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Evoked potentials in Huntington's disease. A comparative and longitudinal study.

Pattern-reversal visual (PRVEPs), brain-stem auditory (BAEPs), and somatosensory (SSEPs) evoked potentials were studied in 12 patients with Huntington's disease (HD) and were repeated in eight at one and two years. The mean cortical SSEP amplitude was decreased compared with that of age-matched controls, with a trend of decreasing amplitude with increasing duration and severity of illness. The SSEP latency was not significantly different from that of controls. The PRVEPs and BAEPs were normal. The serial studies showed a progressive decrease in amplitude of the SSEP over a two-year period. These neurophysiological findings may reflect the pathological involvement of the thalamus reported for HD. While evoked potentials are not of use in individual case diagnosis, the SSEP may be an objective physiological method for following the course of the disease in HD and the effects of therapeutic intervention in patient populations.

Aged↗

A guide to the synaptic analysis of the neuropil.

A morphological analysis of the organization of the gray matter in the central nervous system depends on the discovery of consistent repetitive patterns. Without these, the gray matter remains a chaotic jungle. An hypothesis derived from the study of a few simple regions has been developed to serve as a guide in finding these patterns. It states that all nerve fibers and terminals arising from a particular group of nerve cells, or, more precisely, a particular nerve cell type, display similar axoplasmic configurations despite variations in size and shape of the terminations. This hypothesis is reminiscent of the so-called Dale's principle that a nerve cell makes use of the same transmitter at all of its branches or terminations. These apparent rules of uniformity or congruity merely reflect the functional integrity of the nerve cell and the role of its parts in the nervous system. But as an hypothesis, it needs to be tested, and it needs to be tested anew in each region, since exceptions to the assumed rule can be expected. It is therefore proposed as the first working hypothesis in each new region. If it should prove to be true in general, it will facilitate and rationalize the analysis of the gray matter, as it has already done in the cerebellar cortex and the deep cerebellar nuclei. If it should prove to be false in a few regions, the analysis will become more difficult, and additional modes of marking nerve endings will have to be used. Experimental methods for identifying nerve terminals can be translated from the light microscopic to the electron microscopic level, but there are significant drawbacks at both levels: lack of precision, destruction of fibers of passage, and rapid evolution of the degenerative process may greatly restrict their usefulness. Labeling with tritiated amino acids or transmitters, or with horseradish peroxidase, provide new methods for tracing interneuronal connections at the electron microscopic level. These have the advantages of high specificity, nondestructiveness and a physiological mode of selective marking. However, they do not offer a solution to the problem of short-range connections. For these, careful reconstructions of serial sections may prove necessary, as Sjöstrand (1974) has demonstrated in a remarkable paper on the retina. The aim of all these methods is to discover patterns of synaptic connectivity in order to map the cellular organization of the nervous system. In the foregoing, nothing was said about synapses other than those articulating axons with somata or dendrites and their appendages. Clearly the same principles of recognition apply to axo-axonal and dendro-dendritic synapses. Although the synapses that have been considered here are chemical synapses, the same questions regarding the identity of the partners in electrotonic junctions must be asked as well.

Amino Acids↗

How to survive in the dark: bioluminescence in the deep sea.

Bioluminescent tissues in marine organisms may take the form of point source emitters, internal or external glandular organs or glands containing bacterial symbionts. In many cases additional accessory optical structures have been evolved to increase the efficiency of emission, to restrict the angular direction, to focus or collimate the light, to alter its spectral distribution or to guide it from the source to a distant point of emission. This variety of structure is matched by a variety of locations of luminous tissues and organs over the body of different animals. The time course, intensity and spectral nature of bioluminescence are equally variable. Information can be encoded in the spatial pattern, time course and spectral characteristics of bioluminescent signals and the recognition of this information depends upon the visual abilities of the target organism. The known characteristics of the bioluminescence of certain marine organisms are compared with those that would be predicted for different functional interpretations. It is probable that each type of bioluminescent signal in deep-sea organisms is but one factor in the suite of activities which make up a particular behavioural pattern.

Adaptation, Physiological↗

Bovine peptidoglycan recognition protein-S: antimicrobial activity, localization, secretion, and binding properties.

