Electrical responses to chemosensory stimulation recorded from the vomeronasal duct and the respiratory epithelium in humans

The physiological significance of the human vomeronasal duct (VND) is still unclear. The aim of the present study was to investigate the question whether mucosal responses obtained from the VND are different from those obtained from the respiratory epithelium. There were 15 healthy subjects (8 male, 7 female; age range 19-45 years; 14 normosmic subjects, 1 anosmic subject). All subjects participated in two sessions whereby the first session was used to acquaint them with the experimental conditions. For chemical stimulation, an olfactometer was used which delivered chemical stimulants without altering mechanical or thermal conditions at the stimulated nasal mucosa. For stimulation we used substances previously reported to produce vomeronasal activation ("estra"=estra-1,3,5(10),16-tetraen-3ol and "andro"=androsta-4,16-dien-3-on); in addition, gaseous CO(2) was used as a non-odorous, relatively specific stimulant of the trigeminal nerve. Placement of electrodes either in the VND or on the respiratory epithelium was performed under endoscopical guidance. Subjects rated the overall intensity of the stimuli, the strength of trigeminally mediated sensations, and the hedonic tone of the stimulants. Responses could not be recorded from all subjects. For the remaining 7 subjects, intensity was strongest for CO(2) stimuli (p<0.001), whereas no significant difference was observed between "andro" and "estra" (p=0.33). All three stimulants produced responses at the respiratory epithelium with largest responses obtained after stimulation with CO(2). Similar findings were made for recordings inside the VND. Due to the small sample size sexual dimorphisms could not be addressed. In summary, these results seem to indicate that the presently used stimulants produce similar responses at the respiratory epithelium and in the VND which argues against a specific responsiveness of the VND epithelium to chemosensory stimuli although it has to be kept in mind that the effective sample size was small.

[Open dislocation of the mobile bearing in a unicondylar knee arthroplasty. A rare complication]

Unicompartmental knee arthroplasty can be viewed as a procedure with reliable medium- to long-term success. However, complications occur. To the authors' knowledge, this is the first report on an open dislocation of the tibial component (polyethylene plate) of a mobile bearing unicondylar knee prosthesis. Twelve days after a unicompartmental knee arthroplasty a 69-year-old patient suffered an open knee trauma due to a simple fall on the ground. The clinical examination showed wound dehiscence of the former mid-line approach, ventral dislocation of the polyethylene plate and a rupture of the anterior cruciate ligament. A pragmatic surgical treatment consisting of a jet lavage with saline solution, disinfection and relocation of the polyethylene plate and application of prophylactic antibiotics was performed. No peri- or postoperative complications were observed. The 6-month follow-up revealed a range of motion of 0-0-120° for extension-flexion and an isolated anterior instability. The patient was satisfied. This case report adds an uncommon and previously unpublished complication associated with unicompartmental knee arthroplasty. Surgical management in revision knee arthroplasty is challenging, although pragmatic approaches might be successful. Open dislocation of the bearing in a unicondylar knee prosthesis demands immediate revision. The manner of treatment depends on clinical findings and the surgeon's experience with arthroplasty.

Cytogenetic perspective of ageing and longevity in men and women

Analysis of relationships between the ageing cell phenotype and the age of cell donors is one of the ways towards understanding the link between cellular and organismal ageing. Cytogenetically, ageing is associated with a number of gross cellular changes, including altered size and morphology, genomic instability, and changes in expression and proliferation. Genomic instability can be easily assessed by analyzing the level of cytogenetic aberrations. In this review, we focus on the differences in the level and profile of cytogenetic aberrations observed in donors of different age and gender. Centenarians are a small fraction of the population at the extreme of human longevity. Their inclusion in such studies may shed light on one of the basic questions: whether genome stability is better maintained in successfully aged individuals compared to the rest of the population. At the same time, comparing the profile of age-related amount of chromosomal aberrations in men and women may help explaining the commonly observed gender differences in longevity.

