Clinical and pathological correlates of severity classifications in trigger fingers based on computer-aided image analysis

BACKGROUND: The treatment of trigger finger so far has heavily relied on clinicians’ evaluations for the severity of patients’ symptoms and the functionality of affected fingers. However, there is still a lack of pathological evidence supporting the criteria of clinical evaluations. This study’s aim was to correlate clinical classification and pathological changes for trigger finger based on the tissue abnormality observed from microscopic images. METHODS: Tissue samples were acquired, and microscopic images were randomly selected and then graded by three pathologists and two physicians, respectively. Moreover, the acquired images were automatically analyzed to derive two quantitative parameters, the size ratio of the abnormal tissue region and the number ratio of the abnormal nuclei, which can reflect tissue abnormality caused by trigger finger. A self-developed image analysis system was used to avoid human subjectivity during the quantification process. Finally, correlations between the quantitative image parameters, pathological grading, and clinical severity classification were assessed. RESULTS: One-way ANOVA tests revealed significant correlations between the image quantification and pathological grading as well as between the image quantification and clinical severity classification. The Cohen’s kappa coefficient test also depicted good consistency between pathological grading and clinical severity classification. CONCLUSIONS: The criteria of clinical classification were found to be highly associated with the pathological changes of affected tissues. The correlations serve as explicit evidence supporting clinicians in making a treatment strategy of trigger finger. In addition, our proposed computer-aided image analysis system was considered to be a promising and objective approach to determining trigger finger severity at the microscopic level

Establishing an anatomically and clinically relevant tissue engineered tendon-bone model of the flexor digitorum profundus insertion

Avulsion of the flexor digitorum profundus (FDP) tendon from the distal phalanx (DP) in the finger is a common and distinct clinical injury of the hand (‘jersey finger’) with considerable functional morbidity. Multiple surgical techniques are employed to reattach the tendon to the bone, but no single technique has emerged as the optimal treatment method. Issues such as reduced range of movement, infection, nail deformity and cost complicate the requirement for strong fixation and prevention of re-rupture. Crucially, repair of avulsion injuries does not regenerate the enthesis, the region of graded multiphasic microanatomy at the tendon-bone insertion. The enthesis allows uniform muscle force transmission between the mechanically distinct tendon and bone through specialised adaptations to dissipate stress foci. Avulsion repair is scar-mediated and of low mechanical strength, prone to re-rupture at the tendon-bone interface. Interfacial tissue engineering provides the opportunity to create an in vitro tendon-bone model with potential to re-establish the enthesis through co-culture of tendon and bone cells, which could be used to evaluate repair techniques or as a composite tissue graft for clinical use. The aim of this project was to establish an in vitro model system that was anatomically representative and clinically applicable to the investigation and treatment of FDP avulsion injury. The 2 main objectives were to thoroughly evaluate the native anatomy of the human FDP insertion, and to design and develop a relevant 3-dimensional (3D) in vitro tendon-bone co-culture model. Human cadaveric tissue was dissected and photographed for image analysis to determine gross shape and dimension morphometrics of the FDP-DP tendon-bone interface, FDP tendon and DP bone. Finger and gender differences were found to significantly influence measurement values, with data groupings informing design guidelines for ‘small’, ‘medium’ and ‘large’ model sizes. Cadaveric tissue was also histologically processed to qualitatively describe the fibrocartilaginous FDP enthesis for the first time. Quantitative analysis of tendon fibres revealed a mean angle of insertion across the soft-hard tissue interface of 30o, providing a guide to the angled attachment of the tendon and bone model components. Development of the in vitro model enhanced an existing multi-tissue fibrin scaffold soft tissue-bone anchor design into an FDP tendon analogue-DP bone anchor single species co-culture construct. Rat fibroblast and osteoblast cultures were established and characterised in standard growth medium, mineralising medium and a 50:50 media mix. Formation and maturation of the fibroblast-seeded fibrin tendon analogue was analysed histologically in single and multi-strand cultures for morphological development and collagen deposition. Long term tendon analogues were cultured with different anchor sizes, fibrin constituent volumes, cell numbers and growth media for width comparison with cadaveric tendon data, and assessment of 3D morphology with optical coherence tomography. Investigation of the bone anchor component focused on brushite, a phosphate mineral-based bone scaffold material, including assessment of attachment and proliferation of seeded osteoblasts. Model assembly required development of a novel 3D printed mold and silicone impression system for guided tendon analogue culture and angled bone anchor attachment. Optimal design elements and in vitro culture materials ultimately combined to produce a fibroblast-seeded tendon analogue and osteoblast-seeded bone anchor 3D model, co-cultured in 3 anatomical sizes clinically relevant to FDP tendon avulsion. These models can be used as the basis to study enthesis formation and further optimised towards a clinical product for use in FDP avulsion repair

