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PubMed1994

A comparison of MR and duplex Doppler ultrasound for vascular assessment prior to orthotopic liver transplantation.

A prospective blinded comparison of duplex Doppler ultrasound (DDU) and a magnetic resonance angiography (MRA) 2-D time-of-flight technique was performed to assess the hepatic vasculature in 23 adult patients referred for orthotopic liver transplantation. Both techniques confirmed patency of the inferior vena cava in all patients, demonstrated a complete portal vein occlusion in one patient, and accurately defined the vascular and organ anatomy in a patient with situs inversus. The results were confirmed at surgery in 18 of the patients who have subsequently undergone liver transplantation. In one patient a partial portal vein thrombosis was found at surgery which was not detected by either imaging technique. MRA was more sensitive overall in detecting porto-systemic collaterals (31 locations in 17 patients) compared with ultrasound (24 locations in 17 patients), although ultrasound detected more patients with recanalized para-umbilical veins (DDU: 10 patients; MRA: 8 patients). These results indicate that a simple MRA technique can equal duplex Doppler ultrasound for the non-invasive assessment of patency of the hepatic vasculature and should be considered when DDU examination is equivocal or technically inadequate. MRA may provide additional information on the presence and size of porto-systemic collaterals which may be of value in monitoring portal hypertension.

Adult↗
PubMed1998

GABA-dependent generation of ectopic action potentials in the rat hippocampus.

Intracellular recordings from CA3 pyramidal cells of rat hippocampus in a slice preparation revealed the occurrence of interictal epileptiform discharges and synchronous GABA-mediated potentials during application of 4-aminopyridine (4AP, 50 micrometer). The synchronous GABA-mediated potential consisted of a sequence of early hyperpolarization, long-lasting depolarization (LLD), and late hyperpolarization. Action potentials of variable amplitude occurred at the peak of the early hyperpolarization and during the LLD rising phase (48 of 64 cells); they were not prevented by membrane hyperpolarization and displayed inflections that were reminiscent of the initial segment-somatodendritic (IS-SD) fractionation. Interictal discharges were blocked by excitatory amino acid receptor antagonists, while both GABA-mediated potentials and action potentials of variable amplitude continued to occur (n = 10). The latter events were still recorded in the presence of the GABAB receptor antagonist CGP-35348 (0.5-1 mm, n = 4), but were abolished by the GABAA receptor antagonist bicuculline methiodide (BMI, 10 micrometer, n = 5). Localized application of BMI (20 micrometer, n = 6) or tetrodotoxin (TTX, 5 micrometer, n = 3) to the CA1 stratum radiatum blocked the variable amplitude action potentials; these effects were not seen when BMI (n = 4) or TTX (n = 4) were applied to the CA3 stratum radiatum, although both procedures made LLDs disappear. Our findings indicate that action potentials of variable amplitude recorded from CA3 pyramidal cells in the 4AP model are generated at or near the terminal region of the Schaffer collaterals and that they represent TTX-sensitive ectopic events. These action potentials are generated at this site by a BMI-sensitive (and thus GABAA-mediated) mechanism. We propose that the ectopic action potentials reflect an increased excitability of axon terminals that is presumably caused by [K+]o elevations associated with the 4AP-induced synchronous GABA-mediated potential.

4-Aminopyridine↗
PubMed2006

Variable ECG signs of ischemia during controlled occlusion of the left and right coronary artery in humans.

Infarct size (IS) increases with vascular occlusion time, area at risk for infarction, lack of collateral supply, absence of preconditioning, and myocardial demand for O2 supply. ECG S-T segment elevation is used as a measure of severity of ischemia and a surrogate for IS. This study in 50 patients with coronary artery disease undergoing a first 120-s balloon occlusion of a stenosis sought to determine whether S-T segment elevation, corrected for the above-mentioned variables, in the left coronary artery (LCA group, n = 36) is different from that in the right coronary artery (RCA group, n = 14) territory. After consideration of all known determinants of IS, particularly mass at risk and collateral supply, the LCA territory is more sensitive than the RCA region to a 2-min period of myocardial ischemia.

