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Biomedical subjects

V Dietz

Publications and source records attributed to V Dietz.

At least 127 records · Page 7Linked to original sources
PubMed1996

Modulation, probably presynaptic in origin, of monosynaptic Ia excitation during human gait.

Modulation of presynaptic inhibition of Ia afferents projecting monosynaptically to soleus motoneurones was investigated during human gait. Changes in presynaptic inhibition of Ia afferents were deduced from alterations in the amount of heteronymous soleus H-reflex facilitation evoked by a constant femoral nerve stimulation. It has been shown that this facilitation is mediated through a monosynaptic Ia pathway and that during its first 0.5 ms it is still uncontaminated by any polysynaptic effect and can be used to assess ongoing presynaptic inhibition of Ia terminals to soleus motoneurones. During gait, heteronymous facilitation was reduced with respect to its control value (rest during sitting) and modulated during the step cycle: it reached its maximum at mid-stance and decreased to near zero by the end of stance. At the same time the H-reflex amplitude was to some extent similarly modulated. It is argued that this decrease in heteronymous Ia facilitation and in H-reflex amplitude reflects an increased, ongoing presynaptic inhibition of Ia terminals projecting onto soleus motoneurones, which could be from central and/or peripheral origin. D1 inhibition, i.e. the late and long-lasting inhibition of the soleus H-reflex evoked by a train of stimuli to the common peroneal nerve, was used as another method to assess presynaptic inhibition. This D1 inhibition was decreased during gait, and it is argued that this decrease might reflect an occlusion in presynaptic pathways or increased presynaptic inhibition of pathways mediating the conditioning volley.

Adult↗
PubMed1996

Interaction between central programs and afferent input in the control of posture and locomotion.

Two basic aspects of the neuronal control of bipedal stance and gait have been discussed, namely the interlimb coordination and the antigravity function of leg extensors. During stance and gait both legs act in a cooperative manner as each limb affects the strength of muscle activation and the time-space behaviour of the other. There are indications that interlimb coordination is mediated by spinal interneuronal circuits, which are themselves under supraspinal (e.g. cerebral and cerebellar) control. Proprioceptive reflexes involved in the maintenance of body equilibrium depend on the presence of contract forces opposing gravity. Extensor load receptors are thought to signal changes of the projection of body's centre of mass with respect to the feet. According to recent observations in the spinal cat, this afferent input probably arises from Golgi tendon organs and represents a newly discovered function of these receptors in the regulation of stance and gait.

Adaptation, Physiological↗
PubMed1996

Traumatic cervical spinal cord injury: relation between somatosensory evoked potentials, neurological deficit, and hand function.

OBJECTIVE: Median and ulnar somatosensory evoked potentials (SEP) in the assessment of cervical spinal cord injury (SCI) in relation to the outcome of hand function. DESIGN: Cohort analytical study. SETTING: Spinal cord injury center, university hospital. PATIENTS: Consecutively sampled, 23 acute and 46 chronic tetraplegics. MAIN OUTCOME MEASURES: (1) Median and ulnar SEP recordings graded in 5 categories, from normal to absent; (2) clinical examination of algesia/aesthesia in dermatomes C5/6 and C8/Th1 graded in categories of normal, impaired, and loss of sensation; (3) clinical examination of hand function graded in 4 categories, from active to inactive hand function. RESULTS: Pathological median and ulnar SEP were found in 46% and 76% of patients, respectively. A differentiation between upper (C3-C6) and lower (C6/C7-Th1) cervical SCI was possible by comparing the SEP N20 latencies (but not amplitudes) of both nerves (Mann-Whitney U test, p < .01). In follow-up examinations over 6 months the N20 amplitude increased significantly (ANCOVA, p < .001), while the N20 latency did not change. By both ulnar SEP recordings and assessment of the sensory deficit in dermatome C8/Th1 the outcome of hand function, i.e., the development of active or inactive hand function, could be predicted (Mann-Whitney U test, p < .01). CONCLUSION: Median and ulnar SEP are valuable to indicate the level of injury, the degree of sensory impairment and to predict the outcome of hand function even in unconscious patients. They can improve the diagnostic assessment of cervical SCI.

Adolescent↗
PubMed1996

Neurographic assessment of intramedullary motoneurone lesions in cervical spinal cord injury: consequences for hand function.

