FACTORS AFFECTING INTERPRETATION OF TISSUE DIELECTRIC CONSTANT (TDC) IN ASSESSING BREAST CANCER TREATMENT RELATED LYMPHEDEMA (BCRL)

Tissue dielectric constant (TDC) measurements are increasingly used as quantitative adjunctive tools to detect and assess lymphedema. Various factors affect measured TDC values that may impact clinical interpretations. Our goal was to investigate possible impacts of: 1) anterior vs. medial arm measures, 2) total body water (TBW%) and arm fat percentages (AF%), 3) measurement depth, and 4) skin firmness. In 40 healthy women (24.5±2.5 years), TDC was measured bilaterally on anterior forearm to 0.5, 1.5, 2.5, and 5.0 mm depths using a multiprobe device and on anterior and medial aspects using a compact device. TBW% and AF% were measured at 50KHz and skin firmness measured by skin indentation force (SIF). Results showed: 1) No statistically significant difference in TDC values between anterior and medial arm, 2) a moderate direct correlation between TDC and TBW% (r=0.512, p=0.001), 3) an inverse correlation between TDC and AF% (r= -0.494, p<0.001) with correlations greatest at the deepest depth, and 4) a slight but statistically significant inverse correlation between TDC and SIF (r= -0.354, p=0.001). TDC values with compact vs. multiprobe were within 6% of each other with interarm (dominant/nondominant) ratios not significantly different. The findings provide a framework to help interpret TDC values among divergent conditions.

A newly designed key-hole button

✓ Patients who have undergone frontotemporal craniotomy occasionally complain of scalp deformity in the anterior temporal area. This occurs as a result of inappropriate reconstruction of the temporal muscle and repair of the bone defect at the key hole and surrounding skull. Although several methods have been developed to prevent skin indentation on burr holes located over the convexity, satisfactory cosmetic repair of the key hole remains difficult because of its complicated bone curvature. To prevent such postoperative deformity, the authors designed a button made of hydroxyapatite ceramics to fit the key hole easily. This new, biocompatible “key-hole button” is shaped to alleviate the deformity of the temple by filling the bone defect in a more natural way. The specifications of this device and its clinical application are described.

Electrophysiological studies of acetylcholine and the role of the basal forebrain in the somatosensory cortex of the cat. II. Cortical neurons excited by somatic stimuli

1. Of the sample of 322 neurons located in somatosensory cortex and tested for their responsiveness to somatic stimulation, 91 (28%) responded to stimuli applied to the skin. The majority were located in the middle cortical layers. Each of the cells subjected to tests with glutamate and acetylcholine (ACh) was rapidly adapting to cutaneous stimuli, giving a response at the onset of skin indentation and sometimes after the stimulus withdrawal. 2. Of the 30 cells tested by pairing basal forebrain (BF) stimulation with cutaneous stimulation. 18 (60%) displayed enhanced responses to the same cutaneous stimulus after the pairing. These effects lasted for greater than 5 min in 17 cases, persisting for as long as the cell was studied, sometimes greater than 1 h. 3. The enhanced responsiveness to cutaneous stimuli could not be reversed by atropine, but in each of the 11 cells where atropine was administered while the BF stimulus was paired with the skin stimulus, the pairing produced no enhancement. 4. We conclude that pairing a BF stimulus with a cutaneous stimulus leads to long-term facilitation of the responsiveness of the cortical neuron subjected to this treatment and that this effect is mediated by the release of acetylcholine from BF cholinergic neurons that act on muscarinic receptors found on neurons in the somatosensory cortex.

