State of the Art: Islet Transplantation for the Cure of Type 1 Diabetes Mellitus

Reviews in Endocrine and Metabolic Disorders -     

Stimulation of the ventral tegmental area (A10 region) enhances the hypothalamic attack behavior in the cat

The influence of the A10 region of the ventral tegmental area (VTA) on the quiet biting attack evoked by stimulation of the lateral hypothalamic nucleus (LH) was studied. The latency of the biting was considered as reference value and measured with stop-watches; it remained constant when hypothalamic stimulation was performed with the same parameters. Simultaneous activation of the A10 neuron group induced a facilitation of the aggression in the form of a decrease in the biting latency or a display of the attack pattern when LH was stimulated with parameters below the threshold for biting appearance. The facilitatory effect of the A10 neurons of the VTA is discussed.     

Four ovarian cancers diagnosed during laparoscopic management of 1011 women with adnexal masses.

OBJECTIVES: This study was conducted to assess the value of laparoscopic management of adnexal masses. Two concerns we wish to address are the failure to diagnose early ovarian cancer at laparoscopy and worsening the prognosis of stage I cancer by spilling fluid during surgery. STUDY DESIGN: The setting is a predominantly referral-based, private subspecialty practice. All operations were preformed in the outpatient surgical suite of a large suburban hospital. After extensive patient screenings, which included history and physical examination, preoperative serum CA 125 levels (since 1988), and pelvic ultrasonography, 1209 adnexal masses were managed laparoscopically. RESULTS: Of 1011 patients with surgical management, ovarian cancer was discovered intraoperatively in four. CONCLUSIONS: Our findings indicate that with consistent use of frozen sections of all cyst walls and suspicious tissue, laparoscopic management did not alter the prognosis. Neither CA 125 level, pelvic ultrasonography, nor peritoneal cytologic testing had sufficient diagnostic specificity to predict malignancy. Experienced surgeons using intraoperative histologic sampling may safely evaluate adnexal mass laparoscopically.     

Present status of axially angled angiocardiography

Axial angiography visualizes anatomical details of normal and pathological hearts not previously demonstrated by conventional angiography. Progress in the diagnosis of congenital heart malformations using axial projection technique has been reconsidered, emphasizing that the anatomical details of each congenital heart malformation and their associated anomalies that can be revealed by axial angiography. Three angiographic views form the basis of this study: long axial, four chamber, and elongated right anterior oblique. Relevant findings are presented in isolated ventricular septal defect, tetralogy of Fallot, atrioventricular septa defects, common ventricle, and stradding atrioventricular valves. Variability in the position and orientation of the heart requires adjustment of the degree of obliquity and/or angulation of the X-ray beam in individual patients to obtain the appropriate angiographic views.     

Spondylo-costal dysostosis in two siblings.

Two new cases of Spondylo-Costal Dysostosis (SCD) are reported in two siblings with strikingly similar skeletal abnormalities. Parental consanguinity documents in this family an autosomal recessive inheritance of trait. Clinical variability of SCD is discussed on the basis of clinical and radiological features. Its genetic heterogeneity is pointed out even considering the occurrence of cases with autosomal dominant as well as recessive inheritance.     

Serotonin involvement in the basal ganglia pathophysiology: could the 5-HT2C receptor be a new target for therapeutic strategies?

The basal ganglia are a highly interconnected group of subcortical nuclei in the vertebrate brain that play a critical role not only in the control of movements but also in some cognitive and behavioral functions. Several recent studies have emphasized that serotonergic pathways in the central nervous system (CNS) are intimately involved in the modulation of the basal ganglia and in the pathophysiology of human involuntary movement disorders. These observations are supported by anatomical evidence demonstrating large serotonergic innervation of the basal ganglia. In fact, serotonergic terminals have been reported to make synaptic contacts with dopamine (DA)-containing neurons and gamma-aminobutyric acid (GABA)-containing neurons in the striatum, globus pallidus, subthalamus and substantia nigra. These brain areas contain the highest concentration of serotonin (5-HT), with the substantia nigra pars reticulata receiving the greatest input. Furthermore, in these structures a high expression of 5-HT different receptor subtypes has been revealed. In this paper, evidence demonstrating the serotonergic control of basal ganglia functions will be reviewed, focusing on the role of the 5-HT2C receptor subtype. In addition, the involvement of 5-HT2C receptors in neurological disorders such as Parkinson's disease and other related motor disorders, and their management with drugs blocking the 5-HT2C receptor will be discussed.     

Central serotonin2C receptor: from physiology to pathology

Since the 1950s, when serotonin (5-HT) was discovered in the mammalian central nervous system (CNS), an enormous amount of experimental evidence has revealed the pivotal role of this biogenic amine in a number of cognitive and behavioural functions. Although 5-HT is synthesized by a small group of neurons within the raphe nuclei of the brain stem, almost all parts of the CNS receive serotonergic projections. Furthermore, the importance of 5-HT modulation and the fine-tuning of its action is underlined by the large number of 5-HT binding sites found in the CNS. Hitherto, up to 15 different 5-HT receptors subtypes have been identified. This review was undertaken to summarize the work that has explored the pathophysiological role of one of these receptors, the 5-HT2C receptor, that has been emerged as a prominent central serotonin receptor subtype. The physiology, pharmacology and anatomical distribution of the 5-HT2C receptors in the CNS will be firstly reviewed. Finally, their potential involvement in the pathophysiology of depression, schizophrenia, Parkinson's disease and drug abuse will be also discussed.     

Univentricular heart: An angiographic study

Axial angiograms of 54 patients with a univentricular heart were reviewed to determine the anatomic details demonstrated by this technique. The main ventricular chamber was of left ventricular morphology in 36, right ventricular morphology in 13 and indeterminate in 5 patients. Forty-three patients had a rudimentary ventricular chamber that was supporting a great artery in 35 patients. Eighteen patients had separate atrioventricular (A-V) valves. In four of them, one A-V valve was overriding the trabecular septum, but predominantly committed to the main ventricular chamber. Eleven patients had a single right and 13 a single left A-V valve; a common A-V valve was present in 12.The techniques used provided good demonstration of the morphology of the ventricular mass, particularly the position and orientation of a septum when present. They also delineated the morphology of the A-V valve or valves and their precise ventricular connection. Ventriculoarterial connections and relations were readily determined. It is concluded that these methods are superior to isolated frontal and lateral views and provide thorough demonstration of the intracardiac anatomy of patients with a univentricular heart.