and volume of plasma during feeding to maintain fluid and electrolyte homeostasis. Feed intake during a meal can be limited by the rise in osmolality of ruminal fluid, which is sensed in the wall of the rumino-reticulum. Ruminal microbes appear to be resilient to the short-term changes in ruminal fluid tonicity, but in vitro growth rates are inhibited when the tonicity of the culture medium is increased beyond physiological levels. Although mixing contractions of the rumen are not inhibited by the normal increases in tonicity of ruminal fluid, time to first rumination is increased. This aspect of motility requires further research. The tonicity of plasma increases toward the end of a large meal as a consequence primarily of absorption of VFA and Na+ from the rumen and fluid shifts into the gut. This hypertonicity is sensed centrally to inhibit parotid secretion by a reduction in the parasympathetic stimulation to the gland. Increases in animal production may result from future research directed toward developing ways of counteracting these negative effects of hypertonicity in body fluids on feed intake and ruminal function.

Validation of the AmpFlSTR Profiler Plus PCR amplification kit for use in forensic casework.

According to TWGDAM guideline 4.5 (1), prior to implementing a new DNA analysis procedure or an existing DNA analysis procedure developed by another laboratory, the forensic laboratory must first demonstrate reliability of the procedure in-house. Seven phases were designed to validate the use of the AmpFlSTR Profiler Plus PCR Amplification Kit, as well as the PE Applied Biosystems 310 Genetic Analyzer. This report summarizes the results obtained for each of the seven phases of the validation study which included the following evaluations: polymer, reproducibility, sensitivity, stutter, precision, mixtures and nonprobative casework.

Factors affecting the voluntary intake of food by sheep. 5. The inhibitory effect of hypertonicity in the rumen.

The site where osmotically active substances act to depress food intake was determined in sheep. After 5.5 h of food deprivation, solutions of sodium chloride or polyethylene glycol-200 (PEG-200) were added to either the reticulo-rumen or the abomasum. The sheep were then immediately offered pelleted lucerne (Medicago sativa). Water was withheld during the first 60 min of feeding but was available from 60 to 90 min. There was a linear inhibition in food intake in the first 10 min after loading 2.37, 6.25, 12.5, 25.0 or 50.0 g NaCl into the rumen according to a 5 x 5 Latin square design (P = 0.0001). The intake reduction was 3.49 g food/g NaCl. An osmotic load of PEG-200 equivalent to 50 g NaCl also significantly inhibited food intake in the first 10 min of the meal compared with a control treatment. The inhibition of food intake after loading 55 g NaCl into the rumen was not affected by injecting lidocaine hydrochloride into the reticulum immediately before NaCl loading. NaCl injected into the abomasum did not significantly affect food intake in the first 10 min of feeding even though the tonicity of abomasal digesta was increased to unphysiological levels. There was no consistent relationship between food intake and the change in the tonicity of jugular plasma following solute loading and drinking. The sensing site of hypertonicity was localized to the wall of the reticulo-rumen where neuronal receptors appear to be capable of detecting osmotic pressure within the physiological range to depress food intake. These receptors should be identified and characterized because of their possible significance in limiting food intake by ruminants.

Nonlinear stretch reflex interaction during cocontraction.

1. We investigated the role of stretch reflexes in controlling two antagonist muscles acting at the interphalangeal joint in the normal human thumb. Reflex action was compared when either muscle contracted alone and during cocontraction. 2. The total torque of the flexor pollicis longus (FPL) and extensor pollicis longus (EPL) muscles was measured in response to an externally imposed extension of the interphalangeal joint. The initial joint angle and the amplitude of the extension were constant in all experiments, and the preload of the active muscle(s) was varied. Joint torque was measured at the peak of short-latency stretch reflex action during contraction of the FPL alone, contraction of the EPL alone, and during cocontraction. Incremental joint stiffness was calculated as the change in torque divided by the change in angle. 3. Incremental stiffness increased in proportion to the preload torque during single muscle contractions of either the FPL (lengthening disturbances) or the EPL (shortening disturbances). Thus stiffness was not regulated to a constant value in the face of varying loads for either single muscle stretch or release. 4. Incremental stiffness varied across the range of cocontraction levels while the net torque was maintained at approximately 0. Thus net torque alone did not determine the stiffness during cocontraction. 5. The contributions of each muscle to the net intrinsic torque during cocontraction were estimated by scaling the individual muscles' responses so that their sum gave the best fit (in a least-squares sense) to the cocontraction torque before reflex action. The solution is unique because the individual torques have opposite signs, but the stiffnesses add. This gave estimates of the initial torques of both muscles during cocontraction. 6. The contributions of the two muscles during cocontraction were used to estimate the active joint stiffness that would be expected if the two muscles were activated independently to the same levels as in the cocontraction trials. The stiffness measured at the peak of stretch reflex action during cocontraction trials differed from the sum of the stiffnesses of the two muscles when they were contracting alone. At low cocontraction levels, the measured stiffness was less than expected on the basis of summation of the action of the two muscles, whereas at high cocontraction levels, the measured stiffness was greater than expected. This demonstrates that there is nonlinear stretch reflex interaction. That is, reflex action for a pair of antagonists is not simply the linear sum of the reflex actions of the two muscles acting independently.(ABSTRACT TRUNCATED AT 400 WORDS)

