Cardiac and autonomic responses to change in posture or vitamin C supplementation in sickle cell anemia subjects

Autonomic function following change in posture with or without vitamin C supplementation was studied in ten (10) sickle cell anemia (SCA) and twelve (12) non-sickle cell anemia (NSCA) subjects. Arterial blood pressure and electrocardiographic measurements were taken in the supine position on a couch 80 cm high and immediately on assumption of the upright position. Vitamin C was then administered orally (300 mg/day for 6 weeks). At the end of the period, blood pressure and ECG measurements were again made in the supine position and in response to change in posture.

Change in posture significantly decreased QRS amplitude, QRS duration, PR interval, RR interval and MABP but increased HR and rate pressure product (RPP) in both groups of subjects. The HR and RPP responses were significantly higher in NSCA than in SCA subjects (p < 0.001, respectively). Vitamin C caused greater reductions in QRS duration (p < 0.01), PR duration p < 0.001) in the NSCA subjects than in SCA subjects. It caused, however, greater reduction in RR duration (p < 0.001) and MABP in SCA subjects than in NSCA subjects. It also caused significantly greater increases in HR and RPP (p < 0.001, respectively) in the SCA subjects than in NSCA subjects. After vitamin C supplementation, change in posture decreased RR interval (p < 0.001), QT interval (p < 0.01) and MABP (p < 0.05) but increased RPP (p < 0.01) in NSCA subjects. In SCA subjects, there was a fall in RR interval (p < 0.001) and MABP (p < 0.01), but elevated RPP (p < 0.001). Changes (Δ) in MABP, HR and RPP were similar between NSCA and SCA subjects. In conclusion, these findings indicate a blunted cardiovascular autonomic response to change in posture in sickle cell anemia subjects. Chronic, oral, low-dose vitamin C supplementation equilibrates this response with those of non-sickle cell anemia subjects.     

Oxidation, glycoxidation, lipoxidation, nitration, and responses to oxidative stress in the cerebral cortex in Creutzfeldt-Jakob disease

Gel electrophoresis and Western blotting of frontal cortex homogenates have been carried out in sporadic Creutzfeldt–Jakob disease (CJD) cases and age-matched controls to gain understanding of the expression of glycation-end products (AGEs). N-Carboxymethyl-lysine (CML) and N-carboxyethyl-lysine (CEL) were used as markers of glycoxidation; 4-hydroxynonenal (4-HNE) and malondialdehyde-lysine (MDAL) as markers of lipoxidation; and nitrotyrosine (N-tyr) and neuronal, endothelial and inducible nitric oxide synthase (nNOS, eNos and iNos) as markers of protein nitration and as sources of NO production, respectively. Age receptor (RAGE) and Cu/Zn superoxide dismutase (SOD1) and Mn superoxide dismutase (SOD2) expression levels were also examined. The results showed a significant increase in the expression levels of AGE (p < 0.05), CEL (p < 0.001), RAGE (p < 0.05), HNE-modified proteins (p < 0.01), nNOS, iNOS and eNOS (p < 0.01 and p < 0.05, respectively), N-tyr (p < 0.05), and SOD1 (p < 0.05) and SOD2 (p < 0.05). No relationship was observed between PrP genotype, PrP type, PrP burden, and expression levels of oxidative stress markers. The present findings demonstrate oxidative, glycoxidative, lipoxidative and nitrative protein damage, accompanied by increased oxidative responses, in the cerebral cortex in sporadic CJD. These results provide support for the concept that oxidative stress may have important implications in the pathogenesis of prion diseases.     

Fractures of the tibial spine: epidemiology and outcome

We documented functional outcome in 83 knees with tibial spine fractures. The mean age at injury was 35 years. There was a medial collateral ligament sprain in 17 knees and posterolateral corner injury in three knees. Twenty patients with displaced tibial spine fractures were treated with fixation of the tibial spine and 63 patients with undisplaced or minimally displaced fractures were treated non-operatively.