Biomechanical analysis of the Achilles tendon enthesis organ

The tendon/ligament insertional region is a common site of injury, despite the protection offered by the surrounding tissues. These tissues, termed the enthesis organ, form a concept that has only recently been developed and thus has been the focus of only a few publications. The work in this thesis is the first study to perform a biomechanical analysis of the enthesis organ, providing information that may potentially improve injury management methods. A thorough assessment of the enthesis organ biomechanics was made using a number of techniques. Dissecting room cadavers allowed for micro- and macroscopic examination, whilst magnetic resonance imaging and ultrasound provided in vivo images and movie files. Specially fabricated apparatuses were also developed to investigate the load bearing and lubrication regime. A number of the structures within the enthesis organ were identified as being of biomechanical importance. The paratenon/deep fascia was recognised as influencing the insertional angle of the Achilles tendon, possibly in tandem with the superior tuberosity. It was Kager's fat pad, however, that appeared the most highly specialised and influential tissue. This is currently excised when performing arthroscopic ankle surgery, although microscopic examination revealed a highly specialised structure with 3 separate regions. These appeared to allow independent movement of its distal wedge into the retrocalcaneal bursa, a movement that was hypothesised to both equalise a pressure change and to lubricate the contacting surfaces of the enthesis organ. This work concludes that the surgical removal of Kager's fat pad is likely to starve the Achilles tendon enthesis organ of a number of biomechanical functions performed by this tissue, and thus may influence pain relief post-operatively. The excision of the superior tuberosity, however, appears insignificant as it not believed to increase the likelihood of enthesis failure, although preservation of both the superior tuberosity and the deep fascia/paratenon would ensure continued regulation of the Achilles tendon insertion angle

Estudo de retalhos venosos arterializados no modelo experimental de rato wistar e no cadáver humano

