The reading requirements for Module 6: Reflexogenic systems of Human Kind by Professor Frederick Robert Carrick are taken from PRINCIPLES OF NEURAL SCIENCE, THIRD EDITION, KANDEL, SCHWARTZ AND JESSELL

Chapter 37: Muscle Receptors and Spinal Reflexes: The Stretch Reflex, Pgs 564-580

Chapter 38: Spinal Mechanisms of Motor Coordination: Pgs 581-594

Chapter 39: Posture: Pgs 596-605

 

The following references were used by Prof Frederick Carrick in his lecture on the Reflex system of Human Kind, module 6 of the Diplomate Program in Neurology.

 

Bibliography

 

1. Abbruzzese, M.; Rubino, V.; Schieppati, M. Task-dependent effects

evoked by foot muscle afferents on leg muscle activity in

humans. Electroencephalogr-Clin-Neurophysiol. 1996 Aug;

101(4): 339-48; ISSN: 0013-4694.

IRELAND. The effect of low intensity electrical stimulation of

the posterior tibial nerve (PTN) at the ankle on the active

triceps surae (TS) muscles was studied in normal subjects,

both in a prone position and while standing. PTN stimulation

regularly evoked the H-reflex in the flexor digitorum brevis

and, in the prone position, a short-latency facilitatory effect

in the soleus muscle. During standing, the facilitatory effect

was preceded by a clear-cut reduction in electromyograph

(EMG) activity. The inhibition-facilitation sequence was

evoked in the gastrocnemii under both conditions, on average,

though individual differences were present. An EMG modulation

similar to that observed under standing conditions was

present also in the prone position when subjects pressed the

sole of the foot against the wall. Stimulation of sural or

digital nerves did not evoke similar effects. It is concluded

that foot muscle afferents establish oligosynaptic connections

transmitting mixed effects to the TS motoneuronal pool, and

that contact with the sole of the foot plays an enabling role

for the inhibitory pathway directed to the soleus muscle.

2. Adnet, F.; Baud, F. Relation between Glasgow Coma Scale and

aspiration pneumonia [letter]. Lancet. 1996 Jul 13; 348(9020):

123-4; ISSN: 0140-6736.

ENGLAND.

3. Anand, P.; Terenghi, G.; Warner, G.; Kopelman, P.; Williams

Chestnut, R. E.; Sinicropi, D. V. The role of endogenous nerve

growth factor in human diabetic neuropathy. Nat-Med. 1996

Jun; 2(6): 703-7; ISSN: 1078-8956.

UNITED-STATES. Nerve growth factor (NGF) is trophic to

sensory and sympathetic fibers. In animal models, NGF is

depleted in diabetic nerves and NGF deprivation produces

hypoalgesia. Exogenous NGF can reverse some of the

pathological changes in diabetic nerves and NGF excess leads

to hyperalgesia. We have quantified sensory and autonomic

function in early diabetic polyneuropathy and correlated

changes with levels of NGF and neuropeptides in affected skin.

We describe an early length-dependent dysfunction of sensory

small-diameter fibers, prior to dysfunction of sympathetic

fibers, with depletion of skin NGF and the sensory

neuropeptide substance P. We describe a significant

correlation between NGF depletion and decreased skin axon-

reflex vasodilation, mediated by small sensory fibers partly

via substance P release. Immunostaining shows depletion of

NGF in keratinocytes in diabetic skin. We propose that a

decrease in endogenous skin-derived NGF influences the

presentation of diabetic polyneuropathy, although metabolic or

vascular abnormalities may be the cause of the neuropathy. As

loss of nociception and axon-reflex vasodilation contribute to

diabetic foot ulceration, early and prolonged NGF treatment at

an appropriate dose may provide rational prophylaxis for this

condition.. 0; 33507-63-0.

4. Anastasopoulos, D.; Lempert, T.; Gianna, C.; Gresty, M. A.;

Bronstein, A. M. Horizontal otolith-ocular responses to lateral

translation in benign paroxysmal positional vertigo. Acta-

Otolaryngol-Stockh. 1997 Jul; 117(4): 468-71; ISSN: 0001-

6489.

NORWAY. Benign paroxysmal positional vertigo (BPPV) is

assumed to result from utricular damage, but it is

controversial if patients have manifest utricular dysfunction.

Therefore, we investigated linear vestibulo-ocular reflexes

(LVORs) during lateral whole-body translation in 14 patients

with unilateral BPPV. Patients were subjected to linear

acceleration steps of 0.24 g along the interaural axis, which

were applied randomly to the left and right, both in the dark

and in the light with a visual target at a distance of 60 cm.

The LVOR was measured by EOG from the slow phase velocity

of the averaged and desaccaded compensatory eye movement.

In normal cases, maximum asymmetry of LVOR velocity was

13% in the dark and 10% in the light. In patients, LVOR

velocities were normal in the dark but mildly reduced in the

light (p < 0.05). Five patients had mild LVOR asymmetries in

the dark (range 18-38%) and two in the light (11 and 13%), but

there was no consistent relationship to the affected side. The

absence of gross changes of the LVOR may be explained either

by minor utricular damage that is functionally irrelevant or by

central compensation of a chronic unilateral deficit.

5. Anderson, C. J. Lid speculum for surgery without lid block [letter].

J-Cataract-Refract-Surg. 1996 Jan; 22(1): 4-5; ISSN: 0886-

3350.

UNITED-STATES.

6. Aramideh, M.; Kwa, I. H.; Brans, J. W.; Speelman, J. D.; Verbeeten, B.

Jr. Apraxia of eyelid closure accompanied by denial of eye

opening. Mov-Disord. 1997 Nov; 12(6): 1105-8; ISSN: 0885-

3185.

UNITED-STATES.

7. Ardic, F. N.; Topaloglu, I.; Oncel, S.; Ardic, F.; Uguz, M. Z. Does the

stapes reflex remain the same after Bell's palsy? Am-J-Otol.

1997 Nov; 18(6): 761-5; ISSN: 0192-9763.

UNITED-STATES. OBJECTIVE: The authors investigated the

integrity and function of nervus stapedius 1 year after facial

paralysis. STUDY DESIGN: Patients with Bell's palsy were

observed prospectively for 1 year and compared with healthy

patients. SETTING: The follow-up of patients was done in the

outpatient clinic and tests were applied in the audiology unit.

PATIENTS: The mean age of 32 patients was 41.03 years. Eight

of 32 patients were grade II (25%), 11 were grade III (35%),

and 13 were grade IV (40%) according to House-Brackman

grading system. The mean age of the control group (10 persons)

was 36.5 years. INTERVENTION: Contralateral stimulus was

used in acoustic reflex test at 500 and 1,000 Hz with 80-, 90-

, 100-, and 110-dB stimulus intensity. Tests were applied in

three ways: normal position, eye-closed position, and grin

position. Tests were done in the first 15 days of facial

paralysis and repeated at least 1 year thereafter. The

millimeter difference in amplitude of impedance recording of

middle ear between the normal ear and paralyzed ear was

accepted as criterion. MAIN OUTCOME MEASURES: There were 6-

to 9-mm amplitude differences between normal side and

healed side of grade IV patients with 100- and 110-dB stimuli.

RESULTS: In the second test (after 1 year), statistically

significant differences were present between control group

and grade IV patients on 1,000 and 500 Hz frequencies with

100- and 110-dB stimulus intensity (p < 0.05). There were no

significant differences between grade II and control group and

between grade III and control group. CONCLUSIONS: A

permanent partial denervation is present on the stapedial

nerve, especially after grade IV paralysis, and it affects the

function of stapes muscle in high decibel sounds. But it does

not affect the stapes reflex threshold. No synkinetic

innervation was found in the authors' patient group with their

test method.

8. Averill, D. B.; Matsumura, K.; Ganten, D.; Ferrario, C. M. Role of

area postrema in transgene hypertension. Hypertension. 1996

Mar; 27(3 Pt 2): 591-7; ISSN: 0194-911X.

UNITED-STATES. Transgenic [Tg(+)] rats carrying the mouse

Ren-2d gene [(mRen-2d)27] are a newly established

monogenetic form of experimental hypertension. To determine

whether the area postrema contributes to the development of

hypertension in mRen-2 Tg(+) rats, this circumventricular

organ in the fourth ventricle was removed from 5-week-old

Tg(+) rats. From weeks 4 through 9, systolic blood pressure

was measured weekly by tail-cuff plethysmography in area

postrema-lesioned and sham-lesioned Tg(+) rats. Although

systolic blood pressure rose markedly in sham-lesioned Tg(+)

rats, the increase in systolic blood pressure was significantly

attenuated in area postrema-lesioned Tg(+) rats. At 9 weeks of

age, a femoral artery was cannulated for the measurement of

arterial pressure in awake rats. Mean arterial pressure (MAP)

in area postrema-lesioned Tg(+) rats was significantly (P <

.01) lower than that in sham-lesioned rats: 171 +/- 7 and

132.+/- 5 mm Hg, respectively. Baroreceptor reflex was

evaluated by intravenous infusion of sodium nitroprusside.

There was no significant difference in baroreceptor reflex

sensitivity between the two groups. Intravenous pentolinium

(5 mg/kg), used to produce sympathetic ganglionic block,

caused significant decreases in MAP in both groups. However,

the reduction of MAP in the sham-lesioned group was

significantly (P < .05) greater than that in the area postrema-

lesioned group: -73 +/- 4 and -48 +/- 6 mm Hg, respectively.

The ratio of left ventricular weight to body weight in sham-

lesioned Tg(+) rats was significantly larger than that of area

postrema-lesioned rats. These results suggest that ablation of

the area postrema markedly attenuates the development of

hypertension in mRen-2d Tg(+) rats, and this attenuation may

be attributed to decrease in sympathetic outflow.

9. Baloh, R. W.; Lopez, I.; Beykirch, K.; Ishiyama, A.; Honrubia, V.

Clinical-pathologic correlation in a patient with selective

loss of hair cells in the vestibular endorgans. Neurology. 1997

Nov; 49(5): 1377-82; ISSN: 0028-3878.

UNITED-STATES. We found a selective loss of vestibular hair

cells in a patient followed for more than 10 years with

imbalance and oscillopsia due to idiopathic progressive loss of

vestibular function. Hearing function and cochlear hair cells

were normal. The vestibulo-ocular reflex (VOR) gain at high

frequencies was relatively maintained despite marked

shortening of the dominant VOR time constant (to less than

500 ms). Ultrastructural examination of remaining hair cells

showed mitochondrial abnormalities. The ultrashort VOR time

constant probably resulted from changes in firing patterns of

the primary afferent nerves due to loss of hair cells and

impaired energy metabolism in remaining hair cells.

10. Bapat, P.; Joshi, R. N.; Young, E.; Jago, R. H. Comparison of propofol

versus thiopentone with midazolam or lidocaine to facilitate

laryngeal mask insertion. Can-J-Anaesth. 1996 Jun; 43(6):

564-8; ISSN: 0832-610X.

CANADA. PURPOSE: To assess the ease of insertion of

laryngeal mask airway (LMA) comparing propofol with

lidocaine or midazolam followed by thiopentone and compare

the costs with each technique. METHODS: One hundred and fifty

ASA 1 or 2 patients equally divided into three groups

scheduled for elective surgery were recruited into this

prospective, single blind, randomized, parallel groups study.

