Effects of anti-inflammatory and anti-rheumatic drugs on the activities of purified and membrane-bound Na+/K+ adenosine triphosphatase

We have examined the effects of anti-inflammatory and anti-rheumatic drugs on membrane-bound and purified Na+/K+-ATPase activity in vitro. Only the gold-containing compounds (gold sodium thiomalate and auranofin) were found to inhibit the enzyme activity in a dose-dependent manner. Sodium thiomalate and triethylphosphine, the ligand compounds for gold sodium thiomalate and auranofin, respectively, had no effect on ATPase activity. The antagonistic properties was abolished by preincubation of the gold compounds with dithiothreitol. Lineweaver-Burke analysis of the inhibitions of purified ATPase by the gold compounds was found to follow uncompetitive kinetics. Inhibition of ATPase by gold may cause disruption of transmembrane cation transport and thus result in impairment of several metabolic processes and cellular functions.     

Experience and design recommendations for picture archiving and communication systems in the surgical setting

An analysis of the efficacy of a picture archiving and communication system (PACS) in the surgical domain was undertaken at the Baltimore Veterans Affairs Medical Center. Interviews with surgeons and staff were conducted and supplemented by direct radiologist observation in the operating room (OR) and surgical outpatient clinic to determine patterns of routine clinical PACS use, levels of satisfaction both within and outside of the OR, and perceptions of the relative efficacy of the system in comparison to film. These data as well as suggestions from the surgical staff members were used to make recommendations for specific modifications in PACS design and operation to improve the current system and to help prescribe design improvements for future PAC systems. A high level of satisfaction with the system was found and the use of PACS was favored over film by a majority of surgeons and their staff. Findings of this study suggest that the design of a hospital-wide PAC system must have the flexibility to accommodate the specific requirements of a wide variety of end-users in their unique hospital environments.     

Systolic functional response of normal older and younger adult left ventricles to beta-blockade during exercise

Summary There is controversy over the effects of beta-blockade on the left ventricular systolic response of the heart of the elderly to stress. In this study we compared the effects of acute beta-blockade in normal older and younger adult left ventricles during exercise. The study population consisted of 17 healthy elderly people, 67±3 years old, while 18 young normal subjects, 31±4 years old, served as controls. A symptom-limited exercise treadmill test was performed before and 15 minutes after intravenous administration of 0.12 mg propranolol/kg. M-mode echocardiographic studies were performed before and immediately after each test. Intravenous propranolol at rest decreased heart rate by 14±7 beats/min in the elderly and by 7.5±8 beats/min in the young (p=0.02), decreased the double product by 2500±1200 mmHg/min and 1830±970 mmHg/min (p=0.05), respectively; changed the left ventricular end-systolic dimension by +0.21±0.36 cm and +0.03±0.24 cm (p=0.09), respectively; and changed the end-diastolic dimension by +0.22±0.46 cm in the elderly and by –0.02±0.32 cm in the young (p=0.08). The change in fractional shortening was –1.22±4.17% in the elderly and –0.78±4.05% in the young (p>0.05), and the decrease in the systolic blood pressure/end-systolic dimension ratio was 5.9±7 mmHg/cm and 4.3±3.8 mmHg/cm, respectively (p>0.05). During exercise, however, propranolol had the same effects in the two groups. These results indicate that beta-blockade has the same effects on normal older and younger adult left ventricles during exercise and is well tolerated by the elderly.     

Hunger Modulates the Responses to Gustatory Stimuli of Single Neurons in the Caudolateral Orbitofrontal Cortex of the Macaque Monkey

