Oral versus Intravenous Antibiotics for Bone and Joint Infection

BACKGROUND

The management of complex orthopedic infections usually includes a prolonged course of intravenous antibiotic agents. We investigated whether oral antibiotic therapy is noninferior to intravenous antibiotic therapy for this indication.

METHODS

We enrolled adults who were being treated for bone or joint infection at 26 U.K. centers. Within 7 days after surgery (or, if the infection was being managed without surgery, within 7 days after the start of antibiotic treatment), participants were randomly assigned to receive either intravenous or oral antibiotics to complete the first 6 weeks of therapy. Follow-on oral antibiotics were permitted in both groups. The primary end point was definitive treatment failure within 1 year after randomization. In the analysis of the risk of the primary end point, the noninferiority margin was 7.5 percentage points.

RESULTS

Among the 1054 participants (527 in each group), end-point data were available for 1015 (96.3%). Treatment failure occurred in 74 of 506 participants (14.6%) in the intravenous group and 67 of 509 participants (13.2%) in the oral group. Missing end-point data (39 participants, 3.7%) were imputed. The intention-to-treat analysis showed a difference in the risk of definitive treatment failure (oral group vs. intravenous group) of -1.4 percentage points (90% confidence interval [CI], -4.9 to 2.2; 95% CI, -5.6 to 2.9), indicating noninferiority. Complete-case, per-protocol, and sensitivity analyses supported this result. The between-group difference in the incidence of serious adverse events was not significant (146 of 527 participants [27.7%] in the intravenous group and 138 of 527 [26.2%] in the oral group; P=0.58). Catheter complications, analyzed as a secondary end point, were more common in the intravenous group (9.4% vs. 1.0%).

CONCLUSIONS

Oral antibiotic therapy was noninferior to intravenous antibiotic therapy when used during the first 6 weeks for complex orthopedic infection, as assessed by treatment failure at 1 year. (Funded by the National Institute for Health Research; OVIVA Current Controlled Trials number, ISRCTN91566927 .).

Global precedence, spatial frequency channels, and the statistics of natural images

A great deal of evidence suggests that early in processing, retinal images are filtered by parallel, spatial frequency selective channels. We attempt to incorporate this view of early vision with the principle of global precedence, which holds that Gestalt-like processes sensitive to global image configurations tend to dominate local feature processing in human pattern perception. Global precedence is inferred from the pattern of reaction times observed when visual patterns contain multiple cues at different levels of spatial scale. Specifically, it is frequently observed that global processing times are largely unaffected by conflicting local cues, but local processing times are substantially lengthened by conflicting global cues. The asymmetry of these effects suggests the dominant role of global configurations. Since global spatial information is effectively represented by low spatial frequencies, global precedence potentially implies a low frequency dominance. The thesis is that low spatial frequencies tend to be available before information carried by higher frequency bands, producing a coarse-to-fine temporal order in visual spatial perception. It is suggested that a variety of factors contribute to the "prior entry" of low frequency information, including the high contrast gain of the magnocellular pathway, the amplitude spectra typical of natural images, and inhibitory interactions between the parallel frequency-tuned channels. Evidence suggesting a close relationship between global precedence and spatial frequency channels is provided by observations that the essential features of the global precedence effect are obtained using patterns consisting of low and high frequency sinusoids. The hypothesis that these asymmetric interference effects are due to interactions between parallel spatial channels is supported by an analysis of reaction times (RTs), which shows that RTs to redundant low and high frequency cues produce less facilitation than predictions that assume the channels are independent. In view of previous work showing that global precedence depends upon the low frequency content of the stimuli, we suggest that low spatial frequencies represent the sine qua non for the dominance of configurational cues in human pattern perception, and that this configurational dominance reflects the microgenesis of visual pattern perception. This general view of the temporal dynamics of visual pattern recognition is discussed, is considered from an evolutionary perspective, and is related to certain statistical regularities in natural scenes. Potential adaptive advantages of an interactive parallel architecture that confers an initial processing advantage to low resolution information are explored.

Effect of uncertainty on the time course for selection of verbal name codes

Response selection takes time. Hick's law (Hick, 1952) predicts that the time course of response selection is a logarithmic function of the number of equally likely response alternatives. However, recent work has shown that oculomotor responses constitute noteworthy exceptions in that the latencies of saccades (Kveraga, Boucher, & Hughes, 2002) and smooth pursuit movements (Berryhill, Kveraga, Boucher, & Hughes, 2004) are completely independent of response uncertainty. This finding extends to the case in which the required response was known in advance (i.e., simple reaction times [RTs] were equivalent to choice RTs). In view of these results, we reevaluated reports that latencies to name visually presented digits (Experiment 1) and/or repeat aurally presented digits (Experiment 2) are similarly independent of the size of the response set. We found that naming latencies were equivalent for response set sizes from one to eight, but simple RTs (response set of one) were faster. Thus, the overlearned task of digit naming is indeed highly automatic but has not reached the level of automaticity characteristic of the oculomotor system.

