HMB attenuates muscle loss during sustained energy deficit induced by calorie restriction and endurance exercise

ObjectiveTo investigate the efficacy and underlying mechanisms of β-hydroxy-β-methylbutyrate (HMB) on body composition, muscle mass and physical performance under catabolic versus normal training conditions.Materials/MethodsMice were divided into four groups (n = 10/group): 1) ALT = ad libitum + trained (1 h/d for 3 d/wk); 2) ALTH = ALT + HMB (0.5 g/kg BW/d); 3) C = calorie restricted (? 30%) + trained (6 h/d, 6 d/wk); and 4) CH = C + HMB. Repeated in vivo assessments included body composition, grip strength and sensorimotor coordination before and after the experimental protocol, while in vitro analyses included muscle wet weights, expression of selected genes and proteins regulating muscle mass, and myofiber cross-sectional area. ANOVAs were used with significance set at p < 0.05.ResultsALTH had greater lean mass than ALT and sensorimotor function increased in ALTH, but decreased in ALT under normal training conditions. Grip strength decreased only in C, but was maintained in CH. Gastrocnemius mass and myofiber CSA were greater in CH than C following catabolic conditions. Gastrocnemius atrogin-1 mRNA expression was elevated in C but not in CH compared to all other groups whereas atrogin-1 protein levels showed no significant changes.ConclusionHMB improves body composition and sensorimotor function during normal training and attenuates muscle mass and strength loss during catabolic conditions.     

Anti‐TNF‐Alpha Antibody Induced Interstitial Granulomatous Dermatitis

Cutaneous melanoma is a common and frequently lethal melanocytic neoplasm that can quickly metastasize to regional lymph nodes. Currently, prognosis is determined by measuring tumor thickness but more reliable markers for metastatic spread are urgently needed. We investigated whether the extent of tumor lymphangiogenesis can predict melanoma metastasis to sentinel lymph nodes (SLN). We quantified the extent of tumor lymphangiogenesis, as well as other factors, in excised primary tumors and in SLN biopsy samples from 45 patients with primary cutaneous melanoma. Primary melanomas from patients whose tumors had metastasized to the SLN, along with their metastastic foci, contained prominent hotspots of increased lymphatic vessel density, compared to non‐metastatic tumors. Multivariate risk analysis revealed that the lymphatic vascular area (LVA) of primary melanomas, an index of tumor lymphangiogenesis, was the most sensitive prognostic marker for SLN metastasis, and was even able to more accurately predict which tumors would become metastatic to SLN than measuring tumor thickness. The extent of tumor lymphangiogenesis is a highly sensitive (83%) and specific (89%) prognostic marker of lymph node metastasis. Assessment of lymphangiogenesis in primary melanomas may be a more effective approach than measuring tumor thickness in selecting patients with early metastatic disease for aggressive therapy.     

Prednisone improves chronic inflammatory demyelinating polyradiculoneuropathy more than no treatment

Of 40 patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), 28 completed a controlled three-month trial of prednisone. Prednisone was shown to cause a small but significant improvement over no treatment in scored neurological disability, some measures of computer-assisted sensory detection threshold, graded muscle strength, and some attributes of nerve conduction. No subset of patients was more likely than another to be responsive to prednisone; those with a progressive course were as likely to be responsive as recurrent cases. This finding provides further justification for classifying progressive with recurrent cases as CIDP and demonstrates that prednisone treatment should not be withheld from patients with progressive disease.     

Spontaneous Resolution of Arachnoid Cyst

The natural history of arachnoid cysts is not uniform; some cysts enlarge and some remain unchanged. A less recognized course is spontaneous resolution. A patient with an arachnoid cyst that resolved spontaneously is described, previously reported cases of 6 patients are reviewed, and possible mechanisms for resolution of the cysts are discussed.