A straightforward method for determination of the sevoflurane metabolite hexafluoroisopropanol in urinary occupational medical samples by headspace-gas chromatography mass spectrometry

Biological monitoring of the unmodified sevoflurane and its metabolite hexafluoroisopropanol (HFIP) in urine samples was proposed to determine the individual exposure levels of the medical staff. In this study, a method for simultaneous determination of both compounds in urine using static headspace-gas chromatography-mass spectrometry (HS-GC-MS) was developed. The method is linear over a broad concentration range from 1 to 1000 µg/L (r2 > 0.999) and shows high precision. Limits of quantification (LOQ) are 0.6 µg/L for sevoflurane and 3 µg/L for HFIP, representing an excellent sensitivity without the necessity of analyte enrichment. The method was successfully applied in a German pilot-study to monitor both compounds in samples from medical personnel working in operating theatres. Urinary concentrations of HFIP ranged between < LOQ and 145 µg/L, while sevoflurane was below the LOD in all samples.

Aircraft noise exposure induces pro-inflammatory vascular conditioning and amplifies vascular dysfunction and impairment of cardiac function after myocardial infarction

AIMS

Traffic noise may play an important role in the development and deterioration of ischemic heart disease. Thus, we sought to determine the mechanisms of cardiovascular dysfunction and inflammation induced by aircraft noise in a mouse model of myocardial infarction (MI) and in humans with incident MI.

METHODS AND RESULTS

C57BL/6J mice were exposed to noise alone (average sound pressure level 72 dB; peak level 85 dB) up to 4d, resulting in pro-inflammatory aortic gene expression in the myeloid cell adhesion/diapedesis pathways. Noise alone promoted adhesion and infiltration of inflammatory myeloid cells in vascular/cardiac tissue, paralleled by an increased percentage of leukocytes with a pro-inflammatory, reactive oxygen species (ROS)-producing phenotype and augmented expression of Nox-2/phospho-NFκB in peripheral blood. Ligation of the LAD resulted in worsening of cardiac function, pronounced cardiac infiltration of CD11b+ myeloid cells and Ly6Chigh monocytes and induction of interleukin (IL) 6, IL-1β, CCL-2 and Nox-2, being aggravated by noise exposure prior to MI. MI induced stronger endothelial dysfunction and more pronounced increases in vascular ROS in animals preconditioned with noise. Participants of the population-based Gutenberg Health Cohort Study (median follow-up:11.4y) with incident MI revealed elevated CRP at baseline and worse LVEF after MI in case of a history of noise exposure and subsequent annoyance development.

CONCLUSION

Aircraft noise exposure before MI substantially amplifies subsequent cardiovascular inflammation and aggravates ischemic heart failure, facilitated by a pro-inflammatory vascular conditioning. Our translational results suggest, that measures to reduce environmental noise exposure will be helpful in improving clinical outcome of subjects with MI.

Inhibition of coagulation factor XI attenuates inflammation in myocardial ischemia/reperfusion injury

Background

Increasing evidence suggests that FXI is an attractive target for antithrombotic therapy because it reduces thrombosis without increasing bleeding risk. Patients with decreased levels of FXI are at reduced risk of cardiovascular diseases and thromboembolic events. We have already revealed that depletion of FXI inhibits the vascular coagulation-inflammatory circuit in angiotensin II-induced arterial hypertension. However, the effect of FXI depletion on cardiac inflammation and vascular function in ischemia/reperfusion (I/R) injury is unknown.

Purpose

Using FXI-depleted mice to investigate the role of FXI in inflammation response post cardiac I/R injury.

Methods

8–12 weeks old C57BL/6J male mice were injected intraperitoneally with FXI antisense oligonucleotide (FXI ASO) or scrambled controls for a period of 2 weeks. Then we temporarily ligated the left anterior descending (LAD) for 45 minutes to induce myocardial ischemia, followed by the reperfusion for 72 hours (ischemia/reperfusion injury, IRI). Myocardial inflammation and vascular function were analyzed by flow cytometry, real-time PCR, vascular relaxation studies from isolated aortic segment in organ chamber and chemiluminescence photon counting of oxidative burst in whole blood.

