Litigation and complaints associated with day-case anaesthesia

<span class="paragraphSection">1F012A033A06</span>

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Anaesthetic management of patients requiring vascular access surgery for renal dialysis

<span class="paragraphSection">1A012A033A05</span>

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Anaesthesia and critical care for patients in the criminal justice system

<span class="paragraphSection">1E032A103I00</span>

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A MISSENSE MUTATION IN GRM6 REDUCES BUT DOES NOT ELIMINATE MGLUR6 EXPRESSION OR ROD DEPOLARIZING BIPOLAR CELL FUNCTION

GRM6 encodes the metabotropic glutamate receptor 6 (mGluR6) used by retinal depolarizing bipolar cells (DBCs). Mutations in GRM6 lead to DBC dysfunction, and underlie the human condition autosomal recessive complete congenital stationary night blindness. Mouse mutants for Grm6 are important models for this condition. Here we report a new Grm6 mutant, identified in an electroretinogram (ERG) screen of mice maintained at The Jackson Laboratory. The Grm6^nob8 mouse has a reduced amplitude b-wave component of the ERG, which reflects light-evoked DBC activity. Sequencing identified a missense mutation that converts a highly conserved methionine within the ligand binding domain to leucine (p.Met66Leu). Consistent with prior studies of Grm6 mutant mice, the laminar size and structure in the Grm6^nob8 retina were comparable to control. The Grm6^nob8 phenotype is distinguished from other Grm6 mutants that carry a null allele by a reduced but not absent ERG b-wave, decreased but present expression of mGluR6 at DBC dendritic tips, and mislocalization of mGluR6 to DBC somas. Consistent with a reduced but not absent b-wave, there were a subset of retinal ganglion cells whose responses to light onset have times to peak within the range of those in control retinas. These data indicate that the p.Met66Leu mutant mGluR6 is trafficked less than control. However, the mGluR6 that is localized to the DBC dendritic tips is able to initiate DBC signal transduction. The Grm6^nob8 mouse extends the Grm6 allelic series and will be useful for elucidating the role of mGluR6 in DBC signal transduction and in human disease.

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Split-arm swinging: the effect of arm swinging manipulation on inter-limb coordination during walking

Human locomotion is defined by bilateral coordination of gait (BCG) and shared features with the fore-hind limb coordination of quadrupeds. The objective of the present study is to explore the influence of arm swinging (AS) on BCG. Sixteen young healthy individuals (eight females; eight right motor-dominant, eight left-motor dominant) participated. Participants performed 10 walking trials (2 min). In each of the trials AS was unilaterally manipulated (e.g., arm restriction, weight on the wrist) bilaterally manipulated, or not manipulated. The order of trials was random. Walking trials were performed on a treadmill (TM). Gait kinematics were recorded by a motion capture system. Using feedback-controlled belt speed allowed the participants to walk at a self-determined gait speed. Effects of the manipulations were assessed by AS amplitudes and the phase coordination index (PCI), which quantifies the left-right anti-phased stepping pattern. Most of the AS manipulations caused an increase in PCI values (i.e., reduced lower limb coordination). Unilateral AS manipulation had a reciprocal effect on the AS amplitude of the other arm such that, for example, over-swinging of the right arm led to a decrease in the AS amplitude of the left arm. Side of motor dominance was not found to have a significant impact on PCI and AS amplitude. The present findings suggest that lower limb BCG is markedly influenced by the rhythmic AS during walking. It may thus be important for gait rehabilitation programs targeting BCG to take AS into account.

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Evidence of adaptations of locomotor neural drive in response to enhanced intermuscular connectivity between the triceps surae muscles of the rat

The aims of this study were to investigate changes (i) in the coordination of activation of the triceps surae muscle group and (ii) in muscle belly length of soleus (SO) and lateral gastrocnemius (LG) during locomotion (trotting) in response to increased stiffness of intermuscular connective tissues in the rat. We measured muscle activation and muscle belly lengths, as well as hindlimb kinematics, before and after an artificial enhancement of the connectivity between SO and LG muscles obtained by implanting a tissue-integrating surgical mesh at the muscles' interface. We found that SO muscle activation decreased to 62%, while activation of LG and medial gastrocnemius muscles increased to 134% and 125%, respectively, compared to the levels measured pre-intervention. Although secondary additional or amplified activation bursts were observed with enhanced connectivity, the primary pattern of activation over the stride and the burst duration were not affected by the intervention. Similar muscle length changes after manipulation were observed, suggesting that length feedback from spindle receptors within SO and LG was not affected by the connectivity enhancement. We conclude that peripheral mechanical constraints given by morphological (re)organization of connective tissues linking synergists are taken into account by the central nervous system. The observed shift in activity towards the gastrocnemius muscles after the intervention suggests that these larger muscles are preferentially recruited when the soleus has a similar mechanical disadvantage in that it produces an unwanted flexion moment around the knee.

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Predicting the response of striatal spiny neurons to sinusoidal input

Spike timing effects of small amplitude sinusoidal currents were measured in mouse striatal spiny neurons firing repetitively. Spike timing reliability varied with the stimulus frequency. For frequencies near the cell's firing rate, the cells altered firing rate to match the stimulus and became phase-locked to it. The stimulus phase of firing during lock depended on the stimulus frequency relative to the cell's unperturbed firing rate. Interspike intervals during sinusoidal stimulation were predicted using an iterative map constructed from the cells' phase resetting curve. Variability of interspike intervals was reduced by stimulation at all frequencies higher than about half the cells unperturbed rate, and interspike intervals were accurately predicted by the map. Long sequences of spike times were predicted by iterating on the map. The accuracy of that prediction varied with frequency. Spike time predictability was highest near and during phase lock. The map predicted the phase of firing on the input and its dependence on stimulus frequency. Prediction errors, when they occurred, were of two kinds: unpredicted variation in interspike interval from intrinsic cell noise, and accumulation of prediction errors from previous interspike intervals. Each type of prediction error arose from a different mechanism, and their impact was also predicted from the phase model. When two oscillatory input currents were presented simultaneously, striatal neurons responded selectively to only one of them, the one closest in frequency to the cell's unperturbed firing rate. Their spike times encoded the frequency and phase of that single oscillatory input.

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