A new model of sciatic inflammatory neuritis (SIN): induction of unilateral and bilateral mechanical allodynia following acute unilateral peri-sciatic immune activation in rats.

Immune activation near healthy peripheral nerves may have a greater role in creating pathological pain than previously recognized. We have developed a new model of sciatic inflammatory neuritis to assess how such immune activation may influence somatosensory processing. The present series of experiments reveal that zymosan (yeast cell walls) acutely injected around the sciatic nerve of awake unrestrained rats rapidly (within 3h) produces low threshold mechanical allodynia in the absence of thermal hyperalgesia. Low (4 microg) doses of zymosan produce both territorial and extra-territorial allodynia restricted to the ipsilateral hindpaw. Higher (40-400 microg) doses of zymosan again produce both territorial and extra-territorial allodynia. However, allodynia is now expressed both in the ipsilateral as well as contralateral hindpaws. Several lines of evidence are provided that the appearance of this contralateral ('mirror') allodynia reflects local actions of zymosan on the sciatic nerve rather than spread of this immune activator to the general circulation. Since many clinical neuropathies result from inflammation/infection of peripheral nerves rather than frank physical trauma, understanding how immune activation alters pain processing may suggest novel approaches to pain control.     

Surviving meningococcal septic shock in childhood: long-term overall outcome and the effect on health-related quality of life

Introduction  

The purpose of this study was to evaluate associations between long-term physical and psychological outcome variables in patients who survived meningococcal septic shock (MSS) in childhood.     

Breast cancer oestrogen independence mediated by <Emphasis Type="Italic">BCAR1</Emphasis> or <Emphasis Type="Italic">BCAR3</Emphasis> genes is transmitted through mechanisms distinct from the oestrogen receptor signalling pathway or the epidermal growth factor receptor signalling pathway

Introduction  

Tamoxifen is effective for endocrine treatment of oestrogen receptor-positive breast cancers but ultimately fails due to the development of resistance. A functional screen in human breast cancer cells identified two BCAR genes causing oestrogen-independent proliferation. The BCAR1 and BCAR3 genes both encode components of intracellular signal transduction, but their direct effect on breast cancer cell proliferation is not known. The aim of this study was to investigate the growth control mediated by these BCAR genes by gene expression profiling.     

Craniosynostosis: diagnostic value of three-dimensional CT reconstruction

Three-dimensional computed tomography (CT) has an important role in determining the presence and extent of congenital and acquired craniofacial deformities. The authors compared the sensitivity and specificity of three-dimensional CT in the detection and characterization of craniosynostosis with that of planar CT and skull radiography. Eighty-two patients with isolated and syndromal synostoses were imaged with CT and three-dimensional CT, and 42 with skull radiography. Three-dimensional CT scan processing was performed by shaded-surface reconstruction, volumetric, and depth-coded methods. Two trained observers read each scan series in a blinded fashion. Diagnostic utility of the images was determined with receiver operating characteristic analysis. The observers ranked three-dimensional shaded images higher than the other types, with three-dimensional volumetric images second and three-dimensional surface images ranked third. Results of this study demonstrate that three-dimensional shaded-surface reconstruction from CT scans is superior to conventional plain radiographs and CT scans in diagnosing craniosynostosis.     

Experimental lymph node metastases: enhanced detection with MR lymphography

Magnetic resonance (MR) lymphography with superparamagnetic iron oxide (AMI-25) as a contrast agent was developed in an animal model with tumor-bearing lymph nodes. After interstitial administration of 20 mumol of iron per kilogram of body weight into the footpads of rats, the T2 of popliteal and paraaortic lymph nodes decreased from 67 msec +/- 8.2 to 9.5 msec +/- 0.9 and 9.3 msec +/- 0.9, respectively. T2 relaxation times of lymph nodes containing metastases showed a significantly higher value (61 msec +/- 6.2, P less than .005) after interstitial administration of the contrast agent. Intravenous administration of AMI-25 did not produce enhancement of normal or metastatic lymph node relaxation times. The signal intensity of normal lymph nodes decreased profoundly on spin-echo MR images (repetition time of 500 msec, echo time of 30 msec) after interstitial administration, whereas lymph nodes with metastases showed no significant change in signal intensity. Experimental results indicate that MR lymphography may potentially increase the sensitivity of MR imaging the detection of lymphatic malignancy.     

Antibodies to Cardiolipin in Stroke: Association with Mortality and Functional Recovery in Patients Without Systemic Lupus Erythematosus

Antibodies to cardiolipin were measured in 100 consecutive patientswith first ever stroke, on admission and at three and six monthsafter the acute event. One hundred healthy, age-and sex-matched,British elderly individuals were also screened for antibodiesto cardiolipin as a control group. Elevated levels of anticardiolipin antibody (i.e. 5SD abovethe laboratory control mean) were present in none of the controlgroup, but in 21 per cent of the patients with stroke. Thirteenof these 21 patients (62 per cent) died within three months,compared to 17 (21.5 per cent) of the seventy-nine patientswithout elevated levels of anticardiolipin antibodies (p<0.001).Six of the eight survivors with persistently elevated anticardiolipinantibodies had significant residual disability following stroke(Barthel score 0–9) compared to 11 of the 62 without (p<0.001).Two patients with initially raised anticardiolipin antibodieswho became independent at six months showed a progressive declinein the level of these antibodies to normal. The presence of high levels of anticardiolipin antibody didnot correlate with other recognized prognostic indices of stroke,except for incontinence. No correlation was noted between levelsof antibody to cardiolipin, antinuclear factor, antibody todouble-stranded DNA and C-reactive protein, either in the strokepatients or in the elderly control population. Hypertensionwas significantly more common in the patients with high anticardiolipinantibodies than in the rest of the patients in the stroke population(p=0.33). There was no correlation between levels of anticardiolipinantibody and age. Anticardiolipin antibody may be consideredas an independent prognostic marker for both mortality and clinicaloutcome after acute stroke.