Does a torn anterior cruciate ligament lead to change in the central nervous drive of the knee extensors?

Summary Integrated surface electromyograms of the three superficial parts of the quadriceps and isokinetic knee extensor maximum torque and power production were recorded simultaneously and at different angular velocities in both legs in 11 male subjects with unilateral tear of the anterior cruciate ligament. The cross-sectional area (CSA) of the thigh and its muscular components were measured by computerized tomography. The principal findings were a small but significant decrease in quadriceps CSA on the affected side; a decreased active, but not passive, range of movement; decreased mechanical output, whether or not corrected for differences in CSA; and decreased electrornyographic activity — particularly in rectus femoris. These findings suggest that the reason for the decreased maximum and total knee extensor performance seen in these patients is a change in knee joint receptor afferent inflow.     

Gait speed is more challenging than cognitive load on the stride-to-stride variability in individuals with anterior cruciate ligament deficiency

Background

Several investigations have studied gait variability of individuals with anterior cruciate ligament (ACL) deficiency; however, the effect of dual-tasking on the gait variability of these individuals remained unclear. The aim of the present study was to determine the effect of gait speed and dual-tasking on knee flexion–extension variability in subjects with and without ACL deficiency.

Length-dependent activation and sensitivity in arterial ring segments

This study examines the effect of length on the dose-response (D-R) relationship and the effect of agonist concentration on the length-tension (L-T) relationship in vascular smooth muscle. The experiments used 2-mm rings from isolated segments of the dog anterior tibial artery. In D-R experiments the length (internal ring circumference) for maximum active force (L_max) was determined first. D-R relationships were obtained from cumulative responses to increasing concentrations of norepinephrine (NE) or potassium (K⁺). L-T relationships were obtained from individual responses to a specific concentration of agonist as the ring was stretched in increments of L₀ (the initial length for resting force). Dimensions of the arterial rings were measured with a video caliper. For NE and K⁺ stimulations at lengths equal to and less than L_max: (a) The concentration for half maximal response (ED₅₀) was lowest (most sensitive) at L_max and increased significantly as length decreased from L_max; (b) When the direction of length change was reversed, the direction of change in ED₅₀ was reversed; and (c) The ED₅₀ of repeated dose-response experiments at L_max was not significantly different. For NE: (a) the ED₅₀ decreased significantly when length was increased from L_max; and (b) the ED₅₀ increased significantly when length was decreased to L_max. The results of L-T experiments show L_max is significantly longer for a low concentration of NE (10⁻⁶ M) than for a high concentration (10⁻⁵ M). With force normalized to the maximum force, the L-T curve is significantly lower, and the initial length for an active response was 80% longer for 10⁻⁶ M than for 10⁻⁵ M NE. It may be concluded that vascular smooth muscle has a length-dependent dose-response relationship and a concentration-dependent length-tension relationship.     

Anterior tibial artery and its actual projection on the lateral aspect of the tibia: a cadaveric study

The anterior tibial artery (ATA) is at risk of injury during high tibial osteotomy, Ilizarov wire placement, pin placement in external fixation, or proximal locking screw insertion, as the artery is not visualized intraoperatively. The ATA is anchored to the oval foramen of the interosseous membrane on the proximal tibia by the deep fascia and recurrent genicular vascular branches. Segment 1 (from the bifurcation of the popliteal artery to the level of the interosseous foramen) and the proximal part of segment 2 (from the interosseous foramen to the level where the artery crosses the anterior border of the tibia) may be damaged when pin, wire or screw placement is directed posterolaterally at that level. Distally, a straight mediolateral pin or Ilizarov wires may lacerate the artery. Segment 2 of the ATA descends against the interosseous membrane in its proximal part, which is projected on the posterior third of the tibia relative to the sagittal plane; in its middle part, it runs close to the lateral cortex of the tibia, it is projected on the middle third of the tibia; in its distal part it runs gradually towards the anterior third of the tibia and contacts with the anterior third of the tibial cortical surface. This information may help reduce risk of injury to the ATA during high tibial osteotomy, external fixation and pin placement or insertion of locking screws.     