Peptidoglycan (PGN) recognition proteins (PGRPs) are pattern recognition molecules of innate immunity that are conserved from insects to humans. Various PGRPs are reported to have diverse functions: they bind bacterial molecules, digest PGN, and are essential to the Toll pathway in Drosophila. One family member, bovine PGN recognition protein-S (bPGRP-S), has been found to bind and kill microorganisms in a PGN-independent manner, raising questions about the identity of the bPGRP-S ligand. Addressing this, we have determined the binding and microbicidal properties of bPGRP-S in a range of solutions approximating physiologic conditions. In this study we show that bPGRP-S interacts with other bacterial components, including LPS and lipoteichoic acid, with higher affinities than for PCP, as determined by their abilities to inhibit bPGRP-S-mediated killing of bacteria. Where and how PGRPs act in vivo is not yet clear. Using Immunogold electron microscopy, PGRP-S was localized to the dense/large granules of naive neutrophils, which contain the oxygen-independent bactericidal proteins of these cells, and to the neutrophil phagolysosome. In addition, Immunogold staining and secretion studies demonstrate that neutrophils secrete PGRP-S when exposed to bacteria. Bovine PGRP-S can mediate direct lysis of heat-killed bacteria; however, PGRP-S-mediated killing of bacteria is independent of this activity. Evidence that bPGRP-S has multiple activities and affinity to several bacterial molecules challenges the assumption that the PGRP family of proteins recapitulates the evolution of TLRs. Mammalian PGRPs do not have a single antimicrobial activity against a narrow range of target organisms; rather, they are generalists in their affinity and activity.

Animals↗

Therapeutic implications of circadian variations in myocardial ischemia and related physiologic functions.

Electrocardiographic (ECG) monitoring for long periods documents circadian patterns in myocardial ischemic episodes. The rise begins between 6 AM and 8 AM for patients with effort angina, the zenith of ischemic activity occurs at about noon. Similar peaks occur in the frequency of acute myocardial infarction and sudden death. Triggering mechanisms common to all of these events may include rises in catecholamine secretion, sympathetic nervous system activity, blood pressure, heart rate, cortisol secretion, and aggregability of platelets, as well as a trough in fibrinolytic activity. These coincident peaks and troughs would be expected to increase myocardial oxygen demand and decrease oxygen supply after a person arises in the morning. This vulnerable period merits recognition. Tailoring the dosing and choice of medication to prevent or reduce ischemia may be important if potential disease-activity triggering mechanisms are to be attenuated. By modifying triggering mechanisms, we may be able to modify the frequencies of adverse outcomes such as acute myocardial infarction and sudden death.

Adrenergic beta-Antagonists↗

Immunoglobulin recognition of synthetic and natural left-handed Z DNA conformations and sequences.

The relative immunogenicities of the poly[d(G-C)] and poly[d(A-C).d(G-T)] families of helices have been determined. The specificities of the resultant immunoglobulins have been characterized for recognition of different synthetic and natural left-handed sequences and conformations. Certain modifications of poly[d(G-C)] in the sugar-phosphate backbone and cytosine C-5 potentiate the right(R)-to-left(L) (B----Z) transition under physiological conditions. The resulting polynucleotides, poly[d(G-SC)], poly[d(G-io5C)], poly[d(G-br5C)] and poly[d(G-m5C)], are also highly immunogenic. In contrast, DNAs incapable of assuming the left-handed conformation under physiological salt concentrations are weakly or non-immunogenic. These include unmodified poly[d(G-C)] as well as members of the poly[d(A-C).d(G-T)] family of sequences bearing pyrimidine C-5 substitutions (methyl, bromo, iodo). These polynucleotides undergo the R----L isomerization under more stringent ionic and thermal conditions. The specificities of purified polyclonal and monoclonal anti-Z DNA immunoglobulins (IgG) were measured by binding to radiolabeled polynucleotides, by electrophoretic analysis of IgG bound to covalent closed circular DNAs, and by immunofluorescent staining of polytene chromosomes. The salt-induced left-handed forms of poly[d(G-C)] and its derivatives (including the cytidine C-5 methyl, bromo, iodo, and N-5 aza substituted polynucleotides) and of the modified poly[d(A-C).d(G-T)] polymers are bound to varying degrees by different antibodies. The patterns of substrate recognition demonstrate the existence of several antigenic domains in left-handed DNAs, including the helix convex surface and the sugar-phosphate backbone. Substitutions in these regions can produce enhancing (required substitutions), neutral, or inhibitory effects on subsequent IgG binding. Additionally, certain modifications of either the convex surface of Z DNA at the C-5 position of cytidine (i.e. a methyl group) or of the backbone (i.e. phosphorothioate substitution) can lead to polymorphic left-handed conformations that are compatible with antibody binding when present individually but not in combination. The recognition patterns exhibited with DNA substrates from the two DNA families indicate that some, but not all, IgGs show specificity for different nucleotide sequences. The anti-Z DNA IgGs were used to probe for specific left-handed Z DNA determinants on plasmid (e.g. pBR322) or viral (e.g. simian virus 40 (SV40] DNAs and on the acid-fixed polytene chromosomes of dipteran larvae.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

