Understanding the piezoelectricity mechanism is crucial for developing new materials for better performance. Here, we developed a nanogenerator based on the ZnO thin films having various TC(002) values. The output current well correlated to the magnitude of (002) texture coefficient (TC(002)). Additionally, the TC(002)-dependent photovoltaic and rectification properties are observed. When the film is subjected to persistent compression, the photovoltaic, rectification, and piezoelectric properties fade away. Based on our observation that the ZnO polar structure always shows a spontaneous electron field (SEF), we thus propose a new piezoelectricity mechanism. The [001]-orientated ZnO thin film with the SEF is equivalent to a capacitor, the compression functions as a discharging process, and the removal of the external stress serves as a charging process. The physical mechanism provides an insight into various energy conversion processes that will inspire advanced designs of high-performance nanogenerators, solar cells, and other optoelectronic devices.

In the present study, responses of the somatosensory cortex to sensory input of ten human volunteers were investigated during a one-back task with different conditions of attention. During an condition of attention subjects were requested to detect a predefined sequence of tactile stimuli applied to two different fingers of the dominant hand while a series of visual stimuli was presented simultaneously with an asynchronous stimulus-onset to the tactile stimuli. During an condition of distraction subjects received the identical series of visual and tactile stimuli like in the condition of attention but were now requested to detect a predefined stimulus sequence within the visual stimulus domain. In both conditions, somatosensory evoked magnetic fields (SEFs) to the tactile stimuli were recorded by means of a 31-channel magnetoencephalograph (MEG) from subjects' contralateral primary somatosensory cortex. The mean global field power, the dipole strength, the maximum current density, and the first component of the singular value decomposition (SVD) of magnetic fields were used to compare early components of the SEF in the conditions of attention versus distraction. Surprisingly, results revealed significant decreases of measures of all four parameters during the condition of attention as compared to the condition of distraction indicating that early responses of the primary somatosensory cortex became significantly reduced in the condition of attention. We hypothesize that changes in the centre-periphery-relationship of receptive fields in the primary somatosensory cortex may account for this unexpected result.

The analysis of somatosensory evoked potentials (SEP) and / or fields (SEF) is a well-established and important tool for investigating the functioning of the peripheral and central human nervous system. A standard technique to evoke SEPs / SEFs is the stimulation of the median nerve by using a bipolar electrical stimulus. We aim at an alternative stimulation technique enabling stimulation of deep nerve structures while reducing patient stress and error susceptibility. In the current study, we apply a commercial transcranial magnetic stimulation system for peripheral magnetic stimulation of the median nerve. We compare the results of simultaneously recorded EEG signals to prove applicability of our technique to evoke SEPs including low frequency components (LFC) as well as high frequency oscillations (HFO). Therefore, we compare amplitude, latency and time-frequency characteristics of the SEP of 14 healthy volunteers after electric and magnetic stimulation. Both low frequency components and high frequency oscillations were detected. The HFOs were superimposed onto the primary cortical response N20. Statistical analysis revealed significantly lower amplitudes and increased latencies for LFC and HFO components after magnetic stimulation. The differences indicate the inability of magnetic stimulation to elicit supramaximal responses. A psycho-perceptual evaluation showed that magnetic stimulation was less unpleasant for 12 out of the 14 volunteers. In conclusion, we showed that LFC and HFO components related to median nerve stimulation can be evoked by peripheral magnetic stimulation.

The purpose of this study was to evaluate the antagonism of acupuncture-induced sedation by electroencephalographic spectral edge frequency (SEF) 95 in 10 healthy intact male Miniature Schnauzer dogs (4.2-6.1kg; 2-3 years old) without neurological disorder. The GV20 and Yintang acupoints were administered for 20 min. While the dogs were conscious, SEF 95 baseline values were recorded at 2-min intervals for 4 min. Then acupuncture was administered at the GV20 and Yintang acupoints. During the acupuncture procedure, the SEF 95 values were recorded at 2-min intervals for 10 min. Subsequently, antagonist drugs, naloxone and atipamezole, were administered through the cephalic vein. The SEF 95 values were then measured again at 2-min intervals for 10 min. Those values were found to be significantly increased after administration of atipamezole in dogs sedated by acupuncture at the GV20 and Yintang acupoints (p<0.05). However, the SEF 95 values in the naloxone groups did not show any significant changes before and after administration of the antagonist. It was concluded that sedation induced by acupuncture at the GV20 and Yintang acupoints might be partially associated with the alpha(2)-adrenergic system.

