Biomechanical testing of the spine. Load-controlled versus displacement-controlled analysis

Mechanical testing of the spine can be carried out in either a load-controlled or a displacement-controlled manner. Each method requires certain assumptions and offers different advantages. Dr. W. Thomas Edwards believes that displacement-controlled testing most accurately reflects the in vivo environment, while Drs. Vijay Goel, David Wilder, and Malcolm Pope support the use of the load-controlled method as most logical and easily standardized.     

Transdural spinal cord herniation: imaging and clinical spectra

OBJECTIVE: Many diseases induce asymmetric delays in the visual pathway, resulting in a spontaneous Pulfrich phenomenon (PP). The PP is a visual stereoillusion that may cause difficulties in persons when traveling in cars, crossing the road, or playing ball games. The authors developed and tested a simple new bedside procedure to detect PP. DESIGN: A case series. PARTICIPANTS: Disease simulation in 2 normal subjects and 18 patients with optic neuritis (ON) was examined. Ninety normal subjects were studied to determine normal range of PP. INTERVENTION: The new test, called swinging pen test (SPT), is performed by oscillating a pen by hand. The SPT was compared to a gold standard, a mechanical pendulum (MP). MAIN OUTCOME MEASURES: The authors measured simulated PP in two normal subjects and PP in 18 patients with ON and 90 normal control subjects. The Pearson product-moment correlation (r) and the Spearman rank correlation (rs) between SPT and MP were calculated. RESULTS: The magnitudes of simulated PP determined with the SPT and the MP correlated well (r = 0.92, P < 0.005, and r = 0.96, P < 0.001). Correlation also was good in patients with ON (rs = 0.90, P < 0.05). The positive predictive value of the SPT was 100%, and the negative predictive value was 92%. The PP was absent in all control subjects testing with either pendulum. The normal range for PP varied from -1.40 to 1.52 msec. For the SPT, the intraobserver variability coefficient was 8.2%, and the interobserver variability coefficient was 10.5%. CONCLUSIONS: The authors believe that SPT will be of value to clinicians on bedside evaluation of motion stereopsis dysfunctions. The normal range of PP was approximately +/- -1.5 msec (approximately +/- -1.5 cm), corresponding to a 0.3-log unit neutral density filter).     

Reaction of the cardio-respiratory-system following acetylcholine inhalation and the dependency from the body position on anaesthetised dogs (author's transl)

The bronchomotoric reaction following ACH-aerosol in low concentrations is dependend on the position of the body on dogs. Up till one maximal reaction the increase of the airway resistance is always stronger in the lateral position. Nevertheless the breathing minute volume is constant. Concentration reaction curves will be shown. Arterial blood gases, heart rate, and pressure in the arteria femoralis were also measured. The different strongness of the reaction following ACH-inhalation will be caused by the predominantely unilateral ventilation of the animals in the lateral position.     

Rehabilitation after aortic valve replacement with autologous fascia lata: a sociomedical study

In a series of 50 patients who underwent aortic valve replacement with frame-supported fascia lata, 32 were seen for a combined medical and psychosocial examination 10 to 33 months postoperatively. The investigation included a psychometric test battery and an interview concerning the patient's social and psychological situation at the time of the operation and at follow-up. Twenty-seven patients had improved in their New York Heart Association Functional Classification at the time of follow-up. In most instances NYHA classification correlated well with the patients' subjective opinion on their recovery. Those who for various reasons were not able to return to work did not consider themselves recovered. The employment rate after operation was 66%. There is a great need for more information and support to families as well as for more intensive rehabilitation efforts, especially vocational, for the postoperative patient.     

Cocaine use in women from a defined population: prevalence at delivery and effects on growth in infants

Adverse health effects associated with intrauterine cocaine exposure (prematurity and its associated morbidity, intrauterine growth retardation, possible risk of sudden infant death syndrome) are based on studies from large urban hospitals, but few data exist from other sources. The current study, set in a community hospital, was designed to (1) estimate the prevalence of maternal cocaine use at delivery, (2) describe neonatal outcomes, and (3) evaluate physiological growth in exposed children. The study was conducted over 30 months (total births were 14,074) at The Children's Hospital of Greenville Memorial Hospital, the major source of neonatal care for Greenville County, South Carolina (1990 population: 320,000). A child was considered exposed to cocaine if there was documented evidence of use in the mother's medical record or if one member of the pair had a positive urine drug screen. Growth data were abstracted from clinical records. Overall prevalence of exposure was 1.0%. Of the 137 subjects (89, positive urine drug screen; 48 self-reported exposure), 21 (15%, 95% confidence interval, 9% to 21%) were premature (gestational age < 37 weeks) and 2 died of sudden infant death syndrome. Mean age- and sex-adjusted percentiles for weight, length, and head circumference increased from 23%, 29%, and 18%, respectively, at birth to 43%, 49%, and 54% in children followed for 12 months; however, 50% of the cohort were lost to follow-up, and these children were smaller at birth than those under active follow-up. Rates of prematurity and infant death were similar to those reported in urban hospitals.(ABSTRACT TRUNCATED AT 250 WORDS)     

