Analysis of olfactory function and the depth of olfactory sulcus in patients with Parkinson's disease.

Olfactory deficit is known to occur frequently in Parkinson's disease (PD). This study aimed to explore olfactory deficit in PD and to investigate its possible correlation with the disease severity or the depth of the olfactory sulcus. Fifty-nine PD patients and 25 normal controls were examined by the odor identification test with the crosscultural smell identification test (CC-SIT). Among these subjects, the depth of the olfactory sulcus of 42 PD patients and 8 controls was measured in the plane of the posterior tangent through the eyeballs using the coronal view brain MRI. The CC-SIT scores of the PD patients were significantly lower than those of the normal control (P<0.001). However, CC-SIT did not correlate with the disease duration, H-Y stage, score of UPDRS Part III, or the depth of either side of the olfactory sulcus (P>0.05). Our study confirms that CC-SIT is a helpful test in detecting the olfactory deficit in Korean PD patients. The absence of correlation of olfactory deficit with the disease severity or the depth of olfactory sulcus may suggest that olfactory loss precede the development of motor signs and not be a primary consequence of damage to the olfactory sulcus.     

Pure isolated medial talonavicular joint dislocation following low-energy trauma: a case report

Midtarsal dislocations are relatively rare injuries secondary to high-energy trauma and are typically accompanied by disruption of ligamentous structures and fractures of the midfoot. We herein present a case of a pure isolated medial swivel dislocation of the talonavicular joint (TNJ) that was sustained following low-energy trauma without an associated fracture. A 78-year-old woman visited our emergency department with severe pain in the midfoot area of the right foot without neurovascular deficits. She had sustained this injury after severe ankle inversion while going downstairs. Plain radiographs of the right foot showed that the navicular was dislocated medially on the talus; no other malalignments were present. Three-dimensional computed tomography revealed dislocation of the TNJ, but no other tarsal or midtarsal bone fractures or dislocations. A medial dorsal incision was made to expose the TNJ. The dorsal talonavicular ligament was ruptured and interposed between the navicular and talus. The ligament was removed and the TNJ was reduced. The clinical outcome at the 1-year follow-up was satisfactory with no limitations in daily activities. In summary, we have reported an extremely rare case of a pure isolated medial TNJ dislocation in which the interposed dorsal talonavicular ligament served as an obstacle to reduction.     

Protective effects of adipose-derived stem cells against UVB-induced skin pigmentation

Background: Hyperpigmentation, mainly following UV-irradiation, can cause major cosmetic concerns. Human adipose tissue-derived stem cells (ASCs) have been reported to serve as whitening agents through a paracrine effect. However, there have been few reports on the direct effects of ASCs on skin pigmentation following UVB-irradiation.

Methods: To evaluate the effect of ASCs on UVB-irradiated mouse skin, UVB-irradiation alone was applied to one side of the backs of mice (melanin-processing hairless mouse, HRM-2) as a control, and UVB-irradiation plus injection of ASCs was applied to the contralateral side. Skin pigmentation and histology were evaluated and the number of DOPA-positive melanocytes in the mouse skin was counted. The absolute value of ΔL* via a colorimeter was measured to evaluate the degree of skin pigmentation. The effects of ASCs on the melanogenic activities of mouse skin were examined by measuring the tyrosinase activity and the melanin contents in the epidermis of the mouse skin.

Results: Skin pigmentation was suppressed in the ASC-injected side. Moreover, the change in skin thickness following UVB irradiation was reduced in the ASC-injected side. The number of DOPA-positive melanocytes in the ASC-injected side (139?±?18 cells/mm²) was significantly lower than that in the control side (239?±?48 cells/mm²). The tyrosinase activity (67.4?±?9.8% of that of the control side) and melanin content (63.4?±?5.7% of that of the control side) of the ASC-injected side were also significantly reduced.

