Anatomy and physiology of multipolar cells in the rat inferior collicular cortex using the in vitro brain slice technique

Coronal brain slices from 21-50-d-old hooded rats were used to characterize intracellular responses of cells in both the external and dorsal cortices of the inferior colliculus (IC). These cells could generate both sodium and calcium spikes. Depending on current amplitude, depolarizing current pulses could elicit either phasic or tonic firing patterns, with spike frequency adaptation. Spiking also occurred at the offset of a hyperpolarizing pulse. These patterns were due primarily to the activation of calcium conductances. Stimulation of the commissural pathway connecting the left and right IC produced a short-latency monosynaptic IPSP followed by an EPSP(s) and a late polysynaptic IPSP(s). Non-NMDA glutamate antagonists eliminated or reduced the amplitude of the EPSP and the late portion of the inhibition, while both IPSPs were blocked by GABAA antagonists. As described previously in guinea pig (Smith, 1986) and rat (Pierson et al., 1989), a large NMDA-mediated depolarizing event (paroxysmal depolarizing shift, or PDS) could be elicited by shocking the commissure of the IC in the presence of picrotoxin or bicuculline, NMDA, 4-aminopyridine, or in 0 Mg2+ Ringer's. The picrotoxin-induced PDS was significantly reduced or abolished in Ringer's containing aminophosphonovalerate. Cells displaying the responses described were labeled with neurobiotin. Those labeled are medium-sized multipolar cells. Their dendrites are usually spiny and can extend superficially up to the cortical surface. Their thin axons give rise to collaterals that branch profusely within the cortex. The main axons project laterally along the circumference of the IC or medially into the commissure separating the collicular hemispheres.

Intracellular recordings from neurobiotin-labeled cells in brain slices of the rat medial nucleus of the trapezoid body

Principal cells in the medial nucleus of the trapezoid body (MNTB) are believed to be critical components in the circuit subserving sound localization. These cells, located in the superior olivary complex, convert excitatory inputs, arriving from the contralateral cochlear nucleus by way of large somatic synapses (the calyces of Held), to inhibitory projections onto principal cells in the ipsilateral lateral superior olive (LSO). We have characterized a population of cells in the rat MNTB using intracellular recording and labeling techniques in a brain slice preparation. MNTB principal cells had spherical or ellipsoid somata that gave rise to single large-diameter dendrites, which branched extensively and often extended beyond the borders of MNTB. Commonly observed axonal projection targets included LSO, the superior paraolivary nucleus, and the medial superior olive, and occasionally the lateral nucleus of the trapezoid body. The projections of individual MNTB cells showed an orderly topography that is consistent with the known tonotopic maps of the nuclei. In response to current injection, principal cells exhibited several nonlinearities, including rectification for depolarizing currents and a "sag" in the membrane potential for hyperpolarizing currents. Superthreshold depolarizing currents elicited transient firing behavior. Application of the potassium channel blocker 4-aminopyridine reduced or eliminated the rectification in the current-voltage relationships and caused depolarizing currents to elicit repetitive firing. Stimulation of afferent inputs elicited short-latency spikes, presumably driven by calyceal synaptic inputs; long-latency, presumably polysynaptic, EPSPs; and short- and long-latency IPSPs. The duration of synaptic events was strongly dependent on membrane potential, and this effect was probably due to the intrinsic membrane properties of the cell. In all cases tested, EPSPs were blocked by CNQX or DNQX, and IPSPs were blocked by strychnine. Two injected non-principal cells differed from principal cells in their morphologies and physiological characteristics.

Genetics of the hemolymph esterases of Lucilia cuprina (Diptera: Calliphoridae)

When hemolymph from adults of Lucilia cuprina was partitioned on native polyacrylamide gels, nonspecific esterase staining demonstrated 10 bands with up to six bands in an individual. The bands derive from alleles at two loci, EHA (five alleles) and EHB (four alleles). EHA is located on chromosome 4, 16.3 map units from sv (singed vibrissae) and 22.1 map units from ra (radial vein gaps). EHB is located on chromosome 5, 34.0 map units from to2 (topaz2 eyes) and 7.2 map units from mv (M1-veinless).

Concomitance of psoriasis and atopic dermatitis

There is a widespread belief that psoriasis (Ps) and atopic dermatitis (AD) are clinically mutually exclusive. A prospective study was undertaken to record the concurrent and/or consecutive coincidence of the two conditions and any shared clinical features. Patients attending a dermatology clinic were systematically examined for the presence of Ps and/or AD. Nine hundred and eighty-three patients were studied--428 with Ps, 224 with AD, 45 with both Ps and AD, and 286 controls. Of AD patients 16.7% had Ps, and 9.5% of Ps patients had AD. In consecutive occurrences, Ps generally followed AD. The ratio of concurrent to consecutive incidences was 3:1. The two diseases are shown not to be mutually exclusive and may coexist in the same individual.

Magnetic resonance imaging study of the rat cerebral ventricular system utilizing intracerebrally administered contrast agents

Magnetic resonance imaging (MRI) was employed to study the rat brain in conjunction with intracerebral (ic) injection of three contrast agents: GdHAM, GdDPTA, and MnCl2. The results demonstrate several advantages of ic administration of MRI contrast agents over the other routes of injection in examining CSF dynamics and brain ventricular structure. Apparent affinity of the luminal ventricular wall of the brain for positively charged GdHAM and Mn2+ ions is observed, presumably reflecting the presence of negatively charged wall components. Respiratory distress caused by (intravenous) injection of GdHAM was found to be minimized in the case of ic injections. Time-dependent changes in observed contrast indicate that diffusive processes rather than flow of CSF play a dominant role in distributing the contrast agents. Possible applications of this approach in brain research are discussed.