Fourteen (22%) non-operatively treated knees developed symptomatic instability, three of which underwent ACL reconstruction. Tibial spine fixation restored stability in 18 of 20 knees, but knee stiffness was more common in this group when compared to non-operatively treated knees (60% vs 19%, p < 0.0005). Patients with postoperative knee stiffness had a mean age of 28 years compared to 18 in patients with no knee stiffness (p < 0.05).

We concluded that tibial spine fracture in skeletally mature patients is associated with a significant risk of knee stiffness and instability.     

Age-related changes in the incidence of pineal gland calcification in Turkey: A prospective multicenter CT study

The goal of this cross-sectional observational study was to determine the incidence of pineal gland calcification (PGC), to investigate the interaction of PGC and aging, and to compare the incidence of PGC among the populations living in Turkey. In a prospective study the rate of PGC on CT scans of 1376 individuals in six referral centers from different regions of Turkey was investigated, with emphasis on effects of climatological parameters and aging on PGC. It was found that the incidence of PGC increased rapidly after first decade and the increase remains gradual thereafter, higher in males than in females for all age groups. There was a significant difference for incidence and degree of PGC between different clinics and between both sexes (p < 0.001). In addition, there was a significant difference for the degree of PGC between the clinics in low altitude group and those in high altitude group (p < 0.001 for each). Logistic regression analysis revealed that age, sex, altitude and intensity of sunlight exposure significantly affected the risk of PGC (odds ratios (OR) 1.335, 95% confidence intervals (CI) 1.261–1.414, p < 0.001; OR 1.900, 95% CI 1.486–2.428, p < 0.001; OR 0.715, 95% CI 0.517–0.990, p < 0.05; OR 0.997, 95% CI 0.994–0.999, p < 0.01, respectively). Furthermore, by multiple linear regression analysis, high altitude and increased intensity of sunlight exposure were found to affect the degree of PGC (β = 0.003, p < 0.001). It is concluded that there is a close relationship between PGC and the aforementioned parameters, supporting a link between the development of PGC and these. This study provides some reference data for new clinical studies on the putative role of pineal gland in future.     

Molecular identification of 13 new enterovirus types, EV79-88, EV97, and EV100-101, members of the species Human Enterovirus B

Paired PBMCs and plasma samples from 34 HIV-infected patients were studied to verify the relationship between coreceptor use based on genotyping of V3 region of HIV-1 envelope gp120 and biological phenotype with virus isolation and subsequent correlation to clinical characteristics. The “11/25” rule, geno2pheno and PSSM were compared. All SI patients were HIV-1 subtype B (p = 0.04) and had a lower CD4 count than NSI patients (p = 0.01), while no differences were observed in mean HIV-RNA _log (p = 0.6). SI phenotype was not associated with AIDS-defining events (p = 0.1) or with concurrent antiretroviral therapy (p = 0.4). With geno2pheno, which shows the highest sensibility (83%), an X4 or X4/R5 genotype in PBMC DNA was also associated to B-subtype and lower CD4 count (p = 0.01) compared to R5 isolates. Based on plasma RNA sequences, the predicted coreceptor usage agreed with PBMC DNA in 79% of cases with the “11/25” rule, 82% with geno2pheno, and 82% with PSSM. A X4 virus in plasma (but not in PBMCs) was significantly associated with HAART in all three methods (p = 0.01 for “11/25” rule, p = 0.01 for geno2pheno and p = 0.03 for PSSM). Due to viral mixtures and/or difficulties in genotype interpretation, current V3 sequence-based methods cannot accurately predict HIV-1 coreceptor use.     

A metabolic link between S-adenosylhomocysteine and polyunsaturated fatty acid metabolism in Alzheimer's disease

