Demonstration of postural asymmetry factors in a hypophyseal tissue culture as affected by the cerebrospinal fluid of cats with unilateral damage to the hemispheric cortex

It has been experimentally established that special hypophysiotropic factors--precursors of pose asymmetry factors (PAF) are found in the cerebrospinal fluid of donor animals with cortical lesions during the first postoperative hours. These factors, being specific for the location of the cortical lesion in donor animals, appear to be hypophysiotropic peptide substances inducing the production of corresponding PAF by hypophysial cells. The production of certain PAF by the rat hypophysial tissue cultures under the influence of cerebrospinal fluid from cats gives evidence in favour of species nonspecificity of PAF inductors.     

Ability of the opiate kappa-agonist bremazocine to facilitate the flexor reflex of the right hindlimb in spinal rats

It has been found that bremazocine predominantly enhances the flexor reflex of the right hind limb, without affecting the left limb. The similarity of the visual data measuring the asymmetry of the pose and the asymmetry of EMG responses to painful stimulation has a high probability. No correlation between the asymmetry of the pose and EMG extensor activity has been found.     

平山病的过屈位MRI 表现及其临床价值

目的：探讨平山病的过屈位颈椎MRI特征性影像学表现及其临床诊断价值。方法：总结分析经临床证实的5 例平山病患者 的临床及MRI资料,并结合相关文献报道进行回顾性分析。所有患者均行常规生化检查,脑脊液检查,肌电图检查及肌肉活检。结 果：5 例均为青少年男性,呈单侧上肢远端无力伴萎缩,其中1 例患者累及另一侧,尺侧肌萎缩明显,上肢呈斜坡样改变,均无感觉 障碍和锥体束征;肌电图检查显示神经源性改变,提示受损节段多在下颈髓前角细胞。屈颈MRI检查均可见下颈髓前移、硬脊膜 外间隙增宽,可见迂曲条状血管流空影。结论：平山病的过屈位MRI表现具有一定的特征性,对平山病的诊断具有重要价值。     

平山病的过屈位MRI表现及其临床价值

目的：探讨平山病的过屈位颈椎MRI特征性影像学表现及其临床诊断价值。方法：总结分析经临床证实的5例平山病患者的临床及MRI资料,并结合相关文献报道进行回顾性分析。所有患者均行常规生化检查,脑脊液检查,肌电图检查及肌肉活检。结果：5例均为青少年男性,呈单侧上肢远端无力伴萎缩,其中1例患者累及另一侧,尺侧肌萎缩明显,上肢呈斜坡样改变,均无感觉障碍和锥体束征;肌电图检查显示神经源性改变,提示受损节段多在下颈髓前角细胞。屈颈MRI检查均可见下颈髓前移、硬脊膜外间隙增宽,可见迂曲条状血管流空影。结论：平山病的过屈位MRI表现具有一定的特征性,对平山病的诊断具有重要价值。     

Characteristics of the development of postural asymmetry in rats as affected by the opioids met-enkephalin and the kappa-agonist bremazocine

It has been found that bremazocine and met-enkephalin induce postural asymmetry in spinal rats under subarachnoidal and intravenous administration. Intravenous administration of bremazocine to intact animals--even if after it (an hour later) their spinal cord is sectioned--produces no asymmetry, i. e. the spinal cord section is necessary for asymmetry development. The magnitude of postural asymmetry and the side of limb flexion are not constant for each animal, but they change in time. Though, on the average, the percent of asymmetric animals and the ratio of left and right flexions in each group of animals are practically constant. When the spinal cord is sectioned at the T1-T4 level, the bremazocine and metenkephalin induce mainly the right-leg flexion: when the section is made at the T5-T9 level, the left-leg is bent, i. e. the flexion side depends on the level of the section. It is suggested that the ability of opioids to induce postural asymmetry is based on lateralization of opioid receptors in the rat spinal cord.     

