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At least 793 records · Page 44Linked to original sources
PubMed2003

[Lateral lymphadenectomy in the treatment of rectal carcinoma].

The aim of this work is to present existence of the lateral lymphatic spread of metastases in patients with Dukes C low rectal carcinoma (60% of all patients), located at or bellow peritoneal reflexion. Prospective clinical investigation analyzed the group of 64 patients (32 underwent lateral lymphadenectomy and 32 didn't), all treated at Ist Surgical Clinic, Clinical Center of Serbia. Lateral lymphatic spread of metastases was proven by frozen section in 8 cases, so extensive lateral lymphadenectomy was performed. In the group of patients who underwent lateral lymphadenectomy, positive lymph nodes were registered in 18 patients (56.2%); in group of patients operated without lateral lymphadenectomy, metastatic lymph nodes were registered in 12 patients (37.5%). According to results of this investigation, method of lateral lymphadenectomy, as well as extensive lateral lymphadenectomy, is significant for exact determination of postoperative stage of the disease. Also, there is a significant increase in number of patients with Dukes C stage of the disease. In those patients, mesorectectomy alone is not sufficient.

Adult↗
PubMed1995

Evaluation of varied surgical approaches used in the management of 170 far-lateral lumbar disc herniations: indications and results.

This study was undertaken to determine and compare indications and relative benefits of various surgical approaches in 170 patients (average age 55 years) with far-lateral herniated lumbar discs, identified by magnetic resonance (MR) imaging and computerized tomography (CT) and operated on between 1984 and 1994. Essentially three surgical procedures were performed: complete facetectomy in 73 patients, laminotomy with medial facetectomy in 39 patients, and intertransverse discectomy (also known as ITT) in 58 patients. Follow-up periods averaged 5 years (range 0.5-10 years). Outcomes were scored as excellent (no deficit), good (mild radiculopathy), fair (moderate radiculopathy), and poor (unchanged or worse). Overall, excellent and good results were achieved in 73 and 51 patients, respectively, and fair and poor results in 26 and 20, respectively. There was little difference among the results encountered for the three major surgical groups: 79% of the intertransverse (ITT) group had good-to-excellent outcomes, as compared with 70% of the facetectomy group, and 68% of the group who underwent at minimum laminotomy, and additional hemilaminectomy or laminectomy with medial facetectomy. Results were the same for the 121 patients followed for more than 2 years and for the 49 patients studied for under 2 years. In the management of far-lateral discs, total facetectomy provides the best exposure, but increases the risk of instability. Laminotomy and medial facetectomy uncover the lateral and subarticular recess and preserve stability, but visualization of the far-lateral compartment is often inadequate. The intertransverse approach offers extensive far-lateral but not medial intraforaminal exposure, while also preserving stability. Full facetectomy, laminotomy with medial facetectomy, and the intertransverse approaches yielded nearly comparable outcomes in far-lateral disc surgery. Only the full facetectomy exposes the entire course of the nerve root both medially and laterally, whereas the intertransverse procedure provides direct exposure of the fat-lateral compartment alone. It is important to select the correct approach or combination of approaches to address attendant complicating factors such as spinal stenosis, spondyloarthrosis, and degenerative spondylolisthesis identified on CT and MR studies.

Adult↗
PubMed2003

Shoulder impact response and injury due to lateral and oblique loading.

Little is known about the response of the shoulder complex due to lateral and oblique loading. Increasing this knowledge of shoulder response due to these types of loading could aid in improving the biofidelity of the shoulder mechanisms of anthropomorphic test devices (ATDs). The first objective of this study was to define force versus deflection corridors for the shoulder corresponding to both lateral and oblique loading. A second focus of the shoulder research was to study the differences in potential injury between oblique and lateral loading. These objectives were carried out by combining previously published lateral impact data from 24 tests along with 14 additional recently completed lateral and oblique tests. The newly completed tests utilized a pneumatic ram to impact the shoulder of approximately fiftieth percentile sized cadavers at the level of the glenohumeral joint with a constant speed of approximately 4.4 m/sec. Of the 14 tests, four of them were conducted lateral to the shoulder along the subject's y-axis, four of them were conducted 15 anterior to this axis, and six were conducted 30 anterior to the subject's y-axis. As in the previous testing, the first thoracic vertebrae and both shoulders of the subject were instrumented with tri-axial linear accelerometers on the sternum, clavicle, acromion process, and inferior angle of the scapula. The impacting mass was instrumented with an accelerometer and displacement transducer. In addition to this instrumentation, the tests were documented by high-speed digital imagery. Radiographs (x-rays), magnetic resonance images (MRIs), and autopsies were used to document injury to the subjects. The results from the tests revealed differences between the stiffness of the shoulder when loaded laterally to that when it is loaded obliquely. The shoulder was found to deflect twice as much medially when loaded obliquely then when it is loaded laterally. This can be attributed to the ability of the scapula to slide posteriorly around the thoracic cage. The ability of the shoulder to displace medially while simultaneously deflecting posteriorly in oblique impact is important to replicate in the ATDs because it results in the load being transmitted to the upper thoracic cage.