There is evidence that vascular risk factors contribute to the pathology of Alzheimer's disease. Increased concentrations of circulating homocysteine are associated with vascular risk factors and Alzheimer's disease but the mechanisms involved are unclear. Homocysteine inhibits the hydrolysis of S-adenosylhomocysteine (SAH) which is a product inhibitor of S-adenosylmethionine (SAM) dependent methyltransferase reactions. It has been shown previously that SAH inhibits phosphatidylethanolamine N-methyltransferase (PEMT) in the liver. The activity of PEMT in the liver plays an important role in the methylation of phosphatidylethanolamine (PE) to phosphatidylcholine (PC) and the delivery of essential polyunsaturated fatty acids (PUFAs) to peripheral tissues. In the present study, the plasma concentrations of SAH, SAM and homocysteine and the erythrocyte composition of phosphatidylcholine (PC), phosphatidylethanolamine (PE) and their respective polyunsaturated fatty acid concentrations were determined in 26 patients with Alzheimer's disease and compared to those in 29 healthy control subjects. There was a significant increase in the plasma concentrations of SAH (p < 0.001) and homocysteine (p < 0.001) and a significant increase in the plasma concentrations of SAM (p < 0.001) in the Alzheimer's patients. A significant positive correlation was found between the plasma concentrations of SAH and homocysteine (r = 0.738, p < 0.001). There was a negative correlation between the plasma concentrations of homocysteine and the ratio of SAM/SAH (r = −0.637, p < 0.01). There was a significant decrease in the erythrocyte content of PC (p < 0.001) and an increase in the erythrocyte content of PE (p < 0.001) in the Alzheimer's patients. Plasma SAH concentrations were negatively related to erythrocyte PC concentrations (r = −0.286, p < 0.01) and positively related to erythrocyte PE concentrations (r = 0.429, p < 0.001). The erythrocyte PC from Alzheimer's patients had a significant depletion of docosahexaenoic acid (DHA) (p < 0.001) while there was no significant difference in the DHA content of erythrocyte PE. There was a significant negative correlation between plasma SAH and the DHA composition of erythrocyte PC (r = −0.271, p < 0.001). This data may reflect the inhibition of hepatic PEMT activity by SAH in Alzheimer's disease. The decreased mobilization of DHA from the liver into plasma and peripheral tissues may increases the risk of atherosclerosis and stroke leading to chronic cerebral hypoperfusion. The evidence suggests that a metabolic link between the increased production of SAH and phospholipid metabolism may contribute to cerebrovascular and neurodegenerative changes in Alzheimer's disease.     

Subchondral bone overgrowth in the presence of full-thickness cartilage defects in the knee

Between October 2000 and December 2003, 252 autologous chondrocyte implants were performed in 183 patients. Eighty lesions showed overgrowth of the subchondral bone plate under the chondral lesion, this was termed a “bone boss.” Thirty-seven were on the medial femoral condyle (MFC), 18 on the lateral femoral condyle (LFC), 21 in the trochlea and 4 on the patella. There was a statistically significant association between the LFC and “bone boss.” The lesions showing this finding were of a larger area (3.4 cm² and 2.8 cm² respectively, p = 0.006), and had more diffuse chondral changes than lesions without. The patients with a “bone boss” had a tendency to longer duration of symptoms (85.3 months and 64.3 months respectively, p = 0.089).

The “bone bosses” were resected back to the level of the surrounding subchondral bone prior to implantation. Radiological and clinical follow-up showed no statistical difference between the two groups. A discussion of the possible aetiology of the “bone boss” is made.     

Pineal gland calcification, lumbar intervertebral disc degeneration and abdominal aorta calcifying atherosclerosis correlate in low back pain subjects: A cross-sectional observational CT study

The goal of this cross-sectional observational study was to assess the possible impact of pineal gland calcification upon the intervertebral disc degeneration and abdominal aorta atherosclerosis in subjects with low back pain, and to investigate the course of these processes with aging. The study was carried out on 81 (66 women and 15 men) subjects: younger than 45 years (group X, n = 22), 45–65 years of age (group Y, n = 45), and older than 65 years (group Z, n = 14). In addition to clinical data, computed tomography (CT) scan of the brain as well as X-ray and CT examination of the lumbar spine were recorded in this study. The degree of disc degeneration and calcification rates of aortic wall and pineal gland were independently determined by two radiologists. Both ratio of calcified pineal gland and density of pineal calcification increased progressively with aging. Also, both the degree of aortic wall calcification and disc degeneration score increased with advancing age. On CT scan, a positive correlation between degree of aortic wall calcification and disc degeneration score was found (r = 0.306, p < 0.01). Importantly, there was a positive association between calcification of the pineal gland and degenerative disc disease in X-ray or CT study (r = 0.378 and r = 0.295, p < 0.005 and p < 0.01, respectively), as well as between abdominal aorta atherosclerosis and pineal calcification (r = 0.634, p < 0.001). Our findings suggest that there is a significant interaction between pineal gland calcification and lumbar intervertebral disc degeneration and also abdominal aorta atherosclerosis. However, further studies with a larger subject cohorts are needed.     