Afferent delays and the mislocalization of perisaccadic stimuli

Determining the precise moment a visual stimulus appears is difficult because visual response latencies vary. This temporal uncertainty could cause localization errors to brief visual targets presented before and during eye movements if the oculomotor system cannot determine the position of the eye at the time the stimulus appeared. We investigated the effect of varying neural processing time on localization accuracy for perisaccadic visual targets that differed in luminance. Although systematic errors in localization were observed, the effect of luminance was surprisingly small. We explore several hypotheses that may explain why processing delays are not more disruptive to localization performance.

Ocular pursuit of predicted motion trajectories

The initiation and maintenance of slow eye movements (SEMs) usually depend on the perception of a moving stimulus. However, the endogenous representation of predictable target motion can be sufficient to initiate and maintain brief episodes of SEM even when the stimulus is not present. In this note, we show that expectancies generated by predictable stimulus motion trajectories can also produce smooth deceleration, reversal of direction, and subsequent acceleration in these movements, and explore the limits of the predictive component of the SEM control system quantitatively.

Responses of Human Auditory Association Cortex to the Omission of an Expected Acoustic Event

Unexpected auditory events initiate a complex set of event-related potentials (ERPs) that vary in their latency and anatomical localization. Such "mismatch" responses include active responses to the omission of an expected event or the omission of elements in expected stimulus composites. Here we describe intracranial recordings of middle-latency ERPs elicited by the omission of an auditory event. We first presented a sequence of tones at regular temporal intervals and the tone was omitted 20% of the time. In a second condition, we presented a sequence of tone pairs and the second tone of the pair was omitted 20% of the time. These two conditions are complementary in that the single tone conformed to the expectancy in one condition, but violated the expectancy in the other. All patients demonstrated localized cortical responses to missing tones that were topographically similar to the responses evoked by actual tones. Responses to both actual and omitted tones were observed bilaterally in the vicinity of the temporal--parietal junction, where we also obtained midlatency ERPs to a variety of other auditory stimuli. Responses that appeared to be selective for the nonoccurrence of expected tones were also observed in a number of subjects. We interpret these effects in terms of processes associated with the comparison of sensory inputs to the contents of a short-term auditory memory. Such a system could automatically detect deviant auditory events, and provide input to higher-level, task-dependent cognitive processes.

Spatial characteristics of visual-auditory summation in human saccades

Bimodal (auditory + visual) stimuli reduce saccade latencies in human observers to a degree that exceeds levels predictable by probabilistic summation between parallel, independent unimodal pathways. These interactions have been interpreted in terms of converging visual and auditory afferents within the oculomotor pathways, specifically within the superior colliculus (SC). The present work describes the spatial tuning of auditory-visual summation in human saccades, using diagnostics derived from stochastic models of information processing. Consistent with expectations based on the electrophysiology of the SC, the magnitude of facilitation varied with the degree of spatial correspondence, and the spatial tuning was quite coarse.

A quantifiable model of axonal regeneration in the demyelinated adult rat spinal cord

Strategies to increase the extent of axonal regeneration in the adult CNS must address an array of intrinsic and environmental factors which influence neuritic outgrowth. In order to develop an in vivo model of axonal regeneration in which potential therapies may be assessed, we have quantified growth cones within demyelinated regions in the dorsal funiculus of the spinal cord, following a discrete axotomy. Demyelinated lesions were produced by the intraspinal injection of galactocerebroside antibodies plus serum complement proteins. Axonal integrity was not compromised by the demyelination protocol. Axonal injury was induced at the caudal extent of the demyelinated region using a micromanipulator-controlled Scouten knife. The severity of axonal injury was varied in different animals at the time of surgery and was quantified 8 days later by counting degenerate axons in transverse 1-microm resin sections. Evidence of axonal regeneration within these animals was assessed by an electron microscopic analysis of growth cone frequency and position relative to the site of axotomy. Growth cones were identified within the region of demyelination only; no growth cones were identified within the dorsal column white matter adjacent to the demyelinated region, or rostral or caudal to the region of demyelination, or in animals with an injury but no demyelination. Quantification of growth cones within regions of demyelination indicated a strong linear relationship (P < 0.001) between the number of growth cones and the number of axons severed. These findings indicate that demyelination facilitates axonal regeneration in the adult rat CNS and illustrate a quantifiable method of assessing axonal regeneration.