Results

FXI ASO treatment reduced hepatic FXI mRNA levels and prolonged activated partial thromboplastin time. Compared to scrambled ASO injected mice, oxidative burst from whole blood and endothelial dysfunction were decreased in FXI ASO injected mice with IRI. Compared to control groups, depletion of FXI attenuated cardiac infiltration of CD45+CD11b+ cells, especially LyG-LyChigh monocytes and LyG+ neutrophils at day 3 in I/R injury. Furthermore, the expression levels of adhesion molecules and expression of pro-inflammatory cytokines, such as Vcam-1, CCL2, IL-6 and IL-1b, in ischemic myocardium were significantly decreased in the FXI depleted mice of I/R injury.

Conclusion

Our results suggest that Inhibition of FXI leads to reduction of vascular dysfunction and ROS production in I/R injury, as well as attenuation of the inflammatory response and the influx of inflammatory cells in ischemic myocardium. This indicates that FXI could be a potential target for further treatment in cardiac IRI.

Funding Acknowledgement

Type of funding sources: Public grant(s) – EU funding. Main funding source(s): TICARDIO project has received funding from the European Union's Horizon 2020 research and Innovation programme under the Marie Skłodowska-Curie grant agreement No 813409.

Tubulin-folding cofactor E deficiency is associated with vascular dysfunction and endoplasmatic reticulum stress of vascular smooth muscle cells

Introduction

Endothelial function assessed via flow mediated dilatation (FMD) has shown to predict risk in individuals with established cardiovascular diseases, whereas its predictive value is uncertain in the setting primary prevention.

Purpose

The aim of the current work was to discover and evaluate novel mediators of vascular dysfunction in the general population and in conditional knock-out transgenic animal models.

Methods

In order to identify novel targets that were negatively correlated with FMD and investigate their contribution in vascular function, a Genome Wide Association Study (GWAS) of 5,000 participants was performed and subsequently immune cell-, endothelial- and vascular smooth muscle cell (VSMCs)-targeted conditional knockout mouse models were generated and characterized.

Results

GWAS analysis revealed that single nucleotide polymorphisms (SNPs) in the tubulin folding cofactor E (TBCE) gene were negatively correlated with FMD and TBCE expression in the peripheral blood mononuclear cells (PBMCs). Myelomonocytic cell-targeted TBCE deficiency did not lead to any vascular dysfunction in vivo in the LysM+Cre+/−TBCEfl/fl mice. Endothelial-targeted TBCE deficiency led to an NLR family pyrin domain containing 3 (NLRP3)-dependent activation of the inflammasome in the endothelial cells of Tie2-ERT2Cre+/−TBCEfl/fl mice. Importantly, VSMC-targeted TBCE deficiency was associated with endothelial dysfunction, increased aortic wall thickness and endoplasmatic reticulum (ER) stress-mediated VSMC hyperproliferation in vivo (SMMHC-ERT2Cre+/−TBCEfl/fl), paralleled by calnexin upregulation. Administration of the blood pressure hormone angiotensin II exacerbated the vascular dysfunction and phenotype. Administration of the ER stress modulator tauroursodeoxycholic acid to the SMMHC-ERT2Cre+/−TBCEfl/fl mice reversed vascular dysfunction, paralleled by induction of Raptor/Beclin-1-dependent autophagy both in vitro and in vivo.

Conclusion

TBCE and tubulin homeostasis in the vascular musculature seem to be novel markers of vascular function and represent a new druggable target for the treatment of ER-stress-mediated vascular dysfunction.

Funding Acknowledgement

Type of funding sources: Foundation. Main funding source(s): This work was supported by grants of the German Federal Ministry for Education and Research (BMBF01EO1003 and BMBF01EO1503), the DFG Major Research Instrumentation Programme (DFG INST 371/47-1 FUGG) as well as the Boehringer Ingelheim Foundation. PW received funds from the German Research Foundation in support of his work (DFG WE4361-4-1 and WE 4361/7-1). KS, TM and PW are PIs of the DZHK.