Repair of articular cartilage and clinical outcome after osteotomy with microfracture or abrasion arthroplasty for medial gonarthrosis

This study compared the healing of articular cartilage and the clinical outcome after osteotomy with or without marrow stimulation microfracture or abrasion arthroplasty for osteoarthritis of the knee. Patients with osteoarthritis of the medial compartment of the knee were divided into a group undergoing high tibial osteotomy alone (HTO group: 37 knees), a group undergoing osteotomy plus microfracture (MF group: 26 knees), and a group undergoing osteotomy plus abrasion arthroplasty (AA group: 51 knees). The extent of cartilage repair was compared at 1 year after surgery by arthroscopy with reference to Outerbridge's classification, while the clinical outcome was compared at 1, 3, and 5 years postoperatively. Second-look arthroscopy revealed better repair of the femoral condylar cartilage in the AA group than the HTO group (p < 0.0005) or MF group (p < 0.01), with no difference between the HTO and MF groups. Repair of the tibial condylar cartilage was also better in the AA group than the HTO group (p < 0.005), but there was no difference between the AA and MF groups or the MF and HTO groups. There were no differences of the clinical outcome between the three groups. In conclusion, repair of articular cartilage at 1 year postoperatively was accelerated by abrasion arthroplasty, but not by microfracture. However, there was no difference of the clinical outcome within 5 years after surgery, so the clinical utility of marrow stimulation techniques was not apparent in this study.     

A high n-6 polyunsaturated fatty acid diet reduces muscarinic M2/M4 receptor binding in the rat brain

The aim of this study was to examine the influence of different fat diets on muscarinic acetylcholine receptor binding. Nineteen male Sprague–Dawley rats were divided into four groups and fed a diet of either high saturated fat, n-6 polyunsaturated fatty acid (PUFA), n-3 PUFA or low fat (control) for 8 weeks. Using quantitative autoradiography, [³H]pirenzepine binding to muscarinic M1/M4 receptors and [³H]AF-DX384 binding to M2/M4 receptors were measured throughout the brain in all four groups. The main findings were that compared to the low fat control group, M2/M4 receptor binding was significantly reduced in the dorsolateral, dorsomedial and ventromedial parts of the caudate putamen (61–64%, p < 0.05), anterior cingulate cortex (59%, p < 0.01), dentate gyrus and CA1–3 fields of the hippocampus (32–43%, p < 0.01) of rats on a high n-6 PUFA diet; however, no differences in M1/M4 receptor binding densities between the four groups were observed. These results suggest that a diet high in n-6 PUFA, but not of n-3 PUFAs or saturated fat, may selectively alter M2/M4 receptor-mediated signal transduction in the rat brain.     

Temperament, health-related behaviors, and autonomic cardiac regulation: the cardiovascular risk in young Finns study

Temperament, as indicated by Cloninger's psychobiological model predicts coronary heart disease risk, but its association with autonomic cardiac regulation, a potential mediating mechanism, is unclear. We examined the associations between temperament traits and autonomic cardiac regulation in a resting situation in 798 women and 580 men derived from a population-based sample. After adjustment for age and sex, harm avoidance was associated with lower level of high-frequency (HF) variation, root mean square successive differences (RMSSDs), the percentage of successive R–R intervals >50 ms (pNN50) and higher heart rate (HR) (all p ≤ 0.005), suggesting that harm avoidance is related to low parasympathetic activity. Additional adjustments for behavioral factors attenuated these associations more than the adjustment for biological risk factors. Novelty seeking was associated with higher RMSSD (p = 0.007) and pNN50 (p = 0.012) and lower heart rate (p < 0.001). With adjustment for behavioral risk factors, the associations with RMSSD (p = 0.136) and pNN50 (p = 0.236) attenuated to the null, but adjustment for biological risk factors had little effect. Reward dependence and persistence were unrelated to indices of cardiac regulation.     