Gait synchronized force modulation during the stance period of one limb achieved by an active partial body weight support system

Our purpose was to demonstrate the ability of an actively controlled partial body weight support (PBWS) system to provide gait synchronized support during the stance period of a single lower extremity while examining the affect of such a support condition on gait asymmetry. Using an instrumented treadmill and a motion capture system, we compared gait parameters of twelve healthy elderly subjects (age 65-80 years) during unsupported walking to those while walking with 20% body weight support provided during only the stance period of the right limb. Specifically, we examined peak three-dimensional ground reaction force (GRF) data and the symmetry of lower extremity sagittal plane joint angles and of time and distance parameters. A reduction in all three GRF components was observed for the supported limb during modulated support. Reductions observed in the vertical GRF were comparable to the desired 20% support level. Additionally, GRF components examined for the unsupported limb during modulated support were consistently similar to those measured during unsupported walking. Modulated support caused statistically significant increases in asymmetry for knee flexion during stance (increased 5.9%), hip flexion during late swing (increased 9.1%), and the duration of single limb support (increased 2.8%). However, the observed increases were similar or considerably less than the natural variability in the asymmetry of these parameters during unsupported walking. The ability of the active PBWS device to provide unilateral support may offer new and possibly improved applications of PBWS rehabilitation for patients with unilateral walking deficits such as hemiparesis or orthopaedic injury.     

Met-enkephalin-induced release into the blood of a factor causing postural asymmetry

Met- and Leu-enkephalin applied subarachnoidally into the rostral portion of a transected spinal cord (at the T6-T7 level) induce postural asymmetry of the hind limbs in rats, Met-enkephalin being predominantly responsible for the flexion of the right, and Leu-enkephalin of the left, hind leg. The blood serum of rats injected with Met-enkephalin contains a factor which, when administered subarachnoidally into the caudal portion of the transected spinal cord, is capable of inducing the hind limb postural asymmetry--predominantly, with the right leg flexion. This factor is inactivated by papain and differs from Met- and Leu-enkephalin in chromatographic properties. Apparently, Met-enkephalin induces the release of a peptide factor into the blood, from the brain or organs innervated by the neurons lying above the cut. It is then carried with the blood to the hind limbs and effects the hind limb postural asymmetry.     

Ligament fibre recruitment at the human ankle joint complex in passive flexion

Knowledge of ligament fibre recruitment at the human ankle joint complex is a fundamental prerequisite for analysing mobility and stability. Previous experimental and modelling studies have shown that ankle motion must be guided by fibres within the calcaneofibular and tibiocalcaneal ligaments, which remain approximately isometric during passive flexion. The purpose of this study was to identify these fibres.

Three below-knee amputated specimens were analysed during passive flexion with combined radiostereometry for bone pose estimation and 3D digitisation for ligament attachment area identification. A procedure based on singular value decomposition enabled matching bone pose with digitised data and therefore reconstructing position in space of ligament attachment areas in each joint position. Eleven ordered fibres, connecting corresponding points on origin and insertion curves, were modelled for each of the following ligaments: posterior talofibular, calcaneofibular, anterior talofibular, posterior tibiotalar, tibiocalcaneal, and anterior tibiotalar.

The measured changes in length for the ligament fibres revealed patterns of tightening and slackening. The most anterior fibre of the calcaneofibular and the medio-anterior fibre of the tibiocalcaneal ligament exhibited the most isometric behaviour, as well as the most posterior fibre of the anterior talofibular ligament. Fibres within the calcaneofibular ligament remain parallel in the transverse plane, while those within the tibiocalcaneal ligament become almost parallel in joint neutral position. For both these ligaments, fibres maintain their relative inclination in the sagittal plane throughout the passive flexion range.

The observed significant change in both shape and orientation of the ankle ligaments suggest that this knowledge is fundamental for future mechanical analysis of their response to external forces.     

