Reflex activation patterns in relation to multidirectional ankle torque in decerebrate cats

Cutaneous reflexes have been described primarily according to their actions in the flexion/extension plane. It is shown here, by measuring electromyography and isometric force in decerebrate cats, that ankle muscles are activated in relation to their actions in the abduction/adduction plane during sural nerve (SNR) and crossed-extension (XER) reflexes. Ankle adductors (tibialis posterior, extensor digitorum longus, and flexors digitorum and hallucis longus) were active in XER, but not in SNR. Muscles producing ankle abduction (medial and lateral gastrocnemii and peroneus longus and brevis) were consistently more strongly activated in SNR than in XER. This differential pattern of muscle activation results in greater abduction torque at the ankle in SNR than in XER. These data demonstrate reflex organization in relation to the multidirectional torque generated by individual muscles.

Receptor mechanisms underlying heterogenic reflexes among the triceps surae muscles of the cat

The soleus (S), medial gastrocnemius (MG), and lateral gastrocnemius (LG) muscles of the cat are interlinked by rapid spinal reflex pathways. In the decerebrate state, these heterogenic reflexes are either excitatory and length dependent or inhibitory and force dependent. Mechanographic analysis was used to obtain additional evidence that the muscle spindle primary ending and the Golgi tendon organ provide the major contributions to these reflexes, respectively. The tendons of the triceps surae muscles were separated and connected to independent force transducers and servo-controlled torque motors in unanesthetized, decerebrate cats. The muscles were activated as a group using crossed-extension reflexes. Electrical stimulation of the caudal cutaneous sural nerve was used to provide a particularly strong activation of MG and decouple the forces of the triceps surae muscles. During either form of activation, the muscles were stretched either individually or in various combinations to determine the strength and characteristics of autogenic and heterogenic feedback. The corresponding force responses, including both active and passive components, were measured during the changing background tension. During activation of the entire group, the excitatory, heterogenic feedback linking the three muscles was found to be strongest onto LG and weakest onto MG, in agreement with previous results concerning the strengths of heteronymous Ia excitatory postsynaptic potentials among the triceps surae muscles. The inhibition, which is known to affect only the soleus muscle, was dependent on active contractile force and was detected essentially as rapidly as length dependent excitation. The inhibition outlasted the excitation and was blocked by intravenous strychnine. These results indicate that the excitatory and inhibitory effects are dominated by feedback from primary spindle receptors and Golgi tendon organs. The interactions between these two feedback pathways potentially can influence both the mechanical coupling between ankle and knee.

Relationship between short-range stiffness and yielding in type-identified, chemically skinned muscle fibers from the cat triceps surae muscles

1. Transient, stretch-evoked force responses of chemically skinned muscle fibers from the cat hindlimb were investigated. The purpose of these experiments was to determine the exent to which short-range stiffness, the apparent stiffness exerted by the fiber over the first 0.5% of length change, is higher in type I than type II muscle fibers. Fibers were obtained from soleus and vastus intermedius muscles, which contain predominantly type I fibers, the LGm, a compartment of the lateral gastrocnemius muscle that contains predominantly type II fibers, and LG3, a compartment of mixed type. 2. Beyond a short range of approximately 1% of muscle length during a 0.5 muscle length/s (ML/s) stretch, most fibers exhibited an abrupt decrease in apparent stiffness or yield. Fibers from the muscles containing predominantly type S (slow twitch, or type I) fibers, soleus and vastus intermedius, exhibited such a pronounced decline in apparent stiffness that force declined as well during continued stretch. Most of the fibers from the LG3 compartment could be divided into two distinct groups depending upon whether or not they showed a force yield at the stretch velocity of 0.5 ML/s. 3. The short-range stiffness measured over the first 0.5% of stretch was greater for fibers showing force yield than for those that did not at matched initial forces and normalized stretch amplitudes. This result is consistent with the hypothesis that the same mechanism that endows the fiber with high short-range stiffness is also responsible for a greater extent of yielding. 4. Fibers from soleus were found to exhibit a force yield over a 200-fold range of velocities (0.01-2 ML/s). In contrast, most fibers from the LGm compartment showed only an increase in extent of yield with stretch velocity. Some of these fibers eventually yielded in force, but only when they were stretched at velocities > 2 ML/s. The proposed relationship between high short-range stiffness and yielding was supported by the finding that short-range stiffness increased sharply in the range of velocities where the fiber showed the greatest increase in extent of yield. 5. After the physiological experiments, fibers were subjected to SDS gel electrophoresis. Two distinct patterns of bands in the low molecular weight range were found to correspond to the two types that were identified on the basis of their dynamic mechanical properties. Fibers that did not yield at 0.5 ML/s showed a band pattern very similar to that of rabbit psoas (type II) fibers. 6. These results support the hypothesis that type I fibers are specialized in presenting a high short-range stiffness for effective postural control in advance of reflex mechanisms and that this property results from intrinsic properties of the fiber and is not due to differences in the dimensions of type I and II fibers. Yielding serves to protect the fiber from damaging levels of force during lengthening contractions. The importance of these transient properties to the mechanical behavior of muscle during ongoing movements is suggested by the observation that high stiffness followed by yielding is repeated with little alteration during successive stretches.