Examination of hand function and neurography of the median- and ulnar nerves was performed in 15 patients with acute and 26 patients with chronic tetraplegia due to cervical spinal cord injury (SCI). 30% of patients showed a mild and 20% a severe axonal lesion of motor fibres of both nerves. The latter is caused by intramedullary damage of ventral horn cells and anterior nerve roots as neurographic examination of sensory nerve fibres was normal in these patients. The most frequent and severe nerve lesion was present in those with lower cervical spinal cord injuries (C6/7-Th1) where the median and ulnar nerves originate. In the latter patients the development of active hand function, which enables the patient to perform active grasping movements, was closely related to the result of neurography, already early after trauma. The results of median and ulnar neurography in tetraplegia due to cervical SCI allow to differentiate between intramedullary damage of motoneurones and the anterior nerve roots (peripheral nervous system) or the pyramidal tract fibres (central nervous system) within the spinal cord responsible for the paresis of the intrinsic hand muscles. Neurography is of prognostic value in cervical SCI to predict the outcome of hand function and therefore influences the appropriate occupational therapy and the program and aims of rehabilitation.

Action Potentials↗
PubMed1996

Backward and forward walking use different patterns of phase-dependent modulation of cutaneous reflexes in humans.

1. The phase-dependent modulation of medium-latency (P2) (70-80 ms) responses in semitendinosus (ST), biceps femoris (BF), rectus femoris (RF), and tibialis anterior (TA) was studied with the use of low-intensity stimulation (2 times perception threshold) of the sural nerve. The shocks were given in a random order at 16 phases of the step cycle in 10 normal subjects during forward walking (FW) or backward walking (BW) on a treadmill. 2. All subjects exhibited P2 responses in all muscles studied both during BW and FW. The amplitude of the facilitatory P2 responses showed phase-dependent changes that could not have been predicted on the basis of the variations in background activity throughout the step cycle. 3. During FW, the P2 facilitatory responses in BF were large (with respect to the background activity) throughout the whole step cycle except for a short period near the end of the swing phase. In ST the responses were smaller and appeared primarily at the end of the stance phase and during the first part of the swing phase. During the second half of swing the P2 responses were basically suppressive. A modulation pattern similar to the one in ST was found in RF and TA, except that there was no reversal to suppressive responses in the swing phase in RF. Instead, a reduction in the amplitude of the facilitatory P2 responses occurred. 4. During BW, the modulation pattern recorded in the same subjects was different from the one seen during FW. Large facilitatory P2 responses were present in all muscles in middle and late swing. In the first half of stance the responses were most prominently seen in BF and RF. At the end of stance and/or at the onset of swing the facilitatory responses decreased in amplitude (BF and RF) or reversed to P2 suppressions (ST and TA). 5. We conclude that there are both facilitatory and suppressive pathways from the sural nerve to the leg muscles studied and that the balance of activity in these paths is phase dependent during both FW and BW. It is suggested that the phase-dependent modulation of P2 responses could largely rely on a central motor program. During BW the same motor program is used as during FW, but possibly running in reverse, thereby causing a shift both in the timing of the reflex reversal and in the periods of reflex suppression.

Adult↗
PubMed1996

Loss of circadian blood pressure variability in complete tetraplegia.

Blood pressure (BP) and heart rate (HR) were monitored over 24 h utilising an ambulatory blood pressure monitoring (ABPM) system in 33 subjects with spinal cord injury: 11 patients with complete tetraplegia, 13 patients with incomplete tetraplegia and nine patients with complete paraplegia. Measurements were analysed for overall levels of BP and HR, presence of a physiological day/night cycle and events of autonomic dysreflexia. Paraplegic patients exhibited normal BP and HR levels with a physiological circadian rhythm. In complete tetraplegic patients the circadian rhythm was abolished for BP but preserved for HR, while in patients with incomplete tetraplegia circadian rhythm was preserved for both BP and HR. Complete tetraplegic patients with autonomic dysreflexia revealed a typical pattern in ABPM with multiple hypertensive episodes and concomitant bradycardia. Under adequate treatment these episodes could be reduced or abolished, while the disturbed circadian BP rhythm persisted. These observations shed further light on mechanisms of central BP and HR control. In tetraplegic patients ABPM is an efficient method to assess treatment for autonomic dysreflexia.