RESUMO:Introdução: Os retalhos de perfusão não convencionais (UPFs) são opções reconstrutivas caracterizadas por serem perfundidas exclusivamente por veias. Nos UPFs, pelo menos uma das veias aferentes do retalho é anastomosada a um vaso de alimentação. Normalmente, este vaso de alimentação é uma artéria, e o UPF é chamado de retalho venoso arterializado (AVF). Se o vaso de alimentação for uma veia, o UPF é chamado de retalho venoso (VF). O fluxo de sangue é assegurado na maioria dos casos pela continuidade de uma ou mais veias do UPF com veias vizinhas. Embora os UPFs apresentem várias vantagens potenciais em relação aos retalhos de perfusão convencionais (CFs), raramente são mencionados na literatura, devido às altas taxas de necrose relatadas, particularmente na presença de infeção, e devido a uma má compreensão de seus mecanismos fisiológicos subjacentes. Métodos: Realizámos revisões sistemáticas e metanálises sobre o uso clínico e experimental dos UPFs. Seguidamente, estudamos detalhadamente a anatomia vascular do aspecto ventrolateral do abdômen do rato. Com esse conhecimento, melhoramos o modelo de um retalho convencional colhido na região epigástrica. Posteriormente, desenvolvemos um modelo otimizado de AVF no abdómen do rato. Avaliamos o efeito de transfectar este modelo otimizado com genes de beta defensina humana (BD-2 e BD-3) para aumentar a sobrevivência do retalho na presença de infecção por Pseudomonas aeruginosa e de um corpo estranho. Além disso, comparamos a eficácia dos retalhos neurovenosos arterializados (ANVFs) com outros condutos nervosos com o intuito de reconstruir um hiato de 10 mm no nervo mediano do rato num ambiente de isquémia local. Seguidamente, realizamos estudos cadavéricos para avaliar os aspetos pertinentes da anatomia e histologia das regiões anatômicas comumente usadas para colher UPFs. Finalmente, usamos algumas das informações coletadas para tratar um adolescente com um defeito do pedículo vásculo-nervoso ulnar ao nível do antebraço. Resultados: Estimámos uma taxa de sobrevivência global de UPFs de 89,5% no contexto clínico e de 90,8% em condições experimentais. Clinicamente, houve uma correlação positiva entre a taxa de infeção pós-operatória e a necessidade de um novo retalho (coeficiente de Pearson 0,405; p = 0,001). O fornecimento de sangue ao tegumento abdominal do rato era sobretudo dependente dos vasos axiais, contrastando com o que acontece no Homem. Válvulas venosas foram claramente observadas nesta região. O retalho convencional epigástrico livre e o AVF otimizada homólogo apresentaram taxas de sobrevivência de quase 100% e 76,86 ± 13,67%, respectivamente. Transfectando-se o modelo de AVF com BD-2 e BD-3, observou-se aumento da sobrevivência do retalho e diminuição da formação de biofilmes. Os ANVFs produziram uma recuperação mais completa e mais rápida do que os enxertos nervosos, para a maioria dos parâmetros utilizados para avaliar a regeneração nervosa. Estudos anatómicos e histológicos revelaram que as veias subcutâneas de maiores dimensões encontravam-se envolvidas por desdobramentos da fáscia superficial. Além disso, as veias encontravam-se em profundidades diferentes, estando as maiores colocadas profundamente e as mais pequenas localizadas mais superficialmente. Finalmente, observou-se que os nervos cutâneos superficiais, rotineiramente utilizados como enxertos de nervos autólogos, estavam mais próximos das veias superficiais do que das artérias e respetivas veias comitantes com calibre significativo. Os UPFs podem ser adaptados a defeitos específicos, incluindo pele, tecido celular subcutâneo, tendões, nervos, fáscia muscular e / ou osso em combinações variáveis. O uso de um ANVF no referido adolescente permitiu a reconstrução dos defeitos arterial e nervoso com sucesso. Conclusão: Apesar de muitas questões continuarem por responder em relação à fisiologia, otimização e indicações dos UPFs, parece haver evidência suficiente para apoiar seu uso no âmbito da reconstrução tegumentar e nervosa.ABSTRACT: Introduction: Unconventional perfusion flaps (UPFs) are reconstructive options characterized by being perfused exclusively by veins. In UPFs at least one of the afferent veins of the flap is anastomosed to a feeding vessel. Usually, this feeding vessel is an artery, and the UPF is called an arterialized venous flap (AVF). If the feeding vessel is a vein, the UPF is called a venous flap (VF). The efflux of blood is ensured in most cases by the continuity of one or more of the UPF’s veins with neighboring veins. Although UPFs present several potential advantages relatively to conventional perfusion flaps, they have rarely been mentioned in the clinical literature, due to reported high necrosis rates, particularly in the presence of infection, and due to a poor understanding of their underlying physiologic mechanisms. Methods: We performed systematic reviews and meta-analyses on the clinical and experimental used of UPFs. Followingly, we studied in detail the vascular anatomy of the ventrolateral aspect of the rat’s abdomen. Using this knowledge, we improved a model of a conventional flap (CF) harvested from the epigastric region of the fat. Subsequently, we developed an optimized a model of AVF in the abdomen of the rat. We, then, evaluated the effect of transfecting the optimized model with human beta defensin genes (BD-2 and BD-3) to increase flap survival in the presence of Pseudomonas aeruginosa infection and of a foreign body. Moreover, we compared the efficacy of arterialized neurovenous flaps (ANVFs) with other nerve conduits to reconstruct a 10-mm-long median nerve gap in an ischemic environment in a rat model. Followingly, we performed cadaveric studies to assess pertinent aspects of the anatomy and histology of anatomical regions commonly used to harvest UPFs. Finally, we used some of the information gathered to treat a teenager with an ulnar artery and nerve composite defect at the forearm level. Results: We estimated an overall survival rate of UPFs of 89.5% in the clinical context and of 90.8% in the