Visual evoked potentials in a patient with prosopagnosia.

Visual evoked potentials (VEPs) were recorded from a 53-year-old man with prosopagnosia during presentation of slides of known and unknown faces and under two control conditions. ANOVA comparisons with a normal male group showed no differences in P100 amplitude, P300 amplitude or P300 latency. There were no significant evoked potential differences between the patient and controls specifically related to the face conditions. There was, however, a significant delay in the latency of P100 from both hemispheres during all types of stimuli. This prolonged latency was asymmetrical, showing a right sided emphasis with the control conditions: pattern reversal and slides of geometric designs. This finding, of a dissociation in the interhemispheric delay, provides physiological evidence of stimulus-specific organisation at an early, sensory level. The fact that the P100 component showed a marked delay, yet P300 fell within normal limits for amplitude and latency, suggests that this patient's problem lies at a perceptual level.

Agnosia↗

Effects of increased heart rate and sympathetic tone on intraventricular electrogram morphology.

Electrogram pattern recognition by way of morphologic analysis has been proposed as a technique that may improve discrimination of ventricular tachycardia from sinus rhythm by antitachycardia devices. The potential impact that increases in heart rate and sympathetic tone could have on such techniques, however, has not been previously determined. A comparative study was undertaken to quantify possible changes in ventricular electrogram morphology using correlation waveform, area of difference, and amplitude analyses in 6 patients during atrial overdrive pacing at cycle lengths of 600 and 400 ms (group A), in 13 patients during infusions of physiologic doses of epinephrine (group B), and in 20 patients undergoing infusions of isoproterenol (group C). Four patients were in both groups A and B. A bipolar intraventricular template of cardiac depolarization during sinus rhythm at rest was compared with depolarization during subsequent passages of sinus rhythm at rest and subsequently increased heart rate. In 36 of 39 patients, waveform configuration as assessed by correlation waveform analysis remained relatively stable during atrial overdrive pacing, epinephrine infusion, and isoproterenol infusion when compared with sinus rhythm at rest. The correlation value did not fall below 0.950 in any patient. Area of difference values for the same 36 patients changed by an average of 6 and 37% during atrial overdrive pacing at cycle lengths of 600 and 400 ms intervals, respectively, by 3% during epinephrine infusion, and by 17% during isoproterenol infusion. In these same patients, there was an average change in electrogram amplitude of -1% during atrial overdrive pacing at 600 ms, 26% during pacing at 400 ms, -1% during epinephrine infusion, and 12% during isoproterenol infusion.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

The flow-pressure plot: a new look on the patient-ventilator interaction in neonatal care.

Most modern neonatal ventilators have now a built-in flow sensor and, as a spin-off of their mechanical action, provide some information about lung function characteristics as compliance and resistance after computation of the flow and pressure signals. Additionally, respiratory graphics as volume-pressure and flow-volume plots can be displayed. In clinical practice, however, they are rarely used to refine the ventilator setting. A nonconventional flow-pressure plot is presented in this article, constructed from the volume or flow, and pressure outputs of a Babylog 8000 (Dräger, Lübeck, Germany). This flow-pressure diagram appears to be useful in the real-time computation of respiratory mechanics based on the Rahn's law of respiratory motion. Its major advantage, however, is the easy pattern recognition of subtle changes in infant-ventilator interaction, ie, excessive triggering, fighting against the ventilator, augmented breath, tube subobstruction. It may be useful to add the flow-pressure plot to the classical respiratory graphics allowing to monitor mechanical ventilation more accurately and to fine tune the ventilator setting accordingly.