Genetic control of Lucilia cuprina: analysis of field trial data using simulation techniques

An analytical version of the genetic control simulation program GENCON has been used to further analyze the data obtained during field trials of genetic control of the sheep blowfly, Lucilia cuprina, in 1976-79. In the simulations, population trends from a nonrelease area were used as an estimate of the rates of increase that would have occurred in the target population if there had been no releases. Genetic data from the target area (frequencies of matings by released males) were used to predict the frequencies of descendants of released males, the resulting genetic death, and the effects of this on population trends. In simulations that assumed no migration and full survival and competitiveness of all field-reared descendants of released males (translocation-bearing males and males and females heterozygous for deleterious mutations), neither the predicted genetic changes nor the predicted population trends agreed well with the observed data. Further simulations suggested that reduced survival or competitiveness of field-reared descendants did not account for this disagreement, but that immigration of wild flies into the test areas was probably a major contributor to the failure to achieve suppression. However, immigration alone was not sufficient to explain all the differences between observed and expected results. Other plausible contributors to this failure were: (1) lower survival of translocation males due to the effects of a dieldrin resistance allele carried on the translocation, and (2) increased survival of immature stages of L. cuprina at low population densities.

Multi-centre phase II study of low dose intravesical epirubicin in the treatment of superficial bladder cancer. Yorkshire and Scottish Urological Cancer Research Groups

Forty patients with multiple recurrent superficial bladder tumours received an 8-week course of weekly instillations of 4' epirubicin 30 mg in 50 ml saline. The overall response rate was 58% and side effects were minimal.

Projections of physiologically characterized globular bushy cell axons from the cochlear nucleus of the cat

We made intraaxonal recordings from 30 individual globular bushy cell axons in the trapezoid body of the cat using HRP-filled glass microelectrodes. With subsequent HRP injection, we determined their axonal projection patterns. For cells with characteristic frequencies (CFs) above 3 kHz, short-tone peristimulus time histograms (PSTHs) at CF were typically primarylike at low tone intensities and primarylike with notch (PLN) or onset with low sustained activity (OL) at higher stimulus levels. Cells with CFs between 1 and 3 kHz showed the same response features with the spikes in the sustained region of the response phase-locked to the stimulus tone. Cells with CFs below 1 kHz showed phase-locked PSTHs with exceptionally high levels of synchrony compared to eighth nerve fibers with comparable CFs. This exceptional phase-locking was also noted when cells with CFs of 1-3 kHz were presented with tones below 1 kHz. Although the globular bushy cell axons were not completely filled from the soma of origin to terminal fields in the contralateral brainstem, a number of consistent anatomical features were distinguished in the population. All but one of the myelinated axons crossed the midline in the middle, large fiber component of the trapezoid body. Ipsilaterally, the axon always gave off from one to four collateral branches whose major targets were the posterior periolivary nucleus (PPO) and the lateral nucleus of the trapezoid body (LNTB). Minor termination sites for ipsilateral collateral branches were the dorsolateral periolivary nucleus (DLPO) and the lateral superior olive (LSO). Contralaterally the axon gave rise to one or two calyces of Held in the medial nucleus of the trapezoid body (MNTB). Three other major collateral branches arose from the contralateral axon and innervated a consistent set of areas. One headed caudally to innervate an area just ventromedial to the facial nucleus. Another followed the sixth nerve dorsally to innervate the dorsomedial periolivary nucleus (DMPO). A third collateral headed rostrally toward the ventral nucleus of the lateral lemniscus (VNLL), giving off occasional small sidebranches. Although each injected axon gave rise to a collateral that innervated the MNTB, it did not necessarily give rise to all three of the other collateral branches.

The case for no initial treatment of localized prostate cancer

This contribution summarizes the evidence from the natural history and pathology of this disease that, given the high incidence of latent cancer, a policy of radical treatment at diagnosis will represent over-treatment in the majority of cases. As yet, neither radical prostatectomy nor radical radiotherapy has been shown to be effective in managing the poorly differentiated tumor in the patient with "localized" disease. For the patient with well-differentiated disease, there is little evidence that early treatment is mandatory, because the majority of these patients will not die of prostatic cancer. The adoption of a policy of diagnosis followed by active surveillance would spare many patients the hazard and discomfort of a major operation or of a course of radiotherapy, would minimize expenditure, and would ensure that treatment was given only to those patients in whom progression had been demonstrated. Such an approach is almost certain to be as effective as treatment at diagnosis. Confirmation of this view is likely to be obtained from the existing studies of immediate versus delayed orchiectomy or LHRH therapy currently being undertaken by the Urological Working Party of the Medical Research Council in the United Kingdom and the Urological Group of the EORTC within Europe.

Some limitations of the radioisotope bone scan in patients with metastatic prostatic cancer. A subanalysis of EORTC trial 30853. The EORTC Urological Group

This article reviews the serial bone scans of 149 of 327 patients entered into a randomized prospective trial comparing orchidectomy versus zoladex and flutamide in patients with metastatic prostatic cancer. Attention is drawn to the difficulty of evaluating the response rate and of the importance of tumor load in determining survival. The use of sequential bone scans once the diagnosis of metastatic disease has been confirmed is of questionable value as the scans are expensive and contribute little to the further management of the patient in the absence of symptoms requiring relief.