experimetal setting. Clinically, there was a positive correlation between the rate of postoperative infection and the need of a new flap (Pearson coefficient 0.405; p=0.001). Blood supply to the abdominal integument of the rat was more dependent on axial vessels, comparatively to humans. Venous valves were clearly observed in this region. The free epigastric CF and the homologous optimized AVF presented survival rates of nearly 100%, and 76.86 ± 13.67%, respectively. Transfecting the AVF model with BD-2 and BD-3 increased flap survival, and decreased biofilm formation. ANVFs produced more complete and faster recovery than nerve grafts, for most of the parameters used to assess nerve regeneration. Anatomical and histological studies revealed that large subcutaneous veins were surrounded by doublings of the superficial fascia. Moreover, veins were placed at different depths, with the largest ones being deeply placed and the smallest more superficially placed. Finally, it was noted that superficial cutaneous nerves, routinely used as autologous nerve grafts, were closer to sizeable superficial veins than to arteries and respective comitante veins of significant caliber. UPFs could be tailored to specific defects by including either skin, subcutaneous tissue, tendons, nerves, muscle fascia and/or bone in variable combinations. The used of an ANVF in a teenager allowed the successful reconstruction of both the arterial and nerve defects. Conclusion: Although many question remain to be answered relatively to UPFs physiology, optimization, and indications, there seems to be enough evidence to support their use in the realm of integumentary and nerve reconstruction.RÉSUMÉ: Introduction: Les lambeaux de perfusion non conventionnels (UPF) sont des options de reconstructives caractérisées par une perfusion exclusive pour le veines. Dans les UPF, il ya au moins une des veines afférentes du Lambeau qui est anastomosée à un vase d'alimentation. Habituellement, ce vaisseau d'alimentation est une artère, et l'UPF s'appelle un lambeau veineux arterialisé (AVF). Si le vaisseau est une veine, l'UPF s'appelle un lambeau veineux (VF). L'effusion de sang est assurée dans la plupart des cas par la continuité d'une ou plusieurs veines de l'UPF avec des veines voisines. Bien que les UPF présentent plusieurs avantages potentiels par rapport aux lambeaux de perfusion conventionnels, ils ont rarement été mentionnés dans la littérature clinique, en raison des taux élevés de nécrose reportés, en particulier en présence d'une infection, et en raison d'une mauvaise compréhension de leurs mécanismes physiologiques. Méthodes: Nous avons procédé à deux analyses systématiques et méta-analyses sur l'utilisation clinique et expérimentale des UPFs. Nous avons étudié en détail l'anatomie vasculaire de l'aspect ventral de l'abdomen du rat. À l'aide de cette connaissance, nous avons amélioré un modèle de lambeau conventionnel (CF) récolté dans la région épigastrique de l’abdomen. Par la suite, nous avons développé un modèle optimisé d'AVF dans l'abdomen du rat. Nous avons ensuite évalué l'effet de la transfection du modèle optimisé avec les gènes de la beta-defensine humaine (BD-2 et BD-3) pour augmenter la survie des lambeaux en présence d'une infection pour Pseudomonas aeruginosa et d'un corps étranger. Nous avons aussi comparé l'efficacité des lambeaux neurovenous arterialisés (ANVF) avec d'autres conduits nerveux pour reconstruire un hiatus nerveux de le nerf médian de 10 mm de longueur dans un environnement ischémique dans le modèle de le rat Wistar. Par la suite, nous avons effectué des études cadavériques pour évaluer les aspects pertinents de l'anatomie et de l'histologie des régions anatomiques couramment utilisées pour récolter des UPFs. Enfin, nous avons utilisé une partie des informations recueillies pour traiter un adolescent souffrant d'un défaut composite de l’artère ulnaire e de le nerf ulnaire au niveau de l'avant-bras. Résultats: Nous avons estimé un taux global de survie des UPF de 89,5% dans le contexte clinique et de 90,8% dans le contexte expérimental. Cliniquement, il y avait une corrélation positive entre le taux d'infection postopératoire et la besoin d'un nouveau lambeau (coefficient de Pearson 0,405; p = 0,001). L'approvisionnement en sang du tégument abdominal du rat dépendait davantage des vaisseaux axiaux, comparativement aux humains. Les valves veineuses ont été clairement observées dans cette région. Le lambeau épigastrique conventionnel livre et l'AVF homologue optimisée ont présenté des taux de survie de près de 100% et 76,86 ± 13,67%, respectivement. Transféction de le modèle AVF optimisée avec BD-2 et BD-3 augmenté la survie du lambeau et la formation de biofilm a été diminuée. Les ANVF ont produit une récupération plus complète et plus rapide que les greffes nerveuses, pour la plupart des paramètres utilisés pour évaluer la régénération nerveuse. Des études anatomiques et histologiques ont révélé que les grandes veines sous-cutanées étaient entourées de doublures du fascia superficiel. De plus, les veines ont été placées à différentes profondeurs, les plus grandes étant profondément placées et les plus petites placées plus superficiellement. Enfin, il a été noté que les nerfs cutanés superficiels, habituellement utilisés comme greffes autologues, étaient plus proches des veines superficielles importantes que des artères et des veines comitantes respectives de calibre significatif. Les UPF pourraient être adaptés à des défauts spécifiques en incluant la peau, le tissu sous-cutané, les tendons, les nerfs, le fascia musculaire et / ou l'os dans des combinaisons variables. L'utilisation d'un ANVF chez un adolescent a permis la reconstruction réussie des défauts artériels et nerveux. Conclusion: Bien que beaucoup de questions restent à répondre par rapport à la physiologie, à l'optimisation et aux indications de l'UPF, il semble y avoir suffisamment des preuves scientifiques pour favoriser leur utilisation dans le domaine de la reconstruction de l’integument et des les nerfs