Advances in cubicle design using computational fluid dynamics as a design tool

As part of a recent animal facility refurbishment, a cubicle containment system was designed to increase the amount of experimental space and also provide containment facilities to support the holding and use of specialized animal models. In order to achieve this, a series of computational fluid dynamic (CFD) studies was undertaken to evaluate the effects of different airflows and in order to optimize ventilation, a variety of exhaust/supply arrangements and animal loads was employed. These studies showed that air delivered via two, opposed, low level ducts, at a rate of 20 air changes per hour and exhausted high in the cubicle above the rack, was the optimal configuration resulting in minimal turbulence, stagnation and entrainment.

Spatial scale interactions and visual-tracking performance

It has previously been observed that low spatial frequencies (< or = 1.0 cycles deg-1) tend to dominate high spatial frequencies (> or = 5.0 cycles deg-1) in several types of visual-information-processing tasks. This earlier work employed reaction times as the primary performance measure and the present experiments address the possibility of low-frequency dominance by evaluating visually guided performance of a completely different response system: the control of slow-pursuit eye movements. Slow-pursuit gains (eye velocity/stimulus velocity) were obtained while observers attempted to track the motion of a sine-wave grating. The drifting gratings were presented on three types of background: a uniform background, a background consisting of a stationary grating, or a flickering background. Low-frequency dominance was evident over a wide range of velocities, in that a stationary high-frequency component produced little disruption in the pursuit of a drifting low spatial frequency, but a stationary low frequency interfered substantially with the tracking of a moving high spatial frequency. Pursuit was unaffected by temporal modulation of the background, suggesting that these effects are due to the spatial characteristics of the stationary grating. Similar asymmetries were observed with respect to the stability of fixation: active fixation was less stable in the presence of a drifting low frequency than in the presence of a drifting high frequency.

Fate of neglected targets: a chronometric analysis of redundant target effects in the bisected brain

The authors examined some of the sensorimotor effects of the split-brain operation to understand how a "dual mind" can produce unified behavior. They report psychophysical evidence of extinction to bilateral simultaneous stimulation in callosotomy patient J.W.: Although he could verbally report the occurrence of a unilateral left or right visual field target, left field report accuracy dropped by 34% when targets occurred bilaterally. Paradoxically, the same stimulus conditions produced abnormally robust redundant signal effects on simple manual and vocal reaction times, which exceeded predictions that were based on probability summation. Neural summation is often inferred from redundancy gain of this magnitude. Because this seems less likely after callosotomy, the authors suggest a model that is based on response competition between the disconnected hemispheres to account for J.W.'s redundant target effects. The dissociation between explicit report and motor performance is discussed.

Effects of warning signals and fixation point offsets on the latencies of pro- versus antisaccades: implications for an interpretation of the gap effect

The present study was designed to evaluate whether fixation point offsets have the same effects on the average latencies of prosaccades (responses towards target) and antisaccades (responses away from target). Gap and overlap conditions were run with and without an acoustic warning signal. The 'gap effect' was taken to be the difference in mean reaction time between gap and overlap trials. This effect was dramatically reduced by the presentation of the warning signal. Without this signal, fixation offsets can serve as warning signals themselves, which artifactually inflates the magnitude of the gap effect. The warning effect of fixation offsets was equivalent for pro and antisaccades. A significant gap effect is still evident with the acoustic warning signal; however, in this case it is associated primarily with prosaccades. These results replicate and extend our previous work demonstrating that, if their warning effects are controlled, the facilitatory effects of fixation point offsets are response dependent, and suggesting the existence of a component process (fixation release) which is closely linked with the processing architecture underlying target-directed saccades.

Express saccades in cat: effects of task and target modality

Saccadic eye movements to visual, auditory, and bimodal targets were measured in four adult cats. Bimodal targets were visual and auditory stimuli presented simultaneously at the same location. Three behavioral tasks were used: a fixation task and two saccadic tracking tasks (gap and overlap task). In the fixation task, a sensory stimulus was presented at a randomly selected location, and the saccade to fixate that stimulus was measured. In the gap and overlap tasks, a second target (hereafter called the saccade target) was presented after the cat had fixated the first target. In the gap task, the fixation target was switched off before the saccade target was turned on; in the overlap task, the saccade target was presented before the fixation target was switched off. All tasks required the cats to redirect their gaze toward the target (within a specified degree of accuracy) within 500 ms of target onset, and in all tasks target positions were varied randomly over five possible locations along the horizontal meridian within the cat's oculomotor range. In the gap task, a significantly greater proportion of saccadic reaction times (SRTs) were less than 125 ms, and mean SRTs were significantly shorter than in the fixation task. With visual targets, saccade latencies were significantly shorter in the gap task than in the overlap task, while, with bimodal targets, saccade latencies were similar in the gap and overlap tasks. On the fixation task, SRTs to auditory targets were longer than those to either visual or bimodal targets, but on the gap task, SRTs to auditory targets were shorter than those to visual or bimodal targets. Thus, SRTs reflected an interaction between target modality and task. Because target locations were unpredictable, these results demonstrate that cats, as well as primates, can produce very short latency goal-directed saccades.

