Radiale Stosswellentherapie : eine mögliche konservative Behandlungsalternative bei Patientinnen und Patienten mit mildem bis moderatem Karpaltunnelsyndrom?

Hintergrund : Das Karpaltunnelsyndrom (CTS) ist das am häufigsten auftretende Engpasssyndrom eines peripheren Nervs und macht rund 90% aller peripheren Neuropathien aus. Personen mit einem Karpaltunnelsyndrom leiden unter nächtlichen Schmerzen und brennenden Parästhesien im Bereich des Handgelenks, was die Funktionsfähigkeit der betroffenen Extremität oft einschränkt. Die radiale Stosswellentherapie (rESWT) ist eine noch relativ unerforschte konservative Behandlungsmethode, die kostengünstig verwendet werden kann und kaum Nebenwirkungen aufzeigt. Ziel : Das Ziel dieser Arbeit besteht darin, herauszufinden ob die Funktionsfähigkeit und die Schmerzen bei Patientinnen und Patienten mit einem milden bis moderaten CTS durch die Behandlung mit radialer Stosswellentherapie längerfristig verbessert werden können. Methode : Zur Beantwortung der Fragestellung wurden anhand definierter Ein- und Ausschlusskriterien, in den Datenbanken CINAHL complete, MEDLINE via Ovid und PubMED, vier Studien gefunden. Die Bewertung der Studien erfolgte anschliessend mit dem AICA-Beurteilungsraster und der PEDro-Skala. Ergebnisse Die rESWT kann die Symptomstärke und die funktionellen Einschränkungen bei Betroffenen mit mildem bis moderatem CTS kurz bis mittelfristig positiv beeinflussen. Schlussfolgerung : Sofern herkömmliche konservative Behandlungsmethoden keine positive Wirkung zeigen, bietet die radiale Stosswellentherapie eine gute alternative Möglichkeit um die Symptome der Betroffenen zu verbessern. Der längerfristige Effekt wurde noch nicht untersucht.Background : The carpal tunnel syndrome (CTS) is the most common peripheral entrapment neuropathy and accounts for approximately 90% of all peripheral neuropathies. People suffering from CTS describe nocturnal pain and burning paresthesia in the region of the wrist, which in turn often limits the functioning of the affected extremity. Radial extracorporeal shock wave therapy (rESWT) is a relatively unexplored conservative treatment method that can be used cost efficiently and shows hardly any side effects. Purpose : The purpose of this study is to determine whether functional capabilities and pain in patients with mild or moderate CTS can be improved over the longer term using radial shock waves. Methods : Based on defined inclusion and exclusion criteria, four studies were found using the databases CINAHL complete, MEDLINE via Ovid and PubMED. The studies were appraised using the AICA tool and the PEDro scale. Results : Radial shock wave therapy positively improves functional capabilities and pain in patients with mild or moderate CTS over the short and medium term. Conclusion : If common conservative treatment methods fail, rESWT offers a valid alternative to alleviate symptoms of people with CTS. The long term effect remains unknown

Cortical and trabecular bone density and structure in anorexia nervosa

The aim of the study was to examine bone density and architecture with three different measurement methods in a sample of young women with anorexia nervosa (AN) and in an age-matched control group of women. Three-dimensional periphery quantitative computer tomography (3D-pQCT) at the ultradistal radius, a new technology providing measures of cortical and trabecular bone density and architecture, was performed, as well as quantitative ultrasound (QUS) at the heel, and dual energy X-ray absorptiometry (DXA) at the spine and hip. Thirty-six women with AN aged 18-30 years (mean duration of AN: 5.8 years) and 30 age-matched women were assessed. Bone mineral density measured by DXA at the spine and hip, and broadband ultrasound attenuation measured by QUS at the heel were significantly lower in patients than controls. 3D-pQCT demonstrated a highly significant deficit in the absolute number of bone trabecules and a significant reduction of cortical thickness. Severity of underweight was significantly associated with bone deficits at the hip measured by DXA. 3D-pQCT revealed mostly deficits of cortical bone related with age of onset of eating disorder. Using three different methods to measure bone density and bone structure at the hip, spine, heel and ultradistal radius, significant deficits in bone mineral density both in trabecular and cortical bone, as well in trabecular structure could be demonstrated in the AN patient

Homeostatic adaptation to endoplasmic reticulum stress depends on Ire1 kinase activity

Uncoupling of Ire1’s RNAse and kinase activities reveals that its auto-phosphorylation is important for resolution of the unfolded protein response. (See also a related paper by Chawla et al. in this issue)

被服に対する意識及び行動とそれに影響する要因

博士（学術）神戸大

Glutathione synthesis in maize genotypes with different sensitivities to chilling

