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    The systemic component is probably responsible for multifocal cascade of events leading to generalized and/or multifocal symptoms seen in acute attacks. The sickling phenomenon in turn damages the cell membrane and shortens red cell survival. Chronic and intermittent tissue hypoxia, and possibly inflammation, eventually leads to tissue damage and organ malfunction.

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    Thus, the reciprocal monosynaptic connections between stripes may provide the anatomical substrate for reverberating excitatory circuits how to buy viagra over the counter that maintain the activity of functionally related populations of DLPFC cells, a critical feature of working memory (Lewis & Anderson, 1993). During adolescence, the number of these pyramidal cell interconnections typically decreases, suggesting that the pruning of the intrinsic connections of layer III pyramidal neurons in the DLPFC may confer a selective vulnerability related to the clinical onset of schizophrenic symptoms after maturity (Lewis & Levitt, 2001). Pucak et al., 1995) (Figure 5.8).

    Within the DLPFC, excitatory pyramidal cells in layers II and III send intrinsic axon collaterals horizontally through the supragranular layers, and the terminal fields of these axons are organized as a series of stripes separated by similar size gaps (Levitt, Lewis, Yoshioka, & Lund, 1989). The projections between interconnected stripes are reciprocal, and the majority of these axon terminals synapse on dendritic spines of other pyramidal cells (Lewis, 1995. Consistent with this interpretation, layer III pyramidal cells have been reported to be decreased in size , and to have fewer dendritic spines in subjects with schizophrenia.

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