Pretransplant bilateral hand-assisted laparoscopic nephrectomy in adult patients with polycystic kidney disease.

Laparoscopic procedures continue to gain popularity over traditional open procedures for a number of abdominal and pelvic surgeries. With increasing experience, the application of this technique is rising because it provides an alternative, less invasive, approach to various surgical procedures. Herein, we report our experience with adult patients with polycystic kidney disease, requiring bilateral laparoscopic nephrectomy before renal transplantation.     

Topography and ultrastructure of commissural interneurons that may establish reciprocal inhibitory connections of the Mauthner axons in the spinal cord of the tench,Tinca tinca L.

Summary This study was made to identify the inhibitory interneurons belonging to the spinal circuitry activated by the Mauthner axons in the tench (Tinea tinea L.). The histological investigations were focused on a segmentai pair of commissural interneurons that were reconstructedin toto from their distinguishing topographical and ultrastructural features. These features are: (a) the adendritic soma located 100–150 m dorsal to the central canal; (b) the first node of Ranvier which is precommissural and connected to the ipsilateral Mauthner axon via gap junction; (c) the second node of Ranvier, from which two first-order branches arise postcommissurally each supplying roughly the rostral and caudal half of the contralateral spinal cord segment; (d) their second-order branches, which arise at intervals that correspond closely to those of the Mauthner axon collaterals; (e) the postsynaptic targets of the second-order branches, which are exclusively all the motoneurons and interneurons innervated by the contralateral Mauthner axon; (f) the axon terminals of these branches, which contain F-type vesicles, form Gray type-2 synapses, and abut either on the initial segment or on the first node of Ranvier of the target neurons. Thus, it appears that this segmental interneuron has all the appropriate features that could provide the structural basis for the reciprocal fast-acting inhibitory coupling underlying the startle reflex elicited by the Mauthner neurons in response to auditory stimuli.     

Changes in the craniomandibular relations of acromegaly patients

The dishomeostazical theory (etiopathogenic integrative concept) allows an ample and complex vue on the stomatognathic system dysfunctional syndrome, because it begins from the perception of the stomatognathic system (SS) as a whole in which the alteration of each element can induce the disfunction of the entire system. The purpose of this study is to demonstrate that the neuroendocrine suprasystemic factor (STH hypersecretion on adult organism) disturbs every element of the SS and induces an important alteration of the fundamental cranio-mandibular relations.     

The relationship between circulating fibrinogen and lipoprotein (a) levels in patients with primary dyslipidemia.

The correlation between 2 predictors of vascular events, plasma fibrinogen and serum lipoprotein (a), was evaluated in patients referred to a specialist clinic because of primary hyperlipidemia. A significant correlation existed between fibrinogen and lipoprotein (a) in nonsmokers but not in smokers. Plasma fibrinogen concentration correlated positively and significantly with serum lipoprotein (a) levels in men nonsmokers without cardiovascular disease and in women nonsmokers with cardiovascular disease. Nonsmoker women without cardiovascular disease had significantly higher plasma fibrinogen (3.63 g/L versus 3.07 g/L, P < .0001) than the corresponding men. Nonsmoker women with and without cardiovascular disease had significantly higher lipoprotein (a) levels than the corresponding groups of men (0.36 versus 0.18 g/L; P = .0015 and 0.40 versus 0.26 g/L; P = .008), respectively. The relationship between fibrinogen and lipoprotein (a) levels alters markedly depending on the population selected. This relationship is influenced by gender, the presence of cardiovascular disease and smoking status.     

The relationship between adiponectin, an adiponectin gene polymorphism, and high-density lipoprotein particle size: from the Mima study

This study examined the association among serum adiponectin levels, a single nucleotide polymorphism (SNP) of the adiponectin gene, and the size of serum high-density lipoprotein (HDL) particles in a general population. A total of 275 subjects were examined as part of the community-based Mima study. Serum adiponectin levels were measured with an enzyme-linked immunosorbent assay. Serum small-sized HDL was measured with the electrophoretic separation of lipoproteins using the Lipoprint system. Single nucleotide polymorphism G276T (rs1501299, SNP276) of the adiponectin gene was determined with a fluorescent allele-specific DNA primer assay system. Age- and sex-adjusted correlation test revealed a significant inverse relationship between small-sized HDL and adiponectin levels (r = -0.236, P < .001). More percentages of small-sized HDL were observed in the subjects with the SNP276 G/G and G/T genotypes than in those with the T/T genotype (5.5% ± 5.0% vs 3.0% ± 2.9%, P = .016). In a multiple regression analysis, small-sized HDL was significantly and independently correlated with triglycerides levels (β = 0.133, P = .030), adiponectin levels (β = -0.242, P < .001), and the SNP276 G allele (β = -0.142, P = .014). Our findings indicated that adiponectin and SNP276 of the adiponectin gene may modify the size of HDL particles.     

Neuromuscular transmission in hypoxemic patients with chronic obstructive pulmonary disease

Many studies have focused on the systemic effects of chronic obstructive pulmonary disease (COPD), but none has examined neuromuscular junction transmission (NMT). We evaluated NMT dysfunction using single-fiber electromyography (SFEMG) in patients with COPD. Twenty patients with COPD and 20 age-matched healthy controls were included in the study. All patients and controls underwent SFEMG. Abnormal NMT was found in seven of 20 patients (35%), but in none of the control subjects. The COPD patients were subgrouped according to the presence of hypoxemia. The patients with normoxemia were classified as Group 1, and the patients with hypoxemia were classified as Group 2. Abnormal NMT was found in six patients in Group 2 and in one in Group 1. While there was significant difference in terms of abnormal NMT between Group 2 and the controls, there was none between Group 1 and the controls. Our results show that NMT abnormalities can be present in hypoxemic patients with COPD.