Changes of meniscal interhorn distances: an in vivo magnetic resonance imaging study

The aim of this study was to evaluate the changes of the internal (IID) and external meniscal interhorn distance (EID) of the medial and the lateral meniscus under loading. Sagittal magnetic resonance images of 15 knees were studied. The medial and lateral meniscus were examined with the knee at 0° and 30° of flexion, under no load, with load equal to 50% of body weight and with load equal to 100% of body weight. Under no load, the mean IID was 19.9 mm for the medial meniscus and 12.3 mm for the lateral meniscus and the mean EID was 44.6 mm for the medial meniscus and 34.4 mm for the lateral meniscus. Under load equal to 50% and 100% of patient's body weight, there was a significant increase in both distances (p < 0.05). Under constant loading, flexion of the knee from 0° to 30°, decreased the EID of both menisci. In conclusion, loading increases both IID and EID. Knee position affects only the EID. The quality of magnetic resonance images may affect the reliability of such measurements.     

Intranasal 17beta-estradiol treatment and Vitamin B12, folate and homocysteine in menopause

Objective: This study assessed the effect of intranasal administration of 17β-estradiol (Aerodiol^®) on plasma levels of homocysteine, Vitamin B12 and folate in postmenopausal women.

Methods: In all, 26 symptomatic postmenopausal women who had undergone hysterectomy and oophorectomy at least 12 months previously participated in this 6-month randomized prospective clinical study. Menopause was determined by serum FSH level >30 μIU/ml and serum estradiol concentration <30 pg/ml. Intranasal 17β-estradiol treatment was given once daily at a standard daily dose of 300 μg to 16 women, and 10 did not receive any treatment.

Results: In the group receiving intranasal 17β-estradiol, mean (±S.D.) plasma homocysteine level decreased significantly from pre-treatment values (from 16.68 ± 4.33 to 14.15 ± 1.18 nmol/ml, p = 0.029) and the mean folate level increased (from 4.11 ± 0.80 to 5.64 ± 1.87 ng/ml, p = 0.012). Vitamin B12 levels showed a tendency towards increasing. In the treated group, significant negative correlations were observed between homocysteine and folate values (r = −0.586, p = 0.017) and between homocysteine and Vitamin B12 values (r = −0.672, p = 0.004). No significant changes were observed in the untreated group.

Conclusion: The reduction in plasma homocysteine levels observed after 6 months’ treatment with intranasal 17β-estradiol may reflect an alteration in folate and Vitamin B12 homeostasis.     

Correlation of estrogen receptor beta gene polymorphisms with spinal bone mineral density in peri- and post-menopausal Greek women

Estrogens play a significant role in bone physiology. Their action is mainly exerted through their receptors. Estrogen receptor alpha (ER) plays a major role in bone homeostasis and there is evidence suggesting that estrogen receptor beta (ERβ) has also an effect on BMD.

We investigated the possible effect of two ERβ gene polymorphisms on spinal bone mineral density (BMD) and metabolic bone markers in Greek women.

Spine BMD as well as biochemical bone markers were measured in 147 healthy peri- and post-menopausal women [mean age (S.D.) 54 (7.9) years]. Genotyping was performed for two restriction fragment length polymorphisms (RFLPs) of ERβ gene, RsaI in exon 5 and AluI in exon 8. For each polymorphism studied the cohort was divided into two groups: the “wild-type” group (RR and AA, respectively) and the “carrier” group including subjects with at least one allele with the restriction site (Rr&rr and Aa&aa, respectively).

