Twelve tips for Natural Language Processing in medical education program evaluation

With the increasing application of Natural Language Processing (NLP) in Medicine at large, medical educators are urged to gain an understanding and implement NLP techniques within their own education programs to improve the workflow and make significant and rapid improvements in their programs. This paper aims to provide twelve essential tips inclusive of both conceptual and technical factors to facilitate the successful integration of NLP in medical education program evaluation. These twelve tips range from advising on various stages of planning the evaluation process, considerations for data collection, and reflections on preprocessing of data in preparation for analysis and interpretation of results. Using these twelve tips as a framework, medical researchers, educators, and administrators will have an understanding and reference to navigating applications of NLP and be able to unlock its potential for enhancing the evaluation of their own medical education programs.

A novel SERPINA12 variant and first European patients with diffuse palmoplantar keratoderma

BACKGROUND

Hereditary palmoplantar keratodermas (hPPKs) comprise a heterogeneous group of skin disorders characterized by persistent palmoplantar hyperkeratosis. Loss-of-function variants in a serine peptidase inhibitor, SERPINA12, have recently been implicated in autosomal recessive diffuse hPPK. The disorder appears to share similarities with another hPPK associated with protease overactivity, namely Nagashima-type PPK (NPPK) caused by biallelic variants in SERPINB7.

OBJECTIVES

The aim of this study was to enhance the understanding of the clinical and genetic characteristics of serine protease-related hPPKs caused by variants in SERPINA12 and SERPINB7.

METHODS

Whole-exome sequencing (WES) was performed for hPPK patients. Haplotype analysis was completed for the patients with identified recessive SERPINA12 variants and their available family members. In addition, the current literature of SERPINA12- and SERPINB7-related hPPKs was summarized.

RESULTS

The phenotype of SERPINA12-related hPPK was confirmed by reporting three new SERPINA12 patients, the first of European origin. A novel SERPINA12 c.1100G>A p.(Gly367Glu) missense variant was identified confirming that the variant spectrum of SERPINA12 include both truncating and missense variants. The previously reported SERPINA12 c.631C>T p.(Arg211*) was indicated enriched in the Finnish population due to a plausible founder effect. In addition, SERPINA12 hPPK patients were shown to share a similar phenotype to patients with recessive variants in SERPINB7. The shared phenotype included diffuse transgradient PPK since birth or early childhood and frequent palmoplantar hyperhidrosis, aquagenic whitening and additional hyperkeratotic lesions in non-palmoplantar areas. SERPINA12 and SERPINB7 hPPK patients cannot be distinguished without genetic analysis.

CONCLUSIONS

Recessive variants in SERPINA12 and SERPINB7 leading to protease overactivity and hPPK produce a similar phenotype, indistinguishable without genetic analysis. SERPINA12 variants should be assessed also in non-Asian patients with diffuse transgradient PPK. Understanding the role of serine protease inhibitors will provide insights into the complex proteolytic network in epidermal homeostasis.

Temperature dependence of dark-adapted sensitivity and light-adaptation in photoreceptors with A1 visual pigments: a comparison of frog L-cones and rods

Flash responses of L-cones and rods were recorded as ERG mass potentials in the frog retina at different temperatures (2-25 degrees C). The purpose was to elucidate factors that make cones faster and less sensitive than rods, particularly the possible role of thermal activation of L-cone visual pigment in maintaining a "light-adapted" state even in darkness. Up to ca. 15 degrees C, cones and rods were desensitized roughly equally by warming (Q(10) approximately 2.2-2.7), retaining a 5-fold sensitivity difference. In this range, the cone/rod difference must depend on factors other than thermal activation of the visual pigment. Above 15 degrees C, cones showed an additional component of desensitization compared with rods, coupled to accelerated response shut-off. This behavior is consistent with light-adaptation from temperature-dependent intrinsic activity (dark light). The apparent dark light as measured by the minimum background intensities needed to affect sensitivity and/or kinetics increased by ca. 10-fold between 15 and 25 degrees C, whereas reported increases in visual-pigment activation rates over this range are less than 5-fold. We conclude that the dark state of frog L-cones above 15 degrees C may be largely set by thermal activation of the phototransduction machinery, but only part of the experimentally determined dark light can be ascribed to the visual pigment.

Light responses and light adaptation in rat retinal rods at different temperatures

Rod responses to brief pulses of light were recorded as electroretinogram (ERG) mass potentials across isolated, aspartate-superfused rat retinas at different temperatures and intensities of steady background light. The objective was to clarify to what extent differences in sensitivity, response kinetics and light adaptation between mammalian and amphibian rods can be explained by temperature and outer-segment size without assuming functional differences in the phototransduction molecules. Corresponding information for amphibian rods from the literature was supplemented by new recordings from toad retina. All light intensities were expressed as photoisomerizations per rod (Rh*). In the rat retina, an estimated 34% of incident photons at the wavelength of peak sensitivity caused isomerizations in rods, as the (hexagonally packed) outer segments measured 1.7 microm x 22 microm and had specific absorbance of 0.016 microm(-1) on average. Fractional sensitivity (S) in darkness increased with cooling in a similar manner in rat and toad rods, but the rat function as a whole was displaced to a ca 0.7 log unit higher sensitivity level. This difference can be fully explained by the smaller dimensions of rat rod outer segments, since the same rate of phosphodiesterase (PDE) activation by activated rhodopsin will produce a faster drop in cGMP concentration, hence a larger response in rat than in toad. In the range 15-25 degrees C, the waveform and absolute time scale of dark-adapted dim-flash photoresponses at any given temperature were similar in rat and toad, although the overall temperature dependence of the time to peak (t(p)) was somewhat steeper in rat (Q(10) approximately 4 versus 2-3). Light adaptation was similar in rat and amphibian rods when measured at the same temperature. The mean background intensity that depressed S by 1 log unit at 12 degrees C was in the range 20-50 Rh* s(-1) in both, compared with ca 4500 Rh* s(-1) in rat rods at 36 degrees C. We conclude that it is not necessary to assume major differences in the functional properties of the phototransduction molecules to account for the differences in response properties of mammalian and amphibian rods.

Nebulin expression in patients with nemaline myopathy

Nemaline myopathy is a structural congenital myopathy which may show both autosomal dominant and autosomal recessive inheritance patterns. Mutations in three different genes have been identified as the cause of nemaline myopathy: the gene for slow alpha-tropomyosin 3 (TPM3) at 1q22-23, the nebulin gene (NEB) at 2q21.1-q22, and the actin gene (ACTA1) at 1q42. The typical autosomal recessive form appears to be the most common one and is caused by mutations in the nebulin gene. We have studied the pattern of nebulin labeling, in patients with the typical congenital form (ten patients), the severe congenital form (two patients) or the mild, childhood-onset form (one patient), using antibodies against three different domains of nebulin. A qualitative and quantitative nebulin analysis in muscle tissue showed the presence of nebulin in myofibers from all patients. Some differences relating to the rod structure were observed. The majority of the largest subsarcolemmal rods were not labeled with the N2 nebulin antibody (I-band epitope) and showed an indistinct pattern with the two antibodies directed to the Z-band portion of nebulin (epitopes M176-181 and serine-rich domain). Diffuse rods were not revealed using the three antibodies. A discordant pattern of nebulin N2 epitope labeling was found in two affected sisters with a mutation in the nebulin gene, suggesting that modifications in nebulin distribution inside the rods might occur with the progression of the disease. Western blot analysis showed no direct correlation with immunofluorescence data. In nine patients, the band had a molecular weight comparable to the normal control, while in one patient, it was detected with a higher molecular weight. Our results suggest that presence/absence of specific nebulin Z-band epitopes in rod structures is variable and could depend on the degree of rod organization.

