Light microscopical study of dendrites and perikarya of interneurones mediating la reciprocal inhibition of cat lumbar alpha-motoneurones

Interneurones which mediate disynaptic inhibition from la muscle spindle afferents of the quadriceps nerve to lumbar alpha-motoneurones were stained with intracellular injection of horseradish peroxidase. Seven best stained and most satisfactorily preserved cells were selected for analysis, and the light microscopic morphology of their cell bodies and dendrites were quantitatively investigated in parasagittal sections. The perikarya were located dorsal or dorso-medial to the motoneurones; they had mean diameters of 51 x 27 microns and a mean volume of 35,820 microns 3. The cells had 3 to 7 dendrites, which were arranged asymmetrically around the parent somata. The dendrites extended mainly in the dorso-ventral direction, in which the mean tip to tip distance for each cell was 1742 microns. The dendrites had few spines and they branched almost only in bifurcations. On the average, each process divided 3.5 times and in each cell they gave rise to 14.9 branching points as well as a total combined length of more than 7000 microns. Primary dendrites had a mean length of 193 microns which was generally shorter than the lengths of the branches of higher order. A more detailed analysis of two cells revealed the mean width of primary dendrites to be 5.6 microns while that of the 5th order processes was 1.5 microns. The mean tapering of individual dendritic branches per unit length was 17%, being somewhat more pronounced for the distally located segments, while at branching points the sum of daughter processes approximately equalled the diameter of the parent process.(ABSTRACT TRUNCATED AT 250 WORDS)

[Effect of lumbar sympathectomy on tissue blood flow in the extremities in arteriosclerosis obliterans]

Lumbar sympathectomy in patients with obliterating atherosclerosis of lower extremities in the nearest postoperative period results in acceleration of the intracutaneous blood flow and of intramuscular blood flow as well as in greater extra-tissue blood shunting. At remote terms the intramuscular bloodflow is also accelerated. Patients with the IV degree of ischemia should be divided into two groups according to results of special investigations: patients with traumatic and with ischemic necroses. It is of importance for choice of rational surgical methods and for prognosis of outcomes of the disease.

[Effect of lumbar sympathectomy on orthostatic reactivity of the arteries of the extremities in thromboangiitis obliterans]

Lumbar sympathectomy in majority of patients with thromboangiitis was found to be followed by a reduced pathogenetically reliable orthostatic and post-orthostatic++ spasm of the diseased arteries. Patients with persistent and continuous remission had normo- and hypotonic orthostatic reaction of the extremity vessels. Remote clinical results of the intervention on lumbar sympathetic ganglia were dependent on the degree of correction of local angiotonic and angiospastic disorders.

[Acid-base equilibrium, tissue oxygenation and hemodynamics in arteriosclerosis obliterans after sympathectomy]

The authors have shown that operation of lumbar sympathectomy increases the skin oxygenation level, increases the volume blood flow in the main arteries and gives rise to positive shifts in metabolic processes in the extremity tissues. The operation is most effective at the 2nd stage of the disease but is getting less effective at the third stage. At the 4th stage of the disease the operation is indicated but with limited necroses of distal parts of the extremity, intact blood flow not less than 40% of the normal, the leg skin oxygenation level higher than 30 mm Hg, shift of blood pH to subcompensated acidosis.

Somatotopic organization of the dorsal horn in the lumbosacral enlargement of the spinal cord in the neonatal cat

The somatotopic organization of the light touch receptive fields of single unidentified dorsal horn neurons in the lumbosacral spinal cord has been studied in the neonatal cat anesthetized with chloralose. Satisfactory recordings were obtained from single dorsal horn neurons in kittens aged 3-6 days. Reconstruction of recording tracks from pontamine blue dye spots and comparisons of the depths of recording sites with Nissl-stained sections of cord showed that most single-unit recordings were obtained from laminae III and IV of Rexed. In animals of all ages neurons were found which responded briskly to light cutaneous mechanical stimulation. Their receptive fields varied widely in size, being smallest on the distal digits and largest on proximal skin. Receptive field areas were similar in proportion to the size of the hindlimb to those seen in the equivalent region in the adult cat. Because of the shape of the dorsal horn and the relatively narrow dorsal columns in neonatal kittens it proved difficult to locate units with receptive fields on proximal skin. Nevertheless the main features of the somatotopic organization of the dorsal horn were similar to those in the adult cat. Thus the somatotopic map of the kitten showed a medial representation of glabrous skin that was bounded laterally by the representation of the hairy skin of the toes. Proximal skin was represented in the lateral parts of the dorsal horn, a region which was not easily accessible for microelectrode recording. The individual toes were represented in a rostral to caudal sequence such that toe 2 was represented rostrally and toe 5 caudally. Around the toe representation the medial surface of the foot was represented rostrally, the ventrolateral surface caudally, and the dorsal surface laterally. The results indicate that the mature organization of light touch receptive fields of dorsal horn neurons in the lumbosacral cord of the cat is already largely present at birth.