Visual-auditory interactions in sensorimotor processing: saccades versus manual responses

Reaction times (RTs) to bimodal (visual and auditory) stimuli were examined using 3 different response systems: saccades, directed manual responses, and simple manual responses. The observed levels of intersensory facilitation exceeded race model predictions and therefore support summation (coactivation) models of bimodal processing. However, response-dependent differences suggest that the processing of bimodal targets also depends on the relevant sensorimotor pathways and requirements of the task. Coactivation of response mechanisms might account for the effects found using simple RTs. The results for saccades are consistent with known patterns of auditory-visual convergence in the oculomotor system.

Visual-auditory interactions in sensorimotor processing: saccades versus manual responses

Reaction times (RTs) to bimodal (visual and auditory) stimuli were examined using 3 different response systems: saccades, directed manual responses, and simple manual responses. The observed levels of intersensory facilitation exceeded race model predictions and therefore support summation (coactivation) models of bimodal processing. However, response-dependent differences suggest that the processing of bimodal targets also depends on the relevant sensorimotor pathways and requirements of the task. Coactivation of response mechanisms might account for the effects found using simple RTs. The results for saccades are consistent with known patterns of auditory-visual convergence in the oculomotor system.

Parallel and serial processes in the human oculomotor system: bimodal integration and express saccades

Saccadic reaction times (SRTs) were analyzed in the context of stochastic models of information processing (e.g., Townsend and Ashby 1983) to reveal the processing architecture(s) underlying integrative interactions between visual and auditory inputs and the mechanisms of express saccades. The results support the following conclusions. Bimodal (visual+auditory) targets are processed in parallel, and facilitate SRT to an extent that exceeds levels attainable by probability summation. This strongly implies neural summation between elements responding to spatially aligned visual and auditory inputs in the human oculomotor system. Second, express saccades are produced within a separable processing stage that is organized in series with that responsible for intersensory integration. A model is developed that implements this combination of parallel and serial processing. The activity in parallel input channels is summed within a sensory stage which is organized in series with a pre-motor and motor stage. The time course of each subprocess is considered a random variable, and different experimental manipulations can selectively influence different stages. Parallels between the model and physiological data are explored.

Bidirectional control of saccadic eye movements by the disconnected cerebral hemispheres

The present investigation demonstrates that callosotomy patient J.W. can generate either leftward or rightward saccades in response to color cues presented unilaterally. When asked to name the colors, performance was at chance for left visual field presentations, demonstrating a disability in interhemispheric transfer of chromatic information. The successful control of saccadic direction based on discriminative color cues that appear confined to a single hemisphere may suggest a capacity for bidirectional control of saccadic eye movements in the disconnected cerebral hemispheres.

The perceived duration of gratings

Since visible persistence of grating patterns increases with spatial frequency, it is often inferred that the perceived duration of a grating is also longer at higher spatial frequencies. However, other work has demonstrated that the perceived onset of a grating is also delayed at higher spatial frequencies. Thus it is impossible to infer the subjective duration from the results of visible persistence studies alone. In order to estimate perceived duration in the present study, reaction times (RTs) to grating onsets and offsets were measured for a range of spatial frequencies. The results indicate that although the perceived duration (ie the difference between offset and onset RTs) was consistently longer than the physical duration, the estimates of perceived duration did not vary with changes in spatial frequency. Differences between the present results and earlier findings are interpreted in the context of the different methods used to measure perceived offset.

Fixation-point offsets reduce the latency of saccades to acoustic targets

If an observer's fixation point is extinguished just prior to the onset of a peripheral target, the latency to saccade to that target is reduced. We show that this "gap effect" is not specific to visual targets. Observers made saccades to a light flash or to a white-noise burst. A warning tone was presented on every trial to control for the possible warning effect of the fixation-point offset. For both target modalities, saccade latencies were significantly reduced when the fixation point was extinguished 200 msec prior to the target onset. Implications of this outcome for interpretations of the gap effect are considered. It is argued that the presence of a gap effect for tones, in conjunction with previous findings, is consistent with the hypothesis that the gap effect is produced by a facilitation of premotor processes in the superior colliculus.