Immunohistochemical, volumetric, and functional neuroimaging studies in patients with idiopathic Parkinson's disease

Idiopathic Parkinson's disease (PD) is closely associated with olfactory loss. Deficits in the sense of smell may precede clinical motor symptoms by years. Although there is more and more evidence from recent studies to support this view, it remains unclear which substrates would cause the olfactory deficit. Studies based on biopsies from the olfactory epithelium did not reveal specific changes in the nasal mucosa of PD patients compared to patients who were hyposmic for other reasons. Thus, PD-related olfactory impairment seems not to be directly associated with specific changes in the olfactory epithelium. With regard to volumetrics of the olfactory bulb (OB) results indicated that there is little or no difference between PD patients and healthy controls in terms of OB volume. Again, these data support the idea that olfactory loss in PD is not a consequence of damage to the olfactory epithelium but rather results from central-nervous changes. Finally, studies based on functional MRI suggested that neuronal activity in the amygdala and hippocampus is reduced in PD patients compared to controls which may specifically impact on olfactory function. In addition, neuronal activity in components of cortico-striatal loops appears to be up-regulated indicating compensatory processes involving the dopaminergic system. Thus, it seems that cerebral changes, and not changes at the level of the olfactory epithelium, are the basis of the olfactory loss observed in PD patients.

[Pathologic fracture of the distal femur in total knee arthroplasty. Polyethylene-wear-induced osteolysis? A case report]

Malignant bone tumors and osteitis of the distal femur are common at every age. These conditions must be considered in patients with total knee arthroplasty and suspicious x-rays. A patient with gross polyethylene-wear-induced osteolysis and periprosthetic fracture is described. Neoplasm and infectious granuloma were excluded through biopsy, and the bone defect was bridged with a rotating hinged distal femoral replacement.

Correlation of body mass index with toxicity and survival in locoregionally advanced head and neck cancer patients treated with induction chemotherapy and concurrent chemoradiotherapy

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Background: Concurrent chemoradiotherapy (CRT) offers high functional organ preservation rates for locoregionally advanced head and neck cancer (LRAHNC) patients, but is associated with significant acute and chronic speech and swallowing toxicity. Recently, body mass index (BMI) has been suggested as a predictor of head and neck cancer patient outcome. In this analysis we sought to determine the impact of BMI on survival and toxicity outcomes in LRAHNC patients treated with CRT. Methods: 220 LRAHNC patients were treated on a multiinstitutional protocol consisting of induction carboplatin and paclitaxel followed by CRT. CRT was delivered for 4–5 cycles; each 14-day cycle consisted of 5 days concurrent paclitaxel, continuous infusion 5-FU, hydroxyurea, and 1.5 Gy twice daily radiation followed by 9 days without any treatment. Each patient's pre-treatment BMI was classified as overweight (BMI >= 25) or non-overweight (BMI < 25). As an independent variable, BMI was analyzed as a predictor of IndCT or CRT toxicity, locoregional control, and overall survival. BMI was analyzed as categorical variable, and also a continuous variable in a multivariate proportional hazards model. Results: There was no association between BMI and IndCT toxicity. During CRT overweight patients had significantly lower rates (24/103 vs 42/112) of grade 3 or higher neutropenia (p = 0.027), mucositis (p = 0.05), dermatitis (p = 0.028) and higher rates of anorexia (p = 0.05). Overweight patients had 12% long term PEG tube rate, compared to 34% of non-overweight patients (p < 0.001). On pooled survival analysis, patients with BMI > 25 had significantly better overall survival outcomes (mean 81.2 months, 95% CI 75.1–87.3 months) than patients with BMI < 25 (median 58.2 months; mean 56.5 months, 95% CI 49.6–63.3 months) (log-rank p < 0.001). Conclusions: Our data suggest patients with pre-treatment BMI > 25 experience lower rates of toxicity commonly associated with chemoradiation, and have a significantly better prognosis than patients with BMI < 25. Although the mechanism of BMI as an independent predictor of outcomes is unclear, we are continuing to explore mechanisms underlying this association.

No significant financial relationships to disclose.

Salermide, a Sirtuin inhibitor with a strong cancer-specific proapoptotic effect

Sirtuin 1 (Sirt1) and Sirtuin 2 (Sirt2) belong to the family of NAD+ (nicotinamide adenine dinucleotide-positive)-dependent class III histone deacetylases and are involved in regulating lifespan. As cancer is a disease of ageing, targeting Sirtuins is emerging as a promising antitumour strategy. Here we present Salermide (N-{3-[(2-hydroxy-naphthalen-1-ylmethylene)-amino]-phenyl}-2-phenyl-propionamide), a reverse amide with a strong in vitro inhibitory effect on Sirt1 and Sirt2. Salermide was well tolerated by mice at concentrations up to 100 muM and prompted tumour-specific cell death in a wide range of human cancer cell lines. The antitumour activity of Salermide was primarily because of a massive induction of apoptosis. This was independent of global tubulin and K16H4 acetylation, which ruled out a putative Sirt2-mediated apoptotic pathway and suggested an in vivo mechanism of action through Sirt1. Consistently with this, RNA interference-mediated knockdown of Sirt1, but not Sirt2, induced apoptosis in cancer cells. Although p53 has been reported to be a target of Sirt1, genetic p53 knockdowns showed that the Sirt1-dependent proapoptotic effect of Salermide is p53-independent. We were finally able to ascribe the apoptotic effect of Salermide to the reactivation of proapoptotic genes epigenetically repressed exclusively in cancer cells by Sirt1. Taken together, our results underline Salermide's promise as an anticancer drug and provide evidence for the molecular mechanism through which Sirt1 is involved in human tumorigenesis.