Journal Article↗
PubMed2000

Organization of the lateral line system in embryonic zebrafish.

We describe the organization of lateral line nerves and ganglia in the embryonic zebrafish, Danio rerio. Two lateral line nerves are found anterior to the otic vesicle: the anterodorsal nerve innervates neuromasts of the supraorbital, infraorbital, and otic lines, whereas the anteroventral nerve innervates the mandibular and opercular lines. An additional two lateral line nerves are found posterior to the otic vesicle: the middle lateral line nerve innervates the middle line, whereas the posterior nerve innervates the occipital dorsal and posterior trunk lines. Preotic nerves converge on a single entry zone into the central nervous system at the facial motor root (mVII), as do axons of the octaval nerve. Postotic nerves converge to a posterior entry zone at the glossopharyngeal root. Both lateral line ganglia and neuromasts develop on a stereotypical schedule. To examine the segmental relationships among cranial ganglia, neural crest, and hindbrain, lateral line organization was analyzed in valentino mutants, which have disruptions in the development of rhombomeres 5-7 and in the third arch neural crest, and are missing glossopharyngeal motor neurons. The proposed corresponding lateral line nerve for this head segment, the middle lateral line, appears to develop normally. However, the middle and posterior nerves do not form a posterior entry zone in the absence of a glossopharyngeal root in val mutants, but instead course anteriorly to join the preotic nerves.

Animals↗
PubMed2003

Great increase in bone 66 kDa protein and osteocalcin at later stages with healing rat fractures: effect of zinc treatment.

Fracture healing has been demonstrated to increase production of bone growth factors, and this elevation has been shown to be enhanced by zinc treatment. Moreover, the effect of zinc treatment on production of bone osteocalcin, which is a kind of Ca2+-binding protein localized in bone matrix, at the later stages with bone fracture was investigated. Rats were sacrificed 7 (earlier stage) or 21 (later stage) days after fracture of femoral diaphysis. Femoral-diaphyseal tissues with fracture healing were cultured in a serum-free medium for 24 h. Many proteins in the bone tissues were released into the medium. Bone protein production was markedly elevated 21 days after bone fracture as compared with that of 7 days. A approximately 66 kDa protein molecule, a major protein component which was produced by the diaphyseal tissues during fracture healing, was predominantly increased at the later stages with fracture healing. Bone osteocalcin production was significantly increased during fracture healing. This increase was enhanced at the later stages with fracture healing. The presence of zinc acexamate (10(-4) M) in culture medium caused a significant increase in bone protein and osteocalcin production at 7 or 21 days after bone fracture. The effect of zinc acexamate in increasing bone total protein and osteocalcin production was remarkable at the later stages with fracture healing. Moreover, zinc treatment caused a significant increase in alkaline phosphatase activity, deoxyribonucleic acid (DNA) and calcium content in the femoral-diaphyseal tissues of the later stages with fracture healing in vitro. The present study demonstrates that bone protein production is markedly increased at the later stages with fracture healing, and that zinc treatment can enhance production of bone protein components including osteocalcin in vitro. Zinc treatment may stimulate the healing of femoral fracture at earlier and later stages.

Animals↗
PubMed2004

Legg-Calve-Perthes disease. Part I: Classification of radiographs with use of the modified lateral pillar and Stulberg classifications.

