A new subdivision,the marginal division,in the neostriatum of the human brain

<正> A new subetemtory was discovered byas at the caudal most edge of the neostriatum(St) and surrounding the rostral berder of the globus pallidus(GP) in the rat btain with neuroanato-my and immunohistochemistry methods.This area was named marginal division(MrD)based on its location.     

BamH1 polymorphism in the Chinese,Malays, and Indians in Singapore and its application in the prenatal diagnosis of β-thalassemia

Summary The distribution of restriction fragment length polymorphism (RFLP) at theBamH1 site of the -globin gene was investigated in the Chinese, Indian, and Malay race in Singapore. The sample comprised of 183 normal individuals and 35 -thalassemia carriers in which 13 were couples with at least one -major child. The results from this study indicate thatBamH1 polymorphism will be informative in 22% of pregnancies at risk for -thalassemia major in Chinese, 19% in Malays and 7% in Indians. In prenatal diagnosis usingBamH1 polymorphism for one -major affected family, the fetus was diagnosed to be normal or -carrier. The validity ofBamH1 polymorphism in the exclusion of -thalassemia major was subsequently confirmed at birth by globin chain biosynthesis.     

What Is the Evidence for Rest,Ice, Compression,and Elevation Therapy in the Treatment of Ankle Sprains in Adults?

Context:

Ankle sprains are common problems in acute medical care. The variation in treatment observed for the acutely injured lateral ankle ligament complex in the first week after the injury suggests a lack of evidence-based management strategies for this problem.

Objective:

To analyze the effectiveness of applying rest, ice, compression, and elevation (RICE) therapy begun within 72 hours after trauma for patients in the initial period after ankle sprain.

Study Selection:

Eligible studies were published original randomized or quasi-randomized controlled trials concerning at least 1 of the 4 subtreatments of RICE therapy in the treatment of acute ankle sprains in adults.

Data Sources:

MEDLINE, Cochrane Clinical Trial Register, CINAHL, and EMBASE. The lists of references of retrieved publications also were checked manually.

Data Extraction:

We extracted relevant data on treatment outcome (pain, swelling, ankle mobility or range of motion, return to sports, return to work, complications, and patient satisfaction) and assessed the quality of included studies. If feasible, the results of comparable studies were pooled using fixed- or random-effects models.

Data Synthesis:

After deduction of the overlaps among the different databases, evaluation of the abstracts, and contact with some authors, 24 potentially eligible trials remained. The full texts of these articles were retrieved and thoroughly assessed as described. This resulted in the inclusion of 11 trials involving 868 patients. The main reason for exclusion was that the authors did not describe a well-defined control group without the intervention of interest.

Conclusions:

Insufficient evidence is available from randomized controlled trials to determine the relative effectiveness of RICE therapy for acute ankle sprains in adults. Treatment decisions must be made on an individual basis, carefully weighing the relative benefits and risks of each option, and must be based on expert opinions and national guidelines.Key Words: ankle ligament injury, cryotherapy, bandages

Key Points

• Randomized controlled trials provide insufficient evidence to determine the effectiveness of rest, ice, compression, and elevation (RICE) therapy for acute ankle sprains in adults.
• Treatment decisions must be made on an individual basis, carefully weighing the relative risks and benefits of each option, and must be based on expert opinions and guidelines.
• Sufficiently powered, high-quality, and appropriately reported randomized trials of the different elements of RICE therapy for acute ankle sprains are needed.