Numerical Simulation in Biomechanics and Biomedical Engineering

In the first contribution, Morbiducci and co-workers discuss the theoretical and methodological bases supporting the Lagrangian- and Euler-based methods, highlighting their application to cardiovascular flows. The second contribution, by the Ansón and van Lenthe groups, proposes an automated virtual bench test for evaluating the stability of custom shoulder implants without the necessity of mechanical testing. Urdeitx and Doweidar, in the third paper, also adopt the finite element method for developing a computational model aim to study cardiac cell behavior under mechano-electric stimulation. In the fourth contribution, Ayensa-Jiménez et al. develop a methodology to approximate the multidimensional probability density function of the parametric analysis obtained developing a mathematical model of the cancer evolution. The fifth paper is oriented to the topological data analysis; the group of Cueto and Chinesta designs a predictive model capable of estimating the state of drivers using the data collected from motion sensors. In the sixth contribution, the Ohayon and Finet group uses wall shear stress-derived descriptors to study the role of recirculation in the arterial restenosis due to different malapposed and overlapping stent conditions. In the seventh contribution, the research group of Antón demonstrates that the simulation time can be reduced for cardiovascular numerical analysis considering an adequate geometry-reduction strategy applicable to truncated patient specific artery. In the eighth paper, Grasa and Calvo present a numerical model based on the finite element method for simulating extraocular muscle dynamics. The ninth paper, authored by Kahla et al., presents a mathematical mechano-pharmaco-biological model for bone remodeling. Martínez, Peña, and co-workers propose in the tenth paper a methodology to calibrate the dissection properties of aorta layer, with the aim of providing useful information for reliable numerical tools. In the eleventh contribution, Martínez-Bocanegra et al. present the structural behavior of a foot model using a detailed finite element model. The twelfth contribution is centered on the methodology to perform a finite, element-based, numerical model of a hydroxyapatite 3D printed bone scaffold. In the thirteenth paper, Talygin and Gorodkov present analytical expressions describing swirling jets for cardiovascular applications. In the fourteenth contribution, Schenkel and Halliday propose a novel non-Newtonian particle transport model for red blood cells. Finally, Zurita et al. propose a parametric numerical tool for analyzing a silicone customized 3D printable trachea-bronchial prosthesis

The biomechanics of human locomotion

Includes bibliographical references. The thesis on CD-ROM includes Animate, GaitBib, GaitBook and GaitLab, four quick time movies which focus on the functional understanding of human gait. The CD-ROM is available at the Health Sciences Library

Subsistence Strategy and Tibial Shape: Identifying Variation in Activity Across the Sudanese Landscape

The growing human tibia is uniquely responsive to repeated activities, resulting in identifiable morphological patterns that can be applied to ancient populations. Much of the bioarchaeological research in this area focuses on the transition to agriculture, noting a decline in bone strength and robusticity with increasing levels of sedentism. However, not all human groups adopted agriculture simultaneously or uniformly, and there continues to be variation in subsistence strategy based on climate, resource availability, and cultural practice. In Sudan, groups have continued to practice nomadic pastoralism alongside agriculture, although sedentary agricultural societies tend to be the focus of most archaeological research in the region. This work examines the difference in tibial morphology between groups utilising different subsistence practices within the same geographic region and archaeological period to explore activity-based changes to the tibia, using both cross-sectional geometry and geometric morphometrics to quantify the difference between tibial cross-sectional shapes at midshaft. The results suggest that while clear differences exist in midshaft tibial shape between the Sudanese groups practicing differing subsistence strategies, there is no one shape that is indicative of nomadism or sedentism; rather, there are general trends indicating higher mobility among more members of the nomadic group and more local movement among the members of the sedentary groups. Further, there is more similarity between females of all groups than males, problematising the idea that all individuals respond to bone remodeling activity in the same way. The conclusions presented here recommend that more research needs to be conducted on tibial shape variation in Sudan and worldwide using geometric morphometrics, as it presents a more nuanced approach than cross-sectional geometry, and that bone remodeling in response to activity must continue to be explored in light of differences in age, sex, and musculature

Computer Aided Quantification of Pathological Features for Flexor Tendon Pulleys on Microscopic Images

