Greater auricular nerve neuropraxia with beach chair positioning during shoulder surgery

Neuropraxia of the greater auricular nerve is an uncommon complication of shoulder surgery, with the patient in the beach chair position. The greater auricular nerve, a superficial branch of the cervical plexus, is vulnerable to neuropraxia due to its superficial anatomical location. In this case series, we present three cases of neuropraxia associated with direct compression by a horseshoe headrest, used in routine positioning for uncomplicated shoulder surgery. We outline the risk of using devices of this nature and discourage the use of similar headrest devices due to the potential complications in headrest devices that exert pressure on the posterior auricular area to maintain head position during surgery.

Glutamine repeat variants in human RUNX2 associated with decreased femoral neck BMD, broadband ultrasound attenuation and target gene transactivation

RUNX2 is an essential transcription factor required for skeletal development and cartilage formation. Haploinsufficiency of RUNX2 leads to cleidocranial displaysia (CCD) a skeletal disorder characterised by gross dysgenesis of bones particularly those derived from intramembranous bone formation. A notable feature of the RUNX2 protein is the polyglutamine and polyalanine (23Q/17A) domain coded by a repeat sequence. Since none of the known mutations causing CCD characterised to date map in the glutamine repeat region, we hypothesised that Q-repeat mutations may be related to a more subtle bone phenotype. We screened subjects derived from four normal populations for Q-repeat variants. A total of 22 subjects were identified who were heterozygous for a wild type allele and a Q-repeat variant allele: (15Q, 16Q, 18Q and 30Q). Although not every subject had data for all measures, Q-repeat variants had a significant deficit in BMD with an average decrease of 0.7SD measured over 12 BMD-related parameters (p = 0.005). Femoral neck BMD was measured in all subjects (−0.6SD, p = 0.0007). The transactivation function of RUNX2 was determined for 16Q and 30Q alleles using a reporter gene assay. 16Q and 30Q alleles displayed significantly lower transactivation function compared to wild type (23Q). Our analysis has identified novel Q-repeat mutations that occur at a collective frequency of about 0.4%. These mutations significantly alter BMD and display impaired transactivation function, introducing a new class of functionally relevant RUNX2 mutants.

Rapid onset of renal sympathetic nerve activation in rabbits fed a high-fat diet

Hypertension and elevated sympathetic drive result from consumption of a high-calorie diet and deposition of abdominal fat, but the etiology and temporal characteristics are unknown. Rabbits instrumented for telemetric recording of arterial pressure and renal sympathetic nerve activity (RSNA) were fed a high-fat diet for 3 weeks then control diet for 1 week or control diet for 4 weeks. Baroreflexes and responses to air-jet stress and hypoxia were determined weekly. After 1 week of high-fat diet, caloric intake increased by 62%, accompanied by elevated body weight, blood glucose, plasma insulin, and leptin (8%, 14%, 134%, and 252%, respectively). Mean arterial pressure, heart rate, and RSNA also increased after 1 week (6%, 11%, and 57%, respectively). Whereas mean arterial pressure and body weight continued to rise over 3 weeks of high-fat diet, heart rate and RSNA did not change further. The RSNA baroreflex was attenuated from the first week of the diet. Excitatory responses to air-jet stress diminished over 3 weeks of high-fat diet, but responses to hypoxia were invariant. Resumption of a normal diet returned glucose, insulin, leptin, and heart rate to control levels, but body weight, mean arterial pressure, and RSNA remained elevated. In conclusion, elevated sympathetic drive and impaired baroreflex function, which occur within 1 week of consumption of a high-fat, high-calorie diet, appear integral to the rapid development of obesity-related hypertension. Increased plasma leptin and insulin may contribute to the initiation of hypertension but are not required for maintenance of mean arterial pressure, which likely lies in alterations in the response of neurons in the hypothalamus.

IMF®-Therapy (Intention controlled Myo-Feedback) — an innovative method in the treatment of peripheral nerve lesions

Physiotherapy is a well established part of the rehabilitation of peripheral nerve paralysis. The aim of this type of treatment is to re-establish arbitrary functions by improving the patients’ active and passive mobility as well as their strength and stamina. IMF®-Therapy (Intention controlled Myo-Feedback) is an innovative method in the treatment of peripheral nerve lesions that goes beyond the purely neuro-scientific framework and also takes into account methods and concepts of the psychology of learning. The essential assumption is that things learnt in the past are firmly established in the long term motor memory and can be reactivated by the patient. From results achieved in 32 patients treated with this therapy it can be concluded that IMF®-Therapy may be a promising additional rehabilitation tool in peripheral nerve lesion.

