THE RELATION OF THE SPINAL CORD TO THE SPONTANEOUS LIBERATION OF EPINEPHRIN FROM THE ADRENALS

1. After section of the spinal cord in cats in the cervical region, as low as the last cervical segment, epinephrin continues to be liberated from the adrenal glands. This liberation has all the characters of the normal secretion with intact central nervous system. It is sustained through the same nerve paths connecting the cord with the adrenals. 2. After section of the cord in the middorsal region the spontaneous liberation of epinephrin from the adrenals is abolished within the limits of detectability by the methods employed (denervated eye reactions of Meltzer, and rabbit intestine and uterus segments). 3. The portion of the cord concerned in the liberation of epinephrin does not appear to extend much below the third thoracic segment. 4. In acute experiments on cats under urethane anesthesia no change in the rate of liberation of epinephrin, which could be detected by the tests employed, was observed when the cord was severed in the cervical region.     

EFFECT OF STIMULATION OF SENSORY NERVES UPON THE RATE OF LIBERATION OF EPINEPHRIN FROM THE ADRENALS

An attempt was made to determine whether stimulation of afferent nerves (sciatic and brachial) produced a detectable increase in the rate of liberation of epinephrin from the adrenals, as determined by testing adrenal vein blood on rabbit intestine and uterus segments. The result was negative.     

THE QUESTION OF EPINEPHRIN IN THE CIRCULATION AND ITS RELATION TO BLOOD PRESSURE

1. The modified Meyer method here proposed, of parallel tests upon segments of surviving carotid and coronary arteries from the ox, is a satisfactory means for detecting epinephrin in complex body fluids like blood. 2. At the present time there is no evidence that epinephrin, in amounts sufficient to produce its physiological effects upon any hitherto used test objects, exists in the circulating blood, with the exception of blood from the suprarenal vein. 3. The examination of uncoagulated blood from six persons with high blood pressure has failed to show the presence of epinephrin or other constricting substances. 4. The constrictor substance in defibrinated blood and serum is not an epinephrin-like substance. In its point of action and its effects it is similar to barium chlorid. It is a direct stimulant to smooth muscle and seems to have no relation to the sympathetic innervation of muscle.     

THE INFLUENCE OF CERTAIN FACTORS,ESPECIALLY EMOTIONAL DISTURBANCES,ON THE EPINEPHRIN CONTENT OF THE ADRENALS

1. No evidence has been obtained that in cats and dogs with the nerves of one adrenal cut, emotional disturbances cause depletion of the epinephrin store of the normally innervated adrenal as compared with its fellow. 2. The depletion of the epinephrin store in cats under morphine is not dependent upon so called morphine fright, since a similar depletion is found in dogs in which, as is known, morphine produces symptoms the reverse of those of fright. 3. The signs of morphine fright can all be elicited by administering morphine to a cat in which one adrenal has been removed and the nerve supply of the other cut, and in which accordingly no detectable liberation of epinephrin takes place. 4. The reactions of the denervated iris elicited by emotional disturbance, asphyxia, or etherization in a cat, one of whose adrenals has been removed and the nerves of the other cut, do not differ from these reactions in cats whose adrenals have not been interfered with. 5. The influence of postoperative edema of the adrenal in diminishing the epinephrin load, and the recuperation of the load after a time, have been studied in rabbits. 6. The diminution in the epinephrin store of the adrenals which follows operations on animals (postoperative depletion) has been studied. It is only in part associated with the anesthesia, since it may be as marked 6 or 8 hours after an operation lasting less than 1 hour as after 6 or 8 hours'' anesthesia without operation. 7. One adrenal was removed in rabbits and the epinephrin content of the remaining gland assayed at varying periods of time after removal of the first, the periods being longer than the time necessary for recovery from the postoperative depletion. In general, the second adrenal contained more epinephrin than the first, sometimes double the amount. 8. Marked depletion of the epinephrin store of innervated adrenals as compared with the corresponding denervated glands was seen in animals dead of infections of various kinds. 9. As shown by Elliott, diminution of the stock of epinephrin in the adrenal through electrical stimulation of the splanchnics is not easy to demonstrate, despite the fact that the liberation of epinephrin into the blood is notably increased by the stimulation. With short periods of stimulation, however, repeated over a long time at intervals just long enough to prevent fatigue, it has proved possible to demonstrate a distinct depletion.     