Adolescent↗
PubMed1996

The 1986 dengue and dengue hemorrhagic fever epidemic in Puerto Rico: epidemiologic and clinical observations.

In 1986 Puerto Rico experienced its eleventh dengue outbreak of this century, but the first with simultaneous transmission of three dengue virus serotypes, and the first with significant numbers of severe and fatal hemorrhagic disease. Overall, 10,659 cases were reported; 1,257 cases were laboratory confirmed as having current or recent dengue infection. Dengue 4 (DEN-4) was the predominant serotype (160/363 isolates, 44%) followed by dengue 1 (DEN-1) with 134 isolates (37%) and dengue 2 (DEN-2), 69 isolates (19%). Transmission peaked during September, but large numbers of cases occurred through November. Seventy-one (91%) of Puerto Rico's 78 municipalities had laboratory-confirmed cases. Fifty-one percent of all confirmed cases occurred in metropolitan San Juan. Most cases presented clinically as classical dengue fever, but 37% of all confirmed cases were reported to have developed some type of hemorrhagic manifestation, and 6% reported hematemesis. In addition, 29 laboratory confirmed cases met the WHO case definition for dengue hemorrhagic fever, 3 of which were fatal. Among the 29 laboratory-confirmed cases of dengue hemorrhagic fever/ dengue shook syndrome, virus was isolated from 12; one DEN-1, three DEN-2, and eight DEN-4. Among laboratory confirmed cases, infants less than one year of age were at greater risk of developing dengue hemorrhagic fever/ dengue shook syndrome, hematemesis and any reported hemorrhage than were the other age groups evaluated.

Adolescent↗
PubMed1996

Performance and potency of tetanus toxoid: implications for eliminating neonatal tetanus.

Neonatal tetanus (NT) is a major cause of mortality in developing countries, with over 400,000 deaths estimated to occur annually. WHO has adopted the goal of eliminating NT worldwide, and a major strategy for its prevention is the administration of at least two properly spaced doses of tetanus toxoid (TT) to women of childbearing age in high-risk areas to protect passively their newborns at birth. In certain countries the locally produced TT vaccine has been shown to be subpotent, while other countries have reported NT among infants born to vaccinated women. An extensive review of production and quality control procedures was carried out between 1993 and 1995 in 8 of 22 TT-producing countries that also report NT cases, with a more superficial assessment being carried out in the remaining 14 countries. Only 4 of the 22 countries have a functioning national control authority to monitor TT production and vaccine quality. A total of 80 TT lots from 21 manufacturers in 14 of the 22 NT-reporting countries were tested for potency. Of these, 15 lots from eight manufacturers in seven countries had potency values below WHO requirements. TT potency can also be compromised by improper vaccine handling. To eliminate neonatal tetanus worldwide requires assurance that all doses of TT meet WHO production and quality requirements and that the field effectiveness of TT is monitored through systematic NT case investigations and assessment of coverage.

Adolescent↗
PubMed1995

Locomotor capacity of spinal cord in paraplegic patients.

The induction of complex bilateral leg muscle activation combined with coordinated stepping movements is demonstrated in patients with complete paraplegia. This was achieved by partially unloading patients who were on a moving treadmill. In comparison to healthy subjects, the paraplegic patients displayed a less dynamic mode of muscle activation. In all other respects leg muscle electromyographic activity was modulated in a similar manner to that in healthy subjects. However, the level of electromyographic activity in the gastrocnemius (the main antigravity muscle during gait) was considerably lower in the patients. During the course of a daily locomotor training program, the amplitude of gastrocnemius electromyographic activity increased significantly during the stance phase, while inappropriate tibialis anterior activation decreased. Incompletely paraplegic patients benefited from the training with respect to performance of unsupported stepping movements on solid ground. In about half of completely paraplegic patients with low muscle tone, no beneficial effect of the training was seen. This may be due to an inhibitory effect on spinal neuronal activity by drugs patients were taking (e.g., prazosin, clonidine, cannabinoids). In this study intrathecal application of clonidine drastically reduced, while epinephrine enhanced locomotor muscle electromyographic activity. The results of this study promise to be significant in the treatment of paraplegic patients.

Adolescent↗
PubMed1995

Adaptational and learning processes during human split-belt locomotion: interaction between central mechanisms and afferent input.