Eighteen sika deer (Cervus nippon) and 14 red deer (C. elaphus scoticus) were sampled from two areas where these closely related species are sympatric. Total body weight, carcass weight, age class, sex, and internal parameters (e.g. liver weight, kidney weight, rumen volume) were recorded. Samples of rumen wall mucosa taken from the dorsal rumen wall, atrium ruminis, caudoventral blindsac, and ventral rumen wall were used to compare rumen morphology between the two species (and also any area, sex, and age effects). Sika deer had significantly lower papilla densities in three of the four rumen wall sites and significantly smaller papillae than red deer in two of the four sites. Surface enlargement factors (SEFs) were calculated to provide comparisons of the effective absorptive surface within the rumens of the two species. The mean SEF for sika deer (4.76) was significantly less that for red deer (6.77), which suggests a greater degree of adaptation to digesting fibrous forage. In the central North Island, New Zealand, where the habitat has been considerably modified by introduced herbivores over the last century and food resources are depleted, such an adaptation would confer a competitive advantage on sika deer over red deer. It is postulated that this diet-related difference largely accounts for the ongoing replacement of red deer by sika deer where these two species are sympatric.

BACKGROUND

High-frequency oscillations (HFO) ranging between 300-900 Hz have been shown to be superimposed on an early component of somatosensory evoked potentials (SEP) to median nerve stimulation in humans. Although the HFO are speculated to be a localized activity of the GABAergic inhibitory interneurons, the significance in the epileptogenicity remains unclear. The authors of this study analyzed HFO using magnetoencephalography in patients with benign rolandic epilepsy (BRE) to clarify the neurophysio-logical basis of rolandic discharges (RD).

METHODS

Nine patients with BRE and six patients with other epileptic syndrome (non-BRE) participated in the study. Somatosensory evoked fields (SEF) including HFO to median nerve stimulation were measured in a magnetically shielded room with a 37-channel neuromagnetometer.

RESULTS

Two kinds of HFO, 300 Hz- and 600 Hz-HFO, were identified and the duration of the HFO in patients with BRE was significantly longer than that in patients with non-BRE.

CONCLUSIONS

The results suggest that the longer part of HFO (P30m-related) is closely related to the pathogenesis of RD and that the longer HFO in patients with BRE might be mediated by altered GABAergic inhibition modulated by the cholinergic system.

Interhemispheric transfer is necessary for sensory integration and coordination of body sides. We studied how somatosensory input from one body side may reach both body sides. First, we investigated with 17 healthy adults in which uni- and bilateral brain areas were involved in consecutive stages of automatic sensory processing of non-nociceptive peripheral stimulation. Somatosensory evoked fields (SEFs) to electrical stimulation were recorded with 306-channel magnetoencephalography in two conditions. First, SEFs were registered following sensory radial nerve (RN) stimulation to dorsal surface of the right hand and second, following median nerve (MN) stimulation at the right wrist. Cortical activations were located in contralateral postcentral gyrus after MN and RN stimulations and in bilateral operculo-insular area after RN stimulation. First component occurred earlier after MN than RN stimulation. Middle latency components had similar latencies with stronger activation in contralateral postcentral gyrus after MN than RN stimulation. Interestingly, long latency components located in bilateral operculo-insular area after RN stimulation showed latency difference between hemispheres, i.e. activation peaked earlier in contralateral than in ipsilateral side. Additional experiments comparing novel intracutaneous nociceptive, RN and MN electrical stimuli confirmed bilateral long latency activation elicited by each stimulus type and highlighted latency differences between hemispheres. Variations in activation of bilateral operculo-insular areas may corroborate their role in pain network and in multisensory integration. Our findings imply that these areas present a relay station in multisensory stimulus detection.

