Depressive effect of isoflurane anesthesia on motor evoked potentials

The influence of the volatile anesthetic isoflurane (Forane) on motor evoked potentials was examined in rats. To record motor evoked potentials, single-shock electrical stimulation was delivered to the forelimb representation of the motor cortex. This resulted in elicitation of a compound muscle action potential from the contralateral extensor muscles. The effect of isoflurane was examined at various concentrations ranging from 0.2 to 1.5%. With increasing concentrations of isoflurane there was a progressive increase in onset latency of the compound muscle action potential and a decrease in peak-to-peak amplitude and duration. Latencies were significantly increased over baseline values for concentrations of isoflurane from 0.5 to 1.5% (P values were 0.001 to 0.007). For the amplitude and the duration, responses at 0.5 to 1.5% isoflurane were significantly lower than baseline (P values were 0.001 to 0.007). We conclude that isoflurane anesthesia significantly changes the muscle response evoked by motor cortex stimulation in experimental animals.     

Physiological analysis of motor reorganization following lower limb amputation.

It is now known that amputation results in reorganization of central motor pathways, but the mechanism for the changes is unclear. One possibility is alteration of the excitability of the alpha motoneurons. We studied motor reorganization and excitability of alpha motoneurons to Ia input in 6 subjects with unilateral lower limb amputation. A Cadwell MES-10 stimulator was used to deliver transcranial magnetic stimuli through a circular coil centered on the sagittal axis 4 cm anterior to Cz and through an 8-shaped coil positioned over scalp locations 1 cm apart along the coronal axis. Surface EMG was recorded bilaterally from quadriceps femoris, the first muscle immediately proximal to the site of amputation. Excitability of the spinal alpha motoneuron pool to Ia afferents was assessed by determining the ratio of the maximal H reflex to the maximal M response (H/M ratio) elicited in the quadriceps femoris. Stimuli of equal intensity delivered to optimal scalp positions recruited a larger percentage of the alpha motoneuron pool in muscles ipsilateral to the stump than in those contralateral to the stump (P less than 0.01). Mean onset latencies of motor evoked potentials were shorter in ipsilateral muscles than in contralateral muscles (P less than 0.01). Muscles ipsilateral to the stump showed a trend toward activation from a larger number of scalp positions than those contralateral to the stump (P = 0.06). There was no difference in the quadriceps H/M ratios (7.2% ipsilateral vs. 10.9% contralateral). The absence of changes in the excitability of the alpha motoneuron pool in the presence of motor reorganization targeting muscles proximal to the stump suggests that reorganization occurs proximal to the alpha motoneuron level.     

Granulocytic ehrlichiosis in two dogs in Switzerland.

This case report describes two dogs with granulocytic ehrlichiosis. Dog 1 was a male Labrador retriever with clinical signs of lymphosarcoma. Dog 2 was a female Airedale terrier, whose clinical signs included apathy, pyrexia, diarrhea, and abdominal pain. Examination of blood smears revealed Ehrlichia organisms in the neutrophils of both dogs. There was thrombocytopenia in both dogs, and dog 2 also had leukopenia. In both dogs, bands of identical length were amplified from DNA of leukocytes via nested PCR. The bands had identical nucleotide sequences, which differed from the gene sequences of Ehrlichia equi and E. phagocytophila in three and two positions, respectively. Interestingly, the nucleotide sequence of the 16S rRNA was 100% homologous to that of a human granulocytic ehrlichia.     

Sympathetic skin response (SSR) in erythromelalgia

BACKGROUND: Erythromelalgia (EM) is characterized by severe pain associated with local redness and hotness in the extremities. When the extremity is lowered, or heat is applied, the pain is intensified and when coldness is applied, or the extremity is elevated the pain is decreased. OBJECTIVE: To evaluate if there is any sympathetic nervous system involvement in erythromelalgia, sympathetic skin response (SSR) test was done. SETTING: This study was conducted during the years 1998-2000 in the Department of Physical medicine and Rehabilitation, Shiraz University of Medical Sciences. METHODS: SSR study was done on 22 patients with erythromelalgia and 22 normal subjects were matched for age and sex for comparison. RESULTS: There is a significant difference between the patients and controls especially in the lower extremity findings (P = 0.000). More than 72.7% of the patients had abnormal SSR. CONCLUSION: It is concluded that sympathetic peripheral fibers (C fibers) are involved in erythromelalgia and it is probably the pathogenesis of the disease.     

Cervical myelopathy due to chronic vitamin B12 deficiency or herniated cervical disc or both

OBJECTIVE: A female patient with diagnosis of combined system degeneration due to vitamin B12 deficiency and multi-level cervical disc herniation underwent a comprehensive neurophysiologic tests. MATERIALS AND METHODS: Central conduction time (CCT) was calculated after recording of the SSEPs from cervical, brainstem, and parietal sensory cortex to peripheral stimulation. RESULTS: The CCT between the lower cervical spine and brainstem was 3.63 msec and 3.41 msec for left and right side. All values were within the normal range. The visual EPs and brain-stem auditory EPs were also normal. The MR imaging of the cervical region was remarkable for multi-level degenerative changes as well as osteophyte formation at C4-7 segments causing canal stenosis. CONCLUSIONS: It is possible that her symptoms are related to two separate chronic problems. The first is history of B12 deficiency, causing a subacute systems degeneration syndrome. The second is evidence of a cervical spondylotic myelopathy.     