THE RELATION OF COAT COLOR TO THE SPONTANEOUS INCIDENCE OF MAMMARY TUMORS IN MICE

1. The material included in this paper consists of F₁ and F₂ virgin female mice derived from a cross between a strain high in mammary cancer incidence (dilute brown) and one relatively low in incidence of mammary cancer but relatively high in the incidence of various internal tumors (yellow). 2. In the F₁ and F₂ hybrid generations the yellow animals have a significantly lower incidence of mammary tumors than do the non-yellows. This is the first clear case of a difference in the incidence of spontaneous tumors in mice associated with a color difference. 3. Mammary tumors occur, however, significantly earlier in the yellow mice and are just as malignant as those appearing in the non-yellows. 4. The incidence of tumors other than mammary is not significantly different in the yellow and non-yellow hybrids. Such tumors, however, occur distinctly later in life than do the mammary tumors. This provides additional evidence that, in mice, mammary tumors cannot be considered to be the same biological phenomenon as are other types of tumor. 5. A study of the physiology of reproduction of yellow and non-yellow mice within the yellow stock suggests that the yellows pass through their reproductive cycle earlier than do the non-yellows. The duration of the cycle in the two forms is essentially equal. This fact would satisfactorily explain the earlier incidence of mammary tumors in yellow mice. 6. The lower incidence of mammary tumors in yellows as compared with non-yellows may be at least in part due to the same phenomenon. This would follow because the opportunity for mammary tissue in yellow mice of cancer age to be continuously affected by ovarian secretion would be less than in non-yellows. This would result in a higher percentage of yellows reaching an age at which stimuli from the ovary ceased before the mammary tissue had reached an age at which tumor formation is most frequent. 7. There is some evidence that, in this cross, dilute (d^bd^b) mice are less apt to form mammary tumors than are intensely pigmented animals. This point, however, needs further investigation before it can be considered to be established. 8. The facts recorded in this paper demonstrate that not all forms of tumor or all colors of mice can be lumped together in studying either the physiology or genetics of spontaneous tumor incidence.     

THE PASSAGE OF MENINGOCOCCIC AGGLUTININS FROM THE BLOOD TO THE SPINAL FLUID OF THE MONKEY

Agglutinins for the meningococcus were not found in the spinal fluid of normal monkeys which had received antimeningococcic serum intravenously. The intraspinal injection of isotonic salt solution, normal horse serum, or a culture of living meningococci allows agglutinins for the meningococcus to pass from the blood to the spinal fluid of the passively immunized monkey; and the rate of the passage is affected by the severity of the inflammation induced in the meninges. The rates of elimination from the blood and spinal canal of meningococcic antibodies, as shown by the agglutination reaction, were compared in monkeys treated with immune serum (a) intraspinally, (b) intravenously, and (c) intraspinally and intravenously in combination. (a) When immune serum is given intraspinally the agglutinins are very much diminished after 8 hours and practically disappear at 12 hours. They appear in the blood at the 4th hour after injection and quickly diminish. (b) After intravenous injection of immune serum, when the meninges are inflamed, agglutinins appear in the spinal fluid in small amounts in about 12 hours and increase to the 25th hour. More than one-half of the agglutinins disappear from the blood within 8 hours and remain in low concentration at 25 hours. (c) After combined intraspinal and intravenous injection the agglutinins remain in higher concentration in the spinal fluid and for a longer time than by method (a) or (b). The curve descends after 12 hours, and agglutinins are present at 25 hours. They remain in maximum concentration in the blood for 25 hours.     

MRI对脊髓型多发性硬化的诊断价值

目的探讨MRI在脊髓型多发性硬化（MS）诊断与鉴别诊断中的价值。方法对12例脊髓型MS的临床及MRI影像资料进行回顾性分析。结果12例病人的病灶部位以颈、胸髓多见,病变脊髓TWI为低或等信号,TWI为高信号。增强后无强化或仅有轻度斑片状、环状强化。MRI复查,1例病人发现有新的MS斑块出现。急性期需与髓内肿瘤及急性脊髓炎进行鉴别。结论MRI对脊髓型MS的诊断及鉴别诊断有较高的价值。     

ALTERATIONS IN THE CALCIUM LEVEL OF THE BLOOD FOLLOWING SECTION OF THE SPINAL CORD

A marked rise and disturbance in equilibrium of the calcium in the blood was brought about by section of the spinal cord in the upper dorsal segment. This reaction, however, was not constant.     

