ACADEMIC EMERGENCY MEDICINE, Issue 2009
Annie T. Sadosty MD
Abstract Objective:, A panel of Council of Emergency Medicine Residency Directors (CORD) members was asked to examine and make recommendations regarding the existing Accreditation Council of Graduate Medical Education (ACGME) EM Program Requirements pertaining to educational conferences, identified best practices, and recommended revisions as appropriate. Methods:, Using quasi-Delphi technique, 30 emergency medicine (EM) residency program directors and faculty examined existing requirements. Findings were presented to the CORD members attending the 2008 CORD Academic Assembly, and disseminated to the broader membership through the CORD e-mail list server. Results:, The following four ACGME EM Program Requirements were examined, and recommendations made: 1The 5 hours/week conference requirement: For fully accredited programs in good standing, outcomes should be driving how programs allocate and mandate educational time. Maintain the 5 hours/week conference requirement for new programs, programs with provisional accreditation, programs in difficult political environs, and those with short accreditation cycles. If the program requirements must retain a minimum hours/week reference, future requirements should take into account varying program lengths (3 versus 4 years). 2The 70% attendance requirement: Develop a new requirement that allows programs more flexibility to customize according to local resources, individual residency needs, and individual resident needs. 3The requirement for synchronous versus asynchronous learning: Synchronous and asynchronous learning activities have advantages and disadvantages. The ideal curriculum capitalizes on the strengths of each through a deliberate mixture of each. 4Educationally justified innovations: Transition from process-based program requirements to outcomes-based requirements. Conclusions:, The conference requirements that were logical and helpful years ago may not be logical or helpful now. Technologies available to educators have changed, the amount of material to cover has grown, and online on-demand education has grown even more. We believe that flexibility is needed to customize EM education to suit individual resident and individual program needs, to capitalize on regional and national resources when local resources are limited, to innovate, and to analyze and evaluate interventions with an eye toward outcomes. [source]

Resident Training in Emergency Ultrasound: Consensus Recommendations from the 2008 Council of Emergency Medicine Residency Directors Conference

ACADEMIC EMERGENCY MEDICINE, Issue 2009
Saadia Akhtar MD
Abstract Over the past 25 years, research performed by emergency physicians (EPs) demonstrates that bedside ultrasound (US) can improve the care of emergency department (ED) patients. At the request of the Council of Emergency Medicine Residency Directors (CORD), leaders in the field of emergency medicine (EM) US met to delineate in consensus fashion the model "US curriculum" for EM residency training programs. The goal of this article is to provide a framework for providing US education to EM residents. These guidelines should serve as a foundation for the growth of resident education in EM US. The intent of these guidelines is to provide minimum education standards for all EM residency programs to refer to when establishing an EUS training program. The document focuses on US curriculum, US education, and competency assessment. The use of US in the management of critically ill patients will improve patient care and thus should be viewed as a required skill set for all future graduating EM residents. The authors consider EUS skills critical to the development of an emergency physician, and a minimum skill set should be mandatory for all graduating EM residents. The US education provided to EM residents should be structured to allow residents to incorporate US into daily clinical practice. Image acquisition and interpretation alone are insufficient. The ability to integrate findings with patient care and apply them in a busy clinical environment should be stressed. [source]

The MERC at CORD Scholars Program in Medical Education Research: A Novel Faculty Development Opportunity for Emergency Physicians

ACADEMIC EMERGENCY MEDICINE, Issue 2009
Jeffrey N. Love MD
Abstract Medical educators are increasingly charged with the development of outcomes-based "best practices" in medical student and resident education and patient care. To fulfill this mission, a cadre of well-trained, experienced medical education researchers is required. The experienced medical educator is in a prime position to fill this need but often lacks the training needed to successfully contribute to such a goal. Towards this end, the Association of American Medical Colleges (AAMC) Group on Educational Affairs developed a series of content-based workshops that have resulted in Medical Education Research Certification (MERC), promoting skills development and a better understanding of research by educators. Subsequently, the Council of Emergency Medicine Residency Directors (CORD) partnered with the AAMC to take MERC a step further, in the MERC at CORD Scholars Program (MCSP). This venture integrates a novel, mentored, specialty-specific research project with the traditional MERC workshops. Collaborative groups, based on a common area of interest, each develop a multi-institutional project by exploring and applying the concepts learned through the MERC workshops. Participants in the inaugural MCSP have completed three MERC workshops and initiated a project. Upon program completion, each will have completed MERC certification (six workshops) and gained experience as a contributing author on a mentored education research project. Not only does this program serve as a multi-dimensional faculty development opportunity, it is also intended to act as a catalyst in developing a network of education scholars and infrastructure for educational research within the specialty of emergency medicine. [source]