Anaesthetic induction was achieved with 1 microgram.kg-1

fentanyl i.v. followed by either 2.5 mg.kg-1 propofol (group P),

or a sequence of 1.5 mg.kg-1 lidocaine and 5 mg.kg-1

thiopentone (group LT), or midazolam 0.1 mg.kg-1 and, three

minutes later, 5 mg.kg-1 thiopentone (group MT). The LMA was

inserted by the blinded anaesthetist who assessed and graded

the conditions for LMA insertion and noted any adverse

responses (i.e., inadequate jaw relaxation, gagging, coughing,

limb or head movement, hiccough and laryngospasm).

Conditions were considered "excellent" if there were no

adverse responses, and "satisfactory" if such a response was

mild and transient. RESULTS: Excellent or satisfactory

conditions were observed in 48 (96%) patients in the

midazolam-thiopentone group, 46 (92%) in the propofol group,

and 34 (68%) in the lidocaine-thiopentone group (P = 0.0001).

The incidence of gagging (P = 0.042), limb movement (P =

0.031), and laryngospasm (P = 0.0001) was higher in the

lidocaine-thiopentone group. CONCLUSIONS: With the above

doses, a fentanyl-midazolam-thiopentone combination which

is about 35% less expensive than fentanyl-propofol, provides

equally good conditions for the insertion of LMA.. 0; 0; 137-

58-6; 2078-54-8; 437-38-7; 59467-70-8; 76-75-5.

11. Barger, S. D.; Kircher, J. C.; Croyle, R. T. The effects of social

context and defensiveness on the physiological responses of

repressive copers. J-Pers-Soc-Psychol. 1997 Nov; 73(5):

1118-28; ISSN: 0022-3514.

UNITED-STATES. In previous research (T.L. Newton & R.J.

Contrada, 1992), social context was found to moderate

exaggerated physiological reactivity among individuals

identified as using a repressive coping style. In this

experiment, 119 undergraduates were classified into low-

anxious, high-anxious, repressor, and defensive high-anxious

coping categories. All participants completed a stressful

speech task under either a public or private social context

condition. The experimental social context was related to

physiological reactivity and self-reported affect but did not

moderate reactivity among repressive copers. Additionally,

reactivity among repressive copers was not attributable to

high defensiveness alone. Consistent with a theory of

emotional inhibition, nonspecific skin conductance responses,

but not heart rate, discriminated between repressors and

nonrepressors.

12. Barron, H. V.; Lesh, M. D. Autonomic nervous system and sudden

cardiac death. J-Am-Coll-Cardiol. 1996 Apr; 27(5): 1053-60;

ISSN: 0735-1097.

UNITED-STATES. In the United States, sudden cardiac death is

a major public health problem, accounting for approximately

300,000 deaths annually. Accurate identification of those

patients at highest risk for this event has been problematic.

The use of signal-averaged electrocardiography, Holter

monitoring and assessment of left ventricular function have

been shown to be predictive of future arrhythmic events in

patients after a myocardial infarction. However, the clinical

utility of these tests has been limited by their low sensitivity

and positive predictive value. It has become increasingly clear

that the autonomic nervous system is extremely important in

the pathogenesis of ventricular arrhythmias and sudden

cardiac death. The two most important techniques used to

study the autonomic nervous system--heart rate variability

and baroreflex sensitivity--are reviewed, and the clinical and

experimental data suggesting that these techniques are

powerful predictors of future arrhythmic events are discussed

in depth.

13. Beard, J. P.; Wade, W. H.; Barber, D. B. Sacral insufficiency stress

fracture as etiology of positional autonomic dysreflexia: case

report. Paraplegia. 1996 Mar; 34(3): 173-5; ISSN: 0031-1758.

ENGLAND. The medical literature is replete with case reports

of the syndrome known as autonomic dysreflexia. Although the

majority of cases are known to be induced by either bladder or

bowel distention. there does exist a small number of cases in

which the inciting stimulus is more obscure. In such cases, a

comprehensive medical evaluation is necessary to ensure

proper identification of the source of irritation and the

appropriate medical management of the patient. We present a

patient with a heretofore unreported suspected etiology of

autonomic dysreflexia, axial loading of a sacral stress

fracture.

14. Bearzoti, P. [Magnus-De Kleijn tonic neck reflex]. Consideracoes

sobre o reflexo tonico cervical de Magnus-De Kleijn. Arq-

Neuropsiquiatr. 1997 Mar; 55(1): 70-4; ISSN: 0004-282X.

BRAZIL. The Magnus-De Kleijn's tonic neck reflex is analyzed

concerning to the developmental psychologies of Gesell, Spitz

and Piaget. It is considered its phylogenetic nature, it is taken

into account its favorable disappearing about three months old

and, it is made a great account of its participation in baby

development.

15. Bellamy, Mary Louise Ed.; Frame, Kathy Ed. Neuroscience

Laboratory and Classroom Activities. 1996;

Note: 268 p.

National Association of Biology Teachers, 11250 Roger Bacon

Drive #19, Reston, VA 22090-5202, or Society for

Neuroscience, Suite 500, 11 Dupont Circle, Washington, DC

20036.. Guides - Classroom - Teacher (052). U.S.; Virginia.

This publication is part of a larger project involving

partnerships between high school biology teachers and

neuroscientists. It contains neuroscience laboratories and

classroom activities, most of which provide opportunities for

students to design and conduct their own experiments. Each lab

contains directions for both teachers and students and is

based on the Learning Cycle approach. Directions for teachers

include synopsis, level, student prior knowledge, integration

into the biology curriculum and across the curriculum,

objectives, getting ready, teacher background, safety notes,

procedure, teaching tips, suggested modifications for students

who are exceptional, references, and suggested reading.

Directions for students include introduction, materials, safety

notes, procedure, and analysis. Topics include the sense of

hearing, the vestibular system, reflex responses, neural

processing, neuronal plasticity, making sensory comparisons,

pain pathways, stress and the nervous system, olfactory

fatigue and memory, epilepsy, reaction time and neural

circuitry, and visual perception. Appendices include formats

used to develop the labs and classroom activities and

scientists' guidelines for preparing activities for high school

students. (JRH).

16. Ben Shakhar, G.; Dolev, K. Psychophysiological detection through

the guilty knowledge technique: effects of mental

countermeasures. J-Appl-Psychol. 1996 Jun; 81(3): 273-81;

ISSN: 0021-9010.

UNITED-STATES. The effects of mental countermeasures on

the efficiency of psychophysiological detection with the

Guilty Knowledge Technique were examined in a mock-crime

experiment with 4 groups of participants: innocent

participants who were not involved in the mock crime, guilty

controls who committed the mock crime but received no

countermeasure instructions, and guilty participants who

received countermeasure instructions, and guilty participants

who received countermeasure instructions and were allowed

to practice the countermeasures. The countermeasure

instructions encouraged participants to recall emotional

situations from their past and imagine themselves in these

situations during presentation of irrelevant questions. Results

revealed a significant reduction in electrodermal detection

efficiency under the 2 countermeasure conditions with no

differences between them. No countermeasures effects were

observed with the respiration line length measure.

17. Berliner, M. N. Reduced skin hyperemia during tap water

iontophoresis after intake of acetylsalicylic acid. Am-J-Phys-

Med-Rehabil. 1997 Nov; 76(6): 482-7; ISSN: 0894-9115.

UNITED-STATES. Skin microcirculation and skin temperature

of 10 healthy subjects (6 men and 4 women, 20-44 yr of age)

without any vascular diseases were registered when a

thermoindifferent tap water iontophoresis was applied. The

aim of this controlled study was to evaluate the development

of skin hyperemia after the intake of 500 mg of

acetylsalicylic acid (ASA). The measurement was conducted by

laser-Doppler flowmetry on the proximal forearm. The skin

temperature was measured before and after the treatment by

an infrared thermometer. In all persons there was an intense

erythema on the side of the cathode and only a modest one on

the side of the anode. Without ASA preliminary treatment, the

cutaneous flow showed an increase of 106% at the anodal side

and that of 834% at the cathodal side (P < 0.001). After ending

tap water iontophoresis, the skin temperature increased more

on the cathode side than on the anode side (P < 0.001). After

the intake of 500 mg ASA, the increase of the flow was 78% at

the anode and 88% at the cathode. The comparison of the skin

microcirculation did not show any differences at the anodal

side when acetylsalicylic acid was taken before, but a strong

suppression of the galvanic erythema at the cathodal side was

observed after the intake of ASA. There is a direct influence of

acetylsalicylic acid on the induction of the neurogenic

inflammation caused by a galvanic erythema. The intensity of

the induced erythema correlates with the analgesic effects of

constant current treatment. An attenuation of the

electrotherapeutic analgesia is possible.. 0; 50-78-2.

18. Bertoli, S.; Probst, R. The role of transient-evoked otoacoustic

emission testing in the evaluation of elderly persons. Ear-

Hear. 1997 Aug; 18(4): 286-93; ISSN: 0196-0202.

UNITED-STATES. OBJECTIVE: The purposes of this study were:

To determine the quantitative and qualitative changes that

occur in transient-evoked otoacoustic emissions (TEOAEs) in

older individuals without addressing the effect of aging alone

and without correction for hearing loss of the subject

selection. To investigate the clinical value of measuring

TEOAEs in the routine audiological evaluation of older people

reasoning that a finding of hearing loss in the presence of

TEOAEs could indicate a form of presbycusis with a primary

central component. DESIGN: Click-evoked otoacoustic

emissions (CEOAEs) were measured in 201 subjects without

middle ear problems aged 60 yr and older (range 60 to 97 yr)

who volunteered for the study because of complaints

concerning their hearing. Audiological procedures included a

pure-tone audiogram, modified Speech Perception in Noise test

(German version: Basler Satztest), and the Hearing Handicap

Inventory for the Elderly (German version). Results from ears

with a pure-tone average (PTA) at 0.5, 1, and 2 kHz of < or = 30

dB HL were further analyzed with respect to the presence or

absence of CEOAEs. In addition, tone burst evoked otoacoustic

emissions (TbOAEs) were tested in ears with responses to

click stimuli. The test consisted of a paradigm used previously

in our laboratory to assess superposition and suppression of

frequency within the cochlea (see Xu, Probst, Harris, & Roede,

1994). RESULTS: CEOAEs were not detectable in ears with a

PTA > 30 dB HL. The prevalence of CEOAEs in ears with a PTA <

or = 30 dB HL was 60%. Response levels decreased as hearing

thresholds became poorer, but there was no apparent influence

on TEOAE level due to age alone. The audiological measures

from ears with and without CEOAEs and with PTAs < or = 30 dB

HL were similar with the exception of small between group

differences at lower frequencies. The TbOAE results showed no

differences in linear superposition and suppression when

results were compared with those of younger subjects tested

previously. CONCLUSIONS: The lower overall amplitudes of

TEOAEs and the lower prevalence of 60% in comparison to

results from younger subjects with normal hearing imply that

cochlear changes do occur with aging. However, the

preservation or loss of TEOAEs does not separate subjects

with presbycusis into distinct audiological categories or

handicaps. Tone burst results suggest that frequency

processing within the cochlea is not affected by age alone. We

conclude that TEOAEs add no relevant information in the

routine clinical evaluation of elderly persons with hearing

problems.

19. Blumenthal, T. D.; Schicatano, E. J.; Chapman, J. G.; Norris, C. M.;

Ergenzinger, ER Jr. Prepulse effects on magnitude estimation

of startle-eliciting stimuli and startle responses. Percept-

Psychophys. 1996 Jan; 58(1): 73-80; ISSN: 0031-5117.