BACKGROUND: Accurate and reliable radiographic classifications of the relative severity and outcome of Legg-Calve-Perthes disease are essential in the study of that disease. As part of a prospective multicenter study, we sought to define more clearly the lateral pillar classification of severity and the Stulberg classification of outcome; we sought especially to define the borderlines between classification groups. METHODS: We performed interobserver and intraobserver trials of the lateral pillar and Stulberg classifications using sets of twenty radiographs chosen from a prospective study of 345 hips. To establish reliable definitions of the lateral pillar classification, we added a new, intermediate group termed the B/C border group, which includes femoral heads with a thin or poorly ossified lateral pillar and those with a loss of exactly 50% of the original height of the lateral pillar. The resulting classification consists of four groups: A, B, B/C border, and C. In our application of the classification system of Stulberg et al., we defined a class-II femoral head as round and fitting within 2 mm of a circle on both anteroposterior and frog-leg lateral radiographs. We defined a Stulberg class-III femoral head as out of round by more than 2 mm on either view and a Stulberg class-IV femoral head as one with at least 1 cm of flattening of the weight-bearing articular surface. To assess interobserver and intraobserver agreement, we performed two trials of each classification with six orthopaedic surgeons reviewing twenty radiographs or pairs of radiographs. RESULTS: In the first trial of the lateral pillar classification, there was 81% agreement per radiograph and the average weighted kappa was 0.71. In the second trial, there was 85% agreement per radiograph and the weighted kappa averaged 0.79. Intraobserver reliability testing showed a 77% match between Trials 1 and 2, an average weighted kappa of 0.81, and an average generalizability coefficient of 0.91. In Trial 1 of the Stulberg classification, there was 91% agreement per radiograph and an average weighted kappa of 0.82. In Trial 2, there was 92% agreement per radiograph and an average weighted kappa of 0.82. Intraobserver reliability testing showed an 89% match between Trials 1 and 2, an average weighted kappa value of 0.88, and an average generalizability coefficient of 0.92. CONCLUSIONS: The interobserver and intraobserver trials of these classifications produced kappa values and generalizability coefficients in the excellent range. The modified lateral pillar classification and the redefined Stulberg classification are sufficiently reliable and accurate for use in studies of Legg-Calve-Perthes disease.

Adolescent↗
PubMedDate not supplied

Relationship between duration of unilateral masticatory cycles and the type of lateral dental guidance: a preliminary study.

PURPOSE: This study assessed the duration of different phases of the chewing cycle and the height of the masticatory cycle in relation to the type of lateral guidance. MATERIALS AND METHODS: Fifty-three subjects with the same type of lateral guidance on both sides were categorized into 3 groups: anterior protected articulation, canine protection, and group function. Overbite was measured clinically. Border jaw movements were recorded using a Sirognathograph, and the lateral guidance angle in the frontal plane was measured. Jaw movements during unilateral chewing of peanuts were recorded on the frontal plane using the Sirognathograph connected to an electrocardiograph used for transcription. A single masticatory cycle was divided into opening, closing, and occlusal-level phases. Masticatory parameters were analyzed by one-way analysis of variance, correlations, the paired Student t test, and multiple linear regression. RESULTS: Women showed significantly longer total cycle duration than men. Subjects with canine protection showed the highest lateral guidance angle and the highest chewing cycle duration. Subjects with anterior protected articulation exhibited significantly longer occlusal-level phases. Fifty-nine percent of the variation in duration of the occlusal-level phase can be explained by the type of lateral dental guidance, gender, and lateral guidance angle. Only overbite was a predictor of height of mastication. CONCLUSION: The type of lateral guidance, gender, and frontal guidance angle are correlated with the duration of the occlusal-level phase during unilateral chewing of peanuts. The height of mastication cannot be explained by the type of lateral guidance.

Adult↗
PubMed1989

[Electromyographic study on lateral jaw movements].

This study aims to analyse how jaw-closing muscle activities are modulated during lateral jaw movement. Jaw movements were recorded by Sirognathograph (Siemens Co.) and electromyograms were simultaneously recorded from bilateral masseter, anterior temporal and posterior temporal muscles in 20 young adults without any stomatognathic dysfunction. Each subject sat upright in the chair with the head unsupported. The lateral jaw movements from the intercuspal position were guided three times for each lateral excurtion (right and left). The data were recorded on magnetic tape and later analysed by use of a computer. Following variables were analysed; the number of contacted teeth, the position of contacted teeth, the muscle activities during lateral jaw movement. The results can be summarised as follows; 1) The working-side posterior temporal muscle showed obvious activity in more than 90% subjects during lateral jaw movement. However, this muscle activity was not influence by the number or position of the contacted teeth. 2) The right side masseter muscle tended to show the obvious activity during both right and left lateral jaw movement. The results of this study suggest the difference in the activities between masseter and temporal muscle during lateral jaw movement.

