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Dorn Spinal Therapy

Dorn Spinal Therapy has been in uses in the past 40 years. The credit of this method goes to Dieter Dorn, who has made a significant impact in the medical field. DORN- Method has been used on various patients where results could get witnessed instants. Due to the impact, this method has brought in the country. It has been declared the standard practice in treating Pelvical Disorders, Spinal, and Back pain. Dieter Dorn first used this method on his family, which was a sign of confidence in a method, which later gained much attention from different people in the country and also globally. Every day Dorn was able to offer treatment to 15- 20 patients in a day. His services were purely free which attracted attention both in the local and also global. The primary treatment that DORN-Method which could be treated using this method include spine healing therapy, misalignments of the spine, resolving pelvis and joints, and also solving out significant problems which could get attributed to vertebrae.

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Malignant Glioma of the Spinal Cord

As with adults, malignant gliomas ofthe spinal cord are rare. The natural history is not well defined but these tend to be as aggressive as their corresponding tumors in the brain. The standard treatment involves confirmation by biopsy and surgical resection if possible. Following staging with brain and spine MRI, standard dose radiotherapy is considered the standard of care. In a Children's Cancer Group study, 18 children with malignant glioma of the spinal cord were treated with maximal surgical resection, followed by 2 cycles of 8-in-1 chemotherapy, standard involved-field radiotherapy, and then 8 additional cycles of 8-in-1 chemotherapy. The histology of these tumors included 4 GBM, 8 anaplastic astrocytomas, 1 mixed malignant gliomas, and 5 with discordant malignant glioma pathology. The surgical results included six with gross-total or near-total resections, four with partial or subtotal resections, and three with biopsy only. Leptomeningeal spread of tumor was identified in six...

Cranial and Spinal Nerves

The central nervous system communicates with the body by means of nerves that exit the CNS from the brain (cranial nerves) and spinal cord (spinal nerves). These nerves, together with aggregations of cell bodies located outside the CNS, constitute the peripheral nervous system.

The Spinal Nucleus and the Tract of the Trigeminal Nerve

The spinal nucleus and tract of the trigeminal nerve Extends from the midpons at the level of entry of the trigeminal root to the upper cervical spinal segments Subserves the functions of pain and temperature sensation, touch being a function of the main sensory nucleus, which is at the rostral end of the spinal nucleus The spinal trigeminal nucleus is medial to the tract and divided into three areas corresponding to the areas shown in Figure 8-4 at A, B, and C. These areas do not have the same cutaneous relationships as the three peripheral branches. Area A cuts through all three peripheral divisions and has its cellular components in the most rostral part of the nucleus, area B is intermediate, and area C is related to the most caudal end of the nucleus. (For an excellent account of the anatomy of the nucleus, see A. Brodal, Neurological Anatomy in Relation to Clinical Medicine, 3rd ed. Oxford University Press, New York, 1981, p. 528.)

Identification Of The Spinal Accessory Nerve

The spinal accessory nerve enters the sternocleidomastoid muscle approximately at the junction of the upper and middle third of the muscle. The transverse process of the atlas serves as a useful anatomical landmark (Fig. 4-16). Adequate exposure of the area requires posterior retraction of the sternocleidomastoid muscle. The small vessels that usually go along with the nerve are carefully cauterized and the nerve is examined for divisions that may appear before it enters the muscle. All nerve branches must be preserved to obtain the best shoulder function. Sometimes a branch from the second cervical nerve can be seen joining the spinal accessory nerve before its entrance into the sternocleidomastoid muscle. Although most anatomy books consider this and other branches from the cervical plexus to be mainly sensory, it is our experience that preservation of these branches helps to prevent shoulder dysfunction after the operation. Once the nerve is identified, wet surgical sponges are...

Electrical Stimulation Of The Spinal Cord And Peripheral Nerves

Centuries before the nature of electricity was understood, observant people discovered that electrical stimulation (caused by the proximity of electrical eels) relieved pain. When electricity was controlled, healers replaced the eels with hand-cranked generators and continued to practice electrical therapy without understanding how it relieved pain (12). Eventually, in the mid-20th century, Melzack and Wall crafted a gate-control theory of pain that permitted the incorporation of electrical stimulation with modern medicine (13). Now, despite recognition of the shortcomings of this theory, it is known that SCS can effectively relieve pain (14), and multichannel, computerized systems with percutaneous electrodes allow stimulation of the spinal cord, nerve roots, and peripheral nerves simultaneously (see Fig. 6A,B). In a review of experience with SCS during an 18-year period, North et al. found that, at 7-year mean follow-up, 52 of 171 patients with permanent implants reported at least...

Cerebrospinal Fluid Marker Concentrations

The evaluation of cerebrospinal fluid (CSF) for P-hCG can be a valuable tool in the diagnosis of CNS metastases from GCTs. In patients in whom P-hCG is the predominant marker, measurement of CSF P-hCG may detect patients with CNS involvement with metastatic disease that is below the limits of detection by CT.6 The original work undertaken by Bagshawe and colleagues29,30 (in the era prior to CT and MRI) suggested that a high CSF P-hCG level was predictive of CNS disease. The cutoff for prediction of the presence of CNS metastases was where the CSF concentration exceeded 2 of the serum concentration. In confirmation of this finding, investigators at Memorial Sloan-Kettering Cancer Center reported that a CSF concentration greater than 2 of the serum concentration was of positive predictive value for CNS metastases at autopsy or on imaging studies (Table 17-4).4 Similarly, Kaye and colleagues found that a CSF P-

The Spinal Accessory Maneuver

Osvaldo Suarez used the term spinal accessory maneuver to refer to the surgical step in which the fibrofatty tissue surrounding the spinal accessory nerve in the upper jugular region is passed beneath the nerve to be removed in-continuity with the rest of the specimen (Fig. 5-18). After the spinal accessory nerve has been completely isolated on its course from the sternocleidomastoid muscle to the internal jugular vein, the tissue lying posterior and superior to the nerve is dissected from the splenius capitis and levator scapulae muscles (Fig. 5-18A). Once dissected from the plane of the deep muscles, the tissue is passed underneath the nerve to be removed en bloc with the rest of the specimen (Fig. 5-18B). 2. After the spinal accessory maneuver has been completed, the dissection is continued anterior to the sternocleidomastoid muscle in a downward direction for a few more centimeters. Keeping the sternocleidomastoid muscle retracted posteriorly, a number 10 knife blade is used to...

Neurophysiology Cerebrospinal fluid

Each day 500 ml of Cerebrospinal fluid (CSF) is secreted mostly by the choroids plexus within the lateral and with the 3rd and 4th ventricles. Very little appears to change the production rate of CSF other than quite markedly raised intracra-nial pressure which reduces it. The CSF flows from the lateral ventricles through the foramina of Munro into the 3rd ventricle and thence down the aqueduct of Sylvius situated in the midbrain and upper pons. Once in the 4th ventricle, a very small amount passes down the central canal of the spinal cord but the vast majority flows out through the lateral foramina of Luschka and the central foramen of Magendie. Thereafter the CSF can flow down the subarachnoid space in the spine or pass upwards eventually all CSF passes upward in the subarachnoid spaces around the midbrain and thence over the cerebral hemispheres and particularly to the para-sagittal areas. It is reabsorbed into the blood stream through the arachnoid villi which protrude into the...

Spinal cord compression

The spinal cord lies within the vertebral canal from the foramen magnum to approximately the first lumbar vertebra, and thereafter continues as the nerve roots of the cauda equina. It is surrounded by the three meningeal layers of dura, arachnoid and pia. There is very little spare room within the vertebral canal and space-occupying pathological processes soon lead to spinal cord compression. To some extent the symptomatology depends on the vertebral level, the layer of meninges containing the pathological process and the speed of onset of compression - the faster the onset, the poorer the prognosis for recovery even with expeditious treatment, and the converse applies for slowly compressing lesions. In the thoracic region if the bone is involved, there is often pain in the spine and girdle pain around the chest wall in the distribution of the appropriate intercostal nerve, unilaterally or bilaterally. The arms are unaffected but the legs develop weakness and increased tone, and there...

Lumbar spinal anatomy

The lumbar spine consists of individual motion segments which comprise the vertebral body, intervertebral disc and facet joints. The spinal canal is made up of a bony-ligamentous ring which consists of the posterior aspect of the vertebral body and intervertebral disc anteriorly, pedicles and intervertebral foramina laterally together with the laminae and liga-mentum flavum posteriorly. The articular processes of the facet joints are posterolaterally. The facet joints are enclosed within the facet joint capsules. Along the posterior aspect of the vertebral bodies, extending down the posterior fibres of the annulus fibrosis, is the posterior longitudinal ligament. This bony-ligamentous ring of each motion segment completes the spinal canal posterior to the vertebral body. Contained within the canal are the thecal contents. The spinal cord ends at the lower border of the L1 vertebral body. Below this the cauda equina trails down from the conus medullaris, the individual nerve roots...