UNITED-STATES. The present studies investigated the

relationship between prepulse effects on the modification of

the brainstem startle reflex and magnitude estimates of

startle-eliciting stimuli. In Experiment 1, startle eyeblink

responses were elicited in 24 students, half of whom were

instructed to estimate the loudness of the startle stimulus

(actual intensities of 80, 90, and 100 dB) and half of whom

were instructed to estimate the magnitude of their eyeblink.

When weak acoustic prepulses preceded the startle-eliciting

stimulus, eyeblink amplitude was inhibited, and estimates of

response magnitude decreased, but estimates of startle

stimulus magnitude decreased only when 100-dB startle

stimuli were presented. In Experiment 2, the same startle

stimuli were preceded on some trials by a vibrotactile

prepulse to the hand. In conditions in which startle amplitude

was inhibited, startle stimulus magnitude estimates were not

affected. This suggests that the effect of acoustic prepulses

on 100-dB startle stimuli in Experiment 1 may have been due

to loudness assimilation, an effect independent of the prepulse

inhibition of startle responding.

20. Bono Arino, A.; Pinero Fernandez, A.; Rodriguez Vela, L.; Ascaso

Cornago, I.; Allepuz Losa, C.; Rioja Sanz, L. A. [The neurological

status in patients with erectile dysfunction: somatosensory

evoked potentials and the bulbocavernosus reflex]. Estudio

neurologico en pacientes con disfuncion erectil: potenciales

evocados somatosensoriales y reflejo bulbo-cavernoso. Arch-

Esp-Urol. 1997 Oct; 50(8): 897-905; ISSN: 0004-0614.

SPAIN. OBJECTIVES: The present study investigated the

somatosensory evoked potential (SSEP) from the dorsal penile

nerve and the bulbocavernosus reflex (BCR) in healthy

volunteers and patients with erectile dysfunction in order to

establish a model of normality and investigate the abnormal

neuro-urophysiological measurements in patients with

erectile dysfunction and their relationship with different

factors (age, neurological disease). METHODS: 30 healthy

volunteers and 102 patients who had consulted for erectile

dysfunction underwent neuro-urophysiological diagnostic

evaluation (dorsal penile nerve SSEP and BCR). The mean age

was 51.2 years (range 27 to 66). RESULTS: The group of healthy

volunteers showed SSEP mean latency of 46.374 ms and a BCR

mean latency of 43.721 ms. Thirty-four patients (33.33%) had

at least one abnormal neuro-urophysiological measurement,

the SSEP were abnormal in 7 (20.58%), the BCR in 5 (14.70%)

and both in 22 (64.70%). We found an increased SSEP latency

and BCR latency in the patients with erectile dysfunction and

with no urological disease. Comparison of the older with the

younger patients was only statistically significant for

increased BCR latency in patients > 60 years old. CONCLUSIONS:

The study revealed neuro-urophysiological abnormalities in 34

impotent patients (33.33%). The finding of abnormalities in

both BCR and SSEP was the most frequent.

21. Brandt, T. Bilateral vestibulopathy revisited. Eur-J-Med-Res.

1996 May 24; 1(8): 361-8; ISSN: 0949-2321.

GERMANY. Bilateral vestibular failure (BVF) is an often

undetected disorder of the peripheral labyrinths or the eighth

nerves. Key symptoms are oscillopsia during locomotion or

head movements and unsteadiness, particularly in the dark.

Diagnosis is made by a bedside test for defective vestibulo-

ocular reflex and the absence of nystagmic reaction to both

caloric and rotatory pendular testing. Most frequent etiologies

include ototoxicity, cerebellar degeneration, meningitis,

neuropathies, sequential vestibular neuritis, autoimmune

disorders, tumors, and miscellaneous otological diseases.

Idiopathic BVF is found in more than twenty percent of the

patients. Recovery is possible but mostly incomplete.

Somatosensory and visual input largely substitute the

vestibular deficit for spatial orientation, postural balance and

ocular motor control.

22. Braverman, I.; Jaber, L.; Levi, H.; Adelman, C.; Arons, K. S.; Fischel

Ghodsian, N.; Shohat, M.; Elidan, J. Audiovestibular findings in

patients with deafness caused by a mitochondrial

susceptibility mutation and precipitated by an inherited

nuclear mutation or aminoglycosides. Arch-Otolaryngol-Head-

Neck-Surg. 1996 Sep; 122(9): 1001-4; ISSN: 0886-4470.

UNITED-STATES. OBJECTIVE: To characterize the audiological

and vestibular changes associated with a mitochondrial DNA

mutation in an Arab-Israeli family and in other families with

mitochondrial predisposition to aminoglycoside-induced

hearing loss. DESIGN: Evaluation of audiological (pure tone

thresholds, speech reception thresholds, speech

discrimination, tympanometry, acoustic reflex thresholds,

tone decay, and auditory brain-stem evoked response

recording) and vestibular (complete history, physical

examination, and 2-channel electronystagmography) systems.

In 5 patients, structural evaluation of the inner ear was done

by magnetic resonance imaging. PATIENTS: Fifteen members of

an Arab-Israeli family, and 1 Chinese woman with the same

mitochondrial DNA mutation who experienced hearing loss

after short-term exposure to streptomycin. RESULTS: Most of

the patients had a profound hearing loss due to cochlear

involvement. The hearing loss usually was not accompanied by

notable peripheral vestibular dysfunction. In the patient with

severe hearing loss after exposure to aminoglycoside, the

vestibular function was completely normal. CONCLUSIONS: In

most of the Arab-Israeli patients with congenital deafness,

the vestibular system function was normal, in contrast to the

frequency of vestibular abnormality among deaf children,

which was described in the literature. This may be related to

genetic predisposition to aminoglycoside-induced deafness..

0; 0.

23. Brechue, W. F.; Koceja, D. M.; Stager, J. M. Acetazolamide reduces

peripheral afferent transmission in humans. Muscle-Nerve.

1997 Dec; 20(12): 1541-8; ISSN: 0148-639X.

UNITED-STATES. Carbonic anhydrase has been localized in

skeletal muscle and nerve, thus, inhibition with acetazolamide

(ACZ) may alter nerve and/or muscle function in healthy

humans. ACZ (3 oral doses 14, 8, and 2 h prior to testing)

reduced isometric force (37%) and peak to peak

electromyographic (EMG) amplitude (1.38 mV to 0.83 mV),

while increasing EMG latency associated with a unilateral

Achilles tendon-tap. Reflex recovery profiles, following a

contralateral conditioning tap, were similar in both placebo

and ACZ experiments. ACZ led to significant changes in

Hmax/Mmax ratio (52.19/14.42 to 45.73/15.65) and H-reflex

latency (34.18 +/- 2.54 ms to 35.24 +/- 2.74 ms). Motor nerve

conduction velocity and maximal voluntary isometric torque

(knee extensors) were unaltered by ACZ. These data suggest

that inhibition of the tendon-tap reflex and associated

isometric force, following ACZ, is related to impairment of

synaptic integrity between la fibers of the muscle spindle and

the alpha motor neuron and not impairment of the muscle

spindle or force-generating capacity.. 0; 59-66-5.

24. Brimacombe, J. Jaw thrust and laryngeal mask insertion--a

warning [letter]. Anaesthesia. 1996 Feb; 51(2): 203; ISSN:

0003-2409.

ENGLAND.

25. Brinar, V.; Brzovic, Z.; Papa, J.; Malojcic, B.; Dawidowsky, K.

Autonomic dysfunction in patients with multiple sclerosis.

Coll-Antropol. 1997 Dec; 21(2): 493-7; ISSN: 0350-6134.

CROATIA. The disturbances of autonomic cardiovascular

reflexes have already been described in patients with multiple

sclerosis (MS). It seems that this disturbances are the result

of reflex pathways impairment in the central nervous system.

We have tested 28 patients with MS and control group of 21

healthy volunteers using a set of autonomic cardiovascular

reflexes tests. In all of patients zones of demyelinization have

been discovered with magnetic resonance imaging (MRI). The

biggest number of abnormal results was found in respiratory

sinus arrhythmia (RSA) test (60.7%) and cortical activation

test (35.7%). In 11 patients we found abnormal results in 2 or

more tests. Patients with abnormal results in 4 or more tests

had clinical impairment of other autonomic functions (urinary

bladder regulation). The results of autonomic dysfunction

tests show positive correlation to the MRI findings.

26. Brunt, D.; Robichaud, J. Relationship between motoneuron pool

excitability and parameters of timing and force in an

isometric ankle-extension movement. Percept-Mot-Skills.

1996 Apr; 82(2): 448-50; ISSN: 0031-5125.

UNITED-STATES. The changes in peak facilitation and slope of

facilitation of the H-reflex were compared to the parameters

of an isometric plantarflexion task. The amplitude of the

reflex was significantly greater for reflexes elicited within

50 msec. of the onset of soleus muscle activity. Neither peak

amplitude of the reflex nor slope correlated with rate of rise

of isometric force; however, they did show a modest

relationship between premotor time and reaction time.

27. Burke, J. R.; Kamen, G. Changes in spinal reflexes preceding a

voluntary movement in young and old adults. J-Gerontol-A-

Biol-Sci-Med-Sci. 1996 Jan; 51(1): M17-22; ISSN: 1079-5006.

UNITED-STATES. BACKGROUND. Age-related differences in

spinal excitability during response preparation were assessed

by eliciting either a 50% H-reflex or an Achilles tendon reflex

preceding the onset of a right plantar flexion contraction in 20

young adults (23.1 +/- 1.64 yrs) and 20 old adults (68.5 +/-

5.53 yrs). METHODS. On each simple reaction time trial, the

test reflex was elicited at a specific test interval during

either the foreperiod or the response period. The foreperiod

test intervals were 500, 600, 700, 800, 900, and 1000 msec

after the presentation of the warning stimulus. The response

period test intervals were 50, 100, 150, 200, 250, and 300

msec after the presentation of the response stimulus. Control

reflexes were randomly elicited between the simple reaction

time trials. RESULTS. Changes in reflex excitability were not

observed during the foreperiod in either age group. During the

response period, the percentage of H-reflex facilitation as

compared to control H-reflexes was similar for the young

(68%) and the old (61%) adults, but the magnitude of Achilles

tendon reflex facilitation with respect to control reflex

responses was greater in the young adults (74%) than in the

old adults (38%). The time course of H- and tendon reflex

facilitation was delayed in the old group during the response

period. CONCLUSIONS. The results indicate that processes

underlying the preparation and generation of a motor response

are similar in young and old adults. However, these processes

occur at a slower rate in old adults.

28. Carlson, S. R.; Katsanis, J.; Iacono, W. G.; McGue, M. Emotional

modulation of the startle reflex in twins: preliminary findings.

Biol-Psychol. 1997 Oct 10; 46(3): 235-46; ISSN: 0301-0511.

NETHERLANDS. This study investigated twin similarity in

general startle reflex reactivity and emotional modulation.

Seventeen monozygotic (MZ) and 12 dizygotic (DZ) male twin

pairs received startling acoustic stimuli while viewing

emotionally positive, negative and neutral slides.

Electromyographic (EMG) responses were recorded from the

orbicularis oculi. Members of MZ twin pairs had similar

response amplitudes under all three valence conditions. In

addition, modulation scores for the positive and negative

conditions, representing the percent change in response

amplitude between the affective and the neutral conditions,

also showed significant similarity within MZ twin pairs.

