The relative impact on leg symptoms of fears of getting varicose veins and of great saphenous vein reflux

Objective:

To assess possible links between fears of getting varicose veins and unknown great saphenous vein reflux with the prevalence and features of leg symptoms in healthy people and patients with varicose veins.

Methods:

Questionnaire and venous ultrasound in healthy volunteers and patients with great saphenous vein (GSV) incompetence.

Results:

Intensity of feelings of swelling and heaviness (S&H; scale 0–3) was 0.26 (±0.51) in healthy people without fears of varicose veins ( n = 162), 0.56 (±0.72) in the presence of GSV reflux ( n = 39, P = 0.001), 0.73 (±0.77) in the presence of fears of varicose veins ( n = 43, P, 0.001), 0.95 (±0.98) in the presence of both findings ( n = 10, P = 0.002) and 0.73 (±0.91) in patients ( n = 40, P < 0.001). Intensity of S&H was higher in women ( P < 0.001) and in the presence of a family history of varicose veins ( P = 0.003). Fears had a large influence on S&H ( F = 12.38, P < 0.001) while GSV reflux was less important ( F = 4.58, P = 0.033). Fears and GSV reflux were not related to each other ( r = 20.01, P = 0.933). The prevalence of a crawling sensation was equal in all study groups and cramps were more frequent in volunteers than in patients with GSV reflux ( P < 0.001).

Conclusions:

Healthy people with fears of getting varicose veins experience feelings of leg S&H as frequently as subjects with previously unknown GSV incompetence and patients with manifest varicose veins.

Therapie der Stammvarikose der V. saphena magna

Einleitung: Zu den neuen Therapien der Varikose (endovenöse Verfahren = EV, schallgesteuerte Verödung der Stammvenen = SV und CHIVA) gibt es Vergleichsstudien zu Stripping, jedoch keinen Überblick, bei welcher konkreten Indikation welches Verfahren am sinnvollsten ist. Ziel des Konsensgespräches war es, für die häufigsten Indikationen der Stammvarikose der V. saphena magna (VSM) eine Behandlungsempfehlung unter Beach-tung aller 4 Varianten zu geben.

Methode: 19 phlebologisch-chirurgisch tätige Kollegen, die mit allen 4 Verfahren vertraut und größtenteils erfahren sind, haben zu den häufigsten Indikationen der Stammvarikose der VSM (Hach I – IV, Durchmesser der Vene, Begleiterkrankungen) ein Votum zu „möglich“, „sinnvoll“ und „optimal“ abgegeben, unabhängig von der Bezahlung der Methode. Bei den ersten beiden Optionen waren Mehrfachnennungen möglich.

Ergebnis: Alle Verfahren waren in allen Situationen möglich. Votenverteilung bei „optimal“: Verödung 5% (Hach I und II, eher dünnere Venen, Adipositas), Stripping in 6% (postphlebitische oder kaliberstarke VSM Hach II – IV, Dodd als Insuffizienzpunkt). EV: 33% (Hach III –IV und kaliberstarke VSM, Adi-positas), CHIVA 56% (Hach I–II generell, Hach III–IV bei dünner VSM).

Schlussfolgerung: Alle Verfahren sind immer möglich und meist sinnvoll. Das einzige von den Kassen bezahlte Verfahren, Stripping, wird meist nicht als optimale Therapieoption gese-hen. Es sind nun weitere Studien und Diskussionen nötig, um die Therapieoptionen für die einzelnen Indikationen zu erhärten.

The evolution of synapse models--from numbers to networks to spaces

We review the evolution of synapse models over the last sixty-five years in terms of the changing paradigms: initially, the synapse was modelled only as part of a neuronal system, both as a number (weight of an edge in a connectionist network) and as a channel in a conductance-based model. With the availability of more structural and kinetic data, it came to be seen as a full-fledged biochemical network, accompanied by a shift from the previous "top-down" approach to a more "bottom-up" network reconstruction. Most recently, the synapse is seen as a geometric 3-dimensional space with various processes driving the dynamics. A particular focus is placed on models of the dopamine synapse and their connections to schizophrenia. The advances of detailed modelling on the synaptic level have highlighted the challenges of integrating the various functional levels, which are tightly coupled with processes on different scales in time and space. On the other hand, this effort will contribute to bridging the currently perceived gap between computational neuroscience and (computational) systems biology.

