Total cholesterol and high-density lipoprotein levels in pediatric subjects with type 1 diabetes mellitus

This study reports serum lipid levels in 682 children with type 1 diabetes mellitus. We found that 3.5% of the subjects had a high-density lipoprotein (HDL) cholesterol level < 35 mg/dL, 15.4% had a total cholesterol (TC) level>200 mg/dL, and 18.6% were abnormal for either HDL or TC, compared with prevalences of 5.7%, 11.2%, and 16.3%, respectively, reported in the National Health and Nutrition Examination Survey 2001-02. Hemoglobin A1c value was significantly related to TC and non-HDL cholesterol levels.     

Outcome after anatomic reduction and transfixation with Kirschner wires of Lisfranc joint injuries

Injuries to the tarsometatarsal (Lisfranc) joint are uncommon, and the results of treatment are often unsatisfactory. Open reduction and internal fixation has been recommended as the treatment of choice for most unstable injuries. In the present study, we reviewed 16 patients who underwent closed or open reduction and Kirschner-wire transfixation of a Lisfranc injury in an 11-year period. Mean follow-up was 44 (range, 12–108) months. Average American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score was 78 (range, 45–100) points. Eight patients (50%) developed posttraumatic arthritis of the tarsometatarsal joints. The major cause was nonanatomical reduction, whereas patients with purely ligamentous injury showed a trend toward poorer postoperative outcome. On the basis of our study, open anatomical reduction of fracture-dislocations of the Lisfranc joint and Kirschner-wire transfixation leads to the best long-term outcome.     

Neuroanatomy of the brachial plexus: the missing link in the continuity between the central and peripheral nervous systems

The brachial plexus is a complex network of nerves which extends from the neck to the axilla and which supplies motor, sensory, and sympathetic fibers to the upper extremity. Generally it is formed by the union of the ventral primary rami of the spinal nerves, C5-C8 and T1, the so-called "roots" of the brachial plexus. The goal here is to examine the neural architecture of the brachial plexus. The most constant arrangement of nerve fibers will be delineated, and then the predominant variations in neural architecture will be defined, particularly the prefixed and postfixed plexus, as well as the microanatomy and anatomy of the major terminal branches of the plexus. Multiple tracts connect many parts of the nervous system, and multiple ascending and descending tracts connect the peripheral nervous system (PNS) and lower spinal centers with the brain. This reflects that the nervous system is able to extract different pieces of sensory information from its surroundings and encode them separately, and that it is able to control specific aspects of motor behavior using different sets of neurons. Examination of the major sensory or motor pathways reveals a highly and tightly organized nervous system. In particular, at each of many levels, we see fairly exact maps of the world within the brain. In an effort to understand the functional neuroanatomy of the brachial plexus, this paper will focus briefly on the nervous connections of the nerves of the upper extremity with the brain. The goal here is to better understand "what the brain sees" after nerve injury and repair.     

Characterization of KLK4 expression and detection of KLK4-specific antibody in prostate cancer patient sera

The ability to identify prostate tumor or prostate tissue specific genes that are expressed at high levels and use their protein products as targets could greatly aid in the diagnosis and treatment of prostate cancer. Using a polymerase chain reaction (PCR)-based subtraction technique, we have recovered the recently described KLK4 (prostase) gene from human prostate cDNA. In this study, KLK4 gene expression in human prostate tumors was further characterized using cDNA quantitative PCR and immunohistochemistry, demonstrating that the gene is specifically expressed at both the mRNA and protein levels in normal human prostate tissue, and in both primary and metastatic prostate tumor samples. Quantitative mRNA analysis also demonstrated low level expression including adrenal gland, salivary gland and thyroid. Finally, it was demonstrated that prostate cancer patient sera contain antibodies that bind specifically to recombinant KLK4 protein. This antibody has been used to detect KLK4-specific peptides in epitope mapping experiments. The relatively specific expression profile and elevated level of KLK4 mRNA and protein in both tumor and normal prostate tissues, in addition to detectable KLK4-specific antibody in cancer patient sera, supports additional efforts to determine if KLK4 can play a role in the diagnosis of prostate cancer, the monitoring of residual disease, or act as a target for immunotherapy.     

Effect of meteorological parameters on acute laryngitis in adults

The aim of this study was to investigate the influence of weather conditions on the frequency of acute laryngitis in adults. The medical records of 825 patients with a diagnosis of acute laryngitis obtained over a 5-year period were reviewed. Meteorological data reviewed included the daily values of 13 parameters. The monthly distribution of the disease was assessed. In addition, a detailed 2-part statistical analysis was performed as follows: (i) the relationship between each meteorological parameter and the frequency of the disease was investigated, using contingency tables; and (ii) the 1825-day period was divided into 8 groups characterized by similar weather, using factor and cluster analysis, and the disease frequency in each group was assessed. Our observations were as follows: 1. Meteorological parameters, such as low temperature, low diurnal temperature range, low atmospheric pressure and low mean water vapor pressure, were associated with an increased occurrence of acute laryngitis. 2. Significant changes in maximum temperature or a significant drop in atmospheric pressure, as compared to the previous day's conditions, favored new cases of the disease. 3. The cold period of the year was associated with an almost two-fold increase in the frequency of disease cases, which peaked in March and reaching a minimum during August. 4. The peak frequency of cases was associated with winter weather conditions, which were characterized by high humidity readings. In conclusion, meteorological parameters, and their variation and covariation, are strongly associated with acute laryngitis in adults.     

LMP1 structure and signal transduction

The oncogenic Epstein-Barr virus (EBV)-encoded latent membrane protein 1 (LMP1) has structural features and functions reminiscent of a constitutively active TNF family receptor. LMP1 aggregates at the plasma membrane and initiates the activation of signalling pathways, such as NF- kappa B, the mitogen-activated protein kinases JNK and p38, the small GTPase Cdc42 and the JAK/STAT cascade. The constitutive engagement of these signals and the characteristic molecular interactions that regulate them provide the basis for the molecular explanation of the transforming properties of this key EBV protein.     

Cartilage "shield" grafts in revision tympanoplasty.

OBJECTIVE: To report our experience with cartilage "shield" grafts in revision tympanoplasty. STUDY DESIGN: Retrospective chart review at a tertiary referral center. Patients underwent revision tympanoplasties by replacing the entire tympanic membrane with concha cymba cartilage shaped as a shield. MAIN OUTCOME MEASURES: Successful graft take was defined as having no perforation, graft retraction, or lateralization. Hearing results were analyzed by comparing the preoperative and postoperative pure-tone average air-bone gap and speech discrimination scores. RESULTS: Forty-three patients underwent 46 procedures. Graft take was successful in 43 procedures (93.5%). There was no graft lateralization or displacement into the middle ear. An overall postoperative air-bone gap of 25 dB or less was achieved in 22 of the 39 patients (56.4%), and speech discrimination scores remained unchanged. CONCLUSION: Cartilage shield tympanoplasty is a reliable procedure for revision tympanoplasty patients, with excellent graft take and significant improvement of hearing.