BACKGROUND

Use of a single bolus of a hypnotic together with non-depolarizing muscle relaxants for anaesthesia induction may cause inappropriate light levels of anaesthesia (ILLA). The purpose of this study was to compare the incidence of ILLA during anaesthesia induction using either cis-atracurium (CIS) or succinylcholine (SUC).

METHODS

Patients (n = 65) received fentanyl and propofol. Relaxants were randomly chosen and were either CIS 0.15 mg/kg, or SUC 1 mg/kg. After achieving relaxation, ILLA were assessed double-blinded by the isolated forearm technique and electroencephalogram -derived values.

RESULTS

Time from induction to complete relaxation was 335 ± 55 s with CIS and 141 ± 26 s with SUC. Nine patients in the CIS group (26%), but no patient in the SUC group responded to commands before endotracheal intubation (P < 0.01). During the entire induction up to 1 min after intubation in the CIS group, 24 of 35 patients (68%) showed 31 episodes of ILLA, as defined as responsiveness to commands and spontaneous movements. With SUC, 8 of 30 patients (27%) showed 11 episodes of ILLA (P < 0.01). In patients with ILLA, state entropy (SE) and spectral edge frequency (SEF) were 68 ± 10 (mean ± standard deviation) and 17 ± 4 Hz, respectively, and in patients without ILLA, SE and SEF were 40 ± 14 and 12 ± 3 Hz, respectively (P < 0.01).

CONCLUSIONS

The onset time of a muscle relaxant has substantial impact on the incidence of ILLA during induction of anaesthesia. Entropy and SEF may indicate the presence of ILLA.

Somatosensory evoked magnetic fields (SEFs) following painful electrical stimulation of the sural nerve were examined in 6 normal subjects. Equivalent current dipoles (ECDs) of the deflections shorter than 100 ms in latency were located in the foot area of the primary sensory cortex (SI) in the contralateral hemisphere following both weak and painful stimulations. Two main deflections, N150m-P150m and N250m-P250m, were independently identified only following painful stimulation. ECDs of the N150m-P150m were considered to be located in bilateral second sensory cortices (SII). ECDs of the N250m-P250m were identified in multiple areas including bilateral cingulate cortices and SII. These findings were consistent with the pain-related SEFs following upper limb stimulation. Therefore, we considered that bilateral SII and the cingulate cortices were activated by the painful stimulation and that pain-specific brain activities in those areas did not depend on the stimulation site.

Recent findings indicate that monkeys can report their confidence in perceptual decisions, and that this information is encoded in neurons involved in making decisions, including the lateral intraparietal area (LIP) and the supplementary eye field (SEF). A key issue to consider when studying confidence is that decision accuracy often correlates with confidence. Expanding on work performed in humans, we designed a novel task for monkeys that dissociates perceptual information leading to decisions from perceptual information leading to confidence reports. Using this task, we recently showed that decoded ensemble activity recorded from the superior colliculus (SC) reflected decisions rather than confidence reports. However, our previous population analysis collapsed over multiple SC neuronal types and therefore left open the possibility that first, individual discharge rates might encode information related to confidence and second, that different neuronal cell types within the SC might signal decision confidence independently of decision accuracy. We found that when decision accuracy and decision confidence co-varied, modulation occurred primarily in buildup neurons. However, isolating decision confidence from decision accuracy uncovered that only a few, primarily buildup neurons showed signals correlating uniquely with decision confidence, and the effect sizes were very small. Based on this work and our previous work using decoding methods, we conclude that neuronal signals for decision confidence, independent of decision accuracy, are unlikely to exist at the level of single or populations of neurons in the SC. Together, these results call into question normative models of confidence based on the optimal read-out of decision signals.