Dissection Of The Spinal Accessory Nerve

Accessory Nerve Ijv Relation

The dissection of the spinal accessory nerve is one of the few steps of the operation that we usually perform using scissors instead of scalpel. To approach this area the sternocleidomastoid muscle is retracted posteriorly, and the posterior belly of the digastric muscle is pulled superiorly with a smooth blade retractor (Fig. 4-26). The wet surgical sponges previously left over the nerve at the level of its entrance in the sternocleidomastoid muscle are removed and the nerve is dissected toward the carotid sheath. Figure 4-26 Surgical field prepared for the dissection of the spinal accessory area on the right side of the neck. SC, Sternocleidomastoid muscle IJ, Internal jugular vein sa, spinal accessory nerve hn, hypoglossal nerve mn, marginal mandibular branch of the facial nerve fv, facial vein SG, submandibular gland pg, tail of the parotid gland F, fascia dissected form the upper part of the surgical field. Figure 4-26 Surgical field prepared for the dissection of the spinal...

Spinal injury

Injury to the spine is of importance primarily because of the potentially catastrophic effects of damage to the spinal cord. It is by no means always accompanied by neurological damage, but because of the severe and usually permanent effects of neurological injury, it is essential to assume that the possibility of spinal instability exists in almost all injured patients until this can be satisfactorily excluded. Occasionally, neurological injury can occur, particularly in children, without there being an associated spinal fracture. Most spinal injuries are caused by road traffic accidents, falls or during sport. Many patients sustain a whiplash injury to the soft tissues and ligaments following road accidents, but bony and neurological injuries are more likely when the occupant has been ejected from the vehicle or suffered head injury. Falls from a height, either onto the head or feet, can cause spinal injury, whilst swimming (particularly diving) and horse riding, in addition to...

Spinal Cord Tracts

Sensory information from receptors throughout most of the body is relayed to the brain by means of ascending tracts of fibers that conduct impulses up the spinal cord. When the brain directs motor activities, these directions are in the form of nerve impulses that travel down the spinal cord in descending tracts of fibers. The spinal cord extends from the level of the foramen magnum of the skull to the first lumbar vertebra. Unlike the brain, in which the gray matter forms a cortex over white matter, the gray matter of the spinal cord is located centrally, surrounded by white matter. The central gray matter of the spinal cord is arranged in the form of an H, with two dorsal horns and two ventral horns (also called posterior and anterior horns, respectively). The white matter of the spinal cord is composed of ascending and descending fiber tracts. These are arranged into six columns of white matter called funiculi. The fiber tracts within the white matter of the spinal cord are named...

Spinal Nerves

There are thirty-one pairs of spinal nerves. These nerves are grouped into eight cervical, twelve thoracic, five lumbar, five sacral, and one coccygeal according to the region of the vertebral column from which they arise (fig. 8.23). Each spinal nerve is a mixed nerve composed of sensory and motor fibers. These fibers are packaged together in the nerve, but they separate near the attachment of the nerve to the spinal cord. This produces two roots to each nerve. The dorsal root is composed of sensory fibers, and the ventral root is composed of motor fibers (fig. 8.24). An enlargement of the dorsal root, the dorsal root ganglion, contains the cell bodies of the sensory neurons. The motor neuron shown in figure 8.24 is a somatic motor neuron that innervates skeletal muscles its cell body is not located in a ganglion, but instead is contained within the gray matter of the spinal cord. The cell bodies of some auto-nomic motor neurons (which innervate involuntary effectors), however, are...

Spinal Cord

The first theory for DI of the spinal cord was developed by Boycott and Damant. Lesions in the spinal cord of goats were found to consist, almost entirely, of white matter lesions 9. Indeed human pathology, although rarely observed in this mostly non-fatal condition, has also shown similar punctate, white matter lesions and hemorrhage. However, embolic injury to the spinal cord is, generally speaking, very rare. This is believed to be due to the relative difference in blood flow favoring embolization of the brain. Experimental spinal cord embolism has also been shown to produce ischemic grey matter pathology rather than white matter lesions 73. To confuse the matter further a type of DI was identified that began as rapid onset cerebral arterial gas embolism but then evolved into a particularly resistant form of spinal injury. This has been called combined , concurrent or Type III decompression sickness 30,74-76. Although the exact mechanism is still unknown, the predominant theory is...

Spinal pathology

Children born with a spinal defect often have neurological problems affecting the lower limbs, bladder and rectum. Many patients have neuropathic bladders and may require surgery because of severe voiding dysfunction. Options include management by either an indwelling catheter, ISC or urinary diversion. Due to immobility and chronically poor voiding, renal stone formation and recurrent UTIs are common. Spinal trauma Traumatic spinal injury may result in paraplegia and an abnormally functioning bladder. Initially, during spinal shock, there is suppression of autonomic and somatic activity and the bladder becomes acontractile, areflexic and painlessly distended. It must therefore be drained, to prevent overdistention injury. As the neurological lesion stabilizes, reflex voiding may return, but this depends on the level of injury. Detrusor hyper-reflexia and DSD may also be present. Self-catheterization, a permanent indwelling catheter or urinary diversion are all options. Renal stone...

Spinal Trauma

Cervical spine (C-spine) injuries are present in around 1-2 of all blunt trauma patients and 5-10 of patients with head trauma. It is important to maintain C-spine precautions, document a complete neurologic exam, and assess the respiratory status frequently since high spinal injuries can impair breathing. The patient may be cleared clinically if there is no C-spine pain, a full range of motion, no tenderness to palpation, no intoxication or altered mental status, no distracting injury, and no neurologic deficits. In all other cases, C-spine x-rays must be obtained and the full cervical spine seen, including C7-T1. In patients with a fracture on plain films or those with a neurologic deficit, neurosurgery should be called immediately. Extensive diagnostic investigations, including CT or MRI, may be required. Spinal Cord Injury (SCI) Syndromes Compression of the cord or spinal artery occlusion results in loss of all motor and sensory function below the lesion other than position sense...

Spinal injuries

In the UK, the great majority of spinal injuries are closed and occur from the indirect effect of violence applied to the vertebral column. In military practice open and compound from penetration by missiles of various sorts are found. The distributions of spinal injuries are as follows 10 occur in the cervical region, 10 in the upper thoracic, 50 in the lower thoracic and 30 in the lumbar. Approximately 50 The effects can most easily be described by considering spinal cord and vertebral column injury separately, although clearly these are intertwined. Spinal cord injury Spinal concussion is the transient loss of neurological function which may recover quickly and fully, and is similar to minor concussion of the brain. Spinal contusion involves swelling and haemorrhages in the spinal cord and very quickly there may be a central necrosis. The myelin sheaths are broken up, the axons are ruptured and neurons degenerate. Eventually the swelling subsides some neural tissues may recover but...

Thinspined porcupine

Rabbit-sized and weighing some 2.87 lb (1.3 kg), C. semispinosus has its back covered with long thin bristles. On the head, neck, and shoulders, these are more spine-like. Like sloths, this species has low levels of muscle mass for its body size. with yellow. Spines are pale gray at the spines. Short tail, many lose their tails. Spines present on back. Head and body parts are pale tawny. Spines present on spines may have dark brown and pale buffy, or whitish. Spines present on back. grayish to white. Soft fur, with no spines

Spinal Drug Delivery

During the past 15 years, the use of intraspinal drug delivery to treat chronic and cancer-related pain has increased. The use of implanted pumps for long-term subarachnoid delivery of drugs is safe and efficacious. Compared with an oral medical regime, selective spinal analgesia offers specific benefits, such as improved pain relief, improved lifestyle, and reduced side-effect profile. Patients currently receiving oral medication who experience dose-limiting side effects or uncontrolled pain, for example, may be good candidates for intraspinal drug delivery. This could indicate acute injections of steroids or chronic infusions of analgesics via an implanted pump. The epidural injection of corticosteroids has been used successfully to reduce nerve root irritation and inflammation. This injection can be performed in the neuraxis, where the injection bathes the spinal cord and neighboring nerve roots in the pathological area. Another approach is the transforaminal epidural injection...

Cervical spine pain

Pain emanating from the cervical spine may be localized to the back of the neck radiating into the intercapsular region or be diffusely referred to the shoulder girdle. Radiculopathy implies damage to the nerve root exiting from the spinal cord. It may be secondary to compression or inflammation. Myelopathy implies damage to the spinal cord itself and one can use symptoms and signs to localize the level of myelo-pathy. Radicular pain follows a typical nerve root distribution and is easy to discern by careful history taking. Very commonly, rather diffuse pain is difficult to isolate to any one particular structure in the cervical spine, be it a disc, facet joint or ligament. To assess these patients accurately, a good working knowledge of the anatomy of the cervical spine is needed as well as of the myotomal and dermatomal distribution of the cervical nerve roots to the upper limbs. There may be confusion as to whether the pain emanates from structures within the cervical spine or...

Physical And Chemical Defense

A novel form of defensive behavior in spiders is found in females and immature males of the black widow (Latrodectus hesperus). When threatened, the black widow emits strands of silk and manipulates the silk to cover its vulnerable abdomen and, sometimes, the aggressor. Especially interesting is the defensive behavior of the cerambycid beetles (genus Ham-maticherus) that use spine-like appendages on their antennae to whip their aggressor. Equally fascinating is the behavior of arctiid moths that produce a series of clicks when detecting the sound made by hunting bats.