Nox2+ myeloid cells drive vascular inflammation and endothelial dysfunction in heart failure after myocardial infarction via angiotensin II receptor type 1

Background

Ischemic heart failure (HF) ensuing myocardial infarction (MI) leads to impaired left ventricular function, reduced cardiac output and counterregulatory activation of angiotensin II (AngII) levels. Furthermore, it is characterized by the initiation of a systemic inflammatory response.

Objective

We aimed to elucidate the impact of myelomonocytic cells and their activation by angiotensin II on vascular endothelial function in a mouse model of HF after MI.

Results

HF was induced in male C57BL/6J mice by permanent ligation of the left anterior descending coronary artery. Compared to sham, HF mice had significantly impaired endothelial function accompanied by enhanced mobilization of Sca-1+c-Kit+ hematopoietic stem cells and Sca-1-c-Kit+ common myeloid and granulocyte-macrophage progenitors in the bone marrow as well as increased vascular infiltration of CD11b+Ly6G-Ly6Chigh monocytes and accumulation of CD11b+ F4/80+ macrophages, assessed by flow cytometry. Using mice with Cre-inducible expression of diphtheria toxin receptor in myeloid cells, we selectively depleted lysozyme M+ myelomonocytic cells for 10 d starting 28d after MI. While the cardiac phenotype remained unaltered until 38d post MI, myeloid cell depletion attenuated vascular accumulation of Nox2+CD45+ cells, endothelial dysfunction, oxidative stress and vascular expression of adhesion molecules and angiotensin II receptor type 1 (AT1R). Pharmacological blockade of this receptor for 4 weeks did not significantly alter cardiac function, but mimicked the effects of myeloid cell depletion: Telmisartan (20 mg/kg/d, fed to C57BL/6J mice) diminished bone marrow myelopoesis and myeloid ROS production, attenuated endothelial leukocyte rolling and vascular accumulation of CD11b+Ly6G-Ly6Chigh monocytes and macrophages, resulting in improved vascular function with less abundance of Nox2+CD45+ cells.

Conclusion

Endothelial dysfunction in HF ensuing MI is mediated by inflammatory Nox2+ myeloid cells infiltrating the vessel wall that can be targeted by AT1R blockade.

Funding Acknowledgement

Type of funding source: None

[The South-American eel. Two early letters on animal electricity from the Dutch colonies]

Speculations about the nature of nerve action, including animal spirits, date back to antiquity. Only during the 18th century, when it became possible to store electricity in Leyden jars, did natural philosophers begin to realise that the sensations caused by electric fish are like those produced by these primitive capacitors. The important roles played by amateur observers in the Dutch colonies of South-America, and how they communicated with more established Dutch scientists in The Netherlands, are often relatively overlooked in histories of how the nerves became electrical. In this article we examine two mid-18th-century letters from South-America to the Netherlands. Both dealt with what would soon be called the electric eel, and were published in the proceedings of the first Dutch Society of Science (in Haarlem). The discovery of the electric nature of the shocks produced by these fish in particular proved to be a crucial step in understanding animal electricity and the true nature of neurophysiology.

The eye as an optical instrument: from camera obscura to Helmholtz's perspective

The era of modern vision research can be thought of as beginning in the seventeenth century with Johannes Kepler's understanding of the optics of the camera obscura with a lens and its relation to the eye. During the nineteenth century, Helmholtz used "The eye as an optical instrument" as the title for one of his Popular Lectures, and such a conception of the eye is now accepted as a fundamental feature of visual science. In analysing the optics of the eye, Helmholtz constructed some novel optical instruments for studying the eye. The development of optometers, ophthalmometers, and ophthalmoscopes is presented historically, with emphasis on how these instruments and camera analogies helped scientists to understand the functions of the eye, especially the enigma of accommodation. "The laws of optics are so well understood, and the knowledge of the eye, when considered as an optical instrument, has been rendered so perfect, that I do not consider myself capable of making any addition to it; but still there is a power in the eye by which it can adapt itself to different distances far too extensive for the simple mechanism of the parts to effect." (John Hunter in a letter to Joseph Banks in 1793, published by Home 1794, page 24).

