A heteronymous group I oligosynaptic reflex from the common peroneal nerve to vastus medialis muscle was compared with a group I homonymous monosynaptic reflex to soleus, using electrical stimulation of peripheral nerve trunks in two groups of healthy men, mean ages 22 and 65 years. The oligosynaptic reflex was still elicitable with age, its magnitude decreasing similarly to the monosynaptic reflex. A further group of older subjects, mean age 75 years, showed similar results. Clearly, the oligosynaptic reflex is not lost with healthy aging. The motor interneuronal pool may at least partially avoid the age-related cell loss of motoneuronal pools, with consequent maintenance of segmental participation for movements such as gait. The slowing of conduction velocities, for these proprioceptive reflex arcs, may reduce the effectiveness of autoregulation of the gait.

Adult↗

PubMedDate not supplied

Peritonitis due to Rhizopus in a patient undergoing continuous ambulatory peritoneal dialysis.

A 61-year-old man who had end-stage renal disease secondary to diabetes mellitus and hypertension developed peritonitis due to infection with Rhizopus as a complication of receiving continuous ambulatory peritoneal dialysis (CAPD). At the onset of infection, the patient was neither acidemic nor hyperglycemic; in addition, deferoxamine had not been administered and Elastoplast dressings had not been applied. The infection occurred after the technique for disinfection of the catheter used for CAPD had been changed. The catheter was removed, and therapy with amphotericin B was initiated. Although the patient died of apparently unrelated causes, an autopsy revealed active fungal infection with multiple abscesses and superficial invasion of the ileal wall.

Abscess↗

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Magnetic motor evoked potentials for assessing spinal cord integrity in dogs with intervertebral disc disease.

Magnetically elicited transcranial motor evoked potentials (MEPs) were studied in 37 dogs with type 1 intervertebral disc (IVD) disease. The waveforms were recorded from both cranial tibial muscles before and after surgery. The latencies and amplitudes obtained were compared to those of a control population (n = 14). MEPs were recordable in all dogs with mild or no neurologic deficits, but they were recordable in only 50% of ambulatory dogs that were severely ataxic. MEPs could not be elicited from nonambulatory dogs. There was a significant attenuation of the amplitudes in all clinical cases, even if the dogs demonstrated back pain alone. Significantly prolonged latencies were associated with neurologic deficits. MEPs were not good predictors of neurologic recovery. The responses obtained from the side where the disc material was found were not different from those recorded from the opposite side. MEPs were very sensitive to lesions of the spinal cord, as indicated by the significant changes in the waves in patients with mild or no neurologic deficits and in the loss of response in dogs that still demonstrated purposeful movement. Neurologic exams provided more accurate diagnoses and prognoses than did MEPs in dogs with IVD disease.

Animals↗

PubMedDate not supplied

Ultrastructural immunolabeling: a unique diagnostic tool in monoclonal light chain-related renal diseases.

Ultrastructural labeling can play a key role in the evaluation of morphologic expressions of monoclonal light chain-related renal diseases in cases where light microscopy, electron microscopy, and immunofluorescence data, even when combined, are not definitive in conveying a diagnosis and, in other cases, in clarifying the findings by providing immunomorphologic correlation. The important role of ultrastructural labeling is highlighted by the fact that in some of these cases bone marrow aspirates and biopsy specimens obtained at the time of the evaluation of the renal specimens are often unable to establish unequivocally a diagnosis of plasma cell dyscrasia. This is in part because renal manifestations commonly precede overt diagnostic bone marrow alterations. Overt bone marrow findings and clinical manifestations may be preceded for as long as 16 years by the renal manifestations. Determination or confirmation of monoclonality and detection of early deposition of monotypical light chains before the finding of ultrastructural morphologic correlates (ie, subendothelial, punctate, granular, electron-dense material) represent unique attributes of this technique. The increased sensitivity of ultrastructural immunolabeling compared with other available diagnostic techniques and its exquisite immunomorphologic correlative capabilities result in a comprehensive evaluation. Sixteen monoclonal light chain-related renal disease cases with early, unusual, or equivocal immunomorphologic manifestations that may have not been characterized properly if ultrastructural labeling had not been performed are presented. The crucial role played by ultrastructural labeling in evaluating these cases and establishing an accurate diagnosis is illustrated and emphasized.

Adult↗

PubMedDate not supplied

Nocardia asteroides keratitis: a case associated with soft contact lens wear.

Ocular nocardiosis is rare. Most cases of nocardial keratitis have resulted from corneal trauma by objects contaminated with the organism. We describe the first case of Nocardia asteroides keratitis associated with an extended wear soft contact lens. We also describe its successful treatment with topical trimethoprim-sulfamethoxazole in combination sulfacetamide.

Adolescent↗

PubMedDate not supplied

Within-subject reliability of the Hoffmann reflex in man.

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Electromyography↗