Current Promoted Uses

Physicians routinely used intravenous ephedrine for the prophylaxis and treatment of hypotension caused by spinal anesthesia particularly during cae-sarean section (9). In the past, ephedrine was used to treat Stokes-Adams attacks (complete heart block), and was also recommended as a treatment for narcolepsy. Over the years, ephedrine has been replaced by other, more effective agents (10), and the advent of highly selective -agonists has mostly eliminated the need to use ephedrine in treating asthma.

Physical Characteristics

Body long, compressed, tapering to a fine point and tiny caudal fin. Anus separated from urogenital opening, the former situated between the pelvic fin bases, the latter just ahead of the anal fin. A light organ present on the ventral part of body and sides of head, appearing as purplish, striated area. First dorsal fin has one spine and 7-9 rays second dorsal and anal fins each has more than 123 rays. Anterior portion of anal fin elevated, containing 10-12 rays. Pectoral fin has 14-17 rays. First ray of pelvic fin filamentous. Body silvery, upper part somewhat brownish, belly purplish.

Small Premonitory Release or Contamination

A biosurveillance system would have to rely either on case detection by the healthcare system or on computer-based case detection. Computer-based case detection would have to be capable of diagnostic precision at least at the level of finding individuals with Gram-positive rods in the blood or cerebrospinal fluid and pneumonia on chest radiograph (which would be highly suggestive of anthrax). Examples of potential computer-based components include clinical information systems with decision support at the point of care, systems to monitor laboratory reporting of microbiology cultures and free-text processing algorithms that scrutinize autopsy reports, newspaper stories, and obituaries for unusual deaths of animals or humans. If there are multiple cases, the demographics of the victims or the discovery of a geographic clustering of victims could help to identify a common cause with case detection at lower levels of diagnostic precision. In the absence of...

General Neuroimaging Considerations

The presence and extent of infiltrating brain stem gliomas is best seen with MRI. The higher-grade infiltrating gliomas are usually seen as masses with decreased signal intensities on T1-weighted images and increased signal intensity lesions on T2-weighted images. The tumors typically involve and expand the entire pons, and will often extend into the higher brainstem regions and beyond, as well as caudally into the medulla and upper cervical spinal cord. These tumors tend not to enhance with contrast agents, or do so only minimally. In some cases the tumor seems surprisingly demarcated and localized to one brain stem site, which is often associated with a less aggressive tumor (3-5). Because the higher grade gliomas can disseminate early in the course of the disease, many centers are performing complete spinal cord MRIs with and without contrast at the time of diagnosis to investigate for leptomeningeal spread (8,10-12,30-32).

Role Of Wnt Signaling And Gsk3 In Development

The development of animal organs requires a coordination of cell proliferation and morphogenesis processes. Wnt proteins have been described to regulate early events in the developing nervous system. Wnt3, -3a, -7b, and -8b participate in the development of the forebrain, a region that gives rise to the hippocampus. Ablation of Wntl results in severe defects of the midbrain, the cerebellum and the developing spinal cord, while ablation of Wnt3a results in a total loss of the hippocampus. The deletion of the Wntl gene also results in loss of the midbrain-hindbrain junction and the consequent loss of dopaminergic (DA) neurons 4 . In fact Wnts are involved in the acquisition of a DA phenotype in the developing ventral mesencephalon. Wnt1 mainly regulates the proliferation of neural precursors while Wnt5a is involved in the conversion of precursors positive for nuclear receptor-related factor 1 into DA neurons. Wnts are palmitoylated glycoproteins, poorly soluble ligands, prop

Dorsal Exophytic Brainstem Tumors

Radiation therapy has been generally reserved for patients with either HGG or progression that is not amenable to repeat surgery. For those patients with high-grade neoplasms, it is recommended that surveillance MRI of the spine be performed to properly stage the patient's disease. Unless there is evidence of tumor spread, involved-field radiotherapy using standard dose and dose-fractions is recommended (55-57).

Treatment And Recurrent Pain

It also should be recognized that prolonged pain could lead to disuse atrophy. Again, the resolution of pain may lead to further activity. In this setting, the lack of muscular balance may be associated with malalignment of the spine or increased trauma to insufficiently supported joints. Consequently, injury and pain can result (Fig. 1).

Cardiovascular Diseases

Similar considerations apply to the relationship (if any) between myocardial infarction and ephedrine use. The report by Cockings and Brown described a 25-year-old drug abuser who injected himself with an unknown amount of cocaine intravenously (120). The only other published reports involved a woman in labor who was receiving other vasoactive drugs (121) and two pseudoephedrine users, one of whom was also taking bupropion, who developed coronary artery spasm (122,123). Three cases of ephedra-related coronary spasm in anesthetized patients have also been reported, but multiple agents were administred in all three cases, and the normal innervation of the coronary arteries was disrupted in two of the cases where a high spinal anesthetic had been administered (121,124). One case of alleged ephedrine-re-lated hypersensitivity myocarditis has been reported (125), but the patient was taking many other herbal supplements, and the responsible agent is not known with certainty. Although there...

Horse 43 mph 70 kmh

The horse has a stiffer spine, making it better suited for endurance. B. The cheetah is the fastest land mammal flexibility in its spine allows for longer strides. C. The kangaroo has more upward movement with each leap, and does not move forward as quickly as the horse or cheetah. (Illustration by Patricia Ferrer) A. The horse has a stiffer spine, making it better suited for endurance. B. The cheetah is the fastest land mammal flexibility in its spine allows for longer strides. C. The kangaroo has more upward movement with each leap, and does not move forward as quickly as the horse or cheetah. (Illustration by Patricia Ferrer)

Conditional targeting system

Discussed above, many genetic factors for schizophrenia have roles at different timings during neurodevelopment (Harrison and Weinberger, 2005 Jaaro-Peled et al., 2009), such that DISC1 has roles in cell proliferation, neuronal migration, and dendritic development spine formation in the developing cerebral cortex as well as synapse function in cerebral cortex and positioning of newborn neurons in the dentate gyrus at the adult stage (Duan et al., 2007 Jaaro-Peled et al., 2009 Kamiya et al., 2005 Mao et al., 2009). Therefore, it is critical to segregate each molecule's functions in the developmental stages as well as the adult stage in order to address these mechanisms precisely. To overcome this limitation, an inducible gene expression system has been recently applied to in utero gene transfer (Matsuda and Cepko, 2007). In this system, a plasmid construct in which Cre recombinase is expressed in response to intraperitoneally injected 4-hydroxytamoxifen (4-OHT) and a target gene or...

Manual Versus Automated Segmentation

Semiautomated or fully automated segmentation in anatomical imaging such as CT and MR is very successful, especially in the brain, as there are many well-developed schemes proposed in the literature (see surveys in 14 ). This may be because these imaging modalities provide very high resolution images in which tiny structures are visible even in the presence of noise, and that four general tissue classes, gray matter, white matter, cerebrospinal fluid (CSF), and extracranial tissues such as fat, skin, and muscles, can be easily classified with different contrast measures. For instance, the T1- and T2-weighted MR images provide good contrast between gray matter and CSF, while T1 and proton density (PD) weighted MR images provide good contrast between gray matter and white matter. In contrast to CT and MRI, PET and SPECT images lack the ability to yield accurate anatomical information. The segmentation task is further complicated by poor spatial resolution and counting statistics, and...

The Tau Hypothesis And Tau Pathology

The fibril morphologies in tau-transgenic mice resemble human tauopathy in the disease from which the mutant tau was derived, not the twisted organization of true NFTs that are common in AD. In most instances, tau in transgenic mice is expressed and deposited in areas where it is not seen in AD and yet is missing from areas in which it is found in AD (Lewis et al., 2001). Major pathology in these models occurs in the spinal cord and brain stem, with much less in cortical areas where the pathology is prominent in humans. Relative amounts of expression of the different splice variants seem to be part of the explanation. No Aft deposits have been detected in tau-only transgenic models. The current state of tauopathy models is summarized by Lee et al. (2005).

Effect of hyperoxia on VO2 under pathological conditions

Cerebral oxygen consumption has been investigated in 37 severely brain injured patients40. A maximum of seven treatments per patient had been applied at 151.9kPa (1.5ata) for 60 minutes. Patients were divided into the three categories of reduced, normal or increased pre-session cerebral blood flow. Cerebral blood flow, arterial venous oxygen content difference, cerebral metabolic rate of oxygen (CMRO2), ventricular cerebrospinal fluid lactate and intracranial pressure values were assessed one hour before, and one and six hours after HBO therapy. CMRO2 increased and lactate levels decreased after treatment, which suggested an improvement of aerobic

Neurological disability

Finally, the patient should be exposed such that full and complete examination can be undertaken, but at each stage the patient should be protected from hypothermia. Once this first rapid assessment of the patient's condition has been made, his condition should have begun to stabilise, although continued close observation is needed to ensure that further deterioration from a missed injury does not occur. It is only at this stage that initial radiographs (usually chest, cervical spine, pelvis) and basic monitoring (pulse oximetry, electrocardiogram (ECG), urine output) are instituted. Thereafter, a full top-to-toe reassessment of the entire patient is undertaken and specific investigations arranged as clinically indicated.