Flicker sensitivity as a function of target area with and without temporal noise

Flicker sensitivities (1-30 Hz) in foveal, photopic vision were measured as functions of stimulus area with and without strong external white temporal noise. Stimuli were circular, sinusoidally flickering sharp-edged spots of variable diameters (0.25-4 degrees ) but constant duration (2 s), surrounded by a uniform equiluminant field. The data was described with a model comprising (i) low-pass filtering in the retina (R), with a modulation transfer function (MTF) of a form derived from responses of cones; (ii) normalisation of the temporal luminance distribution by the average luminance; (iii) high-pass filtering by postreceptoral neural pathways (P), with an MTF proportional to temporal frequency; (iv) addition of internal white neural noise (N(i)); (v) integration over a spatial window; and (vi) detection by a suboptimal temporal matched filter of efficiency eta. In strong external noise, flicker sensitivity was independent of spot area. Without external noise, sensitivity increased with the square root of stimulus area (Piper's law) up to a critical area (A(c)), where it reaches a maximum level (S(max)). Both A(c) and eta were monotonic functions of temporal frequency (f), such that log A(c) increased and log eta decreased linearly with log f. Remarkably, the increase in spatial integration area and the decrease in efficiency were just balanced, so A(c)(f)eta(f) was invariant against f. Thus the bandpass characteristics of S(max)(f) directly reflected the composite effect of the distal filters R(f) and P(f). The temporal equivalent (N(it)) of internal neural noise (N(i)) decreased in inverse proportion to spot area up to A(c) and then stayed constant indicating that spatially homogeneous signals and noise are integrated over the same area.

In search of the visual pigment template

Absorbance spectra were recorded by microspectrophotometry from 39 different rod and cone types representing amphibians. reptiles, and fishes, with A1- or A2-based visual pigments and lambdamax ranging from 357 to 620 nm. The purpose was to investigate accuracy limits of putative universal templates for visual pigment absorbance spectra, and if possible to amend the templates to overcome the limitations. It was found that (1) the absorbance spectrum of frog rhodopsin extract very precisely parallels that of rod outer segments from the same individual, with only a slight hypsochromic shift in lambdamax, hence templates based on extracts are valid for absorbance in situ: (2) a template based on the bovine rhodopsin extract data of Partridge and De Grip (1991) describes the absorbance of amphibian rod outer segments excellently, contrary to recent electrophysiological results; (3) the lambdamax/lambda invariance of spectral shape fails for A1 pigments with small lambdamax and for A2 pigments with large lambdamax, but the deviations are systematic and can be readily incorporated into, for example, the Lamb (1995) template. We thus propose modified templates for the main "alpha-band" of A1 and A2 pigments and show that these describe both absorbance and spectral sensitivities of photoreceptors over the whole range of lambdamax. Subtraction of the alpha-band from the full absorbance spectrum leaves a "beta-band" described by a lambdamax-dependent Gaussian. We conclude that the idea of universal templates (one for A1- and one for A2-based visual pigments) remains valid and useful at the present level of accuracy of data on photoreceptor absorbance and sensitivity. The sum of our expressions for the alpha- and beta-band gives a good description for visual pigment spectra with lambdamax > 350 nm.

Wave-front reconstruction with a shack-hartmann sensor with an iterative spline fitting method

One limitation of the conventional Shack-Hartmann sensor is that the spots of each microlens have to remain in their respective subapertures. We present an algorithm that assigns the spots to their reference points unequivocally even if they are situated far outside their subaperture. For this assignment a spline function is extrapolated in successive steps of the iterative algorithm. The proposed method works in a single-shot technique and does not need any aid from mechanical devices. The reconstruction of a simulated steep aspherical wave front (approximately 100 lambda/mm slope) is described as well as experimental results of the measurement of a spherical wave front with a huge peak-to-valley value (approximately 400 lambda). The performance of the method is compared with the unwrapping method, which has been published before.

Measurement of thermal contribution to photoreceptor sensitivity

Activation of a visual pigment molecule to initiate phototransduction requires a minimum energy, Ea, that need not be wholly derived from a photon, but may be supplemented by heat. Theory predicts that absorbance at very long wavelengths declines with the fraction of molecules that have a sufficient complement of thermal energy, and that Ea is inversely related to the wavelength of maximum absorbance (lambda(max)) of the pigment. Consistent with the first of these predictions, warming increases relative visual sensitivity to long wavelengths. Here we measure this effect in amphibian photoreceptors with different pigments to estimate Ea (refs 2, 5-7) and test experimentally the predictions of an inverse relation between Ea and lambda(max). For rods and 'red' cones in the adult frog retina, we find no significant difference in Ea between the two pigments involved, although their lambda(max) values are very different. We also determined Ea for the rhodopsin in toad retinal rods--spectrally similar to frog rhodopsin but differing in amino-acid sequence--and found that it was significantly higher. In addition, we estimated Ea for two pigments whose lambda(max) difference was due only to a chromophore difference (A1 and A2 pigment, in adult and larval frog cones). Here Ea for A2 was lower than for A1. Our results refute the idea of a necessary relation between lambda(max) and Ea, but show that the A1 --> A2 chromophore substitution decreases Ea.

Clinical and genetic heterogeneity in autosomal recessive nemaline myopathy

Autosomal recessive nemaline (rod) myopathy is clinically and genetically heterogeneous. A clinically distinct, typical form, with onset in infancy and a non-progressive or slowly progressive course, has been assigned to a region on chromosome 2q22 harbouring the nebulin gene Mutations have now been found in this gene, confirming its causative role. The gene for slow tropomyosin TPM3 on chromosome 1q21, previously found to cause a dominantly inherited form, has recently been found to be homozygously mutated in one severe consanguineous case. Here we wished to determine the degree of genetic homogeneity or heterogeneity of autosomal recessive nemaline myopathy by linkage analysis of 45 families from 10 countries. Forty-one of the families showed linkage results compatible with linkage to markers in the nebulin region, the highest combined lod scores at zero recombination being 14.13 for the marker D2S2236. We found no indication of genetic heterogeneity for the typical form of nemaline myopathy. In four families with more severe forms of nemaline myopathy, however, linkage to both the nebulin and the TPM3 locus was excluded. Our results indicate that at least three genetic loci exist for autosomal recessive nemaline myopathy. Studies of additional families are needed to localise the as yet unknown causative genes, and to fully elucidate genotype-phenotype correlations.

