Glutamate release in the ventromedial hypothalamus of the female rat during copulation: modulation by estradiol.

Binding of glutamate or its ionotropic receptor agonists in the ventromedial hypothalamus (VMH) of female rats inhibits both appetitive and consummatory aspects of sexual behavior. Because vaginocervical stimulation activates glutamate neurons in the VMH, and administration of estradiol benzoate (EB) and progesterone (P) delays this effect, the present study examined the effects of hormonal priming on glutamate release within the VMH of female rats paired with sexually vigorous males. Ovariectomized, sexually experienced rats were implanted with guide cannula aimed at the ventrolateral VMH, through which microdialysis probes were inserted prior to testing. Females were assigned randomly to one of three hormone treatment conditions: EB+P, EB alone, or the oil vehicle. Testing was conducted over 5h, including a 120-min period of habituation to the testing chamber, a 60-min period of baseline sample collection, and a 120-min period during which a sexually vigorous male was introduced into the testing chamber. Dialysates were collected every 20min during the test and were analyzed for glutamate using HPLC. Females primed with oil had large and significant increases in glutamate release from baseline once the male was introduced to the chamber. Treatment with EB alone decreased glutamate release in response to male cues. Although treatment with EB+P did not differ significantly from EB alone, the degree of reduced glutamate release was less than with EB alone. These results indicate that priming with EB reduces glutamate transmission in the VMH in response to male cues. Taken together with our previous findings, estradiol blunts the activation of glutamate neurons in the VMH thus allowing female rats to copulate.

Coexistence of tight and loose bundled states in a model of bacterial flagellar dynamics.

Many microorganisms propel themselves through their fluid environment by means of multiple rotating flagella that self-organize to form bundles, a process that is complex and poorly understood. In the present work, the bundling behavior of a pair of flexible flagella, each driven by a constant torque motor, is investigated, using a mathematical model incorporating the fluid motion generated by each flagellum as well as the finite flexibility of the flagella. The initial stage of bundling is driven purely by hydrodynamics but the final state of the bundle is determined by a nontrivial balance between hydrodynamics and elasticity. As the flexibility of the flagella increases a regime is found where, depending on initial conditions, one finds bundles that are either tight, with the flagella in mechanical contact, or loose, with the flagella intertwined but not touching. That is, multiple coexisting states of bundling are found. The parameter regime (in terms of flexibility and distance between motors) at which this multiplicity occurs is comparable to the parameters for a number of bacteria.

DNA Molecules in Microfluidic Oscillatory Flow.

The conformation and dynamics of a single DNA molecule undergoing oscillatory pressure-driven flow in microfluidic channels is studied using Brownian dynamics simulations, accounting for hydrodynamic interactions between segments in the bulk and between the chain and the walls. Oscillatory flow provides a scenario under which the polymers may remain in the channel for an indefinite amount of time as they are stretched and migrate away from the channel walls. We show that by controlling the chain length, flow rate and oscillatory flow frequency, we are able to manipulate the chain extension and the chain migration from the channel walls. The chain stretch and the chain depletion layer thickness near the wall are found to increase as the Weissenberg number increases and as the oscillatory frequency decreases.

Transient and sustained changes in myofilament sensitivity to Ca2+ contribute to the inotropic effects of sevoflurane in rat ventricle.

BACKGROUND: The volatile anaesthetics isoflurane and sevoflurane induce both negative and positive inotropic effects in ventricular myocytes, the mechanisms of which are not fully understood. Previous data suggest that changes in myofilament Ca(2+) sensitivity contribute to their sustained negative inotropic effects. In this study, the role of changes in myofilament Ca(2+) sensitivity in both positive and negative inotropic effects of these agents was examined in intact ventricular myocytes. METHODS: Contractility and cytosolic Ca(2+) (fura-2) were recorded optically in ventricular myocytes stimulated electrically (1 Hz) at 30 degrees C. Myofilament Ca(2+) sensitivity was assessed from plots of cell length against fura-2 fluorescence ratio (Fr) from individual twitches at various points before, during and after a 1 or 4 min exposure to 0.6 mM anaesthetic. RESULTS: Isoflurane reduced mean (sd) myofilament Ca(2+) sensitivity from 10.3 (1.9) to 5.9 (1.6) microm Fr(-1) (P<0.001) throughout a 1 min exposure, which returned to control on removal. In contrast, on initial exposure to sevoflurane, Ca(2+) sensitivity was reduced from 10.8 (1.3) to 4.3 (0.9) microm Fr(-1) (P<0.001) but this recovered partially towards control over 3 min. On removal, sensitivity was increased above control (to 17.7 (2.2) microm Fr(-1); P<0.001) before preanaesthetic levels were restored. CONCLUSIONS: These data show that both isoflurane and sevoflurane reduce apparent myofilament Ca(2+) sensitivity at steady state. However, sevoflurane (but not isoflurane) induced transient changes in apparent myofilament Ca(2+) sensitivity, which would contribute to its inotropic profile.