Real-Time Inter-Rater Reliability of the Council of Emergency Medicine Residency Directors Standardized Direct Observation Assessment Tool

ACADEMIC EMERGENCY MEDICINE, Issue 2009
Joseph LaMantia MD
Abstract Objectives:, Developed by the Council of Emergency Medicine Residency Directors (CORD), the standardized direct observation assessment tool (SDOT) is an evaluation instrument used to assess residents' clinical skills in the emergency department (ED). In a previous study examining the inter-rater agreement of the tool, faculty scored simulated resident,patient encounters. The objective of the present study was to evaluate the inter-rater agreement of the SDOT in real-time evaluations of residents in the ED. Methods:, This was a multi-center, prospective, observational study in which faculty raters were paired to simultaneously observe and independently evaluate a resident's clinical performance using the SDOT. Data collected from eight emergency medicine (EM) residency programs produced 99 unique resident,patient encounters and reported on 26 individual behaviors related to specific core competencies, global evaluation scores for each core competency, and an overall clinical competency score. Inter-rater agreement was assessed using percentage agreement analyses with three constructs: exact agreement, liberal agreement, and binary (pass/fail) agreement. Results:, Inter-rater agreement between faculty raters varied according to category of measure used. Exact agreement ranged from poor to good, depending on the measure: the overall competency score (good), the competency score for each of the six core competencies (poor to good), and the individual item scores (fair to very good). Liberal agreement and binary agreement were excellent for the overall competency score and the competency score for each of the six core competencies and very good to excellent for the individual item scores. Conclusions:, The SDOT demonstrated excellent inter-rater agreement when analyzed with liberal agreement and when dichotomized as a pass/fail measure and fair to good agreement for most measures with exact agreement. The SDOT can be useful and reliable when evaluating residents' clinical skills in the ED, particularly as it relates to marginal performance. [source]

ACGME Outcome Project: Phase 3 in Emergency Medicine Education

ACADEMIC EMERGENCY MEDICINE, Issue 7 2009
Sandra M. Schneider MD
Abstract In this article we present a summary of two interactive panel discussions held at the 2008 Council of Emergency Medicine Residency Directors (CORD) annual meeting. Attendees attempted to identify measurable outcomes for resident performance that could be used to evaluate program effectiveness. [source]

Promoting Diversity in Emergency Medicine: Summary Recommendations from the 2008 Council of Emergency Medicine Residency Directors (CORD) Academic Assembly Diversity Workgroup

ACADEMIC EMERGENCY MEDICINE, Issue 5 2009
Sheryl L. Heron MD
Abstract Although the U.S. population continues to become more diverse, ethnic and racial health care disparities persist. The benefits of a diverse medical workforce have been well described, but the percentage of emergency medicine (EM) residents from underrepresented groups (URGs) is small and has not significantly increased over the past 10 years. The Council of Emergency Medicine Resident Directors (CORD) requested that a panel of CORD members review the current state of ethnic and racial diversity in EM training programs. The objective of the discussion was to develop strategies to help EM residency programs examine and improve diversity in their respective institutions. Specific recommendations focus on URG applicant selection and recruitment strategies, cultural competence curriculum development, involvement of URG faculty, and the availability of institutional and national resources to improve and maintain diversity in EM training programs. [source]

Geriatric Emergency Medicine Educational Module: Abdominal Pain in the Older Adult