Interleukin-17 receptor D (IL17RD or IL-17RD) also known as Sef (similar expression to fibroblast growth factor), is a single pass transmembrane protein that is reported to regulate several signaling pathways . IL17RD was initially described as a feedback inhibitor of fibroblast growth factor (FGF) signaling during zebrafish and frog development. It was subsequently determined to regulate other receptor tyrosine kinase signaling cascades as well as several proinflammatory signaling pathways including Interleukin-17A (IL17A), Toll-like receptors (TLR) and Interleukin-1α (IL1α) in several vertebrate species including humans. This review will provide an overview of IL17RD regulation of signaling pathways and functions with emphasis on regulation of development and pathobiological conditions. We will also discuss gaps in our knowledge about IL17RD function to provide insight into opportunities for future investigation. Video Abstract.

Keywords: Cellular signaling; Fibroblast growth factor (FGF); Fibroblast growth factor receptor (FGFR); Interleukin-17; Interleukin-17 receptor D (IL17RD); Sef.

The objective of this study is to propose a method for preliminary processing of the experimental data from an inflation-extension test on tubular arterial specimens. The method is based on the condition for existence of a strain energy function (SEF) and can be used to verify whether the data from a certain experiment validate the assumption that the tissue can be considered as an elastic solid. As an illustrative example of the proposed method, experimental data for a porcine renal artery are used and the sources of the error in satisfying the condition of elasticity are analyzed. The results lead to the conclusion that the experimental data for a renal artery validate that the artery exhibits an elastic mechanical response and a constitutive formulation based on the existence of the SEF is justified. A modification of the proposed method for the case of an in-plane biaxial stretching test of mechanically isotropic and orthotropic tissues is considered.

Epilepsy is a network disease. The primary somatosensory cortex (S1) is usually considered to be intact, but could be subclinically disturbed based on abnormal functional connectivity in patients with temporal lobe epilepsy (TLE). We aimed to investigate if the S1 of TLE is abnormally modulated. Somatosensory evoked magnetic fields (SEFs) evoked by median nerve stimulation were recorded in each hemisphere of 15 TLE patients and 28 normal subjects. All responses were separately averaged in the awake state and light sleep using background magnetoencephalography. Latency and strength of the equivalent current dipole (ECD) was compared between the groups for the first (M1) and second peaks. Latencies showed no significant differences between the groups in either wakefulness or light sleep. ECD strengths were significantly lower in TLE patients than in controls only during wakefulness. The reduction of M1 ECD strength in the awake state is significantly correlated with duration of epilepsy. SEFs of TLE patients showed pure ECD strength reduction without latency delay. The phenomenon occurred exclusively during wakefulness, suggesting that a wakefulness-specific modulator of S1 is abnormal in TLE. Repetitive seizures may gradually insult the modulator of S1 distant from the epileptogenic network.

BACKGROUND

To study the impact of aggressive decongestion in limbs with lymphedema without subcutaneous echo-free space (SEFS) in subcutaneous tissue ultrasonography.

METHODS

In 13 patients with arm lymphedema (ALE) (13 arms) and 16 patients with leg lymphedema (LLE) (18 legs) without SEFS, an aggressive decongestion was performed as the first phase of complex decongestive therapy. Measurements of circumference and calculation of limb volume were performed before and after the treatment.

RESULTS

In ALE, no significant reduction in arm volume (median -63 [range -251 to 176] mL) or edema ratio (-4 [-15 to 12]%) was confirmed. On the other hand, a small but significant reduction in leg volume (-207 [-834 to 131] mL, P < 0.001) and edema ratio (-4 [-14 to 2]%, P < 0.01) was confirmed in LLE.

CONCLUSIONS

In limbs with lymphedema without SEFS, the impact of aggressive decongestion seemed limited.

OBJECTIVE

to describe the characteristics of the color density spectral array (CDSA) of bilateral bispectral index (b-BIS) monitoring system in patients with comatose nonconvulsive status epilepticus (NCSE). We hypothesized that CDSA could be helpful for monitoring NCSE in critically subjects if continuous EEG (cEEG) is not available.