Overall, members of DZ twin pairs were not found to be

significantly similar of any of the measures. These

preliminary findings suggest that emotional modulation of the

startle reflex shows familial resemblance within MZ pairs.

Given the lack of resemblance between DZ twins, it is

tentatively suggested that affective modulation may be under

partial genetic control.

29. Carlsson, M. [The man behind the syndrome: William John Adie. He

won an involuntary victory in an academic dispute]. Mannen

bakom syndromet: William John Adie. Vann ofrivillig seger i

akademisk strid. Lakartidningen. 1996 May 15; 93(20): 1966-9;

ISSN: 0023-7205.

SWEDEN.

30. Chancellor, M. B. Should we be using chili pepper extracts to treat

the overactive bladder? [editorial; comment]. J-Urol. 1997 Dec;

158(6): 2097; ISSN: 0022-5347.

Note: Comment on: J Urol 1997 Dec;158(6):2087-92. Comment

on: J Urol 1997 Dec;158(6):2093-6.

UNITED-STATES. 404-86-4.

31. Charles, P. D.; Davis, T. L. Drug therapy for Parkinson's disease.

South-Med-J. 1996 Sep; 89(9): 851-6; ISSN: 0038-4348.

UNITED-STATES. Parkinson's disease (PD) is a common

neurodegenerative disease characterized by tremor, rigidity,

bradykinesia, and loss of postural reflexes. Although the

agents available for symptomatic treatment now allow most

parkinsonian patients to live a normal life-span, these

patients become progressively unable to participate in social

functions, perform activities of daily living, and work. Therapy

for PD may be associated with many complications that

contribute to these disabilities. For this reason, education is

helpful for the patient newly diagnosed with PD. Over the past

6 years, three new medications (selegiline, pergolide, and

controlled-release levodopa) have been approved for use in

Parkinson's disease. Other agents now available for the

treatment of psychiatric illness may also be helpful in

selected cases of PD. With this in mind, we review the

commonly prescribed drugs and outline a rational plan for

treatment of parkinsonism.. 0; 0.

32. Chaudhry, V.; Moser, H. W.; Cornblath, D. R. Nerve conduction

studies in adrenomyeloneuropathy. J-Neurol-Neurosurg-

Psychiatry. 1996 Aug; 61(2): 181-5; ISSN: 0022-3050.

ENGLAND. OBJECTIVE--Adrenomyeloneuropathy (AMN) is an X

linked metabolic disorder presenting with progressive spastic

paraparesis in the third to fifth decade of life. Although

peripheral neuropathy is also present in most patients,

prominent pyramidal signs may make its clinical recognition

difficult. The objective was to characterise the peripheral

neuropathy in patients with AMN by nerve conduction studies.

METHODS--Nerve conduction studies were performed in 99 men

known to have AMN and in 38 heterozygous women, all of whom

had neurological disabilities. RESULTS--Of the 13 variables

obtained, at least one was abnormal in 82% of patients. The

abnormalities were more common in men than in women (87% v

67%); in legs than in arms (77% v 38%); in motor than in

sensory conduction (80% v 39%); and in latency (distal and F

wave) and velocity compared with amplitude (80% v 29%).

Twenty six patients had at least one nerve variable value in

the demyelinating range. Four variables (sural velocity,

peroneal amplitude, peroneal velocity, and peroneal F wave)

were correlated with the expanded disability status scale;

five variables (peroneal velocity, tibial H reflex, median distal

latency, median conduction velocity, and median F wave

latency) were correlated with serum very long chain fatty

acids (VLCFAs); and two variables (sural amplitude and

peroneal distal latency) were more likely to be abnormal in

patients with normal adrenal function than in patients with

Addison's disease. CONCLUSIONS--Nerve conduction studies in

patients with AMN are often abnormal and suggest a mixture of

axonal loss and multifocal demyelination. Their correlation

with disability status and serum VLCFAs suggests that

measures from nerve conduction studies may be useful in

evaluating future treatments.

33. Christensen, J. Mechanisms of secondary esophageal peristalsis.

Am-J-Med. 1997 Nov 24; 103(5A): 44S-46S; ISSN: 0002-9343.

UNITED-STATES.

34. Chun, M. M. Temporal binding errors are redistributed by the

attentional blink. Percept-Psychophys. 1997 Nov; 59(8): 1191-

9; ISSN: 0031-5117.

UNITED-STATES. When one searches for a target among

nontargets appearing in rapid serial visual presentation

(RSVP), one's errors in performance typically involve the

misreporting of neighboring nontargets. Such illusory

conjunctions or intrusion errors are distributed differently

around the target, depending on task or stimulus variables. It

is shown here that shifts in intrusion error patterns can be

produced by the manipulation of attention alone. In a dual-task

paradigm, the magnitude and distribution of intrusion errors

changed systematically as a function of available attentional

resources. Intrusion errors in RSVP tasks reflect internal

capacity limitations for binding independent features. The

present results support a two-stage model of RSVP target

processing.

35. Clark, A. L.; McDonagh, T. The origin of symptoms in chronic heart

failure [editorial]. Heart. 1997 Nov; 78(5): 429-30; ISSN: 1355-

6037.

ENGLAND.

36. Cohen, M.; Luxon, L.; Rudge, P. Auditory deficits and hearing loss

associated with focal brainstem haemorrhage. Scand-Audiol.

1996; 25(2): 133-41; ISSN: 0105-0397.

DENMARK. Four cases of central pontine haemorrhage are

described in which auditory dysfunction was documented. Two

cases had a hearing loss, in one of which there was recovery of

the low frequencies. This case provides support for the

tonotopic organization of the auditory pathways in the caudal

pontine area, with the lowest frequencies being encoded

medially. In all cases, there were abnormalities of the

auditory brainstem responses, wave V being consistently

involved, while wave III was abnormal in only one patient. In

three cases, the masking level differences and crossed

acoustic reflex thresholds were abnormal. The ipsilateral

reflex thresholds were normal at least on one side in all cases.

In the patient with the most significant hearing loss, loudness

recruitment, assessed both psychophysically and with the

acoustic reflex thresholds, was evident. These data are

interpreted in terms of there being damage to the medial

superior olivary nuclei and trapezoid body involving both

afferent and efferent fibres.

37. Colvin, L. A.; Mark, M. A.; Duggan, A. W. The effect of a peripheral

mononeuropathy on immunoreactive (ir)-galanin release in the

spinal cord of the rat. Brain-Res. 1997 Aug 22; 766(1-2): 259-

61; ISSN: 0006-8993.

NETHERLANDS. The pattern of ir-galanin release in the spinal

cord of rats with a peripheral mononeuropathy was studied. On

the side of the cord ipsilateral to the nerve injury enhanced

ir-galanin release was found in the superficial dorsal horn. It

is probable that, after nerve injury, some primary afferent

neurons spontaneously release galanin from their central

terminals.. 88813-36-9.

38. Conroy, T.; Etienne, P. L.; Adenis, A.; Wagener, D. J.; Paillot, B.;

Francois, E.; Bedenne, L.; Jacob, J. H.; Seitz, J. F.; Bleiberg, H.;

Van Pottelsberghe, C.; Van Glabbeke, M.; Delgado, F. M.; Merle,

S.; Wils, J. Phase II trial of vinorelbine in metastatic

squamous cell esophageal carcinoma. European Organization

for Research and Treatment of Cancer Gastrointestinal Treat

Cancer Cooperative Group. J-Clin-Oncol. 1996 Jan; 14(1): 164-

70; ISSN: 0732-183X.

UNITED-STATES. PURPOSE: To evaluate the response rate and

toxic effects of vinorelbine (VNB) administered as a single

agent in metastatic squamous cell esophageal carcinoma.

PATIENTS AND METHODS: Forty-six eligible patients with

measurable lesions were included and were stratified

according to previous chemotherapy. Thirty patients without

prior chemotherapy and 16 pretreated with cisplatin-based

chemotherapy were assessable for toxicity and response. VNB

was administered weekly as a 25-mg/m2 short intravenous

(i.v.) infusion. RESULTS: Six of 30 patients (20%) without prior

chemotherapy achieved a partial response (PR) (95%

confidence interval [CI], 8% to 39%). The median duration of

response was 21 weeks (range, 17 to 28). One of 16 patients

(6%) with prior chemotherapy had a complete response (CR) of

31 weeks' duration (95% CI, 0% to 30%). The overall response

rate (World Health Organization [WHO] criteria) was 15% (CR,

2%; PR 13%; 95% CI, 6% to 29%). The median dose-intensity

(DI) was 20 mg/m2/wk. VNB was well tolerated and zero

instances of WHO grade 4 nonhematologic toxicity occurred. At

least one episode of grade 3 or 4 granulocytopenia was seen in

59% of patients. A grade 2 or 3 infection occurred in 16% of

patients, but no toxic deaths occurred. Other side effects were

rare, and peripheral neurotoxicity has been minor (26% grade

1). CONCLUSION: These data indicate that VNB is an active

agent in metastatic esophageal squamous cell carcinoma.

Given its excellent tolerance profile and low toxicity, further

evaluation of VNB in combination therapy is warranted.. 0;

71486-22-1; 865-21-4.

39. Cornelius, C. P.; Altenmuller, E.; Ehrenfeld, M. The use of flash

visual evoked potentials in the early diagnosis of suspected

optic nerve lesions due to craniofacial trauma. J-

Craniomaxillofac-Surg. 1996 Feb; 24(1): 1-11; ISSN: 1010-

5182.

SCOTLAND. Craniofacial trauma encroaching on the orbital

apex and optic canal can result in direct or indirect optic

nerve lesions, leading to visual impairment or blindness. Early

diagnosis of a visual loss and immediate therapy are generally

considered crucial for a successful restoration of vision in

indirect trauma. However, in comatose or sedated patients the

assessment of optic nerve function by testing pupillary

reactivity may be severely compromised or impossible because

of tensely swollen eyelids, conjunctival oedema, concussion of

the ciliary muscle or pharmacological effects. In the event

that clinical ophthalmic examination, computer tomography or

nuclear magnetic resonance scanning fail to clarify the state

of the optic nerve, visual evoked potentials (VEPs) to flash

stimulation appear to provide reliable information on function

within the visual pathway. On this basis, treatment with

corticosteroids and/or surgical decompression can be rapidly

initiated. Our results in a preliminary patient series confirm

the value of acutely monitored VEPs as an objective test of

optic nerve function in cases of suspected optic nerve injury

immediately after admission to the emergency care unit. The

imaging techniques usually applied may be complemented by

VEPs to show the functional significance of structural

abnormalities found in the vicinity of the optic nerve.

40. Czarkowska Bauch, J. Variety of muscle responses to tactile

stimuli. Acta-Neurobiol-Exp-Warsz. 1996; 56(1): 435-9; ISSN:

0065-1400.

POLAND. Influences exerted by tactile stimuli on the muscle

activity were investigated with two methods: (1) analysis of

kinematics and electromyographic (EMG) activity of eight

forelimb muscles during contact placing (CP) reactions

elicited by tactile stimuli applied to the dorsal, medial or

lateral sides of the paw in cats, and (2) the Hoffmann (H)-

reflex technique to quantify the effects of the tactile stimuli

on the excitability of the alpha motoneurones of the soleus

muscle in awake rats. The first group of the data showed that

the tactile stimuli applied to dorsal, medial or lateral aspects

of the paw led to different strategies of the forelimb

movements during CP reactions. These differences arose from

various patterns of activation of the elbow flexor and extensor

muscles at the beginning of CP reactions and a various

involvement of the medio-lateral components of movements,

depending on the site of the tactile stimulus application. With

the H-reflex technique it was found that the tactile stimulus

diminished the excitability of alpha motoneurones of the

soleus muscle when applied to the skin overlying the lateral

side of the ankle joint. This effect was in line with the

observation that the tactile stimulus applied to the lateral

side of the paw activated the elbow flexor muscles but not

their antagonists to initiate CP reaction.