[Expediency of combined lumbar sympathectomy with reconstructive-restorative operations in arteriosclerotic lesion of the aorto-femoral segment]

An examination of patients after reconstructive operations on the aorto-femoral segment in combination with lumbar sympathectomy (173 patients) and without it (75 patients) has shown sympathetcomy to promote reduction of the amount of postoperative thromboses and amputations in the early postoperative period. In the remote period the frequency of reocclusions in patients subjected to sympathectomy was higher. The authors consider that sympathectomy is responsible for progress of atherosclerosis.

[Contraindications for lumbar sympathectomy in patients with obliterative lesions of arteries of the legs]

The authors consider that it is the correct choice of patients for lumbar sympathectomy which is responsible for good remote results in 84.3% of patients subjected to the operation.

Pelvic pain and organic dysfunction in a patient with low back pain: response to distractive manipulation: a case presentation

Many patients with low back pain demonstrate pelvic symptomatology attributable to lower sacral nerve root compression. Lower sacral nerve root compression has been identified as a cause of pelvic pain and pelvic organ dysfunction. Pelvic symptomatology secondary to lower sacral nerve root compression is given. Lower sacral nerve root compression is most commonly the result of lumbosacral disc lesion. A case of low back pain accompanied with pelvic symptomatology is presented along with its response to distractive manipulation. chiropractic treatment may be an effective means of treating pelvic disorders secondary to lower sacral nerve root compression provided that the underlying disc lesion is dealt with, although further study is needed.

Catecholamine innervation of the caudal spinal cord in the rat

By means of the aluminum-formaldehyde (ALFA) fluorescence technique for monoamine visualization the distribution of catecholamines was studied in the caudal spinal cord, particularly in relation to motoneurons innervating pelvic structures. In the lumbosacral cord all parts of the spinal gray matter were found to contain catecholamines. In the dorsal horn the most intense fluorescence was seen in the superficial layers. The motoneuron neuropil exhibited the most prominent catecholamine-fluorescence of the ventral horn layers. In the sixth lumbar segment, which contains the motor nuclei that innervate the pelvic striated muscles as well as one innervating muscles in the lower limb, a differential distribution of the density of catecholamine fluorescence was presented by the individual nuclei. The catecholamine fibers in the motoneuron neuropil were seen closely surrounding the motoneuron somata, suggesting the existence of axosomatic contacts, and by utilizing the fluorescent retrograde tracer True Blue in combination with the ALFA method tentative axosomatic noradrenergic synapses on identified neurons innervating small striated pelvic muscles could be visualized in the light microscope. In the intermediate gray the intermediolateral nucleus in thoracic and upper lumbar segments was the most heavily innervated area, followed by the medial lumbar sympathetic group, which contains the majority of the sympathetic preganglionic neurons innervating the pelvic organs. The parasympathetic intermediolateral nucleus in the upper sacral segments received a catecholamine innervation of moderate density. The catecholamine innervation pattern is discussed in relation to the patterns of other putative transmitters. The distribution of catecholamine fluorescence in relation to nuclei that control the pelvic organs differs from the arrangement of other transmitters in this region. The complexity of the innervation of the pelvic organs and their related striated muscles is thus further stressed.

Funicular course of catecholamine fibers innervating the lumbar spinal cord of the cat