Mutations in the skeletal muscle alpha-actin gene in patients with actin myopathy and nemaline myopathy

Muscle contraction results from the force generated between the thin filament protein actin and the thick filament protein myosin, which causes the thick and thin muscle filaments to slide past each other. There are skeletal muscle, cardiac muscle, smooth muscle and non-muscle isoforms of both actin and myosin. Inherited diseases in humans have been associated with defects in cardiac actin (dilated cardiomyopathy and hypertrophic cardiomyopathy), cardiac myosin (hypertrophic cardiomyopathy) and non-muscle myosin (deafness). Here we report that mutations in the human skeletal muscle alpha-actin gene (ACTA1) are associated with two different muscle diseases, 'congenital myopathy with excess of thin myofilaments' (actin myopathy) and nemaline myopathy. Both diseases are characterized by structural abnormalities of the muscle fibres and variable degrees of muscle weakness. We have identified 15 different missense mutations resulting in 14 different amino acid changes. The missense mutations in ACTA1 are distributed throughout all six coding exons, and some involve known functional domains of actin. Approximately half of the patients died within their first year, but two female patients have survived into their thirties and have children. We identified dominant mutations in all but 1 of 14 families, with the missense mutations being single and heterozygous. The only family showing dominant inheritance comprised a 33-year-old affected mother and her two affected and two unaffected children. In another family, the clinically unaffected father is a somatic mosaic for the mutation seen in both of his affected children. We identified recessive mutations in one family in which the two affected siblings had heterozygous mutations in two different exons, one paternally and the other maternally inherited. We also identified de novo mutations in seven sporadic probands for which it was possible to analyse parental DNA.

Gender and risk of autoimmune diseases: possible role of estrogenic compounds

A striking common feature of many autoimmune diseases in humans and experimental animals, despite differences in pathology, is that females are highly susceptible to autoimmune conditions compared to males. In several animal models, estrogens promote, whereas androgens abrogate, B-cell-mediated autoimmune diseases. To understand mechanisms by which estrogens regulate autoimmunity, it is first necessary to decipher estrogen effects on the normal immune system. Estrogen treatment of nonautoimmune mice diminished lymphocyte numbers in both developmental and mature lymphoid organs. Estrogen dysregulated T- and B-cell balance by inducing selective T-cell hypoactivity and B-cell hyperactivity. Even though estrogen did not alter the relative percentages of splenic T-cell subsets, splenic lymphocytes had a reduced proliferative response to T-cell stimulants and were refractory to rescue from activation-induced apoptosis compared to cells from placebo-treated mice. In contrast, estrogen induced B-cell hyperactivity (promoted autoantibodies to double-stranded DNA and phospholipids, increased numbers of plasma cells, and increased autoantibody yield per B cell). Note that treatment of normal mice with estrogen can alter T- and B-cell regulation and overcome B-cell tolerance to result in autoimmunity in normal individuals. Could environmental estrogens promote some human autoimmune disorders? Is there a link between environmental estrogens and autoimmune disorders, especially since these disorders are reported possibly more frequently? These provocative questions warrant investigation. Our findings on immunomodulatory effects may serve as a benchmark to examine whether endocrine-disrupting chemicals will have similar immunologic effects.

Mutations in the nebulin gene associated with autosomal recessive nemaline myopathy

The congenital nemaline myopathies are rare hereditary muscle disorders characterized by the presence in the muscle fibers of nemaline bodies consisting of proteins derived from the Z disc and thin filament. In a single large Australian family with an autosomal dominant form of nemaline myopathy, the disease is caused by a mutation in the alpha-tropomyosin gene TPM3. The typical form of nemaline myopathy is inherited as an autosomal recessive trait, the locus of which we previously assigned to chromosome 2q21.2-q22. We show here that mutations in the nebulin gene located within this region are associated with the disease. The nebulin protein is a giant protein found in the thin filaments of striated muscle. A variety of nebulin isoforms are thought to contribute to the molecular diversity of Z discs. We have studied the 3' end of the 20. 8-kb cDNA encoding the Z disc part of the 800-kDa protein and describe six disease-associated mutations in patients from five families of different ethnic origins. In two families with consanguineous parents, the patients were homozygous for point mutations. In one family with nonconsanguineous parents, the affected siblings were compound heterozygotes for two different mutations, and in two further families with one detected mutation each, haplotypes are compatible with compound heterozygosity. Immunofluorescence studies with antibodies specific to the C-terminal region of nebulin indicate that the mutations may cause protein truncation possibly associated with loss of fiber-type diversity, which may be relevant to disease pathogenesis.

The effects of temporal noise and retinal illuminance on foveal flicker sensitivity

We measured foveal flicker sensitivity with and without external added temporal noise at various levels of retinal illuminance and described the data with our model of flicker sensitivity comprising: (i) low-pass filtering of the flickering signal plus external temporal and/or quantal noise by the modulation transfer function (MTF) of the retina (R): (ii) high-pass filtering in proportion to temporal frequency by the MTF of the postreceptoral neural pathways (P): (iii) addition of internal white neural noise; and (iv) detection by a temporal matched filter. Without temporal noise flicker sensitivity had a band-pass frequency-dependence at high and medium illuminances but changed towards a low-pass shape above 0.5 Hz at low luminances, in agreement with earlier studies. In strong external temporal noise, however, the flicker sensitivity function had a low-pass shape even at high and medium illuminances and flicker sensitivity was consistently lower with noise than without. At low luminances flicker sensitivity was similar with and without noise. An excellent fit of the model was obtained under the assumption that the only luminance-dependent changes were increases in the cut-off frequency (fc) and maximum contrast transfer of R with increasing luminance. The results imply the following: (i) performance is consistent with detection by a temporal matched filter, but not with a thresholding process based on signal amplitude; (ii) quantal fluctuations do not at any luminance level become a source of dominant noise present at the detector; (iii) the changes in the maximum contrast transfer reflect changes in retinal gain, which at low to moderate luminances implement less-than-Weber adaptation, with a 'square-root' law at the lowest levels; (iv) the changes of fc as function of mean luminance closely parallels time scale changes in cones, but the absolute values of fc are lower than expected from the kinetics of monkey cones at all luminances; (v) the constancy of the high-pass filtering function P indicates that surround antagonism does not weaken significantly with decreasing light level.