ACADEMIC EMERGENCY MEDICINE, Issue 2009
Lowell Gerson
The Society for Emergency Medicine (SAEM) Geriatrics Task Force has created an instructional tool to address the complaint of abdominal pain in older adults presenting to the emergency department (ED). This is the first module in a comprehensive, web-based geriatric emergency medicine curriculum that will address common syndromes in older adults presenting to the ED. There is no formal, residency-based curriculum in geriatric emergency medicine and there is a paucity of geriatric Continuing Medical Education (CME) opportunities for practicing emergency physicians. The amount, quality, and convenience of geriatrics training available to emergency physicians is insufficient. This educational gap is particularly concerning given the ever-growing volume of older adult emergency patients. The Task Force chose to focus first on geriatric abdominal pain because a survey of emergency physicians in the mid 1990s found that it is one of the most difficult complaints to evaluate and manage. The module comprises of six clinical cases with a pre- and post-test. Together, these cases encompass the broad differential diagnosis for geriatric abdominal pain and the core medical knowledge pertaining to the subject. The modules will expose the learner, through either content or modeling, to the six Accreditation Council for Graduate Medical Education (ACGME) core competencies and to the Principles of Geriatric Emergency Medicine including rapid evaluation of functional status, communication skills, and consideration of the effect of polypharmacy and co-morbidity on the presenting complaint. This module will be available to residency programs as an "asynchronous educational session" via the Council of Emergency Medicine Residency Directors (CORD) website as well as to practicing emergency physicians via the SAEM and American College of Emergency Physicians (ACEP) websites. [source]

Outcome Assessment in Emergency Medicine,A Beginning: Results of the Council of Emergency Medicine Residency Directors (CORD) Emergency Medicine Consensus Workgroup on Outcome Assessment

ACADEMIC EMERGENCY MEDICINE, Issue 3 2008
Cherri Hobgood MD
Abstract This article is designed to serve as a guide for emergency medicine (EM) educators seeking to comply with the measurement and reporting requirements for Phase 3 of the Accreditation Council for Graduate Medical Education (ACGME) Outcome Project. A consensus workshop held during the 2006 Council of Emergency Medicine Residency Directors (CORD) "Best Practices" conference identified specific measures for five of the six EM competencies,interpersonal communication skills, patient care, practice-based learning, professionalism, and systems-based practice (medical knowledge was excluded). The suggested measures described herein should allow for ease in data collection and applicability to multiple core competencies as program directors incorporate core competency outcome measurement into their EM residency training programs. [source]

Fetal alcohol syndrome through the eyes of parents

ADDICTION BIOLOGY, Issue 2 2004
Jocie DeVries
Although fetal alcohol syndrome (FAS) was first identified by research scientists in the USA in 1973, it was not until 1989 when an adoptive parent, Michael Dorris, wrote The Broken Cord, that a practical description of the disability came into public awareness. Within the next 2 years, parents of children diagnosed with this disability teemed up with interested professionals to organize the FAS Family Resource Institute (FAS*FRI). This educational non-profit organization has now devoted over a decade to their mission to identify, understand and care for individuals with fetal alcohol syndrome/effects (FAS/E) and to prevent this disability from occurring in future generations. Their mission has necessitated the identification of a behavioral phenotype for FAS/E, the development of a professional training curriculum, and operation of a national family advocacy and mentoring network. By adding their own families' experiences to the information gathered from thousands of other families with diagnosed children, they have accumulated enough experiential, frontline reports which are similar enough to serve as their research science base. [source]

Decompression Sickness: MRI of the Spinal Cord

JOURNAL OF NEUROIMAGING, Issue 4 2007
Pin Lin Kei MBChB
ABSTRACT Decompression sickness (DCS) typically causes changes in the white matter of the spinal cord on MR imaging. We present a case of DCS in a scuba diver with dorsal white matter lesions typical of venous infarction. In addition, some central gray matter involvement was noted. Characteristic features of venous spinal cord infarction can be recognized on MR imaging in DCS but may be more extensive in severe cases. [source]

Evidence for enhanced functional activity of cervical cord in relapsing multiple sclerosis

MAGNETIC RESONANCE IN MEDICINE, Issue 5 2008
F. Agosta
Abstract Functional MRI (fMRI) was used to assess proprioceptive-associated cervical cord activity in 24 relapsing multiple sclerosis (MS) patients and 10 controls. Cord and brain conventional and diffusion tensor (DT) MRI were also acquired. fMRI was performed using a block design during a proprioceptive stimulation consisting of a passive flexion-extension of the right upper limb. Cord lesion number, cross-sectional area, mean diffusivity (MD) and fractional anisotropy (FA), whole brain and left corticospinal tract lesion volume (LV), gray matter (GM) MD, and normal-appearing white matter (NAWM) MD and FA were calculated. MS patients had higher average cord fMRI signal changes than controls (3.4% vs. 2.7%, P = 0.03). Compared to controls, MS patients also had a higher average signal change in the anterior section of the right cord at C5 (P = 0.005) and left cord at C5,C6 (P = 0.03), whereas no difference was found in the other cord sections. Cord average signal change correlated significantly with cord FA and brain left corticospinal tract LV, GM-MD, and NAWM-FA. This study shows an abnormal pattern of activations in the cervical cord of MS patients following proprioceptive stimulation. Cord fMRI changes might have a role in limiting the clinical consequences of MS associated with irreversible tissue damage. Magn Reson Med 59:1035,1042, 2008. © 2008 Wiley-Liss, Inc. [source]