1. In order to determine whether the responsiveness of neurons in the caudolateral orbitofrontal cortex (a secondary cortical gustatory area) is influenced by hunger, the activity evoked by prototypical taste stimuli (glucose, NaCl, HCl, and quinine hydrochloride) and fruit juice was recorded in single neurons in this cortical area before, while, and after cynomolgous macaque monkeys were fed to satiety with glucose or fruit juice. 2. It was found that the responses of the neurons to the taste of the glucose decreased to zero while the monkey ate it to satiety during the course of which his behaviour turned from avid acceptance to active rejection. 3. This modulation of responsiveness of the gustatory responses of the neurons to satiety was not due to peripheral adaptation in the gustatory system or to altered efficacy of gustatory stimulation after satiety was reached, because modulation of neuronal responsiveness by satiety was not seen at earlier stages of the gustatory system, including the nucleus of the solitary tract, the frontal opercular taste cortex, and the insular taste cortex. 4. The decreases in the responsiveness of the neurons were relatively specific to the food with which the monkey had been fed to satiety. For example, in seven experiments in which the monkey was fed glucose solution, neuronal responsiveness decreased to the taste of the glucose but not to the taste of blackcurrant juice. Conversely, in two experiments in which the monkey was fed to satiety with fruit juice, the responses of the neurons decreased to fruit juice but not to glucose. 5. These and earlier findings lead to a proposed neurophysiological mechanism for sensory-specific satiety in which the information coded by single neurons in the gustatory system becomes more specific through the processing stages consisting of the nucleus of the solitary tract, the taste thalamus, and the frontal opercular and insular taste primary taste cortices, until neuronal responses become relatively specific for the food tasted in the caudolateral orbitofrontal cortex (secondary) taste area. Then sensory-specific satiety occurs because in this caudolateral orbitofrontal cortex taste area (but not earlier in the taste system) it is a property of the synapses that repeated stimulation results in a decreased neuronal response. 6. Evidence was obtained that gustatory processing involved in thirst also becomes interfaced to motivation in the caudolateral orbitofrontal cortex taste projection area, in that neuronal responses here to water were decreased to zero while water was drunk until satiety was produced.     

Hirnelektrische Studien über Pharmako-Logische Lokalisation im Gehirn

Ohne ZusammenfassungHerrn ProfessorPierre Rijlant möchten wir hier unseren herzlichsten Dank aussprechen für die großzügige Unterstützung unserer Forschungen.     

Improved staging using intraoperative ultrasound for mediastinal lymphadenectomy in non-small lung cancer surgery

BackgroundExtent of lymph node involvement in patients with non-small cell lung cancer (NSCLC) is the cornerstone of staging and influences both multimodality treatment and final outcome. The aim of this study was to investigate accuracy and characteristics of intraoperative ultrasound guided systematic mediastinal nodal dissection in patients with resected NSCLC.MethodsFrom January 2008 to June 2013, 244 patients undergoing intraoperative surgical staging after radical surgery for NSCLC were included in prospective study. The patients were divided in two groups according to systematic mediastinal nodal dissection: 124 patients in intraoperative ultrasound nodal dissection guided group and 120 in standard nodal dissection group. The lymph nodes were mapped by their number and station and histopathologic evaluation was performed.ResultsOperating time was prolonged for 10 min in patients with ultrasound guided mediastinal nodal dissection, but number and stations of evaluated lymph nodes were significantly higher (p < 0.001) in the same group. Skip nodal metastases were found in 24% of patients without N1 nodal involvement. Twelve (10%) patients were upstaged using US guided mediastinal lymphadenectomy. In US guided group 5-year survival rate was 59% and in the group of standard systematic mediastinal lymphadenectomy 43% (p = 0.001) Standard staging system seemed to be improved in ultrasound guided mediastinal lymphadenectomy patients. Complication rate showed no difference between analyzed groups.ConclusionHigher number and location of analyzed mediastinal nodal stations in patients with resected NSCLC using ultrasound is suggested to be of great oncological significance. Our results indicate that intraoperative ultrasound may have important staging implications.     

Flexible intramedullary nailing for radial neck fractures in children

ObjectiveThe aim of this study was to analyze the outcomes of treatment and the rate of complications in children treated with flexible intramedullary nailing (FIN) for radial neck fractures.MethodsThe study included 26 children (11 males and 15 females) with a median age of 9.5 years, treated with FIN for the radial neck fractures between May 2011 and May 2018. Immobilization after the surgery was not used. The median follow-up was 41 months. According to the Judet classification, 15 fractures were classified as type III and 11 as Type IV. For each patient, clinical, radiological, and disability of the arm, shoulder, and hand (DASH) scores were calculated.ResultsAll patients achieved complete radiographic healing at a median of 5 weeks. The nails were removed at a median of 4 months. The rate of complications was 11.5%, including 1 radial head necrosis, 1 angulation of 15°, and 1 displacement of the radial head. Twenty patients (76.9%) achieved a perfect clinical healing, while 23 patients (88.5%) achieved a perfect radiological healing. The median DASH score was 1.25. No cases of delayed healing were recorded. After removing of the nails, all patients returned to full function of the extremity and all complications were resolved.ConclusionThe use of FIN for treating fractures of the radial neck in children shows very good functional and cosmetic results. It allows mobilization with rapid pain reduction. It is a minimally invasive, simple, and reproducible technique with a low rate of complication. Owing to excellent results, surgical stabilization of radial head and neck fractures using FIN is recommended in children and adolescents.Level of EvidenceLevel IV, Therapeutic study