Mechanical actions of heterogenic reflexes among ankle stabilizers and their interactions with plantarflexors of the cat hindlimb

1. The stretch-evoked reflex organization of muscles whose major action is to abduct [peroneus brevis (PB); peroneus longus (PL)] and adduct [tibialis posterior (TP); flexor digitorum longus (FDL); flexor hallucis longus (FHL)] the ankle, and their interactions with the hindlimb extensors gastrocnemius (G) and soleus (S), were studied in 27 unanesthetized decerebrate cats. Ramp-hold-release stretches of physiological amplitudes were applied to muscle tendons detached from their bony insertion, and muscle force output was measured in response to these perturbations. Flexion and crossed-extension reflexes were used to modulate baseline force. 2. PB and TP shared strong, length-dependent, short-latency inhibitory reflexes prominent when the muscles were either actively generating force or quiescent. The mechanical characteristics of this reflex suggest Ia reciprocal inhibition as the underlying mechanism. Just as reciprocal inhibition between S and tibialis anterior stiffens the ankle joint against sagittal perturbations, we propose that reciprocal inhibition between PB and TP stiffens the ankle joint against nonsagittal perturbations. 3. In all preparations (n = 7) and under all conditions examined, PB and PL shared well-demonstrated mutual excitation. The reflex responses were asymmetric (favoring excitation of PL), length dependent, and occurred simultaneously with the stretch reflex at a latency of 16-18 ms. Mutual monosynaptic projections previously described between these two muscles explain all of the above findings. Our data further demonstrate that, under certain conditions, the ensemble activity of this reflex interaction has a powerful effect on the mechanical behavior of the muscle. 4. The heterogenic reflex organization of the ankle adductors was as follows: FDL evoked a modest excitation on TP, whereas FHL evoked weak inhibition. Latency of the excitation from FDL onto TP (24 ms) was greater than expected if the reflex were mediated by heteronymous Ia afferents. In all preparations examined (n = 3), TP contributed no significant reflexes onto either FDL or FHL. 5. Mutual, asymmetric inhibition characterized interactions between PB and the plantarflexors S and G. Most remarkable was a novel, long-latency (72-74 ms) reflex inhibition evoked on both S and G by stretch of PB. When this inhibition occurred, it dramatically decreased the S (or G) stretch response. Longer PB lengths evoked greater inhibition of isometric S; regression analysis indicated that the model best predicting this inhibition contained muscle force and stiffness terms. No long-latency reflexes were noted from either G or S onto PB. The mechanism underlying long-latency inhibition is presently unknown; however, features of this interaction suggest interneurons receive either group II or group III afferent input. 6. G and TP shared short latency, mutually inhibitory, asymmetric reflexes favoring inhibition of TP. No long-latency interactions were noted, nor were there any mechanically significant interactions between S and TP. 7. Reflex interactions across the abduction/adduction axis thus favored inhibition of plantarflexion and adduction torques while emphasizing abduction torques: PB/S (or PB/G) interactions were mutual, asymmetric, and favored inhibition of G and S; TP/G interactions were mutual, asymmetric, and favored inhibition of TP; TP/PB interactions were approximately balanced. The overall mechanical outcome of these inhibitory interactions may partly underlie the global corrective strategy seen in intact cats subjected to linear perturbations. 8. No significant reflex interactions were demonstrated between PL and TP, G, or S, nor were any long-latency reflexes noted. Thus, whereas reflex interactions between the stereotypically activated PB and other stereotypically activated muscles (including TP, G, and S) were strong and well-demonstrated, interactions between the variably activated PL and these same muscles were far weaker.