THE RELATION OF BACILLUS ABORTUS FROM BOVINE SOURCES TO MALTA FEVER

1. Comparative tests on guinea pigs with B. abortus yield the best results when minute doses are injected subcutaneously and the animal kept at least 4 weeks. 2. B. abortus gradually loses its virulence for guinea pigs under artificial cultivation. 3. Two cultures resembling B. abortus from cattle, isolated from human cases of so called Malta fever, are shown to be in their effect on guinea pigs not identical with the bovine strains. 4. The results of studies of B. abortus from swine indicate a close relation between the porcine strains and the two human strains.     

OBSERVATIONS WITH REGARD TO THE ACTION OF EPINEPHRIN ON THE CORONARY ARTERY

1. Excised rings of the coronary artery of the ox properly weighted react to epinephrin by dilatation. 2. This reaction of the ox coronary is not an active dilatation, but is in the nature of a sudden lowering from a high to a relatively low degree of tonus. The tonus is not, however, entirely abolished by epinephrin. 3. The degree of relaxation produced by epinephrin is not constant. It depends on several factors other than the concentration of epinephrin used. 4. It is possible to increase the sensitiveness of the coronary artery to epinephrin. 5. There is no evidence of any primary constrictor effect on the ox coronary from epinephrin in most dilute solutions, nor can the existence in this artery of any constrictor mechanism of sympathetic origin be determined by the excised ring method.     

牛痘疫苗接种家兔炎症皮肤提取物治疗脊髓损伤后神经病理性疼痛的定量感觉检查研究

目的:分析脊髓损伤(spinal cord injury,SCI)后神经病理性疼痛患者损伤平面的皮肤感觉阈值变化与差异,推测牛痘疫苗接种家兔炎症皮肤提取物(神经妥乐平)治疗SCI后神经病理性疼痛的作用机制。方法:39例SCI患者根据神经病理性疼痛的视觉模拟量表评分及使用神经妥乐平的不同情况分为轻、中、重3组,应用定量感觉检查(Quantitative sensory testing,QST)的方法,测试损伤平面皮肤的单丝触觉、冷觉阈值、热觉阈值以及冷痛觉阈值、热痛觉阈值,并与20例正常健康者进行比较。结果:与正常健康者相比,SCI患者损伤平面的单丝触觉阈、热觉阈均明显提高,冷觉阈明显降低。与无明显疼痛者比较,中、重度神经病理性疼痛者的单丝触觉阈、冷痛阈和热痛阈值间的差异存在统计学意义;神经妥乐平治疗有效者与无效者比较,冷痛阈、热痛阈间差异均存在统计学意义。结论:神经妥乐平治疗SCI后的神经病理性疼痛具有其特定的解剖生理学基础。通过QST筛查,有利于对SCI后的神经病理性疼痛进行早期干预。     

THE LOCALIZED ACTION ON THE SPINAL CORD OF INTRAMUSCULARLY INJECTED TETANUS TOXIN

Local tetanus limited to one leg was studied in cats after intramuscular injection of tetanus toxin. 1. The electric and mechanical response of the affected muscle after a single stimulus to the intact sensory-motor nerve is greater in amplitude and duration than the response of the corresponding muscle of the unaffected leg (Fig. 1). 2. This augmented response of the muscle is associated with an augmented response arising from the ipsilateral portion of the spinal cord, while the contralateral part of the cord is unaffected, as demonstrated by electrographic records from the motor nerves (Figs. 2 to 5). 3. The augmented muscular response is abolished when the reflex arc is broken, but the augmented response in the spinal cord is independent of changes in the muscle, the neuromuscular junction, the afferent and efferent peripheral nerves, and the dorsal root ganglia. 4. The augmented spinal response develops in the absence of the peripheral signs of local tetanus. Hence the pathogenesis of the altered state in the spinal cord is independent of the peripheral effects of the toxin. 5. In local tetanus, therefore, the toxin injected intramuscularly acts selectively upon the segments of the spinal cord which supply the innervation of the injected area. 6. The augmented spinal response may be prevented by section of the nerve trunks supplying the area of injection prior to the injection of the toxin. 7. It is concluded that in local tetanus the toxin is carried to the spinal cord by way of peripheral nerves.     