Sensation And Perception

Neural impulses containing sensory information are conveyed from specialized receptors by way of efferent (sensory) nerves to the central nervous system (spinal cord and brain). Then, neural impulses are conveyed from the central nervous system by way of efferent (motor) nerves to the muscles and glands. Combined with the secretions of certain glands, the two types of peripheral nerves afferent and efferent make up the information highway of the body. The efficiency with which sensory information is received, conducted, processed, and acted upon determines how effectively the individual is able to sustain and enhance his or her existence. Conducting information from the external world to the spinal cord and brain is, of course, not only a matter of the intactness of neural transmission pathways but also the specialized receptors connected to those pathways.

Feeding ecology and diet

The purpose of the spine-tipped tail and oddly shaped femur become apparent when logrunners feed. A feeding bird spreads its tail and rests the spine-like quills against the ground. To expose the soil, the bird rakes a foot through the leaf litter and fallen sticks, throwing the leg to the side, perpendicular to the body. Once the ground is sufficiently cleared to feed, the legs are used alternately to scratch the soil front to back in search of insects, larvae and other invertebrates that form the diet, balancing on one leg while at the same time using the tail as a supporting prop. Pivoting around the tail, logrunners produce distinctive small cleared patches about 8 in (20 cm) in diameter on the forest floor. A foraging bird spends a brief period scratching at the one spot before moving on to another a short distance away. Smaller ground-feeding birds, such as the yellow-throated scrubwren (Sericornis citreogularis) and eastern whipbird (Psophodes oli-vaceus), may attend foraging...

Autonomic Innervation Of The Heart

Both the sympathetic and parasympathetic nerves are composed of a two-neuron pathway. These two neurons meet, or synapse, somewhere in the middle and form a structure called a ganglion ( swelling ). Neurons of the sympathetic nervous system emerge from the spinal cord. They emerge from all eight of the cervical segments and the first five of the thoracic spinal cord segments. These neurons travel laterally just centimeters from the spinal cord before they synapse. All of the neurons to the heart are believed to synapse in only two places the middle cervical ganglion and the cervicothoracic (fused inferior cervical first thoracic or stellate star-shaped ) ganglion. Multitudes of fibers then emanate from these ganglia and run to the heart as sympathetic cardiac nerves.

Anaplastic Astrocytoma

The AA can be quite variable in location but nearly all are supratentorial and most are centered in the deep white matter and may secondarily involve the deep gray-matter structures. These masses generally have poorly defined margins and are somewhat heterogeneous in signal intensity characteristics on all MR pulse sequences, most evident on the FLAIR and T2-weighted images (Fig. 1). The amount of surrounding vasogenic edema is quite variable but more commonly relatively mild and frequently indistinguishable from the margins of the nonenhancing component of the mass. Consequently, it is difficult to determine the true extent of neoplastic cell invasion when planning complete resection by MRI. FLAIR and T2-weighted images certainly demonstrate the extent of parenchymal involvement better than the T1-weighted images but tumor cells can extend into parenchyma that is normal in signal intensity on all pulse sequences. Of the two, the FLAIR images generally make it easier to appreciate the...

Glioblastoma Multiforme

The overwhelming majority ofglioblastomas are solitary, supratentorial, intra-axial masses that spread within the parenchyma along white-matter tracts. In less than 5 of cases, these masses may be multifocal or multicentric. Such masses are thought to arise simultaneously at several sites if the masses are clearly separated by normal appearing white matter on all pulse sequences and are not contiguous with a pial or ependymal surface. Even more commonly than AA, glioblastomas may disseminate within the CSF space along the leptomeninges, ependymal surfaces of the ventricles, and pial surfaces of the brain and or spinal cord to cause cranial nerve symptoms, hydrocephalus, radiculopathies, and myelopathy. It is possible to identify larger deposits of neoplasm that have spread within the CSF as hyperintense to isointense nodules of tissue on FLAIR images or hypointense to isointense masses on T1-weighted images. Gadolinium enhanced T1-weighted imaging is a far more sensitive means of...

Indications for Modified Neck Dissections

Radical neck dissection removes all the lymph node groups from the mandible to the clavicle, and from the midline of the neck to the anterior border of the trapezius muscle. Also removed are the nodes in the tail of the parotid, the internal jugular vein, the spinal accessory nerve, and the sternomastoid muscle. The postauricular, suboccipital, buccinator, perifacial, and retropharyngeal nodes are not removed. The radical operation is recommended for extensive lymph node metastases, gross extranodal spread from nodal metastases, and lymph node metastases around the accessory nerve and internal jugular vein. It is the operation often used for surgical salvage

External Signal Segmentation

The approach that was implemented was based on edge detection, line tracing, and histogram thresholding techniques 43 . The requirements for this process do not differ significantly from those followed in standard chest radiography (CXR) and several of the concepts described in CXR literature are applicable to CT as well 62 . One primary issue in this module was the desired level of accuracy in the removal of the external signals, i.e., signals from the rib cage and spine. Increasing the accuracy level, increased the computational requirements and the complexity of the methodology. Figures 4.11 and 4.12 show the external signal removal for the slices of Figs. 4.6(a) and 4.7(a). A histogram equalization approach was used to remove the regions that correspond to the rib cage and spine that usually are the highest intensity regions in the image. Points on the rib cage were defined using the pixel characteristics of the rib cage and these points were interpolated using a spline...

Genetic and Physiological Influences

Based on the extensive evidence relating central nervous system (CNS) serotonin function to the expression of psychosocial factors like hostility and the potentially pathogenic biobe-havioral characteristics that are found in persons with high hostility, Williams (1994) proposed that reduced CNS serotonin function is one brain mechanism that could account for the clustering of hostility and biobehavioral factors that increase disease risk. Using the prolactin response to fenfluramine citalopram challenge as an index of CNS serotonin function, Manuck's research group has provided extensive evidence supporting this hypothesis, showing that lower CNS serotonin function is associated with increased aggressiveness (Manuck et al, 1998, 2002), increased expression of the metabolic syndrome (Muldoon et al, 2006), and even increased carotid arteriosclerosis (Muldoon et al, 2007). They have also used cerebrospinal fluid (CSF) levels of the major serotonin metabolite 5HIAA to index CNS serotonin...

Endotracheal intubation

Nasotracheal intubation involves directing an ETT through the nasal passage and into the trachea. It can be done blindly or with a fiberoptic bronchoscope. It is done without the assistance of a laryngoscope and has been advocated by some to be the method of choice in cervical spinal cord injury where manipulation of the neck is to be avoided. Its primary indication is for rapid awake intubations (e.g. decompensat-ing COAD) where sedation would be undesirable. Other indications for nasotracheal intubation include elective oral surgery or limited mouth opening (e.g. temporo-mandibular joint (TMJ) dysfunction). It is contra-indicated in severe facial trauma to avoid placement of the tube through the cribiform plate, which has happened Advantages of nasotra-cheal intubation are ease of communication for the patient (and potentially less need of sedation), easier mouth care, avoidance of occlusion of the tube by biting down (good in pediatrics or head injury). Disadvantages are that a...

Selective Neck Dissection

The MD Anderson University of Texas Cancer Center and the Memorial Sloan-Kettering group popularized the concept of selective neck dissection. It evolved from the modified dissection, which preserved the spinal accessory nerve. Of lesser influence in North America was the concept of the functional neck dissection of Suarez, popularized in the English-speaking world by Bocca. Data assured surgeons that neck recurrence rates with pathologically negative necks and low-staged clinically positive necks were similar regardless if the accessory nerve was sacrificed or not. The long-term functional consequences of accessory nerve sacrifice were described in the 1960s as the shoulder syndrome. Shoulder droop, diminished range of motion, shoulder abduction, and external rotation and pain led to reconsideration of routine nerve sacrifice. Modified neck dissection that preserved the accessory nerve was a logical first modification. It later became obvious that preserving the nerve, by dissecting...

Guidelines for Survivorship Care

In many situations, however, there is not even a plausible rationale to intensely monitor asymptomatic patients in order to find incurable distant recurrence. Conventional wisdom is that if cancer is caught early it can be cured, but unfortunately the same is usually not true of early detection of metastatic cancer. Second-look surgeries to detect recurrence of ovarian and pancreatic cancers have not been associated with improved outcomes because such recurrences are generally not curable.17 Moreover, early institution of palliative chemotherapy in asymptomatic patients does not appear to provide benefit in most situations.11,18 Detecting and preventing potentially catastrophic complications of recurrence like spinal cord compression and pathological fracture has been put forth as a rationale for surveillance in situations in which recurrences will always be incurable, but randomized trials have not been able to detect a benefit from this.19

Neurohumoral Interactions Contributing To Cardiac Control

Figure 2 summarizes the current working hypothesis for neurohumoral interactions involved in the control of cardiac function. Data indicate that a hierarchy of peripheral autonomic neurons function interdepen-dently via nested feedback loops to regulate cardiac function on a beat-to-beat basis. Figure 2 summarizes the emerging concept of neural control of the heart as mediated by intrathoracic extracardiac and intracardiac neurons, which are continuously influenced by descending projections from higher centers in the spinal cord, brain stem, and suprabulbar regions. Each successive synaptic relay point within this autonomic outflow, from the brain stem to the heart, is in turn influenced by afferent feedback from various cardiopulmonary and vascular afferent receptors. Accumulating evidence suggests that there may be at least four functionally distinct neuronal types within the intrinsic cardiac nerve plexus (see earlier discussion) parasympathetic postganglionic efferent neurons...