Postural asymmetry in rats after unavoidable pain stimulation of different durations

Reaction of pose asymmetry was studied in rats subjected to unavoidable pain stimulation of 5 and 20 min duration after chordotomy. Single 20-min stimulation led to the appearance in all animals of right-side pose asymmetry, if the chordotomy took place immediately after the impact. If the chordotomy took place 24 h after the stimulation, the animals were revealed both with the right- and left-side pose asymmetry, analogous to the rats after 5-min stimulation. Cerebrospinal fluid of the animals subjected to the influence of various duration elicited in recipients pose asymmetry at the same side as in the donor. The role is shown of individual characteristics in the appearance of the definite side of the pose asymmetry.     

Role of the hypophysis in fixing postural asymmetry at the segmental level in hemisection of the spinal cord

The role of the pituitary in the mechanisms of posttraumatic reorganizations of the segmental apparatus was studied. Hypophysectomized rats failed to demonstrate postural asymmetry after spinal cord hemisection. The lack of asymmetry is connected with a considerable decrease in postural asymmetry factor activity in the cerebrospinal fluid and cerebral tissue. It was established that pituitary tissue is characterized by the maximal level of postural asymmetry factor activity after hemisection.     

Opioids evoke postural asymmetry in rats: the side of the flexed paw depends on the type of opioid agonist

Opioid kappa-agonists bremazocine and dynorphin (1-13), sigma-agonist SKF 10.047 and delta-agonist D-Ala2, D-Leu5-enkephalin (DADL) induce postural asymmetry of rats hind limbs under subarachnoidal administration below the level of spinal cord section (T3-T4). The side of the flexed leg depends on the opioid agonist type: bremazocine and dynorphin (1-13) induce predominantly right flexion. SKF 10.047--the left flexion, but not in all doses, DADL--in small doses (1 and 100 pg per animal)--of the right one, in larger doses (up to 10 ng per animal)--of the left one. Saline and opiate mu-agonist morphine do not induce postural asymmetry. Opiate antagonist naloxone prevents asymmetry development when injected prior opioid agonists, and also decreases the number of asymmetries induced by these agonists. Naloxone alone does not influence the per cent of animals with pose asymmetry. The opioid receptors are involved in asymmetry development. The revealed ability of opioid kappa-, delta- and sigma-agonists may be based on lateralization of opioid receptors in the rat spinal cord.     

How to make a zone of polarizing activity: insights into limb development via the abnormality preaxial polydactyly

Early in vertebrate limb development, a program initiates that polarizes the limb along the antero-posterior axis. The mesenchyme at the posterior margin is ultimately responsible for the asymmetry due to a region called the zone of polarizing activity (ZPA). The ZPA produces and secretes the molecule SHH, which coordinates the patterning of the resulting digits. Preaxial polydactyly (PPD) is a commonly occurring limb abnormality; investigating the genetic basis of this defect has provided insights into our understanding of digit patterning. PPD disrupts limb asymmetry by producing an ectopic ZPA at the opposite margin of the limb bud. Mutations in the long-range, limb-specific regulatory element of the Shh gene are responsible for the defect. Genetic analysis of this limb abnormality provides an important approach in understanding the mechanisms that control digit patterning.     

Dermatoglyphic changes in human genetic disorders: preaxial defects of the upper limbs]

Dermatologlyphic prints of 9 patients with preaxial (radial) hand defects were compared with control ones. A correspondence is revealed between a decrease in thumb phalanx length and a respective decrease in ridge count, on the one hand, and between the 1st metacarpal hypo- or aplasia and a decrease in palmar ridge count between the metacarpo-phalangeal and thumb flexion creases, on the other hand. An interrelation is found between the anomalies in flexion crease and respective joint formation. It is suggested, that these disorders are due to genetically determined anomalies in morphogenetic gradients which control the distribution of positional information in upper limb morphogenetic field.     

