Thalamic lesions dissociate breathing inhibition by hypoxia and adenosine in fetal sheep.

The effects of diencephalic lesions on respiratory responses to intra-arterially infused adenosine (ADO) were determined in chronically catheterized fetal sheep (>0.8 term). These studies were designed to test the hypothesis that the inhibitory effects of ADO on fetal breathing, like those of hypoxia, are mediated by the parafascicular nuclear complex (Pf) of the posteromedial thalamus. ADO inhibited breathing [control (C): 26 +/- 2.6, ADO: 4 +/- 1 min/h] in normal fetuses and in a fetus with a lesion that virtually destroyed the thalamus but left intact most of Pf. Neuronal lesions in the diencephalon, produced by injecting ibotenic acid, abolished the inhibitory effects of ADO on breathing (C: 31 +/- 5.1, ADO: 30 +/- 4.5 min/h) when the lesions encompassed Pf or the sector immediately rostral to Pf that retained the capacity to regulate hypoxic inhibition. Smaller lesions created by the insertion of needles also eliminated the depressant effects of ADO when disruptions were within Pf or a rostral component of the thalamic cortical activating system. It is concluded that 1) a medial thalamic sector is critically involved in ADO-induced apnea and 2) ADO-dependent and ADO-independent mechanisms mediate hypoxic inhibition.

Transcutaneous electrical nerve stimulation in the treatment of myofascial pain dysfunction.

The effect of transcutaneous electrical nerve stimulation (TENS) plus conservative therapy (ibuprofen, bite plate, self-physiotherapy) on myofascial pain dysfunction (MPD) was determined. A single-blind trial as done in 10 patients with MPD with subthreshold TENS (frequency 35 Hz, pulse width 100 milliseconds, modulation 50%) compared with sham TENS at 8 visits over 14 weeks. Pain was assessed on a visual analogue scale before and after TENS at each visit and the data were analysed with the analysis of variance (ANOVA) for repeated measures. A highly significant effect was seen for time (F = 4.80, P = 0.0003) but not for TENS. Subthreshold TENS did not increase the symptom relief produced by conservative treatment with the protocol used.

Source of extracellular brain adenosine during hypoxia in fetal sheep.

Microdialysis was performed to determine whether hypoxia increases fetal brain adenosine (ADO) concentration through dephosphorylation of extracellular 5'-adenosine monophosphate (5-AMP). Hypoxia (fetal PaO2 approximately 14 Torr) increased fetal brain ADO levels approximately two-fold when the probes were perfused with synthetic cerebrospinal fluid (CSF) containing inhibitors of the nucleoside transporter but not with this solution plus a blocker of ecto-5'-nucleotidase (AOPCP). The hypoxia-induced rise in fetal brain ADO concentrations depends critically upon the hydrolysis of extracellular 5'-AMP.

Corticothalamic and corticotectal somatosensory projections from the anterior ectosylvian sulcus (SIV cortex) in neonatal cats: an anatomical demonstration with HRP and 3H-leucine.

Corticothalamic and corticotectal projections from the anterior ectosylvian sulcus (AES) in neonatal cats were studied with anterograde and retrograde neuroanatomical techniques. When the injection site was relatively restricted to the sulcal walls and fundus of the rostral AES (i.e., the SIV cortex), heavy ipsilateral thalamic label was observed in the medial subdivision of the posterior group, in the suprageniculate nucleus, and in the external medullary lamina. No terminal label was seen in the contralateral thalamus although the contralateral homotopic cortex was heavily labeled. Within the ventrobasal complex (VB), dense axonal label was observed in fascicles that traversed VB, but only light terminal label was observed within VB itself. However, in cases where the tracer spread into adjacent SII, terminal label in VB was pronounced. Similarly, when the injection site extended into auditory cortex, terminal label was observed in the lateral and intermediate subdivisions of the posterior group. Rostral AES injections produced distinct, predominantly ipsilateral, terminal label in the superior colliculus that was distributed in two tiers: a discontinuous band in the stratum griseum intermedium and a more diffuse band in stratum griseum profundum. Caudally, dense terminal label was seen in the intercollicular zone and dorsolateral periaqueductal gray. When the injection site did not include rostral AES, no label was observed in the superior colliculus. Horseradish peroxidase injections into the superior colliculus of neonates produced retrogradely labeled neurons throughout the AES, but none was found on the crown of the gyrus where SII is located. Thus, the neonatal corticotectal somatosensory projection arises exclusively from AES and parallels that found in adults. These data indicate that the elaboration of a major descending somatosensory pathway from AES to the thalamus and midbrain is largely a prenatal event. The in utero anatomical maturation of the corticofugal projections from SIV cortex to the superior colliculus contrasts with the protracted postnatal development of the corticotrigeminal projections from SI cortex but is consistent with the mature anatomical state of ascending trigeminotectal projections.

Nonoverlapping thalamocortical connections to normal and deprived primary somatosensory cortex for similar forelimb receptive fields in chronic spinal cats.