Uncoupling oxidative/energy metabolism with low sub chronic doses of 3-nitropropionic acid or iodoacetate in vivo produces striatal cell damage

A variety of evidence suggests that the failure of cellular metabolism is one of the underlying causes of neurodegenerative diseases. For example, the inhibition of mitochondrial function produces a pattern of cellular pathology in the striatum that resembles that seen in Huntington's disease. However, neurons can also generate ATP through the glycolytic pathway. Recent work has suggested a direct interaction between mutated huntingtin and a key enzyme in the glycolytic pathway, glyceraldehyde-3-phosphate dehydrogenase (GAPDH). Yet little work has been gone into examination of the cellular pathology that results from the inhibition of this alternative energy source. Therefore, the aim of the present study is to characterize the cellular pathology that results in the striatum of mice after treatment with a toxin (iodoacete, IOA) that compromises anaerobic metabolism. This striatal pathology is compared to that produced by a widely studied blocker of mitochondrial function (3-nitropropionic acid, 3-NP). We found that low doses of either toxin resulted in significant pathology in the mouse striatum. Signs of apoptosis were observed in both experimental groups, although apoptosis triggered by IOA treatment was independent from caspase-3 activation. Importantly, each toxin appears to produce cellular damage through distinct mechanisms; only 3-NP generated clear evidence of oxidative stress as well as inhibition of endogenous antioxidants. Understanding the distinct pathological fingerprints of cell loss produced by blockade of oxidative and anaerobic metabolisms may give us insights into neurodegenerative diseases.

A multi-channel stimulator and electrode array providing a rotating current whirlpool for electrical stimulation of wounds

When electrical stimulation is used on wounds, the electrical current has difficulty penetrating areas where there is necrotic tissue. Further, for an irregularly shaped wound, current distribution is poor in some areas of the wound since conventional two-electrode delivery systems provide the greatest current in a line directly between the electrodes. A new stimulator and electrode system is described which uses three electrodes spaced around a wound to disperse current more evenly. The stimulator senses tissue impedance and then redirects current by altering its Thevenin's output impedance for each electrode; each of the three electrodes becomes the active one in sequence while the remaining are the sink electrodes. Eight subjects were examined to test the stimulator. Electrical stimulation was applied to the skin above the quadriceps muscle at currents of 15 mA in six subjects without wounds and in two subjects with wounds. The relationship between electrode position and current dispersion on the skin was examined with a two-electrode vs. a three-electrode system to set stimulation parameters for the computer. The results showed that the three-electrode system could (1) detect areas of the skin with high impedance; (2) compensate by altering the Thevenin's output impedance at each of the three electrodes to shift current to high impedance areas; (3) provide uniform current across the skin as assessed by skin current and blood flow measurements with a laser Doppler flow imager.

Differential expression of neurotrophins in postnatal C57BL/6 mice striatum

Neurotrophin expression in early stages of development is crucial for brain assembly and function. In particular, postnatal expression of neurotrophins has not been well documented in the neostriatum and in general neurotrophins or their receptor mRNA's are normally reported, but not protein expression. In the present study, immunocytochemical expression of BDNF, NT-3 and NT-4/5 was characterized in striatal tissue of C57BL/6 mice at postnatal days 10^th (P10), 21^st (P21), 42^nd (P42) and 80^th (P80).

We found that the expression of BDNF diminished along the postnatal time course we evaluated, while staining for NT-4 increased up to age P42 and remained constant, thereafter in the cell's soma. In contrast, NT-3 was first expressed in the neostriatal bundles and later on, in neostriatal cell somas. These results provide information about differences in the spatial and temporal expression of each neurotrophin in the neostriatum during the first 80^th postnatal days.

RT-PCR procedures were also carried out to further determine whether protein levels of neurotrophins observed in the neostriatum were under control of gene expression. All neurotrophin mRNAs were expressed and only mRNA^BDNF was reduced during the postnatal evaluated days.