Quantifying the pathological features of flexor tendon pulleys is essential for grading the trigger finger since it provides clinicians with objective evidence derived from microscopic images. Although manual grading is time consuming and dependent on the observer experience, there is a lack of image processing methods for automatically extracting pulley pathological features. In this paper, we design and develop a color-based image segmentation system to extract the color and shape features from pulley microscopic images. Two parameters which are the size ratio of abnormal tissue regions and the number ratio of abnormal nuclei are estimated as the pathological progression indices. The automatic quantification results show clear discrimination among different levels of diseased pulley specimens which are prone to misjudgments for human visual inspection. The proposed system provides a reliable and automatic way to obtain pathological parameters instead of manual evaluation which is with intra- and interoperator variability. Experiments with 290 microscopic images from 29 pulley specimens show good correspondence with pathologist expectations. Hence, the proposed system has great potential for assisting clinical experts in routine histopathological examinations

Global Perspective on Diabetic Foot Ulcerations

Over the last decade, it is becoming increasingly clear that diabetes mellitus is a global epidemic. The influence of diabetes is most readily apparent in its manifestation in foot complications across cultures and continents. In this unique collaboration of global specialists, we examine the explosion of foot disease in locations that must quickly grapple with both mobilizing medical expertise and shaping public policy to best prevent and treat these serious complications. In other areas of the world where diabetic foot complications have unfortunately been all too common, diagnostic testing and advanced treatments have been developed in response. The bulk of this book is devoted to examining the newest developments in basic and clinical research on the diabetic foot. It is hoped that as our understanding of the pathophysiologic process expands, the devastating impact of diabetic foot complications can be minimized on a global scale

