Temperature distributions in 136 superficial radiothermotherapies

Temperature distributions from 136 superficial radiothermotherapies in patients were analysed and three-dimensionally reconstructed. The calculation of mean values and standard deviations of the temperature measuring probes considering water bolus temperature, master probe temperature, site of the probes relatively to different applicator positions and site of the probes in the heated tissues yielded satisfactory temperature distributions for chest wall treatment in contrast to other regions of the body. Radiothermotherapy was statistically not superior to radiotherapy alone with respect to local tumor control.     

The effects of GABA and related drugs on horizontal cells in the isolated turtle retina

The role of GABA in the outer plexiform layer of the turtle retina has been examined by intracellular recordings from L- and C-type horizontal cells in the isolated retina preparation. GABA (1-5 mM) slightly depolarized the L-type horizontal cells, reduced the amplitude of their photoresponses, and slowed down the rate of hyperpolarization during the ON component of the photoresponse. These effects could not be replicated by either muscimol or baclofen. When synaptic transmission from the photoreceptors had been blocked by either kynurenic acid or cobalt ions, GABA depolarized L-type horizontal cells and augmented the remaining photoresponses. Neither muscimol nor baclofen exerted any effect on L-type horizontal cells under these conditions. Nipecotic acid, a competitive inhibitor of the GABA-uptake system, induced effects on turtle L-type horizontal cells which were similar to those exerted by GABA. Thus, the complex GABA effect on turtle L-type horizontal cells seems to represent the summation of at least two actions; an indirect one mediated by the red cones via GABAa-type receptors and a direct one which probably reflects the activation of an electrogenic GABA-uptake system. GABA (1-5 mM) induced a transient depolarization in C-type horizontal cells but eliminated color opponency in only three cells out of seven studied. This observation is inconsistent with the notion that the only neural mechanism responsible for the chromatic properties of C-type horizontal cells in the turtle retina is a GABAergic negative feedback from the L-type horizontal cells onto the green ones.     

A glass/silicon composite intracortical electrode array

A new manufacturing technique has been developed for creating silicon-based, penetrating electrode arrays intended for implantation into cerebral cortex. The arrays consist of a 4.2 mm×4.2 mm glass/silicon composite base, from which project 100 silicon needle-type electrodes in a 10×10 array. Each needle is approximately 1,500 μm long, 80μm in diameter at the base, and tapers to a sharp point at the metalized tip. The technique used to manufacture these arrays differs from our previous method in that a glass dielectric, rather than ap-n-p junction, provides electrical isolation between the individual electrodes in the array. The new electrode arrays exhibit superior electrical properties to those described previously. We have measured interelectrode impedances of at least 10¹³ Ω, and interelectrode capacitances of approximately 50 fF for the new arrays. In this paper, we describe the manufacturing techniques used to create the arrays, focusing on the dielectric isolation technique, and discuss the electrical and mechanical characteristics of these arrays.     

Looking into the black box of “Medical Innovation”: rising health expenditures by illness type

There is agreement among health economists that on the whole medical innovation causes health care expenditures (HCE) to rise. This paper analyzes for which diagnoses HCE per patient have grown significantly faster than average HCE. We distinguish decedents (patients in their last 4 years of life) from survivors and use a unique dataset comprising detailed HCE of all members of a regional health insurance fund in Upper Austria for the period 2005–2018. Our results indicate that among decedents in particular, the expenditures for treatment of neoplasms have exceeded the general trend in HCE. This confirms that medical innovation for this group of diseases has been particularly strong over the last 15 years. For survivors, we find a noticeable growth in cases and cost per case for pregnancies and childbirth, and also for treatment of mental and behavioral disorders. We discuss whether these findings contradict the widespread interpretation of cost-increasing innovations as “medical progress” and offer some policy recommendations.

     

Selective stimulation of cat sciatic nerve using an array of varying-length microelectrodes

Restoration of motor function to individuals who have had spinal cord injuries or stroke has been hampered by the lack of an interface to the peripheral nervous system. A suitable interface should provide selective stimulation of a large number of individual muscle groups with graded recruitment of force. We have developed a new neural interface, the Utah Slanted Electrode Array (USEA), that was designed to be implanted into peripheral nerves. Its goal is to provide such an interface that could be useful in rehabilitation as well as neuroscience applications. In this study, the stimulation capabilities of the USEA were evaluated in acute experiments in cat sciatic nerve. The recruitment properties and the selectivity of stimulation were examined by determining the target muscles excited by stimulation via each of the 100 electrodes in the array and using force transducers to record the force produced in these muscles. It is shown in the results that groups of up to 15 electrodes were inserted into individual fascicles. Stimulation slightly above threshold was selective to one muscle group for most individual electrodes. At higher currents, co-activation of agonist but not antagonist muscles was observed in some instances. Recruitment curves for the electrode array were broader with twitch thresholds starting at much lower currents than for cuff electrodes. In these experiments, it is also shown that certain combinations of electrode pairs, inserted into an individual fascicle, excite fiber populations with substantial overlap, whereas other pairs appear to address independent populations. We conclude that the USEA permits more selective stimulation at much lower current intensities with more graded recruitment of individual muscles than is achieved by conventional cuff electrodes.     