The effect of feeding frequency and meal size on amounts of total and parotid saliva secreted by sheep.

Total and unilateral parotid saliva production during eating were measured in response to offering sheep a fixed amount of lucerne (Medicago sativa) hay as one, two, four or eight meals. Total saliva measurements were obtained using sham-fed oesophageal-fistulated sheep. Unilateral parotid saliva was collected from sheep fitted with reversible re-entrant cannulas. Dry matter intakes and eating times were measured for each meal but were not constrained to particular values. Total and unilateral parotid saliva production during eating increased linearly with the log of the number of meals (P = 0.0001). The amounts corresponding to one, two, four and eight meals of lucerne hay were 1553, 1737, 1851 and 2087 ml during total collections and 209, 248, 307 and 352 ml during unilateral parotid collections. The time-period spent eating and the amount of food consumed both increased as meal number increased. Total saliva collections when lucerne hay was sham-fed as one, two, four or eight meals were associated with eating times of 56.9, 57.4, 70.8 and 86.0 min and intakes of 562, 622, 629 and 638 g dry matter respectively. For unilateral parotid collections, eating times and dry matter intakes were 64.2, 71.3, 78.0, 82.1 min and 515, 579, 614 and 627 g for one, two, four and eight meals of lucerne hay respectively. The saliva production response appeared to be determined through the effects of the time-period spent eating and amounts consumed, but other undetermined effects of feeding frequency contributed to the response. The importance of meal duration on total saliva production was assessed by sham-feeding of 800 g lucerne as stem, leaf, hay, chopped hay or ground and pelleted hay. Increasing meal duration by feeding with stems resulted in the production of 1808 ml saliva, whereas the rapid consumption of pellets resulted in only 442 ml being produced.

Parotid secretion patterns during meals and their relationships to the tonicity of body fluids and to gastrin and pancreatic polypeptide in sheep.

The flow pattern of unilateral parotid saliva in sheep was compared when a total of 800 g lucerne (Medicago sativa) hay was offered as one, two, four or eight distinct meals. These patterns were related to changes in the tonicity of rumen fluid and plasma and to plasma concentrations of gastrin and pancreatic polypeptide. Sheep having ad lib access to hay overnight were offered fresh hay from 08.00 to 09.00 hours and were then given one, two, four, or eight meals of fresh hay according to a schedule such that the mean deprivation period was 6.5 h for each meal frequency-size. Neither the peak in saliva flow rate nor the time of this peak differed among the different meal sizes. The flow rate decreased rapidly after reaching a maximum at 3.2 min into the meal. After 7 min of eating, the tonicity of plasma and rumen fluid had increased by only 2.2 and 8.2 mosmol/kg respectively. These increases would not cause the rapid decline in parotid flow observed after 3.2 min of eating. There was no postprandial change in the concentration of gastrin in jugular plasma. However, it did increase significantly (P = 0.0043) from 16 to 4 min before eating commenced. There was a postprandial peak in plasma pancreatic polypeptide concentration after 4.5 min of eating. However, the parotid flow rate remained low after the concentration of this peptide returned to prefeeding levels. The rapid decrease in parotid secretion rate observed early in the meal may be due to subsiding central excitation rather than to an inhibitory factor limiting production.