Equipment Design↗

Dynamics of cortico-subcortical cross-modal operations involved in audio-visual object detection in humans.

Very recently, a number of neuroimaging studies in humans have begun to investigate the question of how the brain integrates information from different sensory modalities to form unified percepts. Already, intermodal neural processing appears to depend on the modalities of inputs or the nature (speech/non-speech) of information to be combined. Yet, the variety of paradigms, stimuli and technics used make it difficult to understand the relationships between the factors operating at the perceptual level and the underlying physiological processes. In a previous experiment, we used event-related potentials to describe the spatio-temporal organization of audio-visual interactions during a bimodal object recognition task. Here we examined the network of cross-modal interactions involved in simple detection of the same objects. The objects were defined either by unimodal auditory or visual features alone, or by the combination of the two features. As expected, subjects detected bimodal stimuli more rapidly than either unimodal stimuli. Combined analysis of potentials, scalp current densities and dipole modeling revealed several interaction patterns within the first 200 micro s post-stimulus: in occipito-parietal visual areas (45-85 micro s), in deep brain structures, possibly the superior colliculus (105-140 micro s), and in right temporo-frontal regions (170-185 micro s). These interactions differed from those found during object identification in sensory-specific areas and possibly in the superior colliculus, indicating that the neural operations governing multisensory integration depend crucially on the nature of the perceptual processes involved.

Acoustic Stimulation↗

Early identification of intensive care unit-acquired infections with daily monitoring of C-reactive protein: a prospective observational study.

INTRODUCTION: Manifestations of sepsis are sensitive but are poorly specific of infection. Our aim was to assess the value of daily measurements of C-reactive protein (CRP), temperature and white cell count (WCC) in the early identification of intensive care unit (ICU)-acquired infections. METHODS: We undertook a prospective observational cohort study (14 month). All patients admitted for > or =72 hours (n = 181) were divided into an infected (n = 35) and a noninfected group (n = 28). Infected patients had a documented ICU-acquired infection and were not receiving antibiotics for at least 5 days before diagnosis. Noninfected patients never received antibiotics and were discharged alive. The progression of CRP, temperature and WCC from day -5 to day 0 (day of infection diagnosis or of ICU discharge) was analyzed. Patients were divided into four patterns of CRP course according to a cutoff value for infection diagnosis of 8.7 mg/dl: pattern A, day 0 CRP >8.7 mg/dl and, in the previous days, at least once below the cutoff; pattern B, CRP always >8.7 mg/dl; pattern C, day 0 CRP < or =8.7 mg/dl and, in the previous days, at least once above the cutoff; and pattern D, CRP always < or =8.7 mg/dl. RESULTS: CRP and the temperature time-course showed a significant increase in infected patients, whereas in noninfected it remained almost unchanged (P < 0.001 and P < 0.001, respectively). The area under the curve for the maximum daily CRP variation in infection prediction was 0.86 (95% confidence interval: 0.752-0.933). A maximum daily CRP variation >4.1 mg/dl was a good marker of infection prediction (sensitivity 92.1%, specificity 71.4%), and in combination with a CRP concentration >8.7 mg/dl the discriminative power increased even further (sensitivity 92.1%, specificity 82.1%). Infection was diagnosed in 92% and 90% of patients with patterns A and B, respectively, and in only two patients with patterns C and D (P < 0.001). CONCLUSION: Daily CRP monitoring and the recognition of the CRP pattern could be useful in the prediction of ICU-acquired infections. Patients presenting maximum daily CRP variation >4.1 mg/dl plus a CRP level >8.7 mg/dl had an 88% risk of infection.

Adult↗

The Drug Evaluation Classification Program: using ocular and other signs to detect drug intoxication.