脊髓型颈椎病前路减压与内固定手术治疗

目的 评估脊髓型颈椎病前路战压与内固定手术的疗效。方法 对17例脊髓型颈椎病患者采用颈前入路环锯或开槽扩大，显微镜下对致压物施行潜行性减压，植骨后钢板内固定，随访6～48个月。结果 术后症状消失或明显缓解15例，好转2例，无死亡或症状加重。植骨块融合满意，钢板固定无松动，螺钉无松脱。结论 本术式治疗脊髓型颈椎病减压彻底，植骨块融合，内固定钢板稳定可靠。     

Chondral separation in the trochlear groove - a definite clinical entity

Four patients with unusual femoro-patellar chondral defects are presented. We were unable to find their particular lesion described adequately in the literature. The patients all gave a history of relatively minor non-contact injury and presented with anterior knee pain and persistent swelling. The main features on clinical examination were moderate effusion and marked patello-femoral crepitus. Plain X-rays of the knee were unhelpful. At arthroscopy large full thickness chondral defects were seen on the femoral side of the patello-femoral articulation at the site of patellar contact with the knee in about 60° of flexion. The synovium was found to be prolific and vascular. Multiple 1.6-mm drill holes were made in the defect and chondral debris was washed out. Two patients underwent associated lateral patellar release. When a clear cut mechanical patello-femoral disorder presents unexpectedly with associated effusion and a normal radiograph, we suggest that arthroscopy be advised with particular attention to the femoral trochlea.     

Ultrastructure and histochemistry of human anterior lingual salivary glands (glands of blandin and nuhn)

Background: Speciamens of human anterior lingual salivary glans obtained by surgery and by dissection of cadavers were studied ultrastructurally and histochemically. Methods: Specimens were obtained by surgery for ultrastructural study. Other specimens for histochemistry were obtained by dissection of fresh cadavers. Tissues for electron microscopy were fixed and processed by conventional mesns. Formalin-fixed cadaver specimens were subjected to a battery of tests for glycoconjugates. Results: The anterior lingual salivary glands are composed predominantly of mucous tubules (which come in two distinct sizes: large and small), seromucous demilunes, and rare seromucous acini. Regardless of tubule size, mucous cells are typically in appearance and, like mucous cells in other human salivary glands, contain filamentous bodies. Histochemically, the larger tubules contain neutral glycoproteins, low concentrations of sialoglycoproteins, and large amounts of sulfated glycoproteins. The small mucous tubules contain neutral glycoproteins, much sialoglycoprotein, and relatively small amounts of sulfated glycoprotein. The seromucous cells, whether demilunar or acinar, are identical. They contain numerous secretory granules, which show a spectrum of internal patterns from one individual to another. These cells have considerable concentrations of neutral- and sialoglycoproteins and lower concentrations of sulfated gly-coproteins. Countrary to previously published reports, we could find no differences in the ratio of mucous to seromucous cells along the anteriorposterior lingual axis: there was no gradient of seromucous cells in our specimens. The ducts in the anterior lingual salivary glands are not precise counterparts of those in the major salivary glands, since the former have no capsules, hence lack lobulation. Without these familiar structural landmarks, the only duct that can be identified with certainty is the intercalated duct, and then only if it is in continuity with or lies close to a secretory endpiece. Such ducts consist of simple cuboidal epithelium of prosaic appearance. The ductular epithelium gradually thickens and gives rise to what appear to be excretory ducts consisting of columnar cells with few mitochondria. Scattered within the walls of the walls of the larger ducts are patches of typical striated ducts wherein the taller cells display basal striations resulting from highly folded basal plasma membranes and numerous, vertically oriented, virgulate mitochondria. In other atypical regions of the excretory duct, basal cells may have a primary cilium that juts into the intercellular space. Conclusions: There is a high degree of structural variability in human anterior lingual salivary glands. Because of the technical difficulties in collecting pristine saliva from these glands, the precise functions(s) of these organs remains unknown. © 1994 Wiley-Liss, Inc.     