METHODS

we retrospectively analyzed comatose patients admitted to our neurological intensive care unit (NICU) from 2011 to 2014 with a diagnosis of definitive NCSE that underwent b-BIS monitoring for at least 24h to guide anesthetic sedation. Clinical, electroencephalography and neuroimaging findings were analyzed. Moreover, all parameters from the b-BIS data including the CDSA were reviewed during periods of NCSE (NCSE pattern) and profound sedation (sedation pattern).

RESULTS

15 NCSE patients were included. The delay from the diagnosis of NCSE to the onset of b-BIS monitoring was 8 (0.5-31)h and total time of b-BIS monitoring 7.8±6.5 days. CDSA during NCSE pattern was characterized by continuous or intermittent red and dark red tones, spectral edge frequency (SEF) in the delta-theta range, with or without asymmetry and BIS number trend with significant variability. In contrast, CDSA during sedation revealed predominance of orange, yellow, green and occasionally blue tones, SEF in the alpha-beta range, absence of asymmetry and stability of BIS number.

CONCLUSIONS

b-BIS monitoring system and, in particular, CDSA used by nonexpert NICU personnel may be helpful to follow-up episodes of NCSE, to detect recurrences of nonconvulsive seizures (NCSzs), and to monitor profound anesthetic therapy in comatose patients when cEEG is not available.

Endometriosis affects a significant number of young premenopausal women. Quite apart from the medical challenges, endometriosis is a relevant burden for healthcare and social security systems. Standardized quality indicators for the treatment of endometriosis have not previously been systematically verified. The three-stage study QS ENDO was initiated to record and improve the reality and quality of care. One of its aims is to create quality indicators for the diagnosis and treatment of endometriosis. For the first stage of QS ENDO Real, letters were sent to all 1014 gynecological departments in the German-speaking area of Europe (the DACH region) which included a questionnaire as a means of surveying the current state of care. A total of 296 (29.2%) of the centers which received the questionnaire participated in the survey. The subsequent evaluation of the completed questionnaires showed that the majority of patients with endometriosis (around 60%, based on estimates from the data) are not treated in hospitals which have been certified by the SEF. The guidelines recommend the use of specific classification systems (rASRM, ENZIAN) but, depending on the level of care offered by the hospital, only around 44.4 to 66.4% of departments used the rASRM score and only 27% of hospitals used the ENZIAN classification system to describe deep-infiltrating endometriosis. When taking patients' medical history, some centers (6.6 - 17.9%) considered questions about leading symptoms such as dyschezia, dysuria and dyspareunia to be unimportant. QS ENDO Real has made it possible, for the first time, to get an overview of the reality of care provided to patients with endometriosis in the German-speaking areas of Europe. The findings indicate that several of the measures recommended in international guidelines as the gold standard of care are only used to treat some of the patients. In this respect, more efforts will be needed to provide more advanced training. The approach used for treatment must be guideline-based, also in not-certified centers, to improve the quality of care in the treatment of patients with endometriosis.

BACKGROUND

Some contend that gender differences in outcomes after lower extremity bypass (LEB) for peripheral arterial disease (PAD) relate to socioeconomic factors (SEFs). Here, we evaluate these disparities with attention to clinically relevant yet understudied SEF.

METHODS

A retrospective cohort study of patients aged >50 y with PAD undergoing LEB was performed using data from Pennsylvania Health care and Cost Containment Council (2003-2011). Multivariable logistic regression modeling was performed to evaluate the association between gender and outcomes with adjustment for potential confounders including SEF such as income, insurance provider, distance to hospital, and race. Generalized estimating equations were used to adjust for hospital clustering. Independent models were developed to examine death or serious morbidity (DSM) and failure-to-rescue (FTR).