41. da Camara, Carlos C.; And, Others. Survey of Physical Assessment

Course Offerings in American Colleges of Pharmacy. 1996;

Reports - Research (143). Journal Articles (080). A survey of

55 pharmacy schools found that of those offering a pharmacy

doctoral program, three-fourths had a separate course devoted

to physical assessment of patients, most offered in the third

professional year. Most require students to demonstrate use of

stethoscope, sphygmomanometer, ophthalmo-otoscope, tuning

fork, reflex hammer. Reasons for offering the course and

course content were also identified. (Author/MSE).

42. Davis, M.; Walker, D. L.; Lee, Y. Amygdala and bed nucleus of the

stria terminalis: differential roles in fear and anxiety

measured with the acoustic startle reflex. Philos-Trans-R-

Soc-Lond-B-Biol-Sci. 1997 Nov 29; 352(1362): 1675-87; ISSN:

0962-8436.

ENGLAND. Neural stimuli associated with traumatic events

can readily become conditioned so as to reinstate the memory

of the original trauma. These conditioned fear responses can

last a lifetime and may be especially resistant to extinction. A

large amount of data from many different laboratories

indicate that the amygdala plays a crucial role in conditioned

fear. The amygdala receives information from all sensory

modalities and projects to a variety of hypothalamic and

brainstem target areas known to be critically involved in

specific signs that are used to define fear and anxiety.

Electrical stimulation of the amygdala elicits a pattern of

behaviours that mimic natural or conditioned states of fear.

Lesions of the amygdala block innate or conditioned fear and

local infusion of drugs into the amygdala have anxiolytic

effects in several behavioural tests. Excitatory amino acid

receptors in the amygdala are critical for the acquisition,

expression and extinction of conditioned fear.

43. De Ridder, D.; Chandiramani, V.; Dasgupta, P.; Van Poppel, H.;

Baert, L.; Fowler, C. J. Intravesical capsaicin as a treatment

for refractory detrusor hyperreflexia: a dual center study with

long-term followup [see comments]. J-Urol. 1997 Dec; 158(6):

2087-92; ISSN: 0022-5347.

Note: Comment in: J Urol 1997 Dec;158(6):2097.

UNITED-STATES. PURPOSE: We described the long-term

outcome of intravesical capsaicin instillations in patients

with urinary incontinence and compared its efficacy in 2

similar populations of patients with multiple sclerosis in a

dual center study. MATERIALS AND METHODS: During 5 years 79

patients with intractable urinary incontinence have been

treated with intravesical capsaicin. The majority of patients

had spinal cord disease due to multiple sclerosis but 4 were

neurologically normal. Cystometry was performed before and 4

to 6 weeks after intravesical instillation of 1 to 2 mmol./l. of

capsaicin in 30% ethanol in saline. Instillations of vehicle

(30% ethanol in saline) alone were carried out in 5 patients.

RESULTS: In patients with phasic detrusor hyperreflexia

complete continence was achieved in 44%, satisfactory

improvement occurred in 36% and treatment failed in 20%.

Clinical benefit from a single instillation lasted 3 to 6 months

and was repeated in some patients with similar improvement.

Capsaicin was ineffective in patients with poor bladder

compliance and in neurologically normal patients with sensory

urgency and detrusor instability. There was no clinical or

urodynamic improvement in patients treated with vehicle

alone. There have been no long-term complications.

CONCLUSIONS: Our study shows that repeated instillations of

intravesical capsaicin are effective in treatment of patients

with detrusor hyperreflexia due to spinal cord disease and that

effectiveness of the treatment persists at least 3 to 5 years..

404-86-4.

44. Deo, S. D.; Knottenbelt, J. D. Involuntary defaecation in acutely

injured patients: a useful clinical sign. Injury. 1996 Mar; 27(2):

93-5; ISSN: 0020-1383.

ENGLAND. The phenomenon of involuntary defaecation

following acute, severe injuries has never been documented

before, but has been noted by those who work in major trauma

units. The exact cause of the phenomenon is unknown. We

prospectively noted 14 patients who involuntarily defaecated

in a 3-month period and analysed their clinical findings

retrospectively. Involuntary defaecation occurred only in

patients with severe penetrating or blunt injuries. In those

with precordial stabs, involuntary defaecation was

particularly predictive of cardiac injury, and in all injuries

was associated with higher surgical intervention and

mortality rates. The occurrence of involuntary defaecation in

injured patients is a useful sign that nearly always indicates

the need for urgent intervention.

45. Di Lazzaro, V.; Restuccia, D.; Nardone, R.; Tartaglione, T.;

Quartarone, A.; Tonali, P.; Rothwell, J. C. Preliminary clinical

observations on a new trigeminal reflex: the trigemino-

cervical reflex. Neurology. 1996 Feb; 46(2): 479-85; ISSN:

0028-3878.

UNITED-STATES. Short latency trigemino-cervical reflexes

can be recorded from sternocleidomastoid muscle after

stimulation of the infraorbital branch of the trigeminal nerve.

We studied the trigemino-cervical reflexes and the

conventional blink reflex in three patients with an isolated

lesion in the medulla oblongata, eight patients with multiple

sclerosis, and two patients with supratentorial ischemic

lesion. The trigemino-cervical response was abnormal in the

patients with an isolated lesion in the medulla oblongata and

in all multiple sclerosis patients, whereas both components of

the blink reflex were preserved in the patients with a lesion in

the medulla oblongata and in half of the patients with multiple

sclerosis. The trigemino-cervical reflex was preserved in

patients with supratentorial lesions, whereas the late

component of the blink reflex was abnormal. These findings

suggest that central pathways generating the trigemino-

cervical reflex are confined to the medulla oblongata and that

they are independent from those generating the long latency

(R2) component of the blink reflex. The trigemino-cervical

reflex may help in disclosing and localizing brainstem lesions.

46. DiBona, G. F.; Sawin, L. L.; Jones, S. Y. Differentiated sympathetic

neural control of the kidney. Am-J-Physiol. 1996 Jul; 271(1 Pt

2): R84-90; ISSN: 0002-9513.

UNITED-STATES. Anatomic and neurophysiological methods

were used to identify functionally specific subgroups of renal

sympathetic nerve fibers. The distribution of diameters of the

predominating unmyelinated fibers showed a major mode at

1.1 microns and a minor mode at 1.6 microns. The conduction

velocity was 2.10 +/- 0.10 m/s, consistent with unmyelinated

C fibers. Analysis of strength-duration relationships during

renal nerve stimulation showed that both rheobase and

chronaxie values for renal blood flow were greater than those

for urinary flow rate and were independent of stimulation

frequency. This difference suggests a higher stimulation

threshold (smaller diameter) for those renal nerve fibers

involved in the renal blood flow response (renal

vasoconstriction) compared with those for the urinary flow

rate response (antidiuresis) to renal nerve stimulation. Single

renal units that responded to preganglionic splanchnic nerve

stimulation were studied. Those with spontaneous activity

(88%) responded to stimulation of arterial baroreceptors,

arterial and central chemoreceptors, and peripheral

thermoreceptors, whereas those that lacked spontaneous

activity (12%) responded only to stimulation of peripheral

thermoreceptors (known to produce renal vasoconstriction). A

minority population of single renal units has been identified

that, although renal vasoconstrictor, does not exhibit other

characteristic features of vasoconstrictor neurons (i.e.,

responsiveness to stimulation of arterial baroreceptors and

arterial and central chemoreceptors). These findings suggest

the existence of functionally specific subgroups of renal nerve

fibers.

47. Drummond, H. A.; Seagard, J. L. Acute baroreflex resetting.

Differential control of pressure and nerve activity.

Hypertension. 1996 Mar; 27(3 Pt 1): 442-8; ISSN: 0194-911X.

UNITED-STATES. This study evaluated acute resetting of

carotid baroreflex control of arterial blood pressure and renal

or thoracic sympathetic nerve activity in thiopental-

anesthetized mongrel dogs with the use of a vascularly

isolated carotid sinus preparation, the experimental model

used previously to characterize acute resetting in carotid

baroreceptor afferent fibers. Carotid baroreceptors were

conditioned with a pulsatile pressure for 20 minutes at three

pressure ranges: low (50 to 75 mm Hg), mid (100 to 125), or

high (150 to 175). Blood pressure and nerve activity were

recorded in response to slow ramp increases in sinus pressure;

nonlinear regression and best-fit analyses were used for

determination of curve fit parameters of the blood pressure

and nerve activity versus sinus pressure response curves.

Carotid sinus pressure thresholds for blood pressure and renal

nerve activity responses at all conditioning pressures were

significantly different; however, only the pressure threshold

for thoracic nerve activity at the low conditioning pressure

was significantly different from the responses at other

conditioning pressures. Average renal activity resetting (0.506

+/- 0.072) was significantly greater than blood pressure

resetting (0.335 +/- 0.046) in the same dogs, and thoracic

activity (0.200 +/- 0.057) was not different from blood

pressure resetting (0.194 +/- 0.031) in the same dogs. In a

previous investigation, our laboratory had demonstrated that

type 1 carotid baroreceptors acutely reset at a value of about

0.15. These results indicate that (1) renal and thoracic nerve

activities and blood pressure acutely reset to a greater degree

than type 1 carotid baroreceptors and that (2) renal activity

acutely resets to a greater degree than blood pressure and

thoracic nerve activity.

48. Drummond, P. D. The site of sympathetic deficit in cluster

headache. Headache. 1996 Jan; 36(1): 3-9; ISSN: 0017-8748.

UNITED-STATES. The pattern of autonomic deficit in the face

of cluster headache patients resembles the deficit in patients

with a postganglionic sympathetic lesion from some other

cause; however, the presence of abnormal cardiac rhythms and

bilateral pupillary reflex deficit in some patients with cluster

headache suggests that the lesion might compromise central

sympathetic drive. To investigate this possibility, the

vasomotor and sudomotor startle reflex was investigated in

the hands of six cluster headache patients with ocular and

thermoregulatory signs of postganglionic sympathetic deficit

in the face; for comparison, responses were also investigated

in 15 patients with a lesion in the cervical sympathetic

pathway from some other cause. The startle reflex was intact

in the hands of the six cluster headache patients, but was

diminished ipsilaterally in patients with a central or

preganglionic sympathetic lesion and also, surprisingly, in

patients with a postganglionic lesion caused by an aneurysm of

the internal carotid artery. Ocular sympathetic deficit was

greater in patients with an aneurysm of the internal carotid

artery than in cluster headache patients or in patients with a

postganglionic sympathetic lesion from some other cause; the

aneurysm may have compromised neurons with projections to

the face and hand, or could have induced transsynaptic

degeneration of preganglionic fibers supplying both regions.

The findings indicate that central sympathetic drive is not

impaired in cluster headache patients; thus, a peripheral

lesion probably induces sympathetic deficit on the

symptomatic side of the face.