Ankle sprains are one of the most prevalent injuries of the musculoskeletal system. Researchers have estimated that 1 ankle sprain occurs per 10 000 people each day.¹ The most common mechanism of injury is inversion of the plantar-flexed foot. Inversion injuries involve about 25% of all injuries of the musculoskeletal system, which affect more than 20 000 patients in the United States each day.^2,3 About 50% of these injuries are sport related^4,5; some sports (basketball, soccer, and volleyball) have a particularly high incidence of ankle injuries.^6,7 If not treated properly, inversion injuries of the ankle can result in persistent problems in 30% to 40% of patients.^4,8The treatment of inversion ankle injuries is provided by emergency and primary health care physicians, athletic trainers, physiotherapists, and orthopaedic and trauma surgeons. Each year, approximately 1 million patients with acute lateral ankle ligament injuries are examined by primary care physicians in the United States.⁹ The annual cost to society for ankle injuries has been estimated to be approximately €40 million (US $30.4 million) per 1 million people.¹⁰ Most authors use the term sprain to describe a morphologic condition representing a diversity of pathologic conditions, ranging from overstretching of the ligament to complete rupture with gross instability of the joint.¹¹The ankle ligaments are the anterior talofibular ligament (ATFL), calcaneofibular ligament (CFL), and posterior talofibular ligament (PTFL), and together they form the lateral ligament complex of the ankle.¹² The ATFL is the first or only ligament to sustain injury in 97% of the cases.^13,14 Broström⁵ found that combined ruptures of the ATFL and the CFL occurred in 20% of the cases and that isolated rupture of the CFL occurred in only 3%. The PTFL usually is not injured unless a true dislocation of the ankle occurs.⁵ Rest, ice, compression, and elevation (RICE) are generally accepted methods for treating inflammation after trauma, such as acute ankle sprain.^15,16 Inflammation causes pain, edema, hyperalgesia, and erythema, all of which can limit the patient''s ability to perform the rehabilitation required for proper healing.¹⁷ Gentle tension and stretching at the joint promote proper ligament fiber growth into tight, parallel strands. Accumulation of fluid and edema around an injury site also increases tissue damage, delays healing, and can result in some degree of chronic disability.¹⁸According to the Dutch Quality Institute for Healthcare CBO consensus guidelines,¹⁹ RICE therapy is the preferred treatment for the first 4 to 5 days. After this period, the physical examination provides a high-quality assessment.^19–21 The inconsistent outcome of physical examination within 48 hours of trauma is caused by the diffuse character of the pain, the swelling that gives no information about whether it is due to hematoma or edema formation, and the unreliability of the anterior drawer test due to pain and swelling.^19–21Rest, ice, compression, and elevation therapy is an accessible and popular modality in the treatment of acute ankle sprains. Therefore, the objective of our study was to analyze the effectiveness of applying RICE therapy begun within 72 hours after trauma for patients in the initial period of ankle sprain. The specific null hypotheses included the following: (1) No differences existed in outcome measurements between using rest, immobilization, or no movement or mobilization and using early mobilization or movement for acute treatment of ankle sprains; (2) No differences existed in outcome measurements between using ice, cold, cold therapy, cryotherapy, or cooling and using no ice, no cold, or heat for acute treatment of ankle sprains; (3) No differences existed in outcome measurements between using compression and using no compression for acute treatment of ankle sprains; and (4) No differences existed in outcome measurements between using elevation and using no elevation for acute treatment of ankle sprains. In addition to other reviews concerning the treatment of acute lateral ankle sprains^22–28 (also G.M.M.J.K., unpublished data, January 2011), our systematic review will be helpful in the further development of evidence-based treatment recommendations and protocols.     

Do multifilament alloplastic meshes increase the infection rate? Analysis of the polymeric surface,the bacteria adherence,and the in vivo consequences in a rat model

Within the last decade hernia surgery has changed from suture repair to mesh repair. Biomaterials, and multifilaments in particular, are thought to increase the risk of infection. Therefore, the aim of this study was to study the influence of the presence of either a monofilament or a multifilament mesh material on the bacterial infection risk. The filament surface of a monofilament and a multifilament mesh were calculated on the basis of a theoretical model. The adherence of Staphylococcus aureus was measured in vitro by fluorescence analysis. Additionally, the two mesh materials (8-mm platelets) were implanted subcutaneously in Sprague-Dawley rats with daily surveillance for clinical signs of infection. After 7 days the meshes were explanted for histological and microbiological analysis. Calculations of the mesh surface area revealed a higher level for the multifilament mesh. The extent of adherent bacteria corresponded to the estimated filament surface in vitro. In vivo, the implantation of meshes in the presence of 5 x 10(6) S. aureus did not show an increased infection rate in rats with either monofilament or multifilament material, compared to the control groups (mesh implantation without S. aureus contamination). However, after 7 days bacteria were still detectable in the majority of the implantation sites, and a clinically inapparent intensification of local inflammation and fibrosis was induced. The increased surface area of a multifilament meshes promotes the persistence of bacteria in the implant bed, though this alone is not sufficient to create a clinically apparent infection. This might explain the development of mesh-related infections after a delay of several months or even years. In vivo, the adherence of bacteria to the implant material depends on the surface area, which favors the use of monofilament materials.     

Facial trauma in the largest city in Latin America, São Paulo, 15 years after the enactment of the compulsory seat belt law

Traffic accidents are a reality throughout Brazil. The face is one of the anatomic parts most affected by these accidents, especially when a seat belt is not used. These accidents are costly for the public health system and have a significant impact on society and the lives of families involved. The compulsory use of seat belts in Brazil, especially in São Paulo, has decreased the rate of facial trauma. This suggests that the public health policies and measures adopted by the Brazilian authorities have benefited the population 15 years after the enactment of the law of compulsory seat belts in the city of São Paulo.     