A human monoclonal antibody to cytokeratin intermediate filament antigens derived from a tumor draining lymph node

Human lymphocytes derived from a lymph node draining a primary breast adenocarcinoma were fused with the mouse myeloma P3X63Ag8.653 to generate human-mouse hybridomas secreting human monoclonal antibodies (MAbs) to tumor associated antigens (TAAs). One of the resulting human MAbs, YBB 190 (IgM) is described. Enzyme-linked immunosorbent assays (ELISA) employing membrane and cytosol fractions of human tissues demonstrated YBB 190 reactivity against cytosol but not membrane components of malignant and normal epithelial tissues. When tested by an indirect immunoperoxidase staining method against fresh frozen human tissue sections, YBB 190 reacted with malignant cells in 26 of 28 epithelial cancers and with normal epithelia in 11 different benign tissues. Preliminary western blot antigen characterization indicated that YBB 190 recognizes cytokeratin intermediate filaments, or a protein that is closely associated with cytokeratins. These data indicate that B cells with specificity for intermediate filaments are present in tumor draining lymph nodes. Our findings provide insights into the nature of potential autoimmune responses in cancer patients and suggest that improved tumor directed sensitization procedures may be required to more effectively utilize lymphocytes from tumor draining lymph nodes to generate therapeutically useful human MAbs to TAAs.     

A histological and histochemical study of changes of fiber types in experimental myotonia

Summary In both fast and slow muscles of rats treated with 20–25 diazacholesterol there were qualitative alterations, such as changes of fiber outlines, numerous moth-eaten fibers and rare ring fibers. In addition there were generally larger groups of Type I and intermediate fibers than in normal controls (type-grouping tendency) in the preparations for oxidative enzymes in the extensor digitorum longus (EDL) of myotonic animals. Quantitative evaluations of EDL and soleus of myotonic rats revealed moderate hypotrophy of Type I and Type II fibers with an increase in the number of Type I and of Type III fibers in the EDL and a significant decrease of the nondominant fibers in the soleus muscle. The data are discussed in the light of a neurally mediated and/or direct action of the drug on the muscle fiber.

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Zusammenfassung Sowohl in phasischen wie auch in tonischen Muskeln von Ratten, welche mit 20–25 Diazacholesterol behandelt wurden, wurden diskrete Strukturänderungen festgestellt: Änderungen der Umrisse der Einzelfasern, zahlreiche Fasern mit Mottenfraß, seltene Ringfasern. Histochemische Reaktionen für oxidative Enzyme im Extensor digitorum longus myotonischer Tiere zeigten außerdem häufig größere Gruppen von Typ-I-Fasern und Fasern vom Zwischentyp als bei normalen Kontrollen (Tendenz zum Type-Grouping). Quantitative Auswertung zeigte im Extensor digitorum longus und im Soleus myotonischer Ratten eine mäßige Hypotrophie der Typ-I-und Typ-II-Fasern mit einer Zunahme der Anzahl der Fasern vom Typ I und vom Typ III im Extensor digitorum longus und einer signifikanten Abnahme des nicht dominanten Fasertypus im Soleus. Die Befunde werden besonders im Hinblick auf eine neurogen vermittelte oder unmittelbare Wirkung der Substanz auf die Muskelfaser diskutiert.

     

Analysis of microsatellite instability in chronic lymphoproliferative disorders

Microsatellite instability (MSI) represents one specific pattern of genomic instability and is one of the genetic lesions most frequently detected in human neoplasia. Although MSI has been found to be associated with a wide variety of solid cancers, its involvement in lymphoid malignancies is virtually unexplored. In this study, we have investigated the presence of MSI in chronic lymphoproliferative disorders by comparing the pattern of nine microsatellite repeats (two tetranucleotides, two trinucleotides, and five dinucleotides) on autologous germline and tumor DNA of 23 patients, including 17 with B-cell chronic lymphocytic leukemia/small lymphocytic lymphoma (B-CLL/SLL), four with hairy cell leukemia, one with lymphoplasmacytoid lymphoma, and one with T-cell chronic lymphocytic leukemia. All samples at diagnosis displayed a germline pattern of the microsatellites examined, thus suggesting that MSI is not involved in the pathogenesis of these lymphoproliferations. Also, no microsatellite alterations were observed in consecutive samples of B-CLL/SLL obtained from the same patient at various stages of the disease both before and after chemotherapy. Conversely, alterations in 3/9 microsatellite repeats were detected in one case of Richter's syndrome which had evolved from a pre-existent B-CLL/SLL phase. Overall, the low frequency of MSI among chronic lymphoproliferative disorders adds further weight to the common view that the mechanisms and patterns of genomic instability in lymphoid neoplasia differ markedly from those commonly observed in solid cancers.