Split-belt locomotion (i.e., walking with unequal leg speeds) requires a rapid adaptation of biomechanical parameters and therefore of leg muscle electromyographic (EMG) activity. This adaptational process during the first strides of asymmetric gait as well as learning effects induced by repetition were studied in 11 healthy volunteers. Subjects were switched from slow (0.5 m/s) symmetric gait to split-belt locomotion with speeds of 0.5 m/s and 1.5 m/s, respectively. All subjects were observed to adapt in a similar way: (1) during the first trial, adaptation required about 12-15 strides. This was achieved by an increase in stride cycle duration, i.e., an increase in swing duration on the fast side and an increase in support duration on the slow side. (2) Adaptation of leg extensor and flexor EMG activity paralleled the changes of biomechanical parameters. During the first strides, muscle activity was enhanced with no increase in coactivity of antagonistic leg muscles. (3) A motor learning effect was seen when the same paradigm was repeated a few minutes later--interrupted by symmetric locomotion--as adaptation to the split-belt speeds was achieved within 1-3 strides. (4) This short-time learning effect did not occur in the "mirror" condition when the slow and fast sides were inverted. In this case adaptation again required 12-15 strides. A close link between central and proprioceptive mechanisms of interlimb coordination is suggested to underlie the adaptational processes during split-belt conditions. It can be assumed that, as in quadrupedal locomotion of the cat, human bipedal locomotion involves separate locomotor generators to provide the flexibility demanded. The present results suggest that side-specific proprioceptive information regarding the dynamics of the movement is necessary to adjust the centrally generated locomotor activity for both legs to the actual needs for controlled locomotion. Although the required pattern is quickly learned, this learning effect cannot be transferred to the contralateral side.

Adaptation, Physiological↗
PubMed1995

Modulation of sural nerve somatosensory evoked potentials during stance and different phases of the step-cycle.

In order to investigate the modulation of somatosensory processing during stance and locomotion, sural nerve somatosensory evoked potentials were recorded during both stance and different phases of the step-cycle. Characteristic sequences of negative-positive waves were elicited, consisting of an early component, N40, presumably of subcortical origin, followed by a P50-N80-P220 complex of cortical origin. The N40 and N40-P50 components had similar amplitudes in both gait and stance. However, the P50-N80 component was attenuated whereas the N80-P220 complex became biphasic during gait. Within the step-cycle, amplitudes of the cortical components P50-N80 and N80-P110 were larger prior to footfall and smaller at the beginning of the support phase. The results demonstrate that locomotion produces a modulatory effect on somatosensory input at a cortical level. Within the step-cycle, excitability of the somatosensory cortex is increased during the middle and late swing phases and decreased during the support phase. Such modulation may contribute to an improved detection of foot contact at touchdown.

Adult↗
PubMed1995

Embryogeny of oxygen consumption in 13 altricial and precocial birds.

The embryogeny of O2 consumption (VO2) was examined in 6 altricial and 7 precocial bird species (egg mass: 1.13 to 330 g). The 13 species studied were measured in most cases daily, some of them were continuously measured for 24 hours. 10 of 13 species exhibited a clear plateau-phase in about the last fourth of their embryogeny. Mean total energy production during incubation period was 1.83 kJ/g in altricial and 1.77 kJ/g in precocial species. No marked differences concerning the occurrence of a plateau phase could be found in the general course between the two developmental modes. This may reflect the existence of a basically identical course of the embryonic VO2 in the examined bird species.

Animals↗
PubMed1995

Qualitative course of embryonic O2 consumption in altricial and precocial birds.

The course of embryonic VO2 was examined in 24 altricial and 27 precocial bird species to test differences in its phenology. Some authors suggest that altricial species lack a plateau in VO2-development found in precocial species. Based on the recently available data we find the following: All species (except members of the family Megapodiidae) exhibit a plateau. Their VO2-development follows an identical basic course which can be described by an exponential increase interrupted by the plateau. There seems to be no fundamental difference between altricials and precocials with respect to the general presence of a plateau. In small altricials the plateau lasts only a few hours. It can be overlooked easily when the measurement is not continuous or when many individual measurements are averaged. However, the plateau-VO2 is lower (about 35%) and shorter (12.4% of incubation time; 16.9% in precocials) in the altricials. Total energy consumption during incubation is 1.9 kJ/g in altricial and 2.2 kJ/g in precocial species.