The distribution of RsaI genotypes was RR: 91.2% (n = 134), Rr: 8.2% (n = 12), and rr: 0.6% (n = 1) and of AluI genotypes AA: 36.7% (n = 54), Aa: 57.2% (n = 84), and aa: 6.1% (n = 9). No linkage disequilibrium was found between the two polymorphic sites studied. Spine BMD did not differ significantly in the two groups of either polymorphism, after adjusting for age, weight, height, and years since menopause [mean BMD (S.D.) for RR 0.841 (0.17) g/cm² versus Rr&rr 0.798 (0.13) g/cm², p = 0.25, and mean BMD (S.D.) for AA 0.828 (0.16) g/cm² versus Aa&aa 0.848 (0.17) g/cm², p = 0.32]. No significant differences were noted in metabolic bone markers except for a marginal difference of RR versus Rr/rr in urinary hydroxyproline/creatinine ratio [median (IQR) 3.88 (6.04) μmol/mmol in RR versus 8.2 (4.32) μmol/mmol in Rr/rr, p = 0.05]. Furthermore, no interaction between the two polymorphisms on BMD was found.

In conclusion, in a Greek female post-menopausal population, the two ERβ gene polymorphisms were not associated with BMD, or metabolic bone markers.     

Effect of foot deformity on conventional mechanical axis deviation and ground mechanical axis deviation during single leg stance and two leg stance in genu varum

We assessed the effect of foot deformity on the loading axis of lower limbs in 33 patients with genu varum (25 bilateral and eigth unilateral) caused by varying etiologies including achondroplasia, cerebral palsy, prior trauma, rickets, metaphyseal chondrodysplasia and primary osteoarthritis using single leg stance and both leg stance radiographs. Deviation at the knee from the hip ankle line (conventional) and hip foot line (centre of hip to centre of heel) was calculated. A comparison was made between single leg stance and two leg stance for tibiocalcaneal angle, mechanical axis angle, knee and ankle joint line convergence angle, conventional mechanical axis deviation (MADC) and ground mechanical axis deviation (MADG). In addition comparisons were also made among three groups formed depending on the tibiocalcaneal angle and MADC–MADG difference for all the above measurements.

Mechanical axis deviation (calculated using the two methods) varied with the talocalcaneal angle and single leg stance. Patients with a fixed subtalar varus and with severe genu varum, where the normal compensatory subtalar eversion could not compensate showed that conventional mechanical axis deviation was significantly higher by 3.4 ± 2.4 mm and ground mechanical axis deviation degrees was significantly higher by 3.8 ± 3.2 mm in single leg stance when compared to two leg stance (p < .0001).

Foot deformity should be included during preoperative evaluation and planning for knee deformity correction.     

Morphology and electrochemical behavior of Ag-Cu nanoparticle-doped amalgams

The aim of this study was to introduce Ag–Cu phase nanopowder as an additive to improve the corrosion behavior of dental amalgams. A novel Ag–Cu nanopowder was synthesized by the precipitation method. An amalgam alloy powder (World-Cap^®) was added and mixed with 5 wt.% and 10 wt.% of Ag–Cu nanopowders, respectively, to form experimental amalgam alloy powders. The original alloy powder was used as a control. Alloy powders were examined using X-ray diffraction, transmission electron microscopy (TEM), scanning electron microscopy and electron probe microanalysis. Amalgam disk specimens of metallurgically prepared were tested in 0.9% NaCl solution using electrochemical methods. The changes in the corrosion potential and anodic polarization characteristics were determined. Corrosion potential data were analyzed statistically (n = 3, analysis of variance, Tukey’s test, p < 0.05). The diameters of lamellar structure Ag–Cu nanoparticles were measured to be approximately 30 nm. The composition of the Ag–Cu nanoparticles determined by TEM–energy-dispersive spectroscopy was 56.28 at.% Ag–43.72 at.% Cu. A light-shaded phase was found mixing with dark Cu–Sn reaction particles in the reaction zones of Ag–Cu nanoparticle-doped amalgams. The Ag–Cu nanoparticle-doped amalgams exhibited zero current potentials more positive than the control (p < 0.05) and no current peak was observed at −325 mV that related to Ag–Hg phase and Cu₆Sn₅ phase in anodic polarization curves. The results indicated that the corrosion resistance of high-copper single-composition amalgam could be improved by Ag–Cu nanoparticle-doping.     