Coronary Artery Disease↗
PubMed1993

Spectral analysis of flow velocity in the contralateral artery during coronary angioplasty: a new method for assessing collateral flow.

OBJECTIVES: The present study was designed to evaluate a new method for assessing coronary collateral flow and resistance in conscious humans. BACKGROUND: Earlier pathomorphologic and invasive studies have indicated that collateral vessels are important for salvage of myocardium at risk in acute myocardial infarction. Only a few clinical studies have attempted to express the development of the collateral vascular bed in terms of flow or resistance. METHODS: Angiography and flow velocity measurements of the contralateral coronary artery were performed in 38 patients undergoing coronary angioplasty for one-vessel disease. Coronary flow velocity was assessed by zero-crossing frequency analysis in 37 patients and, additionally, by fast Fourier transform spectral analysis in 23. Collateral flow was determined by the decrease of flow velocity after balloon deflation. Mean aortic pressure and coronary wedge pressure were assessed for calculation of collateral vascular resistance. RESULTS: Angiography of the contralateral artery during balloon inflation revealed the presence of collateral vessels in 26 patients (recruitable collateral vessels in 19). Fast Fourier transform spectral analysis demonstrated a significant transient increase of flow velocity during brief coronary occlusion in 15 patients with collateral vessels compared with 8 patients without collateral vessels (4.8 +/- 1.3% vs. 23.4 +/- 17.2%, p < 0.001). A transient increase in flow velocity (> 10%) was less evident by zero-crossing frequency analysis than by fast Fourier transform spectral analysis (sensitivity 8% vs. 87%). The relative resistance of the collateral vascular bed was significantly reduced when collateral vessels were present during coronary occlusion (4.4 +/- 3.8 vs. 16.9 +/- 4.6, p < 0.001). Furthermore, electrocardiographic signs of ischemia were less present in those 15 patients with collateral vessels (p < 0.05). CONCLUSIONS: The beneficial effect of collateral vessels during brief coronary occlusion is exerted by a significant increase of flow in the contralateral artery in combination with a reduced resistance in the collateral vascular bed. The method presented is capable of expressing the development of the collateral vascular bed in terms of flow and resistance.

Adult↗
PubMed1998

Gamekeeper thumb: comparison of MR arthrography with conventional arthrography and MR imaging in cadavers.

PURPOSE: To compare magnetic resonance (MR) arthrography with conventional arthrography and standard MR imaging in the evaluation of gamekeeper thumb. MATERIALS AND METHODS: Eighteen cadaveric thumbs with (n = 12) or without (n = 6) experimental abduction stress were examined with conventional arthrography, standard MR imaging, and MR arthrography. Standard MR imaging and MR arthrography were performed with 0.2-T (low-field-strength) extremity-only and 1.5-T (high-field-strength) magnets. Results of blinded imaging analyses were correlated with pathologic findings. Paired MR images and MR arthrograms were rated with a three-point scale. RESULTS: Fourteen ulnar collateral ligaments were torn, including eight nondisplaced (57%) and six displaced (43%) tears. For the presence of tear, diagnostic accuracy of conventional arthrography, low-field-strength MR imaging, high-field-strength MR imaging, low-field-strength MR arthrography, and high-field-strength MR arthrography was 83%, 89%, 90%, 94%, and 100%, respectively. With regard to displacement of the torn ligament, diagnostic accuracy was 61%, 89%, 90%, 94%, and 100%, respectively. MR arthrograms were rated superior to standard MR images in 72% and 90% of specimens with low-field-strength and high-field-strength magnets, respectively. CONCLUSION: Of the tested methods, MR arthrography proved to be the most sensitive to the diagnosis of a torn ulnar collateral ligament of the first metacarpophalangeal joint and of displacement of the torn ligament.