Discovering trepanation: the contribution of Paul Broca

PAUL BROCA WAS an icon of neuroscience and neurosurgery who also happened to be intrigued by trepanned skulls. His anthropological work established that, thousands of years ago, individuals not only trepanned skulls but also successfully performed these operations on living persons. After first commenting on a pre-Columbian Peruvian skull in 1867 (the first case of trepanning on a living person widely recognized as such), he turned to even older trepanned skulls found on French soil. In the 1870s, he theorized that the procedure originated as a means to treat convulsions in infants. As he saw it, Neolithic man attributed such convulsions to evil spirits, for which trepanation provided a ready means of escape. Because simple infantile convulsions resolve on their own, the practice would have seemed successful, and therefore it would have been propagated and expanded by later generations. Broca's theory skillfully integrated his anthropological and medical knowledge and helped to create the exciting environment in which scientists pondered what Neolithic and primitive people really knew regarding the brain and surgery.

Victor Horsley on "trephining in pre-historic times"

Victor Horsley was intrigued by newly discovered, ancient trepanned skulls, especially those that revealed that the operation was performed on living patients. He examined the man-made openings as an expert on the locus of the primate motor cortex and as a surgeon who had successfully removed parts of the motor cortex to treat Jacksonian epilepsy. He postulated that trepanation originated as a way to treat pain and epilepsy caused by depressed cranial fractures over the motor cortex. Like Broca before him, Horsley helped create the exciting Zeitgeist that led others in the late-1 800s to explore, ponder, and write about ancient trepanned skulls.

Edward Albert Schäfer (Sharpey-Schafer) and his contributions to neuroscience: commemorating of the 150th anniversary of his birth

The year 2000 marks the 150th anniversary of the birth of Edward Albert Schäfer (Sir Edward Albert Sharpey-Schafer). Affiliated first with University College, London, and then with Edinburgh University, Schäfer made monumental contributions to the fields of histology, physiology, endocrinology, and practical medicine. This paper traces his professional life and emphasizes his seminal contributions to the neurosciences, which include his findings in support of neuron doctrine, his research on cortical localization in monkeys, his discovery of adrenaline and its place in the history of neural transmission, and his studies on recovery after nerve damage. Author of many histology and physiology books, founder of the "Quarterly Journal of Experimental Physiology," and mentor to many students who achieved great fame themselves, Schäfer was an active teacher and researcher, a man who remained committed to his vision of medicine based on laboratory science until he died in 1935.

The power of a musical instrument: Franklin, the Mozarts, Mesmer, and the glass armonica

In 1761 Benjamin Franklin invented the armonica (often referred to as the glass harmonica), an instrument designed to simplify the playing of the musical glasses. The instrument immediately became popular and inspired compositions by Wolfgang Mozart, who had the opportunity to hear and play one at the house of Franz Anton Mesmer. Armonica music was used by Mesmer in his séances, because he felt it could promote healing by propagating a mystical fluid that he called animal magnetism through the body. After Mesmer's theories were debunked by a highly respected panel of scientists, the armonica fell out of vogue. Because Franklin was on the panel that examined the discredited mesmerism, he indirectly contributed to his own invention's demise.

Dr. Otto Soltmann (1876) on development of the motor cortex and recovery after its removal in infancy

In 1870, Fritsch and Hitzig demonstrated that dogs have a motor cortex. In a chapter published 6 years later, Otto Soltmann studied the functional development of the motor cortex, which he believed functioned in willed movement. He was the first to show that the dog's motor cortex becomes electrically excitable at about 10 days of age, with the contralateral forepaw area appearing first. He also studied the effects of ablating the cortical motor regions unilaterally and bilaterally, and encountered a remarkable degree of sparing of function in his animals operated on as newborns, but not in older-operated dogs. Soltmann turned to the theory of functional take-over (vicariation) to account for the absence of deficits in his young animals. He was especially intrigued by the fact that electrical stimulation of a healthy motor cortex could produce bilateral matched movements, but only in dogs that sustained opposite motor cortex lesions very early in life.