Comparison of antibody response by use of synthetic adjuvant system and Freund complete adjuvant in rabbits

Two commercially available synthetic adjuvant systems, trehalose dimycolate (TDM) and TDM + monophosphoryl lipid A (MPL), were compared with Freund complete adjuvant (FCA) for the ability to stimulate antibody production in New Zealand White rabbits (Oryctolagus cuniculus). In addition, each animal was evaluated for adverse reactions. The antigen, rat liver microsomal epoxide hydrolase, was administered SC emulsified with FCA, TDM, or TDM + MPL. Serum antibody titers were stimulated with all 3 adjuvant-antigen combinations. The highest titer was produced by use of FCA; TDM + MPL produced an intermediate response, and TDM produced the lowest titer. All of the rabbits immunized with FCA developed sterile subcutaneous abscesses. Rabbits immunized with TDM or TDM + MPL developed no abscesses, and only slight reactions at the injection site. The synthetic adjuvant system TDM + MPL is recommended for use in rabbits, considering its adequate stimulation of antibody production with minimal adverse reactions.

The reduction of saccadic latency by prior offset of the fixation point: an analysis of the gap effect

The latency to initiate a saccade (saccadic reaction time) to an eccentric target is reduced by extinguishing the fixation stimulus prior to the target onset. Various accounts have attributed this latency reduction (referred to as the gap effect) to facilitated sensory processing, oculomotor readiness, or attentional processes. Two experiments were performed to explore the relative contributions of these factors to the gap effect. Experiment 1 demonstrates that the reduction in saccadic reaction time (RT) produced by fixation point offset is additive with the effect of target luminance. Experiment 2 indicates that the gap effect is specific for saccades directed toward a peripheral target and does not influence saccades directed away from the target (i.e., antisaccades) or choice-manual RT. The results are consistent with an interpretation of the gap effect in terms of facilitated premotor processing in the superior colliculus.

Comparison of escape and tail flick thresholds in the rat: a psychophysical analysis of morphine hypoalgesia

The present study describes a wheel turn/tail flick paradigm that was designed to simultaneously assess nociceptive thresholds of responses organized at spinal and supraspinal levels of the CNS in the rat. The paradigm involves training rats to perform an operant wheel turn response in order to escape current applied to the tail. Thresholds for the supraspinally organized escape response and the spinally organized tail flick reflex were determined via the psychophysical method of constant stimuli. Response latencies for wheel turn escape and tail flick were recorded to determine whether changes in nociceptive thresholds were confounded with changes in motor performance. The systemic administration of 3 mg/kg morphine sulfate elevated thresholds for both responses, but escape thresholds were elevated to a greater degree than tail flick thresholds. Because response latencies at threshold were not affected by morphine treatment, it appears that performance deficits did not contribute to the increase in thresholds. Advantage of these psychophysical procedures in assessing nociceptive responding in animals are discussed.

The effects of cage size and pair housing on exercise of beagle dogs

One of the requirements of the 1985 amendments to the Animal Welfare Act is the establishment of an exercise program for dogs. Assumptions have been made by some that larger cages or the presence of a companion animal will motivate exercise. To examine how cage size, pair housing and human contact affect exercise, a study was conducted using a computerized video-data acquisition system that measured distance traveled and time spent moving in 1 x 1 m, (single only) and 1 x 2 m (single and paired) and 1 x 1.5 m cage (paired only) cages. Male beagle dogs (n = 6) housed singly in the 1 m2 cage traveled an average of 55 m/hr spending only 8% (57 min) of the 12 h photo period in motion. When the cage size was doubled, the average distance traveled decreased to 13 m/hr and the time spent moving increased to 11% (77 min/day). When dogs were pair housed in a regulation size cage, the average distance traveled decreased to 8.6 m/hr and they spent less than 6% of the day in exercising (42 min/12 hrs). The greatest amount of exercise was seen when dogs were housed as a pair in a cage less than recommended size (an average of 109 m/hr and 8.8 min/hr). Therefore, these data indicate that larger cages or pair housing in regulation size cages have little or no effect on the activity of purpose bred male beagle dogs. There was, however, a direct correlation between activity, time and distance, and the presence of humans in the animal room.(ABSTRACT TRUNCATED AT 250 WORDS)

Distribution of opiate receptors within visual structures of the cat brain

The distributions of mu, delta, and kappa opiate receptors within visual regions in the cat cortex, thalamus and midbrain were determined by in vitro autoradiography. The overall distribution of receptors was examined using [3H]-etorphine, a ligand that nonselectively labels all types of opiate receptors. [3H]-[D-Ala2, N-Me-Phe4,Gly(ol)5]-enkephalin (DAGO) was used to selectively label mu receptors, [3H]-[D-Pen2, 5]-enkephalin (DPDPE) for delta receptors, and [3H]-bremazocine for kappa receptors. Each of the areas examined showed clear opiate receptor binding with [3H]-etorphine and a differential distribution of mu, delta, and kappa receptors. Compared to other cortical regions, opiate binding in layers 3 and 4 of areas 17 and 18 was sparse. In the adjacent areas a more uniform distribution across layers was observed. The density of kappa opiate receptors was greater in cortex than in subcortical structures, whereas the reverse was the case for mu receptors. Nevertheless, all three types of opiate receptors were found in the ventral and dorsal subdivisions of the lateral geniculate (LGN), the pulvinar complex, and the suprageniculate nucleus. In the midbrain, the superficial layers of the superior colliculus were heavily labelled with the mu receptor ligand, and modestly with the kappa ligand. Compared with other midbrain and diencephalic areas, delta binding was low in the superior colliculus. These results suggest that the diverse effects of opiates on visual perception are mediated by the unique distributions of opiate receptor types throughout the visual areas in the brain.