Disease associations of HHV6A and 6B variants

One complication of CNS disease with HHV-6 could be seizures. CNS involvement may lead to meningitis and encephalitis or encephalopathy (Suga et al., 1993). The CNS is most likely one of the sites of persistence of virus following primary infection. Both variants have been detected in the cerebral spinal fluids (CSF). There is more recent evidence that HHV-6A may have a greater neurotropism (Aberle et al., 1996 Hall et al., 1998). In this study 84 of 660 CSF samples from children under 3 years of age with or without febrile illness were HHV-6 positive by PCR. Seven children had primary infection, and in the remaining 77, HHV-6 was detected in periferal blood mononuclear cells (PBMC) and CSF in 30 (39 ). In CSF alone, 47 (61 ) HHV-6A was detected more frequently than in PBMCs. In children who had HHV-6 in PBMCs and CSF, variant B was detected in the former

Astrocyte glycine transporters

Astroglial cells are heavily involved in transportation of glycine, which acts as a neurotransmitter (inhibitory as well as excitatory) in several regions of the nervous system, particularly in the spinal cord. In addition, glycine is an important neuromodulator acting on NMDA receptors throughout the brain. Glycine transporters present in neurones and astrocytes are functionally and structurally different. Astrocytes predominantly express Glycine transporter 1 (GlyTl), while neurones express GlyT2 both cotransport glycine with Na+ and Cl-, yet their stoi-chiometry is different. Glycine translocation by GlyTl is coupled with cotransport of 2 Na+ and 1 Cl-, whereas GlyT2 requires cotransporting 3 Na+ and 1 Cl-. As a consequence, the reversal potential of glial GlyT1 is very close to the resting membrane potential, and therefore even a slight depolarization may promote the

Evolution and systematics

Despite vacillations regarding the overall taxonomic placement of puffbirds, their closest relatives have never been in doubt a convincing array of morphological features indicates a link with jacamars (Galbulidae). The two families are traditionally combined to form the Galbulae, a suborder within Piciformes. They differ in bill shape, general comportment, the form of the spinal cord (puffbirds exhibit Piciforme design, jacamars that of Coraciiformes), and number of ribs.

Interactions within the ICN

FIGURE 2 Schematic of proposed neural interactions occurring within the intrathoracic autonomic ganglia and between these peripheral networks and the central nervous system. Within the intrinsic cardiac ganglia are included sympathetic (Sympath) and parasympathetic (Parasym) efferent neurons, local circuit neurons (LCN), and afferent neurons. Contained within the extracardiac intrathoracic ganglia are sympathetic efferent neurons, local circuit neurons, and afferent neurons. These intrinsic cardiac and extracardiac networks form separate and distinct nested feedback loops that act in concert with CNS feedback loops involving the spinal cord and medulla to regulate cardiac function on a beat-to-beat basis. These nerve networks are also influenced by circulating humoral factors, including catecholamines (catechol) and angiotensin II (ANG II). Aff., afferent DRG, dorsal root ganglia Gs, stimulatory guanine nucleotide-binding protein Gi, inhibitory guanine nucleotide-binding protein AC,...

Enhanced genital blood flow

The capacity of certain stimuli to produce sexual arousal in the absence of mental representations is probably most evident in the case of tactile stimuli. For example, mechanical stimulation of the clitoris is a most efficient stimulus for enhancing vaginal blood flow. Reflex connections between the sensory receptors in the clitoris and the clitoral vaginal vascular system (Shafik, 1995) as well as between sensory receptors in the penis and its vascular supply have been described (see Giuliano and Rampin, 2004, for a review). Women with spinal cord transection at levels above the sacrum will respond to clitoral stimulation with tumescence of that structure and vaginal lubrication (Sipski et al., 2001). Men in a similar condition also experience erection in response to tactile stimulation of the penis (Riddoch, 1917 Kuhn, 1950 Courtois et al., 1993). Women and men with spinal transection do not consciously register the stimulation, meaning that they do not feel it. This makes it...

Picornaviruses Poliovirus

Poliovirus (PV) is a nonenveloped, positive-stranded RNA virus, which is responsible for causing poliomyelitis. PV RNA is composed of a 5'-nontranslated region that contains an internal ribosomal entry site (IRES) which directs the synthesis of a single polypeptide that is subsequently processed by viral proteases into structural and nonstructural proteins (75). Polioviruses tropism is restricted to cells expressing CD155, a member of the Ig superfamily, which is prevalent on lower motor neurons resident within the spinal cord and brainstem (138). The IRES elements encode strong cell-type specific restrictions and probably play a key role in the neurovirulent behavior of the virus. It subsequently became apparent, that other viruses, such as hepatitis C virus (HCV) or rhinoviruses also contain IRES elements. Experiments into the importance of the IRES elements lead to creation of a poliovirus chimera (referred to as PV1) (139), which contained the human rhinovirus type 2 IRES element....

Interactions within the Intrathoracic Nervous System

Coordination of autonomic outflows from intrathoracic neurons to cardiomyocytes depends to a large extent on sharing of inputs from higher centers along with interactions among and between various peripheral ganglia. Interactions within and between intrathoracic ganglia involve local circuit neurons (see earlier discussion). Activities generated by neurons in intrinsic cardiac ganglia demonstrate no consistent short-term relationship to neurons in extracardiac ganglia (19). However, the sharing of cardiopulmonary afferent information acting through both intrathoracic and brain stem spinal cord feedback loops permits an overall coordination of ef

Cholinergic Mechanisms

Myocardial ischemia reflects an imbalance in the supply demand balance within the heart with resultant activation of cardiac afferent neurons and, as a consequence, the perception of symptoms (i.e., angina pectoris) (49). In addition to such nociceptive responses, activating cardiac afferent neurons can elicit autonomic and somatic reflexes (18, 49). Pharmacological, surgical, and angioplasty therapies are commonly used to improve symptoms and cardiac function in patients exhibiting angina pectoris. Despite the fact that these treatments are usually successful, some patients still suffer from pain of cardiac origin following these procedures (74, 114). Epidural stimulation of the spinal cord (SCS) has been suggested as an alternative to bypass surgery in high-risk patients (81). With SCS, high-frequency, low-intensity electrical stimuli are delivered to the dorsal aspect of the T1-T2 segments of the thoracic spinal cord. This therapy decreases the frequency and intensity of anginal...

Possible Role for FMRP in Regulating Actin Cytoskeletal Dynamics

Castets et al. (2005) have reported a very exciting set of observations that may provide a link between FMRP and the actin dynamics likely to determine the shape of dendritic spines. In particular, they have demonstrated that FMRP appears to bind directly to the 5'-UTR of mRNA for phosphoser-ine threonine phosphatase (PP2A Zolnierowicz 2000), thus diminishing its translation. PP2A is a mediator of Rac1-coupled actin remodeling (Hall 1998 Janssens et al. 2005), which operates by shifting the balance from the inactive (phospho) to the active (dephospho) form of cofilin, an actin depolymerizing protein (Ambach et al. 2000 Meberg and Bamburg 2000 Samstag and Nebl 2003 Paavilainen et al. 2004). The principal finding of Castets et al. (2005) was that Rac1-induced actin remodeling was enhanced in cells that either lacked FMRP or possessed mutant forms of FMRP in which either the KH1 or KH2 domains were altered. These observations provide a possible basis for the altered dendritic spine...


The following tests should be performed on all patients with AIDS a lumbar spine X-ray in the standard anteroposterior and lateral views, bone density measurement (DEXA scan) of the lumbar spine and hip and laboratory blood tests, including calcium, phosphate and alkaline phosphatase. Osteopenia should be treated with 1000 I.E. vitamin D daily and a calcium-rich diet or calcium tablets with a dose of 1200 mg day. Patients should be advised to exercise and give up alcohol and nicotine. In cases with osteoporosis, bisphosphonates (e.g. alendronat 70 mg once a week) should be added. The tablets should be taken on an empty stomach 30 min before breakfast, and an upright position should be maintained for at least 30 min. No calcium should be taken on this day. Antiretroviral therapy should not be taken together with calcium. Because testosterone suppresses osteoclasts, hypogonadism should be treated. Alcohol and smoking should be avoided regular exercise is an essential part of the therapy.

The Molecular Basis of FXTAS

Although the precise molecular mechanism of FXTAS is not known, two observations led to the proposal of an RNA toxic gain-of-function model for disease pathogenesis in FXTAS (Hagerman et al. 2001 Greco et al. 2002 Jacquemont et al. 2003 Hagerman and Hagerman 2004). First, (expanded-repeat) FMR1 mRNA levels are elevated by up to eightfold in premutation carriers, even though FMRP levels are normal to slightly reduced in the premutation range (Tassone et al. 2000a, b Kenneson et al. 2001). Second, FXTAS has not been reported in adults who harbor hypermethylated (silenced) full-mutation alleles, where little or no FMR1 mRNA is produced. In support of this RNA toxicity model, Jin et al. (2003) demonstrated that an expanded approximately 90 r(CGG) repeat, when expressed in the 5'-UTR context of an unrelated reporter gene, was still capable of inducing neuropathology (including inclusion formation) in the eye of the fly (Drosophila). This observation provided a direct demonstration that the...

