Intraoperative EMG recording in stimulation of the glenohumeral joint capsule

In an experimental study we investigated the EMG response in 10 patients after intraarticular stimulation of the joint capsule. Intraoperative stimulation was achieved by arthroscopic placement of the stimulation catheter at the anterior joint capsule. The muscle response was documented by mono- or bipolar electrodes. We found reproducible EMG muscle responses in both superficial and deep muscle layers. The response time was between 100 and 516 ms. The shortest muscle response was found at the anterior part of the deltoid muscle and the longest at the supraspinatus muscle and the lateral part of the deltoid muscle.     

Usefulness of electromyographic techniques of the bulbocavernosus muscle in the diagnosis of neurogenic impotence

OBJECTIVE: To analyze the utility of electromyographic study of the bulbocavernosus muscle. METHODS: 126 impotent patients were evaluated by physical examination and neuroandrologic profile. The physical examination consisted in an exploration of the anal tone and the bulbocavernosus reflex. The neuroandrologic profile consisted in selective electromyography of the bulbocavernosus muscle, the determination of the S2-S4 evoked potentials, somatosensory potential of the pudenal nerve, electromyography of cavernous smooth muscle (SPACE) sympathetic skin response and cystometry. RESULTS: The results of the bulbocavernosus electromyography and S2-S4 evoked potentials were different from the data obtained from the physical examination of the anal tone and the bulbocavernosus reflex. Selective bulbocavernosus electromyography showed a sensitivity of 57% and a specificity of 84%. The S2-S4 evoked potentials showed a sensitivity of 61% and a specificity of 100%. The diagnostic value of the S2-S4 evoked potentials increased at 39 msec cutoff (sensitivity = 66%; specificity = 95%). Exploration of the anal tone is very specific for neurologic lesion in impotence (93%), but has a low sensitivity (30%). The clinical bulbocavernosus reflex showed a good specificity (85%) and sensitivity (75%) in the diagnosis of pudendal efferent lesion, but is less useful in the diagnosis of neurogenic impotence. CONCLUSIONS: The highest diagnostic value was obtained with the S2-S4 evoked potentials. Selective electromyography of the bulbocavernosus muscle showed a moderate diagnostic value. Physical examination of peripheral pudendal innervation does not appear to be useful for screening for neurologic lesion in impotence because of its low sensitivity, which may be due to existing incomplete nervous lesions.     

Intraoperative imaging of the brain

The development of computed imaging techniques has revolutionized contemporary neurosurgical procedures. In a 20-year interval, intraoperative imaging was used in more than 4,000 patients at our center. The selection of the appropriate intraoperative imaging tool was dependent on the neurosurgical procedure performed. In our dedicated operating room suite, intraoperative fluoroscopic imaging was used during transsphenoidal, spinal, and functional procedures, e.g. to treat percutaneous trigeminal neuralgia. A dedicated intraoperative computed tomography scanner was first available in 1981 and was used in more than 1,500 stereotactic or image-guided procedures. During radiosurgical procedures with the Gamma Knife (n = 1,560) a variety of intraoperative imaging tools (MRI, CT, angiography, and digital subtraction angiography) were used to define the target. The output of these imaging tools is currently transferred via fiberoptic ethernet to a wide variety of computer workstations designed to facilitate surgical or radiation dose planning. In addition, intraoperative imaging became increasingly important during vascular neurosurgery. Because of its superior patient accessibility and instrument compatibility. CT is likely to remain the most important imaging tool for conventional intraoperative image-guided stereotactic surgery. In contrast, intraoperative MRI proved to be the superior imaging tool for radiosurgery.     

Neonatal androgen and estrogen treatments masculinize the size of motoneurons in the rat spinal nucleus of the bulbocavernosus

Electrically-assisted transdermal delivery (EATDD) is the facilitated transport of compounds across the skin using an electromotive force. It has been extensively explored as a potential means for delivering peptides and other hydrophilic, acid-labile or orally unstable products of biotechnology. The predominant mechanism for delivery is iontophoresis, although electroosmosis and electroporation have also been investigated. The focus of this review is to put these different mechanisms in perspective and relate them to the drug and skin model system being investigated.     

Intraoperative colonoscopy

We reviewed microbiology and infection control records at a Memphis children's hospital from 1982 to 1990 to obtain epidemiologic, clinical, and microbiologic data on group A streptococcal (GAS) bacteremia. Varicella was the underlying condition in 8 of 37 (22%) patients identified and was often associated with severe GAS disease, including toxic shock-like syndrome. Twenty-one of 31 (68%) available blood isolates made GAS pyrogenic exotoxin (SPE) B by Ouchterlony immunodiffusion; gene probes identified speC and speA in 18 (58%) and 8 (26%) isolates, respectively. The B/C toxin profile, identified in 11 (35%) isolates, was the most common profile in this population, and the overall rate for speC was higher than rates recently reported from other areas. Although the clinical significance of the toxin profiles in our population is unclear, these data emphasize the geographic and temporal variability in the microbiologic properties of GAS disease.     

Report of the recording secretary.

