Change of the human taste bud volume over time

Objective

The specific aim of this study is to measure the taste volume in healthy human subjects over a 2.5-month period and to demonstrate morphological changes of the peripheral taste organs.

Material and methods

Eighteen human taste buds in four fungiform papillae (fPap) were examined over a 10-week period. The fungiform papillae investigated were selected based on the form of the papillae or the arrangement of surface taste pores. Measurements were performed over 10 consecutive weeks, with five scans in a day once a week. The following parameters were measured: height and diameter of the taste bud, diameter of the fungiform papilla and diameter of the taste pore.

Results

The findings of this exploratory study indicated that (1) taste bud volumes changed over a 10-week period, (2) the interval between two volume maxima within the 10-week period was 3–5 weeks, and (3) the diameter of the fPap did not correlate with the volume of a single taste bud or with the volume of all taste buds in the fPap within the 10-week period.

Conclusions

This exploratory in vivo study revealed changes in taste bud volumes in healthy humans with age-related gustatory sensitivity. These findings need to be considered when studying the effect of denervation of fungiform papillae in vivo using confocal microscopy.     

Antegrade catheterization of the superficial femoral artery

A simple method of selective catheterization of the superficial femoral artery (SFA) following antegrade puncture of the common femoral artery is described. The method entails using a Cope-type dilator introducer, which directs the guide wire from its side hole into the SFA while the tip is secured in the deep femoral artery.     

Contrast administration and techniques of digital subtraction angiography performance

Optimal IV-DSA performance depends equally on the digital system, the patient, and the radiologist. Through enhancement and subtraction, the digital system increases contrast sensitivity, thus compensating for the relatively low spatial resolution and for the loss in contrast (density) that results from dilution of the contrast medium by injecting it on the venous side. The degree of this dilution is governed by the patient's cardiac output and the size of the central blood volume. The lower the cardiac output and the larger the central blood volume, the less opacification (more dilution) and longer transit time (more likelihood for artifacts) will result. The role of the radiologist is to optimize the available conditions. He can prevent measures that decrease cardiac output (Valsalva maneuver) or he can take measures to decrease the degree of dilution by choosing optimal contrast administration methods, such as injecting in the right atrium at a high rate and thus allowing more latitude to decrease the total volume per injection and to increase the number of injections per examination. The radiologist also attempts to combat all the sources of noninformation or misinformation resulting from voluntary or involuntary patient motion, which degrades subtraction. By observing studies in real time, the radiologist may recognize motion during the injection, and by increasing the number of exposures, he may have a late mask to save the study. On immediate review of an injection, he may recognize the need to increase the volume per injection to obtain better opacification or, conversely, to reduce the volume if it is apparent that it could be done without compromise to the study and yet allow more injections to be performed, or he may recognize a finding that requires more than the usual routine views and may obtain a better one. IV-DSA can be performed with peripheral injections of contrast medium if the area of interest is limited and superior opacification is not essential, especially if a larger image intensifier (12- to 16-inch field) is available. However, whether peripheral injections are the least invasive, depends on whether one thinks that 200 to 240 ml of Renografin-76 for four views in an outpatient is invasive or not. The notion that IV-DSA can be performed by a nurse who places the IV needle or angiocatheter, a technician who shoots the pictures, and a computer that will do the rest, while the radiologist is peripherally involved and to hope for consistently good studies, is far from realistic.(ABSTRACT TRUNCATED AT 400 WORDS)     

Changes in taste bud volume during taste disturbance

On-line mapping and serial volume measurements of taste buds with confocal laser scanning microscopy provide information on the peripheral gustatory organ over time. We report the volumetric measurements of four selected fungiform papillae over 8 weeks in a 62-year-old man with taste disturbance, which was more apparent on the right than on the left side. In the two papillae on the right side, no taste buds were detected within the fungiform papillae in the sixth and eighth week. During sixth and eighth week, there was no response to the highest presented stimuli in electrogustometry (1 mA) on the right-sided tongue tip nor at the tongue edge. The morphology (shape, diameter) of the fungiform papillae on both sides remained unchanged. Comparison of the time course of the volume changes revealed differences corresponding to gustatory sensitivity. These findings suggest that the time course of volume changes indicated taste disturbance in our patient, rather than morphological changes in the fungiform papillae.     