Neuron-specific enolase as a marker of neuronal lesions during various comas in man

The detection of neuron-specific enolase in biological fluids has been investigated as an indirect marker of neuronal damage in man. This protein was measured by a sandwich enzymoimmunoassay in serums and cerebrospinal fluids from patients with consciousness disorders of various aetiologies. Neuron-specific enolase level was significantly increased in sera from patients with comas resulting from anoxemia, head injury, septic state, cirrhosis and fulminant hepatitis. On the other hand, patients with meningitis (affection not normally accompanied with neuronal lesion) exhibited no change of this marker level. The statistical analysis of our results suggests that, in neurological disorders, the neuron-specific enolase levels in cerebrospinal fluid could have some prognostic value. The correlation between its level in cerebrospinal fluid and in serum was also demonstrated. Neuron-specific enolase increase in biological fluids thus represents a useful and promising marker to biochemically characterize various strokes possibly resulting in neuronal damage.     

Corticotropin-releasing hormone in depression and post-traumatic stress disorder

Corticotropin-releasing hormone (CRH) has been implicated in the regulation of a wide range of behaviors including arousal, motor function, feeding, and reproduction. Because depressed patients are often hypercortisolemic and intracerebroventricular administration of CRH to experimental animals produces a syndrome reminiscent of depression, dysregulation of this compound has been suggested to be involved in the pathogenesis of depressive and anxiety disorders. Studies of cerebrospinal fluid CRH levels and clinical neuroendocrine tests in patients with anxiety and affective disorders have supported this hypothesis. This review discusses these neuroendocrine findings in melancholic and atypical depression as well as post-traumatic stress disorder (PTSD). Overall, the data suggest that melancholic depression is characterized by hyperactive central CRH systems with overactivity of the pituitary-adrenal (HPA) axis. On the other hand, atypical depression is characterized by hypoactive central CRH systems and accompanying underactivity of the hypothalamic-pituitary-adrenal axis. Furthermore, the neuroendocrinology of PTSD appears to be unique, in that patients have hyperactive central CRH systems with underactivity of the pituitary-adrenal axis.     

Immunoglobulin Levels in the Cerebrospinal Fluid

The immunoglobulins G, A, M, and D have been measured in the cerebrospinal fluid of 207 patients with neurological disease. Raised levels of IgG, expressed as a percentage of total cerebrospinal fluid (C.S.F.) protein, were found in 62% of 45 cases of multiple sclerosis compared with 14% of 160 cases with various other neurological disorders. Thus measurement of the IgG level is probably a useful confirmatory investigation in multiple sclerosis. IgA and IgM were found only in the C.S.F. of patients with a raised protein level, and IgD was not detected.     

Empirical evaluation of gastrocnemius and soleus function during walking

Distinguishing gastrocnemius and soleus muscle function is relevant for treating gait disorders in which abnormal plantarflexor activity may contribute to pathological movement patterns. Our objective was to use experimental and computational analysis to determine the influence of gastrocnemius and soleus activity on lower limb movement, and determine if anatomical variability of the gastrocnemius affected its function. Our hypothesis was that these muscles exhibit distinct functions, with the gastrocnemius inducing limb flexion and the soleus inducing limb extension. To test this hypothesis, the gastrocnemius or soleus of 20 healthy participants was electrically stimulated for brief periods (90 ms) during mid- or terminal stance of a random gait cycle. Muscle function was characterized by the induced change in sagittal pelvis, hip, knee, and ankle angles occurring during the 200 ms after stimulation onset. Results were corroborated with computational forward dynamic gait models, by perturbing gastrocnemius or soleus activity during similar portions of the gait cycle. Mid- and terminal stance gastrocnemius stimulation induced posterior pelvic tilt, hip flexion and knee flexion. Mid-stance gastrocnemius stimulation also induced ankle dorsiflexion. In contrast mid-stance soleus stimulation induced anterior pelvic tilt, knee extension and plantarflexion, while late-stance soleus stimulation induced relatively little change in motion. Model predictions of induced hip, knee, and ankle motion were generally in the same direction as those of the experiments, though the gastrocnemius? results were shown to be quite sensitive to its knee-to-ankle moment arm ratio.     