Outcome of total hip arthroplasty in small-proportioned patients

In a prospective, consecutive series, 41 total hip arthroplasties were performed in 27 small-proportioned patients with small femoral dimensions. The 17 female and 10 male patients averaged 23.6 years (range, 14-47 years), and the mean height and weight were 157 cm (range, 132-183 cm) and 53.5 kg (range, 36-84 kg). The most common preoperative diagnosis was juvenile rheumatoid arthritis in 18 patients (28 hips). Most patients were severely disabled in their daily activity, and 68% of the patients were classified as Charnley functional class C. The femoral implants consisted primarily of the proximally porous-coated miniature Anatomic Medullary Locking femoral component (AML/CDH, Depuy, Warsaw, IN) in 33 hips in 22 patients (average stem diameter, 9.5 mm; range, 8-12.0 mm). A porous ingrowth acetabular cup fixed with screws was used in all procedures. At an average follow-up of 51 months, Harris Hip Scores improved significantly from 34 points (range, 0-65 points) preoperatively to 85 points (range, 33-100 points) after arthroplasty. There were no intraoperative complications. There was 1 revision because of femoral implant loosening. Three cementless femoral components showed evidence of nonprogressive subsidence. One patient had significant bilateral acetabular component polyethylene wear and underwent revision. All other femoral and acetabular components were radiographically stable. The relief of pain and improvement of function were dramatic. The miniature AML/CDH femoral component, combined with an uncemented acetabular cup, provides a promising, off-the-shelf alternative in small-proportioned patients.

Margaret Kennard on sparing and recovery of function: a tribute on the 100th anniversary of her birth

Margaret Kennard was an American pioneer in the experimental study of sparing and recovery of function. Her most famous experiments were performed on monkeys and apes at Yale University during the late 1930s and early 1940s. By describing the behavioral effects of brain damage on infantile, juvenile, and older primates, she drew new attention to just how important developmental status can be at the time of neural insult. Kennard also conducted experiments which showed that even adult primates can exhibit significant sparing and recovery of function, especially if brain lesions are made in stages rather than all at once. In many respects, Kennard helped launch the modern era of research on sparing and recovery of function by demonstrating that several factors in addition to lesion locus can affect post-injury performance and by recognizing that, if neural reorganization does occur, it probably takes place in spared parts of the damaged system.

Does Gustave Dax deserve to be forgotten? The temporal lobe theory and other contributions of an overlooked figure in the history of language and cerebral dominance

Gustave Dax played an important role in the early history of cerebral dominance for language. He not only sent the 1836 memoir of Marc Dax, his deceased father, to Paris in 1863, but saw to it that this important document was published before Paul Broca's own article on cerebral dominance appeared later in 1865. In addition, he supported his father's contention that the left hemisphere is special for speech with 140 additional clinical cases. Gustave Dax's own unique contribution, however, has been almost completely overlooked. Although his theory lacked specificity, he preceded Meynert, Schmidt, and Wernicke in suggesting that the left temporal lobe may be especially important for speech.

A perplexing document in the early history of Gilles de la Tourette Syndrome: Melotti's rendition of a "Lecture of Charcot" (including a complete translation from the Italian with commentary)

In 1885, Dr. Guilio Melotti published an Italian translation of a lecture on "Convulsive Tics with Coprolalia and Echolalia" given by Jean-Martin Charcot. Although this lecture often has been cited as an authoritative statement of Charcot's view, until now it has not been translated into English. The lecture presents a number of statements that appear nowhere else in Charcot's published corpus, including some that seem to contradict Charcot's other pronouncements on maladie des tics. Although the Melotti-Charcot lecture may portray Charcot's position accurately in many passages, the article most likely is a compilation from a variety of sources.

Cutaneous sensory spots and the "law of specific nerve energies": history and development of ideas

By use of suitable methods, different spots on the skin surface can be shown to be selectively sensitive to one of four sensory qualities in decreasing order of density: pain, touch, cool and warm. The presence of such spots was observed virtually simultaneously in the early 1880s by three independent investigators. Two papers on punctuate sensitivity of the skin were published in 1882 and 1883 by Magnus Blix of Uppsala University in Sweden; three papers were published in 1884 by Alfred Goldscheider, a German army doctor; and one was published in 1885 by Henry Donaldson of Johns Hopkins University in Maryland. Donaldson's findings originated from a serendipitous observation. In contrast, Blix's and Goldscheider's experiments were based on Johannes Muller's concept of "specific sense energies" and the extension of this idea to sensory qualities (the law of "specific nerve energies") by others, including Hermann von Helmholtz. The discovery of different types of sensory spots had considerable influence on other researchers of the period, including Max von Frey, but has only recently been substantiated by electrophysiological experiments.