Conformation and dynamics of single DNA molecules in parallel-plate slit microchannels.

The conformation and diffusion of a single DNA molecule confined between two parallel plates are examined using both single molecule experiments and Brownian dynamics simulations accounting for hydrodynamic interactions. The degree of chain stretching and the diffusivity are characterized as a function of the chain confinement and the channel geometry. Good agreement is found between the simulations, experiments, and scaling theory predictions.

Solitary coherent structures in viscoelastic shear flow: computation and mechanism.

Starting from stationary bifurcations in Couette-Dean flow, we compute nontrivial stationary solutions in inertialess viscoelastic circular Couette flow. These solutions are strongly localized vortex pairs, exist at arbitrarily large wavelengths, and show hysteresis in the Weissenberg number, similar to experimentally observed "diwhirl" patterns. Based on the computed velocity and stress fields, we elucidate a heuristic, fully nonlinear mechanism for these flows. We propose that these localized, fully nonlinear structures comprise fundamental building blocks for complex spatiotemporal dynamics in the flow of elastic liquids.

Closed tympanomastoidectomy.

The role of closed tympanomastoidectomy in the treatment of chronic ear disease continues to be a subject of debate. This article reviews the position of closed tympanomastoidectomy in the armamentarium of the otolaryngologist. In this article the technique is described and indications are reviewed. A brief history of closed tympanomastoidectomy and the issue of outcome from surgery are also addressed.

Professional associations and managed care. How four provider groups are helping their members.

Managed care is facilitating rapid change in the day-to-day practice of many addiction treatment and mental health professionals. It is only natural, therefore, that the associations representing the various disciplines in behavioral healthcare should seek to present short- and long-term plans, advice, and programs for their members. We have asked leaders from four prominent groups to present what their organizations are doing today to assist professionals in adapting to the new realities of the healthcare system. The comments below are by no means conclusive, and are representative of a few efforts and thoughts. It is our mission at Behavioral Healthcare Tomorrow to provide an independent platform for dialogue in the world of mental health and addiction treatment. It is our hope that the proposals and ideas published here stimulate even more planning amongst providers as managed care assertively enters public sector services.

Abdominal wall sinus: a late complication of gallstone spillage during laparoscopic cholecystectomy.

Long term complications of laparoscopic cholecystectomy are uncommon. However, as experience with this procedure accumulates, sporadic reports of non-biliary complication have been published. We report a case of abdominal wall sinus formation secondary to gallbladder perforation and stone spillage occurring during laparoscopic cholecystectomy.

Bilateral Meniere's disease. Treatment with intramuscular titration streptomycin sulfate.

Most patients with bilateral Meniere's disease treated with streptomycin sulfate titration therapy and followed over the long term have either improvement or relief of their disabling vertigo. Although persistent post-treatment disequilibrium occurs not infrequently, it is mild in the most patients. Stabilization or improvement of hearing occurs in most patients, and the authors have not encountered hearing loss to date as a result of streptomycin sulfate titration therapy. There seems to be considerable separation between the vestibulotoxic and cochleotoxic doses of streptomycin sulfate intramuscularly when administered in humans.

Mechanical versus CO2 laser occlusion of the posterior semicircular canal in humans.