Dental Occlusion↗
PubMed1989

[The macroscopic and microscopic study of the human lateral pterygoid muscle].

The purpose of this investigation was to study the morphology of the human lateral pterygoid muscle and its attachment to the temporomandibular joint. A total of twenty-five lateral pterygoid muscles, twenty for macroscopic and five for microscopic study, were obtained with their temporomandibular joints from eighteen adult cadavers. The results were as follows: 1) The lateral pterygoid muscles observed in this study were classified into three types based on the number of their heads; 65% of the macroscopic specimens had two heads (superior and inferior), 20% three heads (superior, inferior and medial), and 15% a single head. 2) The fascicular architecture of the single-headed specimens was quite simple and so the orientation of their fasciculi was parallel or radial to the line of pull. In their course the fasciculi of the two and three-headed specimens showed a relatively complicated architecture, having a large number of crossover fibers between each head. 3) In all specimens observed macroscopically, the uppermost fasciculi were inserted into the articular disc and capsule of the temporomandibular joint and the rest were inserted into the pterygoid fovea of the neck of the mandible, although no clear boundary could be found between them on their lateral surfaces. The bulk of the fasciculi which were inserted into the articular disc relative to the total amount of the lateral pterygoid muscles was estimated as being in the range of one fifth to one tenth. 4) From the microscopical examination of the specimens the cross-sectional area of the fasciculi which were inserted into the articular disc was about 3 mm2 at their attachment and this corresponded to 30% of the superior head and 3% of total amount of the lateral pterygoid muscle. 5) The fasciculi attached to the articular disc were derived from the superior and medial head of the lateral pterygoid muscle and from the temporalis muscle. In two cases of the twenty examined macroscopically, the fasciculi derived from the inferior head of the lateral pterygoid muscles were inserted into the articular disc.

Humans↗
PubMedDate not supplied

Herniographic appearance of the lateral inguinal fossa.

Herniography frequently reveals clinically undetected groin hernia. Thereby herniography contributes to the clinical work-up in patients with obscure groin pain. However, the distinction between clinically important and unimportant abnormalities within the lateral inguinal fossa can be difficult. This study was therefore designed in order to elucidate the herniographic appearance of the lateral inguinal fossa in patients with obscure groin pain. Herniographic findings were compared with laterality of the patients' symptoms. The lateral umbilical fold was visible in only 47 per cent of the groins. A triangular shaped outpouching from the lateral inguinal fossa and a patent processus vaginalis were found with equal frequency on the left and right side. They were five times as frequent in men as in women. Their presence did not correlate with laterality of the patients' symptoms. Indirect hernias were almost twice as common on the symptomatic side as compared with the asymptomatic side. On the left side they were found twice as often in men as in women while there was no significant sex difference on the right side. Our results show that neither a patent processus vaginalis nor a triangular outpouching from the lateral inguinal fossa correlate with the laterality of the patients' symptoms while true indirect hernias do.

Adolescent↗
PubMed1987

Postoperative patellar complications with or without lateral release during total knee arthroplasty.

Between 1975 and 1984, 84 knees in which an intraoperative lateral release had been performed with total knee arthroplasty (TKA) were compared with 471 knees that, having sufficient patellar tracking at the time of surgery, had not required a lateral release. The lateral superior geniculate artery was routinely sacrificed in all knees in which a lateral release was necessary. The results showed no complications associated with a possible loss of blood supply secondary to the lateral release. No increased evidence of osteonecrosis, patellar bone-cement radiolucency, or patellar fracture was discovered. Clinically, there was no difference in pain, ambulation, or range of motion. Seventeen patellar fractures (3.6%) were observed in patients for whom a lateral release had not been performed, yet only one patellar fracture (1.5%) was encountered among the patients who had required a lateral release. In TKA, lateral release was associated with a relatively high degree of patellar tilting.

Adult↗
PubMed1983

[Quantitative analysis of lateral force of floor reactions in normal and above-knee prosthetic gait].