49. Dukat, M.; Abdel Rahman, A. A.; Ismaiel, A. M.; Ingher, S.; Teitler,

M.; Gyermek, L.; Glennon, R. A. Structure-activity relationships

for the binding of arylpiperazines and arylbiguanides at 5-HT3

serotonin receptors. J-Med-Chem. 1996 Sep 27; 39(20): 4017-

26; ISSN: 0022-2623.

UNITED-STATES. Arylpiperazines are nonselective agents that

bind at 5-HT3 serotonin receptors with moderate to high

affinity, whereas 1-phenylbiguanide is a low-affinity but

more selective 5-HT3 agonist. In an attempt to enhance the

affinity of the latter agent, and working with the assumption

that similarities might exist between the binding of the two

types of agents, we formulated structure-activity

relationships for the binding of the arylpiperazines and then

incorporated those substituents, leading to high affinity for

the arylpiperazines, into 1-phenylbiguanide. A subsequent

investigation examined the structure-activity relationships of

the arylbiguanides and identified arylguanidines as a novel

class of 5-HT3 ligands. Although curious similarities exist

between the structure-activity relationships of the

arylpiperazines, arylbiguanides, and arylguanidines, it cannot

be concluded that all three series of compounds are binding in

the same manner. Furthermore, upon investigating pairs of

compounds in the three series, the arylpiperazines behaved as

5-HT3 antagonists (von Bezold-Jarisch assay) whereas the

arylbiguanides and arylguanidines acted as 5-HT3 agonists.. 0;

0; 0; 0; 0.

50. Eekhof, J. L.; Aramideh, M.; Bour, L. J.; Hilgevoord, A. A.; Speelman,

H. D.; Ongerboer, de Visser BW. Blink reflex recovery curves in

blepharospasm, torticollis spasmodica, and hemifacial spasm.

Muscle-Nerve. 1996 Jan; 19(1): 10-5; ISSN: 0148-639X.

UNITED-STATES. R1 and R2 blink reflex responses to single

and paired stimuli were investigated in 23 control subjects,

21 patients with blepharospasm (BSP), 20 patients with

torticollis spasmodica (TS), and 23 with hemifacial spasm

(HFS). For paired stimuli, we compared measurements of area

and peak responses at two and three times R2 threshold. R1

and R2 indices were calculated as the average of the recovery

values at 0.5-, 0.3-, and 0.21-s interstimulus intervals to test

individual patients. Peak amplitude measurements at three

times R2 threshold were optimal. The R2 index was abnormal

in 67% of BSP patients, 37% of TS patients, and 50% of HFS

patients on the affected side and 20% on the unaffected side. A

normal R2 index in one third of patients with BSP may indicate

that different pathophysiological mechanisms are involved in

this type of focal dystonia.

51. Epelboim, J.; Steinman, R. M.; Kowler, E.; Pizlo, Z.; Erkelens, C. J.;

Collewijn, H. Gaze-shift dynamics in two kinds of sequential

looking tasks. Vision-Res. 1997 Sep; 37(18): 2597-607; ISSN:

0042-6989.

ENGLAND. Gaze-shift dynamics of unrestrained seated

subjects were examined. The subjects participated in two

tasks. In the first task, they tapped sequences of 3-D targets

located on a table in front of them. In the second task, they

only looked at similar sequences of targets. The purpose of the

task (tapping vs only looking) affected the dynamics of gaze-

shifts. Gaze and eye-in-head peak velocities were higher and

gaze-shift durations were shorter during tapping than during

looking-only. We conclude that task variables affect gaze-

shift dynamics, altering characteristics of the so-called

saccadic "main sequence".

52. Ertas, M.; Uludag, B.; Ertekin, C. Slow motor conduction mainly

limited to motor root in amyotrophic lateral sclerosis.

Muscle-Nerve. 1996 Aug; 19(8): 1003-8; ISSN: 0148-639X.

UNITED-STATES. Motor conduction velocity is expected to be

normal or nearly normal in amyotrophic lateral sclerosis

(ALS). Some studies have suggested that pathology may be

present in the proximal axons. Indeed, some investigators have

shown a decrease in the proximal conduction velocity in ALS

by using motor conduction velocity measurements and H-reflex

and F-response recordings, but they could not delineate the

precise region of the conduction pathology. In this study,

unlike the ones carried out previously, the most proximal

segment has been studied in 11 patients with ALS, 13 normal

controls, and 5 patients with sequel of poliomyelitis (SPM) by

recording sensory and motor spinal root potentials. While no

conduction pathology, H-reflex, or F-response abnormalities

were found in ALS patients compared to normal subjects, it

was shown that conduction velocity decreased in the proximal

segment of the lower motor neuron of the ventral root. Despite

motor neuron pathology in SPM, there was no proximal motor

conduction slowing compared with that in normal subjects.

53. Faist, M.; Dietz, V.; Pierrot Deseilligny, E. Modulation, probably

presynaptic in origin, of monosynaptic Ia excitation during

human gait. Exp-Brain-Res. 1996 Jun; 109(3): 441-9; ISSN:

0014-4819.

GERMANY. Modulation of presynaptic inhibition of Ia afferents

projecting monosynaptically to soleus motoneurones was

investigated during human gait. Changes in presynaptic

inhibition of Ia afferents were deduced from alterations in the

amount of heteronymous soleus H-reflex facilitation evoked by

a constant femoral nerve stimulation. It has been shown that

this facilitation is mediated through a monosynaptic Ia

pathway and that during its first 0.5 ms it is still

uncontaminated by any polysynaptic effect and can be used to

assess ongoing presynaptic inhibition of Ia terminals to soleus

motoneurones. During gait, heteronymous facilitation was

reduced with respect to its control value (rest during sitting)

and modulated during the step cycle: it reached its maximum

at mid-stance and decreased to near zero by the end of stance.

At the same time the H-reflex amplitude was to some extent

similarly modulated. It is argued that this decrease in

heteronymous Ia facilitation and in H-reflex amplitude

reflects an increased, ongoing presynaptic inhibition of Ia

terminals projecting onto soleus motoneurones, which could be

from central and/or peripheral origin. D1 inhibition, i.e. the

late and long-lasting inhibition of the soleus H-reflex evoked

by a train of stimuli to the common peroneal nerve, was used

as another method to assess presynaptic inhibition. This D1

inhibition was decreased during gait, and it is argued that this

decrease might reflect an occlusion in presynaptic pathways

or increased presynaptic inhibition of pathways mediating the

conditioning volley.

54. Feng Chen, K. C.; Wolpaw, J. R. Operant conditioning of H-reflex

changes synaptic terminals on primate motoneurons. Proc-

Natl-Acad-Sci-U-S-A. 1996 Aug 20; 93(17): 9206-11; ISSN:

0027-8424.

UNITED-STATES. Operant conditioning of the primate triceps

surae H-reflex, the electrical analog of the spinal stretch

reflex, creates a memory trace that includes changes in the

spinal cord. To define the morphological correlates of this

plasticity, we analyzed the synaptic terminal coverage of

triceps surae motoneurons from animals in which the triceps

surae H-reflex in one leg had been increased (HRup mode) or

decreased (HRdown mode) by conditioning and compared them

to each other and to motoneurons from unconditioned animals.

Motoneurons were labeled by intramuscular injection of

cholera toxin-horseradish peroxidase. A total of 5055

terminals on the cell bodies and proximal dendrites of 114

motoneurons from 14 animals were studied by electron

microscopy. Significant differences were found between HRup

and HRdown animals and between HRup and naive (i.e.,

unconditioned) animals. F terminals (i.e., putative inhibitory

terminals) were smaller and their active zone coverage on the

cell body was lower on motoneurons from the conditioned side

of HRup animals than on motoneurons from the conditioned

side of HRdown animals. C terminals (i.e., terminals associated

with postsynaptic cisterns and rough endoplasmic reticulum)

were smaller and the number of C terminals in each C complex

(i.e., a group of contiguous C terminals) was larger on

motoneurons from the conditioned side of HRup animals than

on motoneurons either from the conditioned side of HRdown

animals or from naive animals. Because the treatment of HRup

and HRdown animals differed only in the reward contingency,

the results imply that the two contingencies had different

effects on motoneuron synaptic terminals. In combination with

other recent data, they show that H-reflex conditioning

produces a complex pattern of spinal cord plasticity that

includes changes in motoneuron physiological properties as

well as in synaptic terminals. Further delineation of this

pattern should reveal the contribution of the structural

changes described here to the learned change in behavior.

55. Fleminger, S.; Murphy, L.; Lishman, W. A. Malignant distress on eye

contact after severe head injury [letter]. J-Neurol-Neurosurg-

Psychiatry. 1996 Jul; 61(1): 114-5; ISSN: 0022-3050.

ENGLAND.

56. Floeter, M. K.; Kohn, A. F. H-reflexes of different sizes exhibit

differential sensitivity to low frequency depression.

Electroencephalogr-Clin-Neurophysiol. 1997 Dec; 105(6): 470-

5; ISSN: 0013-4694.

IRELAND. The amplitude of the H-reflex declines when

activated repetitively. The magnitude of decline is greater

when the amplitude of the H-reflex is small. To explore

whether pre- or postsynaptic factors contribute to the

differences observed in H-reflexes of different sizes, changes

in the amplitude of H-reflexes of different sizes were

measured during a train of stimulation in 10 normal subjects.

Amplitudes of different sizes were obtained using differing

stimulus intensities or during superimposed contraction, two

manipulations which differently affect the number of active

afferents and the excitation of the motoneuron pool. Small

amplitude H-reflexes depressed to a lower plateau than larger

H-reflexes and superimposed contraction did not alleviate the

depression during each train. Nearly all the decline in larger

amplitude H-reflexes occurred in a component that was in

common with smaller amplitude H-reflexes. This suggests that

the depressibility of the earliest activated units is greater

than later activated units in H-reflexes and that the magnitude

of decline is affected by prior activity as well as size.

57. Flowers, WM Jr; Patel, B. R. Radionuclide angiography as a

confirmatory test for brain death: a review of 229 studies in

219 patients. South-Med-J. 1997 Nov; 90(11): 1091-6; ISSN:

0038-4348.

UNITED-STATES. BACKGROUND: Radionuclide angiography (RA)

has been used for many years to confirm the clinical diagnosis

of brain death, but quantitative data regarding the technique

are unavailable. METHODS: We conducted a retrospective

review of 229 RA procedures done in 219 patients. RESULTS: Of

206 patients who had interpretable studies and met clinical

criteria for brain death (profound coma, absent brain stem

reflexes, and apnea), including 10 patients who had repeated

studies, 203 (98.5% sensitivity) had positive studies, and 6

(2.9%) had negative studies. Of nine patients who had

interpretable studies and did not meet the clinical criteria for

brain death, five (56% specificity) had positive studies and

four (44%) had negative studies. CONCLUSIONS: Radionuclide

angiography is a sensitive confirmatory test of brain death.

The study does not evaluate the posterior fossa circulation,

and an occasional patient may have residual brain stem

function. The examination is most reliable when the patient is

in a deep coma, has no brain stem reflexes, and has failed a

formal apnea test.. 0; 23288-60-0.

58. Frohman, E. M.; Tusa, R.; Mark, A. S.; Cornblath, D. R. Vestibular

dysfunction in chronic inflammatory demyelinating

polyneuropathy. Ann-Neurol. 1996 Apr; 39(4): 529-35; ISSN:

0364-5134.

