Neuromuscular Junction

Has the neuromuscular junction been over-exposed or is it perhaps already a closed book? I asked myself this at a recent International Congress when an American colleague complained that the Journal of Physiology had articles on nothing but the neuromuscular junction, while another colleague asked why I was editing a volume on a subject about which everything was already known. It is worrying to think that these views may be shared by other people. I hope that this volume will convince my two colleagues and other readers that the neuromuscular junction is very much alive and continues to attract the interest of many workers from a variety of fields; strange as it may seem, the synapse between a motor nerve ending and muscle fibre, with its relatively simple architecture, is one of the most inter esting sites in the body-I do hope we have done it justice. The various chapters of this volume present a cross section of knowledge as viewed by a group of 13 individuals, actively engaged in research. Multi-author volumes such as this are frequently criticised on the grounds that chapters or sec tions overlap. I believe that such criticium is only valid where the overlap is repetitious. Where it results in the reader having available discussions of material from differing stand-points, overlap becomes a valuable feature of this type of publication.

Inhalt
Introductory Chapter The Neuromuscular Junction: Areas of Uncertainty.- Neuromuscular Block by Prolonged Depolarisation.- Desensitisation.- The Clinical Picture.- The Presence of Other Drugs.- The Importance of the Drug Structure and that of the Acetylcholine Receptor.- Pre-Synaptic or Post-Synaptic Action?.- Closing Remarks.- References.- 1 The Anatomy and Pathology of the Neuromuscular Junction.- A. Introduction.- B. Normal Muscle.- C. Development, Growth, and Plasticity of the Neuromuscular Junction.- D. The Neuromuscular Junction in Disorders of Transmission.- E. The Neuromuscular Junction in Disorders of the Muscle Fibre.- F. Conclusion.- References.- 2 Neurochemistry of Cholinergic Terminals.- A. Introduction.- B. Methods for Extracting and Measuring Acetylcholine.- C. Acetylcholine Synthesis.- D. Acetylcholine Storage.- E. Acetylcholine Release.- F. Acetylcholine Turnover.- G. Removal of Acetylcholine.- H. Axonal Transport of Materials Related to Cholinergic Transmission.- I. Prolonged Neurochemical Changes Resulting from Synaptic Activity.- References.- 3 Transmission of Impulses from Nerve to Muscle.- A. Introduction.- B. The Muscle Fibre and the Action of Acetylcholine.- C. Pre-Synaptic Events.- D. Postscript.- References.- 4A Depolarising Neuromuscular Blocking Drugs.- A. General Introduction.- B. An Introduction to the Pharmacological Actions of Decamethonium at the Neuromuscular Junction.- C. End-Plate Depolarisation by Decamethonium and Suxamethonium in vivo.- D. Effect of Decamethonium, Suxamethonium and Acetylcholine on the Electrical Properties of Single Mammalian Muscle Cells.- E. Depolarisation Versus Desensitisation.- F. Species Differences and Depolarising Neuromuscular Blocking Drugs.- G. Factors which May Modify the Action of Depolarising Neuromuscular Blocking Drugs and Variations Due to Experimental Conditions.- H. Concluding Remarks.- References.- 4B Competitive Neuromuscular Blocking Drugs.- A. Introduction and Terminology.- B. Chemical Structure.- C. Methods Used to Measure Neuromuscular Blockade.- D. Distribution of Competitive Neuromuscular Blocking Drugs.- E. Factors Affecting Duration of Action in Animals and Man.- F. Mechanism of Action at Neuromuscular Junction.- G. Effects at Cholinergic Synapses in the Autonomic Nervous System.- H. Histamine Release in Animals and Man.- J. Miscellaneous Drugs which Cause Muscle Paralysis.- References.- 4C Pharmacology of Anticholinesterase Drugs.- A. Introduction.- B. Morphology and Function of Acetylcholinesterase (AChE).- C. Inhibition of AChE.- D. Actions of Anticholinesterases of the Carbamate and Organophosphate Type and of Anilinium Ions.- General Conclusions.- Appendix I Studies on Frog Muscles.- Appendix II Anticholinesterases and Anilinium Ions Referred to in the Text.- Appendix III An Outline of the Methods Used to Calculate the Quantal Content of the e.p.p. and the Rate of Refilling and Size of the ACh Store in Nerve Terminals.- References.- 5A The Clinician Looks at Neuromuscular Blocking Drugs.- A. Introduction.- B. General Anaesthesia before Neuromuscular Blocking Drugs.- C. Clinical Influence of Neuromuscular Blocking Drugs.- D. Three Possibly Fatal Reactions to Suxamethonium.- E. Less Serious Reactions to Suxamethonium.- F. Personal Technique.- G. Conclusions.- References.- 5B Neuromuscular Blocking Drugs in Man.- A. Introduction.- B. Measurement of Drug Action.- C. Pharmacokinetics of Neuromuscular Blocking Drugs.- D. Action of Neuromuscular Blocking Drugs at the Neuromuscular Junction.- E. Other Actions of Neuromuscular Blocking Drugs.- References.- 5C Twenty Years' Experience with Decamethonium.- A. Introduction.- B. First Clinical Reports.- C. Analysis of 32000 Administrations of Decamethonium.- D. Assessment.- References.- Author Index.