Analysis of the lateral force of floor reactions has only been reported with reference to the vertical and fore- and-aft force because of large individual variations and great differences between the right and left limb of the same individual on the normal pattern of the force curve. In this study, the lateral force in normal and above-knee prosthetic gait was evaluated by calculating the total impulse during stance phase duration as well as by characteristic points of the force curve. The sensitivity of the electronic unit connected to the Kistler 's force plate was enhanced four times. The following results were obtained: In normal gait, the lateral stability during stance phase was shown by the lateral force which was proved to be a regulative element for rhythmical forward movement of the center of gravity of the body. The lateral stability in above-knee prosthetic gait was evaluated not only by the characteristic pattern of the force curve, but also by a decreased difference of the impulse of lateral force between the natural and artificial limb. The initial adduction angle of above-knee prostheses was determined by such a definition of the lateral force. Five degrees proved to be the most appropriate angle, as has been generally accepted. The lateral force of floor reaction can be definitely measured by a quantitative analysis of the total impulse during stance phase duration.

Adult↗
PubMed1982

[Correlation between fetal abdominal longitudinal and lateral diameters and the baby's weight on discharge (author's transl)].

By ultrasonic diagnostics, fetal abdominal longitudinal and lateral diameters were measured in 200 pregnant women from 37th to 41st weeks of pregnancy before the start of the birth for the study of the correlation coefficients between the diameters and the baby's weight on discharge. The following results were obtained. 1) Before the determination of the above coefficients, the great lateral diameter, the girths of the head, chest and abdomen and sitting height were measured in newborn infants in from six to 12 hours after birth. The correlation coefficient was 0.66 for the great lateral diameter, 0.71 for the head girth, 0.85 for the chest girth, 0.81 for the abdominal girth and 0.66 for the sitting height. The chest and abdominal coefficients were found to be low. 2) By ultrasonic diagnostics, measurements were taken of the fetal heads, chest, abdomen and head length. In consideration of dimensions and distinctness of ultrasonically delineated images, the chest and head length seemed unsuitable for measurement. On the contrary, the head lateral diameter and abdominal longitudinal and lateral diameters can be measured with relative ease. 3) The fetal head lateral diameter can be measured with ease and high accuracy, but its correlation coefficient becomes 0.62 which is low. Due to soft tissues, difficulty is encountered in measuring the fetal abdominal longitudinal and lateral diameters. However, if check points are properly set, they can be measured with relative ease. Their correlation coefficient to the weight on discharge is very high at 0.87. Clinically for the estimation of the weight on discharge, the method of measuring the fetal longitudinal and lateral diameters is presumably the better method at present, based on the above results.

Abdomen↗
PubMed1993

Differential expression of correlates of classical conditioning in identified medial and lateral type A photoreceptors of Hermissenda.

Classical conditioning of Hermissenda produces neurophysiological correlates in the primary sensory neurons of the pathway mediating the conditioned stimulus (CS), the type B and type A photoreceptors. Biophysical and biochemical changes intrinsic to the type B photoreceptors have been studied extensively in conditioned animals. A second site for intrinsic modification with learning has been recently identified in type A photoreceptors. We have recorded from identified medial and lateral type A photoreceptors in conditioned animals and animals that received pseudorandom presentations of light (CS) and rotation (unconditioned stimulus). Here we report that conditioning produces differential effects upon CS-elicited spike frequency and intrinsic excitability detected in identified lateral and medial type A photoreceptors. Lateral type A photoreceptors from conditioned animals exhibited significant increases in spike frequency elicited by the CS as compared to pseudorandom controls. In contrast, CS-elicited spike frequency recorded in medial type A photoreceptors was not significantly different from random controls. The amplitude of the peak and plateau phases of the generator potential of medial and lateral type A photoreceptors was decreased in conditioned animals as compared to random controls. In addition, only lateral type A photoreceptors exhibited enhanced cellular excitability as expressed by increased spike discharges produced by the injection of extrinsic depolarizing current pulses. Conditioning also decreased spike frequency accommodation in lateral type A photoreceptors. In normal controls, medial type B photoreceptors produced stronger synaptic inhibition of medial type A photoreceptors than the lateral type B photoreceptors inhibition of lateral type A photoreceptors.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1996

[The study of lateral thrust of the knee in normal and osteoarthritic knees--evaluation with an accelerometric technique].