Studies in physiology

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The effect of stimulus modality and position on the discharge of units in the superior colliculus. Proc. Can. Fed. Biol. Soc. 9: 47. • • Abrahams, V. C. 1966. The form of averaged evoked potentials in the chloralosed cat and the effect of background activity. Proc. Can. Fed. Biol. Soc. 9: 47. • • Abrahams, V. C. 1966. Some factors affecting the form of averaged evoked potentials. J. Physiol. 185: 60-61P. • • Abrahams, V. C., and Falchetto, S. 1966. Patterns of unit response in the cat superior colliculi elicited by non-visual stimuli. The Physiologist 9: 128. • • Abrahams, V. C. , and Williams, R. L. 1967. Blood flow, heart rate, and blood pressure alterations elicited by direct electrical stimulation of lower brain stem. J. Physiol. 189: 58-59P. • • Abrahams, V. C. , and Langworth, E. P. 1967. The contribution of background electrical activity to the form of averaged evoked potentials in chloralose anaesthetized cats. Exp. Neurol. 18: 253-266. • • Abrahams, V. C. and Falchetto, S. 1967. Hind leg ataxia following section of a nerve to a neck extensor muscle. Proc. Can. Fed. Biol. Soc., 10: 145. • • Abrahams, V. C. 1968. Cervico-lumbar spinal interactions involving a brain pathway. Proc. Can. Fed. Biol. Soc., 11: 74. • • Abrahams, V. C., Butler, D. and Falchetto, S. 1968. A spinal-brain-spinal reflex and hind limb ataxia of cervical origin. Fed. Proc. , 27: #2. • • Abrahams, V. C., Milligan, J. V. and Falchetto, S. 1968. Determination of "significant" differences in unit discharge patterns. Proc. Can. Soc. Med. Biol. Eng. • • Abrahams, V. C. and Falchetto, S. 1968. Ataxia of the hind limbs of the cat following section of nerves to a neck extensor muscle and a possible reflex substrate. Proc. 24th Int. Congr. Physiol. Sci. • • Abrahams, V. C., Butler, D. and Daynes, J. 1969. A cortical relay site in cervico-lumbar interactions in cats. Proc. Can. Fed. Biol. Soc., 12: 55. • • Abrahams, V. C., Butler, D. and Daynes, J. 1969. Proprioceptive relays to the cerebral cortex and their significance in intraspinal organization. The Physiologist, 12: 154. • • Abrahams, V. C. 1969. Pathways involved in potentiation of lumbo-sacral reflexes by biventer cervicis nerve stimulation. Proc. Can. Physiol. Soc. • • Abrahams, V. C. and Falchetto, S. 1969. Hind leg ataxia of cervical origin and cervico-lumbar spinal interactions with a supratentorial pathway. J. Physiol. 203: 435-447. • • Abrahams, V. C. 1969. Proprioceptive projection areas of the cerebral cortex and their relation to cervico-lumbar spinal interactions. J. Physiol., 204: 82-83. • • Abrahams, V. C. and Teare, J. L. 1969. Peripheral pathways and properties of uterine afferents in the cat. Can. J. Physiol, and Pharmacol., 47: 576-577. • • Jagannthan, T., Foote, J., Abrahams, V. C., Bruce, A. W., Hetherington, R. F., Lywood, D. W. and English, C. J. 1969. A new approach to bladder evacuation: Studies in dogs. Inv. Urol., 7: 15-22. • • Abrahams, V. C. 1969. Intraspinal mechanisms in cortically mediated descending cervicolumbar reflex interactions. Can. Physiol., 1: 37. • • Abrahams, V. C. 1970. Computers in Medical Diagnosis. IEEE, Student J., 8: 35-38. • • Abrahams, V. C. 1970. Cervico-lumbar reflex interactions involving a proprioceptive receiving area of the cerebral cortex. J. Physiol., 209: 45-56. • • Abrahams, V. C. 1970. Intraspinal excitability changes during cortically mediated descending cervico-lumbar reflex interactions. Fed. Proc. 29_: #824, p.391. • • Abrahams, V. C. 1970. Individual mechanisms activated in descending spino-spinal activity in the chloralose anaesthetized cat. J. Physiol., 210: 175-176. • • Abrahams, V. C. 1971. Spino-spinal mechanisms in the chloralose anaesthetized cat. J. Physiol., 215: 755-768. • • Abrahams, V. C. 1971. Some effects on vestibulo-spinal outflow at lumbosacral levels from neck muscle afferents. J. Physiol., 215: 49-50. • • Rose, P. K. and Abrahams, V. C. 1972. Some characteristics of the neck muscle proprioceptive input to the superior colliculus of the cat. Can. Fed. Biol. Soc., 15: #732. • • Abrahams, V. C. 1972. Site of fixation in the spinal cord of the cat. Can. Fed. Biol. Soc., 1_5: #693. • • Abrahams, V. C. and Rose, P. K. 1972. Proprioceptive connections to the superior colliculi of the cat. Fed. Proc., 31: 383, #929. • • Abrahams, V. C. 1972. Neck muscle proprioceptors and a role of the cerebral cortex in postural reflexes in subprimates. Rev. Can. Biol., 31_: suppl., 115-130. • • Abrahams, V. C. 1972. Neck muscle proprioceptives and vestibulospinal outflow at lumbosacral levels. Can. J. Physiol, and Pharmacol., 50: 17-21. • • Abrahams, V. C. and Daynes, J. 1972. Fixation of inhibition of a spinal reflex by electrical stimulation of the medulla.' Soc. Neurosc., 2nd Ann. Meeting, p. 204. • • Abrahams, V. C. and Rancier, F. 1973. ATPase distribution in dorsal neck muscles of the cat. Can. J. Physiol, and Pharmacol. 