Properties and localization of the anterior semicircular canal-activated vestibulocollic neurons in the cat

Summary Unit activites of secondary vestibular neurons that selectively responded to stimulation of the anterior semicircular canal nerve (ACN) were recorded extracellularly in the anesthetized cat. Axonal pathways and projections in the spinal cord of the ACN-activated neurons were examined by recording their antidromic responses to stimulation of the lateral and medial vestibulospinal tracts (LVST and MVST), and the bilateral neck extensor motoneuron pools in the C₁segment (C₁dorsal rami [DR] motoneuron pools). In order to determine whether the neurons had ascending axon collaterals to the extraocular motoneurons, the contralateral (c-) inferior oblique (IO) motoneuron pool was also stimulated. Twenty-seven neurons sent their axons to the ipsilateral (i-) C₁DR motoneuron pool via the LVST without any projection to the extraocular motoneuron pool. All the cells except one were located in the ventral part of the lateral vestibular nucleus. This pathway produced monosynaptic EPSPs with short time-to-peak and short half-width in C₁DR motoneurons (16/16 motoneurons). Eight neurons sent axons to the i-C₁DR motoneuron pool via the MVST without any to the extraocular motoneuron pool. Cell somata were located in the descending nucleus or in the ventral part of the lateral nucleus. These neurons did not produce postsynaptic potentials (PSPs) in any C₁DR motoneurons. All thirty-five neurons sending axons to the c-C₁DR motoneuron pool have ascending axon collaterals to the c-IO motoneuron pool.     

Topographical organization of the cortical afferent connections to the cortex of the anterior ectosylvian sulcus in the cat

Summary The cortical afferents to the cortex of the anterior ectosylvian sulcus (SEsA) were studied in the cat, using the retrograde axonal transport of horseradish peroxidase technique. Following injections of the enzyme in the cortex of both banks, fundus and both ends (postero-dorsal and anteroventral) of the anterior ectosylvian sulcus, retrograde labeling was found in: the primary, secondary, and tertiary somatosensory areas (SI, SII and SIII); the motor and premotor cortices; the primary, secondary, anterior and suprasylvian fringe auditory areas; the lateral suprasylvian (LS) area, area 20 and posterior suprasylvian visual area; the insular cortex and cortex of posterior half of the sulcus sylvius; in area 36 of the perirhinal cortex; and in the medial bank of the presylvian sulcus in the prefrontal cortex. Moreover, these connections are topographically organized. Considering the topographical distribution of the cortical afferents, three sectors may be distinguished in the cortex of the SEsA. 1) The cortex of the rostral two-thirds of the dorsal bank. This sector receives cortical projections from areas SI, SII and SIII, and from the motor cortex. It also receives projections from the anterolateral subdivision of LS, and area 36. 2) The cortex of the posterior third of the dorsal bank and of the posterodorsal end. It receives cortical afferents principally from the primary, secondary and anterior auditory areas, from SI, SII and fourth somatosensory area, from the anterolateral subdivision of LS, vestibular cortex and area 36. 3) The cortex of the ventral bank and fundus. This sulcal sector receives abundant connections from visual areas (LS, 20, posterior suprasylvian, 21 and 19), principally from the lateral posterior and dorsal subdivisions of LS. It also receives abundant connections from the granular insular cortex, caudal part of the cortex of the sylvian sulcus and suprasylvian fringe. Less abundant cortical afferents were found to arise in area 36, second auditory area and prefrontal cortex. The abundant sensory input of different modalities which appears to converge in the cortex of the anterior ectosylvian sulcus, and the consistent projection from this cortex to the deep layers of the superior colliculus, make this cortical region well suited to play a role in the control of the orientation movements of the eyes and head toward different sensory stimuli.Supported by FISSS grants 521/81 and 1250/84     

Dependence of the anterior olfactory area self-stimulation upon the lateral hypothalamic area

The functional relation between the anterior olfactory area (AO) and the lateral hypothalamic area (LH) was examined in a self-stimulation situation. Bar-pressing responses for AO sitmulation were suppressed by unilateral injection of procaine, and enhanced by glutamate, into LH. Neither procaine nor glutamate injected into AO had any influence upon LH self-stimulation. It is unlikely that the procaine effect was due to motor disturbance because similar injection of procaine into LH did not disturb the performance of a one-way avoidance task. It appears that the rewarding effect of AO stimulation is dependent upon the excitation of the more caudal structures including LH.