An accelerometric method was performed on 30 normal and 148 osteoarthritic (OA) knees to clarify sideways movement of the knee (lateral thrust) which occurs suddenly in the early stance phase of walking. Three thrust patterns were observed: (1) lateral thrust (LT) pattern, (2) medial thrust (MT) pattern, (3) unclassifiable (U) pattern. LT, MT and U patterns were observed in 66.7, 26.6, 6.7% respectively of the 30 normal knees; 76.6, 0, 23.4% of the 137 medial compartmental OA knees, and 0, 45.5, 54.5% of the 11 lateral compartmental OA knees. Descending steps and slope, increased walking speed, and walking with a heavy (20 Kg) object on the shoulders, all significantly increased the first peak of acceleration compared with the usual level walking in both normal and OA knees. However, the rate of increase was significantly greater in OA than in normal knees. A laterally elevated wedged-insole (LWI) decreased the first peak of lateral acceleration, whereas a medially elevated wedged-insole (MWI) increased it. In OA knees, effectiveness of the insole was well correlated with a degree of a reduction in the first peak value of acceleration. Although the LWI caused changes in the magnitude of the lateral acceleration, none of the insoles changed the accelerographic patterns, suggesting their limited effects on the lateral thrust. Clinically properly performed high tibial osteotomy (HTO) showed much greater restraining effects on the lateral thrust of the knee than any insoles, since HTO changed the LT pattern of the 25 medial OA knees to either the MT pattern (72%) or U pattern (28%).

Acceleration↗
PubMed1996

Distinct lateral and medial projections of the spinohypothalamic tract of the rat.

We recently described a direct nociceptive projection from the spinal cord to the hypothalamus in the rat. Several electrophysiological studies of this projection indicated that the axons of some spinohypothalamic tract neurons (SHT) reach the hypothalamus either by a lateral or by a medial route. The purpose of this study was to determine the origin of all SHT neurons that reach the hypothalamus through the lateral and the medial projections, and to investigate the possibility of ablating the SHT without damaging other important sensory and motor tracts by combining retrograde tracing techniques with axonal ablation. As compared with control cases, significant (P < .05) reductions in the number of labeled SHT neurons were encountered, 26% in the ipsilateral spinal cord following lesions of the medial projection, 67% in the contralateral spinal cord following lesions of the lateral projection, and 94% in both contra- and ipsilateral sides following lesions of both the medial and lateral projections. Bilateral lesions of the lateral projections had no effect on the distribution of labeled neurons in the spinal cord and dorsal column nuclei following injections of Fluoro-Gold (FG) into the thalamus, and a small unilateral lesion of the lateral projection reduced the ipsilateral labeling in the motor cortex following injections of FG into the pyramidal decussation. These findings suggest that most SHT neurons ascend through the contralateral lateral projection and that less than half continue in the medial projection to the ipsilateral side. They also suggest a site that can be lesioned without affecting other ascending sensory spinal pathways.

Afferent Pathways↗
PubMed1997

Simultaneous anterograde labeling of axonal layers from lateral superior olive and dorsal cochlear nucleus in the inferior colliculus of cat.

The laminar organization of the central nucleus of inferior colliculus includes layers of axons that may be important in shaping the responses of neurons. Depending on their source, some layered axons are afferents that are superimposed and terminate on the same postsynaptic neurons, while other layered afferents, such as those from the ipsilateral and contralateral lateral superior olive, terminate side-by-side. The specific pattern of convergence may dictate which populations of axons are presynaptic to layered disc-shaped neurons in the central nucleus. We compared the distribution of afferent axons from the dorsal cochlear nucleus and the lateral superior olive to the contralateral inferior colliculus in the cat. Injection sites in cochlear nucleus and superior olive were physiologically characterized by extracellular recordings of single and multiple units in response to monaural and binaural acoustic stimulation. Two separate injections were made in each case, and both injection sites contained units with overlapping best frequencies. Biotinylated dextran, fluorescent dextran, 3H-leucine, and wheat germ agglutinin conjugated to horseradish peroxidase were used as anterograde tracers. The present results show that layered axons from the dorsal cochlear nucleus and lateral superior olive are superimposed in part of the contralateral central nucleus. Both projections were arranged in rostro-caudally oriented axonal layers that converged in the ventral part of the central nucleus. However, in the dorsal part of the central nucleus, the same layer of axons from the dorsal cochlear nucleus did not terminate with afferents from the lateral superior olive. Within the overlapping layers in the ventral central nucleus, the overlap of axons from the dorsal cochlear nucleus and the lateral superior olive was uniform except for small patches that were usually smaller than the dendritic fields of disc-shaped neurons. These data suggest that the layers may create specific functional zones in the central nucleus of the inferior colliculus. One zone may contain neurons with binaural responses that combine the properties of the inputs from the contralateral lateral superior olive and the dorsal cochlear nucleus. A second zone may contain inputs from the cochlear nucleus but lack those of the lateral superior olive.