Stiffness regulation by reflex action in the normal human hand.

1. The torque and electromyographic (EMG) responses to stretch of the first dorsal interosseous muscle (externally imposed joint rotation) were recorded in five normal human subjects. The total measured stiffness was decomposed into three individual stiffness components; passive, intrinsic, and reflex. 2. The passive component was measured with the subject relaxed. Compared with the total response at the height of short latency reflex action, the passive component comprised 6-32% of the total stiffness recorded at an initial torque level of 20 N-cm [15-39% maximum voluntary contraction (MVC)]. The passive response also reflected a significant acceleration component during rapid joint rotation due primarily to digit inertia. 3. The intrinsic stiffness component, attributed to the mechanical properties of the active muscle fibers, was estimated by recording the response to joint rotation with the muscle activated in a distributed manner using a single intramuscular electrode. The dynamic stiffness (measured at the end of a ramp displacement) and the static stiffness (measured 1 s after onset of the displacement) both scaled in a straight-line manner with the initial torque level. This relationship held whether the initial torque level was varied by changes in recruitment or temporal summation. 4. The reflex component was calculated by subtracting the passive and the estimated intrinsic component from the total response. The timing of the EMG signal recorded during measurement of the total response and the fact that the estimated intrinsic component matched the total active response over the first 65-100 ms after displacement onset supported the case that this was the true reflex component. The peak of the reflex activity occurred 155-360 ms after displacement onset and, at this peak, accounted for 18-44% of the total stiffness (at an initial torque level of 20 N-cm). 5. Over the low to intermediate torque range employed, we observed that both intrinsic muscle stiffness and total stiffness increased with initial torque. Because total stiffness increased more rapidly than intrinsic stiffness, the difference between them (equal to reflex stiffness) also increased with initial torque. Furthermore, when the total active response trials (passive stiffness removed) were shifted vertically so that the initial torque levels matched, it was seen that reflex action did not reduce the stiffness range to less than the stiffness range encountered for the intrinsic response alone.(ABSTRACT TRUNCATED AT 400 WORDS)

Clinical presentation, radiographic findings, and diagnostic methods of pulmonary blastomycosis: a review of 100 consecutive cases.

BACKGROUND: We sought to determine the relationship among radiographic findings, clinical presentation, and diagnostic testing of pulmonary blastomycosis. METHODS: We reviewed the medical records of 100 consecutive patients with pulmonary blastomycosis. RESULTS: Air-space infiltrates were the usual radiographic finding of pulmonary blastomycosis. Mass-like infiltrates were associated more with chronic than acute presentations. Air-space and mass-like infiltrate were predominately involved in the upper lobes. Sputum analysis made the initial diagnosis of blastomycosis most often. Acute and chronic presentations were not different between immunosuppressed patients and the remainder of the patients. In addition, infiltrates on chest radiographs in immunosuppressed patients were similar to the other patients. CONCLUSIONS: In an endemic area, pulmonary blastomycosis should be considered for any pulmonary infiltrate, especially in the upper lobes. Sputum analysis in most cases aids in the diagnosis, but bronchoscopy and/or tissue biopsy should be considered if the suspicion of blastomycosis is high and sputum analysis is inconclusive, negative, or not possible. Follow-up with chest radiographs after antifungal therapy is reasonable until complete resolution or fibrotic changes in patients with pulmonary blastomycosis.

Stability of the interface between neural tissue and chronically implanted intracortical microelectrodes.

The stability of the interface between neural tissue and chronically implanted microelectrodes is very important for obtaining reliable control signals for neuroprosthetic devices. Stability is also crucial for chronic microstimulation of the cerebral cortex. However, changes of the electrode-tissue interface can be caused by a variety of mechanisms. In the present study, intracortical microelectrode arrays were implanted into the pericruciate gyrus of cats and neural activities were recorded on a regular basis for several months. An algorithm based on cluster analysis and interspike interval analysis was developed to sort the extracellular action potentials into single units. We tracked these units based on their waveform and their response to somatic stimulation or stereotypical movements by the cats. Our results indicate that, after implantation, the electrode-tissue interface may change from day-to-day over the first 1-2 weeks, week-to-week for 1-2 months, and become quite stable thereafter. A stability index is proposed to quantify the stability of the electrode-tissue interface. The reasons for the pattern of changes are discussed.