SOUND PSYCHOMETRIC PROPERTIES OF THE SWEDISH VERSION OF THE SPINAL CORD INDEPENDENCE MEASURE SELF-REPORT

ObjectiveTo describe data completeness, targeting and reliability of the Swedish version of the Spinal Cord Independence Measure Self-Report (s-SCIM-SR).DesignTranslation and reliability study.SubjectsProgramme participants (n = 48) and peer mentors (n = 42) with spinal cord injury enrolled in the INTERnational Project for the Evaluation of “activE Rehabilitation” (inter-PEER).MethodsThe translation process was based on guidelines/recommendations, and involved expert competence, including consumers. The s-SCIM-SR was distributed online, once for programme participants and twice for peer mentors.ResultsSixty-nine individuals (77%) obtained a total score. Most missing data were found in the items Respiration and Using the toilet. Cronbach’s alpha for the full scale was 0.89, for Self-care 0.92, for Respiration and sphincter management 0.37 and for Mobility 0.86. The intraclass correlation coefficient was excellent for all subscales and the full scale. Measures of variability showed high sensitivity to changes and Bland Altman analyses revealed no systematic changes between evaluation points.ConclusionThese results support the data completeness, targeting and reliability of the Swedish version of the SCIM-SR. However, some problems were found in the subscale Respiration and sphincter management. The s-SCIM-SR can be considered psychometrically sound and suitable to assess physical independence among persons with spinal cord injury in Swedish community settings.LAY ABSTRACTAfter spinal cord injury, an important goal in rehabilitation is to attain a high level of physical independence. In Sweden, no spinal cord injury-specific assessment tool to evaluate physical independence has previously been nationally available. This study presents the translation process and evaluation of the measurement properties of the Swedish version of the Spinal Cord Independence Measure Self-Report (s-SCIM-SR) in a community rehabilitation setting. The translation process involved expert competence, including consumers, and resulted in minor cultural adaptations. The s-SCIM-SR was distributed online to 90 persons with chronic spinal cord injury. Overall, the s-SCIM-SR performed equally as well as the original version in terms of missing data, general agreement between items, and agreement between 2 evaluation points. However, some problems were found in the subscale Respiration and sphincter management. In conclusion, the s-SCIM-SR can be considered psychometrically sound and suitable to assess physical independence among persons with spinal cord injury in Swedish community settings.Key words: outcome measures, psychometrics, rehabilitation, spinal cord injury

Sustaining a spinal cord injury (SCI) can be a life-altering event, and often results in a variety of impairments, activity limitations and participation restrictions. A major goal in rehabilitation after SCI is to attain a high level of physical independence. In order to assess the effectiveness of interventions and to monitor spontaneous improvements, valid and reliable measures are needed (1) to evaluate functioning and disability over time after SCI, in both inpatient and community rehabilitation settings.The Spinal Cord Independence Measure (SCIM) (2) is a SCI-specific measurement of independence in daily activities, taking into account the time needed to perform the activities, the difficulty and the subjective value of tasks performed (3). The current third version comprises 19 items covering 3 domains of activities of daily living: self-care, respiration and sphincter management, and mobility (4); and has shown satisfying psychometric properties (4–6). The SCIM has been suggested to be the primary outcome measure of functional recovery after SCI (7). It was originally developed by Catz and co-workers as a clinician-administered assessment based on observation (2), and is therefore time-consuming and resource intensive. For research purposes, the tool is often used as an interview, resulting in slightly decreased precision due to variability between raters (8) and a general risk of the respondent to over- or under-rate their performance.To overcome these barriers and facilitate data collection in community settings, a self-report version was developed by Fekete et al. (9), the SCIM Self-Report (SCIM-SR). Fekete et al. adapted the wording in SCIM III by using personal pronouns and avoiding or explaining technical terms. Several complex items were divided into simpler components and a scoring algorithm was developed to obtain consistency with SCIM III. Another separate and less widely-received attempt to develop a version of SCIM III for self-report use was performed by Michailidou et al. (10). This version included only simple grammatical adjustments without making adaptations that would facilitate self-reporting (11). In Europe, the German (9), Spanish (12), and Italian (13) translations of the SCIM-SR have shown satisfying criterion validity compared with the clinician-administered versions. Neither SCIM-SR nor SCIM III have previously been nationally available in Swedish. Moreover, European versions of the SCIM-SR have neither been evaluated for test-rest reliability nor tested in a community rehabilitation setting.We recently initiated the INTERnational Project for the Evaluation of “activE Rehabilitation” (Inter-PEER) (14), a collaboration between an international team of researchers and the non-profit organizations using the Active Rehabilitation (AR) concept. AR is a community rehabilitation concept, based on the use of peer mentors as trainers and educators. Inter-PEER is a prospective cohort study with the primary aim to assess the effects of AR training programmes on community-dwelling individuals with SCI with regard to physical independence, wheelchair skills, participation, life satisfaction, level of physical activity, resilience, and self-efficacy (14). As part of Inter-PEER, we translated and culturally adapted the SCIM-SR into Swedish (s-SCIM-SR). The aim of the present study is to describe the psychometric properties regarding data completeness, targeting and reliability of the s-SCIM-SR in a community setting.     