Aged↗
PubMed2006

Ommatidial type-specific interphotoreceptor connections in the lamina of the swallowtail butterfly, Papilio xuthus.

The eye of the butterfly Papilio xuthus contains a random array of three types of ommatidia (types I-III), each bearing nine photoreceptors, R1-R9. Of the six spectral classes of photoreceptors identified, types I, II, and III ommatidia contain four, three, and two classes, respectively: the ommatidia are thus spectrally heterogeneous. The photoreceptors send their axons to the lamina where, together with some large monopolar cells (LMCs), the nine from a single ommatidium contribute to a module called a lamina cartridge. We recently reported that among different photoreceptor axon terminals visualized by confocal microscopy, the number and length of axon collaterals differ for different spectral receptors, suggesting that lamina circuits are specific for each ommatidial type. Here we studied the distribution of synapse-like structures in the cartridges, first characterizing a photoreceptor by measuring its spectral sensitivity and then injecting Lucifer yellow (LY). We subsequently histologically identified the type of ommatidium to which the injected photoreceptor belonged, cut serial ultrathin sections of the entire lamina, labeled these with anti-LY immunocytochemistry, and then localized synapse-like structures. We found numerous interphotoreceptor contacts both within and between cartridges, the combination of which was again specific for the ommatidial type. R3 and R4, which are green-sensitive photoreceptors in all ommatidia, have thick axons lacking collaterals. We found that these cells exclusively make contacts with LMCs and not with photoreceptors. We therefore presume that R3 and R4 construct a system for motion vision, whereas other randomly distributed spectral types provide inputs for color vision.

Animals↗
PubMed2005

The "moving valgus stress test" for medial collateral ligament tears of the elbow.

BACKGROUND: The diagnosis of a painful partial tear of the medial collateral ligament in overhead-throwing athletes is challenging, even for experienced elbow surgeons and despite the use of sophisticated imaging techniques. HYPOTHESIS: The "moving valgus stress test" is an accurate physical examination technique for diagnosis of medial collateral ligament attenuation in the elbow. STUDY DESIGN: Cohort study (diagnosis); Level of evidence, 2. METHODS: Twenty-one patients underwent surgical intervention for medial elbow pain due to medial collateral ligament insufficiency or other abnormality of chronic valgus overload, and they were assessed preoperatively with an examination called the moving valgus stress test. To perform the moving valgus stress test, the examiner applies and maintains a constant moderate valgus torque to the fully flexed elbow and then quickly extends the elbow. The test is positive if the medial elbow pain is reproduced at the medial collateral ligament and is at maximum between 120 degrees and 70 degrees. RESULTS: The moving valgus stress test was highly sensitive (100%, 17 of 17 patients) and specific (75%, 3 of 4 patients) when compared to assessment of the medial collateral ligament by surgical exploration or arthroscopic valgus stress testing. The mean shear range (ie, the arc within which pain was produced with the moving valgus stress test) was 120 degrees to 70 degrees. The mean angle at which pain was at a maximum was 90 degrees of elbow flexion. CONCLUSIONS: The moving valgus stress test is an accurate physical examination technique that, when performed and interpreted correctly, is highly sensitive for medial elbow pain arising from the medial collateral ligament.

Adolescent↗
PubMed1999

Sevoflurane selectively increases coronary collateral blood flow independent of KATP channels in vivo.