Psychomotor seizures of temporal lobe onset: analysis of symptom clusters and sequences

We analyzed 91 psychomotor seizures from 31 patients seizure free at least one year after temporal lobectomy (implying temporal lobe onset). Fifty symptoms were looked for in every seizure and their time of onset and ending noted. Statistical analysis was used to define symptom clusters and the order of appearance of symptoms. Of the eighteen most common symptoms examined, all of these symptoms form a tight cluster showing a high degree of correlation. Within this cluster, there was a tendency towards the following subclusters: (a) epigastric aura, ictal vomiting, alimentary and hand automatisms; (b) behavioral arrest, complete loss of consciousness, staring and bilateral facial contraction; (c) unilateral dystonic posturing of an arm, mimetic automatisms, complex gestures, ictal speech and partial loss of consciousness; (d) looking around, agitation, vocalizations and whole body movements. We also found a strong correlation between epigastric sensation and ictal vomiting in psychomotor seizures arising from the right but not the left temporal lobe. The commonest sequence of symptoms was: behavioral arrest followed by alimentary and hand automatisms, looking around and whole body movements, in that order.

Mechanical actions of heterogenic reflexes linking long toe flexors with ankle and knee extensors of the cat hindlimb

1. To study the means whereby ankle biomechanics are represented in the interneuronal circuitry of the spinal cord we examined stretch-evoked reflex interactions between the physiological extensors flexor hallucis longus (FHL) and flexor digitorum longus (FDL) as well as their interactions with gastrocnemius (G), soleus (S), and the quadriceps group (Q) in 34 unanesthetized decerebrate cats. To evoke stretch, DC motors provided ramp-hold-release length changes to tendons detached from their bony insertions. Semiconductor myographs measured resultant muscle force response. Reflexes were examined under both quiescent (no active force generation) and activated conditions; muscle activation was achieved through either crossed-extension or flexion reflexes. 2. FHL and FDL share mutual excitatory stretch-evoked interactions under most conditions examined. These interactions depended on muscle length, were asymmetric (with FHL contributing a larger magnitude of reflex excitation onto FDL), and occurred at a latency of 16 ms. Mutual Ia synergism previously described for these two muscles provides a basis for all of the above findings. Our data demonstrate that for this muscle pair, reflex connectivities revealed at the intracellular level can be extrapolated to cover the entire motoneuron pool; further, our data directly demonstrate the net mechanical result of ensemble synaptic events. 3. FHL was found to share strong, mutually inhibitory stretch-evoked interactions with G, S, and Q. Stepwise regression statistical analyses determined that these interactions depended on recipient muscle force and donor muscle force. These reflex interactions all occurred at a latency of 28 +/- 4 (SE) ms. Further, the heterogenic inhibition between FHL/G and FHL/S was attenuated by strychnine infusion (intravenous) but unaffected by either mecamylamine, picrotoxin, or baclofen infusion (intravenous, intrathecal). Disynaptic Ib inhibition previously described among hindlimb extensors provides a basis for the above findings; our data demonstrate that under certain conditions the ensemble activity of this system can cause a dramatic decline in whole muscle force output. 4. By contrast, FDL was found to share mutually inhibitory, stretch-evoked reflex interactions with G, S, and Q that were much weaker than those observed between FHL and these same muscles. The small magnitude of inhibition observed in these interactions made it difficult to assess reflex latency or to determine the factor(s) that best predicted the heterogenic inhibition. 5. This study provides further evidence of intrinsic differences in interneuronal organization between muscles whose activity occurs in a periodic manner during locomotion ("stereotypical") and a muscle whose locomotor activity is characterized by both periodic and nonperiodic components ("facultative").(ABSTRACT TRUNCATED AT 400 WORDS)