Defensins: key players or bystanders in infection, injury, and repair in the lung?

Antimicrobial peptides have been identified as key elements in the innate host defense against infection. Recent studies have indicated that the activity of antimicrobial peptides may be decreased in cystic fibrosis, suggesting a major role for these peptides in host defense against infection. One of the most intensively studied classes of antimicrobial peptides are defensins. Defensins comprise a family of cationic peptides that in human subjects can be divided into the alpha- and beta-defensin subfamilies. The alpha-defensins are produced by neutrophils and intestinal Paneth's cells, whereas beta-defensins are mainly produced by epithelial cells. Although studies on beta-defensins have so far focused on their antimicrobial activity, studies on alpha-defensins have suggested a role of these peptides in inflammation, wound repair, and specific immune responses. alpha-Defensins, which accumulate in airway secretions of patients with various chronic inflammatory lung disorders, were shown to be cytotoxic toward airway epithelial cells and to induce chemokine secretion in several cell types. Furthermore, the capacity of alpha-defensins to promote bacterial adherence to epithelial cells in vitro further supports a role for these peptides in the pathogenesis of chronic obstructive pulmonary disease and cystic fibrosis. Increased numbers of neutrophils are also present in the airways of patients with asthma, suggesting that neutrophils are involved in the pathogenesis of this disease. Because defensins are able to induce histamine release by mast cells and increase the airway hyperresponsiveness to histamine, it is tempting to speculate that defensins may also contribute to the inflammatory processes in asthma. Besides these proinflammatory effects, alpha-defensins may also display anti-inflammatory activities, including regulation of complement activation and proteinase inhibitor secretion. Finally, defensins may be involved in wound repair because defensins increase epithelial cell proliferation. Thus recent defensin research has revealed potential links between the innate and acquired immune system.     

Neonatal estrogen treatment with β-estradiol 17-cypionate induces in post-pubertal mice inflammation in the ductuli efferentes,epididymis, and vas deferens,but not in the testis,provoking obstructive azoospermia

Neonatal estrogen treatment (NET) induces morphological changes in male reproductive organs. NET with β-estradiol 17-cypionate is reported to induce inflammation with stromal-epithelial abnormalities in the prostate and seminal vesicles in post-pubertal mice. The aim of this study was to investigate the histopathology of the testis, ductuli efferentes, epididymis, and vas deferens in mice after NET with β-estradiol 17-cypionate. No morphological changes in these organs were observed until 4 weeks after NET. However, some inflammatory cells were found in epididymis and vas deferens 6 weeks after NET. Eight weeks after NET, inflammatory cells spread to the ductuli efferentes and inflammation was severe from 6 to 12 weeks after NET. Inflammatory cells were never seen in the whole testis, but cystic dilatation of the rete testes with spermatogenic disturbance was found around the mediastinum testis. Many inflammatory cells emigrated into the lumen of the epididymis, resulting in complete absence of spermatozoa in the vas deferens. Most of the inflammatory cells penetrating into the epithelial layers of epididymal ducts were neutrophils. These results indicate that in post-pubertal mice, NET with β-estradiol 17-cypionate induces inflammation in the ductuli efferentes, epididymis, and vas deferens, but not in the testis, provoking obstructive azoospermia.     

Effectiveness of the PPARγ agonist, GW570, in liver fibrosis

Introduction  

The peroxisome proliferator-activated receptors (PPARs) are well established to be important in modulating the fibrogenic response to liver injury. PPARγ plays a role in hepatic fibrosis, presumably by virtue of its expression in hepatic stellate cells, which are key effectors of fibrosis. In this study, we evaluated whether the potent nonthiozolidinedione PPARγ agonist, GW570, had effects on isolated stellate cells and hepatic fibrosis in vivo.     

The spread of the wild Poliovirus in the rural environment, the case of the Adzopé health district, Côte d'Ivoire

Wild Poliovirus spreading in rural environment in Adzopé, C?te d'Ivoire In order to determine the level of wild Poliovirus spreading among rural children in an endemic poliomyelitis country 469 stools samples, from children aged between three weeks and twelve years old were processed according to WHO procedures for transportation, conservation, isolation and identification of Poliovirus. Intratypic differenciation was performed by an antigenic method using monoclonal antibodies and a genomic RFLP (Restriction Fragment Length Polymorphism). 50 Poliovirus strains (10.7%) were isolated and analyzed: 15 vaccine-like Poliovirus type 1 (30%), 30 vaccine-like Poliovirus type 2 (60%), 4 vaccine-like Poliovirus type 3 (8%) and one wild Poliovirus type 3 (2%). As expected, in the major cases the duration of post-vaccinal viral excretion did not exceed two months. However, in 14% of cases, it varied between 3 and 9 months after the third OPV dose. This long excretion could be due to an inefficient local intestinal immunity or no local immunity at all, in spite of the three OPV doses. These results argue in favor of an increase of the number of OPV doses in such endemic zones. Moreover, OPV strains are well-known to revert to pathogenicity in vaccinees, therefore, the long term excretion of pathogenic OPV derived strains by a certain amount of vaccinees needs to be considered quite seriously.     