BACKGROUND: Volatile anesthetic agents produce coronary vasodilation via activation of adenosine triphosphate-sensitive potassium (KATP) channels. The authors tested the hypothesis that sevoflurane selectively increases coronary collateral blood flow and assessed the role of KATP channel activation in this process. METHODS: Experiments were conducted in dogs 8 weeks after long-term implantation of a left anterior descending coronary artery (LAD) ameroid constrictor to stimulate coronary collateral growth. Dogs were instrumented for measurement of retrograde LAD blood flow (an index of large coronary collateral blood flow) and LAD tissue flow (via radioactive microspheres; an index of small collateral blood flow). Coronary collateral perfusion and normal (left circumflex coronary artery [LCCA]) zone tissue blood flow were determined in four groups of dogs pretreated with intracoronary glyburide (50 microg/kg) or vehicle in the presence or absence of sevoflurane (1 minimum alveolar concentration). Dose-response relationships to the KATP channel agonist nicorandil were established in each dog using doses (25, 50, and 100 microg/min) previously shown to increase coronary collateral blood flow. RESULTS: Sevoflurane increased blood flow through large and small collaterals and increased collateral vascular conductance in the presence of glyburide but did not affect LCCA blood flow or conductance. In contrast, nicorandil increased blood flow through small but not large collaterals. Nicorandil also increased LCCA blood flow and conductance, actions that were attenuated by glyburide. CONCLUSIONS: The results demonstrate that sevoflurane selectively increases large and small coronary collateral blood flow via mechanism(s) independent of KATP channel activation.

Adenosine Triphosphate↗
PubMed1995

Language-related field potentials in the anterior-medial temporal lobe: I. Intracranial distribution and neural generators.

Field potentials were recorded from intracranial electrodes in humans to study language-related processing. Subjects viewed sentences in which each word was presented successively in the center of a video monitor. Half of the sentences ended normally, while the other half ended with a semantically anomalous word. The anomalous sentence-ending words elicited a large negative field potential with a peak latency near 400 msec, which was focally distributed bilaterally in the anterior medial temporal lobe (AMTL), anterior to the hippocampus and near the amygdala. Subdural electrodes positioned near the collateral sulcus just inferior and lateral to the amygdala recorded a positive field potential at the same latency. This spatial distribution of voltage suggested that this language-sensitive field potential was generated in the neocortex near the collateral sulcus and anterior fusiform gyrus. Additional task-related field potentials were recorded in the hippocampus. The AMTL field potential at 400 msec shares characteristics with the N400 potential recorded from scalp electrodes that has been associated with semantic processing.

Action Potentials↗
PubMed1990

Diagnosis of alcohol use disorders in schizophrenia.

Alcohol use disorders are common comorbid conditions in schizophrenia, and their presence is associated with poor adjustment and poor treatment response. Standard alcohol assessment instruments have not been validated for use with schizophrenic patients, and several authors have questioned the validity of these patients' self-reports. A reliable and valid screening procedure for assessing alcohol use is needed. The present study used the following three methods to evaluate a rural sample of 75 outpatients with DSM-III-R schizophrenia or schizoaffective disorder: (1) clinical records; (2) research interviews using standard alcohol assessment instruments; and (3) case managers' ratings. In addition, consensus diagnoses, determined by combining information from all three methods with intensive case reviews, were used to determine the sensitivity and specificity of the other approaches. As expected, clinical evaluations frequently missed alcohol problems. Research interviews and case managers' ratings differentiated between alcoholic and nonalcoholic schizophrenic patients and were highly correlated. Case managers' ratings, which incorporated longitudinal observations of behavior and collateral reports as well as interview data, were more sensitive measures of current alcohol use disorders than research interviews. Subjects frequently manifested alcohol-related problems that interfered with community adjustment without the full dependence syndrome, suggesting that schizophrenic patients may be particularly vulnerable to negative effects of alcohol.

Adult↗
PubMed1995

Salutary effects of myocardial ischemia in coronary artery disease.

Although myocardial ischemia in patients with coronary artery disease should be eliminated with medical and surgical treatment, it paradoxically contributes to the preservation of compromised myocardium through various mechanisms. First, ischemic vasodilation of coronary and collateral vessels resulting from the activation of the ATP-sensitive K+ channel maximizes a blood supply to the area having imbalance between myocardial oxygen supply and demand. Second, myocardial ischemia secondary to severe coronary stenosis develops functionally significant collateral circulation, which alleviates the deleterious sequelae of coronary obstructive disease. Finally, myocardial preconditioning with ischemia attenuates the subsequent ischemic insult. Particularly if combined with early reperfusion of the infarct-related coronary artery, the infarct size is decreased to one fourth of the permanent occlusion in dogs. A thorough understanding of the mechanisms of self-protecting benefits of myocardial ischemia would be useful in the care of patients with coronary artery disease.