Reinnervated muscles fail to produce stretch reflexes

1. We studied the stretch-evoked reflex organization of hind limb muscles in two decerebrate cats 36 mo after unilateral section and immediate surgical repair of the common nerve supplying the lateral gastrocnemius (LG) and soleus (S) muscles. 2. The production of considerable reflex force by reinnervated muscles in response to electrical stimulation of uninjured nerves indicated substantial functional recovery of motor units. However, reduction in the responsiveness of reinnervated muscles to stretch of the untreated medial gastrocnemius (MG) muscle indicated some deficit in recovery of normal synaptic integration. 3. Stretch failed to elicit autogenic excitation of the reinnervated S and LG. This failure was observed whether the reinnervated muscles were quiescent or contracting in other reflexes. 4. The heterogenic reflex organization of reinnervated muscles was abnormal. Stretch of the reinnervated S failed to evoke heterogenic reflexes both in the untreated MG and in the reinnervated LG. Stretch of the reinnervated LG failed to produce excitation of MG. 5. These findings demonstrate deficiencies in proprioceptive feedback from reinnervated muscles and lead us to expect incomplete recovery of motor function after nerve section.

A biomechanical perspective on spinal mechanisms of coordinated muscular action: an architecture principle

A principle of organization of spinal circuitry which emerges from the studies reviewed here is that the structure of the distributed network of pathways in the spinal cord contains a detailed representation of the corresponding three dimensional architecture of the musculoskeletal system. The pertinent architectural features for a given muscle include (1) the number and identity of spanned joints, and (2) the line of action at a joint with respect to the torque directions of other muscles and to the gravity vector. In accordance with established ideas, muscles with common primary actions (synergists) at the ankle are linked by excitatory, length-dependent pathways. Those muscles which have opposite actions are linked by reciprocal inhibition, although muscles which are not principally involved in postural control are not connected in this way. Among antigravity and stabilizing muscles, force-dependent, inhibitory pathways link (1) muscles crossing different joints, and (2) members of different synergistic groups which exert torques in different directions. Therefore, each muscle has a unique set of actions in terms of joints spanned and line of action, and each muscle receives a unique combination of reflex inputs. The cross-joint coordination resulting from actions of force-dependent pathways becomes stronger at higher forces with a consequent reduction in degrees of freedom of the musculoskeletal system. Length-dependent pathways link muscles which share some, but not all, mechanical actions at a joint and may have different patterns of activation during locomotion. Length-dependent pathways appear to coordinate muscle responses to postural disturbances and enhance joint stiffness.

Cat hindlimb muscles exert substantial torques outside the sagittal plane

1. We studied the contributions of several hindlimb muscles to ankle torque in adult cats deeply anesthetized with pentobarbital sodium. Isometric torques were measured with a multiaxis, force-moment sensor connected to the plantar surface of the foot. 2. Individual muscle torques were provoked by using a combination of muscle nerve stimulation and selective denervations and tenotomies. Torques were represented by three orthogonal components; defined as dorsiflexion/plantarflexion, inversion/eversion (rotation about the long axis of the foot), and toe-in/toe-out (rotation about the axis of the tibia). 3. Most of the muscles tested exerted substantial torques about more than one of the orthogonal axes, each of which shared a common origin centered midway between the medial and lateral malleoli. The lateral and especially the medial head of the gastrocnemius muscle exhibited large toe-out torques and eversion torques as well as the classical plantarflexion components. 4. The torque exerted by tibialis anterior was seen to oppose that of both medial and lateral gastrocnemius in each of the three directions. The toe-in and inversion torques exerted by tibialis posterior was opposed in these directions by both peroneus brevis and peroneus longus. Flexor hallucis longus exerted approximately 10 times more plantarflexion torque than did flexor digitorum longus; therefore, these two muscles cannot be considered pure synergists. 5. The major plantarflexors and dorsiflexor of the cat ankle joint contribute substantial torques outside the sagittal plane. Their opposing torques lead to increased joint stiffness; the net effect of coactivation of these muscles causes ground reaction forces oriented so as to maintain stability during quadrupedal stance.