The current role of renal angioplasty in the treatment of renovascular hypertension

Percutaneous transluminal renal angioplasty, a relatively noninvasive technique, has assumed an increasing role in the treatment of renovascular hypertension. The combined advent of digital subtraction angiography, renal-vein renin samples, and percutaneous transluminal angioplasty have prompted many physicians to reassess their treatment strategies. The authors present their experience with renal angioplasty at the New York Hospital and briefly describe the history and mechanism of action of this procedure.     

Druy ureteral stent set: clinical experience in 25 patients

Clinical experience with a new universal-length silicone ureteral stent set is described. The technique for placing the stent is discussed in detail. The softness and universal length of the stent are important advantages over rigid stents. The set includes a peel-away sheath-introducing system, which allows for easy and rapid placement of a soft stent in most cases. Thirty-one stents have been placed since July 1985, with a mean follow-up of 17 weeks for 21 patients. There have been no stent malfunctions, and no significant complications have been encountered.     

Cohort-Controlled Comparison of Umbilical Cord Blood Transplantation Using Carlecortemcel-L,a Single Progenitor–Enriched Cord Blood,to Double Cord Blood Unit Transplantation

Umbilical cord blood (UCB) transplantation has a high early mortality rate primarily related to transplanted stem cell dose. To decrease early mortality and enhance engraftment, a portion of selected cord blood units (20% to 50%) was expanded with cytokines and the copper chelator tetraethylenepentamine (carlecortemcel-L) and transplanted with the unmanipulated fraction after myeloablative conditioning. The primary endpoint was 100-day survival, which was compared with a contemporaneous double-unit cord blood transplantation (DUCBT) group. We enrolled 101 patients at 25 sites; the DUCBT comparison (n?=?295) was selected from international registries using study eligibility criteria. Baseline carlecortemcel-L study group unit nucleated cell (NC) and CD34⁺ were 3.06?×?10⁷ cell dose/kg and 1.64?×?10⁵ cell dose/kg. Median NC and CD34⁺ fold expansion were 400 and 77, with a mean total CD34 infused of 9.7?×?10⁵/kg. The 100-day survival was 84.2% for the carlecortemcel-L study group versus 74.6% for the DUCBT group (odds ratio, .50; 95% CI, .26 to .95; P?=?.035). Survival at day 180 was similar for the 2 groups; the major cause of death after day 100 was opportunistic infections. Faster median neutrophil (21 days versus 28 days; P?<?.0001), and platelet (54 days versus 105 days; P?=?.008) engraftment was seen in the carlecortemcel-L study group; acute and chronic graft-versus-host disease rates were similar. In this multinational comparative study, transplanting expanded CD34⁺ stem cells from a portion of a single UCB unit, with the remaining unmanipulated fraction improved 100-day survival compared with DUCBT control patients while facilitating myeloid and platelet engraftment. This trial was registered at www.clinicaltrials.gov as #NCT00469729.     

Hepatitis A disease following the implementation of universal vaccination: Who is at risk?

Summary. The incidence of acute hepatitis A in Israel has decreased 25 folds in less than a decade, following the introduction of a two‐dose universal toddler’s hepatitis A immunization in July 1999. This retrospective study describes demographic data and behavioural determinants of hepatitis A patients following the implementation of a vaccination programme. All records of hepatitis A patients reported to the Ministry of Health during the years 2003 through 2005 were reviewed, and an epidemiological investigation was conducted. During the study period, 420 hepatitis A patients were reported, representing an average annual incidence of two per 100 000 population. Case fatality rate was 0.5%. The majority of the patients were younger than 15 years of age, males and non‐Jewish. The highest incidence was recorded in east Jerusalem, where vaccine coverage is relatively low. After exclusion of 165 east Jerusalem patients, 133 (52.2%) patients were available for an interview. Of those, 16 (6%) had possible occupational exposure, 37 (27.8%) travelled to endemic areas, 44 (17%) were contacts of hepatitis A cases, and 3 male patients had sex with men. No known risk determinant was identified in 33 (24.8%) patients. Four patients (3%) were previously immunized with one dose, and none had two doses. The introduction of universal toddler hepatitis A vaccination decreased morbidity. Most of the patients who were detected 4–6 years after the implementation of the vaccination programme could be classified into one of the known risk groups for hepatitis A infection or living in a partly vaccinated community.