A happy state of mind: a history of mild elation, denial of disability, optimism, and laughing in multiple sclerosis

Although multiple sclerosis (MS) is often looked on as a disorder of the sensory and motor systems, it can also be associated with changes in emotion and personality. Many patients with MS seem cheerful, optimistic about the future, and strangely unconcerned about their ongoing physical deterioration. In addition, patients with MS have a tendency to break into uncontrollable laughing, even when they have no reason to be happy. This article looks at how these seemingly upbeat affective changes were viewed by early researchers of MS, including Cruveilhier, Charcot, and Moxon during the 19th century and Cottrell, Wilson, and Ombredane in the 1920s. Frequently cited studies on the emotional correlates of MS from the mid-20th century are also presented, and some trends in the more recent literature are identified.

David Hartley's psychobiological associationism and the legacy of Aristotle

The idea that there are certain "laws" of learning (similarity, contrast, contiguity) can be traced to Aristotle. He maintained that external stimuli cause small movements in the vessels to the dominant heart, the vestiges of which can be linked to one another. Aristotle's laws of learning were incorporated into the writings of Hobbes, Locke, and Berkeley, men who said nothing about the physiological correlates of mental associations. This left the door open for David Hartley to combine mental associationism with the Newtonian idea that sensations can cause minute particle vibrations in the nerves. Hartley's amalgam of psychology, philosophy, and neurology was first presented in 1746, as a "trial balloon" at the end a little-known monograph on a treatment for kidney stones. It was repeated three years later in his better-known Observations on Man. In many ways, modern psychobiological connectionism can be traced back to Hartley's Conjectures of 1746, in which Aristotle's original thoughts were modified with then current ideas about functions of the mind and the nervous system.

Gustave Dax and his fight for recognition: an overlooked chapter in the early history of cerebral dominance

The year 1865 was revolutionary in neuroscience. In this year, three papers were published on the topic of cerebral dominance for speech. These papers were authored by Paul Broca, Marc Dax, and Gustave Dax, and they contributed to a priority debate that cannot be easily resolved. Gustave Dax claimed that his long dead father had written a memoir and presented it orally in Montpellier in 1836, thus making him the first person to write about cerebral dominance. He also claimed that he was the second person to write on the subject, the first to support his father's claims, and the first to try to localize the center for speech in just one part the left hemisphere, the middle (temporal) lobe. Paul Broca, however, was now getting much of the credit for these discoveries. To set the record straight, Gustave published several letters. This paper presents translations of Gustave's letters of 1866, 1875, and 1877, as well as the historical note written by Raymond Caizergues in 1879, and recreates the events that triggered the younger Dax's anger.

Gram stain detection of infection during revision arthroplasty

We reviewed 194 revision arthroplasties of the hip and knee performed over a ten-year period. The results of intraoperative Gram staining were available in 169 (87%). Thirty-two were found to be infected (11 hips and 21 knees) and 137 had no evidence of infection. Intraoperative Gram staining was negative in all 169 cases. The method therefore had a sensitivity of 0% for detecting infection. We conclude that the absence of organisms on intraoperative Gram staining during revision arthroplasty does not confirm the absence of infection.

GRAM STAIN DETECTION OF INFECTION DURING REVISION ARTHROPLASTY

We reviewed 194 revision arthroplasties of the hip and knee performed over a ten-year period. The results of intraoperative Gram staining were available in 169 (87%). Thirty-two were found to be infected (11 hips and 21 knees) and 137 had no evidence of infection.

Intraoperative Gram staining was negative in all 169 cases. The method therefore had a sensitivity of 0% for detecting infection. We conclude that the absence of organisms on intraoperative Gram staining during revision arthroplasty does not confirm the absence of infection.

