Hypoglossal and reticular interneurons involved in oro-facial coordination in the rat

Chewing, swallowing, breathing, and vocalization in mammals require precise coordination of tongue movements with concomitant activities of the mimetic muscles. The neuroanatomic basis for this oro-facial coordination is not yet fully understood. After the stereotaxic microinjection of retrograde and anterograde neuronal tracers (biotin-dextran, Fluoro-Ruby, Fluoro-Emerald, and Fluoro-Gold) into the facial and hypoglossal nuclei of the rat, we report here a direct bilateral projection of hypoglossal internuclear interneurons onto facial motoneurons. We also confirm the existence of a small pool of neurons in the dorsal part of the brainstem reticular formation that project ipsilaterally to both facial and hypoglossal nuclei. For precise tracer injections, both motor nuclei were located and identified by the electrical antidromic activation of their constituent motoneurons. Injections of retrograde tracers into the facial nucleus consistently labeled neurons in the hypoglossal nucleus. These neurons prevalently lay in the ipsilateral side, were small in size, and, like classic intrinsic hypoglossal local-circuit interneurons, had several thin dendrites. Reverse experiments - injections of anterograde tracers into the hypoglossal nucleus - labeled fine varicose nerve fiber terminals in the facial nucleus. These fiber terminals were concentrated in the intermediate subdivision of the facial nucleus, with a strong ipsilateral prevalence. Double injections of different tracers into the facial and the hypoglossal nuclei revealed a small, but constant, number of double-labeled neurons located predominantly ipsilateral in the caudal brainstem reticular formation. Hypoglossal internuclear interneurons projecting to the facial nucleus, as well as those neurons of the parvocellular reticular formation that project to both facial and hypoglossal nuclei, could be involved in oro-facial coordination.     

The Functional Independence Measure used in a Dutch rehabilitating stroke population; a pilot study to assess progress

In contrast to the United States, the Functional Independence Measure (FIM) is seldom used in Dutch rehabilitation settings. The purpose of this study was to determine if the FIM could be used in a Dutch stroke population to assess progress during rehabilitation. Patients with a recent stroke who received inpatient treatment were included in this longitudinal pilot study, which used the standard error of measurement (SEM) to quantify progress. Mean (SD) age of the subjects (n=48) was 61.3 (10.5) and 25 (56%%) were male. Mean (SD) length of stay (LOS) was 141.3 (75.0) days. For 42 subjects, admission and discharge scores of the FIM were registered. The mean admission (93.0, SD=23.3), as well as the discharge (112.4, SD=11.0) scores were rather high. The mean FIM difference (SD) between admission and discharge was 19.3 (16.9). However, only 55% exceeded a difference score of 13 points, indicating progress. Results of this pilot study confirm the ceiling effect of the FIM in this population. Based on the findings of our pilot study we conclude that the FIM is not suitable to assess progress in a Dutch rehabilitating stroke population.     

Abhängigkeit des uni- und bilateralen Riechvermögens von der nasalen Strömung bei Patienten mit chronischer Rhinosinusitis

OBJECTIVE: Olfactory dysfunction is a common finding in patients with chronic rhinosinusitis (CRS). The aim of this study was to investigate the relationship between olfaction and nasal flow as determined by active anterior rhinomanometry (AAR). METHODS: Thirty patients with CRS were included in this series. Patients' histories and subjective assessments of olfaction were documented with questionnaires. Smell tests, assessments of olfaction, AAR, and results of rhinoscopy were recorded, including odor identification, discrimination and thresholds measured with the "Sniffin' Sticks"-test. RESULTS: CRS influenced olfactory performances variably in the different tests: 10% of the patients had pathologic rates of odor discrimination, compared with 34% in odor identification and 73% in thresholds. Statistical analyses (using Spearman's test) indicated a significant correlation between nasal airflow and odor identification screening (r29 = 0.56, P < 0.01) and n-butanol-threshold (r29 = 0.44, P < 0.05), respectively. CONCLUSION: Olfactory performance in CRS was correlated to several parameters of nasal airflow measured with AAR. The n-butanol threshold test revealed the most frequent pathological results and may best be used for detecting olfactory disorders. However, because a number of factors may influence olfactory dysfunction in CRS, our findings must be evaluated in a lager series.     

Das antiphlogistisch-rheologische Infusionsschema nach Stennert in der Behandlung von kochleovestibulären Störungen

The pathogenetic mechanisms of acute cochleo-vestibular lesions are still unknown, but viral infections and vascular phenomena with impairment of microvascular perfusion are thought to play a major role. Between 1 July, 1986 and 28 February 1998, 1501 patients were treated with an infusion protocol using cortisone, dextrane 40 and pentoxifylline. Group 1 contained 1001 patients with sudden hearing loss, group 2a 107 patients with isolated tinnitus and group 2b 393 patients with labyrinthine disorders (among which were 81 patients with cochleovestibular dysfunction). The records were evaluated retrospectively. In group 1 complete hearing recovery occurred in 44.8%, partially in 40.4%, no change in 12.1% and worsened in 2.6%. In group 2a with isolated tinnitus 17.9% had a complete recovery, 43.9% partial recovery, 35.5% no change and 2.8% worsened symptoms. In group 2b vertigo disappeared in 56.8%, had partial recovery in 21.0% and did not change in 7.4%. In the 1501 patients treated, no significant side-effects were found to the medical interventions used. From these results we conclude that the infusion protocol is safe and effective in the treatment of cochleo-vestibular disorders.     