Prostatic specific antigen and the prediction of prognosis in metastatic prostatic cancer

Serum prostate-specific antigen (PSA) levels were studied in the EORTC trial of zoladex plus flutamide versus orchidectomy in metastatic prostatic cancer. Forty-four of 60 patients had a decrease of PSA to less than or equal to 10 ng/ml at 3 to 6 months after treatment. The combination of a PSA less than 10 ng/ml after 3 to 6 months treatment and less than 15 spots on the bone scintigram at entry gave the highest probability of not having progressed by 24 months. A rising PSA anticipated bone progression by 6 to 12 months in 13 of 28 patients (46%). The PSA at entry to the trial was related to survival; a discriminant of 300 ng/ml distinguished a poor and better risk group. The lowest level of PSA reached during the first 6 months of treatment was also a univariate survival factor.

Identity in adolescence: Influences of dysfunction and psychosocial task issues

The Erikson Psychosocial Stage Inventory (EPSI) was utilized in two studies to investigate task resolutions (trust, autonomy, initiative, industry, identity) in adolescence. In the first study, a comparison of delinquents and non-delinquents indicated that delinquents have less successful task resolutions. In the second study, a comparison of adolescents with high and low dysfunctional attitudes again revealed that troubled adolescents have less successful task resolutions. In this study, 7th graders, 12th graders, first-year college students, and junior and senior college students participated. Older adolescents demonstrated more successful task resolutions than younger adolescents, and different identity issues were salient during early adolescence as compared to later adolescence. Also, first-year college students had more problems with identity consolidation and less positive overall task resolutions than high school seniors or college juniors and seniors. A life-context approach to identity formation is discussed.

Orchidectomy vs. Zoladex plus flutamide in patients with metastatic prostate cancer. The EORTC GU Group

Treatment with bilateral orchidectomy was compared with Zoladex, 3.6 mg depot, plus flutamide, 250 mg t.i.d., in a randomized prospective study by the European Organization for Research and Treatment of Cancer (EORTC). Small but statistically significant differences in time to subjective and objective progression of disease were found in favor of Zoladex plus flutamide. However, time from objective progression to death was longer in the orchidectomy group. The clinical significance of these differences requires further follow-up and analysis. No difference was found in overall survival between the 2 treatment groups.

Molecular recognition and metal ion template synthesis

Methods for the design and synthesis of ligands intended to be specific for a metal ion have been a recent chemical development. This article describes how this process can be inverted so that the specifics of the coordination environment around the metal ion can be used as a template in large-scale ligand synthesis. The synthesis of macrobicyclic ligands for ferric ion has been accomplished by using active esters of catechol ligands in which catecholate coordination to iron is a prelude to the organic chemical reactions that link the coordination subunits together into one ligand system surrounding a central metal ion coordination site. The lanthanide(III) ions, which are among the most labile metal ions known, have coordination numbers of 8 or higher, and thus their encapsulation into a macrobicyclic structure is a challenging problem. Lanthanide amine complexes have been used as metal templates in the synthesis of such macrobicyclic lanthanide complexes. There is evidence that such a complex is inert to exchange in aqueous solution.

Structural and functional properties distinguish two types of multipolar cells in the ventral cochlear nucleus

We distinguish two types of large multipolar cells designated sustained (CS) and onset (OC) choppers in the anterior posteroventral cochlear nucleus (A-PVCN)/nerve root region on the basis of certain anatomical and physiological features. CS axons head into the trapezoid body, while OC axons use the intermediate acoustic stria of Held. At the electron microscopic (EM) level, collateral terminals of OC axons contain pleomorphic vesicles; CS terminals contain small round vesicles. CS dendritic trees tend to be distributed in a stellate fashion while OC dendritic trees tend to be elongated. At the EM level the sustained chopper somata are sparsely innervated while the proximal dendritic tree receives considerably more input. The OC somata are highly innervated and this heavy innervation continues out onto the proximal dendrites. Distally the dendritic innervation falls off considerably for both categories. Physiologically, members of the OC population have wider dynamic ranges at the characteristic frequency (CF), wider response areas that are typically not flanked by inhibitory sidebands, and responses to short tones that do not show the same form of regularity expressed by sustained choppers. Intracellularly the sustained choppers exhibit sustained depolarization to short tones for the duration of the stimulus with resultant regular spiking at a rate that is stimulus level dependent. The response to swept tone shows this same level-dependent regularity. In response to tones, the OC cells also show a sustained depolarization whose amplitude is stimulus-level dependent but whose range is much greater and whose onset is initiated more abruptly. Although the onset component of the OC spike output is reliably initiated by these levels of depolarization, regular firing to the sustained depolarization is not initiated at levels of depolarization that would surely generate regular firing in sustained choppers. This regularity is also absent in the swept tone response despite marked levels of excitation.

Multivariate analysis of prognostic factors in patients with advanced prostatic cancer: results from 2 European Organization for Research on Treatment of Cancer trials

The European Organization for Research on Treatment of Cancer Genitourinary Group performed a multivariate statistical analysis of prognostic factors based on 436 patients entered between 1976 and 1981 in 2 randomized prospective trials that compared 4 different hormonal treatment regimens. Only previously untreated patients with advanced (stage T3/T4/M0 or M1) prostatic cancer were eligible. After identification of prognostic factors by means of univariate analyses a multivariate analysis using Cox's proportional hazards regression model was done. This test identified performance status (according to the Eastern Cooperative Oncology Group scale) as the most important factor, followed by acid phosphatase (more than 2 times normal) for stage M0 cancer patients, and alkaline phosphatase, T category and the presence or absence of associated chronic disease for stage M1 cancer patients. Based on these 4 variables nonbedridden patients with metastatic disease can be divided into 2 groups: poor and good risk patients, with median survivals of 1 and 3 years, respectively. This study shows that routine clinical and laboratory data already provide an excellent indication as to the prognosis.

Expectancies and memory for spatiotemporal events in 5-month-old infants

Five-month-old infants were trained to fixate four event locations, and recall was assessed following training in three experiments. Memory for four events was demonstrated in the first two studies, and memory for these events was also found to be robust following a 6- to 7-day delay. Infants demonstrated that they can anticipate upcoming events during training: they increased anticipatory behaviors during latter training trials, and they appeared to form expectancies of future events during periods of both stimulus onset and stimulus offset. Results are interpreted as consistent with a script representational view of memory for spatiotemporal events.

TNM classification of genitourinary tumours 1987--position of the EORTC Genitourinary Group

This report analyses the changes in the classification of the genitourinary tumours introduced by the 1987 edition of the TNM system. Criticism and suggestions for improvement are given. These are based on the extensive experience of the EORTC GU Group with clinical trial work particularly the identification of prognostic factors, on their success in reaching international consensus on tumour classification, and on information from the literature. Many of the changes introduced in the 1987 system are not considered to be strictly necessary. These include the introduction of the new additional descriptors, including "C" and "R", the changes in the T classification of prostatic and renal cancer, and the introduction of uniform N categories for all tumours and other features. We regret the omission of minimal requirements, the omission of the V classification for macroscopic or microscopic vascular invasion, the changes in the T categories of carcinoma of the bladder and the introduction of stage groupings for all urological tumours. Some of these changes are considered unacceptable. The attitude of the EORTC GU Group toward the use of the new TNM classification is indicated in detail.

Computer simulation of genetic control. Comparison of sterile males and field-female killing systems

A computer program, GENCON, designed to simulate genetic control using field-female killing systems, is described. These systems incorporate sex-linked translocations and conditional lethal mutations. Genetic death in field populations is caused by semisterility of the translocation and by homozygosis of the mutations in females and non-translocation males of field origin. Simulations using the program compare the effectiveness, in populations regulated by density, of genetic control using this type of system with control using sterile-male release. At high release rates, sterile males cause more rapid suppression and earlier eradication than sex-linked translocation strains. However, if releases are interrupted before eradication, the rate of recovery of density-dependent populations is more rapid following sterile-male release than following suppression with translocation strains. In such populations, the cumulative population suppression (number of individuals killed) is greater with translocation-strain release than with sterile-male release. At low release rates, sex-linked translocation strains can be much more effective at suppressing and eradicating density-dependent populations than sterile males. In continental Australia, eradication of the sheep blowfly Lucilia cuprina is probably not practicable. A suppression campaign using sex-linked translocation strains could yield a higher benefit to cost ratio than one using sterile males.

Long-term therapy with a depot luteinizing hormone-releasing hormone analogue (Zoladex) in patients with advanced prostatic carcinoma

We treated 191 patients with histologically proved locally advanced stage (T3 or T4) and/or metastatic prostate cancer with a biodegradable depot formulation of a luteinizing hormone-releasing hormone analogue (Zoladex). After an initial increase in serum testosterone in week 1 of therapy a continuous decrease of testosterone to castrate levels was obtained. With a monthly injection of the luteinizing hormone-releasing hormone analogue 4 patients (2 per cent) experienced a transient increase in bone pain, 1 had ureteral obstruction and 1 suffered paraplegia during the first few weeks of therapy. Over-all objective and subjective responses were similar to those obtained by castration or estrogen therapy. The absence of local and systemic (long-term) side effects proves the validity of this approach for patients with advanced prostatic cancer.

Effect of intravesical mitomycin C on recurrence of newly diagnosed superficial bladder cancer: interim report from the Medical Research Council Subgroup on Superficial Bladder Cancer (Urological Cancer Working Party)

A randomised control trial of intravesical instillation of mitomycin C was conducted in 457 patients with cancer of the bladder that was confined to the submucosa on histological examination. The events studied were the recurrence free rate, the recurrence rate/year, and the number of new tumours developing/year. At the initial cystoscopy the tumours were completely resected and the patients randomised to have no instillation of mitomycin C, a single instillation of 40 mg in 40 ml of water at that cystoscopy, or a single instillation and then four further instillations. All patients had follow up cystoscopies every three months for the first year, twice in the second year, and yearly thereafter. After a median of 12 months, follow up information was available for 397 patients. Patients receiving both the single instillation of mitomycin C and the instillations at five cystoscopic examinations had significantly lower yearly recurrence rates and tumour rates than those in the control group, and the group receiving multiple instillations fared significantly better than those receiving a single instillation. The figures on progression to invasive cancer were too small to allow conclusions to be drawn.

Characterization of HRP-labeled globular bushy cells in the cat anteroventral cochlear nucleus

We report on the anatomical and physiological features of globular bushy cells in the posterior division of the anteroventral cochlear nucleus based on the characteristics of 20 cells from this population. Each of these cells was recorded from and characterized intracellularly and/or extracellularly, injected with horseradish peroxidase, and studied at the light and/or electron microscopic level. Intracellular records from the vicinity of the globular bushy cell body displayed large, fast synaptic potentials, and in some instances a larger presumed action potential both in silence and during short tone stimulation. Intraaxonal recordings displayed large action potentials in addition to small, fast potentials, which evidence indicates may be the decrementally conducted subthreshold synaptic potentials. Both recording situations indicated that these auditory nerve inputs need not be suprathreshold. Bushy cells with high characteristic frequencies (CFs greater than 3 kHz) typically showed primary-like-with-notch responses to short tones at CF or on-type L responses if the sustained level of discharge after the notch was not as robust. Low-CF bushy cells phase-locked after a well-timed onset spike. Light microscopic anatomy revealed a typically oval cell body giving rise to one or two primary dendrites that branched profusely and an axon that gave off no collaterals within the cochlear nucleus before entering the trapezoid body. Electron microscopic analysis showed a high concentration of large, round, vesicle-containing terminals on the cell body and primary dendrite while the population of terminals on the initial segment and sparsely covered distal dendrites was made up mostly of flat and pleomorphic vesicle-containing terminals.

Immediate versus deferred treatment for early prostatic cancer

The diagnosis of early (non-metastatic) prostatic cancer is dependent upon the patient presenting himself with symptoms or for routine rectal examination or ultrasound screening. Diagnosis in the absence of symptoms is more common outside the United Kingdom and as a result the opportunity to treat such patients occurs more commonly in other countries. The treatment options for the different stages are reviewed and the evidence for their effectiveness is considered. A review of the literature yields conflicting evidence of the efficacy of and the necessity to institute early therapy. This basic gap in our current knowledge should be filled when the results of the existing Medical Research Council (MRC) clinical trial of immediate and deferred orchidectomy are available.

Herd evaluation of Fasciola hepatica infection levels in Louisiana cattle by an enzyme-linked immunosorbent assay

An enzyme-linked immunosorbent assay (ELISA) was evaluated as a method of determining relative immunoconversion rates in calves and how immunoconversion rates and strength of optical density values correlate with prevalence of Fasciola hepatica fecal egg shedding. Ten to 55 calves and cows were examined from each of 10 separate beef cattle herds in central and southern Louisiana. Infection prevalence rates for calves averaged 8% higher when ELISA optical density values were used than those when fecal egg count data were used. Of 55 calves in 8 herds that were ELISA positive, 39 were shedding F hepatica eggs; of 53 calves that were shedding eggs, 14 were ELISA negative. Significant correlation of calf fecal and ELISA prevalence was observed for 8 herds by linear regression analysis. A chi 2 analysis showed that calf ELISA and fecal egg shedding data were not independent. Results indicate that positive ELISA reactions for as few as 10 to 15 calves from the fall calf crop of a given herd are sufficiently accurate to be used to assess F hepatica herd infection rates, the likelihood of liver condemnations at feedlot destinations, and variation between individual farms in fascioliasis infection risk. The test was less valuable as a diagnostic test when used in adult animals previously exposed to F hepatica or on an individual animal basis.

Intravesical mitomycin C for the treatment of recurrent superficial bladder tumours

Forty-three patients with recurrent multiple superficial bladder tumours (Tis, Ta and Tl) were treated with Mitomycin C 20 mg in 20 ml water intravesically weekly for 8 to 12 weeks, and monthly instillations were continued for 5 to 6 months. Residual tumour was resected at 12 weeks, at which time 40 patients (93%) showed a response to treatment. A complete response was seen in 24 (56%) and 16 (37%) showed a partial response. After a follow-up of 12 to 48 months (median 19), 19 of 33 evaluable patients (58%) have shown tumour recurrence. Invasive tumour has developed in seven (17%) and transitional cell tumours of the ureter in two of those patients who showed an initial response to treatment.

A comparison of retrobulbar block produced by etidocaine 1% and by a mixture of lidocaine 2% and bupivacaine 0.75%

In this double-blind study, retrobulbar block for cataract surgery was produced in 43 patients with etidocaine 1% and in 37 patients with a mixture of equal volume of lidocaine 2% and bupivacaine 0.75% (final concentrations of 1% and 0.375%, respectively). While a greater proportion of etidocaine-treated patients needed supplemental drug for block, the times of onset of sensory and motor block were not different for the two groups. Compared to treatment with etidocaine, patients treated with the mixture had a slower recovery of motor function. While the proportion of patients reporting postoperative pain was about the same in each group, both the onset of pain and the use of analgesic agents occurred earlier in the group treated with etidocaine. Thus retrobulbar blocks produced by the combination of lidocaine and bupivacaine occurred as rapidly as those produced by etidocaine but had a longer duration.

A comparison of mercury and digital clinical thermometers

A primarily clinical trial has been undertaken to investigate and compare the use of mercury and digital thermometers in a ward situation. Both laboratory and clinical studies show that there is no significant difference in the average accuracy of the two types of thermometers, however there is a greater fluctuation of readings of temperature when using electronic thermometers. In clinical studies between 9 and 23% of repeated measurements using an electronic thermometer differ by 0.5 degrees C or more whilst the corresponding range for mercury thermometers is 0.6%. It is also shown that when making clinical measurements with mercury thermometers there is no clinical advantage in using a measurement time longer than 3 minutes.

A comparison of the effect of diethylstilbestrol with low dose estramustine phosphate in the treatment of advanced prostatic cancer: final analysis of a phase III trial of the European Organization for Research on Treatment of Cancer

In a randomized phase III trial performed by the Urological Group of the European Organization for Research on Treatment of Cancer low dose estramustine phosphate (280 mg. twice daily for 8 weeks and 140 mg. twice daily thereafter) was compared to diethylstilbestrol (1 mg. 3 times daily) in patients with stages T3 to T4, M0 or M1 prostatic cancer. Of 248 patients entered 227 were evaluable for analysis: 115 received estramustine phosphate and 112 received diethylstilbestrol. The best response of the local tumor as assessed by palpation was seen in patients receiving diethylstilbestrol. There was no significant difference between treatments for response rate of metastases, interval to local progression, distant progression, over-all survival and death of carcinoma of the prostate. Duration of survival was correlated with the assessment of local response as determined by palpation. The response of distant lesions also was correlated closely with survival. Diethylstilbestrol (1 mg. 3 times daily) was associated with a significantly worse degree of cardiovascular toxicity than estramustine phosphate. This finding was especially obvious in patients who had no history of cardiovascular disease. Gastrointestinal toxicity occurred in 25 patients treated with estramustine phosphate, including 6 in whom cessation of treatment was necessary. Further studies are required to determine the optimum dose of diethylstilbestrol and estramustine phosphate, and to establish the best form of hormonal treatment for prostatic carcinoma.

Physiological studies on neurons in the dorsal cochlear nucleus of cat

Results reported here support the conclusion that an individual neuron in the dorsal cochlear nucleus (DCN) can exhibit pauser, buildup, and chopper patterns in response to tone pips. Fusiform cells have been previously identified as the principal cell exhibiting these patterns. Fusiform cells can also exhibit an onset response followed by suppression of spontaneous activity at their characteristic frequency (CF). Off CF only suppression is seen. These neurons are characterized by a restricted excitatory region near threshold. All these cells can exhibit nonmonotonic rate curves, narrow excitatory regions, and inhibitory sidebands. Nonmonotonicity occurred in 34% of pausers, 52% of buildup, 89% of onsets with a graded response, and 50% overall in the DCN cells. Chopper units occur as often as the other types combined in the DCN. Only 14% show nonmonotonic rate curves. Those with high-spontaneous activity also show inhibitory sidebands. Cells with a predominant buildup pattern occur most frequently in the fusiform cell layer, whereas pausers occur throughout the DCN below the molecular layer. Intracellular potentials often reflect the average response pattern. Sharply delimited response areas indicate that these cells may be useful for performing a spectral analysis. These cells show almost no phase locking suggesting that temporal encoding is an unlikely function. It is suggested that the effects of anesthetic on the function of the DCN is not as marked as previously indicated.

Encoding timing and intensity in the ventral cochlear nucleus of the cat

Physiological response properties of neurons in the ventral cochlear nucleus have a variety of features that are substantially different from the stereotypical auditory nerve responses that serve as the principal source of activation for these neurons. These emergent features are the result of the varying distribution of auditory nerve inputs on the soma and dendrites of the various cell types within the nucleus; the intrinsic membrane characteristics of the various cell types causing different responses to the same input in different cell types; and secondary excitatory and inhibitory inputs to different cell types. Well-isolated units were recorded with high-impedance glass microelectrodes, both intracellularly and extracellularly. Units were characterized by their temporal response to short tones, rate vs. intensity relation, and response areas. The principal response patterns were onset, chopper, and primary-like. Onset units are characterized by a well-timed first spike in response to tones at the characteristic frequency. For frequencies less than 1 kHz, onset units can entrain to the stimulus frequency with greater precision than their auditory nerve inputs. This implies that onset units receive converging inputs from a number of auditory nerve fibers. Onset units are divided into three subcategories, OC, OL, and OI. OC units have extraordinarily wide dynamic ranges and low-frequency selectivity. Some are capable of sustaining firing rates of 800 spikes/s at high intensities. They have the smallest standard deviation and coefficient of variation of the first spike latency of any cells in the cochlear nuclei. OC units are candidates for encoding intensity. OI and OL units differ from OC units in that they have dynamic ranges and frequency selectivity ranges much like those of auditory nerve fibers. They differ from one another in their steady-state firing rates; OI units fire mainly at the onset of a tone. OI units also differ from OL units in that they prefer frequency sweeps in the low to high direction. Primary-like-with-notch (PLN) units also respond to tones with a well-timed first spike. They differ from onset cells in that the onset peak is not always as precise as the spontaneous rate is higher. A comparison of spontaneous firing rate and saturation firing rate of PLN units with auditory nerve fibers suggest that PLN units receive one to four auditory nerve fiber inputs. Chopper units fire in a sustained regular manner when they are excited by sound.(ABSTRACT TRUNCATED AT 400 WORDS)

Insulin-like material in parotid and submaxillary salivary glands of normal and diabetic adult male mice

Acid-ethanol extracts of homogenates from the parotid and submaxillary salivary glands of normal and streptozocin-induced diabetic adult male mice were investigated for insulin-like material. Extracts of both the parotid and submaxillary glands contained insulin-like immunoreactivity. The values were 156 +/- 72 ng/g wet tissue in the parotid and 104 +/- 36 ng/g wet tissue in the submaxillary gland. Fractionation of this material on Sephadex G-50 (superfine) columns revealed a single peak corresponding to the elution volume of isotopically labeled insulin. Isolated fat cells were stimulated by these extracts to convert [14C]glucose to 14CO2. This effect was blocked by preincubation with anti-insulin serum. It was observed with the avidin-biotin immunocytochemical technique that both the parotid and submaxillary glands of adult male mice possess a population of cells containing an insulin-like material. After intraperitoneal injection of streptozocin there was a marked decrease of insulin-like material extractable from both the parotid and submaxillary glands. However, this beta-cell cytotoxic agent did not completely destroy the salivary cells containing the insulin-like material. These data suggest that both the parotid and submaxillary salivary glands may be extrapancreatic sources of insulin in mice.

Immunocytochemical localization of insulin- and glucagonlike peptides in rat salivary glands

An avidin-biotin immunocytochemical technique was used to localize cells containing an insulin- or glucagon-like peptide in the major salivary glands of Sprague-Dawley rats. Cells with insulin-like staining were observed in the intercalated ducts of both the parotid and submandibular glands, but none were found in the sublingual gland. A discrete population of cells with intense glucagon-like immunostaining was associated with the acini of all three major salivary glands. This immunostaining only followed use of a glucagon antiserum with N-terminal specificity and not after incubation of tissues with an anti-glucagon serum having C-terminal specificity. These results suggest that rat salivary glands may contain peptides potentially capable of influencing substrate metabolism. In addition, the present findings indicate that the glucagon-like peptide found in salivary glands has a greater immunocytochemical similarity to glicentin (gut-type glucagon) and/or glucagon precursors than to the 3500 molecular weight pancreatic glucagon.

Cardiovascular side effects of diethylstilbestrol, cyproterone acetate, medroxyprogesterone acetate and estramustine phosphate used for the treatment of advanced prostatic cancer: results from European Organization for Research on Treatment of Cancer trials 30761 and 30762

Two randomized trials were started in 1976 by the European Organization for Research on Treatment of Cancer urological group. Trial 30761 compared 1 mg. diethylstilbestrol orally 3 times daily to 250 mg. oral cyproterone acetate daily and to 500 mg. medroxyprogesterone acetate intramuscularly 3 times weekly for 8 weeks, then 200 mg. orally daily. Trial 30762 compared 3 mg. diethylstilbestrol to 560 mg. estramustine phosphate orally for 8 weeks and then 280 mg. daily. The 239 patients in study 30761 and 226 in study 30762 were evaluated for cardiovascular toxicity during treatment. Various types of side effects (fluid retention, hypertension, electrocardiographic changes, myocardial infarction and thromboembolic disease) and their degrees of severity were analyzed. In both studies the most frequent type of cardiovascular toxicity was represented by fluid retention. Cardiovascular toxicity as a whole was higher with diethylstilbestrol than with estramustine phosphate or medroxyprogesterone acetate therapy, and was the lowest with cyproterone acetate therapy. The risk of severe cardiovascular complications developing was the highest during the first 6 months of treatment. Increasing age, body weight greater than 75 kg. and, especially, the presence of previous cardiovascular disease represented adverse factors in the development of cardiovascular toxicity.

Immunochemical studies of an insulin-like material in the parotid gland of diabetic BB rats

Immunocytochemical and radioimmunoassay studies were performed on pancreatic and parotid tissues from diabetic BB and control Wistar rats. Compared with those of normoglycemic controls, the pancreata of diabetic BB rats generally lacked insulin-containing B-cells. Extracts from the parotid glands of diabetic rats contained less immunoassayable insulin-like material than was present in parotid extracts of controls. However, the parotid glands of both groups of animals contained numerous cells displaying insulin-like immunoreactivity. These insulin-immunoreactive cells, located mainly in the intercalated portion of the duct system, were comparable to those we reported recently in the parotid glands of normal and streptozocin-diabetic Sprague-Dawley rats. The presence of an insulin-like material in the parotid salivary gland of two types of diabetic animals suggests that such cells may be spared, in part, from the effects of both chemical and hereditary diabetogenic factors.

Mitomycin C in superficial bladder cancer: 24-month follow-up

Twenty-three patients who were given intravesical Mitomycin C for treatment of superficial bladder cancer have been followed up for a further 12 and 24 months after an initial assessment 5 weeks after completing therapy. At 5 weeks 17 (74%) showed complete disappearance of tumour and 4 (17%) showed a partial response. Twelve months later 8 (35%) remained tumour-free and 15 (65%) had recurrences; 5 of these (22% of all patients) had progressed to invasive cancer. The results at 24 months were little different except that one further patient (27% in all) progressed to invasive cancer. Six patients with symptomatic carcinoma in situ became symptom-free after Mitomycin C, but despite remaining free of symptoms three have progressed to invasive cancer. This small series shows that involvement of large areas of bladder urothelium by tumour, carcinoma in situ and previous therapy for tumour are unfavourable prognostic indices.

Effects of substantia nigra lesions on the volumes of A, B, and D cells and the content of insulin and glucagon in the rat pancreas

The effects of substantia nigra lesions on the volume densities of islet cells and on the content of insulin and glucagon in the pancreas were examined using five groups of age-matched, Sprague-Dawley rats. Two groups received bilateral substantia nigra lesions using intrathecal injections of either a low (6 micrograms/hemisphere) or a high (12 micrograms/hemisphere) dose of 6-hydroxydopamine. Rats given sham lesions served as controls for the effects of the neurotoxic drug. These three groups, plus a fourth consisting of unoperated controls, were provided with a high-fat diet to minimize lesion-induced alterations of food intake and body weight. Eleven weeks after lesion placement, tissue was collected from all animals for the assessment of islet cell volume densities and the pancreatic content of insulin and glucagon. Plasma samples also were obtained to determine the levels of glucose, insulin, and glucagon. Data from those animals were compared with that obtained from a fifth group, termed "pre-lesion controls", sacrificed at the beginning of the experiment. Linear-scan morphometry documented an increase of B-cell volume density in the pancreas of non-lesioned rats over the 11-week period (p less than 0.05). However, the volume density of B cells in the pancreas of lesioned animals did not increase compared with that of pre-lesion controls. In terms of A or D cells, no significant differences of volume density were found between the five groups. Compared with that of the pre-lesion controls, pancreatic insulin and glucagon content increased in the lesioned and neurally-intact animals.(ABSTRACT TRUNCATED AT 250 WORDS)

Electron microscopic features of physiologically characterized, HRP-labeled fusiform cells in the cat dorsal cochlear nucleus

We report on the anatomy and physiology of three fusiform cells in the dorsal cochlear nucleus (DCN) of the cat. The extra- and intracellular responses of these cells to pure tones showed features typical of the cell type. Peristimulus time histograms (PSTHs) were usually of the pauser or buildup configuration with chopping behavior noted in certain instances. Intracellular records during stimulus presentations revealed sustained depolarizations for the duration of the tone followed by a prolonged after-hyperpolarization (AHP). On rare occasions, a hyperpolarization corresponding to the pause region of the PSTH was noted. Occasionally, a stimulus-induced depolarization would be maintained after stimulus offset. Rebound excitation was also observed after the AHP. Morphologically, all three cells showed the standard fusiform cell features at the light microscopic level. The cell body gave rise to apical and basal dendritic trees. The apical tree branched frequently and displayed numerous spines distally. The basal tree had fewer branches and fewer, more irregular appendages. The axon originated from the cell body and gave rise to one or more collaterals before leaving the nucleus via the dorsal acoustic stria (DAS). At the electron microscopic (EM) level, the axon collaterals may terminate on a variety of cell types in the DCN, including fusiform cells. Their vesicles are round and the terminals closely resemble many unlabeled terminals seen on the cell body and apical and basal dendrites of our labeled fusiform cells. Terminals containing round vesicles, believed to be eighth nerve terminals, were found, with one exception, only on the basal dendrites. The spine-laden, distal apical dendrites received primarily terminals containing round vesicles, presumed to originate from the unmyelinated axons of granule cells. The cell body and unmyelinated initial segment received mostly terminals containing pleomorphic and flat vesicles, which also made up a large percentage of the dendritic input. Some relevant correlations, between the distribution of synaptic terminals and the observed physiology, may be possible.

Effects of doxylamine and acetaminophen on postoperative sleep

The separate and combined effects of doxylamine succinate (25 mg) and acetaminophen (1 gm) on sleep were studied by interview procedures and information from medical records of 2,931 postoperative patients. The sample contained 1,617 patients with mild or moderate pain and 1,314 who were free of pain. Each received either doxylamine alone (S), acetaminophen alone (A), a combination of both drugs (C), or placebo (P). Drug treatment was double blind and randomized separately for the pain and pain-free subsamples. Twelve measures of sleep were determined. C was more beneficial than S or A, and S and A were each superior to P. For all 12 sleep measures, the effect of the combination (C - P) approximated or exceeded the sum of the two separate effects (S - P) + (A - P). The presence of either drug tended to enhance the sleep benefit of the other. The sedative and analgesic benefits to sleep were at least additive, and some outcome measures suggested synergism. In the total sample, the contributions of sedative and analgesic similar. Among patients with pain, contributions of the analgesic surpassed those of the sedative. For patients free of pain, the sedative was better, but even pain-free patients had enhanced sleep after the analgesic. The analgesic, but not the sedative, reduced pain; the analgesic induced the feeling of being well rested and not tired; the sedative induced a feeling of being drugged. Nondrug variables (e.g., pain, sex, age, and sleep expectations) influenced sleep outcome at least as much as drugs, but randomization and the large sample prevented those extraneous variables from biasing drug comparisons.

Characteristics of tone-pip response patterns in relationship to spontaneous rate in cat auditory nerve fibers

The responses of single auditory nerve (AN) fibers in the cat were recorded in response to 25 ms tone pips. Peristimulus time histograms (PSTH) of discharge patterns recorded from fibers with high spontaneous rates (high SRs), show that the discharge rate rapidly adapts to a much lower steady-state level over a 15 ms period with shorter times for units with best frequencies (CFs) greater than 5 kHz. The PSTHs of auditory nerve fibers with low SRs do not show this pattern of rapid adaptation. Differences between the high and low SR populations include higher thresholds, better tuning, and longer latency in the low SR population. The peak-to-steady-state discharge ratio is an increasing function of SR and CF; it varies from 1.0 for fibers with SR = 0 to over 8 for fibers with high SRs and CFs near 10 kHz. This ratio increases with increasing stimulus intensity and stimulus recovery time. The high SR population shows a number of responses to transients which are weak or absent in the low SR population. Increasing the recovery time shortened the latency of both high and low SR AN fibers by as much as 1 ms. A number of other response properties of AN fibers are also reported that are important when interpreting the responses of cochlear nucleus neurons to tone pips.

Treatment of invasive bladder cancer by local resection and high dose methotrexate

Fifty-seven patients with transitional cell carcinoma of the bladder, categories pT2, pT3a and pT3b, were treated by transurethral resection of the tumour mass (54 cases) or partial cystectomy (3 cases) followed by 8 doses of methotrexate 2 g i.v. every 3 weeks with appropriate Leucovorin rescue. At completion of chemotherapy 6 months after TUR 33/57 patients were tumour-free; 5/57 had new superficial tumours; 13/57 had persistent tumour invading muscle, 3 showed tumour progression and 3 had died from treatment complications. One-year survival was 45/57 (82%); 2-year survival was 23/39. Although some patients developed metastases and others have grown new superficial tumours, of those surviving, the bladder was free of the original invasive tumour in 38/45 (84%) at 1 year and in 19/24 (79%) at 2 years. It is concluded that transurethral resection plus high dose methotrexate may offer an effective alternative to radiotherapy or cystectomy for a significant proportion of patients with invasive bladder cancer.

Immunocytochemical localization of insulin- and somatostatin-like material in human breast tumors

Four types of human breast lesions and C3H mouse mammary adenocarcinomas (type A) were examined for the immunocytochemical localization of cells containing hormone-like substances. Insulin- or somatostatin-like immunoreactive material was observed in scattered single cells and nests of tumor cells in seven of eight infiltrating duct carcinomas, and in the majority of tumor cells from an anaplastic carcinoma. A few somatostatin-immunoreactive cells were observed in only one of seven fibroadenomas studied. No immunoreactive cells were observed in mouse adenocarcinomas or in human breast dysplasias. These results suggest that cells with hormone-like immunoreactivity may be a common feature in two types of malignant human breast tumors.