Noise-equivalent and signal-equivalent visual summation of quantal events in space and time

Noise recorded in visual neurons, or variability in psychophysical experiments, may be quantified in terms of quantal fluctuations from an "equivalent" steady illumination. The conversion requires assumptions concerning how photon signals are pooled in space and time, i.e. how to pass from light fluxes to numbers of photon events relevant to the Poisson statistics describing signal/noise. It is usual to approximate real weighting profiles for the integration of photon events in space and time (the sensitivity distribution of the receptive field [RF] and the waveform of the impulse response [IR]) by sharp-bordered apertures of "complete," equal-weight summation of events. Apertures based on signal-equivalence cannot provide noise-equivalence, however, because greater numbers of events summed with smaller weights (as in reality) have lower variances than smaller numbers summed with full weight. Thus sharp-bordered apertures are necessarily smaller if defined for noise- than for signal-equivalence. We here consider the difference for some commonly encountered RF and IR profiles. Summation areas, expressed as numbers of photoreceptors (cones or rods) contributing with equal weight, are denoted NS for signal and NN for noise; sharply delimited summation times are correspondingly denoted tS and tN. We show that the relation in space is NN = 0.5 NS for the Gaussian distribution (e.g. for the RF center mechanism of retinal ganglion cells). For a photoreceptor in an electrically coupled network the difference is even larger, e.g., for rods in the toad retina NN = 0.2 NS (NS = 13.7 rods and NN = 2.8 rods). In time, the relation is tN approximately 0.7 tS for realistic quantal response waveforms of photoreceptors. The surround input in a difference-of-Gaussians RF may either decrease or increase total noise, depending on the degree of correlation of center and surround noise. We introduce a third useful definition of sharp-bordered summation apertures: one that provides the same signal-to-noise ratio (SNR) for large-long stimuli as the real integration profiles. The SNR-equivalent summation area is N* = N2S/NN and summation time t* = t2S/tN.

Rhodopsins from three frog and toad species: sequences and functional comparisons

The frequency of thermal 'dark events' in the membrane current of rhodopsin rods of the bullfrog, Rana catesbeiana, is considerably lower than observed in rods of two toad species, even though all three rhodopsins have approximately the same absorbance characteristics. In order to map amino acid substitutions possibly associated with thermal stability in the genus Rana, the cDNA's coding for the rhodopsins of Bufo bufo, B. marinus and R. temporaria were sequenced and the conceptually translated protein sequences aligned to the previously sequenced rhodopsins of R. catesbeiana, R. pipiens and Xenopus laevis. Across the six anuran species studied, there are sixteen non-conserved substitutions and six changes that include gain or loss of a hydroxyl group. Serine or threonine at position 220 is unique to the three Rana species, phenylalanine at position 270 is unique to all three Ranas and to X. laevis, and phenylalanine at position 274 is unique to both species of the genus Bufo. This investigation produces a list of substitutions that are candidates for future studies of thermal stability. In addition, a number of amino acids are identified that apparently do not influence absorbance characteristics, at least not cumulatively.

Light adaptation of cone photoresponses studied at the photoreceptor and ganglion cell levels in the frog retina

The sensitivity and time scale of the dominant (562 nm) cone system of the frog, Rana temporaria, were studied as functions of steady adapting illuminance (IB). Photoreceptor responses to brief flashes of light were recorded as aspartate-isolated ERG mass potentials from the isolated retina. The characteristics of the cone signal after transmission through the retina were derived from response thresholds and stimulus--intensity-response--latency functions for extracellularly recorded spike discharges of single ganglion cells in the eyecup. At 14 degrees C, the single-photon response of dark-adapted cones, extrapolated from ERG intensity-response functions, had an amplitude of 0.5% of the saturated response (Umax) and peaked at tp approximately 0.4 sec. Steady background illumination decreased both tp and flash sensitivity (SF), starting from apparent "dark lights" of, respectively, less than 10 (for time scale) and about 100 (for sensitivity) photoisomerisations per cone per second [P*sec-1]. From there upwards, two distinct ranges of background adaptation were apparent. Under moderate backgrounds (up to IB approximately 10(4) - 10(5) P*sec-1), sensitivity fell according to the relation SF alpha IB-0.64 and time scale shortened according to tp alpha IB-0.16. Under brighter backgrounds, from approx. 10(5) P*sec-1 up to the limit of our light source at 10(7) P*sec-1, the decrease in SF was significantly stronger than predicted by the Weber relation (SF alpha IB-1), while the decrease in tp levelled out and even tended to reverse. All these changes were virtually identical at the photoreceptor and ganglion cell levels, although the absolute time scale of cone signals apparent at the latter level was 2-fold longer. Our general conclusion is that photoreceptors have several distinct regimes for light adaptation, and traditional descriptions of functional changes (in sensitivity and kinetics) relevant to vision need to be restated with higher resolution, in view also of recent insights into the diversity of underlying mechanisms.

Summation of Quantal Noise in Space and Time

Noise in visual neurons, or variability in psychophysical experiments, may be quantified in terms of photon fluctuations from an ‘equivalent’ steady illumination. The conversion requires assumptions on how photon signals are pooled in space and time, ie how to pass from the light flux to the numbers of photon events relevant to the Poisson statistics describing signal/noise. Real weighting profiles for the integration of photon events in space and time [the sensitivity distribution of the receptive field (RF) and the waveform of the impulse response (IR)] are commonly approximated by sharp-bordered apertures of ‘complete’, equal-weight summation of events. Such apertures based on signal equivalence cannot provide noise equivalence, however, because greater numbers of events summed with lower weights (as in reality) have lower variances than smaller numbers summed with full weight. Thus sharp-bordered apertures are necessarily smaller if defined for noise equivalence rather than for signal equivalence. We have calculated the difference for some commonly encountered RF and IR profiles. Summation areas, expressed as numbers of photoreceptors (cones or rods) contributing with equal weight, are denoted NS for signal and NN for noise, and sharply delimited summation times are correspondingly denoted tS and tN. We show that the relation in time is tN=0.6 tS to 0.7 tS for realistic quantal response waveforms of photoreceptors. In space, the relation is NN=0.5 NS for the Gaussian distribution (eg for the RF centre mechanism of retinal ganglion cells). For a photoreceptor in an electrically coupled network the difference is still greater, eg for rods in the toad retina NN=0.2 NS ( NS=13.7 rods and NN=2.8 rods). We introduce a third possible definition of sharp-bordered summation apertures: one that provides the same signal-to-noise ratio (SNR) for large-long stimuli as the real integration profiles. The SNR-equivalent summation area is N*= NS2/ NN and the summation time is t*= tS2/ tN.

Rhodopsins with Similar Absorbance Characteristics but Different Rates of Thermal Activation: Amino Acid Sequences

Thermal activation of the visual pigment is thought to be an important factor that in many cases limits the absolute sensitivity of vision in darkness. It has been suggested that pigments with high \lambdamax (ie with good absorbance at long wavelengths, allowing ‘red-sensitive’ vision) are associated with a cost in terms of high thermal activation rates, degrading signal/noise and hence visual sensitivity [Barlow, 1957 Nature (London)179 255 – 256]. While rhodopsins in different species do show a general correlation between red-sensitivity and high thermal activation rates as measured electrophysiologically in whole rods (Firsov and Govardovskii, 1990 Sensornye Sistemy4 25 – 34), a comparison of the toads Bufo marinus and B. bufo with the bull-frog Rana catesbeiana has suggested that the two properties are not tightly coupled. Toad and bull-frog rhodopsins have almost the same \lambdamax, yet the thermal activation rate in bull-frog rods is lower by almost one order of magnitude [Donner et al, 1990 Journal of Physiology (London)428 673 – 692]. We have sequenced the cDNA coding for the rhodopsins of the two toad species and that of the common frog R. temporaria and aligned them to previously sequenced rhodopsins of R. catesbeiana, R. pipiens and Xenopus laevis in an attempt to identify substitutions that could underlie the greater thermal stability of bull-frog rhodopsin compared with toad rhodopsins.