Release of prostaglandin D2 and leukotriene C4 in response to hyperosmolar stimulation of mast cells

ALLERGY, Issue 12 2006
M. Gulliksson
Background:, Mannitol-induced bronchoconstriction in subjects with exercise-induced asthma is associated with increased urinary excretion of 9,, 11, -PGF2, a metabolite of prostaglandin D2 (PGD2) serving as a mast cell marker. It has however been questioned whether or not human mast cells release PGD2 and leukotriene C4 (LTC4) after osmotic challenge with mannitol in vitro. Methods:, Cord blood-derived human mast cells were stimulated osmotically, immunologically or with a combination of both. Supernatants were analysed for PGD2, LTC4 and histamine contents with enzyme immunoassays. Results:, Significant release of de novo synthesized eicosanoids, predominantly PGD2 [12 (8.8, 14) pmol/106cells; median (25th, 75th percentile) but also LTC4 (0.1 (0.08, 0.15) pmol/106 cells] were found in mast cells in vitro in response to 0.7 M mannitol stimulation. A massive release of histamine [70 (5.3)% of total; mean (SEM)] was also found. There were no correlations between the levels of released mediators after mannitol stimulation. In contrast, there was a correlation between release of PGD2 and LTC4, following immunological stimulation. Conclusion:, The findings support that hyperosmolar challenge activates mast cells, but different than antigen stimulation. [source]

"Closely Draw the Cord of Virtue": Instructive Plays and American Society, 1795 to 1825

THE JOURNAL OF AMERICAN CULTURE, Issue 1 2004
M. Susan Anthony
First page of article [source]

Congenital Cytomegalovirus Infection Diagnosed by Polymerase Chain Reaction With the Use of Preserved Umbilical Cord in Sensorineural Hearing Loss Children,

THE LARYNGOSCOPE, Issue 11 2006
Hiroshi Ogawa MD
Abstract Objectives/Hypothesis: Congenital cytomegalovirus (CMV) infection is estimated to account for 30% of sensorineural hearing loss (SNHL) cases. Differences in clinical characteristics between CMV-related and unrelated SNHL cases were scrutinized. Methods: Using dried umbilical cord, we have recently developed a polymerase chain reaction (PCR)-based assay for the retrospective detection of congenital CMV infection. Medical records of 7 CMV-related patients identified from 31 SNHL patients by the assay were evaluated for the following: type and degree of hearing impairment, computed tomographic scan results, mental retardation, cerebral palsy, autism, and other multiple disorders. Results: Clinical characteristics of the seven CMV-related SNHL cases were as follows: 1) six of the seven exhibited severe bilateral SNHL, whereas one had severe unilateral SNHL in the right ear. Although the hearing levels of CMV-related patients were more greatly impaired than those of CMV-negative patients, there was no hearing impairment pattern specific to the CMV-related patients; 2) five patients had mental retardation, which was more frequent than in CMV-negative patients; 3) birth weights of the CMV-positive cases were relatively lower. Discussion: Although CMV-positive cases are clinically indistinguishable from CMV-negative cases, our PCR system allowed the retrospective diagnosis of CMV-related SNHL. Conclusion: CMV-related SNHL tends to accompany mental retardation and low birth weight more frequently than does CMV-negative SNHL. [source]

Comparison of Localization of the Neurokinin 1 Receptor and Nitric Oxide Synthase with Calbindin D Labelling in the Rat Spinal Cord