Conclusions: Collectively, these results suggest that ASCs injected subcutaneously into the backs of mice can attenuate tanning following UVB-irradiation, through suppression of tyrosinase activity.     

The correlation between pharyngeal narrowing and the severity of sleep-disordered breathing.

OBJECTIVE: The aim of this study was to examine the correlation between the degree or shape of pharyngeal narrowing as observed during the Muller maneuver and the severity of sleep-disordered breathing (SDB). SUBJECTS AND METHODS: We enrolled 33 patients with SDB, and they underwent polysomnography (PSG). The degree of pharyngeal narrowing (grade I-IV) according to fiberoptic nasopharyngoscopy with the Muller maneuver (FNMM) and the shape of pharyngeal narrowing were evaluated at different anatomical levels. These variables were compared with the total apnea hypopnea index (AHI), the supine AHI, and the lateral AHI obtained by PSG. RESULTS: The retroglossal FNMM grades revealed significant correlation with total AHI (P = 0.030) and supine AHI (P = 0.012). The retropalatal FNMM grades were significantly correlated with lateral AHI (P = 0.020). The lateral-narrowing type at the retropalatal level is more significantly associated with higher total AHI compared with the anteroposterior-narrowing type (P = 0.010). CONCLUSION: The anatomic level and the degree of pharyngeal narrowing observed during FNMM revealed a correlation with the AHIs of different sleeping positions.     

Comparison study of olfactory function and substantia nigra hyperechogenicity in idiopathic REM sleep behavior disorder, Parkinson’s disease and normal control

Rapid eye movement (REM) sleep behavior disorder (RBD) is a preclinical feature of synucleinopathies, such as Parkinson’s disease (PD).This study aimed to investigate the presence of potential early manifestations of parkinsonism, such as olfactory dysfunction and substantia nigra (SN) hyperechogenicity, in idiopathic RBD (iRBD) patients, PD patients and normal controls. We performed an olfactory function test using the cross-cultural smell identification test (CC-SIT) and midbrain transcranial sonography (TCS) in 15 patients with iRBD as confirmed by polysomnography, 30 patients with PD, and 30 normal controls. The CC-SIT scores of the iRBD patients and PD patients were significantly lower than those of the normal controls and similar between iRBD and PD (mean ± SD, 7.1 ± 2.2 and 7.6 ± 2.4 vs. 10.4 ± 1.2, respectively, p < 0.01). The sum of bilateral SN echosignals in the iRBD patients was greater than that of the normal controls but lower than that of the PD patients (0.29 ± 0.47, 0.11 ± 0.17 and 0.72 ± 0.41 cm², respectively, p < 0.01). In conclusion, we found that the concomitant abnormality of olfaction and increased SN echogenicity was more frequent in iRBD compared with normal control. Olfactory dysfunction and SN hyperechogenicity could be preclinical manifestations of parkinsonism in iRBD patients.     

BMS-191095, a cardioselective mitochondrial katp opener, inhibits human platelet aggregation by opening mitochondrial katp channels

We evaluated the antiplatelet effects of two classes of ATP-sensitive potassium channel openers (K(ATP) openers) on washed human platelets, and the study's emphasis was on the role of mitochondrial K(ATP) in platelet aggregation. Collagen-induced platelet aggregation was inhibited in a dose dependent manner by lemakalim and SKP-450, which are potent cardio-nonselective K(ATP) openers, and also by cardioselective BMS-180448 and BMS-191095 (IC50: 1,130, >1,500, 305.3 and 63.9 microM, respectively), but a significantly greater potency was noted for the cardioselective K(ATP) openers. The latter two K(ATP) openers also inhibited platelet aggregation induced by thrombin, another important blood-borne platelet activator, with similar rank order of potency (IC50: 498.0 and 104.8 microM for BMS-180448 and BMS-191095, respectively). The inhibitory effects of BMS-191095 on collagen-induced platelet aggregation were significantly blocked by a 30-min pretreatment of platelets with glyburide (1 microM) or sodium 5-hydroxydecanoate (5-HD, 100 microM), a nonselective and selective mitochondrial K(ATP) antagonist, respectively, at similar magnitudes; this indicates the role of mitochondrial K(ATP) in the antiplatelet activity of BMS-191095. However, glyburide and 5-HD had no effect when they were added to the platelet cuvette immediately prior to the addition of BMS-191095. These findings indicate that cardioselective mitochondrial K(ATP) openers like BMS-191095 are able to exert cardioprotective effects in cardiac ischemia/reperfusion injury via dual mechanisms directed at the inhibition of platelet aggregation and the protection of cardiomyocytes, and both these mechanisms are mediated by mitochondrial K(ATP).     