The open reading frame predicted proteins of 354 amino acids. There was 96% identity between species of the same genus and 90% identity between genera. Across the six species studied, there is a total of 22 non-conserved substitutions and changes that include gain or loss of hydroxyl groups. Our study produced a list of substitutions that apparently do not significantly affect absorbance characteristics. We could not, however, unequivocally identify substitutions important for thermal stability.

Retinal Mechanisms Underlying Pedestal Effects in Brightness Discrimination: A Model

The dependence of the minimal discriminable intensity difference (MDD) of two flashed stimuli on the pedestal (the intensity of the dimmer one) is known to follow a nonmonotonic ‘dipper’ function. When the pedestal is zero, the MDD is by definition identical to the threshold for light detection. Very dim pedestals have little effect on the MDD, but there is a range of fairly dim pedestals, of intensities around the detection threshold, where the MDD decreases with increasing intensity. Beyond that range, the MDD is a monotonically increasing function of intensity. Functions of this type have been observed with spatially very different stimuli.

We propose that dipper functions arise owing to the fact that different aspects of the primary light response of photoreceptors are relevant to near-threshold and suprathreshold visual signals. Decisions near the detection threshold are based on signals determined by the peak amplitude of photoreceptor responses, which for dim stimuli grows linearly with intensity. By contrast, visual signals for clearly suprathreshold stimuli reflect the rate of rise of early parts of the photoreceptor response, tracing only a short segment of the photoreceptor response just after the point where it has reached threshold amplitude. The latter type of signal shows a similar intensity dependence as do psychophysical brightness judgments, starting with a supralinear segment and passing via linearity into a compressive power function at high stimulus intensities (Donner, 1989 Visual Neuroscience3 39 – 51; Djupsund et al, 1996 Vision Research36 3253 – 3264). Discrimination sensitivity is in principle proportional to the derivative of this function. The transition from the ‘peak-amplitude-based’ linear signalling range around detection threshold to the ‘early-rise-based’ signalling range described by the nonlinear brightness function implies a sharp contraction of the response time window. Intensity discrimination improves, because the intensity dependence of the signal scaled by its variability becomes steeper than linear. As pedestal intensity is raised further, however, the MDD begins to increase again, basically in inverse proportion to the decreasing derivative of the brightness function.

Refined localisation of the genes for nebulin and titin on chromosome 2q allows the assignment of nebulin as a candidate gene for autosomal recessive nemaline myopathy

A locus for autosomal recessive nemaline myopathy (NEM2) has been assigned by linkage analysis to a 13-cM region between the markers D2S150 and D2S142 on 2q21.2-q22. The genes for the giant muscle proteins nebulin and titin have previously been assigned by FISH to 2q24.1-q24.2 and 2q31, respectively. By using radiation hybrid mapping, we have reassigned the nebulin gene close to the microsatellite marker D2S2236 on 2q22 and the titin gene to the vicinity of the markers D2S384 and D2S364 on 2q24.3. The genomic orientation of the nebulin gene was determined as 5'-3' and of TTN as 3'-5' from the centromere. We conclude that the nebulin gene resides within the candidate region for NEM2 on the long arm of chromosome 2, while the titin gene is located outside this region.

Regulation of intracellular pH in salamander retinal rods

1. We measured intracellular pH (pHi) in rods isolated from the retina of the axolotl salamander, Ambystoma mexicanum, using the fluorescent indicator 2',7'-bis(carboxyethyl)-5(and -6)-carboxyfluorescein (BCECF). 2. The light exposures associated with data acquisition had no marked effect on pHi. There was no sharp change between the value obtained from the first exposure of dark-adapted rods and subsequent readings. Increasing the acquisition frequency from 1 to 10 min-1 either had no effect, or brought about a slow acidification, which was stopped or reversed when the low frequency was restored. 3. In nominally HCO3(-)-free solution at pH 7.5, the rods had a steady-state pHi of 7.09 +/- 0.02 (n = 46) and a buffering power (beta i) of 24 +/- 1 mM (pH unit)-1 (n = 48). The buffering power was virtually constant in the pH range 6.6-8.0. In the same range, pHi dependent linearly on perfusion pH (pHo) with regression coefficients of 0.4-0.5. 4. There were no significant differences between the inner and outer segment of intact rods as regards steady-state pHi or responses to experimental treatments. 5. Recovery from an intracellular acid load imposed by sodium propionate or an NH4Cl prepulse in nominally bicarbonate-free perfusate was completely blocked by decreasing the extracellular Na+ concentration to 7 mM, and slowed by 86% by applying 1 mM amiloride. 6. Introduction of 2% CO2-13 mM HCO3- caused an alkalinization that was often preceded by a transient acidification. Steady-state pHi was on average 0.1 pH units higher than in nominally bicarbonate-free solution. The mean acid extrusion rate, calculated on the assumption that CO2-HCO3- behaves as an open system, was 19% higher (31 +/- 2 mM h-1) than in a solution buffered only by Hepes (26 +/- 2 mM h-1). 7. In the presence of CO2-HCO3-, 100 microM 4,4'-diisothiocyanatostilbene-2,2'-disulphonic acid (DIDS) decreased the acid extrusion rate by 20% on average. Lowering the extracellular Cl-concentration to 7 mM raised pHi, but did not significantly affect the acid extrusion rate. 8. We conclude that retinal rods regulate pHi by both Na(+)-H+ exchange and mechanism(s) involving HCO3(-)-Cl- exchange. In the present conditions, the Na(+)-H+ exchanger appears as the dominant mechanism for acid extrusion.

Flicker sensitivity as a function of spectral density of external white temporal noise

Foveal flicker sensitivity at 0.5-30 Hz was measured as a function of the spectral density of external, white, purely temporal noise for a sharp-edged 2.5 deg circular spot (mean luminance 3.4 log phot td). Sensitivity at any given temporal frequency was constant at low powers of external noise, but then decreased in inverse proportion to the square root of noise spectral density. Without external noise, sensitivity as function of temporal frequency had the well-known band-pass characteristics peaking at about 10 Hz, as previously documented in a large number of studies. In the presence of strong external noise, however, sensitivity was a monotonically decreasing function of temporal frequency. Our data are well described (goodness of fit 90%) by a model comprising (i) low-pass filtering by retinal cones, (ii) high-pass filtering in the subsequent neural pathways, (iii) adding of the temporal equivalent of internal white spatiotemporal noise, and (iv) detection by a temporal matched filter, the efficiency of which decreases approximately as the power -0.58 of temporal frequency.

pH changes in frog rods upon manipulation of putative pH-regulating transport mechanisms