Control of torque direction by spinal pathways at the cat ankle joint

To study the biomechanics of the calcaneal tendon's complex insertion onto the calcaneus, we measured torque-time trajectories exerted by the triceps surae and tibialis anterior muscles in eight unanesthetized decerebrate cats using a multi-axis force-moment sensor placed at the ankle joint. The ankle was constrained to an angle of 110 degrees plantarflexion. Muscles were activated using crossed-extension (XER), flexion (FWR), and caudal cutaneous sural nerve (SNR) reflexes. Torque contributions of other muscles activated by these reflexes were eliminated by denervation or tenotomy. In two animals, miniature pressure transducers were implanted among tendon fibers from the lateral gastrocnemius (LG) muscle that insert straight into the calcaneus or among tendon fibers from the medial gastrocnemius (MG) that cross over and insert on the lateral aspect of calcaneus. Reflexively evoked torques had the following directions: FWR, dorsiflexion and adduction; SNR, plantarflexion and abduction; and XER, plantarflexion and modest abduction or adduction. The proportion of abduction torque to plantarflexion torque was always greater for SNR than XER; this difference was about 50% of the magnitude of abduction torque generated by tetanic stimulation of the peronei. During SNR, pressures were higher in regions of the calcaneal tendon originating from MG than regions originating from LG. Similarly, pressures within the MG portion of the calcaneal tendon were higher during SNR than during XER, although these two reflexes produced matched ankle plantarflexion forces. Selective tenotomies and electromyographic recordings further demonstrated that MG generated most of the torque in response to SNR, while soleus, LG, and MG all generated torques in response to XER.(ABSTRACT TRUNCATED AT 250 WORDS)

Mechanical analysis of heterogenic inhibition between soleus muscle and the pretibial flexors in the cat

1. The role of proprioceptive pathways linking the direct antagonists soleus (S) and tibialis anterior (TA) muscles in governing the mechanical properties of the ankle joint were studied in the decerebrate cat. Actions of these heterogenic pathways were compared with those between S and extensor digitorum longus (EDL), a muscle that also acts at the metatarsophalangeal joint. These neurally mediated interactions between S and either TA or EDL were studied by applying controlled length changes to the isolated tendons of pairs of these muscles and recording the resulting changes in force. The muscles were activated with the use of electrically evoked crossed-extension reflexes, flexion reflexes, and brain stem stimulation. 2. Heterogenic inhibition from TA or EDL onto S was well developed whether S was initially quiescent or activated by a crossed-extension reflex. The inhibition persisted for the duration of the stretch of TA or EDL. During a crossed-extension reflex, TA did not generate background force, but brief stretch reflexes could be obtained. During flexion reflexes, stretch reflexes in S were usually abolished, and heterogenic inhibition from S to TA was weak or absent. 3. The strength of the heterogenic inhibition onto S was dependent on the initial length and activation level of TA and EDL. Changes in flexor length or activation level per se did not alter the background force or strength of the stretch reflex in S. Even taking into account the variation of strength of inhibition with the initial state of the muscle of origin, the strength of the inhibition was stronger from TA to S than the other way around. 4. The contributions of heterogenic inhibition from TA and EDL to S were independent in the sense that these components summed linearly with each other and with the autogenic reflex in S. In addition, the magnitude of the inhibition from TA to S was proportional to the amplitude of stretch for low to intermediate levels of initial force in S. The inhibition appeared to affect the mechanical responses of S essentially as rapidly as the stretch reflex in this muscle. 5. The heterogenic inhibition from TA to S was reduced or abolished by intravenous injections of strychnine but unaffected by injections of picrotoxin or bicuculline. These results, together with the observation that the inhibition sums linearly with the stretch reflex, suggest that the mechanism of this heterogenic inhibition is glycinergic and postsynaptic and, therefore, may include Ia-disynaptic reciprocal inhibition.(ABSTRACT TRUNCATED AT 400 WORDS)

The organization of heterogenic reflexes among muscles crossing the ankle joint in the decerebrate cat