Nanostructured block copolymer blends and complexes via hydrogen bonding interactions

This thesis investigates the influence of hydrogen bonding interactions on the self-assembly, phase behaviour and nanostructures of the block copolymer/homopolymer systems. The different combinations of block copolymer blends and complexes of AB/C, AB/CD, and ABC/D mixtures open a convenient way to tailor various morphologies with controlled size and shape.

Overcoming interfacial affinity issues in natural fiber reinforced polylactide biocomposites by surface adsorption of amphiphilic block copolymers

This work demonstrates that the interfacial properties in a natural fiber reinforced polylactide biocomposite can be tailored through surface adsorption of amphiphilic and biodegradable poly (ethylene glycol)-b-poly-(L-lactide) (PEG-PLLA) block copolymers. The deposition from solvent solution of PEG-PLLA copolymers onto the fibrous substrate induced distinct mechanisms of molecular organization at the cellulosic interface, which are correlated to the hydrophobic/hydrophilic ratios and the type of solvent used. The findings of the study evidenced that the performance of the corresponding biocomposites with polylactide were effectively enhanced by using these copolymers as interfacial coupling agents. During the fabrication stage, diffusion of the polylactide in the melt induced a change in the environment surrounding block copolymers which became hydrophobic. It is proposed that molecular reorganization of the block copolymers at the interface occurred, which favored the interactions with both the hydrophilic fibers and hydrophobic polylactide matrix. The strong interactions such as intra- and intermolecular hydrogen bonds formed across the fiber−matrix interface can be accounted for the enhancement in properties displayed by the biocomposites. Although the results reported here are confined, this concept is unique as it shows that by tuning the amphiphilicity and the type of building blocks, it is possible to control the surface properties of the substrate by self-assembly and disassembly of the amphiphiles for functional materials.

Reduced preprandial dipping accounts for rapid elevation of blood pressure and renal sympathetic nerve activity in rabbits fed a high-fat diet

Consumption of a high-fat diet (HFD) by rabbits results in increased blood pressure (BP), heart rate (HR), and renal sympathetic nerve activity (RSNA) within 1 wk. Here, we determined how early this activation occurred and whether it was related to changes in cardiovascular and neural 24-h rhythms. Rabbits were meal-fed a HFD for 3 wks, then a normal-fat diet (NFD) for 1 wk. BP, HR, and RSNA were measured daily in the home cage via implanted telemeters. Baseline BP, HR, and RSNA over 24 h were 71 ± 1 mm Hg, 205 ± 4 beats/min and 7 ± 1 normalized units (nu). The 24-h pattern was entrained to the feeding cycle and values increased from preprandial minimum to postprandial maximum by 4 ± 1 mm Hg, 51 ± 6 beats/min, and 1.6 ± .6 nu each day. Feeding of a HFD markedly diminished the preprandial dip after 2 d (79–125% of control; p < 0.05) and this reduction lasted for 3 wks of HFD. Twenty-four-hour BP, HR, and RSNA concurrently increased by 2%, 18%, and 22%, respectively. Loss of preprandial dipping accounted for all of the BP increase and 50% of the RSNA increase over 3 wks and the 24-h rhythm became entrained to the light-dark cycle. Resumption of a NFD did not alter the BP preprandial dip. Thus, elevated BP induced by a HFD and mediated by increased sympathetic nerve activity results from a reduction in preprandial dipping, from the first day. Increased calories, glucose, insulin, and leptin may account for early changes, whereas long-term loss of dipping may be related to increased sensitivity of sympathetic pathways.

A new route to prepare multiresponsive organogels from a block ionomer via charge-driven assembly

We report a novel route to prepare multiresponsive organogels through charge-driven assembly between a block ionomer and a diblock copolymer. The ionic complex aggregates to form spherical cores, which are connected by the middle block of the block ionomer to form gels. The organogels are responsive to acids, amines and salts.