Angina Pectoris↗
PubMed1994

Digital angiographic impulse response analysis of regional myocardial perfusion. Detection of autoregulatory changes in nonstenotic coronary arteries induced by collateral flow to adjacent stenotic arteries.

BACKGROUND: Our study compares the effect of acute proximal stenosis of a coronary artery supplying a myocardial perfusion bed with that of stenosis of an adjacent artery resulting in collateral flow diversion supplied by the same perfusion bed. These alterations in coronary physiology were quantified by digital angiographic impulse response analysis of contrast material mean transit time for the coronary microcirculation, Tmicro, and by flowmeter and microsphere assessment of flow and regional flow distribution. METHODS AND RESULTS: In 25 open-chest, anesthetized dogs, progressive circumflex artery stenosis led to a concordant decrease of circumflex artery resting and hyperemic flow, coronary flow reserve, and inverse angiographic mean transit time Tmicro-1 (P < .01). Progressive left anterior descending artery stenosis led to no or only minor changes of circumflex artery resting or hyperemic flow or flow reserve; only occlusion induced a significant decrease of coronary flow reserve (from 4.0 +/- 0.7 to 3.2 +/- 0.5, P < .05), whereas resting flow was increased by +8.6 +/- 5.9%. In contrast, circumflex artery Tmicro-1 diminished significantly with critical left anterior descending artery stenosis and occlusion (from 16.7 +/- 4.2 to 12.6 +/- 2.2 [P < .05] and 12.0 +/- 3.0 min-1 [P < .01], respectively). In 8 dogs, collateral flow induced by left anterior descending artery occlusion was quantified by microsphere injections. The decrease of circumflex artery Tmicro-1 correlated with the magnitude of collateral flow (r = .76) and was associated with the angiographic extent of collateral filling. CONCLUSIONS: Digital angiographic impulse response analysis is a sensitive method to detect the influence of proximal artery stenosis on an artery's myocardial perfusion bed as well as the changes induced by an adjacent artery stenosis inducing collateral flow diversion from the supplying myocardial perfusion zone.

Angiography, Digital Subtraction↗
PubMed1987

Morphological characteristics of low-threshold primary afferents in the trigeminal subnuclei interpolaris and caudalis (the medullary dorsal horn) of the golden hamster.

Intra-axonal recording and horseradish peroxidase (HRP) injection techniques were employed to define the response characteristics of low-threshold, rapidly conducting trigeminal primary afferents and the morphological features of their axon arbors in subnucleus interpolaris and subnucleus caudalis (or the medullary dorsal horn; these last two terms are used synonomously throughout the paper). A total of 61 such afferents were characterized and recovered. Of these, ten gave rapidly adapting (RA) and 17 slowly adapting (SA type I) responses to vibrissa deflection. Twenty were sensitive to guard hair deflection and 14 were responsive to indentation of the hairy skin. The vibrissa-sensitive primary afferents were all quite similar morphologically. Primary collaterals proceeded directly, in a radial fashion, to their zone of termination and gave rise to dense and compact arbors. These tended to be larger in the medullary dorsal horn (MDH) than in interpolaris and they also gave rise to more boutons in the former nucleus. Guard hair afferents generally had smaller arbors and gave rise to fewer boutons than vibrissa-sensitive axons. Like vibrissa afferents, their arbor were generally circumscribed in both interpolaris and MDH, but they were larger in the latter nucleus. Skin-sensitive afferents had arbors that tended to be somewhat larger than those of vibrissa- or guard-hair-related fibers. Unlike the other fiber types, the arbors of skin-sensitive afferents were on average larger in interpolaris than MDH. Quantitative analysis of the morphological data from well-filled examples from each of these four functional types verified our qualitative impressions regarding differences between interpolaris and MDH collaterals of a given fiber-type. Statistical comparison of data from different functional classes indicated trends that supported our qualitative impressions, but none of these was statistically significant. The topography of the trigeminal primary afferent input to interpolaris was organized such that the head was inverted and fibers with caudal receptive fields terminated in the lateral portion of the nucleus. This was true for all of the functional afferent types that we examined. Vibrissa-related fibers differed from nonvibrissa afferents in that they tended to avoid the most rostral portion of interpolaris. In the MDH, the primary afferent representation of the head was also inverted, but fibers with caudal facial receptive fields tended to terminate medially rather than laterally.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1997