UNITED-STATES. Chronic inflammatory demyelinating

polyneuropathy (CIDP) has occasionally been associated with

clinical or laboratory evidence (magnetic resonance

imaging,[MRI], visual evoked response, and brainstem auditory

evoked response [BAER] of cranial neuropathy. In most cases,

the relationship of cranial nerve involvement to CIDP remains

unclear. A 45-year-old woman noted foot numbness, limb

weakness, gait and postural instability, and oscillopsia. An IgG

kappa monoclonal gammopathy of undetermined significance

was found. Bilateral vestibulopathy was documented by

clinical examination, bithermal calorics, rotary chair testing,

BAERs, and dynamic posturography. MRI with gadolinium

demonstrated enhancement of cranial nerve VIII bilaterally.

Over the next 6 years, the patients's relapsing and remitting

course of CIDP and vestibulopathy was assessed by

quantitative muscle and vestibular function testing (clinically

and neurophysiologically), and dynamic visual acuity. There

was a striking synchronization between her CIDP and

vestibulopathy with respect to clinical course including

relapses and responses to immune therapy. The response to

therapy, and evidence derived from clinical and laboratory

investigations, suggest that the vestibular dysfunction was

immune mediated.

59. Froklaer, J.; Djurhuus, J. C. [Renorenal reflexes]. Renorenale

reflekser. Ugeskr-Laeger. 1996 Jun 3; 158(23): 3329-30; ISSN:

0041-5782.

DENMARK. 0.

60. Fukuda, M.; Fullard, R. J.; Willcox, M. D.; Baleriola Lucas, C.;

Bestawros, F.; Sweeney, D.; Holden, B. A. Fibronectin in the tear

film. Invest-Ophthalmol-Vis-Sci. 1996 Feb; 37(2): 459-67;

ISSN: 0146-0404.

UNITED-STATES. PURPOSE. Fibronectin plays an important role

in corneal healing and has been detected previously in the tear

film. To investigate the levels of fibronectin in normal human

tears, the authors measured and compared fibronectin

concentration in open-eye, closed-eye, and reflex tear fluid.

The origin of fibronectin in the tear film was investigated by

comparing fibronectin concentration in sequentially collected

reflex tear samples with the concentrations of total protein

and albumin in the same samples. METHODS. Open-eye and

closed-eye tears were collected from 11 noncontact lens

wearers. From 7 subjects, 20 uninterrupted reflex tear

samples (10 microliters each) subsequently were collected,

using the sneeze reflex method of stimulation, followed by an

additional 10 nonstimulated tear samples (3 microliters each)

immediately after cessation of stimulus. Enzyme-linked

immunosorbent assays were used to determine fibronectin and

albumin concentrations, and bicinchoninic acid protein assays

were used to determine total protein concentration in each

sample. RESULTS. Fibronectin concentration in open-eye tears

(19 +/- 24 eta g/ml, range 3 to 78 eta g/ml) was significantly

different (P = 0.004) from that in closed-eyes tears (4127 +/-

3222 eta g/ml, range 1177 to 11384 eta g/ml). In the first 50

microliters of reflex tears, fibronectin concentrations were

low (10 +/- 23 eta g/ml), but they increased significantly (P =

0.028) after 100 microliters of reflex tears had been collected

(220 +/- 126 eta g/ml). There was a further marked transient

increase (767 +/- 946 eta g/ml) after cessation of stimulus.

Total protein concentration in the same samples decreased

significantly during reflex tear collection compared to open-

eye tears, and it increased gradually after cessation of

stimulus. Albumin concentration in the same samples,

analyzed for two subjects only, showed a pattern similar to

that for fibronectin. Dilation of conjunctival blood vessels

was noted in all subjects after reflex tear collection.

Administration of a topical vasoconstrictor in two subjects

eliminated the increase in fibronectin concentration during

reflex tearing but did not affect total protein concentration.

Under reducing conditions, the molecular mass of fibronectin

in open-eye and reflex tears was 240 kDa, identical to

commercially available purified plasma fibronectin, whereas

fibronectin in closed-eye tears was degraded into small

molecular mass fragments. CONCLUSIONS. These findings

suggest that fibronectin in tear fluid is derived from plasma

and that the increase in concentration in closed-eye and reflex

tear fluid is caused by leakage from dilated conjunctival blood

vessels.. 0; 0; 0; 0.

61. Fuller, R.; Hansson, L.; Karlsson, J. A. Neurophysiology of the cough

reflex [letter]. Eur-Respir-J. 1996 Mar; 9(3): 622-4; ISSN:

0903-1936.

DENMARK.

62. Funase, K.; Imanaka, K.; Nishihira, Y. Inhibition of the soleus H-

reflex during dorsiflexion is dependent on individual

differences in maximal soleus H-reflex as a test reflex.

Percept-Mot-Skills. 1996 Apr; 82(2): 403-10; ISSN: 0031-

5125.

UNITED-STATES. The quantitative differences among

individuals in the natural reciprocal inhibition of the soleus H-

reflex during dorsiflexion were examined, in conjunction with

the maximal H-reflex as the test reflex size in each individual.

Maximal H-reflex was expressed relative to the maximal M-

response (H(max)) when compared among individuals. Analysis

showed that with increases in H(max) at rest in each

individual, the inhibitory effect was first enhanced, then

reached a peak, and was finally alleviated. This pattern was

similar to the intraindividual pattern of the inhibitory effect

induced by specific conditioning stimulus as a function of the

test reflex size.

63. Furman, J. M.; Mendoza, J. C. Visual-vestibular interaction during

off-vertical axis rotation. J-Vestib-Res. 1996 Mar; 6(2): 93-

103; ISSN: 0957-4271.

UNITED-STATES. The aim of this study was to further define

the eye movement response to combined visual and vestibular

stimulation, especially during linear acceleration. Subjects

included 15 asymptomatic healthy individuals (8 females and 7

males) between the ages of 20 and 31 years. Vestibular

stimulation consisted of earth-vertical axis rotation and off-

vertical axis rotation (OVAR). Visual stimuli consisted of

projected vertical stripes that were rotated for optokinetic

trials and stationary for visual augmentation trials. A small

laser target (0.5 mW, 0.5 degree arc) that rotated with the

subject was used for fixation trials. Eye movements were

measured with electro-oculography. Results showed that

visual-vestibular interaction during sinusoidal rotation was

not affected by a 15 degree off-vertical tilt. Constant velocity

OVAR induced a continuous nystagmus whose slow component

velocity contained a nonzero baseline, that is, a bias, and a

periodic fluctuation at the rotation frequency, that is, a

modulation component. The modulation component during

visual fixation was reduced as compared with that seen during

rotation in the dark, but was not absent. Constant velocity

OVAR in the presence of earth-fixed stripes induced a

consistent sinusoidal modulation. Our results suggest that

visual-vestibular interaction for otolith stimulation differs

from visual-vestibular interaction for semicircular canal

stimulation. The modulation component of the response to

OVAR appears to be modified by visual stimulation to a lesser

extent than other vestibular-induced eye movements and thus

may reflect a more "direct" vestibulo-ocular response. The

bias component of the response to OVAR can be substantially

influenced by vision and thus may depend upon more "indirect"

pathways.

64. Garber, N. The use of photoscreening to identify visual problems

in the preschool population. J-Ophthalmic-Nurs-Technol. 1997

Sep; 16(5): 235-43; ISSN: 0744-7132.

UNITED-STATES.

65. Gasecki, A. [Josef Babinski: co-founder of contemporary neurology

and neurosurgery]. Jozef Babinski wspoltworca wspolczesnej

neurologii i neurochirurgii. Neurol-Neurochir-Pol. 1997 May;

31(3): 641-56; ISSN: 0028-3843.

POLAND.

66. Gasecki, A. P.; Hachinski, V. On the names of Babinski. Can-J-

Neurol-Sci. 1996 Feb; 23(1): 76-9; ISSN: 0317-1671.

CANADA. The 100th anniversary of the discovery of the

extensor plantar response will be celebrated in 1996. It was

Joseph Francois Felix Babinski who became known worldwide

for the sign that bears his name. In order to help Joseph in

establishing his career, brother Henri gave up his aspirations

and abandoned engineering. Clovis Vincent, "father' of French

neurosurgery and pupil of Joseph, stated: "Joseph Babinski

lived for science, and Henri lived for his brother; without

Henri Babinski, Joseph would not have accomplished that

much". However, Henri's name became famous in all Paris for a

cookbook Gastronomie Pratique written under the pseudonym

of "Ali-Bab.' Throughout Joseph's career his surname remained

distorted despite his own efforts to spell and pronounce it

correctly. Several people can claim the name Babinski, but in

neurology and neurosurgery there is only one, Joseph.

67. Gecelovska, V.; Javorka, K. [Cardiovascular and hemodynamic

changes after artificial pulmonary ventilation].

Kardiovaskularne a hemodynamicke zmeny pocas umelej

ventilacie pluc. Bratisl-Lek-Listy. 1996 May; 97(5): 260-6;

ISSN: 0006-9248.

SLOVAKIA. The cardio-respiratory interactions include

mechanical, reflex and humoral mechanisms. However, in the

organism they mutually overlap, thus mating their separate

investigation is problematic. Mechanical effects of

conventional artificial ventilation (AV) and high frequency

ventilation (HFV) are elicited by increased intrapulmonary

pressure during lung inflation, as well as during application of

positive end expiratory pressure (PEEP). The increase in

intrapulmonary pressure compresses the pulmonary vessels

and increases the pulmonary vascular resistance. These

changes deteriorate the right ventricular function. Mechanical

factors are responsible for the fall of the left ventricular (LV)

filling, stroke volume and alteration of the LV preload and

afterload. LV filling is decreased during artificial ventilation

(AV) owing to the shifting of blood from the central to the

peripheral circulation, and to the rise in pulmonary vascular

resistance. Application of positive intrathoracic pressure

during ventricular ejection phase can diminish LV afterload

and increase the cardiac output. This effect is striking in LV

failure. The reflex effects of artificial ventilation are due to

the activation of baroreflexes and pulmo-vagally cardiac and

vasoactive reflexes. Activation of these reflexes depends on

the level and characteristic of the pressure in the airways,

lungs, heart and vessels. Humoral effects of AV on the

cardiovascular system and hemodynamics are triggered by lung

expansion, circulatory changes, and they result in a release of

vasoactive substances from lung parenchyma. (Fig. 5, Ref. 45.).

68. Goddard, Sally. A Teacher's Window into the Child's Mind and

Papers from the Institute for Neuro-Physiological Psychology.

A Non-Invasive Approach to Solving Learning and Behavior

Problems. 1996;

Note: 128 p.

Fern Ridge Press, 1927 McLean Boulevard, Eugene, OR 97405

($19.95; video available).. Books (010). Guides - Non-

classroom (055). U.S.; Oregon. This book describes a neuro-

developmental approach to learning difficulty assessment and

remediation through assessment of a student's reception of

information through the sensory channels, processing of

sensory information in the brain, and repertoire of responses

for expression. Chapter 1, "Reflexes: Their Impact on Success

or Failure in Education," describes the Moro, Palmar,

Asymmetrical Tonic Neck , Rooting, Spinal Galant, Tonic

Labyrinthine, and Symmetrical Tonic Neck reflexes. Chapter 2,

"From Primitive Reflex to Postural Control" discusses postural

reflexes and in particular the Landau, Amphibian, and

Segmental Rolling Reflexes as well as equilibrium reflexes.