Rod intracellular pH (pHi) in the intact frog retina was measured fluorometrically with the dye 2',7'-bis(2-carboxyethyl)-5(and-6)-carboxyfluorescein under treatments chosen to affect putative pH-regulating transport mechanisms in the plasma membrane. The purpose was to relate possible pHi changes to previously reported effects on photoresponses. In nominally bicarbonate-free Ringer, application of amiloride (1 mM) or substitution of 95 mM external Na+ by K+ or choline triggered monotonic but reversible acidifications, consistent with inhibition of Na+/H+ exchange. Bicarbonate-dependent mechanisms were characterized as follows: (1) Replacing half of a 12 mM phosphate buffer by bicarbonate caused a sustained rise of pHi. (2) Subsequent application of the anion transport inhibitor 4,4'-diisothiocyanatostilbene-2',2'-disulphonic acid (DIDS, 0.2 mM) set off a slow acidification. (3) Substitution of external Cl- by gluconate (95 mM) caused a rapid pHi rise both in normal Na+ and low-Na+ perfusion. (4) This effect was inhibited by DIDS. The results support a consistent explanation of parallel electrophysiological experiments on the assumption that intracellular acidifications reduce and alkalinizations (in a certain range) augment photoresponses. It is concluded that both Na+/H+ exchange and bicarbonate transport control rod pHi, modulating the light-sensitive current. Part of the bicarbonate transport is by Na(+)-independent HCO3-/Cl- exchange, but a further Na(+)-coupled bicarbonate import mechanism is implicated.

The effect of background luminance on visual responses to strong flashes: perceived brightness and the early rise of photoreceptor responses

The threshold intensity for large-long incremental stimuli rises proportionally to adapting background luminance IB (Weber adaptation), but the intensity required to evoke a criterion high-brightness sensation rises much less steeply. We propose that this difference originates in the very first stage of visual processing, in the phototransduction and adaptation properties of the retinal photoreceptor cells. A physiological model previously found to account for visual latency and brightness as functions of stimulus intensity in the dark-adapted state [Donner, K. (1989). Visual Neuroscience, 3, 39-51] is extended to cover different states of adaptation. It is assumed that the neural coding of high intensities is based on the rate of rise (quasi-derivative) of the photoreceptor response just after it reaches a small threshold amplitude. The shallow background adaptation functions for high-brightness criteria emerge as a consequence of the relative constancy of the leading edge of large responses under backgrounds, a phenomenon that can be formally described by compensating changes in photoreceptor sensitivity and time scale. We first test the model on supra-threshold responses in the frog retina, where the discharge rate of ganglion cells (a possible neural code for brightness) and the primary rod hyperpolarizations can be recorded under identical conditions. The two are related as predicted over at least 3 log units of background intensity. We then show that published data on the background adaptation of human foveal high brightness judgments conform to the same model, assuming that human cones accelerate as IB-b with b = 0.14-0.15.

Mechanisms and Meaning of Devries—Rose Adaptation

‘Square-root’ or ‘deVries — Rose’ light adaptation is observed over a substantial luminance range in human foveal vision. The classical interpretation is that a detector (presumably in the brain) discriminates the neural signal evoked by the stimulus from the neural noise evoked by quantum fluctuations. It is known, however, that the retina may adjust its gain in inverse proportion to the square root of mean luminance, as observed eg in cat retinal ganglion cells under scotopic or mesopic adaptation. This kind of gain change is approximated even by the primary visual cells, the rods and cones, in at least some vertebrate species up to luminances producing 103 – 104 photoisomerisations per photoreceptor cell, per second. Is square-root adaptation in fact mainly an expression of an inverse-square-root gain in retinal cells? We investigated the roles of gain and noise in human foveal detection of 0.25 deg incremental spots presented for 50 ms on 5 deg steady backgrounds ranging from −0.25 to 2.35 log td, by measuring effects of pixel noise added to the stimulus and background. The results were consistent with the hypothesis that square-root adaptation mainly reflects gain changes, whereas the signal is detected against a constant level of neural noise. They were not consistent with the idea that signals proportional to stimulus intensity are detected against a noise that increases in proportion to quantum fluctuations. Thus, they do not support a simple interpretation of the deVries — Rose law. Still, an inverse-square-root retinal gain may in an evolutionary sense be seen as an adaptation to quantum fluctuations, in view of its functional consequences: (1) that output noise stays constant, independent of luminance level; (2) that light signals of constant statistical significance are encoded by visual responses of constant size.

Modelling the spatio-temporal modulation response of ganglion cells with difference-of-Gaussians receptive fields: relation to photoreceptor response kinetics

Difference-of-Gaussians (DOG) models for the receptive fields of retinal ganglion cells accurately predict linear responses to both periodic stimuli (typically moving sinusoidal gratings) and aperiodic stimuli (typically circular fields presented as square-wave pulses). While the relation of spatial organization to retinal anatomy has received considerable attention, temporal characteristics have been only loosely connected to retinal physiology. Here we integrate realistic photoreceptor response waveforms into the DOG model to clarify how far a single set of physiological parameters predict temporal aspects of linear responses to both periodic and aperiodic stimuli. Traditional filter-cascade models provide a useful first-order approximation of the single-photon response in photoreceptors. The absolute time scale of these, plus a time for retinal transmission, here construed as a fixed delay, are obtained from flash/step data. Using these values, we find that the DOG model predicts the main features of both the amplitude and phase response of linear cat ganglion cells to sinusoidal flicker. Where the simplest model formulation fails, it serves to reveal additional mechanisms. Unforeseen facts are the attenuation of low temporal frequencies even in pure center-type responses, and the phase advance of the response relative to the stimulus at low frequencies. Neither can be explained by any experimentally documented cone response waveform, but both would be explained by signal differentiation, e.g. in the retinal transmission pathway, as demonstrated at least in turtle retina.

Changes in retinal time scale under background light: observations on rods and ganglion cells in the frog retina

The kinetics of rod responses to flashes and steps of light was studied as a function of background intensity (IB) at the photoreceptor and ganglion cell levels in the frog retina. Responses of the rod photoreceptors were recorded intracellularly in the eyecup and as ERG mass potentials across the isolated, aspartate-superfused retina. The kinetics of the retinally transmitted signal was derived from the latencies of ganglion cell spike discharges recorded extracellularly in the eyecup. In all states of adaptation the linear-range rod response to dim flashes could be modelled as the impulse response of a chain of low-pass filters with the same number of stages: 4 (ERG) or 4-6 (intracellular). Dark-adapted time-to-peak (tp, mean +/- SD) at 12 degrees C was 2.4 +/- 0.6 sec (ERG) or 1.7 +/- 0.4 sec (intracellular). Under background light, the time scale shortened as a power function of background intensity, I-bB with b = 0.19 +/- 0.03 (ERG) or 0.14 +/- 0.04 (intracellular). The latency-derived time scale of the rod-driven signal at the ganglion cell agreed well with that of the photoreceptor responses. The apparent underlying impulse response had tp = 2.0 +/- 0.7 sec in darkness and accelerated as I-bB with b = 0.17 +/- 0.03. The photoreceptor-to-ganglion-cell transmission delay shortened by 30% between darkness and a background delivering ca 10(4) photoisomerizations per rod per second. Data from the literature suggest that all vertebrate photoreceptors may accelerate according to similar power functions of adapting intensity, with exponents in the range 0.1-0.2. It is noteworthy that the time scale of human (foveal) vision in experiments on flicker sensitivity and temporal summation shortens as a power function of mean luminance with b approximately 0.15.