Animals↗
PubMed1995

Leg muscle activation during gait in Parkinson's disease: adaptation and interlimb coordination.

Adaptation in leg muscle activity and coordination between lower limbs were studied during walking on a treadmill with split belts in one group of parkinsonian patients and one of age-matched healthy subjects. Four different belt speeds (0.25/0.5/0.75/1.0 m/sec) were applied in selected combinations to the left and right leg. While these walking conditions were easily tolerated by the healthy subjects, the parkinsonian patients usually reached the limits of their walking capabilities. Both groups adapted automatically to a change in belt speed within approximately 20 stride cycles. Healthy subjects adapted by reorganizing their stride cycle with a relative shortening of duration of support and lengthening of the swing phase of the "fast" leg and vice versa on the "slow" leg. The patients showed a restricted range of stride frequencies for the various belt speeds during normal and split-belt walking with consequent deviations in the reorganization of the stride cycle. In both healthy subjects and patients, ipsilateral gastrocnemius and contralateral tibialis anterior electromyographic (EMG) activity increased predominantly with an ipsilateral increase in belt speed. Two main differences were observed in the EMG patterns: (1) In the patients leg muscle EMG activity was less modulated and gastrocnemius EMG amplitude was small during normal and split-belt walking. However, there was no significant difference between the two groups in respect to the reorganization of the EMG pattern required for the various split-belt walking conditions. (2) The amount of co-activation of antagonistic leg muscles during the support phase of the stride cycle was greater in the patients compared to the healthy subjects during normal and split-belt walking. It is suggested that reduced EMG modulation and recruitment in the leg extensors may contribute to the impaired walking of the patients. This in turn is a result of an impaired proprioceptive feedback from extensor load receptors. This defective control is partially compensated for in parkinsonian patients by a greater amount of leg flexor activation which leads to a higher degree of co-activation. Visual input plays a role in the control of this increased activation.

Adaptation, Physiological↗
PubMed1995

Bipedal reflex coordination to tactile stimulation of the sural nerve during human running.

1. Cutaneous reflex responses were elicited during human running (8 km/h) on a treadmill by electrical stimulation of the sural nerve at the ankle. Stimulus trains (5 pulses of 1 ms at 200 Hz) at three nonnociceptive intensities, which were 1.5, 2.0, and 2.5 times perception threshold (PT), were delivered at 16 phases of the step cycle. For 11 subjects the surface electromyographic (EMG) activity of both the ipsilateral and contralateral long head of the biceps femoris (iBF and cBF, respectively), the semitendinosus (iST and cST), the rectus femoris (iRF and cRF), and the tibialis anterior (iTA and cTA) were recorded. 2. During human running nonnociceptive sural nerve stimulation appears to be sufficient to elicit large, widespread and statistically significant reflex responses, with a latency of approximately 80 ms and a duration of approximately 30 ms. These reflex responses seem to be an elementary property of human locomotion. This is indicated by the occurrence of the responses in all subjects, the consistency of most of the reflex patterns across the subjects and, apart from a small amount of habituation, the reproducibility of the responses during the course of the experiment. 3. The responses are modulated continuously throughout the step cycle such that their magnitude does not in general covary with the background locomotor activities. This is observed most clearly in iST, iTA, and cTA for which statistically significant reflex reversals are demonstrated, and in cRF and cTA for which the responses are gated during most of the step cycle. 4. The response magnitude generally increases as a function of increasing intensity, whereas the phase-dependent reflex modulation is intensity independent. 5. A functional dissociation within the ipsilateral hamstring muscles is demonstrated: the iBF and iST show an antagonistic reflex pattern (facilitatory and suppressive, respectively) during the periods of synergistic background locomotor activity in the step cycle. Contralaterally, however, the cBF and cST are reflexively activated as close synergists during these periods. 6. The reflex responses and their phase-dependent modulation are different for the homologous muscles in the two legs. Yet, some similarities are observed. These are present rather with respect to the phase of the corresponding leg than with respect to the phase of the stimulated leg. Both observations suggest that the phase-dependent reflex modulation is controlled separately in the ipsilateral and contralateral legs. 7. The response simultaneity in all investigated muscles supports the notion of a coordinated cutaneous interlimb reflex during human running.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