BACKGROUND: A systematic approach to determining drug intoxication has been developed for use by police officers. By considering specific physiological signs, trained officers can detect the effects of seven major drug types. METHODS: Officers follow a 12-step testing sequence and evaluate signs such as pupil sizes and responses, eye movements, heart rate, body temperature, mental timing, and balance. A matrix is then used to compare that subject's signs to those that would be produced by the seven types of drugs. If a pattern match is found, the officer concludes that the subject is under the influence of a drug and specifies the drug type. RESULTS: Several field and laboratory validation studies have been conducted using these procedures. In general, officers were 70% to 90% accurate in determining intoxication status and drug classification, but poly-drug use and drug rebound effects can sometimes cause problems in interpretation. CONCLUSION: Ocular and other physiological signs can be used to detect drug intoxication and classify the type of drug taken. Knowledge of the procedures used in the Drug Recognition Program can enable optometrists to serve as consultants to the police and as expert witnesses in cases involving the use of ocular signs that indicate illicit drug use.

Body Temperature↗

Neutrophil marrow profiles in patients with rheumatoid arthritis and neutropenia.

Neutrophil marrow cellularity was determined in 14 neutropenic patients with rheumatoid arthritis (RA) from measurements of neutrophil-normoblast ratios in marrow biopsies and ferrokinetic estimates of marrow normoblasts. A marrow profile was developed for each patient comprising the numbers of promyelocytes and myelocytes, of metamyelocytes and bands, and of segmented neutrophils in whole marrow. In each case a maturation ratio was calculated by dividing the number of metamyelocytes and bands by the number of promyelocytes and myelocytes. The physiologic marrow response to loss of neutrophils from circulation was assumed to be an increase in promyelocytes and myelocytes due to proliferation and influx, a reduction in segmented cells due to early release, and a normal maturation ratio. The results were interpreted in the light of the 95% confidence limits for data previously obtained from 13 normal subjects: in patients with neutropenia reduced or basal numbers of promyelocytes and myelocytes were interpreted as absence of the anticipated proliferative response; increased numbers of marrow segmented cells were attributed to failure of release; a low maturation ratio was assessed to reflect intramedullary cell loss. The pattern in two patients with Felty's syndrome was consistent with a physiological response to neutrophil destruction. The other 12 patients had neutrophil marrow abnormalities. Seven patients with Felty's syndrome and four patients without splenomegaly had absolute or relative hypoplasia of neutrophil marrow or low maturation ratios. One patient with a normal spleen size had an increased number of marrow segmented cells yet failed to mobilize cells normally in response to dialysis coil-activation of C3. Abnormalities of neutrophil marrow may contribute to neutropenia in RA irrespective of the presence of splenomegaly. Recognition of neutrophil marrow abnormalities in these patients may be of value in prognosis and management.

Adult↗

Working memory and inhibitory control in early childhood: Contributions from physiology, temperament, and language.

This study examined the cognitive skills of working memory and inhibitory control (WMIC) in relation to physiological functioning, temperament, and language in early childhood. WMIC skills were assessed in twenty-five 4 1/2-year-old children using the day--night Stroop-like task and the yes--no task; each task required the child to remember two rules and to inhibit a dominant response. Electroencephalogram (EEG) and heart period (HP) were recorded during baseline and WMIC tasks. An increase in 6- to 9-Hz EEG power from baseline to task was found for the medial frontal region. In addition, a decrease in HP (i.e., an increase in heart rate) was found from baseline to task. Associations were found between performance on the WMIC tasks and scales of the Children's Behavioral Questionnaire (CBQ) related to the effortful control of behavior. The Peabody Picture Vocabulary Test-III (PPVT-III) distinguished between high and low WMIC performance. Results of a discriminant function analysis indicated that physiology, temperament, and language were able to correctly predict 90% of WMIC performance.

Arousal↗

Estrogen- and tamoxifen-associated effects on brain structure and function.

We evaluated the effects of estrogen and tamoxifen, a selective estrogen receptor modulator, on positron emission tomography (PET) measures of brain glucose metabolism and magnetic resonance imaging (MRI) measures of hippocampal atrophy. Three groups of postmenopausal women were studied, women taking estrogen (ERT+), women with breast cancer taking tamoxifen (TAM), and women not taking estrogen or tamoxifen (ERT-). All subjects received a PET scan, an MRI scan, and cognitive testing. The TAM group showed widespread areas of hypometabolism in the inferior and dorsal lateral frontal lobes relative to the other two groups. The ERT- group showed lower metabolism in the inferior frontal cortex and temporal cortex with respect to the ERT+ group. The TAM group also showed significantly lower semantic memory scores than the other two groups. Finally, the TAM group had smaller right hippocampal volumes than the ERT+ group, an effect that was of borderline significance. Both right and left hippocampal volumes were significantly smaller than the ERT+ group when a single outlier was removed. The ERT- group had hippocampal volumes that were intermediate to the other two groups. These findings provide physiological and anatomical evidence for neuroprotective effects of estrogen.

