Effect of TRPA1 activator allyl isothiocyanate (AITC) on rat dural and pial arteries

BackgroundTransient receptor potential ankyrin 1 (TRPA1) channels may have a role in migraine as some substances known to cause headache activate the channel. In the craniovascular system such activation causes a calcitonin gene-related peptide (CGRP)-dependent increase in meningeal blood flow. TRPA1 channels in the endothelium of cerebral arteries cause vasodilation when activated. The headache preventive substance feverfew inhibits activation of TRPA1 channels. In this study we aim to compare and characterize the effect of the TRPA1 agonist allyl isothiocyanate (AITC) on the diameter of rat dural and pial arteries in vivo.MethodsThe genuine closed-cranial window technique in rats was used to examine changes in dural and pial artery diameter and mean arterial blood pressure (MABP) after intracarotid infusion of AITC. Blockade experiments were performed by intravenous infusion of olcegepant, HC-030031, sumatriptan or capsazepine immediately after infusion of AITC, in four different groups of rats.ResultsAITC caused a significant dilation of dural arteries, which was inhibited by HC-030031, olcegepant and sumatriptan, but not by capsazepine.In pial arteries AITC caused a significant dilation, which was not inhibited by any of the pre-treatments, suggesting a poor penetration of the blood-brain barrier or autoregulation due to dimethyl sulfoxide (DMSO) mediated decrease in MABP during HC-030031 infusion.AITC did not cause a significant change in MABP.ConclusionAITC causes dilation of dural arteries via a mechanism dependent on CGRP and TRPA1 that is sensitive to sumatriptan. AITC causes a small but significant dilation of pial arteries.     

Moore prosthesis in the treatment of fresh femoral neck fractures: A critical review with special attention to secondary acetabular degeneration

A consecutive series of 106 patients with displaced femoral neck fractures was treated initially with Moore prostheses. The patients' mean age was 82.5 years (range, 67–91). At follow-up after two years, 71 patients attended. Thirty-seven per cent of these were in need of a conversion of their one-piece device to a total hip replacement on account of hip pain. When only active patients living in their own homes were considered, 55 per cent were found to need total hip replacements. The main reason for the development of hip pain was acetabular derangement.

It was concluded that active patients, disregarding their age, should not be treated with one piece prostheses if their fractures could be satisfactorily reduced and pinned. If this cannot be accomplished, a primary total hip replacement may be considered.     

Perineal sinus after removal of the rectum: Occlusion with fibrin adhesive

Ten patients with a discharging perineal sinus that developed after proctectomy were treated with a new fibrin adhesive system in order to close the sinus. Four of the patients also had a fistula that extended from the sinus to the vagina. Treatment was unsuccessful in two patients: one had retained foreign bodies in the sinus and the other had a rather large spheric cavity. In eight patients the sinus healed after application of fibrin adhesive, even when a fistula to the vagina was present. The method seems to be effective for closing a long, narrow perineal sinus.     

An easy procedure for in vivo estimation of protein binding and correction of elevated serum values induced by venous stasis.

Venous stasis augments the apparent concentrations of serum proteins. A theoretical mathematical model for the correction of serum protein-bound constituents is propounded and an easy procedure for such corrections described. It is suggested that the effect of venous stasis can also be utilized for in vivo estimation of the average protein binding. The hypotheses were tested in 19 epileptic patients. The results obtained by serum determinations of sodium, magnesium, calcium and phenytoin indicate the validity of the theories.     

Femoral neck fractures in young adults

Seventeen young adults with subcapital femoral neck fractures that occurred after injury and with no signs of osteoporosis were treated conservatively (2 cases) or by closed reduction and internal fixation. Evaluation of the results was based on clinical, radiological and scintigraphical examinations. The incidence of non-union was 24 per cent ($\text{4}\text{17}$) and the incidence of avascular necrosis of the femoral head was 41 per cent ($\text{7}\text{17}$). The total failure rate was 41 per cent as all fractures with non-union also had avascular necrosis. It was found that reduction was the most important factor determining the outcome, as only 17 per cent ($\text{2}\text{12}$) of fractures with a good reduction subsequently developed non-union compared with 100 per cent ($\text{5}\text{5}$) with malreduction. High-velocity injury was no more crucial than low-velocity injury. The final outcome of femoral neck fractures in young persons did not differ from the known outcome in elderly persons.     

