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The perception of heading during eye movements.

When a person walks through a rigid environment while holding eyes and head fixed, the pattern of retinal motion flows radially away from a point, the focus of expansion (Fig. 1a). Under such conditions of translation, heading corresponds to the focus of expansion and people identify it readily. But when making an eye/head movement to track an object off to the side, retinal motion is no longer radial (Fig. 1b). Heading perception in such situations has been modelled in two ways. Extra-retinal models monitor the velocity of rotational movements through proprioceptive or efference information from the extraocular and neck muscles and use that information to discount rotation effects. Retinal-image models determine (and eliminate) rotational components from the retinal image alone. These models have been tested by measuring heading perception under two conditions. First, observers judged heading while tracking a point on a simulated ground plane. Second, they fixated a stationary point and the flow field simulated the effects of a tracking eye movement. Extra-retinal models predict poorer performance in the simulated condition because the eyes do not move. Retinal-image models predict no difference in performance because the two conditions produce identical patterns of retinal motion. Warren and Hannon observed similar performance and concluded that people do not require extra-retinal information to judge heading with eye/head movements present, but they used extremely slow tracking eye movements of 0.2-1.2 deg s-1; a moving observer frequently tracks objects at much higher rates (L. Stark, personal communication). Here we examine heading judgements at higher, more typical eye movement velocities and find that people require extra-retinal information about eye position to perceive heading accurately under many viewing conditions.

Eye Movements↗

Neuromuscular and skeletal adaptations following mandibular forward positioning induced by the Herbst appliance.

The purpose of this study was to examine neuromuscular and skeletal adaptations to changes in sagittal jaw relationships induced by the Herbst appliance. Six patients (age, 9 years and 5 months to 11 years and 2 months) with Angle Class II, division 1 malocclusions were studied longitudinally. The structural changes were determined by analyzing serial lateral cephalograms. Electromyographic recordings of specific masticatory muscles were used to evaluate neuromuscular adaptations. Similar cephalometric changes were observed in all patients. In all patients, lateral pterygoid muscle activity increased immediately after insertion of the appliance, but the activity decreased markedly after 4 to 6 months of treatment. In 4 of the 6 patients studied, however, the condyles were located in a slightly more downward and forward position. These findings indicate that the adaptation of muscular function occurs within a relatively short period and precedes the compensatory morphological changes produced through functional appliance therapy.

Adaptation, Physiological↗

Modulation of masticatory muscle activity by tongue position.

The purpose of this study was to test whether the tongue position affects the electromyographic (EMG) activities of masticatory muscles. We recorded the EMG activities of the masseter and anterior temporalis muscles in 10 skeletal Class I adults. Tongue position was monitored by two pressure transducers embedded in the midpalatal region and the lingual flange of a custom-made acrylic monoblock. We instructed subjects to assume three different tongue positions: rest, superior, and anterior. Friedman's test and Sheffe's F-test were used to statistically examine differences in muscle activities induced by changes in tongue position. Significant differences were found in masseter muscle activity between the rest and anterior positions and in anterior temporalis muscle activity between the rest and both the anterior and the superior tongue positions. We concluded that masticatory muscle activity is affected by tongue position.

Adult↗

Influence of functional appliances on masticatory muscle activity.

The purpose of the present study was to investigate the influence of an activator appliance and a spring active appliance on masticatory muscle activity by means of electromyography (EMG). Twelve adult males with good general health were recruited as subjects. Three functional appliances were used in each subject for long-period EMG recording during daytime and sleep and short-time EMG recording during voluntary biting. Following findings were obtained. (1) The activity of all muscles was greater during biting than during daytime and sleep, (2) the muscle activities tended to increase in the digastric muscle and to decrease in the temporal muscle with activators under all conditions, and (3) the temporalis-masseter ratios became lower with the biting use of appliances. Therefore, this study suggests that functional appliances should be used during sleep and during the day in combination with voluntary biting to achieve adaptation and development of the masticatory muscles.

Adaptation, Physiological↗

Panendoscopic feedback in the study of voluntary velopharyngeal movements.

A videopanendoscope system was used to record velopharyngeal movements and to display those movements to subjects who produced them. Three normal adults were studied as they attempted to produce nonspeech velopharyngeal closure by use of two maneuvers: (1) laryngeal fixation and (2) modification of an elicited gag reflex. A rating system was devised to extract data from the videotapes. The findings indicated that subjects were able to utilize the videopanendoscopic feedback to guide voluntary velopharyngeal movements. The velopharyngeal movements were accompanied by larynx displacement and other neck muscle contraction. The uvula was observed to contract during some motor acts.