Role of endogenous carbon monoxide in central regulation of arterial pressure

We investigated the contribution of neural mechanisms to the arterial pressure increase produced by zinc deuteroporphyrin 2,4-bis glycol (ZnDPBG), an inhibitor of endogenous carbon monoxide synthesis. The arterial baroreceptor reflex control of heart rate was examined in rats with and without ZnDPBG pretreatment (45 micromol/kg IP) by analysis of the arterial pressure-heart rate relationship during infusions of phenylephrine or sodium nitroprusside to vary arterial pressure. ZnDPBG increased arterial pressure from 110 +/- 3 to 126 +/- 2 mm Hg without eliciting bradycardia. The maximum gain of the heart rate response to changes in arterial pressure was attenuated by ZnDPBG treatment (-1.9 +/- 0.3 versus -4.8 +/- 1.0 bpm/mm Hg). The possibility that ZnDPBG elevates arterial pressure by attenuating baroreceptor reflex function was addressed by comparing the pressor response to ZnDPBG (45 micromol/kg IP) in rats with and without sinoaortic denervation. The pressor effect of ZnDPBG was similar in rats with and without arterial baroreceptor deafferentation, implying that the increase in pressure is not simply the consequence of attenuated baroreceptor reflex function per se. The possibility that ZnDPBG increases arterial pressure via an effect on the nucleus tractus solitarii (NTS) also was investigated. ZnDPBG (1 nmol in 100 nL) injected into the NTS of rats increased arterial pressure from 111 +/- 4 to 126 +/- 5 mm Hg, and this effect was reversed by an ipsilateral microinjection of carbon monoxide into the NTS. Accordingly, the pressor effect of ZnDPBG may rely on inhibition of carbon monoxide production in the NTS. This implies that carbon monoxide formed by brain heme oxygenase plays a role in the central regulation of arterial pressure.     

Crystal structure of farnesyl protein transferase complexed with a CaaX peptide and farnesyl diphosphate analogue

The crystallographic structure of acetyl-Cys-Val-Ile-selenoMet-COOH and alpha-hydroxyfarnesylphosphonic acid (alphaHFP) complexed with rat farnesyl protein transferase (FPT) (space group P61, a = b = 174. 13 A, c = 69.71 A, alpha = beta = 90 degrees, gamma = 120 degrees, Rfactor = 21.8%, Rfree = 29.2%, 2.5 A resolution) is reported. In the ternary complex, the bound substrates are within van der Waals contact of each other and the FPT enzyme. alphaHFP binds in an extended conformation in the active-site cavity where positively charged side chains and solvent molecules interact with the phosphate moiety and aromatic side chains pack adjacent to the isoprenoid chain. The backbone of the bound CaaX peptide adopts an extended conformation, and the side chains interact with both FPT and alphaHFP. The cysteine sulfur of the bound peptide coordinates the active-site zinc. Overall, peptide binding and recognition appear to be dominated by side-chain interactions. Comparison of the structures of the ternary complex and unliganded FPT [Park, H., Boduluri, S., Moomaw, J., Casey, P., and Beese, L. (1997) Science 275, 1800-1804] shows that major rearrangements of several active site side chains occur upon substrate binding.     

"Periodic" seizures

PURPOSE: To describe regularly recurring ictal phenomena as recorded in a single patient whose seizure disorder related to a left temporal cavernous angioma. METHODS: Seizures were recorded by left temporal subdural strip electrodes which were bilaterally placed because of ambiguous seizure origin and right temporal memory dysfunction at Wada testing. Seizure length, interseizure intervals, and interseizure onset intervals were visually assessed. The coefficient of variation was used as an estimate of variability in seizure periodicity. RESULTS: Mean seizure durations varied from 68 to 95 s; coefficients of variation varied from 0.08 to 0.18, values similar to other periodic biological phenomena. Mean daily seizure intervals varied from 96 to 152 s with coefficients of variation ranging from 0.12 to 0.35. Interseizure onset intervals had smaller coefficients of variation (0.03-0.20). Manifestations of these simple partial seizures included a rising epigastric sensation and nausea. CONCLUSIONS: Previously described periodic EEG phenomena are interictal events or appear with peripheral events of similar cadence. Therefore, we remain unaware of any documentation of periodic ictal electrographic events. The restricted propagation and duration of these recorded seizures may have simplified their pathophysiology allowing a stereotyped involvement of excitatory and inhibitory mechanisms producing the periodicity.