Water-Free Sodium Accumulation

The widely accepted concept of body fluid and electrolyte homeostasis is that Na⁺ is restricted mainly to the extracellular fluid and K⁺ to the intracellular space, where both ions act to hold water and thereby control the extracellular and intracellular fluid volume by their osmotic activity. Na⁺ accumulation thus inevitably leads to water retention. The constancy of the extracellular volume is the task of the kidneys, which control the total body Na⁺ content. More recent data have questioned this traditional view, suggesting that large amounts of Na⁺ can be accumulated without accompanying water retention by osmotically inactive Na⁺ retention, or by osmotically neutral Na⁺/K⁺ exchange. Besides the control of the body Na⁺ content by the kidneys, redistribution of body electrolytes hence provides an extrarenal regulatory alternative in the maintenance of body fluid volume and blood pressure control.     

A direct neural projection from the intergeniculate leaflet of the lateral geniculate nucleus to the deep pineal gland of the rat, demonstrated with Phaseolus vulgaris leucoagglutinin.

The anterograde tracerPhaseolus vulgaris leucoagglutinin (PHA-L) was injected into different subregions of the rat lateral geniculate nucleus. After a survival for 5–10 days, the rats were fixed by perfusion with 4% paraformaldehyde, whereafter the brains were cut in a cryostat and the tracer was localized by immunohistochemistry. After deposits of PHA-L involving the intergeniculate leaflet, a high number of PHA-L-immunoreactive fibers were observed to project directky into the posterior commissure. From the posterior commissure, some nerve fibers turned dorsally and entered into the deep pineal gland, a part of the pineal complex located in between the posterior and the habenular commissure. A few PHA-L-immunoreactive fibers were observed in the pineal stalk, but no fibers were detected in the superficial pineal gland. In cases where the injections were placed in the dorsal or ventral subnuclei, no immunoreactive nerve fibers were observed to enter the pineal complex. These results indicate that the intergeniculate leaflet of the lateral geniculate nucleus, a nucleus considered to be involved in circadian rhythmicity, might influence the pineal gland, via a neural projection to the rostral part of the pineal complex.     

Treatment of Patients with Early Breast Cancer: Evidence,Controversies, Consensus: German Expert Opinions on the 17th International St. Gallen Consensus Conference

This yearʼs 17th St. Gallen (SG) Consensus Conference on the Treatment of Patients with Early Breast Cancer (SG-BCC) with the title “Customizing local and systemic therapies for women with early breast cancer” focused on the challenge of targeting the treatment of early breast cancer more specifically to the individual disease situation of each patient. As in previous years, a German working group of leading breast cancer experts discussed the results of the international SG-BCC 2021 in the context of the German guideline. It is helpful to compare the SG recommendations with the recently updated treatment recommendations of the Breast Commission of the German Working Group on Gynaecological Oncology (Arbeitsgemeinschaft Gynäkologische Onkologie e. V., AGO) and the S3 guideline because the SG-BCC panel comprised experts from different countries, which is why country-specific aspects can be incorporated into the SG recommendations. The German treatment recommendations of the AGO and the S3 guideline are based on current evidence. Nevertheless, any therapeutic decision must always undergo a risk-benefit analysis for the specific situation and to be discussed with the patient.Key words: St. Gallen Consensus 2021, early breast cancer, surgery, radiotherapy, (neo)adjuvant systemic therapy, targeted therapy     

Manganese-enhanced MRI of the mouse auditory pathway.

Functional mapping of the lateral lemniscus and the superior olivary complex as part of the auditory pathway was accomplished for the first time in mice in vivo using manganese-enhanced MRI (2.35T, 3D FLASH, 117 microm isotropic resolution). These and other auditory centers in the brainstem presented with pronounced signal enhancements after systemic administration of manganese chloride when animals were exposed to acoustic stimuli for 48 hr, but not when kept in a quiet environment. The results indicate an activation-dependent accumulation of manganese in the neural circuit composed of the cochlear nucleus, the superior olivary complex, the lateral lemniscus, and the inferior colliculus. The marked enhancement of the lateral lemniscus suggests that the stimulus-related accumulation of manganese reflects not only a regional uptake from extracellular fluid but also a concurrent delivery by axonal transport within the auditory system.     

Agreement,reliability and validity in 3 shoulder questionnaires in patients with rotator cuff disease

Background  

Self-report questionnaires play an important role as outcome measures in shoulder research. Having an estimate of the measurement error of these questionnaires is of importance when assessing follow-up results after treatment and when planning intervention studies. The aim of this study was to cross-culturally adapt the Norwegian version of the OSS and WORC questionnaire and examine and compare agreement, reliability and construct validity of the disease-specific shoulder questionnaire WORC with two commonly used shoulder questionnaires, SPADI and OSS, in patients with rotator cuff disease.