RESULTS

Of 4202 patients identified, 1510 (36%) were women. SEF differed by gender. DSM was more frequent in women (15.6% versus 12.2%; P = 0.002). There was no association between gender and FTR in univariate analysis (P = 0.49). SEFs were associated with DSM and FTR. After adjustment for potential confounders including SEF, women remained more likely to experience DSM (odds ratio = 1.28; P = 0.01). There remained no significant association between gender and FTR on independent modeling (odds ratio = 0.49; P = 0.11).

CONCLUSIONS

Women undergoing LEB in the state of Pennsylvania are at increased risk of poor outcomes, which is not completely explained by SEF. Quality of postoperative care does not appear to be different between gender as there was no difference in FTR. To improve these outcomes, efforts should be made to increase awareness of PAD and promote screening among high-risk women to ensure timely diagnosis and referral.

Contralateral somatosensory evoked fields (SEF) by whole head MEG after unilateral median and ulnar nerve stimulation of both hands were studied in 10 healthy right-handed subjects. Major parameters describing cortical activity were examined to discriminate median and ulnar nerve evoked responses. Somatic sensitivity showed high similarity in the 4 study conditions for both hand and nerve. The brain SEFs consisted of 7-8 major peak stages with consistent responses in all subjects at M20, M30, M70 and M90. Comparable inter-hemispheric waveform profile but high inter-subject variability was found. Median nerve induced significantly shorter latencies in the early activities than those of the ulnar nerve. The 3D cortical maps in the post stimulus 450 ms timeframe showed for both nerves two polarity reversals, an early and a late one which is a new finding. Dipole characteristics showed differential sites for the M20 and M30 in the respective nerve. Higher dipole moments evoked by the median nerve were noticed when compared to the ulnar. Furthermore, the results of the dipole distances between both nerves for M20 were calculated to be at 11.17 mm +/- 4.93 (LH) and 16.73 mm +/- 5.66 (RH), respectively after right hand versus left hand stimulation. This study showed substantial differences in the cortical responses between median and ulnar nerve. Especially the dipole distance between median and ulnar nerve on the cortex was computed accurately for the first time in MEG. Little is known however of the cortical responses in chronic pain patients and the parameter(s) that may change in an individual patient or a group. These results provide precise basis for further evaluating cortical changes in functional disorders and disease sequelae related to median and ulnar nerves.

We have recorded short latency somatosensory evoked magnetic fields (SEFs) to left median nerve stimulation in three healthy subjects. The locations of the deduced dipole sources were projected onto the 3-Dimensional magnetic resonance imaging (3D-MRI) of the individual subjects providing an anatomical localization. We found that the deduced sources were located at the primary sensorimotor hand area on the posterior surface of the central sulcus, at an average depth of 26mm (11mm) from the scalp (brain surface). This technique that combined MEG with 3D-MRI was able to precisely determine source locations and analyze the relationships between dipole sources and brain structures. By using this technique, we can confirm functional anatomy of the brain noninvasively, and obtain much useful information preoperatively and during operation.

The present study was undertaken to investigate after-effects of 7 Hz non-painful prolonged stimulation of the median nerve on somatosensory-evoked fields (SEFs). The working hypothesis that conditioning peripheral stimulations might produce delayed interfering ("gating") effects on the response of somatosensory cortex to test stimuli was evaluated. In the control condition, electrical thumb stimulation induced SEFs in ten subjects. In the experimental protocol, a conditioning median nerve stimulation at wrist preceded 6 electrical thumb stimulations. Equivalent current dipoles fitting SEFs modeled responses of contralateral primary area (SI) and bilateral secondary somatosensory areas (SII) following control and experimental conditions. Compared to the control condition, conditioning stimulation induced no amplitude modulation of SI response at the initial stimulus-related peak (20 ms). In contrast, later response from SI (35 ms) and response from SII were significantly weakened in amplitude. Gradual but fast recovery towards control amplitude levels was observed for the response from SI-P35, while a slightly slower cycle was featured from SII. These findings point to a delayed "gating" effect on the synchronization of somatosensory cortex after peripheral conditioning stimulations. This effect was found to be more lasting in SII area, as a possible reflection of its integrative role in sensory processing.