Aged↗

Interpretation of heart rate variability via detrended fluctuation analysis and alphabeta filter.

Detrended fluctuation analysis (DFA), suitable for the analysis of nonstationary time series, has confirmed the existence of persistent long-range correlations in healthy heart rate variability data. In this paper, we present the incorporation of the alphabeta filter to DFA to determine patterns in the power-law behavior that can be found in these correlations. Well-known simulated scenarios and real data involving normal and pathological circumstances were used to evaluate this process. The results presented here suggest the existence of evolving patterns, not always following a uniform power-law behavior, that cannot be described by scaling exponents estimated using a linear procedure over two predefined ranges. Instead, the power law is observed to have a continuous variation with segment length. We also show that the study of these patterns, avoiding initial assumptions about the nature of the data, may confer advantages to DFA by revealing more clearly abnormal physiological conditions detected in congestive heart failure patients related to the existence of dominant characteristic scales.

Adult↗

Redistribution of synaptic efficacy supports stable pattern learning in neural networks.

Markram and Tsodyks, by showing that the elevated synaptic efficacy observed with single-pulse long-term potentiation (LTP) measurements disappears with higher-frequency test pulses, have critically challenged the conventional assumption that LTP reflects a general gain increase. This observed change in frequency dependence during synaptic potentiation is called redistribution of synaptic efficacy (RSE). RSE is here seen as the local realization of a global design principle in a neural network for pattern coding. The underlying computational model posits an adaptive threshold rather than a multiplicative weight as the elementary unit of long-term memory. A distributed instar learning law allows thresholds to increase only monotonically, but adaptation has a bidirectional effect on the model postsynaptic potential. At each synapse, threshold increases implement pattern selectivity via a frequency-dependent signal component, while a complementary frequency-independent component nonspecifically strengthens the path. This synaptic balance produces changes in frequency dependence that are robustly similar to those observed by Markram and Tsodyks. The network design therefore suggests a functional purpose for RSE, which, by helping to bound total memory change, supports a distributed coding scheme that is stable with fast as well as slow learning. Multiplicative weights have served as a cornerstone for models of physiological data and neural systems for decades. Although the model discussed here does not implement detailed physiology of synaptic transmission, its new learning laws operate in a network architecture that suggests how recently discovered synaptic computations such as RSE may help produce new network capabilities such as learning that is fast, stable, and distributed.

Algorithms↗

Changes in the electric dipole vector of human serum albumin due to complexing with fatty acids.

The magnitude of the electric dipole vector of human serum albumin, as measured by the dielectric increment of the isoionic solution, is found to be a sensitive, monotonic indicator of the number of moles (up to at least 5) of long chain fatty acid complexed. The sensitivity is about three times as great as it is in bovine albumin. New methods of analysis of the frequency dispersion of the dielectric constant were developed to ascertain if molecular shape changes also accompany the complexing with fatty acid. Direct two-component rotary diffusion constant analysis is found to be too strongly affected by cross modulation between small systematic errors and physically significant data components to be a reliable measure of structural modification. Multicomponent relaxation profiles are more useful as recognition patterns for structural comparisons, but the equations involved are ill-conditioned and solutions based on standard least-squares regression contain mathematical artifacts which mask the physically significant spectrum. By constraining the solution to non-negative coefficients, the magnitude of the artifacts is reduced to well below the magnitudes of the spectral components. Profiles calculated in this way show no evidence of significant dipole direction or molecular shape change as the albumin is complexed with 1 mol of fatty acid. In these experiments albumin was defatted by incubation with adipose tissue at physiological pH, which avoids passing the protein through the pH of the N-F transition usually required in defatting. Addition of fatty acid from soluion in small amounts of ethanol appears to form a complex indistinguishable from the "native" complex.

Binding Sites↗