Simulation of motion on the skin. III. Mechanisms used by rapidly adapting cutaneous mechanoreceptors in the primate hand for spatiotemporal resolution and two-point discrimination

1. The contribution of rapidly adapting (RA) mechanoreceptors to two-point discrimination has been evaluated by examining their ability to resolve the spacing of grating patterns shifted across the skin. The experiments test two different neural coding mechanisms that have been proposed to underlie resolution of spatial detail on the hand: 1) a rate-intensity code in which the spacing of surface features is encoded by the average frequency of firing of individual sensory afferents, and 2) an isomorphic representation of shape in which variations in the firing patterns of individual afferents reflect the spatiotemporal profile of skin indentation. 2. To measure the spatial acuity of RA mechanoreceptors innervating the hands of macaque monkeys, we displayed pairs of horizontal bars spaced 1-13 mm apart on a computer-controlled OPTACON stimulator placed over glabrous skin. Two-point resolution was measured by simultaneously pulsing pairs of rows at rates of 100, 50 and 25 Hz; each pair was shifted in tandem across the hand to simulate lateral motion. Single-fiber recordings were made from physiologically identified RA afferents in anesthetized monkeys. 3. Receptive field diameter appears to be the critical determinant of spatial resolution of gaps between two bars. RAs fire continuously if bar spacing is less than the field diameter but do not summate inputs when both active rows are contained within the field. Response profiles evoked by two bars spaced less than 4.8 mm apart can be predicted from the single-bar profiles, assuming occlusion between overlapping inputs with the strongest member dominating axonal output. Two-thirds of the RAs tested discharge 1 spike/pulse as bar patterns cross the field, yielding a uniform spike train whose frequency reflects stimulus pulse rates but fails to indicate gaps between bars. An additional 17% fire 2 spikes/pulse when the bars contact or straddle the field center, but also fail to differentiate individual stripes spaced less than 3.6 mm apart. 4. Only 17% of RAs represent gaps narrower than the field diameter. These fibers show double-peaked response profiles to bar patterns spaced at least 2.4 mm apart, firing 2 spikes/pulse as first one, and then the second stripe crosses the field center. Timing between peaks corresponds to bar spacing. Responses are reduced in amplitude when adjacent bars straddle the field center, as occlusion between simultaneous inputs prevents summation of inputs from the two stimuli. Fifteen of 16 RAs failed to resolve bars spaced 1.2 mm apart, as double-spike responses were evoked only by the leading stripe.(ABSTRACT TRUNCATED AT 400 WORDS)

Mechanoreceptors in rat glabrous skin: redevelopment of function after nerve crush

In the glabrous skin of the rat's hindfoot the same triple set of low-threshold mechanoreceptors is present as has been found in other mammals: slowly adapting (SA), rapidly adapting (RA), and very rapidly adapting Pacinian corpuscle-like (PC) receptors. Their functional characteristics were examined in normal rats and compared with those of sensitive mechanoreceptors found in the glabrous skin of the foot 2-24 wk after crush of the plantar nerves, resulting in regeneration of the transected nerve fibers. After 2 wk of nerve regeneration, low-threshold RA and SA cutaneous mechanoreceptors reappeared in the foot skin. Responses of PC receptors were recorded again after 3 wk, at which time the proportion of fibers that could be identified as low-threshold cutaneous mechanoreceptors had regained control level. Discharge patterns of regenerated cutaneous mechanosensitive receptors were very similar to those of normal skin mechanoreceptors. Their sensitivity to controlled mechanical stimulation was, however, still reduced 4 wk after the lesion. After 8 wk RA and SA receptors had regained their normal dynamic sensitivity, i.e., the responsiveness to the velocity of skin indentation. The static sensitivity of SA receptors, i.e., responsiveness to maintained skin indentation, was not consistently reestablished within 24 wk. No shift in sensitivity could be deduced from tuning curves of PC receptors examined 3-24 wk after nerve crush. In addition to the low-threshold mechanoreceptors, high-threshold (HT) mechanoreceptive fibers were found in controls and in animals with regenerating nerves. This type of fiber was most frequently found 1 wk after the nerve crush, when reinnervation of the foot started. They probably represent fibers not connected to specific mechanoreceptor end organs. Thus, functional restitution of the highly specific cutaneous mechanoreceptors occurs fairly soon after invasion of the original territory by the regenerating nerve. It is assumed that the underlying mechanism is the rapid reconnection of fibers with the end organs that have either survived during the period of denervation or regenerated subsequent to reinnervation of the skin.