ANATOMIA, HISTOLOGIA, EMBRYOLOGIA, Issue 3 2000
M. Nazli
Summary A comparison of the localization of the neurokinin 1 (NK1) receptor and nitric oxide synthase with calbindin D labelling in the lumbar spinal cord was carried out in the rat using immunocytochemistry. Considerable regional variations were observed. Application of the antibody to calbindin D resulted in dense staining in laminae I and II and light staining in the other laminae. Occasional scattered cells were seen in the deep laminae and in the lamina X, the ventral horn and the lateral spinal nucleus. The results indicate that neurones expressing calbindin D, NK1 receptor and NOS are three separate populations in the dorsal horn of the lumbar spinal cord. [source]

Cavernous Malformations of the Brain and Spinal Cord

ANZ JOURNAL OF SURGERY, Issue 12 2009
FRACS, John D. Laidlaw MB BS
No abstract is available for this article. [source]

Lactate concentration in umbilical cord blood is gestational age-dependent: a population-based study of 17 867 newborns

BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 6 2008
N Wiberg
Objective, To study the influence of gestational age on lactate concentration in arterial and venous umbilical cord blood at birth and to define gestational age-specific reference values for lactate in vigorous newborns. Design, Population-based comparative. Setting, University hospitals. Sample, Vigorous newborns with validated umbilical cord blood samples. Material and methods, From 2000 to 2004, routine cord blood gases, lactate and obstetric data from two university hospitals were available for 17 867 newborns from gestational week 24 to 43. After validation of blood samples and inclusion only of singleton pregnancies aimed for vaginal delivery, 10 700 women remained. Among those, reference values were defined in 10 169 vigorous newborns, that is in newborns with a 5-minute Apgar score corresponding to the gestational age-specific median value minus 1 point score, or better. Main outcome measures, Cord lactate concentration relative to gestational age. Results, The arterial and venous lactate concentrations increased monotonously with gestational age from 34 weeks. Considerable differences were found between mean and median values, but after logarithmic transformation the log-lactate values were normally distributed. Simple linear regression analysis showed a significant association between the log-lactate values and gestational age (P < 10,6, R2= 0.024). Reference curves were constructed after anti-logarithmic transformation. Both the gestational age and the time of the second stage of labour influenced, independently of each other, the lactate concentrations. Conclusions, Lactate concentrations in arterial and venous umbilical cord blood are increasing significantly with advancing gestational age. [source]

Diffusion tensor magnetic resonance imaging in spinal cord injury

CONCEPTS IN MAGNETIC RESONANCE, Issue 3 2008
Benjamin M. Ellingson
Abstract Noninvasive assessment of spinal cord integrity following injury is critical for precise diagnosis, prognosis, and surgical intervention strategies. Diffusion weighted imaging and diffusion tensor imaging are more sensitive to the underlying spinal cord microstructure than traditional imaging techniques. As a result, diffusion imaging is emerging as the clinical technique for imaging the spinal cord after trauma, surgery or during progressive degenerative diseases. This review describes the basic physics of diffusion imaging using magnetic resonance, techniques used to visualize diffusion measurements, and expected changes in diffusion measurements following spinal cord injury. © 2008 Wiley Periodicals, Inc.Concepts Magn Reson Part A 32A: 219,237, 2008. [source]

Functional magnetic resonance imaging of the human brain and spinal cord by means of signal enhancement by extravascular protons

CONCEPTS IN MAGNETIC RESONANCE, Issue 1 2003
P.W. Stroman
Abstract A review of functional magnetic resonance imaging (fMRI) signal changes in spin,echo image data is presented. Spin,echo fMRI data from the human brain and spinal cord show a consistent departure from that expected with blood oxygen level dependent (BOLD) contrast. Studies to investigate this finding demonstrate fMRI signal changes of 2.5% in the spinal cord and 0.7% in the brain at 1.5 T, which is extrapolated to an echo time of zero. Consistent evidence of a non-BOLD contrast mechanism arising from a proton-density change at sites of neuronal activation is demonstrated. A mathematical model and physiological explanation for signal enhancement by extravascular protons is also presented. © 2003 Wiley Periodicals, Inc. Concepts Magn Reson 16A: 28,34, 2003 [source]

Endocrine disruptor issues in Japan

CONGENITAL ANOMALIES, Issue 2 2002
Taisen Iguchi
ABSTRACT, Monitoring of environmental chemicals in Japan has revealed that several endocrine active chemicals are in river water, sediments, and wildlife as well as in the human umbilical cord. In 2001, risk assessments of tributyltin and nonylphenol have been conducted by the Ministry of the Environment, Japan. Risk assessments of di(2-ethylhexyl)phthalate and di-isononyl phthalate have also been performed by the Ministry of Health, Labour and Welfare using a toxicological point of view in 2001. In this review, an overview of recent progress in endocrine disruptor research in Japan will be provided. [source]