Donor Smoking and Older Age Increases Morbidity and Mortality After Lung Transplantation

Background

The lack of lung transplant donors has necessitated the use of donors with a smoking history and donors of older age. We have evaluated the effects of donor smoking history and age on recipient morbidity and mortality with baseline values of pulmonary function and survival free of chronic lung allograft dysfunction (CLAD) as morbidity variables.

The Hamilton Anxiety Scale. Evaluation of homogeneity and inter-observer reliability in patients with depressive disorders

In the present study the Hamilton Anxiety Scale (HAS), originally constructed for patients with neurotic anxiety, has been applied to patients with diagnosis of depressive disorders. The inter-rater reliability and homogeneity are evaluated and total scale score has been correlated to the Bech-Rafaelsen Melancholia Scale (BRMES). Twenty-two patients entered the study, 13 with endogenous depressions, and 9 with non-endogenous depressions when classified according to the ICD-8. For both scales the inter-rater reliability was found statistically significant. Concerning the homogeneity of the HAS, statistical significance was obtained for 7 items reflecting psychic anxiety, whereas in the BRMES statistical significance was found in all items apart from 2. Total scale score on HAS correlated positively with total score on BRMES for all 2 patients. However, when the patients were classified according to the ICD-8 this correlation seemed to be due to the endogenously depressed group as no significant correlation was seen for the group of non-endogenous depression. On the other hand, when the patients were classified according to the MULTI-CLAD system no significant intercorrelation of the HAS and BRMES scores was found within the subtypes of depression.     

Prevalence and causes of visual impairment according to World Health Organization and United States criteria in an aged, urban Scandinavian population: The Copenhagen City Eye Study

PURPOSE: To evaluate the prevalence and causes of visual impairment in an epidemiologic study of aged, urban individuals in Denmark. DESIGN: Cross-sectional study. PARTICIPANTS: The study population consisted of 1000 randomly selected residents aged 60 to 80 years in Copenhagen, Denmark. Of 976 eligible persons, 946 (96.9%) could be examined. Information about best-corrected visual acuity (VA) was obtained from 944 cooperative persons (96.7%). METHODS: Data from the Copenhagen City Eye Study were used to assess the cause-specific prevalence of visual impairment as defined by the World Health Organization (WHO) (VA worse than 20/60-20/400 in the better eye) and the criteria used most commonly in the United States (VA worse than 20/40 but better than 20/200 in the better eye). Eligible subjects underwent an extensive ophthalmologic examination at The National University Hospital of Denmark. MAIN OUTCOME MEASURES: Best-corrected VA and primary causes of visual impairment. RESULTS: The prevalence of low vision according to the WHO definition ranged from 2.6% in subjects aged 70 to 74 years to 4.8% in subjects 75 to 80 years of age, with an age-adjusted relative prevalence of 1.58%. Using the U.S. definition, the overall age-adjusted prevalence of visual impairment was 2.9%. The causes of visual impairment according to the WHO criteria were age-related macular degeneration (AMD) (44.4%), cataract (33.3%), glaucoma in combination with cataract (11.1%), myopic macular degeneration (5.6%), and diabetic retinopathy (5.6%). However, according to the U.S. criteria, cataract was the most frequent primary cause (50.0%) and AMD was the second most frequent primary cause (34.4%) of visual impairment. Furthermore, using the U.S. criteria diabetic retinopathy was revealed as equally important as AMD and cataract as a cause of visual impairment among persons aged 65 to 69 years (33.3%). CONCLUSIONS: Increasing age was an independent predictor of visual impairment. Cataract and AMD were the leading causes. Adequate implementation of surgery to treat cataract could reduce visual impairment by 33.3% according to the WHO criteria and by 50% according to the U.S. criteria.