1. Mechanical actions of heterogenic (intermuscular) reflexes arising from proprioceptors in flexor and extensor ankle muscles were measured in intercollicular and premammillary decerebrate cats. Length inputs were applied to the freed tendons of one of a pair of muscles crossing the ankle joint and resulting changes in force in both muscles were measured. Interactions between autogenic and heterogenic reflexes were studied by applying length changes to both muscles. 2. A consistent asymmetry was observed in the heterogenic inhibition between the single-joint antagonists soleus and tibialis anterior (TA). Inhibition from soleus to TA was weak or absent during the reflex activation of TA. In contrast, a strong heterogenic inhibition was consistently observed from TA to soleus during the activation of soleus by a crossed-extension reflex. The effect of this inhibition in the intact joint is to increase the apparent mechanical stiffness of soleus. 3. Mutual synergism among soleus, medial gastrocnemius (MG) and lateral gastrocnemius (LG) was demonstrated only at low to moderate forces by the observation of excitatory reflexes among them. During a naturally or electrically evoked crossed-extension reflex, however, a unidirectional inhibitory reflex from MG and LG to soleus was observed. This inhibition increased with force in MG or LG. These results suggest that the knee and ankle joints become more tightly linked mechanically at high forces since the stiffness of the biarticular gastrocnemius muscle predominates over that of the uniarticular soleus. 4. Under quiescent conditions (no resting muscle activation), mutual synergism was obeyed among the ankle extensors soleus, LG and MG and also between the pretibial flexors TA and extensor digitorum longus (EDL). Moreover, inhibition was generally observed between a pretibial flexor and an ankle extensor. Departures from this expected pattern of heterogenic reflexes occurred when the muscle groups were activated by crossed-extension and flexion reflexes. Reflexes onto soleus, TA and EDL reversed in sign or increased in magnitude. 5. The observed patterns of reflex connectivity among the ankle flexors and extensors were similar in both intercollicular and premammillary preparations, although changes in reflex strength were sometimes noted in cases where a second, lower transection was performed during the experiment. 6. It is argued from the large magnitudes of certain heterogenic reflexes that the mechanical response properties of muscles crossing the ankle joint in the intact animal are not dominated by autogenic reflexes and intrinsic mechanical properties.(ABSTRACT TRUNCATED AT 400 WORDS)

Neurologic complications of endocarditis: a 12-year experience

We reviewed the neurologic complications in 113 patients with native and 62 patients with prosthetic valve endocarditis. Neurologic complications occurred with the same frequency (35.3% vs 38.7%) and distribution among the two groups. Death occurred in 20.6% of patients with neurologic complications and in 13.6% of patients without neurologic complications (p = 0.23). Staphylococcus aureus endocarditis correlated statistically with the development of neurologic complications (p less than 0.01) and death (p less than 0.01). Among 50 patients discharged from the hospital after receiving only medical treatment for native valve endocarditis, and followed for a mean period of 48 months, there was one patient with mitral valve prolapse and stroke. We conclude that (1) neurologic complications occur with the same frequency in native and prosthetic valve endocarditis, (2) S aureus endocarditis increases the risk of neurologic complications and death, (3) mortality is not significantly increased in patients with neurologic complications, and (4) an episode of treated native valve endocarditis does not increase the natural history of stroke in valvular disease.

The association of atopic diseases with endometriosis

Comparisons of the incidence of health-related problems were conducted between women with demonstrable endometriosis (N = 88) and a control group (N = 88). Increased incidence of respondents' reports of allergic manifestations (p less than .005) were found. Directions for further research are suggested.

A technique for measuring the mechanical actions of heterogenic (intermuscular) reflexes in the decerebrate cat

Two muscle pullers were used to study the natural mechanical actions of autogenic reflexes, which arise from muscle receptors and feed back to the muscle of origin, and heterogenic reflexes, which feed back to muscles other than the muscle of origin. In the study reported here, the reflexes associated with muscles which act about the ankle joint of the decerebrate cat were investigated. Actions of autogenic pathways were measured by imposing length changes on the muscle and recording the resulting changes in force and EMG (electromyogram). Actions of heterogenic reflexes for pairs of muscles were measured by imposing appropriate combinations of length changes on the muscle of origin and on the muscle receiving the heterogenic reflex. In some cases, length changes were applied in such a way as to mimic normal mechanical coupling to evaluate the physiological importance of the reflexes, while in other cases the tests departed from normal coupling to address questions about mechanisms of reflex action. It was found that several pairs of muscles could be studied in a single experiment so that supraspinal influences on the pattern of spinal reflex connectivity can be conveniently evaluated.