Spectral sensitivities of short- and long-wavelength sensitive cone mechanisms in the frog retina

ERG mass photoreceptor responses were recorded across the isolated, aspartate-perfused retina of the frog, Rana temporaria, in order to determine spectral sensitivities of cones. Cone responses were distinguished from rod responses by their faster kinetics, and responses from different cone types were isolated by selective background adaptation. Our main finding is that of a novel short-wavelength sensitive cone population peaking at about 431 nm. Further, we find that the sensitivity spectrum of the dominant long-wavelength sensitive cone population fully accounts for the most common type of photopic ganglion cell spectrum. Both can be described by a nomogram with lambda max = 562 nm. This resolves a long-standing apparent conflict between cone absorbance spectra and ganglion cell sensitivities. Including the 502 nm cones previously described by microspectrophotometry, the frog possesses a collection of cones that could support trichromatic photopic vision.

Response univariance in bull-frog rods with two visual pigments

Rods in the bull-frog retina contain varying proportions of rhodopsin (lambda max = 502 nm) and porphyropsin (lambda max = 527 nm) in a dorso-ventral gradient from the porphyropsin-rich dorsal rim to the virtually pure rhodopsin fields of the central and ventral retina. We investigated if quantal excitations in the same rod are different depending on whether they are initiated by isomerization of a rhodopsin or a porphyropsin molecule. Current photoresponses were recorded from dark-adapted rods by sucking the outer segment into a recording pipette. The relation between pigment composition and spectral sensitivity was established by comparison with microspectrophotometrically measured absorbance spectra of rods from the same neighbourhood. Rods with suitable porphyropsin: rhodopsin mixtures (ideally between 1:4 and 1:2) were stimulated with flashes of red (608 nm) and blue (465 nm) light, whereby the red light will isomerize porphyropsin much more often than rhodopsin, and the reverse will be true of the blue light. The amplitude and shape of the single-photon response were found to be identical for the "red" and "blue" flash series to within measurement error (ca 10%). This indicates that the quantal responses initiated by the two pigments are identical.

Changes in the light-sensitive current of salamander rods upon manipulation of putative pH-regulating mechanisms in the inner and outer segment

The light-sensitive current of dark-adapted rods isolated from the Ambystoma retina was recorded while either the inner or the outer segment (IS or OS) protruding from the suction pipette was exposed to treatments intended to reveal the physiological roles of pH-regulating transport mechanisms. Applied to the IS, both amiloride (presumed to block Na+/H+ exchange, 2 mM) and 4-4'-diisothiocyanatostilbene-2,2'-disulphonic acid (DIDS) (presumed to block bicarbonate transport, 0.1 mM) generally abolished light sensitivity completely but reversibly, consistent with acidification of the IS. Yet, the circulating ("dark") current often persisted, implying that the OS was not acidified. Applied to the OS, amiloride depressed but DIDS increased the dark current and photoresponses. Given the fact that the current increases with rising OS-pHi, this suggests alkalinization, which could be due to DIDS inhibiting bicarbonate extrusion by HCO3-/Cl- exchangers in the OS. Consistent with this idea, replacing external Cl- by other anions increased the current as would be expected if HCO3-/Cl- exchange is reversed. We propose that the IS and OS manage their acid balances independently and with different sets of transport mechanisms. Acidosis in either compartment suppresses the photosensitivity of the rod, but by differing mechanisms.

pH regulation in frog cones studied by mass receptor photoresponses from the isolated retina

Mass cone photoresponses were recorded across the aspartate-treated frog retina under treatments chosen to affect putative pH-regulating mechanisms. The saturated response amplitude (Umax) was found to be a monotonically increasing function of perfusion pH in the range 7-8, and thus presumably of intracellular pH (pHi). Accepting that Umax can be used as an index of pHi changes, two results indicate the importance of bicarbonate transport for preventing intracellular acidification: (1) bicarbonate-buffered (6 mM HCO3- + 6 mM HEPES) perfusate increased Umax compared with nominally bicarbonate-free perfusate (12 mM HEPES); (2) the anion transport blocker DIDS (0.1 mM) caused a strong decrease in the amplitude of photoresponses. Substitution of 95 mM chloride by gluconate in the perfusing fluid boosted photoresponses indicating that at least part of the bicarbonate transport involves HCO3-/Cl- exchange. Amiloride (2 mM) also caused a decrease of photoresponse amplitude, which suggests that Na+/H+ exchange contributes to pHi regulation. In all these respects, cones behaved similarly to rods. Cones differed from rods (in the intact retina) in that addition of 0.5 mM of the carbonic anhydrase inhibitor acetazolamide reduced (never augmented) photoresponses. The difference is considered in relation to the presence of carbonic anhydrase in cone, as opposed to rod, outer segments.

Visual performance of the toad (Bufo bufo) at low light levels: retinal ganglion cell responses and prey-catching accuracy

The accuracy of toad snapping towards moving worm dummies under various levels of dim illumination (from absolute threshold to "moonlight") was video-recorded and related to spike responses of retinal ganglion cells exposed to equivalent stimuli. Some toads (at ca. 16 degrees C) successfully snapped at dummies that produced only one photoisomerization per 50 rods per second in the retina, in good agreement with thresholds of sensitive retinal ganglion cells. One factor underlying such high sensitivity is extensive temporal summation by the ganglion cells. This, however, is inevitably accompanied by very long response latencies (around 3 s near threshold), whereby the information reaching the brain shows the dummy in a position where it was several seconds earlier. Indeed, as the light was dimmed, snaps were displaced successively further to the rear of the dummy, finally missing it. The results in weak but clearly supra-threshold illumination indicate that snaps were aimed at the advancing head as seen by the brain, but landed further backwards in proportion to the retinal latency. Near absolute threshold, however, accuracy was "too good", suggesting that the animal had recourse to a neural representation of the regularly moving dummies to correct for the slowness of vision.