Afferent Pathways↗
PubMed2002

Recombinant human insulin-like growth factor I (rhIGF-I) for amyotrophic lateral sclerosis/motor neuron disease.

BACKGROUND: Trophic factors, including recombinant human insulin-like growth factor I have been postulated as possible disease modifying therapies for amyotrophic lateral sclerosis. Randomised clinical trials of recombinant human insulin-like growth factor I in amyotrophic lateral sclerosis to date have yielded conflicting results. OBJECTIVES: The main objective of this review was to examine the efficacy of recombinant human insulin-like growth factor I in amyotrophic lateral sclerosis. Occurrence of adverse events has also been reviewed. SEARCH STRATEGY: A search was carried out using the Cochrane Neuromuscular Disease Group register for randomised clinical trials of recombinant human insulin-like growth factor I in amyotrophic lateral sclerosis. Enquiries were also made of authors of randomised clinical trials as well as the manufacturers of recombinant human insulin-like growth factor I regarding any other randomised clinical trials which had not yet been published. SELECTION CRITERIA: Types of studies: all randomised controlled clinical trials involving recombinant human insulin-like growth factor I treatment of amyotrophic lateral sclerosis. TYPES OF PARTICIPANTS: Adults with a clinical diagnosis of definite or probable amyotrophic lateral sclerosis according to the El Escorial Criteria. Types of interventions: Treatment with recombinant human insulin-like growth factor I or placebo. Types of outcome measures: Primary: Change in Appel Amyotrophic Lateral Sclerosis Rating Scale (AALSRS) total score with 0.1mg/kg/day of recombinant human insulin-like growth factor I after nine months treatment. Secondary: Change in AALSRS with recombinant human insulin like growth factor I 0.1mg/kg/day and 0.05mg/kg/day at 1, 2, 3, 4, 5, 6, 7, 8, 9 months, change in quality of life (Sickness Impact Profile scale), survival and adverse events. DATA COLLECTION AND ANALYSIS: We identified two randomised clinical trials. Each reviewer graded them for methodological quality. Data were extracted and entered by the lead reviewer and checked by the other two. Some missing data had to be regenerated by calculations based on ruler measurements of data presented in published graphs. MAIN RESULTS: The primary outcome measure was change in disease progression as determined by the Appel ALS Rating Scale total score with 0.1 mg/kg/day of recombinant human insulin-like growth factor I subcutaneously after nine months treatment. The level of significance was lower in the European trial which compared 59 patients on placebo with 124 on insulin-like growth factor I 0.1 mg/kg/day (weighted mean difference -3.30, 95%CI -8.68 to 2.08) than in the North American trial which compared 90 patients on placebo with 89 on recombinant human insulin-like growth factor I 0.05 mg/kg/day 89 patients and 87 patients on 0.1mg/kg/day (weighted mean difference -6.00, 95%CI -10.99 to -1.01). The combined analysis from both randomised clinical trials showed a weighted mean difference of -4.75 (95% CI -8.41 to -1.09) favouring the treated group. The secondary outcome measures showed similar trends favouring recombinant human insulin-like growth factor I but these did not reach significance at the five per cent level. Similarly the data with the 0.05mg/kg/day dose showed trends favouring recombinant human insulin-like growth factor I at all time points but did not reach significance at the five per cent level at any point. Evaluation of adverse events showed an increased risk of injection site reactions/inflammation with recombinant human insulin-like growth factor I (relative risk 2.53, 95% CI 1.40 to 4.59). The drug was otherwise safe and well tolerated. REVIEWER'S CONCLUSIONS: Recombinant human insulin-like growth factor I may be modestly effective but the evidence currently available is insufficient for a definitive assessment. Further randomised clinical trials need to be done.

Amyotrophic Lateral Sclerosis↗