Channel Catfish Ictalurus punctatus

Physical characteristics Channel catfish are about 3 feet, 11 inches (1.3 meters) long and weigh about 58 pounds (26 kilograms). The mouth has four pairs of barbels. The adipose fin is small and far from the caudal fin, which is deeply forked. The spine on each pectoral fin has sawlike teeth at the end. Young channel catfish are mottled and brownish on the back and whitish on the belly. Adults are mainly deep brown.

Structure and Expression of GPR54

The human GPR54 gene has five exons and four introns in a length of approximately 3.5 kb. It encodes a seven-transmembrane receptor with 398 amino acids and has also a weak homology with the galanin receptors, although neither galanin nor galanin- like peptide bind to GPR54 (Fig. 1).14-16 The human GPR54 receptor, also named AXOR12 and hOT7T175, is widely expressed in the brain, particularly in the hypothalamus, midbrain, pons, medulla, hippocampus, and amygdala and also in the pituitary, pancreas, placenta, and spinal cord.14-16 Lower level expression was found in the heart, muscle, kidney, liver, intestine, thymus, lung, and testis.14-16

Project Title Cvd Risk Health In Postmenopausal Phytoestrogen Users

Summary (Adapted from Investigator's Abstract) In the United States, heart disease is the leading cause of death in postmenopausal women. Estrogen replacement therapy is beneficial for heart disease risk factors as well as for bone density. However, a large proportion of postmenopausal women are not compliant with therapeutic regimens. Phytoestrogens are naturally occurring compounds found in plants and soy products that have estrogenic effects, and may represent an alternative treatment for the prevention of heart disease and osteoporosis in postmenopausal women. However, few intervention trials have examined the extent to which it is possible to improve heart disease risk factors, bone density, and quality of life in postmenopausal women through use of a dietary supplement of Phytoestrogen. The proposed randomized, double-blind, placebo controlled study is designed to determine the acceptability and benefits of use of a dietary supplement of Phytoestrogen (genistein) versus placebo...

In Vivo Studies and Tissue Specificity of Gene Transfer

The feasibility of Ad vector-mediated gene transfer in vitro posed the question of the efficiency of this vector system in vivo. Because Ad gene transfer vectors are made from human adenoviruses, there was no a priori reason to believe they would infect rodents or other model animals. Some early studies used cotton rats because this species had been shown previously to be permissive for replication of human adenoviruses (52-54). For example, intratracheal administration of a replication-deficient virus expressing the reporter gene p-galac-tosidase to cotton rats resulted in expression of p-galactosi-dase in the airway epithelium (55). Numerous other animals have been used to demonstrate efficient adenovirus vector-mediated gene transfer, including rats, mice, pigs, rabbits, and nonhuman primates. From these studies, a number of general conclusions can be drawn. Importantly, many tissues can be infected based on the route of administration. As expected from the tropism of Ad5, the...

Amino Acids as Neurotransmitters

The inhibitory effects of glycine are very important in the spinal cord, where they help in the control of skeletal movements. Flexion of an arm, for example, involves stimulation of the flexor muscles by motor neurons in the spinal cord. The motor neurons that innervate the antagonistic extensor muscles are inhibited by IPSPs produced by glycine released from other neurons. The importance of the inhibitory actions of glycine is revealed by the deadly effects of strychnine, a poison that causes spastic paralysis by specifically blocking the glycine receptor proteins. Animals poisoned with strychnine die from asphyxiation because they are unable to relax the diaphragm. g Benzodiazepines are drugs that act to increase the ability of GABA to activate its receptors in the brain j and spinal cord. Since GABA inhibits the activity of

Ricardo C Sampaio And Charles L Truwit

Abstract Myelination in the human central nervous system (CNS) is a complex but orderly process, occurring in predictable topographical and chronological sequences. CNS myelination begins as early as 12-14 weeks of gestation in the spinal cord and continues well into the fourth decade of life. The most significant period of CNS myelination, however, occurs between midgestation and the second postnatal year. Myelination can be studied by various methods, including myelin-stained histopathological brain sections and, more recently, magnetic resonance (MR) imaging. The latter constitutes the focus of this chapter. weeks of gestation in the spinal cord and continues well into the third and fourth decades of life in the intra-cortical fibers of the cerebral cortex but the most important and dramatic changes occur between mid-gestation and the end of the second postnatal year, with myelination accounting in large part for the large gain in brain weight, which more than triples during this...

The Androgen Receptor Gene

The AR is a member ofthe superfamily of steroid receptors and like most receptors in this family has a DNA binding domain, a hormone binding domain and a transcription modulatory domain which for the AR is completely encoded by the large exon 1 of the AR gene (15). The AR gene maps to the long arm of the X chromosome (15). Within exon 1 are two highly polymorphic tri-nucleotide repeats a (CAG)n and a (GGC)n . We became interested initially in the CAG repeat with the recognition that an expansion of that repeat from the normal size range of approximately 8-33 to 36 or greater, was the cause of an uncommon adult onset motor neuron disease, spinal and bulbar muscular atrophy, or Kennedy's disease (16). Men with Kennedy's disease have evidence of hypoandrogenization, including gynecomastia, low sperm counts, and sub-fertility (17). In-vitro studies have demonstrated that ARs with an expanded glutamine tract encoded by this repeat, bind androgens normally but transactivate androgen...

Polypeptides as Neurotransmitters

Spinal motor neurons that innervate skeletal muscles, the intravenous infusion of benzodiazepines acts to inhibit the muscular spasms in epileptic seizures and seizures resulting from drug overdose and poisons. Probably as a result of its general inhibitory effects on the brain, GABA also functions as a neurotransmitter involved in mood and emotion. Benzodiazepines such as Valium are thus given orally to treat anxiety and sleeplessness. Exogenous opioids such as opium and morphine can produce euphoria, and so endogenous opioids may mediate reward or positive reinforcement pathways. This is consistent with the observation that overeating in genetically obese mice can be blocked by naloxone. It has also been suggested that the feeling of well-being and reduced anxiety following exercise (the joggers high ) may be an effect of endogenous opioids. Blood levels of P-endorphin increase when exercise is performed at greater than 60 of the maximal oxygen uptake (see chapter 12) and peak 15...

Strategies Using Nonviral Vectors In Cancer Gene Therapy

Lipoplex has been shown to greatly enhance the efficiency of gene transfer in the spinal cord (70), lungs (71), and tumors (72), both, by intratumoral injection and intravenous injection. That delivery of cationic liposomes is safe in humans, even with the high charge ratio of cationic liposome to DNA, was shown early in gene therapy trials (41,73). This was in contrast to the previous understanding that the positive charge of cationic liposomes led to potential harmfull aggregations with serum proteins that could impede blood circulation and hemostasis. In clinical studies, complex of DNA and cationic liposomes induces gene expression resulting in reduction of tumor size (74). That repeated administration of lipoplex is feasible and well supported was made evident in a recent clinical study in patients with cystic fibrosis (75). In that study, repeated administration of the cystic fibrosis transmembrane regulator (CFTR) cDNA in DC-Chol DOPE cationic liposomes resulted in continued...

General rules of myelination

There are exceptions to these rules, however. In the spinal and cranial nerves, motor roots myelinate earliest and rapidly, and anticipate myelination of the sensory roots. Maturation of myelin occurs in the optic tract before it does in the optic chiasm. Similarly, myelination is completed in the auditory radiation before it is in the brachium of the inferior colliculus. In addition, myelination of the callosal rostrum, genu, body, and splenium occurs before the respective subcortical and central white matter origins (Kinney et al., 1994).

Review Activities

Grafting peripheral nerves onto the two parts of a cut spinal cord in rats was found to restore some function in the hind limbs. Apparently, when the white matter of the peripheral nerve was joined to the gray matter of the spinal cord, some regeneration of central neurons occurred across the two spinal cord sections. What c. glycine in the spinal cord.

MR of postnatal brain development

Tl-weighted images look like cut brain. Cerebrospinal fluid spaces, such as the ventricles and sulci, are dark on Tl-weighted images. Fatty tissues are bright. Myelin, containing phospholipids, is also bright relative to other intracranial structures. Thus, by the process of myelination, brain areas that are myelinated appear bright or hyperintense relative to other areas on the image. Moreover, areas of the brain with very tightly packed fiber bundles, such as the corpus callosum, extrude any free water from their myelin fibers and thus appear even brighter on the image.

Neurogenesis in the adult brain

In many vertebrates, neurogenesis persists throughout adulthood throughout the CNS. For example, new neurones are continuously born in all brain regions in birds, whilst lizards can very effectively regenerate the retina and spinal cord. In primates, including humans, neurogenesis in the adult is restricted to the hippocampus and subventricular zone. In both locations, the stem elements that produce neurones are astroglia. These 'stem' astrocytes have the morphology, physiology and biochem-ical immunological markers characteristic for astrocytes they express GFAP, form vascular endfeet, have negative resting membrane potentials, are nonexcitable, and predominantly express K+ channels. 'Stem' astrocytes differ from 'classical' mature astrocytes by specific expression of the protein nestin (a marker for neural stem cells), and some of them form cilia. Neurones born in the subventricular zone migrate to the olfactory bulb, whereas those produced in the hippocampus remain there and...