The fluorescent dye retrograde tracing technique, using fast blue in combination with fluorogold, was used to examine thalamocortical projections from the ventrobasal complex to primary somatosensory cortex in chronic spinal cats that sustained T12 cord transection at 2 weeks of age. Following cord transection at this age, it has been shown that forelimb afferents can excite the deprived hindlimb projection zone, in addition to the region of somatosensory cortex that they normally occupy (McKinley et al., 1987). These two regions of cortex are separated by over 10 mm, thus facilitating the determination of whether the forelimb representation in "hindlimb cortex" is derived from the sector of the ventrobasal complex of the thalamus representing the forelimb, hindlimb, or both. Injections of the two dyes into separate regions of the cortex that were excited by the same peripheral forelimb receptive fields produced single labeling of two nonoverlapping clusters of thalamic neurons. This finding suggests that the projections for these two areas are independent and distinct, and indicates that altered thalamocortical projections do not contribute the critical component underlying reorganizational changes observed at the cortical level after spinal cord transection. It is hypothesized that the degree of reorganization required to achieve the magnitude of change observed in the cortex must occur below the level of the thalamocortical relay.

Intraoperative autologous transfusion in children undergoing spinal surgery.

An intraoperative autologous transfusion program was used in conjunction with preoperative phlebotomy in 25 children undergoing elective spinal surgery. Operative red blood cells, 10,000 ml, with an average hematocrit of 55%, as well as 7,300 ml of preoperative phlebotomy blood were returned to the patients. No complications were noted. The complete blood count on discharge was satisfactory, and the clotting parameters were unchanged. The results of this study show that intraoperative autologous transfusion with preoperative phlebotomy is safe, easy to perform, and cost-effective in children undergoing elective spinal surgery. The risks of homologous blood transfusions were eliminated.

An axonal transport study of the ascending projection of medial lemniscal neurons in the rat.

The pattern of projection of the rat medial lemniscus was studied by axonal transport labeling following injections of tritiated leucine, proline and/or adenosine, or of horseradish peroxidase for retrograde identification of the neurons of origin. The vast majority of neurons in the gracile, cuneate, and principal trigeminal nuclei contribute to an almost totally crossed projection primarily to the thalamic ventrobasal complex. Additional thalamic components were traced to specific sites within the "posterior group," including a medial component largely traversed by lemniscal axons and a caudolateral component lying between the principal nucleus of the medial geniculate and ventral nucleus of the lateral geniculate. We have designated this latter zone "intermediate geniculate," distinguishing a somatosensory portion of the geniculate group on the basis of its myelo- and cytoarchitecture, as well as its connections. Other projections replicated in several animals included the zona incerta and nearby sectors of the substantia nigra; three distinct mesencephalic arrangements within the deep layers of the superior colliculus, the external nucleus of the inferior colliculus, and the intercollicular nucleus; the anterior pretectal nucleus; dorsal sectors of the inferior olivary complex and the ipsilateral cerebellar cortex. The results are compared with findings in other species (with emphasis on the caudal thalamic region) in an attempt to resolve some of the apparent inconsistencies in nomenclature.

The organization of projections to selected points of somatosensory cortex from the cat ventrobasal complex.

The organization of neurons in the cat ventrobasal complex (VB) which project to somatosensory cortex (SI) was investigated by the use of the retrograde transport of the enzyme horseradish peroxidase (HRP). Two histochemical procedures were used to visualize retrogradely transported HRP. Injections of HRP in electrophysiologically characterized points of SI cortex labeled distinctive zones of neurons in VB ipsilateral to the injections. Injections placed in the forelimb or hindlimb cortical areas labeled laminar-like aggregates of neurons have long axis corresponded to the long axis of VB. Injections of the SI trigeminal representation resulted in very compact aggregates of HRP positive neurons which were less clearly laminar. The density of projection from VB to various portions of SI paralleled the general innervation density of the peripheral skin. Injections of the cortical vibrissal, face and forepaw representations labeled a greater number of neurons in VB per unit area of cortex injected than did injections of the hindpaw or trunk representations. For a given somatotopic area, the number of labeled neurons in VB increased linearly as the area of the cortical HRP injection increased. Differences in the sensitivity of each histochemical procedure and the relationship of differing sensitivities to the observed results are also discussed.

Relationship between visual and tactile representations in cat superior colliculus.

A stratified organization of visual, somatic and acoustic representations was observed in the cat SC. Cells of the superficial laminae were exclusively visual. Visual, somatic, and acoustic cells were observed in the intermediate laminae while the deeper laminae were predominantly nonvisual. A detailed examination of the tactile representation revealed a somatotopic plan which was in register with the overlying visuotopy. The magnified representation of central visual fields overlapped the magnified tactile representation of the face and, as visual RFS moved temporally, the underlying tactile RFS were displaced caudal and distal. This topographical overlap can be recognized if the visual field is depicted as a flexible sheet which is stretched over the body with the area centralis superimposed on the nose and the limbs radiating out at an acute angle. The overlapping topographies and similarities in stimulus specificity of somatic and visual cells, as well as the similar behavioral deficits previously described following SC lesions, suggests a functional parallel between modalities in the SC. The possibility that visual, somatic, and acoustic cells converge on a common delivery or distribution system, which is located in the intermediate-deeper SC strata and organizes orienting and following responses on the basis of multimodality cues, is discussed.