Differences in temporal expression of neurotrophins may be related to the heterochronic development of neostriatal cell populations, but also with the specificity of each neurotrophin modulating different neuronal targets.

Modelling the CheY(D10K,Yl00W) Halobacterium salinarum mutant: sensitivity analysis allows choice of parameter to be modified in the phototaxis model

A recent phototaxis model of Halobacterium salinarum composed of the signalling pathway and the switch complex of the motor explained all considered experimental data on spontaneous switching and response time to repellent or attractant light stimuli. However, the model which considers symmetric processes in the clockwise and counter-clockwise rotations of the motor cannot explain the behaviour of a CheY(D10K,Yl00W) mutant which always moves forward and does not respond to light. We show that the introduction of asymmetry in the motor switch model can explain this behaviour. Sensitivity analysis allowed us to choose parameters for which the model is sensitive and whose values we then change in either direction to obtain an asymmetric model. We also demonstrate numerically that at low concentrations of CheYP, the symmetric and asymmetric models behave similarly, but at high concentrations, differences in the clockwise and counter-clockwise modes become apparent. Thus, those experimental data that could previously be explained only by ad hoc assumptions are now obtained 'naturally' from the revised model.

[Parathyroid cancer in a patient with previous history of hypernephroma: a clinical case]

We report the clinical case of a 55 year-old male patient, with a previous history of nephrectomy by hypernephroma sixteen years ago, first presenting hypercalcemia and rising of intact parathyroid hormone (iPTH) levels. A localization study revealed an intrathyroid nodule with cystic appearance. After undergoing a hemi-thyroidectomy, the patient is diagnosed with parathyroid carcinoma. This article analyzes previously published cases presenting parathyroidal pathologies associated with hypernephroma. A broader differential diagnosis--including the screening of parathyroidal pathologies should be considered in patients with hypercalcemia and hypernephroma.

[VOT analysis in cleft palate patients after surgery]

OBJECTIVES

To determine the factors that modify the measures of voice onset time (VOT) as acoustic parameter in operated cleft palate children. The voice of cleft palate patient is defined by the generation of an abnormal intraoral pression. This doesn't allow the normal generation of voiceless plosives consonants and produces an increased VOT. Acoustic analysis of voice quantifies these parameters. In this study we observed an increased VOT if the patient hadn't got a normal teeth occlusion and a normal soft palate function. Also VOT measures were influenced by cleft lip and delay in beginning of ortodoncy. Hearing loss is associated with increased VOT. Our results are based in a correct sample and statistical analysis by multiple lineal regression.

Phenotypic and transcriptional characterization of the meningococcal PhoPQ system, a magnesium-sensing two-component regulatory system that controls genes involved in remodeling the meningococcal cell surface

We previously identified and characterized a two-component regulatory system in the meningococcus with homology to the phoP-phoQ system in salmonella and showed that allele replacement of the NMB0595 regulator gene led to loss of virulence, sensitivity to antimicrobial peptides, perturbed protein expression, and magnesium-sensitive growth. On the basis of these findings we proposed that the system should be designated the meningococcal PhoPQ system. Here we further characterized the NMB0595 mutant and demonstrated that it had increased membrane permeability and was unable to form colonies on solid media with low magnesium concentrations, features that are consistent with disruption of PhoPQ-mediated modifications to the lipooligosaccharide structure. We examined the transcriptional profiles of wild-type and NMB0595 mutant strains and found that magnesium-regulated changes in gene expression are completely abrogated in the mutant, indicating that, similar to the salmonella PhoPQ system, the meningococcal PhoPQ system is regulated by magnesium. Transcriptional profiling of the mutant indicated that, also similar to the salmonella PhoPQ system, the meningococcal system is involved in control of virulence and remodeling of the bacterial cell surface in response to the host environment. The results are consistent with the hypothesis that the PhoP homologue plays a role in the meningococcus similar to the role played by PhoP in salmonella. Elucidating the role that the PhoPQ system and PhoPQ-regulated genes play in the response of the meningococcus to the host environment may provide new insights into the pathogenic process.