The purpose of this study was to determine the funicular location of descending catecholamine (CA) fibers innervating the lumbar spinal cord from the dorsolateral pons (DLP). The locations of catecholamine-containing cell bodies which project to the lumbar spinal cord were determined by combining the use of the retrogradely transported fluorescent dye, Evans Blue (EB), with the glyoxylic acid histofluorescence technique. Lumbar injections of Evans Blue were combined with thoracic lesions of the dorsolateral funiculi (DLF) or ventrolateral funiculi (VLF) in order to retrogradely label those CA-containing or non CA-containing cell bodies whose axons descend within the spared hemispinal cord. By this technique it was determined that descending CA fibers innervating the lumbar spinal cord of the cat project through both the DLF and the VLF. The nucleus subcoeruleus, the Kolliker-Fuse nucleus and the CA cell bodies in the area of A5 each contain a significant number of CA-containing cells whose fibers descend both within the DLF and the VLF, while the nucleus locus coeruleus projects to the lumbar cord primarily through the VLF. Catecholamine cells of the DLP innervate the lumbar spinal cord bilaterally, although there is an ipsilateral predominance. The CA-containing cells of the DLP which innervate the contralateral spinal cord were shown by ipsilateral or contralateral thoracic hemisection to decussate both above and below the thoracic lesion. Non-CA-containing cells from the DLP also crossed at all levels of the spinal cord; however, cells from the caudal pons had a larger number of cells which crossed above the thoracic lesion while cells of the more rostral pons had a larger number of cells which crossed below the lesion.

Mechanism of elevation of hindquarter vascular resistance in spontaneously hypertensive rats

In spontaneously hypertensive rats and normotensive control rats in the conscious state, hindquarter flow was observed with an electromagnetic flow probe chronically implanted around the terminal aorta. In separate groups of hypertensive and control rats, arterial pressure was observed with an indwelling catheter inserted into the terminal aorta. On ganglion blockade with hexamethonium bromide, hindquarter flow tended to increase in hypertensive rats and to decrease in normal rats. The percent change of hindquarter flow on ganglion blockade was significantly greater in the former than in the latter (p less than 0.05). Hindquarter peripheral resistance, estimated from flow and pressure values obtained in separate rat groups, was greater in hypertensive rats than in normal rats before ganglion blockade, but there was no difference between the groups after blockade. Presumably, an elevated sympathetic tone is responsible for the higher hindquarter peripheral resistance in spontaneously hypertensive rats, which plays an important part in the elevation of total peripheral resistance. However, bilateral lumbar sympathectomy did not induce chronic lowering of arterial pressure in hypertensive rats. This was at least partly due to the development of denervation supersensitivity.

[Regional oxygenation in the treatment of severe destructive forms of occlusive arterial diseases of the limbs]

Femoral regional perfusions and continuous intraarterial infusions were used for the treatment of 84 patients. The 0,15-0,25% solution of H2O2 was used as the oxygenator. The methods used when combined with sympathectomy allowed to restrict the operation by a parcimonious amputation of the extremity and to retain the knee joint in most of the patients.

An unusually severe subacute motor neuronopathy in Hodgkin's disease

A patient in whom an unusually severe Hodgkin's disease was complicated by subacute motor neuronopathy is described. This is a syndrome involving the lower motor neurons, recently described in patients with Hodgkin's disease and other lymphomas; its course is more often benign, and independent from that of the underlying lymphoma. In our patient it was unusually severe. Its pathological features are described. We found only 13 cases of subacute motor neuronopathy reported in current literature, with pathological documentation in 5 of these. A brief discussion and review of the literature follow.

Urethral responses during selective electrostimulation of lumbosacral spinal nerve roots in the female spinal dog

Urethral responses on the urethral pressure profile (UPP) during selective electrostimulation of the ventral or dorsal roots in a group of lower lumbar (L5-7) or sacral (S1-3) nerves were observed in female spinal (C1-transected) dogs. The UPPs were recorded by using a balloon catheter, and square pulse wave of 5 V, 10 Hz, 1 msec was applied for electrostimulation of the spinal nerve root. The UPPs were analyzed by dividing the functional profile length (FL) into three equal parts and comparing the height of maximal clossure pressure at each UPP segment. After lumbosacral rhizotomies proximal to the electrodes, stimulation of the lower lumbar ventral roots produced a marked elevation at the proximal third (bladder neck) of UPP, while similar response was found at the middle third (midsphincteric urethra) and distal third (external urethral sphincter) of UPP during the sacral ventral roots stimulation. The stimulation of the dorsal roots of the lower lumbar and sacral nerves also produced a similar response as that of the ventral roots stimulation though less in amplitude. So it could be concluded that in female dog the sphincteric urethra might receive a functional innervation from the lower lumbar and sacral spinal segments in somewhat different manners.