The role of inhibitory neurotransmission in locomotor circuits of the developing mammalian spinal cord

ACTA PHYSIOLOGICA, Issue 2 2009
H. Nishimaru
Abstract Neuronal circuits generating the basic coordinated limb movements during walking of terrestrial mammals are localized in the spinal cord. In these neuronal circuits, called central pattern generators (CPGs), inhibitory synaptic transmission plays a crucial part. Inhibitory synaptic transmission mediated by glycine and GABA is thought to be essential in coordinated activation of muscles during locomotion, in particular, controlling temporal and spatial activation patterns of muscles of each joint of each limb on the left and right side of the body. Inhibition is involved in other aspects of locomotion such as control of speed and stability of the rhythm. However, the precise roles of neurotransmitters and their receptors mediating inhibitory synaptic transmission in mammalian spinal CPGs remain unclear. Moreover, many of the inhibitory interneurones essential for output pattern of the CPG are yet to be identified. In this review, recent advances on these issues, mainly from studies in the developing rodent spinal cord utilizing electrophysiology, molecular and genetic approaches are discussed. [source]

Could chronic pain and spread of pain sensation be induced and maintained by glial activation?

ACTA PHYSIOLOGICA, Issue 1-2 2006
E. Hansson
Abstract An injury often starts with acute physiological pain, which becomes inflammatory or neuropathic, and may sometimes become chronic. It has been proposed recently that activated glial cells, astrocytes and microglia within the central nervous system could maintain the pain sensation even after the original injury or inflammation has healed, and convert it into chronic by altering neuronal excitability. Glial cell activation has also been proposed to be involved in the phenomenon of spread of pain sensation ipsilaterally or to the contralateral side (i.e. mirror image pain). Substance P and calcitonin gene-related peptide, released due to an inflammatory process, interact with the endothelial cells of the blood,spinal cord and blood,brain barriers. The barriers open partially and substances may influence adjacent glial cells. Such substances are also released from neurones carrying the ,pain message' all the way from the injury to the cerebral cortex. Pro-inflammatory cytokines may be released from the microglial cells, and astroglial Ca2+ -transients or oscillations may spread within the astroglial networks. One theory is that Ca2+ -oscillations could facilitate the formation of new synapses. These new synapses could establish neuronal contacts for maintaining and spreading the pain sensation. If this theory holds true, it is possible that Ca2+ waves, production of cytokines and growth factors could be modified by selective anti-inflammatory drugs to achieve a balance in the activities of the different intercellular and intracellular processes. This paper reviews current knowledge about glial mechanisms underlying the phenomena of chronic pain and spread of the pain sensation. [source]

Differential expression and localization of neuronal intermediate filament proteins within newly developing neurites in dissociated cultures of Xenopus laevis embryonic spinal cord

CYTOSKELETON, Issue 1 2001
Jayanthi Undamatla
Abstract The molecular subunit composition of neurofilaments (NFs) progressively changes during axon development. In developing Xenopus laevis spinal cord, peripherin emerges at the earliest stages of neurite outgrowth. NF-M and XNIF (an ,-internexin-like protein) appear later, as axons continue to elongate, and NF-L is expressed after axons contact muscle. Because NFs are the most abundant component of the vertebrate axonal cytoskeleton, we must understand why these changes occur before we can fully comprehend how the cytoskeleton regulates axon growth and morphology. Knowing where these proteins are localized within developing neurites and how their expression changes with cell contact is essential for this understanding. Thus, we examined by immunofluorescence the expression and localization of these NF subunits within dissociated cultures of newly differentiating spinal cord neurons. In young neurites, peripherin was most abundant in distal neuritic segments, especially near branch points and extending into the central domain of the growth cone. In contrast, XNIF and NF-M were usually either absent from very young neurites or exhibited a proximal to distal gradient of decreasing intensity. In older neurites, XNIF and NF-M expression increased, whereas that of peripherin declined. All three of these proteins became more evenly distributed along the neurites, with some branches staining more intensely than others. At 24 h, NF-L appeared, and in 48-h cultures, its expression, along with that of NF-M, was greater in neurites contacting muscle cells, arguing that the upregulation of these two subunits is dependent on contact with target cells. Moreover, this contact had no effect on XNIF or peripherin expression. Our findings are consistent with a model in which peripherin plays an important structural role in growth cones, XNIF and NF-M help consolidate the intermediate filament cytoskeleton beginning in the proximal neurite, and increased levels of NF-L and NF-M help further solidify the cytoskeleton of axons that successfully reach their targets. Cell Motil. Cytoskeleton 49:16,32, 2001. © 2001 Wiley-Liss, Inc. [source]