The lack of effect of baclofen on action potentials of spinal motor axon collateral terminations in vivo.

In the lumbar ventral horn of pentobarbitone-anaesthetised cats, (-)-baclofen reduces both the synaptic release of excitatory transmitter from muscle group Ia afferent terminations and the duration of the presynaptic action potentials of these terminations, presumably by interfering with the influx of calcium ions through voltage-activated channels. Baclofen, however, has little or no effect on cholinergic excitation at motor axon collateral synapses on spinal Renshaw cells and, in the present study, was found not to reduce the duration of the action potential of axon collateral terminations located in the vicinity of Renshaw cells in pentobarbitone-anaesthetised cats. Furthermore, in contrast to group Ia terminations, a 4-aminopyridine-sensitive potassium conductance could not be detected as contributing to axon collateral termination action potentials. These results suggest that there may be differences in presynaptic ion fluxes associated with transmitter release at the intraspinal terminations of group Ia afferent fibres and motor axon collaterals in the cat spinal cord.

4-Aminopyridine↗
PubMed2006

Unifocalization and repair of pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries.

AIM: To correlate anatomic and genetic features of paediatric patients with pulmonary atresia, ventricular septal defect (VSD) and multiple aortopulmonary collateral arteries with surgical outcome. METHODS: 44 consecutive patients aged 33 +/- 40 mo underwent either primary one-stage unifocalization (n = 32) or palliative right ventricular outflow tract reconstruction (n = 12) followed by secondary unifocalization and repair (n = 10) based on preoperative morphometric and functional evaluation of pulmonary blood sources. Chromosome 22q11.2 microdeletion occurred in 41% of cases. Combined VSD closure during one-stage procedures was guided by an intraoperative pulmonary flow study. Complete repair was accomplished in 35 cases (83%, 95% CI 72-95%). Variables examined included occurrence of confluent intrapericardial pulmonary arteries, central pulmonary arteries, confluent intraparenchymal pulmonary arteries, dominant collateral or pulmonary arteries, and chromosome 22q11.2 microdeletion. The sensitivity and specificity of the pulmonary flow study in predicting postoperative pulmonary haemodynamics were also tested. RESULTS: Eight-year actuarial survival and freedom from reoperation were 85% and 63%, respectively. Sensitivity and specificity of the pulmonary flow study were 94% and 100%, respectively. None of the anatomical variables examined was significantly related to the outcome of treatment. The only statistically relevant association was detected between survival and occurrence of 22q11.2 microdeletion (p < 0.003). Logistic analysis showed an increased likelihood of positive outcome in relation to first- (p < 0.02) or second-stage (p < 0.04) complete correction. CONCLUSION: Morphology of pulmonary blood supply has no major impact on surgical outcome. Pulmonary flow study is a highly specific and sensitive intraoperative test. Chromosome 22q11.2 microdeletion remains the only variable significantly affecting survival.

Adolescent↗
PubMed2006

Can the modified Allen's test always detect sufficient collateral flow in the hand? A computational study.

