Vesicoureteral reflux in adults: a review of 95 patients

Ninety-five adult patients with primary vesicoureteral reflux were reviewed concerning the presenting symptoms, radiological findings, associated renal damage, treatment and results of follow-up. We found a relatively high incidence of reflux in adult males. Although urinary tract infection and flank pain were the most common presentation, others had a wide variety of complaints not directly attributable to reflux. Renal anomalies were present in 37 patients. We found surgical correction of reflux useful in preventing infection, and recommend it especially in young women who may become pregnant.     

The relation between sensitivity changes and response time scale in the barnacle photoreceptor

Responses to brief light flashes were recorded intracellularly from the photoreceptors of the barnacle in order to study the relation between changes in sensitivity and latency. Conditioning lights either increased the response to a test flash (facilitation) or reduced it (desensitization). In both cases there was a shortening of the response latency. Similar observations were made when background illumination was used instead of conditioning lights. These effects were not qualitatively altered when the extracellular Ca2+ concentration was lowered. The results suggest that facilitation is not the result of a reduction of intracellular Ca2+ concentration; i.e. it is not the reverse of desensitization. Since during facilitation there is an increase in photoresponse associated with latency shortening it can be suggested that the underlying mechanism is an enhancement of the effective light intensity. The experiments do not provide quantitative evidence for this idea.     

Prolactin modulates hypothalamic preproenkephalin,but not proopiomelanocortin,gene expression during lactation

The aim of this study was to examine prolactin (PRL) regulation of preproenkephalin and proopiomelanocortin (POMC) gene expression in the hypothalamus during lactation. In the first experiment, lactating rats were deprived of pups for 3, 6, 12, or 24 h. Preproenkephalin mRNA levels were decreased in the arcuate nucleus (ARC) to 60 or 53% of suckled levels and in the ventromedial nucleus to 70% of suckled levels after 12 or 24 h but were unchanged in the striatum. POMC mRNA levels in the ARC and periarcuate area were increased to 165% of suckled levels within 3 h and remained elevated two- to threefold for 24 h. Subcutaneous administration of bromocriptine to suckled dams markedly suppressed circulating PRL levels and decreased preproenkephalin mRNA signal levels to 38 and 50% of control levels in the arcuate and ventromedial nuclei, respectively. Intravenous administration of oPRL completely reversed this effect. By contrast, bromocriptine with or without administration of ovine PRL (oPRL) did not alter POMC mRNA signal levels in the ARC. Administration of oPRL to pup-deprived dams increased preproenkephalin mRNA levels in the arcuate and ventromedial nuclei and reduced POMC mRNA levels in the ARC to levels similar to suckled control levels. In conclusion, POMC neurons in the ARC appear to be refractory to PRL regulation in the presence of a suckling stimulus, and other components of the suckling stimulus may contribute to the suppression of POMC mRNA levels during lactation. By contrast, PRL provides a regulatory influence for the suckling-induced increase in preproenkephalin mRNA signal levels in arcuate and ventromedial nuclei.     

Postoperative infections after heart surgery under extracorporeal circulation

Postoperative infection is still an important cause of mortality and morbidity after cardiac surgery. The aim of this study was to assess its incidence and causes in order to optimise treatment. Between January 1996 and December 1997, 1,000 consecutive patients (253 women and 747 men) were operated for cardiac aortic pathology under cardiopulmonary bypass. The mean age was 66 +/- 11 years. The initial pathology was coronary artery disease (N = 663), valvular heart disease (N = 193), an association of the two (N = 94), thoracic aortic pathology (N = 38) or other pathologies (N = 12). The global postoperative infection rate was 4.9% (N = 49). The incidence of sternal and/or mediastinal infections was 0.7%, of bronchopneumonia 0.9%, urinary infection 2.1%, and septicaemia 1.7%. Nine patients died of the consequences of an infection. The hospital stay was significantly longer in infected patients, irrespective of the site of infection. Statistical analysis of the whole population did not show any predictive factor related to the preoperative clinical status of the patients. The only predictive factor demonstrated was the day on which surgery was performed: the infection rate in patients operated during the first 4 days of the week was 2.2% compared with 7.3% for the patients operated during the last 3 days (p = 0.004, odds ratio (OR) = 3.57). In those patients who had an urinary infection, the two identified risk factors were the female gender (p = 0.006, OR = 3.34) and an operation performed at the end of the week (p = 0.017, OR = 3.77). In patients with sternal and medistinal infections, the only identified predictive factor was combined coronary artery and valvular surgery (p = 0.009, OR = 7.43). With respect to pulmonary infections, the only predictive factor was recent preoperative myocardial infarction (< 1 month) (p = 0.004, OR = 7.5). Finally, no predictive risk factors were identified in those patients who developed septicaemia. In conclusion, this study showed that postoperative infection remains a serious complication of cardiac surgery. The prevention of these complications should be a priority for quality health care.     

Systemic inflammation activates satellite glial cells in the mouse nodose ganglion and alters their functions

Satellite glial cell (SGCs) in trigeminal and dorsal root ganglia are altered structurally and functionally under pathological conditions associated with chronic pain. These changes include reactive gliosis, augmented coupling by gap junctions, and increased responses to ATP via purinergic P2 receptors. Similar information for nodose ganglia (NG), which receive sensory inputs from internal organs via the vagus nerves, is missing. Here, we investigated changes in SGCs in mouse NG after the intraperitoneal administration of lipopolysaccharide (LPS), which induces systemic inflammation. Using calcium imaging we found that SGCs in intact, freshly isolated NG are sensitive to ATP, acting largely via purinergic P2 receptors (mixed P2X and P2Y), with threshold at 0.1 μM. A single systemic injection of LPS (2.5 mg/kg) induced a 6‐fold increase in the responses to ATP, largely by augmenting the sensitivity of P2X receptors. Immunohistochemical analysis revealed that at 1–14 days post‐LPS injection the expression of glial fibrillary acidic protein in SGCs was 2–3‐fold greater than controls. The expression of pannexin 1 channels increased 2‐fold at day 7 after LPS injection. Using intracellular labeling we examined dye coupling among SGCs around different neurons, and observed an over 2‐fold higher incidence of dye coupling after the induction of inflammation. Incubating the ganglia with ATP increased dye coupling by acting on neuronal P2X receptors, suggesting a role for ATP in the LPS‐induced changes. We conclude that inflammation induces prominent changes in SGCs of NG, which might have a role in vagal afferent functions, such as the inflammatory reflex. GLIA 2015;63:2121–2132