Are cognitive processes manifested in event-related gamma, alpha, theta and delta oscillations in the EEG?

The restricted capacity of the nervous system to regenerate calls for novel therapeutic concepts. We have tested biocompatible polylactide fibers as potential nerve guides that could bridge proximal nerve stumps and synaptic target regions after nerve lesion. Polylactides have the great advantage that they degrade and resorb after completion of regeneration. Material surface properties were optimized three-fold by oxygen plasma treatment, polyanion coating and the seeding of Schwann cells from rat sciatic nerve. Immunocytochemistry and scanning electron microscopy revealed that in vitro axonal outgrowth of dorsal root ganglia on two specifically synthesized lactide polymers can be greatly improved by these surface treatments. The approach aims to develop an 'intelligent neuroprosthesis' that in vivo facilitates directed axonal regrowth in the first place and disappears thereafter.     

Placentophagia in naïve adults, new fathers, and new mothers in the biparental dwarf hamster, Phodopus campbelli

Placentophagia in mammals typically occurs only in females during the birth. Male hamsters, Phodopus campbelli, with an extensive paternal behavior repertoire eat placenta during the birth and as alloparental juveniles. Two fresh placentae were presented to sexually naïve males and females covering the developmental range from puberty through reproductive maturity and into senescence. Expectant parents and new mothers were also tested. Placentophagia occurred in both sexes at all developmental stages and was higher in reproductive than in naïve hamsters. Placentophagia declined with increasing age in females, but not males. Liver was readily accepted, but acceptance did not decline with age in females, and was not low in juvenile males, confirming that animals distinguished between the two tissues. Senescent females consumed both tissues willingly. In these paternal males, which do not experience pregnancy or parturition, and in naïve females that selectively refuse placenta, the stimuli influencing placentophagia remain unknown. © 2005 Wiley Periodicals, Inc. Dev Psychobiol 47: 179–188, 2005.     

HBV infection in HIV-infected subjects in the state of Piauí, Northeast Brazil

In this study, the prevalence, genotype frequency, and risk factors for HBV infection in 768 HIV-infected subjects living in Piauí were determined. Forty-six (6.0 %) HIV-positive subjects were reactive for HBsAg and positive for HBV-DNA. Genotypes A (71.8 %), F (23.9 %) and D (4.3 %) were identified. Multivariate analysis revealed an association between HIV-HBV coinfection and male gender, older age groups, unprotected sex, reporting more than ten sexual partners throughout life, STD, and tattooing. This study shows the importance of monitoring sites and professionals who perform tattooing and practice safe sex to prevent the spread of HIV and HBV infections.     

Mutations in the gene encoding KIAA1199 protein,an inner-ear protein expressed in Deiters’ cells and the fibrocytes,as the cause of nonsyndromic hearing loss

We report three possibly disease-causing point mutations in one of the inner-ear-specific genes, KIAA1199. We identified an R187C mutation in one family, an R187H mutation in two unrelated families, and an H783Y mutation in one sporadic case of nonsyndromic hearing loss. In situ hybridization indicated that the murine homolog of KIAA1199 mRNA is expressed specifically in Deiters cells in the organ of Corti at postnatal day zero (Pn) P0 before the onset of hearing, but expression in those cells disappears by day P7. The signal of KIAA1199 was also observed in fibrocytes of the spiral ligament and the spiral limbus through to P21, when the murine cochlea matures. Thus, the gene product may be involved in uptake of potassium ions or trophic factors with a particular role in auditory development. Although the R187C and R187H mutations did not appear to affect subcellular localization of the gene product in vitro, the H783Y mutation did present an unusual cytoplasmic distribution pattern that could underlie the molecular mechanism of hearing impairment. Our data bring attention to a novel candidate for hearing loss and indicate that screening of mutations in inner-ear-specific genes is likely to be an efficient approach to finding genetic elements responsible for deafness.Nucleotide sequence data reported herein are available in the DDBJ/EMBL/GenBank databases; for details, see the electronic eatabase section of this article.