Biofeedback, Psychology↗

Comparison of regulated-breathing verses abbreviated desensitization on reported stuttering episodes.

This study was an investigation of the regulated-breathing method for controlling stuttering as compared to a placebo-control method consisting of abbreviated desensitization training. The regulated-breathing procedure, given to 21 stutterers, taught the speaker to breathe smoothly and deeply, to pause at natural juncturing points, to plan ahead for the content of the speech, and to relax chest and neck muscles. Several general behavioral procedures were also used including relaxation training, self-correction for errors, social support, daily home practice, and response awareness, which are components of the general habit reversal procedure for diverse habits. Training was given in one or two sessions plus regular follow-up telephone calls. Daily self-recordings were obtained of the number of stuttering episodes during everyday speech, to determine the generalized effect of the treatment. The regulated-breathing method reduced the reported stuttering episodes by 94% on the first day after training and by 97% during the fourth week and the three-month follow-up. The control procedure reduced reported stuttering only slightly (about 10%). The results indicate substantial effectiveness of the regulated-breathing method for reducing reported stuttering episodes in everyday speech as compared with an alternative treatment of equal duration.

Adolescent↗

Brain extracellular glucose assessed by voltammetry throughout the rat sleep-wake cycle.

In the present study, cortical extracellular levels of glucose were monitored for the first time throughout the sleep-wake states of the freely moving rat. For this purpose, polygraphic recordings (electroencephalogram of the fronto-occipital cortices and electromyogram of the neck muscles) were achieved in combination with differential normal pulse voltammetry (DNPV) using a specific glucose sensor. Data obtained reveal that the basal extracellular glucose concentration in the conscious rat is 0.59 +/- 0.3 m M while under chloral hydrate anaesthesia (0.4 g/kg, i.p.) it increases up to 180% of its basal concentration. Regarding the sleep-wake cycle, the existence of spontaneous significant variations in the mean glucose level during slow-wave sleep (SWS = +13%) and paradoxical sleep (PS = -11%) compared with the waking state (100%) is also reported. It is to be noticed that during long periods of active waking, glucose level tends towards a decrease that becomes significant after 15 min (active waking = -32%). On the contrary, during long episodes of slow-wave sleep, it tends towards an increase which becomes significant after 12 min (SWS = +28%). It is suggested that voltammetric techniques using enzymatic biosensors are useful tools allowing direct glucose measurements in the freely moving animal. On the whole, paradoxical sleep is pointed out as a state highly dependent on the availability of energy and slow-wave sleep as a period of energy saving.

Anesthesia↗

The relationship between signs and symptoms of temporomandibular disorders and bilateral occlusal contact patterns during lateral excursions.

The relationship between signs and symptoms of temporomandibular disorders (TMD) and bilateral occlusal contact patterns was investigated in 143 TMD patients (mean age: 34.0 +/- 15.9 years; 38 male and 105 female). In addition to an interview regarding chief complaints and accompanying symptoms, various muscles and the temporomandibular joints were palpated bilaterally and occlusal analyses were made. Only 5 out of 108 paired variables were found to be significantly associated by using the chi-squared test. Medial pterygoid muscle pain on palpation showed significant associations with the occlusal contact pattern (P < 0.005), especially working side contacts (interocclusal tooth contacts on the working side) (P < 0.005), during contralateral excursions; sternocleidomastoid muscle pain on palpation showed a significant association with balancing side contacts (interocclusal tooth contacts on the balancing side) during ipsilateral excursions P < 0.05); shoulder stiffness and pain in the eye showed significant associations with balancing side contacts during contralateral excursions (P < 0.05). The results show only a weak relationship between some TMD symptomatology and bilateral occlusal contact patterns during lateral excursions. The findings suggesting the specific laterality of a few TMD signs and symptoms associated with particular occlusal contacts may deserve closer case-control study.

Adult↗

The relationship between dentofacial morphology and the isometric jaw-opening and closing muscle function as evaluated by electromyography.

The purpose of this study was to clarify the relationship between the dentofacial morphology and masticatory muscle function in both isometric jaw-opening and closing. The subjects consisted of 26 male adults without masticatory dysfunction. Electromyograms were obtained from the digastric and masseter muscles to evaluate their muscle activities. The sum energy, median frequency, and equilibrium index were calculated as parameters of the muscle activity. A correlation analysis was performed between the parameters for the muscle activity and the dentofacial morphology on lateral roentgenographic cephalograms. The sum energy in the jaw-closing muscle showed a significant relationship with the gonial angle, mandibular length, and facial height, but not in the jaw-opening muscle. A median frequency in the jaw-opening muscle showed a significant relationship with size and position of the mandible, and also that in the jaw-closing muscle with the mandibular plane angle, facial height, and mandibular body length. Furthermore, the equilibrium index of the median frequency was related to the facial height, mandibular length, and inclination of the mandibular incisor. In conclusion, the dentofacial morphology was found to be closely related to the muscle activity not only of the jaw-closing muscle but also of the jaw-opening muscle during isometric muscle contraction.