Gustave Dax and the early history of cerebral dominance

In 1863, 2 years before Paul Broca published his heralded paper on the special role of the left hemisphere in speech, Gustave Dax sent a paper to the Académie de Médecine in Paris, France. His lengthy submission included an insightful memoir presumably written by his father Marc in 1836 and supportive material that he had collected himself. The present article examines the events leading to Gustave's 1863 submission to the Académie. It also presents an English translation of the negative response that this paper received and a translation of the short article that Gustave published in 1865. These materials help to show how cerebral dominance was first discovered, how it was made public, and how the first advocates of the concept were judged by their contemporaries.

Gilles de la Tourette and the discovery of Tourette syndrome. Includes a translation of his 1884 article

In 1885, Gilles de la Tourette described 9 patients who suffered from a disorder characterized by involuntary movements, echolalia, echopraxia, coprolalia, and strange, uncontrollable sounds. In his article, Gilles de la Tourette presented some earlier descriptions of this disorder. To appreciate what first led Gilles de la Tourette to Tourette syndrome, however, it is necessary to turn to an article that he published a year earlier. In his 1884 article, Gilles de la Tourette cited several movement disorders that he thought were similar to each other, yet different from true chorea. After describing these disorders, namely, "jumping" of Maine, latah of Malaysia, and miryachit of Siberia, he briefly mentioned a boy in Charcot's ward in Paris, France, who seemed to exhibit the same condition. In an addendum, he then said that other cases were now surfacing in Paris and that he would write an additional article describing these individuals. To achieve a more thorough understanding of the events that led Gilles de la Tourette to his 1885 description of the disorder that now bears his name, we herein present an English-language translation of his 1884 article along with a commentary.

Descartes and the pineal gland in animals: a frequent misinterpretation

René Descartes presented a number of reasons for his choice of the pineal gland as a logical place for the soul to interact with the physical machinery of the body. It is often stated that one of his reasons was that he believed animals do not have pineal glands, whereas humans alone possess a soul and this small structure. This is a misinterpretation of Descartes. The philosopher knew that barnyard and other animals possess pineal glands, having seen this with his own eyes. His point was that the pineal is unique in humans only because of a special function - acting as the seat for the rational soul.

Holeboard performance of rats after hippocampal lesions and treatment with nimodipine

Rats were taught to select eight holes in a 4 x 4 holeboard for food reinforcements. Upon reaching criterion, they were given subtotal lesions of the anterior hippocampus or sham operations. They then received either the calcium channel blocker, nimodipine, or vehicle alone. Retention testing revealed a significant main effect of lesion and evidence for nimodipine reducing this effect. These data are consistent with previous findings from this laboratory in which it was demonstrated that nimodipine can enhance performance on higher cognitive tasks after hippocampal damage.

Medial frontal cortex lesions: deficits and treatment with nimodipine

Rats with bilateral lesions of the medial frontal cortex were tested in a T-maze for the ability to learn a position habit and to make four reversals of it. Rats with medial frontal cortical lesions showed deficits in reversal learning. In addition, they were found to be hyperactive in an open field. Treatment with the dihydropyridine calcium channel antagonist, nimodipine, did not reduce these behavioral deficits.

Effects of nimodipine on two neurologic measures sensitive to sensorimotor cortex damage

Seventeen rats with lesions involving the sensorimotor forepaw and hindpaw regions were tested for the ability to run along a narrow bridge without slipping and to hold on to a small-diameter dowel suspended above the ground. Nine of the animals received the calcium channel blocker, nimodipine, once per day for the first 2 weeks after surgery, while the remaining eight rats received vehicle alone. Repeated measurements over the first 3 postoperative weeks showed deficits among the rats with lesions on both tasks. The animals treated with nimodipine, however, showed much better recovery, especially after the initial testing sessions.