Using acoustic resonance analysis, it is possible to detect embryonic development. In fertile eggs, the resonant frequency suddenly decreases after about 100 h of incubation. Previous research has shown that this decrease coincides with changing mechanical properties of the albumen near the shell, caused by the formation of subembryonic fluid (SEF). In the present experiment, the adhesive forces between the shell, the membranes, and the albumen were measured before and after the decrease in the resonant frequency. The adhesive forces between shell and outer membrane and between the 2 membranes remained constant, whereas the adhesive force between the inner membrane and the albumen, indirectly measured by a Kjeldahl analysis, increased significantly. Whether the decrease in resonant frequency is caused by the increase of adhesive force between albumen and inner membrane or by the changed properties of the membranes (both of which are altered by dehydration of the albumen) is still open for discussion.

We quantified and compared neuroimaging data and behavioral data (cortical plasticity and hand sensibility, respectively) from a patient who underwent toe-to-index transplantation. Magnetoencephalographic (MEG) recordings of somatosensory-evoked fields (SEFs) response to mechanical tactile stimulation of the index and little fingers of both hands were obtained in parallel with a hand sensibility test from the patient at multiple sessions (week 4, 12, and 24 after the operation). Cortical plasticity refers to SEFs' latency, dipole strength, and primary somatosensory representation, and the Euclidean distance between primary somatosensory representations of the index and the little fingers. Hand sensibility refers to a patient's conscious perception of tactile stimulation applied to the transplanted index finger and scored by Semmes-Weinstein monofilaments. SEFs recordings from six healthy participants at one session were used for comparative purposes. At week 4, although the patient had no conscious perception in the left transplanted index to tactile stimulation, SEFs were recorded in response to tactile stimulation. At weeks 12 and 24, the Euclidean distance between primary somatosensory representations of the transplanted index and little fingers increased, together with SEFs dipole strength, whereas SEFs latencies decreased. These occurred in parallel to improvement in hand sensibility. Primary somatosensory representations of the index and little fingers of the patient's intact right hand were similar to those of the healthy participants' right hand, indicating the consistency of MEG recording during the follow-up sessions. In conclusion, a combination of neuroimaging and behavioral data may be essential for better assessment of functional recovery after a toe-to-digit operation because the cortical recovery observed by MEG preceded that of hand sensibility observed clinically.

A decline in ejection fraction at stress compared with rest images has been associated with increased severity of coronary artery disease (CAD) and suggests a poorer prognosis. Myocardial perfusion imaging (MPI) using high-dose dipyridamole (HDD) has been shown to more accurately detect CAD than either standard dose dipyridamole (SDD) or exercise-induced stress (EST), but has not been looked at to determine its usefulness in detecting changes in stress and rest ejection fractions. To determine the relationship between changes in left ventricular ejection fraction (LVEF) and the severity of CAD, 36 Individuals underwent gated single photon emission computed tomography (SPECT) MPI using HDD. In each case resting and stress LVEFs were determined along with MPI results. Subjects with single-vessel CAD demonstrated an increase in LVEF from 77.8% (sd +/-8.8%) to 85.6% (sd +/-8.4%) resulting in a statistically significant increase in LVEF of 7.8% (p = 0.009). Patients with two-vessel disease showed a smaller increase from 73.2% (sd + 8.3%) to 79.8% (sd + 9.8%) following HDD stress. This increase was statistically (p = 0.008) significant. Patients with triple-vessel CAD showed a reduction in LVEF from 67.4% (sd +/-14.07) to 65.1% (sd +/-16.5%) which represented a decrease in LVEF of 2.7% and approached (p = 0.25) but did not reach statistical significance. Both the resting and stress LVEFs were statistically lower (p<0.05) in patients with triple-vessel CAD. Changes in resting LVEF (REF) and HDD pharmacologically induced stress LVEF (SEF) provide a valuable diagnostic marker as to the number of significantly diseased coronary arteries and can be acquired from gated SPECT sestamibi images.