Single preganglionic sympathetic neurons of the cat branch intraspinally and project through different rami communicantes albi--a retrograde double labelling study with fluorescent tracers

Evidence is presented that in lumbar segments of the cat, two neighbouring rami communicantes albi (white rami, WR) may contain axons of one and the same preganglionic sympathetic neurone (PSN). This was shown with bisbenzimide (Bb) and propidium iodide (PI) applied in the same cat to the central cut ends of two WR (PI to WRL1, Bb to WRL2). PSN, double labelled from both these sites, were observed in the intermediolateral and intercalate nuclei of the L1 segment. It is postulated that axons of PSN branch intraspinally and project through different WR.

Probability of neuronal spike initiation as a curve-crossing problem for Gaussian stochastic processes

Probability of neuronal spike initiation was considered within the framework of a simple stochastic model. The time of spike occurrence was defined as the first time of crossing of a stochastic process and a determined time function. This problem has been investigated in the case of a stationary Gaussian stochastic process and a linear time function. An integral equation obtained for the probability density function of the first time crossing was numerically solved by means of computer calculations. The model was applied to the analysis of temporal pattern of spike activity evoked in the cat spinal motoneurones by depolarizing current injected through the recording microelectrode.

Localization of lumbar epaxial motoneurons in the rat

In the rat, lateral longissimus and the lumbar transverso-spinalis muscles are lumbar trunk muscles, and participate in the lordosis reflex (female sexual posturing). Medial longissimus, the remaining major lumbar epaxial muscle, is a muscle of the proximal tail-tailbase. To allow an analysis of the motor control of lordosis, motoneurons for these muscles must be localized. Horseradish peroxidase (HRP) was injected into lumbar epaxial muscles of female rats. Following injection into medial longissimus, labeled cells were found posterior to the lumbar enlargement, ventrolaterally in the ventral horn. Following injections into lateral longissimus or into lumbar transverso-spinalis muscles, most labeled cells were found on the medial side of the ventral horn, extending through and anterior to the lumbar enlargement. Injections into lumbar transverso-spinalis muscles at more posterior levels led to more posterior locations of labeled cells. The distributions of the labeled cells agree with previous observations on innervation of the muscles. Additionally, the spinal cord was scanned for sites at which microstimulation produced visible twitches of medial longissimus or transverso-spinalis muscles. Locations of low threshold twitch sites were consistent with conclusions based on the HRP findings.

[Possible mechanism of morphine-induced Straub tail reaction (STR) (author's transl)]

Mechanical contraction of the dorsal sarco-cocygeus muscle and electrical stimulation of spinal cord elicited tail elevation such as straub tail reaction (STR). When morphine, 0.25 approximately 0.5 microgram, was injected into the lumbothecal space, STR was produced dose-dependently and such was the same as that produced by systemic injection of morphine. STR was not observed, when morphine was injected into the lumbo-thecal space in spinal mice. STR was antagonized by tubocurarine given subcutaneously and by naloxone injected into the lumbothecal space. STR was not antagonized by the right, left or both dorsal spinal lesion at C5 approximately 6 as well as by the right or both dorsal spinal lesion at T11 approximately 12. However, STR was antagonized by the spinal transection at T11 approximately 12. The lesion of spinal serotonergic neurons enhanced STR. These results suggest that morphine acts on both the lumbo-sacral nerve cell bodies and the nerve terminals descending via the spinal ventral horn, by which the morphine-induced contraction of dorsal sarco-coccygeus muscle tendons produce STR.

The development of motor projection patterns in the chick hind limb

1. Retrograde transport of horseradish peroxidase was used to map the initial projection patterns of lumbosacral motoneurones to the embryonic chick hind limb. 2. The stage 28 segmental projection pattern to each of the four primary muscle masses was characteristic and indistinguishable from the stage 36 projection pattern to the sum of the muscles derived from that mass. In addition, the adductor motoneurone pool was found to be similar in position (both rostro-caudal and mediolateral) at stages 29, 30, 32, 33 1/2 and 36. 3. Therefore axons from lumbosacral motoneurones project for the most part only to appropriate regions from early times shortly after they grow into the limb bud. Furthermore, the attainment of the segmental projection pattern occurs prior to the normal time of, and therefore without the aid of, cell death. This conclusion was supported by electrophysiological recordings made from muscle nerves. 4. A regionalization of the projection patterns within a single muscle mass could be shown both anatomically and physiologically prior to the cleavage of the mass into individual muscles and the projections were in a general way appropriate for the muscles derived from those regions. 5. Therefore the process of muscle cleavage does not in itself create the specific projection patterns observed, and motoneurone axons appear to grow to and to ramify and make synapses only within regions which correspond to their adult muscles. 6. Finally, the termination site of each motoneurone axon in the early limb was found to be tightly correlated in a somatotopic fashion with the position occupied by its soma in the cord. This suggests that some feature of the motoneurone related to its position may be of importance in achieving the specific projection patterns observed.

