Norepinephrine reduces heat responses of cutaneous C-fiber nociceptors in Sprague-Dawley rats in vitro

Nociceptors are excited or sensitized by many inflammatory mediators as well as by elevation of tissue temperature. We have shown that there is a facilitatory synergistic interaction between norepinephrine (NE) and bradykinin (BK) on cutaneous C-fiber nociceptors in normal Lewis rats. These interactions may play an important role in the mechanism of sympathetically maintained pain. In the present experiment, using skin-saphenous nerve in vitro preparations, we tested the effect of NE on the activity of nociceptive fibers and their response to heat in normal Sprague-Dawley rats. For comparison with the previous data on Lewis rats, we also examined the effect of NE on BK response. NE (10(-5) or 10(-6) M) did not excite nociceptive fibers before repeated heat stimuli or BK superfusion (10(-5) or 10(-6) M) to the receptive field. In contrast, after a few applications of heat or BK, NE excited 20-43% of nociceptive fibers to similar magnitudes. We also found that NE sensitized subsequent BK responses, but somewhat unexpectedly that it suppressed subsequent heat responses. This occurred regardless of the presence or absence of NE-induced excitation. These results suggest different mechanisms of NE modification to the BK and heat responses of cutaneous C-fiber nociceptors.     

Cytological diagnosis of nonulcerative penile neoplasms: report of two cases

Nonulcerative penile mass lesions are rare. Pathological diagnosis of these lesions would traditionally be a biopsy. We report two such primary penile lesions which were diagnosed by fine-needle aspiration cytology (FNAC). Both lesions were present in the shaft and were diagnosed as squamous cell carcinoma (SCC). The first patient had a recurrence on the penile stump of partial amputation without any ulceration. The second had a primary urethral carcinoma on the terminal penile shaft infiltrating the corpora cavernosa dorsally. Open biopsies were avoided in both cases. FNAC was associated with very little and tolerable discomfort. There were no complications. The aspirate yield was sufficient for cytological diagnosis. FNAC of nonulcerated penile lesions is safe, well tolerated, and capable of providing a cytological diagnosis. Hence, it is a very useful outpatient procedure and could be the procedure of choice for diagnosis.     

Grebe chondrodysplasia and brachydactyly in a family

A family is reported in which various skeletal abnormalities have been segregating over three generations. The Great-grandfather (11) of the consultand had features consistent with Grebe chondrodysplasia. The other members of the family have brachydactyly, radiologically characterised by short first metacarpals and short middle phalanges of the index and little fingers. The possibility of association of familial brachydactyly and Grebe chondrodysplasia is discussed. An attempt has been made to deal with the genetic counselling problem in this particular family.     

Bilateral sternalis with unusual left-sided presentation: a clinical perspective

An unusual variation creates interest among anatomists, but is a cause of concern among clinicians when it mimics a pathology. The sternalis muscle is one such variant of the anterior chest wall located subcutaneously over the pectoralis major, ranging from a few short fibers to a well-formed muscle. We observed a bilateral case, which was accompanied by an atypical presentation on the left side where a huge, bulky sternalis muscle was associated with the absence of the sternal fibers of the pectoralis major. The fibers arose as a lateral strip from the upper two-thirds of the body of the sternum and costal cartilages 2 through 6 with the intervening fascia and aponeurosis of the external oblique. The right sternalis was strap-like and was placed vertically over the sternal fibers of the pectoralis major, arising from the underlying fascia and aponeurosis of the external oblique. The sternalis muscles, on each side, converged into an aponeurosis over the manubrium that was continuous with the sternal heads of the right and left sternocleidomastoid muscle, respectively. This rare anomaly has puzzled radiologists and surgeons in confirming diagnosis, missing it all together or mistaking it for a tumor on mammography or CT scan. These findings prompted us to review its topography, development, and application in relation to the anterior chest wall.     

Stress as a precipitating factor in subjects with recurrent herpes labialis

The model of recurrent herpes labialis was selected to evaluate the role played by stress in increasing susceptibility to illness. Initially, 35 paid volunteers with recurrent herpes were enrolled in the project. Compared with 35 age- and sex-matched controls, this group demonstrated a familial predisposition for recurrent herpes labialis. Eighteen subjects without confounding variables known to precipitate recurrent herpes infections completed a pretested "stress" questionnaire during a dormant and again during an active stage of infection. In the week prior to the appearance of a recurrence, this group experienced increased daily hassles, increased stressful life events, and higher state anxiety. These findings are discussed in the broader context of stress-associated disease with some speculations concerning a possible biologic mechanism, which involves modulations of T-lymphocyte function.     

Ephemeral pseudonym based de-identification system to reduce impact of inference attacks in healthcare information system

Health Services and Outcomes Research Methodology - As healthcare data is extremely sensitive, it poses a risk of invading individuals' privacy if stored or exported without proper security...