Multiple anterograde tracing, combining Phaseolus vulgaris leucoagglutinin with rhodamine- and biotin-conjugated dextran amine

The simultaneous use of different neuroanatomical anterograde tracers provides a potentially powerful method to study the convergence of afferent systems in a particular brain area. However, a simple routine procedure to apply multiple anterograde tracers in conjunction with their simultaneous visualization is still missing. We report an easy and straightforward application of three sensitive anterograde tracers: Phaseolus vulgaris leucoagglutinin (PHA-L), rhodamine-conjugated dextran amine (RDA) and biotin-conjugated dextran amine (BDA). These tracers can be visualized simultaneously and permanently through a triple-staining procedure with nickel-enhanced diaminobenzidine (DAB-Ni), DAB and 1-naphthol/Azur B as chromogens. Our test model comprised the projections from the nucleus reuniens thalami and entorhinal cortex. Both projection systems show a high degree of overlap in their terminal fields in the hippocampus. Two tracers were injected in the left and right entorhinal cortex, respectively; a third tracer was injected in the nucleus reuniens. This combination of injections provided a good opportunity to compare the three tracers in one and the same animal. PHA-L, RDA and BDA, injected in either of the injection sites, turned out to be equally sensitive and revealed the morphology of the involved projection systems in great detail. The triple-staining protocol yielded an excellent, simultaneous detectability of the three tracers with a remarkably low background level. Thus, the combination of the anterograde tracers PHA-L, RDA and BDA, in conjunction with the triple-staining procedure, offers a very attractive approach for neuroanatomical research.     

Surgical release of elbow-capsular contracture in pediatric patients

Nine pediatric patients with elbow-capsular contractures were treated by surgical release. Six patients had sustained prior trauma and three patients had medical conditions leading to capsular contracture. A lateral approach was used to release the anterior and posterior capsules, as well as to remove sites of bony impingement. All patients were treated with postoperative range of motion and splinting, with six patients receiving a continuous brachial plexus block to facilitate therapy. Average loss of extension improved from 47 to 15 degrees, mean angle of flexion from 102 to 124 degrees, and total arc of motion increased from 55 to 108 degrees at an average of 17 months after surgery. Complications included wound infection and catheter-site erythema.     

Right and left ventricular geometry and myocyte contractile processes with dilated cardiomyopathy: myocyte growth and beta-adrenergic responsiveness

OBJECTIVES: Comparison of the effects of supraventricular tachycardia-induced dilated cardiomyopathy on left and right ventricular isolated myocyte geometry and function. BACKGROUND: Chronic ventricular tachycardia and supraventricular tachycardia cause left ventricular dilation and dysfunction in humans. However, it is unknown whether supraventricular tachycardia-induced dilated cardiomyopathy is a homogenous process for both the left and right ventricles. METHODS: Dilated cardiomyopathy was induced by rapid atrial pacing (240 beats/min, 3 weeks) in 5 pigs. Five age- and weight-matched pigs served as controls. Ventricular mass was measured, myocyte dimensions were obtained, and isolated right and left ventricular myocyte contractile performance was evaluated at baseline and after beta-adrenergic receptor stimulation. RESULTS: With the development of dilated cardiomyopathy, there was no change in left ventricular mass. In contrast, right ventricular mass was increased, as was right ventricular myocyte cross-sectional area. In the control group, baseline right ventricular myocyte contractile function was increased compared to left ventricular myocytes. beta-adrenergic receptor stimulation increased myocyte contractile function in both left and right ventricular myocytes. With supraventricular tachycardia-induced cardiomyopathy, both left and right ventricular myocyte contractile function and beta-adrenergic responsiveness were reduced. CONCLUSIONS: This study demonstrated differences in left and right ventricular myocyte growth with supraventricular tachycardia-induced dilated cardiomyopathy and this differential growth response was associated with changes in contractile performance. Thus, in this model of cardiomyopathic disease, left and right ventricular growth and changes in contractile performance are not a homogenous process.     

Visual results of progressive multifocal posterior chamber intraocular lens implantation

PURPOSE: To evaluate corrected and uncorrected near, intermediate, and distance visual acuities in eyes with a progressive multifocal intraocular lens (IOL) and to determine the effect of the lens on contrast sensitivity. SETTING: Multicenter study. METHODS: This prospective study comprised 59 eyes that had uneventful cataract surgery and implantation of a progressive multifocal IOL at three study centers. Uncorrected and corrected near, intermediate, and distance visual acuities were measured, as was contrast sensitivity at different frequencies. One year results are reported. Patient satisfaction was assessed using a subjective questionnaire. RESULTS: Distance visual acuity improved from 0.13 Snellen lines uncorrected and 0.23 with best correction preoperatively to 0.77 and 0.96 lines, respectively, postoperatively. Uncorrected preoperative near acuity was 13.28 Jaeger lines and best corrected acuity, 8.93 lines. These improved to 4.75 and 2.69 lines, respectively. The differences between visual acuity at intermediate distances and best distance and near acuities were not significant. Patient satisfaction was highest with vision under good light conditions and when viewing larger objects. CONCLUSION: Visual performance with the multifocal progressive IOL was adequate at various distances without additional correction. It was less satisfactory under poor light conditions.