[Treatment of complicated proximal segmental tibia fractures with the less invasive stabilization locking plate system]

BACKGROUND

Proximal segmental tibia fractures are rare injuries. Concomitant soft tissue injury, additional articular involvement and ligament injuries, secondary displacement, infection and pseudarthrosis present high demands for the implant and the surgeon. This clinical study was designed to clarify whether Tibia-LISS is a suitable implant for this type of fracture.

MATERIAL AND METHODS

From January 2002 to June 2005, 24 consecutive patients with proximal segmental tibia fractures were evaluated prospectively. All fractures were treated with Tibia-LISS. Follow-up examination was every 4 weeks until fracture healing. The final follow-up examination was at least 1 year after surgery and the average time was 23 months.

RESULTS

Of the 24 patients, 23 could be considered for the follow up examination. On average 3.4 operations per patient were necessary, in 19 patients the fractures (82.6%) healed within 6 months after surgery, 2 deep-seated infections and 5 postoperative misalignments occurred. No patient suffered from secondary loss of reduction but 11 patients (47.8%) suffered from a complicated healing process.

CONCLUSION

Tibia-LISS is a suitable implant for the treatment of proximal segmental tibia fractures with an acceptable rate of complications.

The significance of caveolin-1 expression in parietal epithelial cells of Bowman's capsule

AIMS

To analyse the expression of caveolin-1 in normal human kidney and during diseases leading to nephrotic syndrome in children and to compare its pattern with those observed in control samples, both human and animal.

METHODS AND RESULTS

The study group was composed of 104 children diagnosed with minimal change disease (MCD), focal segmental glomerulosclerosis (FSGS), lupus glomerulonephritis (LGN) and Schönlein-Henoch glomerulopathy (SH). The research protocol employed direct immunohistochemical assay with the use of mono- and polyclonal antibodies against caveolins. Kidney samples of Wistar rats, wild-type mice and caveolin-1-deficient mice were also analysed. In the control human samples, caveolin-1 was most abundant in the muscle layer of blood vessels and parietal epithelial cells (PECs). Its expression in PECs was significantly lower in children diagnosed with FSGS and LGN than in those with MCD, SH or in controls. In the control animal tissues, except for knock-out mice, caveolin-1 was present in distal convoluted tubules, PECs, endothelial cells and muscle.

CONCLUSIONS

Caveolae are extremely stable elements of PECs and can be excluded from their cell membrane only in response to the dramatic cell reconstruction observed in FSGS and LGN.

Immunohistochemical detection of galectin-1 in renal biopsy specimens of children and its possible role in proteinuric glomerulopathies

AIMS

Galectin-1 is an endogenous lectin that specifically binds to beta-galactoside structures. It has been associated with developmental mechanisms ranging from differentiation to apoptosis and exerts immunoregulatory functions in autoimmune diseases. The aim was to determine the immunohistochemical expression of galectin-1 in renal biopsy specimens of children with primary idiopathic proteinuric glomerulopathies.

METHODS AND RESULTS

We examined 18 children with minimal change disease (MCD), 30 with diffuse mesangial proliferation (DMP) and 11 with focal segmental glomerulosclerosis (FSGS). An indirect immunohistochemical protocol using a polyclonal antibody directed against galectin-1 was applied. Galectin-1 was detected in renal podocytes in DMP and FSGS cases, while control glomeruli and MCD were negative. Galectin-1 immunoreactivity was found within parietal epithelial cells in patients with FSGS.

CONCLUSIONS

These results suggest a possible role for galectin-1 in the pathogenesis of primary glomerulopathies in children as a kind of podocyte-related self-protective activity and probably involvement of epithelial cells of Bowman's capsule in inflammatory processes. Immunohistochemistry using galectin-1 antibodies may further be helpful in histological distinction between MCD and DMP.