Adult↗

Prenatal protein malnourished rats show changes in sleep/wake behavior as adults.

Prenatal protein malnutrition significantly elevates brain levels of serotonin in rats, and these levels remain elevated throughout their lives. This biogenic amine is involved in the regulation of many physiological functions, including the normal sleep/wake cycle. The present study examined the effects of prenatal protein malnutrition on the sleep/wake cycle of freely moving adult rats. Six prenatally protein malnourished (6% casein) and 10 well-nourished (25% casein) male rats (90-120-day-old) were chronically implanted with a standard set of electrodes (to record cortical electroencephalogram, neck muscle electromyogram, electrooculogram, and hippocampal theta wave) to objectively measure states of sleep and wakefulness. Six-hour polygraphic recordings were made between 10.00 and 16.00 h; a time when the rats normally sleep. Prenatally malnourished rats spent 20% more time in slow wave sleep (SWS) compared to the well-nourished rats. The total percentage of time spent in rapid eye movement (REM) sleep was 61% less in prenatally malnourished rats compared to well-nourished control rats. These findings demonstrate the adverse consequences of prenatal protein malnutrition on the quality and quantity of adult sleep in rats. These sleep changes are potentially detrimental to normal social behavior and cognitive functions. Prenatally malnourished rats are an excellent animal model to study the role of endogenous serotonin in the regulation of the normal sleep/wake cycle.

Aging↗

Myotonic dystrophy associated with 47 XYY syndrome.

A case of myotonic dystrophy with 47 XYY presented with tall stature and mental retardation. The patient was a 37-year-old male. In addition to grip myotonia and percussion myotonia, severe weakness and atrophy were noted in the face and the neck muscles and in the distal muscles of the four limbs. He also had diabetes mellitus, cataracts and sexual behavior abnormalities. He was found to be 47 XYY from chromosomal examinations. The combination of 47 XYY syndrome and myotonic dystrophy has not been reported previously.

Adult↗

Potentiation of amygdaloid and hippocampal auditory-evoked potentials in a discriminatory fear-conditioning task in mice as a function of tone pattern and context.

According to the local memory storage hypothesis, information about the tone-shock association in an auditory fear-conditioning paradigm is stored in synapses within the lateral amygdala. Thus, fear-conditioning-induced potentiation of auditory-evoked potentials in response to a conditioned stimulus (CS+, a series of short lasting tones; patterned tone) has been interpreted as an in vivo correlate of amygdaloid synaptic plasticity. Here, we re-examine the specificity of potentiation of auditory-evoked potentials in terms of (i) local confinement to the lateral amygdala, (ii) parameters of CS+ and (iii) influence of context, using a discriminatory fear-conditioning paradigm. Adult male C57BL/6J mice were implanted with recording electrodes aimed at the lateral amygdala, the CA1 region of the hippocampus and the neck muscles for simultaneous recordings of auditory-evoked potentials and startle responses. In a neutral context, auditory-evoked potentials within lateral amygdala and CA1 as well as startle and freezing responses to the CS+ were significantly potentiated following conditioning, as compared with pre-conditioning values and responses to a neutral stimulus (CSn; tone of different frequency). Potentiation was only evident if CS+ was presented as a uniform series but not if presented mixed with CSn. Accordingly, mice failed to show intensified freezing to a patterned tone if a single lasting tone of the same frequency served as CS+. Both CA1 and lateral amygdala auditory-evoked potentials were potentiated in response to CSn if presented in the conditioning context. These findings demonstrate that (i) potentiation of auditory-evoked potentials is not restricted to the lateral amygdala, (ii) both tone frequency and pattern of tone presentation are essential for proper CS+ recognition and (iii) contextual memory leads to a general potentiation of auditory-evoked potentials.

Acoustic Stimulation↗

EMG in common migraine: changes in absolute and proportional EMG levels during real-life stress.

The absolute and proportional EMG levels of the frontal, temporal, and corrugator muscles of 37 migraine patients and 37 matched controls were recorded during three experimental sessions: adaptation and real-life and experimental stress, both of long duration. Migraine patients did not show significantly different absolute EMG levels but had higher proportional EMG levels of the corrugator muscle than controls in each session. Migraine patients did not have different facial muscle responses to stress, and the two experimental groups reacted similarly to real-life and experimental stress. No relation was found between muscle activity and reported headache within 24 h after real-life stress. Increased EMG activity due to stress does not seem to be a significant cause of headache in common migraine as defined in this study, but rather a response to pain. Migraine patients with headache during stress showed lower muscle tension than patients without headache.