Neuroanatomy and neurophysiology of itch

DERMATOLOGIC THERAPY, Issue 4 2005
Joanna Wallengren
ABSTRACT:, The specific pathway of "pure," histaminergic itch is traced from the mechano-insensitive nerve fibers in the skin to their central cortical projections. Neuropathic itch created at different levels of this anatomical pathway is reviewed. In this review the present author discusses damage to pruritoceptors in the skin, entrapment syndromes, damage to spinal ganglia, nerve root impingement, injury of the spinal cord, and cerebral damage in the distribution of the middle cerebral artery, capsula interna, or thalamus. Itch in inflamed skin resulting from interactions between nerve transmitters and other mediators of inflammation is described. [source]

Repulsive guidance of axons of spinal sensory neurons in Xenopus laevis embryos: Roles of Contactin and notochord-derived chondroitin sulfate proteoglycans

DEVELOPMENT GROWTH & DIFFERENTIATION, Issue 7 2005
Naoko Fujita
An immunoglobulin superfamily neuronal adhesion molecule, Contactin, has been implicated in axon guidance of spinal sensory neurons in Xenopus embryos. To identify the guidance signaling molecules that Contactin recognizes in tailbud embryos, an in situ binding assay was performed using recombinant Contactin-alkaline phosphatase fusion protein (Contactin-AP) as a probe. In the assay of whole-mount or sectioned embryos, Contactin-AP specifically bound to the notochord and its proximal regions. This binding was completely blocked by either digestion of embryo sections with chondroitinase ABC or pretreatment of Contactin-AP with chondroitin sulfate A. When the spinal cord and the notochord explants were co-cultured in collagen gel, growing Contactin-positive spinal axons were repelled by notochord-derived repulsive activity. This repulsive activity was abolished by the addition of either a monoclonal anti-Contactin antibody, chondroitin sulfate A or chondroitinase ABC to the culture medium. An antibody that recognizes chondroitin sulfate A and C labeled immunohistochemically the notochord in embryo sections and the collagen gel matrix around the cultured notochord explant. Addition of chondroitinase ABC into the culture eliminated the immunoreactivity in the gel matrix. These results suggest that the notochord-derived chondroitin sulfate proteoglycan acts as a repulsive signaling molecule that is recognized by Contactin on spinal sensory axons. [source]

Immunohistochemical analysis of nervous system regeneration in chimeric individuals of Dorvillea bermudensis (Polychaeta, Dorvilleidae)

DEVELOPMENT GROWTH & DIFFERENTIATION, Issue 2 2004
Monika C. M. Müller
In regeneration experiments, 0.5% of the two- or five-segmented fragments of the polychaete Dorvillea bermudensis were found unexpectedly transplanted: two fragments of each that were lying close together during the initial period, fused and regenerated a chimeric individual. Of the three theoretical possibilities (i.e. fusion of (i) two posterior ends; (ii) one anterior and one posterior end; (iii) or two anterior ends) only the last two were realized. The similarly oriented fragments regenerated a normal animal while anterior,anterior fused ones produced two heads or a double head. Whether the ventral cords of the fragments are located vis-à-vis or adjacent, influences the course of regeneration as well. Immunohistochemical methods (anti-acetylated ,-tubulin) in conjunction with confocal laser scanning microscopy were used to investigate the wiring pattern of the nervous systems of the grafts. In all cases, at least two supraesophageal ganglia were formed and palps, antennae and nuchal organs were innervated by the correct nerves but, in special cases, were innervated vice versa from the other brain. From these results it can be concluded that fusion of a regenerating connective with another connective results in formation of a new brain, irrespective of whether it belongs to the same nerve cord or not. [source]