The purpose of this study was to compare the effectiveness of mechanical and laser-assisted posterior semicircular canal occlusion (PCO) for the treatment of intractable benign paroxysmal positional vertigo (BPPV). Twelve consecutive patients with intractable BPPV underwent PCO by three surgeons, six with mechanical PCO and six with CO2 laser-assisted PCO. PCO eliminated positional vertigo in all patients treated with the laser and five of six patients treated without the laser. Dysequilibrium was present in all patients immediately postoperatively. This resolved in all patients treated with the CO2 laser but in only two of six patients treated without the laser (p = 0.03). Patients were hospitalized for dysequilibrium for an average of 5.2 and 2.8 days for the mechanical and laser-assisted groups, respectively. Preoperative and postoperative hearing was not significantly different between the groups. No clinically significant postoperative hearing loss was encountered in either group. These results suggest that PCO is an effective treatment for intractable BPPV. The incidence of dysequilibrium that persists following PCO may be reduced by using the CO2 laser to seal the membranous canal prior to occluding the bony canal.

Temporal bone encephalocele and cerebrospinal fluid leaks.

Nineteen cases of temporal bone brain herniation and cerebrospinal fluid (CSF) leaks in 17 adult patients since 1987 are reviewed. Of these 19 cases, 11 were spontaneous CSF leaks, 6 were related to chronic otitis media, and 2 were posttraumatic. Among the 10 women and 7 men, the average age was 51.2 years, with average follow-up time of 2 years, 7 months. Two cases were repaired by a middle fossa craniotomy approach, 1 case by a transmastoid approach, and 16 by a combined transmastoid and middle fossa approach. Ten cases utilized the preferred technique of fascia-bone-fascia to repair the defects. The diagnosis was made on clinical grounds in 18 of the 19 cases, with ancillary diagnostic test providing little useful information. There were no postoperative surgery-related complications, and definitive repair was accomplished in one stage in all cases.

Meatal facial nerve decompression in acoustic neuroma resection.

Delayed facial palsy occurs after approximately 15% of acoustic neuroma resections. Whereas in most cases facial nerve function recovers satisfactorily, in about 12% of cases delayed facial palsy may have a poor functional recovery. The fate of facial nerve function was studied in 55 consecutive translabyrinthine acoustic neuroma resections, 23 of whom underwent meatal facial nerve decompression (MFND) at the time of tumor resection. The facial nerve results also were reviewed in 19 middle cranial fossa resections, of whom 14 underwent MFND. There was a bimodal distribution of the delayed palsies, with one group having the onset of palsy within hours to 2 days after surgery and the second group having onset of palsy up to 17 days after surgery. The poorest recoveries were seen in the first group. Although the effect was not statistically significant due to the small sample size, the chance of facial weakness in patients who underwent MFND after translabyrinthine surgery was about 40% less than in those who did not undergo decompression. The apparent protective effect of MFND was increased when the confounding factors of tumor size and degree of resection were taken into account, although the effect was not statistically significant. The duration of palsy was shorter and ultimate recovery better among the patients who underwent facial nerve decompression than in those who did not. Of the translabyrinthine patients who underwent MFND, 100% had House-Brackmann grade I-II function at 2 years, whereas 87% of patients who did not have MFND had grade I-II function and 13% had grade III-IV function. Without MFND, 57% of translabyrinthine patients whose onset of facial palsy was within 2 days of surgery had grade III-IV facial nerve function.

Facial nerve outcome in acoustic tumor surgery.

Seventy-three procedures involving 70 acoustic tumors were carried out over 3 years. The majority of tumors (65) were removed by the translabyrinthine approach. Tumor size ranged from 0.5 through 5.0 cm. All patients underwent intraoperative facial nerve monitoring: 22 patients developed immediate facial palsy (House-Brackmann grades II-VI); 11 patients recovered completely; 11 patients (15.7%) had persistent paralysis. The incidence of long-term, poor outcome (H-B grade IV-VI) was 5.7 percent. The overall incidence of facial palsy was not found to be related to tumor size; however, facial paralysis associated with large tumors exhibited a poorer House-Brackmann grade compared to small and medium lesions. The use of intraoperative facial monitoring has enhanced the surgeon's ability to preserve facial nerve function by reducing the overall incidence of postoperative facial paralysis.

Labyrinthectomy. Indications and surgical technique.

Surgical intervention is considered for patients whose disabling vertigo fails to respond to appropriate medical therapy. Topics discussed in this article include indications, preoperative assessment, and surgical techniques. Fifteen case studies supplement the text, followed by a discussion.