Neuronal activity in the lateral vestibular nucleus of the cat

The synaptic input to Deiters neurones evoked by stimulation of peripheral somatic nerves was measured by intracellular recordings. EPSPs with broad receptive fields and latencies which indicate polysynaptic connexions were commonly evoked from the FRA. In other cells, low threshold cutaneous afferents were effective at rather short latencies suggesting oligosynaptic connexions from fast ascending fibres. One example was found of EPSPs due to low threshold muscle afferents. IPSPs due to climging fibre activation of Purkinje cells as observed in most of the neurones were evoked by cutaneous volleys above 1.5-2.0T and muscle volleys above 5T (above 3-3.5T in case of Q). Often, IPSPs were evoked by stimulation of nerves, to the segmental level of which the the vestibulospinal neurone under investigation projected. A small proportion of cells received short latency IPSPs involving direct fast mossy fibre tracts, which were evoked from low threshold cutaneous afferents. IPSPs due to polysynaptic mossy fibre activation of Purkinje cells were evoked from the FRA bilaterally and from ipsilateral cutaneous afferents at 1.5-2.0T ("prolonged inhibition"). Prolonged excitatory/inhibitory events mediated by mossy fibre pathways may be involved in quadruped locomotion or other processes making use of a broad motor integration.     

Transcranial magnetic stimulation disrupts eye-hand interactions in the posterior parietal cortex

Recent neurophysiological studies have started to shed some light on the cortical areas that contribute to eye-hand coordination. In the present study we investigated the role of the posterior parietal cortex (PPC) in this process in normal, healthy subjects. This was accomplished by delivering single pulses of transcranial magnetic stimulation (TMS) over the PPC to transiently disrupt the putative contribution of this area to the processing of information related to eye-hand coordination. Subjects made open-loop pointing movements accompanied by saccades of the same required amplitude or by saccades that were substantially larger. Without TMS the hand movement amplitude was influenced by the amplitude of the corresponding saccade; hand movements accompanied by larger saccades were larger than those accompanied by smaller saccades. When TMS was applied over the left PPC just prior to the onset of the saccade, a marked reduction in the saccadic influence on manual motor output was observed. TMS delivered at earlier or later periods during the response had no effect. Taken together, these data suggest that the PPC integrates signals related to saccade amplitude with limb movement information just prior to the onset of the saccade.     

ALK expression in extranodal anaplastic large cell lymphoma favours systemic disease with (primary) nodal involvement and a good prognosis and occurs before dissemination

AIMS: In anaplastic large cell lymphoma (ALCL), the site of origin has been described as an important prognostic factor. Recently, a fusion protein containing anaplastic lymphoma kinase (ALK) was described in systemic nodal ALCL, and shown to be associated with a good prognosis. The aims of this study were to investigate whether the presence of ALK protein differs between ALCL of different sites of origin; to determine whether ALK expression occurs before dissemination to other sites; and, finally, to investigate whether the site of origin remains a prognostic parameter in ALK negative ALCL. METHODS: ALK expression, as detected by immunohistochemistry using the monoclonal antibodies ALK1 and ALKc, was studied in 85 ALCLs from different sites of origin. In 22 patients, ALK expression was studied in multiple biopsies from different sites (including 13 skin, 16 lymph node, and nine other). Overall survival time was analysed using the Kaplan Meier method. RESULTS: ALK expression was found in 20 of 51 systemic ALCLs with (primary) nodal involvement. No ALK expression was found in 15 primary cutaneous, 14 gastrointestinal, and five nasal ALCLs. Multiple and subsequent biopsies of patients showed ALK expression to be identical to that seen in the primary diagnostic biopsy. Kaplan Meier survival curves showed that in ALK negative ALCLs originating from different sites, primary cutaneous cases are associated with an excellent overall survival, whereas the other cases show a comparable five years survival of less than 40%. CONCLUSIONS: If present, ALK expression favours systemic ALCL with (primary) nodal involvement, and can be used in differentiating between extranodal involvement of systemic (nodal) ALCL and primary extranodal ALCL. ALK is expressed consistently in multiple biopsies of a given patient, indicating that the chromosomal abnormality leading to aberrant ALK expression occurs before dissemination to other sites. Finally, in ALK negative non-cutaneous ALCLs, different sites of origin show comparable poor survival.     