Retention of urine in anogenital herpetic infection

In 17 patients, 15 women and 2 men, acute retention of urine developed in association with an attack of anogenital herpes. Constipation, blunting of sensation over the 2nd and 3rd sacral dermatomes, and neuralgic pains in the same area (with absence of the bulbocavernosus reflex in some individuals) suggested localised lumbosacral meningomyelitis with involvement of mainly sacral-nerve roots. The urinary dysfunction persisted on average for ten days and in 4 patients was severe enough to warrant catheterisation. Anogenital herpes should always be considered as a possible cause of acute retention of urine in sexually active young people and the possibility of occult herpetic infection of the cervix and rectum should be investigated.

The Grimonster symposium on the occasion of the 50th anniversary of the first lumbar sympathectomy

Under the auspices of the Belgian Surgical Society, a small group of American and European surgeons discussed in detail the place of lumbar sympathectomy in present day surgical practice. A consensus was reached concerning the physiologic effect, anatomical variations and indications for the operation. Conclusions included the questionable value of lumbar sympathectomy for treating intermittent claudication due to aortoiliac disease alone, its possible effectiveness when obliterative arterial disease is limited to the femoral popliteal segment, and its occasional beneficial effect when performed in conjunction with some reconstructive arterial operations.

[Plastic surgery of the arteries of the lower limbs with autologous vein and its association with lumbar sympathectomy]

In surgical treatment of patients with arterial occulsion of the lower limbs an autovein was employed as a transplant in 66 patients. In 22 patients reconstructive operation was performed after preliminary lumbar sympathectomy. Restored patency of the operated segment with restoration of foot artery pulsation was noted in 53 patients. Late results were followed up for 1--6 years in 32 patients. Major blood flow was maintained in 24 patients (75%). Other conditions being equal, reconstructive operations yield better results, if lumbar sympathectomy was preliminary performed.

Degenerative changes in the intervertebral discs of the lumbar spine and their sequelae

Careful pathological examination of lumbar spines removed at autopsy has shown that degenerative changes are present in the intervertebral discs of all subjects by middle age. The degenerative changes are more marked and occur at an earlier age when evidence of vertical or posterior disc prolapse is also present. Degenerative changes in the discs are always accompanied by osteophyte formation on the margins of the vertebral bodies and remodelling changes in the apophyseal joints. There is a direct relationship between the degree of disc degeneration, marginal osteophyte formation on vertebral bodies, and apophyseal joint changes, which suggests that disc degeneration is the primary event leading to the clinical condition of 'degenerative spondylosis'.

The lumbosacral dorsal rami of the cat

The lumbosacral dorsal rami of the cat were studied by gross dissection. The L1-6 dorsal rami form three discrete branches - lateral, intermediate and medial. The lateral branches supply the iliocostalis lumborum and become cutaneous over the back. The intermediate branches ramify in the longissimus lumborum, and are separated from the lateral branches by the lumbar intermuscular septum. The medial branches supply the multifidus and have a constant branch - the nerve to intertransversarii mediales. The L7 dorsal ramus forms only medial and intermediate branches. The S1 and S2 dorsal rami form three branches, the middle of which form the ascending sacral trunk and accessory ascending sacral trunk. The ascending sacral trunk is derived from S1 and S2, the accessory ascending sacral trunk from S2. Both nerves are the exclusive nerve supply of lumbococcygeus.

The anatomy of the lumbar intervertebral disc syndrome

Four elements of the nervous system may be involved in the production of the lumbar intervertebral disc syndrome. These are the lumbosacral nerve roots, the spinal nerves, the dorsal rami and the sinuvertebral nerves. Each nerve is associated with a particular group of pathological conditions which may irritate the nerve and produce symptoms. The anatomy of each nerve determines which particular conditions may irritate it. Moreover, one or both of two mechanisms may be involved in symptom production. The type of nerve irritated determines which mechanism is involved. In the first mechanism, low back pain and referred lower limb symptoms are produced when afferent fibres from dorsal and ventral rami are stimulated where they pass in common through spinal nerves or nerve roots. In the second mechanism, dorsal rami or sinuvertebral nerves are stimulated. This directly produces low back pain, but referred pain is produced by reflex mechanisms in the spinal cord.