A 'puff and advance' technique for visually controlled staining of turtle retinal ganglion cells.

We describe a 'puff and advance' technique for visually controlled staining of retinal ganglion cells (GCs) in the unfixed, living retina for light and electron microscopy. Glass microelectrodes are filled with rhodamine-isothiocyanate labeled horseradish peroxidase (Rh-HRP), or Lucifer yellow (LY), or a mixture of both, or with 5,6-carboxytetramethylrhodamine (5,6-Rh) and advanced tangentially through the GC layer with microscopic observation using epifluorescence. Brief "puffs" of LY or 5,6-Rh are constantly ejected from the advancing electrode tip by a train of negative current pulses. GC penetration is signaled by virtually instantaneous staining of its soma (and eventually its axon and dendrites if the electrode is not advanced further). An impaled GC can be electron densely stained with the Rh-HRP complex by switching to positive current pulses. The extent of dye filling is monitored through the microscope using a filter combination appropriate for the dye. After fixation, standard histochemical procedures reveal HRP stained GCs in wholemount views for light microscopical examination. Furthermore, the preservation of the labeled cells and the neuropil is of a quality to allow electron microscopic analysis for synaptic input. This technique can be used in combination with LY backfiling of GCs from the optic nerve and with retinas in which GCs have been prelabeled with rhodamine beads retrogradely transported from the optic tectum as well.     

Caterpillar envenomations: a prospective study of 112 cases

A 1-year prospective study was conducted to identify epidemiological factors associated with caterpillar envenomations. Of 117 envenomations, 112 were included in the study. Identification of the caterpillars involved was accomplished in 68% of the cases. Six caterpillar species were identified, 4 of which [Hemileuca maia (Drury), Automeris io (F), Megalopyge opercularis (JE Smith)/Lagoa crispata (Packard) and Sibine stimulea (Clemens)] were properly implicated in envenomations. Clinical effects most commonly reported were local pain, erythema and swelling in 96%, 89% and 72% of patients, respectively. Atypical responses including muscle spasms, paresthesia and radiating pain to an extremity were noted in 26% of patients. Sixteen percent of patients had a history of allergy, but no patient in this subgroup exhibited a "hive-like" dermatologic or anaphylactic allergic response. No positive correlation could be drawn between allergy history and extent of clinical effect following envenomation. Mild to moderate local response following envenomation was typical. However, 61% of patients evaluated experienced mild to moderate effects at least 24 h post-envenomation.     

A neural interface for a cortical vision prosthesis.

The development of a cortically based vision prosthesis has been hampered by a lack of basic experiments on phosphene psychophysics. This basic research has been hampered by the lack of a means to safely stimulate large numbers of cortical neurons. Recently, a number of laboratories have developed arrays of silicon microelectrodes that could enable such basic studies on phosphene psychophysics. This paper describes one such array, the Utah electrode array, and summarizes neurosurgical, physiological and histological experiments that suggest that such an array could be implanted safely in visual cortex. We also summarize a series of chronic behavioral experiments that show that modest levels of electrical currents passed into cortex via this array can evoke sensory percepts. Pending the successful outcome of biocompatibility studies using such arrays, high count arrays of penetrating microelectrodes similar to this design could provide a useful tool for studies of the psychophysics of phosphene perception in human volunteers. Such studies could provide a proof-of-concept for cortically based artificial vision.     

Population coding in spike trains of simultaneously recorded retinal ganglion cells

To achieve a better understanding of the parallel information processing that takes place in the nervous system, many researchers have recently begun to use multielectrode techniques to obtain high spatial- and temporal-resolution recordings of the firing patterns of neural ensembles. Apart from the complexities of acquiring and storing single unit responses from large numbers of neurons, the multielectrode technique has provided new challenges in the analysis of the responses from many simultaneously recorded neurons. This paper provides insights into the problem of coding/decoding of retinal images by ensembles of retinal ganglion cells. We have simultaneously recorded the responses of 15 ganglion cells to visual stimuli of various intensities and wavelengths and analyzed the data using discriminant analysis. Models of stimulus encoding were generated and discriminant analysis used to estimate the wavelength and intensity of the stimuli. We find that the ganglion cells we have recorded from are non-redundant encoders of these stimulus features. While single ganglion cells are poor classifiers of the stimulus parameters, examination of the responses of only a few ganglion cells greatly enhances our ability to specify the stimulus wavelength and intensity. Of the parameters studied, we find that the rate of firing of the ganglion cells provides the most information about these stimulus parameters, while the timing of the first action potential provides almost as much information. While we are not suggesting that the brain is using these variables, our results show how a population of sensory neurons can encode stimulus features and suggest that the brain could potentially deduce reliable information about stimulus features from response patterns of retinal ganglion cell populations.