Epinephrine hand nebulizer in asthma; technique of use,clinical aspects

It behooves the physician seeking relief for asthmatic patients not to be casual about the epinephrine hand nebulizer and the manner in which it is used. Patients who claim to get no relief from the nebulizer should be asked to demonstrate their technique. If the nebulizer produces a hardly visible mist, it should be discarded. For many patients, the goal in spraying by hand must be the production of more or less continuous and voluminous aerosol, regardless of the phase of respiration, in order to effect relief. If the respiratory pattern has not deviated too far from normal in rate and depth, inhalations may be carried out in courses or cycles of about a half-minute duration and spaced a few minutes apart. If the respiratory pattern is abnormal during the act of spraying, it must be corrected. Inhaled epinephrine aerosols as constituted today appear to be somewhat irritating to the mouth, throat, and upper portion of the pulmonary tract of some persons, but it has not been convincingly demonstrated that serious and permanent damage to the lower respiratory tract of humans can occur from long-continued use of inhaled epinephrine.     

Specialized use of two fingers in free-ranging aye-ayes (Daubentonia madagascariensis)

The aye-aye (Daubentonia madagascariensis) possesses a highly specialized hand with two fingers, the third and the fourth, being used in a way unparalleled by any other primate. We observed the use of the third and the fourth fingers in various activities in four free-ranging aye-ayes. We found that the thin third finger was used exclusively or preferably for tapping, inserting into the mouth (probably for cleaning the teeth) and probing for nectar, kernels and insects in bamboo, twigs and live wood. In contrast, the robust fourth finger was used preferably when eating jackfruit (Artocarpus heterophyllus). When probing for invertebrates in soft plant tissues and in dead wood, both fingers were used in high proportions. To extract the contents from coconuts, the two fingers were apparently used for different tasks. From this small (686 observations), but unique, study of free-ranging aye-ayes, we conclude that the third finger appears to be specialized for use in tasks requiring high mobility, sensitivity and precision, whereas the fourth finger appears to be specialized for tasks requiring strength, scooping action and deep access.     

The use of arteriovenous anastomosis for replantation of the distal phalanx of the fingers.

Microvascular replantation at the distal phalangeal level has recently been reported by several authors, but as yet the rate of success has not been constant owing to the technical difficulties associated with small vessels. To solve this problem, over the last 4 years we have used arteriovenous anastomosis to reestablish either the arterial system or the venous drainage system in the 33 digits of our 23 patients. The results have been excellent, with a 91 percent success rate. Such results for replantation of the distal phalanx may be maintained and improved if a small venous graft with several branches is also utilized.     

Epinephrine: A Potential Neurotransmitter in Retina

Abstract: Dopamine (DA), norepinephrine (NE), and epinephrine (EPI) are present in rat retina. DA is the major catecholamine, whereas NE and EPI represent ∼5% of the DA content. DA is contained in a subpopulation of amacrine cells and has been the subject of numerous studies. We investigated the origin and properties of NE and EPI in retina. Following superior cervical ganglionectomy, there was a decrease in NE content, but no decrease in EPI or phenylethanolamine- N -methyltransferase (PNMT) activity. PNMT in retina has many of the substrate-specificity and inhibitor-sensitivity characteristics of other tissues. Enzyme activity is enhanced in newborn rats by treatment with dexamethasone. Exposure to a lighted environment increases retinal EPI in normal and superior cervical ganglionectomized rats. EPI content increased for more than 2 h in a lighted environment. We conclude that most of the NE is contained within the sympathetic neurons that innervate the eye from the superior cervical ganglion, whereas EPI is contained in retinal elements that are responsive to photic stimulation.     

Somatosensation: Touching the mind's fingers

Whether mental operations can be reduced to the biological properties of the brain has intrigued scientists and philosophers alike for millennia. New microstimulation experiments on awake, behaving monkeys establish causality between activity of specialized cortical neurons and a controlled behavior.     

Pattern influence on the fingers.

In this study dermatoglyphic traits in 16 populations in northern Hungary were examined. The occurrence and probability of the manifestation of finger pattern types were analysed. Certain relationships were found that show that if a given pattern type is present on one of the fingers, then, in these cases, the frequency of pattern types on the other nine fingers typically is different from that in the entire sample. We termed this relationship or effect; pattern influence. In most cases there was a strong significant difference in frequency values between the entire sample and the studied cases. We studied the relationship of populations and pattern types using correspondence analysis. In the entire sample, most populations are located around the ulnar loop and the whorl. This arrangement is significantly and typically different in pattern-influence cases. Most populations aggregated around the pattern type in which pattern influence was studied. Pattern influence was found in all populations studied, and in both sexes.     

Plasmodium's sticky fingers

The life cycle of the malaria parasite (Plasmodium) is remarkably complex. Malaria parasites must engage in highly specific and varied interactions with cell types of both the mammalian host and the mosquito vector. In this issue of Cell, report detailed molecular insights into an intimate interaction between a malaria parasite protein and its host cell receptor that enables the parasite to invade erythrocytes.