A new portacaval shunt

A new prosthetic, segmented polyether polyurethane portacaval shunt featuring quick-connect anastomotic ends was constructed and evaluated as part of a short-term pharmacokinetic study. The shunts were easily implanted, did not require the use of anticoagulants, and decreased the operative time normally required for this surgical preparation. There was no evidence of thrombosis or venous stasis associated with the shunts.

Some effects of limited exercise on purpose-bred beagles

Amendments to the Animal Welfare Act (PL 99-198) require that an exercise program for dogs be established by the attending veterinarian. A 6-week study was conducted to determine the effects of a moderate exercise program in purpose-bred Beagles. Sixteen male Beagles (4/group) were maintained as follows: (1) standard cage without exercise; (2) standard cage with individual exercise periods (35 minutes, 3 times/week); (3) large cage without exercise; and (4) standard cage with group-release exercise periods. Blood samples were collected for CBC, serum biochemical analysis including determination of serum cortisol concentration, and immune function (lymphocyte transformation assay). Group-released dogs interacted with each other during most of the exercise time. Fighting in these dogs occurred only during the third week. Dogs had little inclination to exercise when released alone into the exercise area. Regardless of the size of the cage, dogs did not exercise unless human beings were present in the room. There were no significant differences in laboratory findings among dogs in the 4 groups. This moderate exercise program had no demonstrable effects. Similarly, continuous cage housing, without a formal exercise program, could not be determined to be detrimental to the physiologic or health status of dogs.

The effects of pentobarbital, fentanyl-droperidol, ketamine-xylazine and ketamine-diazepam on arterial blood pH, blood gases, mean arterial blood pressure and heart rate in adult male rats

Although anesthetics are known to cause respiratory and cardiovascular depression in humans, these adverse effects rarely have been investigated in laboratory rodents. This study evaluated the effects of four different injectable drugs, pentobarbital, fentanyl-droperidol (Innovar-Vet), ketamine-xylazine and ketamine-diazepam on the respiratory and cardiovascular systems of rats. Results showed marked acidosis, hypercarbia and hypoxia with high doses of Innovar-Vet, moderate respiratory depression with all dosages of pentobarbital and minimal respiratory depression with ketamine-xylazine and ketamine-diazepam. Innovar-Vet, ketamine-xylazine and pentobarbital caused profound hypotension, particularly at high dosages, while ketamine-diazepam caused the least depression in mean arterial blood pressure of all drugs evaluated. None of the drugs studied produced significant alterations in heart rate. Throughout all dosages investigated, the ketamine-diazepam combination showed the least overall effects on ventilation and perfusion of the four parenteral drug combinations studied.

The effects of pentobarbital, fentanyl-droperidol, ketamine-xylazine and ketamine-diazepam on noxious stimulus perception in adult male rats

The increased use of rats for laboratory studies has increased the urgency for a better understanding of their perception of painful or noxious stimuli and the means of obtunding such stimuli. Four different injectable drugs, pentobarbital, fentanyl-droperidol (Innovar-Vet), ketamine-xylazine and ketamine-diazepam, were evaluated in this study. Unlike previous studies in rodents, this study has quantitated noxious stimulus perception following a temporal sequence of observations. Results showed the greatest inhibition of noxious stimulus perception with Innovar-Vet, lesser inhibition with ketamine-xylazine and ketamine-diazepam, and the least obtunding of nociception with pentobarbital. Results of this study also suggested that a spatial orientation, similar to that present in man, exists within the CNS of rats for receipt of noxious stimulation.

The effects of pentobarbital, fentanyl-droperidol, ketamine-xylazine and ketamine-diazepam on core and surface body temperature regulation in adult male rats

Many commonly used anesthetics cause hypothermia by inhibiting central and peripheral thermoregulatory mechanisms. Although it is probable that a loss of thermal homeostasis contributes directly to the high mortality frequently reported following anesthesia of laboratory rodents, this adverse effect has been investigated rarely in the past. This study compared the effects of three parenteral anesthetics (pentobarbital, ketamine-xylazine and ketamine-diazepam) and a neuroleptanalgesic (fentanyl-droperidol) on core and surface body temperature regulation in rats. Results showed a profound hypothermia with all dosages of pentobarbital, while ketamine-xylazine and ketamine-diazepam caused a dose-dependent depression in core and surface body temperature. All dosages of fentanyl-droperidol (Innovar-Vet) caused minimal depression in thermoregulation, suggesting that it is the drug which requires the least external thermal support. Results of this study also suggested that inability to compensate for heat loss, particularly from the body core, may profoundly influence anesthetic toxicity and the safety of anesthetic procedures.