Adult↗

Exteroceptive suppression of the masseter, temporalis and trapezius muscles produced by mental nerve stimulation in patients with chronic headaches.

Exteroceptive suppression of the masseter, temporalis and trapezius muscles, produced by mental nerve stimulation, was studied in 46 patients with chronic headaches. The background contracting electromyographic activity prior to stimulation showed no difference between normal subjects and patients with any type of headache. In patients with chronic tension-type headache associated with a disorder of the pericranial muscles, the duration and degree of exteroceptive suppression were lower when compared with normal subjects. A low degree of exteroceptive suppression was observed also in patients suffering from migraine without aura, although exteroceptive suppression in patients suffering from migraine with aura and cluster headache was the same as that in normal subjects. A low degree of exteroceptive suppression may play a role not only in chronic tension-type headache associated with a disorder of the pericranial muscles, but also in migraine without aura.

Adolescent↗

[Endoscopic parathyroidectomy. Surgical technique in primary hyperparathyroidism].

We report our experience and technique of endoscopic removal of parathyroid adenomas in case of primary hyperparathyroidism. Scintigraphy, MRI scan and cervical ultrasound enable exact diagnosis and therefore exact localisation and placement of the three 5 mm trocars for endoscopic operation. The placement of the optic and the function trocars depends on the localisation of the adenoma. The free room to work in is created between thyroid and neck muscles and supported by insufflated CO2 with a pressure of 12 mm Hg. After the adenoma is taken out through an incision above the jugulum. With this technique we operated upon 3 patients successfully. Benefits for the patients seem to be a less painful postoperative course with minimal blood loss because of the exact exploration of the adenoma with minimal invasion of the surrounding tissue.

Adenoma↗

Fall or shaken: traumatic brain injury in children caused by falls or abuse at home - a review on biomechanics and diagnosis.

In cases of traumatic brain injuries in children it may be difficult to differentiate between physical abuse and accidental occurrence. This review will shed light on discriminating epidemiological as well as biomechanical data, morphological findings, and clinical features. As a basic principle, simple injuries are caused by simple mechanisms like falls whereas life-threatening injuries should be attributed to abuse until proven otherwise. Implausibilities between reported events and mechanisms by caregivers as well as more than one explanation of injury indicate suspicion of child abuse. From reviewing the literature, it can be stated that falls from less than 1.5 m lead only in few cases to severe brain injuries. Children who experienced a fall at home seldom exhibit fractures of the skull but just minor intracranial injuries without neurological deficits. Regarding biomechanical aspects, multiple or complex skull fractures, depression fractures, additional fractures of the body, and intracranial hemorrhages as a consequence of an impact are the most important findings in child abuse. Moreover, additional specific morphological criteria give evidence of clinical and/or post-mortem diagnosis of the shaken baby syndrome. These include subdural hemorrhage and laceration of the brain and retinal bleeding, epidural hemorrhage of the cervical cord, gripping marks (bruises) on chest and/or shoulders, and tearing injuries of the throat and neck muscles. Post-mortem signs of recurrent shaken baby syndrome are indicated by iron-positive cells or microglial cells in neuronal or retinal tissue. A clinical diagnosis will be dependent on the one hand on the exclusion of coagulation diseases, on the other hand on the demonstration of a subdural hemorrhage by means of neuroimaging techniques, i.e., CT and MRI, as well as retinal hemorrhage. The shaken baby syndrome will usually be observed within the first year of life. The doctor has to manifest his diagnosis to the caregivers and - before informing the caregivers - he must be sure of his diagnosis.

Accidental Falls↗

[Laryngo-tracheo-oesophageal cleft and G-syndrome--interposition of a flap from the sternocleidomastoid muscle (author's transl)].

A 7-month-old dystrophic infant weighing 3.8 kg was investigated endoscopically in relation to recurrent pneumonia. A tracheo-esophageal cleft was demonstrated. The situation was complicated by the coexistence of achalasia of the cardia. There was also hypertelorism and malformation of the urinary tract, so that this would appear to be a case of the G-Syndrome. A Heller's operation with fundoplication and gastrostomy was performed and only after this was the tracheooesophageal cleft closed. A flap of sternomastoid muscle was interposed between the trachea and oesophagus. Stenosis was treated by dilatation.

Abnormalities, Multiple↗