Presents the (1967) report of the Recording Secretary of the Council of Representatives of the American Psychological Association (APA). Issues addressed include proposed accreditation of doctoral programs in school psychology, the continuing problem of accreditation of internship agencies, a proposal that training programs requesting evaluation be assessed a part of the cost of the accreditation, and issues related to APA's financial needs. Issues briefly noted included the role of psychology with respect to social issues, Congressional and other attacks on the use of psychological tests, and public affairs policies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

EEG video recording

We analyse EEG data from video-EEG recordings of 24 patients, selected among the 63 with "pure" temporal lobe epilepsy. As to interictal EEG features, 62.5% of patients show a less regular background activity on the affected side, in 70% of patients slow waves are either localised or lobar, while in 58% are spikes. Slow waves and spikes have the same well-defined localisation in 37.5% of the patients. Ictal recordings show an initial EEG pattern with high localising value (low-voltage fast activity, flattening or slow waves interruption) in 74/121 seizures (61%). Five out of these 24 patients were operated on without invasive recordings on the basis of ictal video-EEG data. In the 19 patients left, video-EEG ictal informations were used for the planning of the stereo-EEG exploration.     

Actions of drugs affecting the cough reflex

BACKGROUND AND AIM: Authors evaluated the part of some receptor systems in the antitussive activity of drugs. METHOD: The cough was induced by mechanical stimulation of the airways. Unanesthetized cats were used in this study. RESULTS: They followed: 1. statistically highly significant decrease of cough parameters after administration the drugs influencing the different types of opiate receptors--tramadol, tilidine, pentazocine, codeine and butorphanol. Every of these drugs were administered in a dose 10 mg/kg b.w. intraperitoneally, 2. the antitussive activity of codeine was decreased by pretreatment with naloxone only in part, 3. selective antagonist 5-HT2 receptors ketanserine (1 mg/kg b.w.) decreased antitussive effect of codeine by 10% and effect of tramadol by 20%, 4. the ability of codeine to reduce the cough parameters was unchanged after pretreatment with haloperidol (0.1 mg/kg b.w.), 5. whereas the pretreatment with reserpine decreased the cough-suppressing effect of codeine, 6. the application of gabaergic agent gabalid leads to the highly significant decrease the cough parameters. Results of these experiments showed that gaba-ergic mechanism might be involved in the mechanism of action of narcotic antitussives agents, 7. we showed, that inhibition of glutaminergic synaptic transmissions afferent impulses from cough receptors with dextromethorphan leads to suppressing cough reflex in cats. CONCLUSIONS: Antitussive activity of agents is not only mediated by means of mí opiate receptors. The results suggest, that gabaergic, serotoninergic systems and activity of NMDA receptors play an important role in the mechanism of action of antitussive drugs. Decrease in levels of brain monoamines modifies the cough-depressant effect of codeine. (Fig. 7, Ref. 23.)     

Nonlinearities of the human carotid baroreceptor-cardiac reflex

Carotid baroreceptors of nine healthy young men and women were stretched or compressed with neck suction or pressure, before and after beta-adrenergic and cholinergic blockade, to evaluate several nonlinearities of sinus node baroreflex responses. Sinus node inhibition was related linearly to the intensity of brief baroreceptor stimuli over a range extending from carotid-distending pressures of about 101 +/- 5 (mean +/- SE) to 160 +/- 6 mm Hg (the subject's average systolic pressure was 108 +/- 2 mm Hg). Sinus node response to sustained (5 seconds) neck suction or pressure were strikingly asymmetrical. Responses were abolished by atropine, or by atropine and propranolol. Propranolol alone augmented sinus node responses to both neck suction and pressure. These results suggest that, in normal human subjects, sinus node responses to abrupt alterations of afferent baroreceptor traffic are nonlinear and are mediated by fluctuations of efferent cholinergic activity. Most of the observed nonlinear behavior of the integrated reflex can be explained on the basis of known properties of afferent and central portions of the baroreflex arc.     

The grasp reflex of the foot and related phenomena in the absence of other reflex abnormalities following cerebral commissurotomy

The grasp reflex of the foot and related pheonomena were examined in six subjects with no abnormalities of deep tendon or plantar (and related) reflexes 6 to 10 years after cerebral comissurotomy. In all subjects they were more marked on the same side as the more damaged hemisphere. These tonic phenomena seem to be facillitated by sitting and standing postures. Practical and theoretical implications of the tonic foot responses in the absence of similar phenomena of the hand are discussed.     

The vestibulo-collic reflex

This study was undertaken to compare the fixation of the semitubular blade plate with that of the AO T plate. Cadaveric humeri (n=12 pairs) from an elderly population (41 to 89 years) had either a blade plate (n=12) or a T plate (n=12) fixed to them, subsequent to which a transverse osteotomy was performed. Mechanical testing in tension was performed in 1 series (n=5, blade plate; n=5, T plate) by applying a single maximal load to failure and in a second series (n=7, blade plate; n=7, T plate) by applying submaximal cyclic loading before failure was induced. Results showed that the fixation provided by the semitubular blade plate was significantly better (P < .05) than that of the T plate in those specimens subjected to submaximal cyclic loading before failure (series 2). This latter testing method contains some component of the clinical situation compared with monotonic distraction to failure. Based on these results plus favorable clinical results reported in the literature, the semitubular blade plate is possibly a better alternative to the T plate in the management of proximal humeral fractures that require open reduction and internal fixation.     

Intraoperative cytodiagnosis of ovarian tumors

The authors report on their experience in applying rapid intraoperative cytologic analysis in 83 benign and 54 malignant ovarian tumors of various pathohistologic types. The entire procedure, from the receiving of the material, fixing and staining, up to the cytologic diagnosis, did not last longer than 6 minutes. The cytologic findings were negative in all benign tumors except one (99.3%). In cases of malignant tumors the cytologic diagnosis was correct in 49 cases (96.4%). On the basis of cytomorphologic criteria it was also possible to predict the pathohistologic type of most of investigated tumors. The high overall accuracy rate of intraoperative cytologic examination permits the surgeon to make a quick and adequate therapeutic decision concerning the extent of intervention.