51: 549-552. • • Rose, P. K. and Abrahams, V. C. 1973. An electrophysiological demonstration of extraocular muscle receptor projections to the superior colliclus in the cat. Can. Physiol., 4: 47. • • Rose, P. K. and Abrahams, V. C. 1973. Extraocular muscle proprioceptive projections to the superior colliculus in the cat. Fed. Proc. 32: 340, #698. • • Abrahams, V. C. and Rose, P. K. 1973. Afferent connections of cells in the superior colliculus of the cat giving rise to the tectospinal tract. Soc. Neurosc., 3rd Ann. Meeting, p. 336. • • Abrahams, V. C. 1974. On the induction of prolonged change in the functional state of the spinal cord. Advances in Neurology, Vol. 4, Pain. Raven Press, New York, pp. 243-251. • • Abrahams, V. C., Rancier, F., and Rose P. K. 1974. Neck muscle and extraocular receptors and their relationship to the tectospinal tract. Advances in Behavioural Biology, 7: 191. Plenum Publishing Corporation. • • Richmond, F. J. and Abrahams, V. C. 1974. Muscle spindles in the dorsal neck muscles of the cat. Can. Physiol. 4: 204. Rose, P. K. and Abrahams, V. C. 1974. Afferent connections to systems descending to neck motoneurons. Can. Physiol. 4: 205. • • Abrahams, V. C., Richmond, F. J. and Rose, P. K. 1974. Proprioceptive and retinal afferent connections to the superior colliculus of the cat and their connections to the tectospinal tract. J. Physiol. 244: 101. • • Abrahams, V. C., Richmond, F. J. and Rose, P. K. 1974. Basic physiology of the head-eye movement system. Wenner-Gren Symposium Series: Basic Mechanisms of Ocular Motility and Their Clinical Implications. Eds. G. Lennerstrand and P. Bach-y-rita. Pergamon Press, Oxford, 1975. • • Richmond, F. J. and Abrahams, V. C. 1974. Enzyme distribution in extrafusal fibres of cat dorsal neck muscles. Fed. Proc., 33: 103. • • Abrahams, V. C. and Rose, P. K. 1974. Fore and hind-limb muscle afferent projections to the superior colliculus of the cat. J. Physiol. 244: 45. • • Abrahams, V. C. and Rose, P. K. 1974. Medullary projections of Gp I and II afferents from neck muscle in the cat. Soc. Neurosc., 4th Ann. Meeting, p. 111. • • Abrahams, V. C. and Rose, P. K. 1975. Projections of extraocular, neck muscle, and retinal afferents to superior colliculus in the cat: their connections to the cells of origin of the tectospinal tract. J. Neurophysiol. 38: 10-18. • • Abrahams, V. C. and Rose, P. K. 1975. The spinal course and distribution of fore and hind-limb muscle afferent projections to the superior colliculus of the cat. J. Physiol. 247: 117-130. • • Abrahams, V. C. and Rose, P. K. 1975. The effect of passive eye movement on unit discharge in the superior colliculus of the cat. Brain Research, 974 95-106. • • Abrahams, V. C. and Rose, P. K. 1975. Velocity and displacement characteristics of passive eye movements which initiate unit discharge in the superior colliculus. J. Physiol. 246: 101. • • Abrahams, V. C., Richmond, F. J. and Rose. P. K. 1975. Absence of monosynaptic reflex in dorsal neck muscles of the cat. Brain Research 92: 130-131. • • Rose, P. K. and Abrahams, V. C. 1975. Spinal and medullary projections of afferents from dorsal neck muscles. Can. Physiol. 6: 50. • • Richmond, F. J. and Abrahams, V. C. 1975. Muscle spindle complexes in the dorsal muscles of the cat neck. Can. Physiol. 6: 48. • • Richmond, F. J. and Abrahams, V. C. 1975. The distribution and morphology of muscle spindles in dorsal neck muscles of the cat. Fed. Proc., 34: 388. • • Richmond, F. J. and Abrahams, V. C. 1975. Morphology and Enzyme Histochemistry of dorsal muscles of the cat neck. J. Neurophysiol., 38: 1312-1321. • • Richmond, F. J. and Abrahams, V. C. 1975. Morphology and distribution of muscle spindles in dorsal muscles of the cat neck. J. Neurophysiol., 38: 1322-1339. • • Rose, P. K. and Abrahams, V. C. 1975. Unit response in the superior colliculus and its relationship to activation of receptors in extraocular muscle. Proc. Fed. Biol. Soc., 18: 147. • • Abrahams, V. C. 1975. Proprioceptive projections to the spinal nucleus of the Vth nerve in the cat. Proceedings of First World Congress of the International Association for the Study of Pain. • • Abrahams, V. C. and Richmond, F. J. 1975. The organization of muscle afferent and cutaneous input to the upper cervical cord in the cat. 5th Annual Meeting, Society for Neuroscience, Neuroscience Abstract 1_, #248, p. 160. • • Richmond, F. J. and Abrahams, V. C. 1976. Physiological properties of dorsal muscles of the cat neck. Fed. Proc., 3_5: 291. • • Abrahams, V. C. and Rose, P. K. 1976. Tectospinal and tectoreticular cells their distribution and afferent connections. Fed. Proc., 35: 484. • • Abrahams, V. C., Anstee, G. and Richmond, F. J. 1976. Further studies on the organization of the upper cervical cord. Proc. Can. Fed. Biol. Soc., 19th Ann. Meeting, 1976. Richmond, F. J. and Abrahams, V. C. 1976. Physiological properties of dorsal muscles of the cat neck. Can. Physiol., 7: 50. • • Anstee, G. C. B., Richmond, F. J. and Abrahams, V. C. 1976. Sensory and motor fibre spectra of neck muscle nerves in the cat. Can. Physiol., 7: 16. • • Richmond, F. J., Anstee, G. B. C., Sherwin, L., and Abrahams, V. C. 1976. Motor and sensory fibres of neck muscle nerves in the cat. Can. J. Physiol, and Pharmacol., 54: 294-304. • • Abrahams, V. C., Richmond, F. J. and Rose, P. K. 1977. Spinal and medullary projections from neck muscle afferents in the cat. J. Neurophysiol. - manuscript for submission. • • Abrahams, V. C. 1977. The motor system of the head. A short review. In press. • • Rose, P. K. and Abrahams, V. C. 1977. Tectospinal and tectoreticular cells. A comparison of their distribution within the superior colliculus and their afferent connections. J. Neurophysiol., - manuscript for submission