Anomalous development of brain structure and function in spina bifida myelomeningocele

DEVELOPMENTAL DISABILITIES RESEARCH REVIEW, Issue 1 2010
Jenifer Juranek
Abstract Spina bifida myelomeningocele (SBM) is a specific type of neural tube defect whereby the open neural tube at the level of the spinal cord alters brain development during early stages of gestation. Some structural anomalies are virtually unique to individuals with SBM, including a complex pattern of cerebellar dysplasia known as the Chiari II malformation. Other structural anomalies are not necessarily unique to SBM, including altered development of the corpus callosum and posterior fossa. Within SBM, tremendous heterogeneity is reflected in the degree to which brain structures are atypical in qualitative appearance and quantitative measures of morphometry. Hallmark structural features of SBM include overall reductions in posterior fossa and cerebellum size and volume. Studies of the corpus callosum have shown complex patterns of agenesis or hypoplasia along its rostral-caudal axis, with rostrum and splenium regions particularly susceptible to agenesis. Studies of cortical regions have demonstrated complex patterns of thickening, thinning, and gyrification. Diffusion tensor imaging studies have reported compromised integrity of some specific white matter pathways. Given equally complex ocular motor, motor, and cognitive phenotypes consisting of relative strengths and weaknesses that seem to align with altered structural development, studies of SBM provide new insights to our current understanding of brain structure,function associations. © 2010 Wiley-Liss, Inc. Dev Disabil Res Rev 2010;16:23,30. [source]

Activity-based restorative therapies: Concepts and applications in spinal cord injury-related neurorehabilitation

DEVELOPMENTAL DISABILITIES RESEARCH REVIEW, Issue 2 2009
Cristina L. Sadowsky
Abstract Physical rehabilitation following spinal cord injury-related paralysis has traditionally focused on teaching compensatory techniques, thus enabling the individual to achieve day-to-day function despite significant neurological deficits. But the concept of an irreparable central nervous system (CNS) is slowly being replaced with evidence related to CNS plasticity, repair, and regeneration, all related to persistently maintaining appropriate levels of neurological activity both below and above the area where the damage occurred. It is now possible to envision functional repair of the nervous system by implementing rehabilitative interventions. Making the transition from "bench to bedside" requires careful analysis of existing basic science evidence, strategic focus of clinical research, and pragmatic implementation of new therapeutic tools. Activity, defined as both function specific motor task and exercise appears to be a necessity for optimization of functional, metabolic, and neurological status in chronic paralysis. Crafting a comprehensive rehabilitative intervention focused on functional improvement through neurological gains seems logical. The terms activity-based restorative therapies, activity-based therapies, and activity-based rehabilitation have been coined in the last 10 years to describe a new fundamental approach to deficits induced by neurological paralysis. The goal of this approach is to achieve activation of the neurological levels located both above and below the injury level using rehabilitation therapies. This article reviews basic and clinical science evidence pertaining to implementation of physical activity and exercise as a therapeutic tool in the management of chronic spinal cord-related neurological paralysis. © 2009 Wiley-Liss, Inc. Dev Disabil Res Rev 2009;15:112,116. [source]

Planar cell polarity effector gene Fuzzy regulates cilia formation and Hedgehog signal transduction in mouse

DEVELOPMENTAL DYNAMICS, Issue 12 2009
Westley Heydeck
Abstract Precise planar cell polarity (PCP) is critical for the development of multiple organ systems in animals. A group of core-PCP proteins are recognized to play crucial roles in convergent extension and other PCP-related processes in mammals. However, the functions of another group of PCP-regulating proteins, the PCP-effector proteins, are yet to be fully studied. In this study, the generation and characterization of a mouse mutant for the PCP effector gene Fuzzy (Fuz) is reported. Fuz homozygous mutants are embryonically lethal, with multiple defects including neural tube defects, abnormal dorsal/ventral patterning of the spinal cord, and defective anterior/posterior patterning of the limb buds. Fuz mutants also exhibit abnormal Hedgehog (Hh) signaling and inefficient proteolytic processing of Gli3. Finally, a significant decrease in cilia was found in Fuz homozygous mutants. In conclusion, Fuz plays an important role in cilia formation, Hh signal transduction, and embryonic development in mammals. Developmental Dynamics 238:3035,3042, 2009. © 2009 Wiley-Liss, Inc. [source]