脊髓电刺激对神经病理性疼痛镇痛作用及相关机制研究

目的:探索脊髓电刺激(spinal cord stimulation, SCS)对小鼠神经病理性疼痛的镇痛作用并阐明相关机制。方法:30只健康成年雄性野生型CD1小鼠随机分为对照组(Sham)、坐骨神经结扎损伤组(chronic constriction injury, CCI)和治疗组(CCI+SCS),每组10只。通过行为学观察SCS对外周神经损伤引起的机械痛敏和热痛敏的缓解情况,以及对小鼠运动功能影响程度;采用电生理方法记录各组小鼠背根神经节(dorsal root ganglion, DRG)中小神经元的兴奋性;通过酶联免疫吸附试验测定DRG内炎性因子TNF-α的表达水平。结果:与对照组比较,CCI组小鼠机械痛阈值和热痛阈值明显降低(P <0.05)。治疗组与CCI造模组比较,SCS可提高小鼠的机械痛和热痛阈值。同时,各组转棒实验评分无差异。电生理及酶联免疫吸附试验结果提示外周神经损伤后,同侧小鼠背根神经节(dorsal root ganglion, DRG)神经元的兴奋性增强,同时DRG内TNF-α的释放增加,治疗组与CCI组比较,SCS可以明显抑制DRG神经元的兴奋性增强(P <0.05)和DRG内TNF-α的释放增加(P <0.05)。结论:SCS通过抑制外周神经损伤导致的DRG神经元的兴奋性增强,从而有效地减缓小鼠CCI导致的机械感觉过敏和热痛敏,并可减少CCI小鼠DRG中TNF-α的表达水平。     

急性脊髓损伤的MRI诊断

目的探讨急性脊髓损伤的MRI表现及临床诊断价值。方法回顾分析60例急性脊髓损伤病人的MRI表现。结果按脊髓损伤程度分为脊髓震荡水肿、挫裂出血、受压扭曲及脊髓完全、不完全横断。脊髓震荡水肿的MRI表现为脊髓肿胀增粗,在T1WI加权像上呈稍低或等信号,在T2WI加权像上呈等或高信号;脊髓挫裂出血在T1WI加权像上呈等或高信号,在T2WI加权像上呈高信号;脊髓受压变形表现为脊髓曲度改变,有时呈＂S＂形扭曲;脊髓完全、不完全横断表现为正常脊髓连续信号完全中断或部分中断。结论MRI表现能反映脊髓损伤的形态和病理改变,可以指导治疗方案的选择,还有助于判断预后。     

脊髓半切洞损伤后人胚嗅鞘细胞移植的时机选择

目的　通过对脊髓损伤后不同时间进行嗅鞘细胞移植治疗产生的不同效果进行比较 ,从而选择细胞移植治疗脊髓损伤的最佳时机。方法　将 2 0只SD大鼠分成 3组 ,制成脊髓半切洞模型 ,第 1组予损伤后即刻移植细胞 ,其余 2组分别予伤后 2周和 4周移植等量的细胞 ,每组动物均饲养 1月后处死 ,观察比较治疗前后动物不同时间的神经功能评分 ,应用HRP TMB神经示踪计数伤侧中脑红核大细胞的数量 ,间接评价脊髓轴索再生的程度。结果　无论是神经功能评定还是中脑红核大细胞计数结果 ,伤后 2周和 4周组的动物均优于伤后即刻移植组 ,差异有显著性 ( P <0 0 5 ) ,伤后 4周组要优于 2周组 ,但 2组间差异无显著性。结论　脊髓损伤后延期进行细胞移植效果要优于伤后即刻移植