Acute cytomegalovirus infection and the host immune response. II. Relationship of suppressed in vitro lymphocyte reactivity to bacterial recall antigens and mitogens with the development of cytomegalovirus-induced lymphocyte reactivity

Cellular immunity in cytomegalovirus (CMV) infection was studied in eighteen patients with CMV infection in the acute stage and thereafter. Peripheral blood lymphocyte reactivity (LR) to mitogens, bacterial recall antigens and CMV was tested sequentially in fourteen out of eighteen patients and once in four patients and sex and age-matched healthy controls. LR to a cocktail of bacterial recall antigens was impaired (P<0·01) during the acute phase of the CMV infection (<50 days after onset of illness symptoms). Despite a gradual improvement during the first (convalescent and post-convalescent, 50–250 days) and second (follow-up) period (>250 days) it still remained markedly impaired as opposed to LR of the controls (P<0·01 and P<0·02 respectively). In ten out of eighteen patients twelve superinfections were suspected clinically and two viral and eight bacterial infections documented during the observation period of 1 year after onset of CMV infection. In vitro LR to Con A and PWM appeared grossly disturbed as opposed to PHA-LR which was decreased only slightly in the acute phase. Although a gradual improvement of mitogenic LR was seen after the acute phase, PWM-LR remained decreased during the follow-up period as opposed to that of the controls (P<0·05). CMV-specific LR to heat-inactivated AD 169 strain virion antigens was generally negative or lowgrade initially but a positive CMV-LR test was obtained in all patients studied sequentially during or after the acute phase. To a certain extent, the appearance of positive CMV-LR was associated with improvement of LR to bacterial recall antigens and mitogens. In individual cases CMV-LR development apparently preceded the restoration of the generalized immunosuppression as reflected by LR tests with mitogens and bacterial recall antigens. It is concluded that CMV infection of adults causes a (relatively) longlasting cellular immunosuppression. Possible pathogenetic mechanisms are discussed. A relationship with increased sensitivity to infections of an opportune nature after CMV infection is suggested.     

A comparison of labetalol and prazosin combined with atenolol in non-responders to atenolol plus hydrochlorothiazide in uncomplicated hypertension

Summary After screening two local populations in the northern part of The Netherlands for hypertension, patients with a diastolic pressure (DP) between 95 and 120 mmHg were treated daily either with 50 mg hydrochlorothiazide or 100 mg atenolol. Non-responders were given the combination and if necessary the dose of atenolol was increased to 200 mg. Non-responders to the latter combination were randomized and treated either with 50 mg hydrochlorothiazide and labetalol or with 50 mg hydrochlorothiazide, 200 mg atenolol and prazosin. If after 1 month a DP90 mmHg had been reached the patient was reassessed after a further 3 months. If a DP>90 mmHg was found the dose of labetalol or prazosin was increased and the patient was re-examined after 1 month.This protocol was followed until the maximum dose was reached or adverse reactions prevented a further increase in dosage.During 6 months of treatment there was a further drop in systolic and diastolic blood pressures under both regimens of, respectively, 8.6 and 2.4 mmHg for labetalol, and 7.7 and 5.0 mmHg for the prazosin group. At the end of the period the average daily doses of labetalol and prazosin were 1256 mg and 4.3 mg, respectively. There was no significant difference in the average number of complaints between the labetalol and the prazosin group.     

Randomized controlled trial comparing magnetic marker localization (MaMaLoc) with wire-guided localization in the treatment of early-stage breast cancer

Wire-guided localization (WGL) is the standard of care in the surgical treatment of nonpalpable breast tumors. In this study, we compare the use of a new magnetic marker localization (MaMaLoc) technique to WGL in the treatment of early-stage breast cancer patients. Open-label, single-center, randomized controlled trial comparing MaMaLoc (intervention) to WGL (control) in women with early-stage breast cancer. Primary outcome was surgical usability measured using the System Usability Scale (SUS, 0–100 score). Secondary outcomes were patient reported, clinical, and pathological outcomes such as retrieval rate, operative time, resected specimen weight, margin status, and reoperation rate. Thirty-two patients were analyzed in the MaMaLoc group and 35 in the WGL group. Patient and tumor characteristics were comparable between groups. No in situ complications occurred. Retrieval rate was 100% in both groups. Surgical usability was higher for MaMaLoc: 70.2 ± 8.9 vs. 58.1 ± 9.1, p < 0.001. Patients reported higher overall satisfaction with MaMaLoc (median score 5/5) versus WGL (score 4/5), p < 0.001. The use of magnetic marker localization (MaMaLoc) for early-stage breast cancer is effective and has higher surgical usability than standard WGL.     