Neurological correlates of unilateral and bilateral "strokes" of the middle cerebral artery in the rat

Rats with unilateral lesions of the middle cerebral artery (MCA) were tested for the ability to detect (touch) and remove a square of adhesive tape from each forepaw, and for performance on a number of neurological tests (e.g., placing and hopping reflexes, activity). Rats with MCA damage showed deficits in both touching and removing the tape from the paw contralateral to the damage, but not ipsilateral to the damage, while performing within normal limits on the other tests. After scores of the MCA rats dropped into the control group range on the adhesive tape test, they sustained damage to the opposite MCA. This did not reinstate the original deficit, suggesting that the recovery seen after the unilateral lesion was not mediated by the opposite cortex. The second lesion, however, caused a deficit in removing the adhesive tape from the limb opposite the new stroke. Some of the rats that originally had sham operations received bilateral MCA lesions at this time. These animals showed much more severe deficits on the adhesive tape test than the rats with sequential strokes. Rats with bilateral MCA damage (simultaneous or sequential) also slipped on a long narrow plank more often than control animals. Nimodipine did not enhance recovery on any of the behavioral measures.

Nimodipine-enhanced survival of suboptimal neural grafts

The present experiment was conducted to see whether nimodipine, a calcium channel blocker with the potential to protect vulnerable neurons, could improve the survival rate of striatal grafts under suboptimal conditions. The drug markedly improved graft viability of rats with near-term (E21) striatal implants. Untreated rats showed no surviving neurons while all treated rats showed surviving grafts rich in neuron. It did not affect the survival of striatal grafts from E14/15 donors into the striatum, in which the high rates of survival are normally obtained.

Nimodipine enhances new learning after hippocampal damage

Rats were trained to lever press and then were given either bilateral lesions of the hippocampus or control operations. Half of the rats in each group received oral nimodipine, a calcium entry blocker, while the remaining rats received vehicle, over a 14-day period that began the evening of surgery. The rats were studied on a DRL 20-s schedule of reinforcement (differential reinforcement of low rates of responding) that required them to withhold a response for at least 20 s after their last lever press in order to earn a reward. Rats with lesions that did not receive the drug performed poorly on the DRL 20-s schedule. In contrast, rats sustaining the same hippocampal lesions but given the drug showed scores that were virtually equivalent to those of the sham-operated control animals. Similar trends were observed when the rats were then tested on a DRL 40-s schedule of reinforcement. These findings suggest that nimodipine may attenuate the effects of acute, focal brain lesions on new learning of even difficult behavioral and cognitive tasks.

Nimodipine enhances growth and vascularization of neural grafts

The potential of the calcium channel antagonist, nimodipine, to enhance vascularization and growth of neural grafts has been investigated. Four groups of rats received unilateral 6-OHDA lesions of the nigrostriatal pathway followed 16-23 days later by intrastriatal grafts of embryonic ventral mesencephalon. The grafts were derived from (i) Embryonic Day 14 embryos (group E14), (ii) Day 17 embryos (group E17), and (iii) Day 20 embryos (group E20), all implanted within 90 min of preparation, or (iv) Day 14 embryos with a 6-h delay prior to implantation (group E14/6H). Half the rats in each group received intragastric intubation with nimodipine daily for 14 days after transplantation surgery, whereas the other half received control intubations. The rats were killed by perfusion with formalin containing Indian ink 6 weeks after grafting. Nimodipine treatment enhanced the vascularization of the grafts in all four groups and induced a significant increase in the volume of grafts under the three suboptimal transplantation conditions (i.e., groups E17, E20, E14/6H). The results suggest that vascularization of graft tissue is an important determinant of survival and growth of neural transplants prepared by the dissociated cell suspension technique and show that vascular perfusion of grafts can be enhanced by nimodipine.

Basal forebrain lesions impair tactile discrimination and working memory

Rats received bilateral injections of the excitotoxin, N-methyl-D,L aspartate, which resulted in degeneration of basal forebrain cholinergic (BFC) neurons in the nucleus basalis magnocellularis. Most tests of general neurological function revealed no differences between control rats and those with BFC lesions and where differences were found they appeared to be due to hyperemotionality. Rats with BFC lesions demonstrated significant deficits in working memory, as evaluated in an 8-arm radial maze. In addition, these rats showed a severe impairment in tactile discrimination learning, an effect of BFC lesions not previously demonstrated. We propose that cholinergic deafferentation of the somatosensory cortex with consequent disruption in somatosensory information processing might account at least in part for this effect.