Endometriosis: a comparison of associated disease histories

We examined a subgroup of 43 women with endometriosis who reported family members affected by the disease. A matched group of female friend-controls (n = 43) was used for comparison, and reports of selected autoimmune diseases, infectious diseases, and allergic manifestations were compared. For this subset of women, there appeared to be a strong familial tendency to allergic manifestations. Vaginal yeast infections, a history of mononucleosis, eczema, hayfever, and food sensitivities were reported to occur much more frequently for these women. All statistical tests on these conditions were significant at the .05 level of probability or less.

Resetting of resultant stiffness in ankle flexor and extensor muscles in the decerebrate cat

Flexor (tibialis anterior, TA, and extensor digitorum longus, EDL) and extensor (soleus, SOL) muscles in the decerebrate cat were subjected to length changes and the force responses were measured. Resultant muscular stiffness, which arises from the mechanical reaction of muscle fibers contracting prior to the length change and from a change in force due to reflex action, was calculated by dividing the changes in force by the corresponding length changes. As shown previously in the premammillary preparation, resultant stiffness was usually higher in SOL than in TA or EDL. Following an intercollicular transection in some preparations, resultant stiffness increased markedly for TA but not substantially for SOL. During continuous electrical stimulation in the magnocellular red nucleus in premammillary preparations, resultant stiffness of SOL decreased for a wide range of forces while EDL responses were unaffected. These results show that reflex gain is not determined solely by the level of motoneuronal excitability but also by a descending control from the brainstem, and that the lower resultant stiffness in flexors compared to extensors in the decerebrate cat is set by this control system and not by inherent differences in the strength of autogenetic reflex pathways for the two muscles.

Family trait analysis: a case-control study of 43 women with endometriosis and their best friends

Analyses of lineage patterns show that for 43 women with endometriosis who reported that other family members have the disease, the vast majority of these familial cases involve the maternal lineage (79% to 93%). Of these women 34.9% of their mothers and 21.2% of their sisters were affected. With use of these rates, expected rates for first-degree relatives in a general population of women with endometriosis were determined. These rates were 6.2% and 3.8%, respectively; in combination, these rates yield an overall risk of 4.9% for first-degree relatives. Prior studies estimated this overall risk to be 6.9%; however, z scores determined that these rates do not differ statistically. Rates for second-degree maternal relatives are reported for grandmothers and aunts (0.4% compared to 3.1%, respectively), thus expanding results of former studies. In combination, an overall risk of 1.9% is estimated for second-degree relatives, as measured.

In vitro testing for the risk of arachnoiditis from myelographic contrast media

The risk of arachnoiditis from aqueous myelographic contrast media has been assayed reliably only in experimental animals. The effect of contrast media on protein and collagen production by fibroblasts in vitro was studied. Iocarmate, metrizamide, and iopamidol added to the culture medium caused cells to produce more protein and collagen. The degree to which the contrast medium stimulated collagen production correlated with the risk of arachnoiditis from the intrathecal use of the contrast medium. In vitro testing appears to be an effective assay for arachnoiditis.

Autogenetic reflex action in tibialis anterior compared with that in soleus muscle in the decerebrate cat

The regulatory actions of autogenetic reflex pathways on the mechanical properties of an ankle flexor (tibialis anterior) and an extensor (soleus) in the premammillary decerebrate cat were studied. The two muscle were isolated in the same cat and each was stretched during its separate activation. The yield in stiffness shown by areflexive muscles during stretch was largely compensated for in tibialis anterior as well as in soleus by reflex action. Resultant (total) stiffness varied by less than a factor of two over a wide range of contractile forces in the two muscles. Further, resultant stiffness increased as stretch amplitude decreased in both muscles, but the variation was less for TA. In most preparations, the resultant stiffness in soleus was significantly larger than the resultant stiffness of tibialis anterior. It is concluded that autogenetic reflexes govern the mechanical properties of both flexors and extensors. In addition, the extensor bias in the decerebrate preparation is due not only to greater activation in extensors but to a greater resultant stiffness as well.