Blood flow in the largest arteries of the arm up to the digital arteries is numerically modelled using the one-dimensional equations of pressure and flow wave propagation in compliant vessels. The model can be applied to different anatomies of arterial networks and can simulate compression of arteries, these allowing us to simulate the modified Allen's test (MAT) and to assess its suitability for the detection of sufficient collateral flow in the hand if radial blood supply is interrupted. The test measures blood flow in the superficial palmar arch before and during compression of the radial artery. The absence of reversal flow in the palmar arch with the compression indicates insufficient collateral flow and is referred to as a positive MAT. This study shows that small calibres of the superficial palmar arch and insufficient compression of the radial artery can lead to false-positive results. Measurement of the drop in digital systolic pressures with compression of the radial artery has proved to be a more sensitive test to predict the presence of sufficient ulnar collateral flow in networks with small calibres of the superficial palmar arch. However, this study also shows that digital pressure measurements can fail in detecting enough collateral flow if the radial artery is insufficiently compressed.

Collateral Circulation↗
PubMed1997

Patterns of connectivity of spinal interneurons with single muscle afferents.

A technique was developed to measure, in the anesthetized and paralyzed cat under artificial ventilation, changes of excitability to intraspinal stimulation simultaneously in two different afferent fibers or in two collaterals of the same afferent fiber. Intraspinal stimulation reduced the threshold of single muscle afferent fibers ending in the intermediate nucleus. This effect was seen with strengths below those required to activate the afferent fiber tested (1.5-12 microA), occurred at a short latency (1.5-2.0 ms), reached a maximum between 15 and 30 ms, and lasted up to 100 ms. The effects produced by graded stimulation applied at the shortest conditioning-testing stimulus time intervals increased by fixed steps, suggesting recruitment of discrete elements, most likely of last-order interneurons mediating primary afferent depolarization (PAD). The short-latency increases in excitability produced by the weakest effective intraspinal stimuli were usually detected only in the collateral closest to the stimulating micropipette, indicating that the stimulated interneurons mediating PAD have spatially restricted actions. The short-latency PAD produced by intraspinal stimuli, as well as the PAD produced by stimulation of the posterior biceps and semitendinosus (PBSt) nerve or by stimulation of the bulbar reticular formation (RF), was depressed 19-30 min after the i.v. injection of 0.5 mg/kg of picrotoxin, suggesting that all these effects were mediated by GABAergic mechanisms. The PAD elicited by stimulation of muscle and/or cutaneous nerves was depressed following the i.v. injection of (-)-baclofen, whereas the PAD elicited in the same collateral by stimulation of the RF was baclofen-resistant. The short-latency PAD produced by intraspinal stimulation was not always depressed by i.v. injections of (-)-baclofen. Baclofen-sensitive and baclofen-resistant monosynaptic PADs could be produced in different collaterals of the same afferent fiber. The results suggest that the intraspinal terminals of single muscle afferents receive synapses from more than one PAD-mediating GABAergic interneuron and that a single last-order interneuron has synaptic connections with a restricted number of intraspinal terminals and/or collaterals of the same afferent fiber. In addition, they support the existence of separate subsets of last-order baclofen-sensitive and baclofen-resistant interneurons that respond predominantly to segmental and to descending inputs. It is suggested that the restricted nature of the PAD plays an important role in the central control of the synaptic effectiveness of group I muscle afferents.

Afferent Pathways↗
PubMed1986

Effects of nasal and laryngeal stimulation upon peripheral lung function.

Arterial hypoxemia and sudden death have been associated with the placement of posterior packs for control of severe epistaxis. There exists some controversy as to the mechanism underlying the clinically observed hypoxemia; some authors postulate a nasal pulmonary reflex as the basis for the hypoxemia. In an attempt to further investigate this theory, collateral ventilation was measured in the dog model during nasal and laryngeal stimulation. Collateral ventilation is thought to be one of the most sensitive techniques available to assess the resistive and elastic properties of the lung periphery. In the dog, with respiratory rate controlled (i.e., anesthetized and paralyzed), nasal stimulation with mechanical, thermal, and chemical stimuli failed to affect collateral ventilation. This finding suggests that the reflex may be acting either in larger lung segments or on the pulmonary vascular bed itself.

Airway Resistance↗