A comparison of pentobarbital, fentanyl-droperidol, ketamine-xylazine and ketamine-diazepam anesthesia in adult male rats

Proper use of anesthetics is of paramount importance for humane animal care. Current research trends show a greater reliance on rats for laboratory investigations. This study compared several dosages for four different drugs, (pentobarbital, fentanyl-droperidol, ketamine-xylazine and ketamine-diazepam) for use in the laboratory rat. Each drug was evaluated in respect to its onset, duration of effect, recovery, adverse effects and mortality. A quantitative assessment of the depth of anesthesia also was obtained for all dosages of each drug. Results showed that all tested dosages of pentobarbital, ketamine-xylazine and ketamine-diazepam were suitable anesthetics for use in the laboratory rat. Low dosages of fentanyl-droperidol (Innovar-Vet), however, appeared to produce a state known as neuroleptanalgesia as opposed to anesthesia seen with the other agents.

Natural boundaries for the spatial spread of directed visual attention

The spatial characteristics of directed attention were studied using spatial precues in a suprathreshold luminance detection task. Visual response times to probe flashes presented at various distances from the presumed focus of attention provided the dependent measure. The variation in response times with distance from the attentional focus was used to create spatial maps of the expectancy effect. The results indicate that, in an uncluttered visual field, the effects of precuing are widely distributed, and that the principal transitions in performance tend to occur either at the horizontal meridian, the vertical meridian, or both meridians, depending on the locus of the observers' expectancy.

Distractor-target interactions during directed visual attention

The spatial extent of directed visual attention (DVA) was examined in a series of experiments using precuing in a suprathreshold luminance detection (reaction time) paradigm. Previous findings (Hughes, H. C. and Zimba, L. D. J. Exp. Psychol.; Human Percept Perf., 1985, 11, 409-430) indicated that, in an empty visual field, the effects of DVA were primarily manifest as a uniform elevation of response times to all probe targets in the hemifield contralateral to the observer's expectancy. The present experiments were designed to determine whether increased spatial selectivity could be found when luminous markers indicated the exact location of the expected visual target. To maintain equivalent states of adaptation in both hemifields, luminous markers were also present at the same location in the contralateral hemifield. In general, hemifield effects were again obtained, but with two notable exceptions. First, marking locations in the unattended hemifield produced a local increase (enhanced interference) in RTs above the level characteristic of other locations within that hemifield. Second, when multiple locations were indicated with identical luminous markers, graded costs were obtained in both hemifields. However, scaling the markers according to estimates of cortical magnification factor (M) substantially reduced the slope of these inhibitory gradients, and the results once again approached those characteristic of an unstructured visual field. The findings suggest that when attention is directed to a marked location along the horizontal meridian, a transition in performance typically occurs at the vertical meridian. In addition, irrelevant stimuli some distance from the attentional focus interfere with detection times to unexpected targets that appear in the same vicinity. This interference may relate to an enhanced susceptibility to spatial interactions between the distractors and target away from the attentional focus. The interference appears to extend over a constant area of visual cortex, since it is reduced when the markers are M-scaled.

Swine in cardiovascular research

Swine are being chosen with increasing frequency as subjects for cardiovascular research. Similarities to humans in their cardiovascular physiology, size, anatomy, and the perfusion distribution of blood flows make them better subjects than most species. In addition, swine can be less expensive than dogs and primates and they generally are not associated with the same high concern as other species about humane issues.

Cortical mechanisms for local and global analysis of visual space in the cat

The effects of lesions in the striate or extra-striate visual cortex of cats were evaluated using visual discrimination problems which required either local or global pattern processing. The results indicate that damage to areas 17 and 18 preferentially impairs local processes, while in addition they suggest that damage to the extra-striate cortex preferentially affects global processing. These findings may be related to the observations that cats with large lesions in the extra-striate cortex demonstrate deficits in form perception without reductions in visual acuity and those with lesions in areas 17-18 show elevations of acuity thresholds while maintaining excellent pattern and form vision.