Cardioprotective effect of KR-33889, a novel PARP inhibitor,against oxidative stress-induced apoptosis in H9c2 cells and isolated rat hearts

Oxidative stress plays a critical role in cardiac injury during ischemia/reperfusion (I/R). Despite a potent cardioprotective activity of KR-33889, a novel poly (ADP-ribose) polymerase inhibitor, its underlying mechanism remains unresolved. This study was designed to investigate the protective effects of KR-33889 against oxidative stress-induced apoptosis in rat cardiomyocytes H9c2 cells and isolated rat hearts. H₂O₂ caused severe injury to H9c2 cells, mainly due to apoptosis, as revealed by TUNEL assay. However, KR-33889 pretreatment significantly attenuated H₂O₂-induced apoptosis of H9c2 cells, which was accompanied by decrease in expression of both cleaved caspase-3 and Bax and increase in Bcl-2 expression and the ratio of Bcl-2/Bax. KR-33889 also significantly enhanced the expression of anti-oxidant enzymes including heme oxygenase-1, Cu/Zn-superoxide dismutase (SOD), Mn-SOD, and catalase, thereby inhibiting production of intracellular ROS. Furthermore, KR-33889 reversed H₂O₂-induced decrease in phosphorylation of Akt, GSK-3β, ERK1/2, p38 MAPK, and SAPK/JNK during most H₂O₂ exposure time. In globally ischemic rat hearts, KR-33889 inhibited both I/R-induced decrease in cardiac contractility and apoptosis by increasing Bcl-2, decreasing both cleaved caspase-3 and Bax expression, and enhancing expression of anti-oxidant enzymes. Taken together, these results suggest that KR-33889 may have therapeutic potential to prevent I/R-induced heart injury in ischemic heart diseases mainly by reducing oxidative stress-mediated myocardial apoptosis.     

Surgical,radiologic, and histologic findings of the antrochoanal polyp

BACKGROUND: Of 15 patients with primary unilateral antrochoanal polyps (ACPs), we noticed that all ACPs except one extended through the accessory ostium of the maxillary sinus projected posterior along the nasal cavity. We observed no structural changes in ostiomeatal area on a coronal computed tomography scan. METHODS: We classified 15 patients with ACP into three stages according to the coronal computed tomography findings of (i) status of the accessory ostium of the maxillary sinus and (ii) level of extension to the nasopharynx. The extent of inflammation in the computed tomography and histologic aspects were also evaluated according to such stages. RESULTS: In three patients, ACPs did not extend to the nasopharynx (stage I). Among the other ACPs reaching the nasopharynx, complete occlusion of the opening (stage II) was noted in seven patients, and partial occlusion of the opening (stage III) was noted in five patients. The extent of ipsilateral, as well as bilateral, inflammation in the maxillary sinus in stages I and II was greater than that in stage III. More severe inflammatory cell infiltration was observed in stage II in histologic examination. CONCLUSIONS: We hypothesize that stage I may correspond to an early stage, stage II to full-blown disorder, and stage III to a regression stage. When the exit site of an ACP is the accessory ostium, this opening should be connected to the natural ostium of the maxillary sinus to prevent a possible recirculation phenomenon.