Epidemiology of hereditary hearing disorders in childhood: a retrospective study in Germany with special regard to ethnic factors

Recent studies have revealed marked differences in the prevalence of hearing impairment in childhood. It remains unknown whether this is caused by geographic, sociocultural or ethnic factors. In order to provide consistent data, 314 children in residence at a school for hearing impaired children of a well-defined German area were investigated retrospectively. We estimated an overall prevalence of .43/1000 of hearing impairment for this area. A striking variability between different nationalities could be observed. For German children, the prevalence was .36/1000, for Turkish 1.04/1000 and for Italian children 1.37/1000. Hereditary hearing losses and, in particular, autosomal recessive caused hearing disorders were the most common cause of hearing impairment in foreign but not in native children. One reason might be the frequency of marriages between relatives resulting from the social isolation of the foreign groups in German society.     

Exogenous antigen containing perivascular phagocytes induce a non-encephalitogenic extravasation of primed lymphocytes.

Recent evidence suggests that T-lymphocyte extravasation and CNS-parenchymal infiltration during autoimmune disease might be regulated by antigen-presenting (ED2(+)) cerebral/spinal perivascular phagocytes (CPP/SPP). Since the massive erythrocytic and leukocytic infiltrates in the CNS of rats with experimental allergic encephalomyelitis do not allow a precise differentiation between CPP/SPP and the invading cells in the Virchow-Robin space, we developed a new immune-response model whereby the extravasation of T-lymphocytes was not followed by other blood cells. Adult Lewis rats were sensitized to horseradish peroxidase (HRP). Subsequent intracerebroventricular (i.c.v.) injections of HRP and/or Fluoro-Emerald (FE) served to: (1) challenge the primed T-lymphocytes and (2) label the CPP/SPP for additional immunocytochemical analysis. We found that 24 h and 3 days after single, double, or triple antigen boosting T-lymphocytes (R73(+), W3/25(+), OX50(+)) entered the Virchow-Robin space but did not break through the astrocytic glia limitans. Instead they adhered to HRP-containing activated CPP/SPP (mabs OX-6(+), SILK6(+), CD40(+), CD80(+), CD86(+)). This selective contact was mediated neither by cell adhesion molecules (P-selectin, ICAM-1, VCAM-1), nor promoted by chemokine receptors (CCR1, CCR5) or chemokines (monocyte chemoattractant protein (MCP)-1, MIP-1alpha, MIP-1beta, RANTES). This non-inflammatory, but antigen-dependent lymphocyte extravasation provides optimal conditions to further study the CNS immune response.     

Qualit?tssicherung in der HNO – Tumorchirurgie

Hintergrund und Fragestellung. Qualit?tsmanagement ist für eine optimale Behandlung maligner Tumoren von besonderer Bedeutung. Im Gegensatz zu anderen Fachgebieten sind in der HNO-Heilkunde Qualit?tssicherungsstandards bisher nicht erarbeitet worden. Der aktuelle Stand der Qualit?tssicherung in der Kopf-Hals-Onkologie an den deutschen Hauptabteilungen des Fachgebiets wurde erfasst.     

Underlying mechanisms of improving physical activity behavior after rehabilitation

Background: Regular physical activity is beneficial for the health and functioning of people with a disability. Effective components of successful physical activity promotion interventions should be identified and disseminated. Purpose: To study the underlying mechanisms of the combined sport stimulation program “Rehabilitation & Sports” (R&S) and daily physical activity promotion program “Active after Rehabilitation” (AaR). Method: Subjects in four rehabilitation centers received R&S + AaR (n = 284). Subjects in six control centers (n = 603) received usual care. Physical activity and its determinants were assessed with questionnaires at seven weeks before and nine weeks and one year after rehabilitation. Results: Variables that were determinants of the intervention-induced improvement in physical activity behavior at both follow-up measurements were attitude, the perceived benefits “improved health and reduced risk of disease,” “better feeling about oneself,” and “ improved fitness,” and the barrier “limited environmental possibilities.” The percentage change in the intervention coefficient caused by these determinants ranged from –35.3% to –16.3% and from –28.4% to –11.3% at nine weeks and one year after rehabilitation, respectively. Conclusion: Personalized tailored counseling interventions can improve physical activity behavior in people with a disability by targeting both personal and environmental determinants of physical activity behavior.