Spatial maps of directed visual attention

Simple reaction times (RTs) to a visual target are facilitated when the target occurs at a location expected by an observer, and are slowed when the target occurs at the mirror-symmetric location contralateral to the expectancy (e.g., Posner, 1978; Posner, Snyder, & Davidson, 1980). The spatial extent of this attention effect was examined by inducing subjects to expect the target at one location and introducing occasional probe flashes at other locations throughout the visual field. The results indicated that RTs to these probes were equivalent to those obtained at the expected location so long as the probe was in the same hemifield as the subject's expectancy. Conversely, RTs to probes in the hemifield opposite the expectancy generated uniformly slower response times. These results were obtained when the expected location varied in eccentricity from 2 degrees to 16 degrees along the horizontal meridian. In addition, when the expected and unexpected locations were within the same hemifield, no expectancy effects were observed. Under these conditions, the frequently used metaphor that directed visual attention operates like a spatially restricted "beam" appears inaccurate. The implications of these findings for current views of directed attention are considered.

Spatial maps of directed visual attention

Simple reaction times (RTs) to a visual target are facilitated when the target occurs at a location expected by an observer, and are slowed when the target occurs at the mirror-symmetric location contralateral to the expectancy (e.g., Posner, 1978; Posner, Snyder, & Davidson, 1980). The spatial extent of this attention effect was examined by inducing subjects to expect the target at one location and introducing occasional probe flashes at other locations throughout the visual field. The results indicated that RTs to these probes were equivalent to those obtained at the expected location so long as the probe was in the same hemifield as the subject's expectancy. Conversely, RTs to probes in the hemifield opposite the expectancy generated uniformly slower response times. These results were obtained when the expected location varied in eccentricity from 2 degrees to 16 degrees along the horizontal meridian. In addition, when the expected and unexpected locations were within the same hemifield, no expectancy effects were observed. Under these conditions, the frequently used metaphor that directed visual attention operates like a spatially restricted "beam" appears inaccurate. The implications of these findings for current views of directed attention are considered.

Simultaneous atrial and ventricular electrogram transmission via a specialized single lead system

No telemetrically monitorable pacemakers are capable of detecting and transmitting the complete electrogram (EGM) during normal and paced rhythms, although some are capable of detecting and transmitting either the P- or R-wave. A new lead and telemetry-pacemaker system has been developed that permits the transmission of the complete EGM and is not adversely affected by pacemaker outputs or after-potentials. Electrodes are placed in the right ventricle and atrium to optimize EGM detection. These A-V data probe electrodes are electrically separate from the pacing-sensing electrodes but are structurally part of a coaxial ventricular lead that is no larger than a conventional bipolar lead (2.3 mm). The telemetry system is also compatible with telephone monitoring systems. The system has consistently demonstrated its ability to detect accurately the EGM during normal sinus rhythms and does not affect atrial, ventricular, or A-V sequential pacing. In addition, this system can detect and transmit EGM abnormalities, including ectopic beats, retrograde conduction, and ischemic changes. A-V data leads with telemetry monitored VVI pacemakers have been implanted in dogs for over two years. This system will provide the means to detect and telemetrically record noninvasively the entire normal and abnormal EGM, even in pacer dependent patients. (PACE, Vol. 7, November-December, 1984).

Ventriculoatrial conduction in swine during cardiac pacing: animal model for retrograde conduction

Studies on cardiac conduction disorders and pacemaker tachycardias are usually conducted in patients because the phenomenon of ventriculoatrial (retrograde) conduction resulting from ectopic beats and pacing the ventricles has only been reported in humans. This study was conducted to characterize the ventriculoatrial (VA) conduction and retrograde P wave electrogram (EGM) amplitude and slew rate in 10 anesthetized pigs. Three transvenous pacemaker leads were positioned in the heart: one in the right atrial appendage, one in the sinoatrial (SA) node region, and another in the apex of the right ventricle. Ventriculoatrial conduction always occurred when the heart was paced from the right ventricle. There was a significant difference (p less than 0.05) between the amplitude and slew rate of the intrinsic P wave EGM (6.36 +/- 1.88 mV, 1.03 +/- 0.35 mV/msec) compared to the retrograde P wave EGM (3.12 +/- 1.37 mV, 0.57 +/- 0.18 mV/msec) detected at the SA node region. However, there was no significant difference between the intrinsic P wave EGM (4.81 +/- 2.01 mV, 0.40 +/- 0.26 mV/msec) and the retrograde P wave EGM (4.13 +/- 3.74 mV, 0.13 +/- 0.05 mV/msec) detected in the atrial appendage. The advantage of positioning an electrode in close proximity to the SA node for optimum atrial EGM detection and differentiation from retrograde P wave EGM is evident. The VA conduction time (178.5 +/- 8.5 msec) was significantly greater (p less than 0.01) than the antegrade conduction time (120.0 +/- 18.2 msec). The pig with its VA conduction is a useful model for pacemaker-induced tachycardias and for in vivo testing of drugs and/or pacemaker programs that can be utilized for controlling or preventing them.