Zebrafish as a Model for Aging

-galactosidase staining Protein oxidation Spinal curvature appearance of senescence-associated -galactosidase staining and oxidized protein (Kishi et al., 2003). Additionally, spinal curvature occurs with age in zebrafish (Gerhard et al., 2002b). Fish have been said to show three types of senescence rapid, gradual, and negligible. Teleost fish, of which zebrafish are members, generally undergo gradual senescence, as observed in most vertebrates (Kishi et al., 2003). Whether or not zebrafish undergo gradual senescence as well is not yet fully understood, though they are reported to show increasing senescent morphology with aging, including spinal curvature and muscle degeneration (Gerhard et al., 2002b). It has also been suggested that zebrafish may undergo ''very gradual senescence'' based on molecular changes, including senescence-associated -galactosidase activity and accumulation of oxidized protein with age in the face of continuously proliferating myocytes and constitutive...

Clinical Features and Pathology

Friedreich ataxia (FA) is the most common of the early-onset hereditary ataxias in Indo-European and North African populations. The disease was first described in 1863 by Nickolaus Friedreich, Professor of Medicine at Heidelberg. Although Friedreich's papers described the essential clinical and pathological features of the disease as degenerative atrophy of the posterior columns of the spinal cord leading to progressive ataxia, sensory loss and muscle weakness, often associated with scoliosis, foot deformity and heart disease, subsequent descriptions of atypical cases and of clinically similar diseases clouded classification for many years. Diagnostic criteria were established in the late 1970s, after a renewed interest in the disease prompted several rigorous clinical studies (Geoffroy et al. 1976 Harding 1981). The following clinical features were considered essential to establish the diagnosis (1) autosomal recessive inheritance, (2) onset before 25 years of age, (3) progressive...

Multiple System Atrophy

MSA refers to a neurodegenerative disease characterized by parkinsonism, cerebellar ataxia, and orthostatic hypotension (31). There is no known genetic risk factor or genetic locus in MSA. The MSA brain shows varying degrees of atrophy of the cerebellum, cerebellar peduncles, pons and medulla, as well as atrophy and discoloration of the posterolateral putamen and pigment loss in the substantia nigra. The histopathological findings include neuronal loss, gliosis, and microvacuolation, involving the putamen, substantia nigra, cerebellum, olivary nucleus, pontine base, and intermediolateral cell column of the spinal cord. White matter inevitably shows demyelination, with the brunt of the changes affecting white matter tracts in the cerebellum and pons (Fig. 3).

Gliogenesis in adult brain

In the adult brain, in contrast to neurogenesis, gliogenesis occurs everywhere. New glial cells are born locally and the locality also mainly determines the type of glial cell produced. In the subcortical white matter most of the newly produced glial cells are oligodendrocytes, whereas in the spinal cord astrocytes and oligodendrocytes are produced roughly in the same quantities.

Hyperbaric oxygen HBO

Pressures48'49 with an ensuing reduction in neuronal apoptosis following ischemic damage of the brain and spinal cord 14,50-56. This might seem paradoxical given the nature of hyperoxic vasoconstriction (see chapter 1.5) and indeed the literature is divided on this mechanism48,57-59. However, changes in NO levels may explain the differential and sometimes variably detrimental or positive effects of HBO58, 60.

Gene Structure and Expression

The gene is expressed in all cells, but at variable levels in different tissues and at different times during development (Campuzano et al. 1996 Jiraler-spong et al. 1997 Koutnikova et al. 1997). In adult humans, frataxin mRNA and protein are most abundant in the heart, brain and spinal cord, followed by liver, skeletal muscle, and pancreas. In mouse embryos, expression starts in the neuroepithelium at embryonic day 10.5 (E10.5), then reaches its highest level at E14.5 and into the postnatal period (Jiralerspong et al. 1997 Koutnikova et al. 1997). In developing mice, the highest levels of frataxin mRNA are found in the spinal cord, particularly at the thoracolumbar level, and in the DRG. The developing brain is also very rich in frataxin mRNA, which is abundant in the proliferating neural cells in the periventricular zone, in the cortical plates, and in the ganglionic eminence. Robust expression is also detected in the heart, in the axial skeleton, and in some epithelial (skin,...

Sequences of CNS myelination

Myelin sheaths appear in the motor root fibers of the spinal nerves at the end of the fourth fetal month, while the sensory fibers begin to myelinate at the end of the fifth month. The motor nerve roots reach their adult pattern of myelination at about term while the sensory nerve rootlets continue to myelinate for several months after birth. Among the cranial nerves, the roots of the eighth pair are the first to show myelinated fibers. At the end of the fifth fetal month, the roots of both divisions of the eighth nerve are myelinated. The oculomotor nerves (III, IV, VI) and the motor division of the trigeminal nerve myelinate next, at about the same time. As in the spinal roots, the cranial motor roots seem to myelinate at a faster pace than the sensory roots. The cycle of myelination of the cranial nerve roots appears to be completed early in the first postnatal year. Except for the dorsal root fibers in the posterior columns of the spinal cord, there are no myelinated fibers in the...

Prospective Basic Studies of Aging and Senescence in Zebrafish

However, humans possess only a limited capacity to restore their missing or injured body parts. Therefore, stimulating regenerative capability may circumvent some tissue deterioration in aging humans. Adult zebrafish have been shown to possess a remarkable capacity for regeneration. Zebrafish regenerate almost all tissues and organs such as fins, spinal cord, retina, and heart. By dissecting molecular mechanisms of zebrafish regeneration, it may be possible to illuminate novel factors that can stimulate a regenerative response in higher vertebrates. Thus, research of regeneration in zebrafish during the aging process will contribute to aging medicine as well as to regenerative medicine in humans.

Divisions of the Autonomic Nervous System

Preganglionic neurons of the sympathetic division of the autonomic system originate in the thoracic and lumbar levels of the spinal cord and send axons to sympathetic ganglia, which parallel the spinal cord. Preganglionic neurons of the parasympathetic division, by contrast, originate in the brain and in the sacral level of the spinal cord, and send axons to ganglia located in or near the effector organs.

No Common Name Antrobathynella stammeri

Physical characteristics Males and females have a row of four spines at the base of the uropods. The spine closest to the front of the body is larger and distinctly separated from the others. The base of the seventh leg of the male has a clear, cone-shaped bump on the inside.

Parasympathetic Division

The parasympathetic division is also known as the craniosacral division of the autonomic system. This is because its preganglionic fibers originate in the brain (specifically, in the midbrain, medulla oblongata, and pons) and in the second through fourth sacral levels of the spinal column. These pre-ganglionic parasympathetic fibers synapse in ganglia that are located next to or actually within the organs innervated. These parasympathetic ganglia, called terminal ganglia, supply the postganglionic fibers that synapse with the effector cells. The comparative structures of the sympathetic and parasympathetic divisions are listed in tables 9.2 and 9.3. It should be noted that most parasympathetic fibers do not travel within spinal nerves, as do sympathetic fibers. As a result, cutaneous effectors (blood vessels, sweat glands, and arrector pili muscles) and blood vessels in skeletal muscles receive sympathetic but not parasympathetic innervation. Figure 9.3 The pathway of sympathetic...

Expression Studies

Kisspeptin and GPR54 are widely expressed in human tissues.15,16,18 It was demonstrated by RT-PCR that KISS1 mRNA is expressed mainly in the placenta, but also in the brain, including the hypothalamus, basal ganglia, pituitary, and peripheral organs, such as pancreas, testis and, in lower levels, in the liver and small intestine.15,16,18 GPR54 transcripts were particularly abundant in placenta, brain, pituitary, spinal cord, and pancreas, whereas lower levels were detected in other tissues, including lymphocytes, spleen, testis, and adipose tissue.15,16,18

Structural function creation of the functional microarchitecture of the brain

Using clearly delineated anatomical territories, astrocytes divide the whole of grey matter (both in the brain and in the spinal cord) into separate domains, the elements of which (neurones, synaptic terminals and blood vessels) are integrated via the processes of protoplasmic astrocytes the membranes of a single astrocyte

The Extremities and Bone

For example, painful sacral fractures are a late effect of pelvic radiation that can be concerning for local recurrence or osseous spread of a malignancy like rectal cancer. A history of radiation is associated with increased risk of spinal compression fractures within the field. Recently an increased risk of hip fracture has also been recognized following pelvic radiation.44 Providers must recognize that in these patients osteopenia and osteoporosis may be focal, and if present, consider interventions such as bisphosphonates and recommendations for weight-bearing and muscle-strengthening exercise.

Dissecting Through Fascial Spaces

The Latin approach is based on the anatomical compartmentalization of the neck. The fascial system creates spaces and barriers separating the lymphatic tissue from the remaining neck structures. The lymphatic system of the neck is contained within a fascial envelope, which, under normal conditions, may be removed without taking out other neck structures such as the internal jugular vein, sternocleidomastoid muscle, or spinal accessory nerve. The surgical technique that made this possible was initially referred to as functional neck dissection because it allowed a more functional approach to the neck in head and neck cancer patients. However, as previously emphasized, the most important but less well known fact about functional neck dissection is that it represents a surgical concept with no implications regarding the extent of the surgery. Osvaldo Suarez never performed functional neck dissection as the comprehensive type of neck dissection that some have made of it. In fact, the...