Partial medial meniscectomy and rotational differences at the knee during walking

Loss of meniscal function due to injury or partial meniscectomy is common and represents a significant risk factor for premature osteoarthritis. The menisci can influence the transverse plane movements (anterior–posterior (AP) translation and internal–external (IE) rotation) of the knee during walking. While walking is the most frequent activity of daily living, the kinematic differences at the knee during walking associated with the meniscal injury are not well understood. This study examined the influence of partial medial meniscectomy (PMM) on the kinematics and kinetics of the knee during the stance phase of gait by testing the differences in anterior–posterior translation, internal–external rotation, knee flexion range of movement, peak flexion/extension moments, and adduction moments between the PMM and healthy contralateral limbs. Ten patients (45±9 years old, height 1.75±0.06 m, weight 76.7±13.5 kg) who had undergone partial medial meniscectomy (33±100 months post-op) in one limb with a healthy contralateral limb were tested during normal walking. The contralateral limb was compared to a matched control group and no differences were found. The primary kinematic difference was a significantly greater external rotation (3.2°) of the tibia that existed through stance phase, with 8 of 10 subjects demonstrating the same pattern. The PMM subjects also exhibited significantly lower peak flexion and extension moments in their PMM limbs. The altered rotational position found likely results in changes of tibio-femoral contact during walking and could cause the type of degenerative changes found in the articular cartilage following meniscal injury.     

Tibio-femoral movement in the living knee. A study of weight bearing and non-weight bearing knee kinematics using 'interventional' MRI

The aim of this study was to image tibio-femoral movement during flexion in the living knee. Ten loaded male Caucasian knees were initially studied using MRI, and the relative tibio-femoral motions, through the full flexion arc in neutral tibial rotation, were measured. On knee flexion from hyperextension to 120 degrees , the lateral femoral condyle moved posteriorly 22 mm. From 120 degrees to full squatting there was another 10 mm of posterior translation, with the lateral femoral condyle appearing almost to sublux posteriorly. The medial femoral condyle demonstrated minimal posterior translation until 120 degrees . Thereafter, it moved 9 mm posteriorly to lie on the superior surface of the medial meniscal posterior horn. Thus, during flexion of the knee to 120 degrees , the femur rotated externally through an angle of 20 degrees . However, on flexion beyond 120 degrees , both femoral condyles moved posteriorly to a similar degree. The second part of this study investigated the effect of gender, side, load and longitudinal rotation. The pattern of relative tibio-femoral movement during knee flexion appears to be independent of gender and side. Femoral external rotation (or tibial internal rotation) occurs with knee flexion under loaded and unloaded conditions, but the magnitude of rotation is greater and occurs earlier on weight bearing. With flexion plus tibial internal rotation, the pattern of movement follows that in neutral. With flexion in tibial external rotation, the lateral femoral condyle adopts a more anterior position relative to the tibia and, particularly in the non-weight bearing knee, much of the femoral external rotation that occurs with flexion is reversed.     

The activity of postural asymmetry factors in symmetrical sections of the rat spinal cord

The distribution of the low-molecular weight and high-molecular weight postural asymmetry factors (FPA) activity in the left and right parts of the lumbal region of the rat spinal cord was studied. Low-molecular weight FPA induces flexion of the hind limb ipsilateral to the half of the spinal cord from which FPA was isolated, while high-molecular weight FPA induces contralateral flexion. The activities of the low- and high-molecular weight FPAs in each half of the spinal cord are comparable in normal rat. After the suction lesion of the motor areas in the left hemisphere the increase of the low-molecular weight FPA activity in the right half of the lumbal region of the spinal cord was observed.