Retinal origins of the temperature effect on absolute visual sensitivity in frogs

1. The absolute sensitivity of vision was studied as a function of temperature in two species of frog (Rana temporaria, 9-21 degrees C, and Rana pipiens, 13-28 degrees C). 2. Log behavioural threshold (measured as the lowest light intensity by which frogs trying to escape from a dark box were able to direct their jumping) rose near-linearly with warming with a regression coefficient of 1.26 +/- 0.03 log units per 10 degrees C (Q10 = 18). Threshold retinal illumination corresponded to 0.011 photoisomerizations per rod per second (Rh* s-1) at 16.5 degrees C. 3. The effect of dim backgrounds on jumping thresholds suggested 'dark lights' of 0.011 Rh* s-1 at 16.5 degrees C and 0.080 Rh* s-1 at 23.5 degrees C, corresponding to Q10 = 17. 4. Response thresholds of retinal ganglion cells were extracellularly recorded in the isolated eyecup of R. temporaria. The thresholds of the most sensitive cells when stimulated with large-field steps of light were similar to the behavioural threshold and changed with temperature in a similar manner. 5. The decrease in ganglion cell 'step' sensitivity with warming consisted of a decrease in summation time (by a factor of 2-3 between 10 and 20 degrees C) and an increase in the threshold number of photoisomerizations (a decrease in 'flash' sensitivity, by a factor of 2-5 over the same interval). No effect of temperature changes on spatial summation was found. 6. Frequency-of-response functions of ganglion cells indicated an 11-fold increase in noise-equivalent dark light between 10 and 20 degrees C (mean values in four cells 0.009 vs. 0.10 Rh* s-1). 7. The temperature dependence of ganglion cell flash sensitivity could be strongly decreased with dim background illumination. 8. It is concluded that the desensitization of dark-adapted vision with rising temperature is a retinal effect composed of shortened summation time and lowered flash sensitivity (increased numbers of photons required for a threshold response) in ganglion cells. The desensitization bears no simple relation to the apparent retinal noise increase.

Influence of loperamide and loperamide oxide on the anal sphincter. A manometric study

The objective of this study was to investigate the effects of the opioid loperamide and its recently synthesized pharmacologically inactive prodrug loperamide oxide on the anal sphincter. In a double-blind, placebo-controlled crossover study, anorectal manometry was performed in 12 healthy volunteers five hours after oral bolus application of 10 mg of loperamide, loperamide oxide, or placebo. Loperamide significantly increased the threshold volumes for minimal perception and urgency to defecate (P less than 0.05) and raised the volume required to abolish recovery of the rectoanal inhibitory reflex (P less than 0.05). These findings suggest that loperamide has a specific continence-improving action on the anal sphincter. However, anal resting pressure and maximal squeeze pressure were unaffected in our study and do not seem to be responsible for this effect. The effects under loperamide oxide showed a similar tendency but were without statistical significance.

On the relation between ERG waves and retinal function: inverted rod photoresponses from the frog retina

In rod mass receptor photoresponses recorded across the isolated frog retina, a paradoxical cornea-positive wave may precede the response of normal polarity. We present a model which shows that the light-induced decrease in rod current can give rise to inverted or biphasic ERG signals if the distal part (tip) of the rod outer segment responds more slowly and/or less sensitively than the proximal part (base). The condition is that current entering at the tip is represented with greater weight in the ERG. The model reproduces recorded ERG waveforms well. It further predicts that if there is a light-insensitive conductance in the tip membrane, ERG photoresponses may be non-recordable although current photoresponses are only slightly reduced. The model reveals a type of complexity in the relation between mass potentials and underlying physiological processes which has not previously received attention.

Noise and the absolute thresholds of cone and rod vision

Literature data on light detection by cone and rod vision at absolute threshold are analysed in order (1) to decide whether the threshold performance of dark-adapted cone vision can, like that of rod vision, be consistently explained as limited by noise from a "dark light"; (2) to obtain comparable estimates of the dark noise and dark light of (foveal) cones and (peripheral) rods. The dark noise was estimated by a maximum-likelihood procedure from frequency-of-seeing data and compared with the dark light derived from increment-threshold functions. In both cone and rod vision, the estimated dark noise coincides with Poisson fluctuations of the estimated dark light if 17% (best estimate) of lambda max-quanta incident at the cornea produce excitations. At that fraction of quanta exciting, dark lights are equivalent to 112 isomerisations per sec in each foveal cone and 0.011 isomerisations per sec in each rod. It is concluded that (1) the threshold performance of dark-adapted cone as well as rod vision can be consistently described as noise-limited, but not by postulating a multi-quantum coincidence requirement for single receptors; (2) the underlying intrinsic activity in both the cone and the rod system is light-like as regards correspondence between noise effect and background adaptation effect. One possibility is that this activity is largely composed of events identical to the single-photon response, originating in the visual pigment, in cones as well as in rods.

Intraindividual variability of anorectal manometry parameters

The present study investigates the intraindividual day-to-day variability of anorectal manometry parameters. Manometric studies were performed in twelve healthy volunteers on three different days. A low compliance capillary perfusion system was used. The values measured on day 1 and day 2, as well as those on day 2 and day 3, showed no significant (p greater than 0.05) differences for any parameter in Wilcoxon's test. Mean percentage of differences as a measure for intraindividual day-to-day variation was relatively low for anal resting (mean: 13.5%) and maximal squeeze (17.5%) pressure. However, it was high for the threshold volumes for minimal perception (71.8%) and urgency to defecate (38.5%) during rectal balloon distention as well as for the minimal volume required to abolish recovery of the rectoanal inhibitory reflex (41.2%). We conclude that anal resting pressure and maximal squeeze pressure both are the most stable anorectal manometry parameters in man, at least over a period of a few days.

The frequency of isomerization-like 'dark' events in rhodopsin and porphyropsin rods of the bull-frog retina

1. The dark current and responses to dim flashes were recorded with the suction pipette technique from single rods in pieces of bull-frog retina taken from either the dorsal porphyropsin or the ventral rhodopsin field. 2. The composition of visual pigment in the rods was determined by microspectrophotometry. Rods from the dorsal pieces contained 70-88% porphyropsin523 mixed with rhodopsin502. The ventral rods contained almost pure rhodopsin, any possible admixture of porphyropsin being below the level of detectability (less than 5%). 3. In most cells, the responses to dim flashes were well fitted by a four-stage linear filter model, with no systematic differences in the response kinetics of porphyropsin and rhodopsin rods. The amplitude of saturated responses varied between 8 and 55 pA and that of responses to single isomerizations between 0.4 and 3.5 pA. 4. In porphyropsin rods, discrete events similar to the response to one photoisomerization were clearly seen in complete darkness. The dark current amplitude histogram was fitted by a convolution of the probability densities for the Gaussian continuous noise component and the averaged dim-flash response waveform. This allows estimation of the frequency and amplitude of discrete events and the standard deviation of the continuous component. The mean frequency of discrete dark events thus obtained from six porphyropsin cells was 0.057 rod-1 s-1 at 18 degrees C. 5. In rhodopsin rods, the dark current amplitude histogram appeared completely symmetrical, indicating that the frequency of discrete events must be lower than 0.005 rod-1 s-1 (except in one rod where it was 0.006 events rod-1 s-1). Per molecule of rhodopsin, the events are then at least 5 times rarer than reported for toad rhodopsin rods at the same temperature. 6. The low rate of isomerization-like 'dark' events in bull-frog rhodopsin rods shows, firstly, that results cannot be generalized across species even for rhodopsins which appear spectrally identical. Secondly, it suggests that these events need not (in an evolutionary sense) constitute an irreducible noise factor which must set the ultimate limit to the sensitivity of dark-adapted vision. 7. The difference between porphyropsin and rhodopsin rods shows that, given (presumably) the same opsin, the pigment utilizing retinal2 and absorbing maximally at longer wavelengths produces more noise. The signal/noise ratio attained in the photoreceptor may be an important factor in the natural selection of visual pigments.