Temperature Sensation

The cutaneous representation of pain perception by the three divisions of the spinal trigeminal nucleus. Area C has its cellular components in the rostral part of the nucleus and area A is in the caudal part of the nucleus, while area B is intermediate. Figure 8-4. The cutaneous representation of pain perception by the three divisions of the spinal trigeminal nucleus. Area C has its cellular components in the rostral part of the nucleus and area A is in the caudal part of the nucleus, while area B is intermediate.

Frataxin Structure and Function

The FA gene (FRDA) (Chamberlain et al. 1988 Campuzano et al. 1996) encodes a small mitochondrial matrix protein, frataxin that is highly conserved in evolution. A single frataxin gene is found in all eukaryotes, including fungi and plants. A homologue, CyaY, is present in Gram-negative bacteria and in other prokaryotes like Rickettsia prowazeckii, thought to be related to the hypothetical mitochondrial precursor. FRDA is expressed in all cells, but at variable levels in different tissues and during development (Koutnikova et al. 1997 Jiralerspong et al. 1997). In adult humans, frataxin mRNA is most abundant in the heart, brain, and spinal cord, followed by liver, skeletal muscle, and pancreas.

Vestibular Apparatus and Equilibrium

The sensory structures of the vestibular apparatus and cochlea are located within the membranous labyrinth (fig. 10.12), a tubular structure that is filled with a fluid similar in composition to intracellular fluid. This fluid is called endolymph. The membranous labyrinth is located within a bony cavity in the skull, the bony labyrinth. Within this cavity, between the membranous labyrinth and the bone, is a fluid called perilymph. Perilymph is similar in composition to cerebrospinal fluid.

Systemic Manifestations

More than 30 of skeletal TB cases involve the spine (tuberculous spondylitis or Pott's disease). The most commonly affected area is the lower thoracic spine, followed by the lumbar, cervical, and sacral areas. The mode of spread to the spine is usually hematogenous, but it also can result from contiguous disease or lymphatic spread from TB pleuritis. In contrast to common bacterial causes of spinal osteomyelitis that initially present as discitis with adjacent vertebral body involvement, TB spondylitis typically begins within the anterior vertebral body. With time, spread to the adjacent disc and vertebra occurs, and vertebral body wedging develops. Pott's disease is a disease of older age in developed countries and presents with local symptoms of pain and stiffness without systemic manifestations such as fever or weight loss. Initial roentgenograms can be negative. Thus, the diagnosis can be difficult to make, and late complications often appear. These can include...

Humoral Immunity As Indirect Evidence For Autoimmunity In Ms

Although CSF IgG is typically the only Ig isotype measured by clinical laboratories, published studies indicate that CSF IgM levels and OCBs composed of IgM may also portend a worse prognosis, perhaps with better accuracy than magnetic resonance imaging (MRI) (102,103). The presence of IgM OCBs in the initial diagnostic spinal tap has been associated with both increased disability accumulation (P 0.002) and with conversion to secondary progressive MS (P 0.0009) (104).

Development and Initial Field Trials of Yellow Fever 17D Vaccine

Between 1934 and 1936, multiple attempts were made to cultivate the Asibi virus in other substrates that might favor selection of attenuated variants, including minced tissue culture of mouse and guinea pig testicle, and of chick embryo 49 . After initial propagation in whole mouse embryo tissue culture, passage to these alternative substrates was achieved, in each case with an attendant decrease in vis-certotropism of the virus. Since neurotropism was not markedly diminished it was decided to attempt sequential passages in chicken embryo tissues from which brain and spinal cord had been removed before mincing. The most important experiment, designated 17D, was initiated after 18 subcultures in whole mouse embryo cultures, as which point the virus as passed to whole minced chick-embryo cultures. After 59 subcultures in the latter tissue, the virus was then passed in minced chick embryo devoid of nervous tissue, each subpassage being checked for virus intracerebral inoculation of mice....

Astrocytes and extracellular potassium homeostasis

During intense (but still physiological) neuronal activity the extracellular potassium concentration may rise almost twice, from 2-2.5 mM to 4-4.2 mM such an increase can be observed, for example, in the cat spinal cord during rhythmic and repetitive flexion extension of the knee joint. As a rule, however, during regular physiological activity in the CNS the K+ o rarely increases by more than 0.2 to 0.4 mM. Nonetheless, locally, in tiny microdomains such as for instance occurring in narrow clefts between neuronal and astroglial membranes in perisynaptic areas, K+ o may transiently attain much higher levels. The relatively small rises in K+ o accompanying physiological neuronal activity indicate that powerful mechanisms controlling extracellular potassium are in operation. Disruption of these mechanisms, which do occur in pathology, results in a profound K+ o dyshomeostasis upon epileptic seizures, for example, K+ o may reach 10-12 mM, while during brain ischaemia and spreading...

How Does Growth Hormone Gain Access To The

There is some evidence that GH can enter cerebral spinal fluid (CSF), at least at high secretory rates (55), and that exogenous GH can affect CSF endorphin levels (56). As mentioned earlier, GH might enter the CNS by receptor-mediated or GHBP-mediated transport in the choroid plexus as is suggested for prolactin (57). The choroid plexus has been shown to contain GHR binding sites in humans (58) and in the rat, GHR immunore-activity (5) and GHR gene transcripts (59) have been identified in this region. Alternatively, GH could reach some areas of the hypothalamus by retrograde transport from the pituitary up the pituitary stalk (60). Studies carried out on the ability of iodinated GH to cross the blood-brain barrier have mainly demonstrated low levels of GH uptake (61-63) apart from one earlier study in rat brain (64), although this could change if the blood-brain barrier is compromised, either from disturbances in the pituitary stalk vasculature secondary to tumor growth or to other...

Behavior And Reproduction

Many cusk-eels and their relatives produce sound with their swim bladder, forward vertebrae (ver-teh-BREE), and the ligaments and muscles attached to those vertebrae. The swim bladder is an internal sac that fishes use to control their position in the water. Vertebrae are the bones that make up the spinal column. In some cusk-eels and their relatives, the swim bladder is hard and serves as an echo chamber. Some species make the sound just before mating.

Synapse formation and the development of neuronal connections in the hippocampal formation

Postnatal development of the hippocampal formation and its connections has been described in detail in rats. There are but few available data in primates, and data pertaining to human development are particularly sparse. The lack of empirical study can be partially explained by the difficulties of tissue preservation due to the regulated postmortem delay between the time of death and autopsy. After a few hours' delay, the cellular ultrastructure is obscured in human tissue. In rats, synaptic connections and dendritic development of a few cell types have been described, such as those of the granule cells (Seress and Pokorny, 1981), mossy cells (Ribak, Seress, and Amaral, 1985), and the pyramidal cells of the CA1 area of Ammon's horn (Pokorny and Yamamoto, 1981). Light microscopic changes of the dendrites, such as spine density and spine morphology, correlate with the increasing number of afferent terminals that establish synapses with dendrites of hippocampal neurons. Studies in rats...

The Autoimmune Hypothesis Is Supported By Animal Models

In 1935, Rivers and Schwenkter reported that an inflammatory demyelinating CNS disorder could be induced in monkeys with repeated injections of CNS tissue. The pathology of this disease had similarities to MS and its potential as a model for MS was immediately recognized (136). This model is known as experimental allergic (later autoimmune) encephalomyelitis (EAE). Although EAE does not identically replicate every aspect of MS, its similarities lend plausibility to the theory of auto-immunity as the cause of MS. Many components of the immune response in EAE have been corroborated in human MS, as will be discussed below. In the 1980s, it was demonstrated that this disease, induced readily in certain strains and species with whole spinal cord homogenate, could be induced with specific components of myelin (137). Later, Pettinelli and McFarlin (138) showed that CD4+ T-cells reactive with MBP could transfer the disease, confirming the primary role of T-cells. Moreover, following a single...

Prevention and Treatment of DI

Ironically Paul Bert in 1878 had already validated this concept 8. He had demonstrated that the cause of DI was nitrogen going into gas phase in the tissues and that this bubble formation was responsible for symptoms. Bert understood that prompt recompression was the key to effective treatment. Remarkably, he already highlighted the existence of silent bubbles in the venous blood used oxygen at one atmosphere following very rapid decompression and observed that cardiopulmonary symptoms, but not spinal cord paralysis, were relieved by normobaric oxygen breathing.

Introduction and Disease Features

Histologically, the brain shows degenerative changes which can be easily distinguished from Lafora bodies, the characteristic acid mucopolysaccharide inclusions found in EPM2 (Carpenter and Karpati 1981). The most consistent finding in EPM1 is the marked loss of Purkinje cells in the cerebellum, neuronal loss in medial thalamus and spinal cord, and most likely cell loss in the granular cell layer (Haltia et al. 1969 Koskiniemi et al. 1974a, b Eldridge et al. 1983 Meldium and Bruton 1992 Mascalchi et al. 2002 Takuma et al. 2003). Extracellular and occasionally intracellular periodic acid-Schiff positive granulations were found in neurons and glial cells and in the liver, spleen, heart, lungs, renal tubules, and posterior lobes of the pituitary gland in a large consanguineous Swiss family (Klein et al. 1968 Klein and Rabinowicz 1980). Membrane-bound vacuoles with clear contents in eccrine cells have also been reported in some EPM1 patients (Cochius et al. 1994).