Vascular anatomy of the patella: Implications for total knee arthroplasty surgical approaches

BackgroundIatrogenic disruption of the patellar vascular supply has been identified as a possible contributing factor to the commonly reported patellofemoral complications following total knee arthroplasty (TKA). We performed an anatomic cadaveric study evaluating the extra-osseous vascular anatomy of the patella, and correlated our findings to routine TKA surgical dissection to determine how to better preserve patellar vascularity.Methods and materialsIn twenty-one cadaveric knees arterial cannulas were placed proximally and distally to the patella. A polyurethane compound was then injected producing a visible arterial network. Specimens underwent gross dissection.ResultsIn all 21 specimens, the supreme genicular (SGA), medial/lateral superior genicular (MSGA/LSGA), medial/lateral inferior genicular and anterior tibial recurrent arteries communicate forming a peripatellar anastomotic ring supplying the intraosseous patellar system. Both the SGA (24%) and MSGA (76%) demonstrated dual medial ring contribution. Relating the arterial location to common TKA exposures suggested severe compromise of patellar vascularity.ConclusionThe medial sided vessels seem to contribute more significantly to the peripatellar anastomotic ring when compared to the lateral sided vessels. Careful soft tissue management has the potential to preserve key vascular structures that could maintain the intraosseous vascular supply to the patella. Understanding the anatomic locations of major arterial systems around the knee joint can potentially help during hemostasis, and can minimize blood loss during TKA.Clinical relevanceRecognition of major arterial systems around the knee joint has the potential to minimize iatrogenic disruption of the vascular supply and the complications that can follow (patella devascularization and blood lost).     

Spinal blockade of TNF blocks spinal nerve ligation-induced increases in spinal P-p38

Although research on DNIC has revealed the inhibitory effect occurring between two remote pain stimuli, the interrelation between two adjacent painful stimuli has not yet been characterized. In the present study, we used a sample of 40 healthy volunteers to examine the effect of 30-s immersion of the fingers in water of 1 °C, as a conditioning stimulus, on pain intensities produced by conditioned mechanical punctuate stimuli, applied both adjacent and contralateral to the cooled area. There was a significant decrease in mechanical pain intensities from 17.23 ± 2.39 at baseline to 12.45 ± 2.39 when stimulating immediately after the cold immersion at an adjacent site, and from 20.00 ± 2.39 to 15.08 ± 2.39 at remote sites (F = 20.02, p < 0.0001). A significant positive correlation between the extent of pain reduction in the cooled and in the uncooled hand was found (r_s = 0.59, p = 0.0001). The extent of pain reduction following cooling in the cooled and in the uncooled hand was also found to be similar for males and for females (p = 0.63). It is concluded that under the conditions of this experiment, EA affects heterotopic and homotopic regions similarly and without gender differences.     

Influence of PROP taster status and maternal variables on energy intake and body weight of pre-adolescents

Genetic taste blindness to the bitterness of 6-n-propylthiouracil (PROP) may be a marker for increased energy intake and body weight. This hypothesis has not been tested in pre-adolescent children. This study determined if non-taster children would report higher energy intakes and maintain higher body weights than taster children. Maternal variables which are known to influence food intake and body weight during childhood were also considered including maternal weight, maternal restraint and disinhibition and child feeding practices. Sixty-five children with a mean age of 9.0 ± 0.2 years participated. They completed a 3-day diet recall for the estimation of daily energy and macronutrient intakes. BMI (mothers) and BMI%-for-age (children) were calculated from measured heights and weights. Non-taster children reported higher daily energy intakes than super-taster children (p ≤ 0.05), but no differences in macronutrient selection were observed. Also, children of disinhibited mothers reported higher daily energy intakes than children of mothers who were not disinhibited (p ≤ 0.05). However, these variables did not predict children's body weight. Rather, regression modeling (R² = 0.59; p ≤ 0.0001) revealed that restriction, concern for child weight and maternal BMI were positive predictors of children's BMI%-for-age and pressure to eat was a strong negative predictor (p-value range = 0.02–0.004). PROP status was not a predictor of body weight in these children. These results suggest that in pre-adolescent children, current energy intakes were negatively related to children's PROP status and positively related to maternal disinhibition. However, BMI%-for-age, a measure of long-term energy balance, was related to child feeding practices and maternal BMI.