Chapter 3, "Brain Development," looks at development in the

first year of life. Chapter 4, "The Senses," covers balance and

the vestibular system, touch, hearing, seeing, taste, and smell

as well as proprioception or kinesthesis. Chapter 5, "Reflex

Testing," gives test procedures and scoring ranges for 15

reflexes and is illustrated with drawings. Chapter 6,

"Remedial Steps Available to the Teacher," discusses various

sensory difficulties and corrective activities, and provides

tables outlining the development and transformation of the

reflex system, historical indicators of neuro-developmental

delays, and suggested remediation for retained reflexes. An

appendix contains useful addresses, a glossary and index, and

three selected papers: "Elective Mutism: The Unchosen

Silence"; "Developmental Milestones: A Blueprint for Survival";

and "Why Do Our Children Roll and Tumble?" (Contains 84

references.) (JB).

69. Gould, T. J.; Steinmetz, J. E. Changes in rabbit cerebellar cortical

and interpositus nucleus activity during acquisition,

extinction, and backward classical eyelid conditioning.

Neurobiol-Learn-Mem. 1996 Jan; 65(1): 17-34; ISSN: 1074-

7427.

UNITED-STATES. Multiple- and single-unit neuronal activities

were recorded from cerebellar cortex (Larsell's lobule HVI and

adjacent ansiform cortex) and the cerebellar interpositus

nucleus during forward (CS-US), backward (US-CS), and

explicitly unpaired classical eyeblink conditioning in several

rabbits. Whereas learning-related activity was observed in the

interpositus nucleus only during forward pairing of the

conditioning stimuli, a variety of patterns of learning-related

neuronal firings were observed in cerebellar cortex during

forward, backward, and even unpaired presentations of the

conditioning stimuli. These data suggest that the cerebellar

cortex and the deep cerebellar nuclei play different roles

during classical eyeblink conditioning.

70. Gratadour, P.; Viale, J. P.; Parlow, J.; Sagnard, P.; Counioux, H.;

Bagou, G.; Annat, G.; Hughson, R.; Quintin, L. Sympathovagal

effects of spinal anesthesia assessed by the spontaneous

cardiac baroreflex. Anesthesiology. 1997 Dec; 87(6): 1359-67;

ISSN: 0003-3022.

UNITED-STATES. BACKGROUND: The changes in sympathovagal

balance induced by spinal anesthesia remain controversial. The

spontaneous baroreflex method allows the continuous

assessment of the spontaneous engagement of the cardiac

baroreflex, giving an index of sympathovagal balance. The

purpose of this study was to follow the effects of spinal

anesthesia on spontaneous baroreflex sensitivity. METHODS:

Continuous electrocardiogram and noninvasive blood pressure

were recorded in 24 patients scheduled for elective inguinal

hernia repair and randomly assigned to three groups: (1) no

volume loading, (2) volume loading of 15 ml/kg lactated

Ringer's solution, and (3) continuous infusion of etilefrine (an

ephedrine-like drug). Each patient was studied before, during,

and after bupivacaine-induced spinal anesthesia (mean sensory

block: T4). Spontaneous baroreflex sensitivity and parameters

of time-domain analysis of heart rate variability were

calculated from 30 min of recording of each period. RESULTS:

No significant change in spontaneous baroreflex slope or

parameters of time-domain analysis were observed after

regional anesthesia in any group. However, three patients

experienced episodes of bradycardia and hypotension in the

absence of a high block; these three patients showed an

increase in spontaneous baroreflex sensitivity and time-

domain parameters. CONCLUSIONS: Using a noninvasive,

continuous technique to estimate cardiac sympathovagal

balance, no significant variation in autonomic balance induced

by spinal anesthesia was observed. However, untoward

episodes of bradycardia and hypotension occurred in three

patients, who could not be prospectively identified by the

parameters studied.. 0; 0; 0; 0; 2180-92-9; 59467-70-8; 709-

55-7; 8022-63-7.

71. Grunwald, Bernice Bronia; McAbee, Harold V. Guiding the Family:

Practical Counseling Techniques. 1985;

Note: 355 p.

Accelerated Development Inc., Publishers, 3400 Kilgore Ave.,

Muncie, IN 47304-4896 ($22.95).. Books (010). U.S.; Indiana.

This book, intended as a text for therapists and counselors in

family counseling, is based on principles of Adlerian

psychology. The first chapter examines Adlerian theory and

family counseling. Basic principles of individual psychology

are applied to family counseling, and the goals of children

with disturbing behavior are discussed. Reasons why parents

pamper children are examined. The second chapter provides a

framework within which the counselor can find an

individualistic approach. Basic considerations are outlined

which are safe and consistent with Adlerian psychology. The

third chapter contains seven basic steps considered essential

to family counseling. The fourth chapter outlines and

discusses confrontation techniques for psychological

disclosure, goals of distributing behavior, and the recognition

reflex. The fifth chapter examines diagnostic techniques and

discusses how to gather significant information. The sixth

chapter examines the use of corrective measures. Use of

recommendations, encouragement, training children with

logical consequences, paradoxical intentions, the family

council, and giving directions are all examined. The seventh

chapter contains vignettes with concrete suggestions for

improving relationships between parents and their children in

a variety of problem situations. The eighth chapter focuses on

counseling adolescents. Special sections are included for

counseling the defiant adolescent and juvenile delinquents. The

ninth chapter is concerned with special family circumstances

such as single parent families, blended families, and extended

families. The tenth chapter contains case studies which

illustrate principles and techniques delineated throughout the

book. (LLL).

72. Guyot, J. P.; Psillas, G. Test-retest reliability of vestibular

autorotation testing in healthy subjects. Otolaryngol-Head-

Neck-Surg. 1997 Dec; 117(6): 704-7; ISSN: 0194-5998.

UNITED-STATES. Vestibulo-ocular reflex rotational chair

testing in the high-frequency range is seldom performed

because it requires specialized and powerful systems. But

today a new method of sweep-frequency vestibulo-ocular

reflex testing, the Vestibular Autorotation Test system

(Western Systems Research, Inc., Pasadena, Calif.), based on

active head movements increasing from 2 to 6 Hz, is available

on the market. The goal of this study was to evaluate the test-

retest variability of this test in healthy subjects. Twelve

young adults (22 to 42 years old) without any history of

auditory or vestibular dysfunction were included in the study.

Subjects underwent five tests under standardized conditions

with a 1-week interval. Each test consisted of three

measurements of the gain and phase of the vestibulo-ocular

reflex in the horizontal and vertical planes. Statistical

analysis shows that the test-retest reliability of the

Vestibular Autorotation Test is poor. Therefore this method

cannot be used routinely to evaluate precise vestibulo-ocular

reflex anomalies.

73. Haapaniemi, J. J. Immittance findings in school-aged children.

Ear-Hear. 1996 Feb; 17(1): 19-27; ISSN: 0196-0202.

UNITED-STATES. OBJECTIVE: The purpose of the present study

was to obtain the median values and distributions of

tympanometric variables and the distributions of acoustic

reflex thresholds for three age groups of unselected school-

aged children. Furthermore, the investigation was undertaken

to provide normative immittance data for selected,

otologically normal 7-, 10-, and 14-yr-old children. DESIGN: A

total of 687 children, aged 6 to 15 yr, were thoroughly

examined clinically, audiometrically, and tympanometrically.

The same examinations were made in 471 otologically normal

children, selected from the total population on the basis of the

findings that both tympanic membranes were

otomicroscopically healthy, and the hearing thresholds were

better than or equal to 25 dB HL at all frequencies. RESULTS:

The results showed that the median equivalent ear canal

volume (Vec) increased from 0.65 ml to 1.00 ml with

increasing age both in the unselected and selected populations.

The median peak admittance values (Ytm) were between 0.55

and 0.5 mmho in the respective study groups, somewhat higher

in older than in younger children. The same tendency was also

seen in gradient and tympanometric peak pressure (TPP)

results. Depending on the age, the median tympanometric peak

pressures were 5 to 10 daPa higher in otologically normal

children than in the unselected population. The median TPP

was -10 daPa in a group of unselected children, and -5 daPa in

a group of otologically normal children. The distribution of

ipsi- and contralateral acoustic reflex thresholds is

presented. Thresholds were higher in younger than in older

children. CONCLUSIONS: The obtained results give new

information on immittance findings in an unselected sample of

school-aged children who were representative of children in

the general population. Furthermore, the results are useful as

normative immittance values in 7-, 10-, and 14-yr-old

children when the limitations relating to the equipment are

taken into account.

74. Hallett, M.; Daroff, R. B. Blepharospasm: report of a workshop.

Neurology. 1996 May; 46(5): 1213-8; ISSN: 0028-3878.

UNITED-STATES.

75. Hannam, S.; Ingram, D. M.; Milner, A. D. A possible role for the

Hering-Breuer deflation reflex in apnea of prematurity. J-

Pediatr. 1998 Jan; 132(1): 35-9; ISSN: 0022-3476.

UNITED-STATES. BACKGROUND: The vagally mediated Hering-

Breuer deflation reflex terminates expiration and initiates

inspiration when lung volume is reduced to less than

functional residual capacity. The effects of prematurity on

this reflex are not known. STUDY DESIGN: Fifteen term and 20

preterm nonventilated infants were studied. Lung deflation

was achieved by chest compression using an inflatable jacket.

Relative changes in expiratory time and inspiratory time on

chest compression were calculated from airflow recordings.

Esophageal pressure changes in the term infants and chest

wall movements in the preterm infants were also measured.

RESULTS: The term infants had a mean prolongation of

inspiratory time on squeezing of 15% versus a 24% shortening

in the preterm infants (p < 0.001). The term infants had a mean

shortening of expiratory time on squeezing of 35% versus 18%

in the preterm infants (p < 0.001). Fifteen of the 20 preterm

infants demonstrated a tendency to have short apneas (2 to 5

seconds) on squeezing, 88% of which were central in origin. In

these infants shortening of inspiratory time was greater than

that seen in the preterm infants not having apneas (p < 0.05).

CONCLUSIONS: Preterm infants responded to a rapid reduction

in lung volume with a shortened inspiratory effort and a

tendency to have central apneas. This may be due to an

immaturity in part of the reflex arc responsible for

transmitting the Hering-Breuer deflation reflex.

76. Herrero, J. F.; Cervero, F. Supraspinal influences on the

facilitation of rat nociceptive reflexes induced by carrageenan

monoarthritis. Neurosci-Lett. 1996 May 3; 209(1): 21-4; ISSN:

0304-3940.

IRELAND. During hyperalgesia there is an enhancement of

wind-up and the appearance of a novel wind-up of the A-fibre-

mediated responses. We have examined if these phenomena are

influenced by supraspinal mechanisms by analysing single

motor unit activity in control and arthritic rats, either intact

or acutely spinalised. Enhancement of the C-fibre wind-up and

the novel A-fibre wind-up were only observed in the intact

arthritic animals. We conclude that C-fibre wind-up is a spinal

phenomenon, whereas the enhancement of the C-fibre wind-up

and the novel A-fibre wind-up during arthritis depend also on

supraspinal influences.. 9000-07-1.

77. Herzog, W. On sounds and reflexes. J-Manipulative-Physiol-Ther.

1996 Mar; 19(3): 216-8; ISSN: 0161-4754.

UNITED-STATES.

78. Hesse, S.; Krajnik, J.; Luecke, D.; Jahnke, M. T.; Gregoric, M.;

Mauritz, K. H. Ankle muscle activity before and after botulinum

toxin therapy for lower limb extensor spasticity in chronic

hemiparetic patients. Stroke. 1996 Mar; 27(3): 455-60; ISSN: