Simple and complex visual motion response properties in the anterior medial bank of the lateral suprasylvian cortex

The cortical regions surrounding the suprasylvian sulcus have previously been associated with motion processing. Of the six areas originally described by Palmer et al. [J Comp Neurol 177 (1978) 237], the posteromedial lateral suprasylvian (PMLS) cortex has attracted the greatest attention. Very little physiological information is available concerning other suprasylvian visual areas, and in particular, the anteromedial lateral suprasylvian cortex (AMLS). Based on its cortical and sub-cortical connectivity patterns, the AMLS cortex is a likely candidate for higher-order motion processing in cat visual cortex. We have investigated this possibility by studying the receptive field sensitivity of AMLS neurons to complex motion stimuli. Neurons in AMLS cortex exhibited large (mean of 354 degrees (2)) and complex-like receptive fields, and most of them (74%) were classified as direction selective on the basis of their responses to sinusoidal drifting gratings. Most importantly, direction selectivity was present for complex motion stimuli. A subset of the neurons sampled (eight of 38 cells; 21%) exhibited pattern-motion selectivity in response to moving plaid patterns. The capacity of AMLS neurons to signal higher-order stimuli was further supported by their selectivity to moving complex random-dot kinematograms. Finally, 45% of 20 neurons were direction selective to a radial optic flow stimulus. Overall, these results suggest that AMLS cortex is involved in higher-order analyses of visual motion. It is possible that the AMLS cortex represents a region between PMLS and the anterior ectosylvian visual area in a functional hierarchy of areas involved in motion integration.

Effects of methanol on the retinal function of juvenile rats

We have investigated the effect of methanol exposure on the retinal function of juvenile rats. The electroretinogram (ERG) and oscillatory potentials (OPs) were recorded prior to and up to 72 h after the administration of methanol. Data were compared to a control group which was only exposed to physiological saline. Our findings can be summarized as follows: methanol generally reduced the amplitude of all retinal potentials, and in some cases, to baseline levels. The ERG b-wave was affected earlier and more prominently than the a-wave. All measured OPs (2-4) were decreased but OP2 was less affected, suggesting that the cone pathway may be less sensitive to methanol than the rod-mediated pathway. These data indicate that juvenile rats (21 days old, i.e. with an immature synaptic development) present a sensitivity to methanol comparable to that observed in adult animals.

Key-factor analysis of immature stages of Aedes scapularis (Diptera: Culicidae) populations in southeastern Brazil

Development times and mortality factors were investigated for populations of Aedes scapularis (Rondani) occurring in natural temporary ground pools in southeastern Brazil. Analysis of life tables by the key-factor method showed that mortality caused by desiccation of breeding sites was the principal factor accounting for fluctuations in population sizes throughout the study period. For cohorts that completed development, mortality attributed to predation by aquatic insects ranged from 68 to 96% and was the most important cause of death. In these cohorts, final population size was determined by the high mortality rates that occurred during the fourth larval instar and pupal stages; however, the key-factor best accounting for the population fluctuations was predation of fourth instar larvae. The short mean time of 7.1 days for synchronous development of the larvae and the lack of evidence of density-dependent mortality suggested that the A. scapularis populations were not strongly regulated and can attain relatively high densities.

Response properties in the pulvinar complex after neonatal ablation of the primary visual cortex

Injuries to specific areas of the brain (such as cerebrovascular accidents or surgical procedures) and particularly to the primary visual cortex, yield profound visual defects. The level of spared visual functions or residual vision depends on the extent and location of the lesion as well as the age at which the trauma occurs. For instance, in primate as well as non-primate species, it is well established that lesions in adulthood have a more profound effect than those occurring in young animals. The recovery of visually guided behavior observed after massive destruction of the occipital cortex in young animals across many species has been generally associated with the reorganization of the pathways from the extrageniculate thalamus to the spared visual cortex, i.e. the extrastriate areas. In this chapter, we present some evidence that the lateral posterior-pulvinar (LP-pulvinar) complex may contribute to maintaining visual capacities in brain-damaged cats. Our data indicate that the overall visual responsiveness of the lateral part of the LP (LPl) cells is not altered by the early removal of the visual cortex. However, some specific properties differ from those of intact animals: on average, LPl neurons in brain-damaged animals are more broadly tuned for orientation than that in intact cats. Spatial frequency tuning functions are also affected since most units in lesioned animals are of the low-pass type. Moreover, most LPl cells of lesioned cats responded to drifting gratings with modulated discharges and a linear spatial summation within their receptive field, a characteristic that is infrequently observed in intact animals. The change in LPl response properties observed in the present study is likely to come from the reorganization of cortical and retinal fibers reaching this extrageniculate nucleus.

Higher-order motion processing in the pulvinar

Thalamic nuclei have long been considered as passive relay stations for sensory signals en route to the cerebral cortex, where higher level processing occurs. In recent years, it has been proposed that thalamic nuclei may actively participate in the processing of specific information in conjunction with cortical areas. In support of this hypothesis, we recently discovered that neurons in the main extrageniculate visual nucleus, the pulvinar, exhibit higher-order visual properties that were, until now, only associated with higher-order cortical areas. Pulvinar neurons can indeed code the veridical direction of a moving plaid pattern, indicating that these cells can integrate ambiguous signals into a coherent percept. This finding as well as our demonstration that there are cortico-thalamo-cortical loops involved in complex motion analysis open promising avenues in unraveling the function of the pulvinar complex in normal vision.

When the auditory cortex turns visual

We studied visually guided behavior and the visual response properties of single auditory cortex (A1) neurons in neonatally operated hamsters with surgically induced, permanent, ectopic retinal projections to auditory thalamic nuclei and to visual thalamic nuclei which normally receive little direct retinal input. The surgically induced retino-thalamo-cortical pathways can mediate visual guided behaviors whose normal substrate, the pathway from the retina to the primary visual cortex via the primary thalamic visual nucleus, is missing. The visually evoked response properties of A1 neurons resemble in many respects those of neurons in V1 of normal hamsters: many A1 neurons have well-defined visual receptive fields and preferences for orientation or direction of movement. In addition, some visually responsive cells in A1 are bimodal--they also respond to auditory stimuli. The visually responsive neurons in A1 probably account for the capacity of the auditory cortex to mediate visual behavior in 'rewired hamsters'.

Functional sub-regions for optic flow processing in the posteromedial lateral suprasylvian cortex of the cat

During locomotion, an observer sees a large and complex pattern of visual motion called optic flow. This phenomenon is characterized by elements in the environment accelerating and expanding as they move peripherally. In cats, previous studies have indicated that the posteromedial part of the lateral suprasylvian (PMLS) cortex may be involved in the processing of optic flow fields. We further addressed this issue by studying the importance of specific parameters of the optic flow patterns and investigating whether cell responses to these stimuli depend on receptive field (RF) location in the visual field. Results can be summarized as follows: approximately two-thirds of PMLS cells responded to optic flow fields and a subset of these (84/153) showed a clear direction selectivity for motion along the frontal axis. Of these units, the majority responded preferentially to expansion rather than contraction of the pattern. Cells' responses depend on RF location in the visual field. For centrally located RFs, tested both when the origin of motion was within the RF or at the area centralis, responses were generally comparable whether or not size or speed gradients were removed from the optic flow pattern. A different tendency was observed for peripherally located RFs. In general, these cells exhibited a preferred direction almost exclusively when the origin of motion was placed at the area centralis, and neuronal discharges and direction selectivity for many of them were reduced when the optic flow cues were removed from the pattern. The results of this study suggest that there may be functional differences in response properties between PMLS cells located in the central and peripheral parts of the visual field that may reflect a specialization of the PMLS cortex in optic flow processing.

[Triatoma infestans in area under entomological surveillance for Chagas' disease in São Paulo State, Brazil]

In response to notification of the capture of a winged triatomine bug by local inhabitants, an epidemiological investigation was investigated in the rural area of the Municipality of Paulínia, São Paulo State (Brazil). This led to the collection of 109 specimens of Triatoma infestans from peridomiciliary breeding sites. Local conditions favored colonization by triatomine bugs: many abandoned outbuildings were inhabited by pigeons and sparrows, which meant abundant feed for these bugs. Thus, surveillance is mandatory as long as conditions for triatomine breeding persist. Nevertheless, entomological and serological indicators ruled out immediate concern over vectorial transmission of Chagas' disease in this municipality. All domiciliary units of the region were sprayed with residual-effect insecticides and the triatomine breeding sites were destroyed by the use of mechanical control of bird nests. The importance of reporting the occurrence of triatomine bugs, particularly Triatoma infestans, in this region, is emphasized.

Global motion integration in the cat's lateral posterior-pulvinar complex

Our laboratory previously showed that thalamic neurons in an extrageniculate nucleus, the lateral posterior-pulvinar complex (LP-pulvinar) could perform higher-order neuronal operations that had until then only been attributed to higher-level cortical areas. To further assess the role of the thalamus in the analysis of complex percepts, we have investigated whether neurons in the LP-pulvinar complex can signal the direction of motion of random-dot kinematograms wherein the individual elements of the pattern do not provide coherent motion cues. Our results indicate that a subset of LP-pulvinar cells can integrate the displacement of individual elements into a global motion percept and that their large receptive fields permit the integration of motion for elements separated by large spatial intervals. We also found that almost all of the global motion-sensitive neurons were not systematically pattern-motion-selective when tested with plaid patterns. The results indicate that LP-pulvinar cells can perform the higher-level spatio-temporal integration required to detect the global displacement of objects in a complex visual scene, further supporting the notion that extrageniculate thalamic cells are involved in higher-order motion processing. Furthermore, these results provide some evidence that there may be specialized mechanisms for processing different types of complex motion within the LP-pulvinar complex.

[Hospitalizations due to ambulatory care sensitive conditions: selection of diagnostic codes for Spain]

BACKGROUND

Hospitalisations due to Ambulatory Care Sensitive Conditions (ACSC) are considered an indicator to measure the use of hospital services because of health conditions that could have been prevented and controlled by primary health care. The objective of this study is to select the list of diagnostic codes to assess the performance of primary health care in Spain.

METHODS

The five criteria proposed by Weissman and Solberg, to select an appropriate indicator, were applied to a first list of 87 ACSC diagnostic codes identified through bibliographic search. Information on two main criteria-whether care for a health condition was a primary health care role and whether hospitalisation was needed once the health problem occurred was obtained by means of the Delphi technique. A group of 44 experts gathered together for the study. For the remaining criteria, information came from the results of the Pilot study on hospitalisations due to ACSC in Catalonia, Spain. Meeting the five criteria was the criterion selected to evaluate the solving ability of primary health care.

RESULTS

a) from the Delphi group: 42 (95.4%) participants completed the three rounds. The question on whether the care of the selected health conditions was responsibility of primary health care reached a high level of consensus (between 86.1 and 100%). The consensus on the need for hospitalisation was lower, from 75.7 to 88.6%, moreover, 5 diagnostic codes did not reach the established consensus, and b) from the ACSC selection process: five diagnostic codes did not meet the criteria and were excluded. Out of the remaining 82, all them were considered as health problems to be cared for at primary level and in 37 cases hospitalisation was considered always as necessary. Thirty-five diagnostic codes, that met the five criteria, represented the set of ACSC diagnostic codes in our setting.

CONCLUSIONS

A set of 35 diagnostic codes of ACSC, adapted to our setting, is proposed to evaluate primary health care performance. The selected codes reduce significantly the limitations that stem from hospital admission criteria due to patient clinical characteristics, variations in hospital medical practice, and hospital admission policies.

A soil emergence trap for collections of phlebotomine sand flies

The identification of breeding sites of sand flies is of great epidemiological interest. A soil emergence trap for investigating potential sand fly breeding sites is described. The trap was tested in two rural areas in the Mogi Guaçu River Valley where the American cutaneous leishmaniasis is an endemic disease. Seventy-three sand fly individuals of three species, Lutzomyia intermedia s. l., L. whitmani and L. pessoai, were collected on the forest floor and peridomicile.

Retinogeniculate projections following early cerebral hemispherectomy in the vervet monkey

The effects of early, unilateral cerebral hemispherectomy on retinogeniculate projections were studied in the vervet monkey (Cercopithecus aethiops sabeus). Hemispherectomy eliminates all geniculocortical pathways and thus removes cortical factors involved in the survival of retinogeniculate projections. Complete removal of the left cerebral cortex was performed in two monkeys at 6 months and 8 months of age. After a post-surgical survival period of 50 months (SHG3) and 45 months (SHG4), both animals and a normal adult monkey received intraocular injections of [3H]proline (5 mCi) in the left eye and WGA-HRP (100 microliters, 5%) in the right eye. The dorsal lateral geniculate nucleuseuron (LGNd) ipsilateral to the hemispherectomy was on average 73% smaller than the contralateral LGNd. The magno- and parvocellular layers ipsilateral to the cortical ablation in both hemispherectomized subjects received a layered, eye-specific pattern of retinal input. This suggests that retinogeniculate projections could be sustained in the absence of geniculate relay cells.

Long-term controlled trial of nocturnal nasal positive pressure ventilation in patients with severe COPD

STUDY OBJECTIVES

To determine the 1-year efficacy of noninvasive positive pressure ventilation (NPPV) added to long-term oxygen therapy (LTOT) in patients with stable severe COPD. PATIENT SELECTION AND METHODS: We prospectively randomized 52 patients with severe COPD (FEV(1) < 45%) to either NPPV plus "standard care" (96% patients with LTOT) or to standard care alone (93% patients with LTOT). The outcomes measured included the following: rate of acute COPD exacerbations; hospital admissions; intubations; and mortality at 3 months, 6 months, and 12 months. The patients were also evaluated at 3 months and 6 months for dyspnea using the Medical Research Council and Borg scales, gas exchange, hematocrit, pulmonary function, cardiac function with echocardiogram, and neuropsychological performance.

RESULTS

One-year survival was similar in both groups (78%). The number of acute exacerbations was similar at all time points in patients receiving NPPV, compared with control subjects. The number of hospital admissions was decreased at 3 months in the NPPV group (5% vs 15% of patients, p < 0.05), but this difference was not seen at 6 months (18% vs 19%, respectively). The only beneficial differences were observed in the Borg dyspnea rating, which dropped from 6 to 5 (p < 0.039), and in one of the neuropsychological tests (psychomotor coordination) for the NPPV group at 6 months.

CONCLUSIONS

Our study indicates that over 1 year, NPPV does not affect the natural course of the disease and is of marginal benefit in outpatients with severe COPD who are in stable condition.

Responses of neurons in the cat posteromedial lateral suprasylvian cortex to moving texture patterns

The posteromedial lateral suprasylvian cortex represents a point of convergence between the geniculostriate and extrageniculostriate visual pathways. Given its purported role in motion analysis and the conflicting reports regarding the texture sensitivity of this area, we have investigated the response properties of cells in PMLS to moving texture patterns ("visual noise"). In contrast to previous reports, we have found that a large majority of cells (80.1%) responds to the motion of a texture pattern with sustained discharges. In general, responses to noise were more broadly tuned for direction compared to gratings; however, direction selectivity appeared more pronounced in response to noise. The majority of cells was selective for drift velocity of the noise pattern (mean optimal velocity: 26.7 degrees /s). Velocity tuning was comparable to that of its principal thalamic input, the lateral posterior pulvinar nucleus. In general, responsiveness of cells in the posteromedial lateral suprasylvian cortex increased with increasing texture element size, although some units were tuned to smaller element sizes than the largest presented. Finally, the magnitude of these noise responses was dependent on the area of the visual field stimulated. In general, a stimulus corresponding to roughly twice the size of the receptive field was required to elicit an equivalent half-maximal response to that for gratings. The results of this study indicate that the majority of cells in the posteromedial lateral suprasylvian cortex can be driven by the motion of a fine texture field, and highlight the importance of this area in motion analysis.

Effects of angiotensin II on visual evoked potentials in the superior colliculus of juvenile rats

There are age-related changes in the relative expression of the AT(1)and AT(2)receptors of angiotensin II (Ang II) in brain regions such as the superior colliculus, a midbrain visual structure where both receptor subtypes are found. We investigated the effects of Ang II on gross visual activity in the colliculus of anesthetized rats aged between 15 and 35 post-natal days. Microinjection of Ang II in the superficial layers yielded a strong reduction in the amplitude of visual evoked potentials in a dose-related manner. Injection of the peptide in more ventral collicular layers did not modify the potential confirming the discrete localization of the angiotensinergic receptors in the superficial layers. Preliminary data indicated that the co-injection of Ang II with Losartan or PD 123319 yielded a partial blockade of Ang II suppressive effects, indicating that both AT(1)and AT(2)receptors are likely to be involved in mediating these responses. Overall, this study shows that the inhibitory nature of Ang II action is similar in juvenile and adult animals (Merabet et al. 1994 and Merabet et al. 1997)

Chagas disease in an area of recent occupation in Cochabamba, Bolivia

INTRODUCTION

A descriptive, entomological and seroepidemiological study on Chagas disease was conducted in a place of recent occupation on the outskirts of Cochabamba, Bolivia: Avaroa/Primer de Mayo (population:3,000), where the socio-economic level is low and no control measures have been made available.

METHODS

The immunofluorescent antibody test (IFAT) was used for IgG and IgM anti-Trypanosoma cruzi antibodies in filter paper bloodspot eluates from 128 subjects (73 females, 55 males) selected by systematic sampling. Concerning each subject age, gender, birthplace, occupation, duration of residence and building materials used in their houses were recorded. Vectors were captured both in domestic and peridomestic environments.

RESULTS

Seropositive, 12.5% (16/128): females, 15.1% (11/73); males, 9.1% (5/55). Average time of residence: 6.1 years for the whole population sample and 7.4 years for the seropositive subjects. Most houses had adobe walls (76. 7%, n= 30), galvanized iron rooves (86.7%) and earthen floors (53. 4%) 80% of the walls had crevices. One hundred forty seven specimens of Triatoma infestans were captured, of which 104 (70.7%) were domestic, and 1 peridomestic Triatoma sordida. Precipitin host identification: birds, 67.5%; humans, 27.8%; rodents, 11.9%; dogs, 8. 7%; cats, 1.6%. House infestation and density indices were 53.3 and 493.0 respectively. We found 21 (14.3%) specimens of T. infestans infected with trypanosomes, 18 (85.7%) of which in domestic environments.

DISCUSSION

The elements for the vector transmission of Chagas disease are present in Avaroa/Primer de Mayo and the ancient custom of keeping guinea pigs indoors adds to the risk of human infection. In neighboring Cochabamba, due to substandard quality control, contaminated blood transfusions are not infrequent, which further aggravates the spread of Chagas disease. Prompt action to check the transmission of this infection, involving additionally the congenital and transfusional modes of acquisition, is required.

Motion integration in a thalamic visual nucleus

Thalamic nuclei have long been regarded as passive relay stations for sensory information en route to higher level processing in the cerebral cortex. Recently, physiological and theoretical studies have reassessed the role of the thalamus and it has been proposed that thalamic nuclei may actively participate with cortical areas in processing specific information. In support of this idea, we now show that a subset of neurons in an extrageniculate visual nucleus, the lateral-posterior pulvinar complex, can signal the true direction of motion of a plaid pattern, indicating that thalamic cells can integrate different motion signals into a coherent moving percept. This is the first time that these computations have been found to occur outside the higher-order cortical areas. Our findings implicate extrageniculate cortico-thalamo-cortical loops in the dynamic processing of image motion, and, more generally, as basic computational modules involved in analysing specific features of complex visual scenes.

[Sandflies (Diptera, Psychodidae) from the transmission area for American cutaneous leishmaniasis in the town of Itupeva, the southeastern region of São Paulo state, Brazil]

The present study was effected aiming the verification of the seasonal, spatial and hourly of the phlebotominic species found in the county of Itupeva. Captures were performed fortnightly and 864 sand flies were collected between april/94 and march/95. 81.3% of the captured specimens belonged to 4 species: L. migonei (32.4%), L. whitmani (26.0%), L. intermedia (12.0%) e L. fischeri (10.9%). Such species showed larger densities during the cold and dry season of the year (from april to september/94) and were more active between the second and the fifth hour after twilight. L. migonei predominated almost in all the investigated surroundings being followed by L. whitmani and L. longipalpis in the domestic environments. In conclusion it is thought that in conjunction with L. intermedia, a suspect vector in the State of São Paulo, L. migonei and L. whitmani may have an important role in the transmission of cutaneous leishmaniasis in the area under study.

Spatial frequency processing in posteromedial lateral suprasylvian cortex does not depend on the projections from the striate-recipient zone of the cat's lateral posterior-pulvinar complex

It is generally considered that the posteromedial part of the cat's lateral suprasylvian cortex is involved in the analysis of image motion. The main afferents of the posteromedial lateral suprasylvian cortex come from a direct retinogeniculate pathway and indirect retinotectal and retino-geniculo-cortical pathways. Removal of the primary visual cortex does not affect the spatial and temporal processing of suprasylvian cortex cells suggesting that these properties are derived from thalamic input. We have investigated the possibility that the striate-recipient zone of the lateral posterior nucleus-pulvinar complex may be responsible for the spatial (and temporal) frequency processing in posteromedial lateral suprasylvian cortex since these two regions establish strong bidirectional connections and share many visual properties. Experiments were done on anaesthetized normal adult cats. Visual responses in suprasylvian cortex were recorded before, during, and after the deactivation of the lateral part of the lateral posterior nucleus accomplished by the injection of lidocaine or GABA. Results can be summarized as follows. A total of 64 cells was tested. Out of this number, 11 units were affected by the deactivation of the lateral part of lateral posterior nucleus and one cell, by the blockade of pulvinar. For all cells, except one, the effect consisted in a global reduction of the evoked discharge rate suggesting that the thalamo-suprasylvian cortex projections are excitatory in nature. We did not find any significant differences in the optimal spatial frequency, nor in the width of the tuning function, whether the grating was presented at half- or saturation contrast. In addition, there were no significant differences between the low- and high cut-off spatial frequency values computed before and after the deactivation of the lateral posterior nucleus. No specific changes were observed in the contrast sensitivity function of the posteromedial lateral suprasylvian cortex cells. Similar results were observed with respect to the temporal frequency tuning functions. Deactivating the lateral posterior nucleus did not modify the direction selectivity nor the organization of the subregions of the lateral suprasylvian cortex "classical" receptive fields. The absence of strong changes in posteromedial lateral suprasylvian cortex cell response properties following the functional blockade of the lateral posterior nucleus suggests that the projections from this part of the thalamus are not essential to generate the spatial characteristics of most posteromedial lateral suprasylvian cortex receptive fields. These properties may be derived from other thalamic inputs (e.g., medial interlaminar nucleus) and/or from the intrinsic computation of the afferent signals within the lateral suprasylvian cortex. On the other hand, it is possible that the lateral posterior nucleus lateral suprasylvian cortex loop may be involved in other functions such as the analysis of complex motion as suggested by the findings from our and other groups.

Persistent pulmonary hypertension of the neonate and asymmetric growth restriction

OBJECTIVE

To evaluate the possible associations between persistent pulmonary hypertension of the neonate, need for extra-corporeal membranous oxygenation, small for gestational age (SGA), and low ponderal index for gestational age in infants with persistent pulmonary hypertension of the neonate and in matched controls.

METHODS

Eighty-six infants with persistent pulmonary hypertension of the neonate delivered from 1991 to 1994 at our hospital were matched with 430 contemporaneous control singleton neonates. Birth weight and ponderal indices (100 x weight/length3) less than the tenth percentile for gestational age and gender were defined as SGA and low ponderal index, respectively. We assessed associations between these markers, the presence of persistent pulmonary hypertension of the neonate, and the need for extracorporeal membranous oxygenation.

RESULTS

Low ponderal index was associated with persistent pulmonary hypertension of the neonate (odds ratio [OR] 5.4), whereas SGA was not. Low ponderal index (OR 4.0) was an independent correlate of persistent pulmonary hypertension of the neonate after adjustment with logistic regression for 5-minute Apgar scores less than 7, umbilical arterial pH less than 7.10, and presence of meconium. Low ponderal index was associated with need for extracorporeal membranous oxygenation in neonates with persistent pulmonary hypertension (P < .001).

CONCLUSION

Fetal developmental events may significantly affect neonatal pulmonary status. Diminished neonatal nutritional status, as measured by low ponderal index for gestational age, is associated with increased risk of persistent pulmonary hypertension of the neonate and severity of the disease process.

The impact of patient experience on practice: the acceptability of emergency contraceptive pills in inner-city clinics

OBJECTIVES

This article reports on a study of 119 women who sought and used emergency contraceptive pills (ECPs) at Planned Parenthood of New York City (PPNYC) clinics between June 1996 and May 1997. It focuses on their satisfaction with the method, their attitudes toward ECPs, their reactions to the service, and the impact their perceptions had on changing the provision of care.

METHOD

The PPNYC clinical protocol employed the Yuzpe method and fairly conservative procedures, including restrictive screening, a pelvic examination for all new patients, and limited appointment slots. A two-part survey captured information on patient experience with ECPs.

RESULTS

The largest group of respondents (40%) found out about ECPs from friends. Almost 90% of the women were using contraception before their visit to the clinic. Sixty-eight percent reported that they sought ECPs because the condom failed. In the follow-up, a majority (57%) reported that they intended to change or had changed their method of contraception--more than three-quarters to a hormonal contraceptive. While generally satisfied with the service, many respondents were cautious of more extensive distribution of ECPs.

CONCLUSION

The survey results had a profound impact on services: PPNYC revised the ECP protocol, developed a staff training package, expanded its service, and planned a multidimensional public media campaign. Further research, including a closer examination of participants' cautious attitude toward unrestricted distribution of ECPs, will be needed as PPNYC expands access to ECP.

Dose-dependent inhibitory effects of angiotensin II on visual responses of the rat superior colliculus: AT1 and AT2 receptor contributions

Angiotensin II (Ang II) has traditionally been regarded as a peripherally circulating and acting hormone involved in fluid homeostasis and blood pressure regulation. With the rather recent localization of Ang II receptors within the mammalian brain, renewed interest has emerged in the hope of elucidating the central impact and function of this hormone. One region that has been clearly demonstrated to express Ang II receptors is the superior colliculus (SC). This mesencephalic structure plays an important role in sensory visuomotor integration. Receptors for Ang II (of both the AT1 and AT2 subtypes) have been localized within the superficial layers of this structure, i.e. the areas that are visually responsive. In the hopes of characterizing the role of Ang II in the SC, we have attempted to physiologically activate these receptors in vivo and observe the effects of Ang II on visually evoked responses. In the attempt to identify the receptor subtype(s) responsible in mediating these effects, Ang II was injected concomitantly with selective receptor ligands. Experiments were performed on adult rats prepared in classical fashion for electrophysiological studies. Through microinjection of Ang II, and the simultaneous recording of visually evoked potentials to flash stimulation, we have observed that this peptide yields a strong suppressive effect on visual neuronal activity. By injecting Ang II at various concentrations (10(-3)-10(-10) M), we have further observed that the effects of this peptide express a dose-related dependency. Injection of Ang II in progressively more ventral layers yielded less pronounced effects, demonstrating physiologically the discrete localization of these receptors in the stratum griseum superficiale. Coinjection of Ang II with Losartan yielded a near complete blockade of Ang II suppressive effects, suggesting that AT1 receptors play a prominent role in mediating these responses. However, coinjection of Ang II with PD 123,319 yielded a slight, yet significant partial blockade. Coinjection of Ang II with both the AT1 and AT2 receptor antagonists yielded a complete blockade of the Ang II effect. Finally, some of the results suggest that the AT2 receptor ligand CGP 42,112 may possess agonist properties. Taken together, these findings suggest that the AT1 receptor is predominantly involved in mediating Ang II responses in the SC and there also appears to be some indication of AT2 receptor involvement. However, the underlying mechanisms (such as receptor interactions), the exact specificity of the ligands used, and the possibility of other receptor subtype implication have yet to be explored fully.