Vertebral level of the ending of the spinal cord and its relationship to the length of the vertebral column in Northern Turkish neonates

Summary Racial and sex differences in the level of ending of the spinal cord of the adult have been reported. It is lower in Africans and in females. Since such differences may affect even fetuses and newborns we aimed to study in Northern Turkish neonates. The study was made on 40 full-term newborn still-births (23 male, 17 female). In all cases, the length of the vertebral column, the length of the spinal cord and the body weight were measured and the vertebral level of ending of the spinal cord was noted. It was found that the termination of the spinal cord varied from the first lumbar to the second sacral vertebra, with a mean level between L2 and L3. In female neonates, it was observed that the spinal cord ended at a slightly lower level (0.2 vertebra) than in males. Our findings approximately agreed with those of Barson [2] who studied neonates in England and of Jit and Charnalia [5] in North India. However, we found that the spinal cord ended one and half vertebrae lower in Northern Turkish neonates than in South African and South Indian subjects. The correlations between body-weight and length of the spinal cord, weight and length of the vertebral column, length of the spinal cord and length of vertebral column, length of the vertebral column and level of ending of the cord were statistically highly significant for males, females and both sexes together (p<0.001). The longer the vertebral column, the higher the termination of the spinal cord.

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Niveau vertébral de la terminaison de la moelle épinière et sa relation avec la longueur de la colonne vertébrale chez le nouveau-né en Turquie du Nord

Résumé Selon la race et le sexe, les différences de niveau de la terminaison de la moelle épinière ont été rapportées chez l'adulte. Elle est plus basse chez les Africains et chez les femmes. Dès lors il se peut qu'il existe déjà des différences raciales et selon le sexe, chez le foetus et le nouveau-né. Nous nous proposons d'étudier une population de nouveau-nés du Nord de la Turquie. Cette étude est faite à partir de 40 nouveau-nés à terme, décèdes (23 garçons et 17 filles). Chez tous ces nouveau-nés, la longueur de la colonne vertébrale, la longueur de la moelle épinière et le poids ont été mesurés. Le niveau vertébral de la terminaison de la moelle épinière variait entre la première vertèbre lombaire et la deuxième vertèbre sacrée. Le niveau moyen de cette terminaison était situé entre L2 et L3. Chez les filles nouveau-nés, il était observé que la moelle épinière se terminait légèrement plus bas (0,2 vertèbre) que chez les garçons nouveaunés. Nos observations rejoignent celles de Barson [2] qui étudia des nouveaunés d'Angleterre et celles de Jit et Charnalia [5] qui étudièrent des nouveau-nés du Nord de l'Inde. Cependant, nous avons trouvé que la moelle épinière se terminait une vertèbre et demie plus bas chez les nouveau-nés de la Turquie du Nord que chez les nouveau-nés d'Afrique du Sud et d'Inde du Sud. La corrélation entre le poids des spécimens et la longueur de la moelle épinière; le poids et la longueur de la colonne vertébrale, la longueur de la moelle épinière et la longueur de la colonne vertébrale, la longueur de la colonne vertébrale et le niveau vertébral de la terminaison de la moelle épinière parmi les garçons, les filles, et dans les deux sexes, étaient statistiquement très significatifs (p<0.001). Plus la colonne vertébrale était longue, plus haute était située la terminaison de la moelle épinière.

     

Academic education of dentists

The aims of an academic education are phrased on the basis of a report of the Rectors of Dutch Universities, published in 1993. These aims are explicited in more detail for academic dental education. In this respect notable educational forms used in the dental schools in the Netherlands and Flanders (Belgium) are mentioned. A minimum-curriculum for academic education in dentistry is formulated, including theoretical courses, application courses and methods of reinforcement in all parts of the entire dental curriculum.     

Phase II studies of Elsamitrucin in breast cancer, colorectal cancer, non-small cell lung cancer and ovarian cancer

PURPOSE:: To test the antitumor activity of Elsamitrucin in metastaticcancer of the breast, colon and rectum, non-small cell lungand ovary. PATIENTS AND METHODS:: Eligibility required histologically proven cancer. Patientswith colorectal or non-small cell lung cancer could not havereceived prior chemotherapy. Patients were entered if WHO PSwas 2 and organ functions were normal. Treatment consisted ofElsamitrucin 25 mg/m²/week given as a 5–10 min infusionfor at least 3–6 weekly doses. RESULTS:: One hundred and five patients entered the studies, 97 were eligible,94 are evaluable for toxicity and 75 for response. Toxicitymainly consisted of mild nausea/vomiting, and less frequentlyreversible hepatotoxicity and malaise. No objective responseswere seen. CONCLUSION:: Elsamitrucin at this dose and schedule is not an active drugin metastatic breast cancer, colorectal cancer, non-small celllung cancer or ovarian cancer. Elsamitrucin, phase II, breast, colorectum, nonsmall cell lung, ovary