The effect of chilling on enzymes, substrates and products of sulfate reduction, glutathione synthesis and metabolism was studied in shoots and roots of maize (Zea mays L.) genotypes with different chilling sensitivity. At full expansion of the second leaf, chilling at 12° C inhibited dry weight increase in shoots and roots compared to controls at 25° C and induced an increase in adenosine 5´-phosphosulfate sulfotransferase and γ-glutamylcysteine synthetase (EC 6.3.2.2) activity in the second leaf of all genotypes tested. Glutathione synthetase (EC 6.3.2.3) activity was about one order of magnitude higher than γ-glutamylcysteine synthetase activity, but remained unchanged during chilling except for one genotype. During chilling, cysteine and glutathione content of second leaves increased to significantly higher levels in the two most chilling-tolerant genotypes. Comparing the most tolerant and most sensitive genotype showed that chilling induced a greater incorporation of 35S from 35S-sulfate into cysteine and glutathione in the chilling-tolerant than in the sensitive genotype. Chilling decreased the amount of35S-label incorporated into proteins in shoots of both genotypes, but had no effect on this incorporation in the roots. Glutathione reductase (EC 1.6.4.2) and nitrate reductase (EC 1.6.6.1) activity were constitutively higher in the chilling-tolerant genotypes, but showed no changes in most examined genotypes during 3 d at 12° C. Our results indicate that in maize glutathione is involved in protection against chilling damage

Increasing the Glutathione Content in a Chilling-Sensitive Maize Genotype Using Safeners Increased Protection against Chilling-Induced Injury

With the aim of analyzing their protective function against chilling-induced injury, the pools of glutathione and its precursors, cysteine (Cys) and γ-glutamyl-Cys, were increased in the chilling-sensitive maize (Zea mays) inbred line Penjalinan using a combination of two herbicide safeners. Compared with the controls, the greatest increase in the pool size of the three thiols was detected in the shoots and roots when both safeners were applied at a concentration of 5 μm. This combination increased the relative protection from chilling from 50% to 75%. It is interesting that this increase in the total glutathione (TG) level was accompanied by a rise in glutathione reductase (GR; EC 1.6.4.2) activity. When the most effective safener combination was applied simultaneously with increasing concentrations of buthionine sulfoximine, a specific inhibitor of glutathione synthesis, the total γ-glutamyl-Cys and TG contents and GR activity were decreased to very low levels and relative protection was lowered from 75% to 44%. During chilling, the ratio of reduced to oxidized thiols first decreased independently of the treatments, but increased again to the initial value in safener-treated seedlings after 7 d at 5°C. Taking all results together resulted in a linear relationship between TG and GR and a biphasic relationship between relative protection and GR or TG, thus demonstrating the relevance of the glutathione levels in protecting maize against chilling-induced injury

Micro‐CT examinations of trabecular bone samples at different resolutions: 14, 7 and 2 micron level

International audienceTomographic techniques are attractive for the investigation of trabecular bone architecture. Using either conventional X‐ray sources or synchrotron sources currently allows the acquisition of 3D images in a wide range of spatial resolution that may be as small as a few micrometers. Since it is technically possible to examine trabecular architecture at different scales, a question is to know what type of information it is possible to get at each scale. For this purpose, a series of ten vertebrae samples from healthy females of different ages (33 to 90) was imaged at various resolutions on three different micro‐CT systems (cubic voxel size respectively 14, 6.7 and 1.4 \mum). The comparison of morphometric parameters extracted from the different images is in agreement with simulation results on the influence of spatial resolution on structure parameters. The conclusion is that a 14 \mum voxel size gives a reasonably good parameterisation of trabecular architecture. Besides the synchrotron radiation 2 \mum level images reveal interesting features on the irregularities and rupture of trabecular surface, and on remodeling zones

Inhibition of glutathione synthesis reduces chilling tolerance in maize

The role of glutathione (GSH) in protecting plants from chilling injury was analyzed in seedlings of a chilling-tolerant maize (Zea mays L.) genotype using buthionine sulfoximine (BSO), a specific inhibitor of gamma-glutamylcysteine (gamma EC) synthetase, the first enzyme of GSH synthesis. At 25 degrees C, 1 mM BSO significantly increased cysteine and reduced GSH content and GSH reductase (GR: EC 1.6.4.2) activity, but interestingly affected neither fresh weight nor dry weight nor relative injury. Application of BSO up to 1 mM during chilling at 5 degrees C reduced the fresh and dry weights of shoots and roots and increased relative injury from 10 to almost 40%. Buthionine sulfoximine also induced a decrease in GR activity of 90 and 40% in roots and shoots, respectively. Addition of GSH or gamma EC together with BSO to the nutrient solution protected the seedlings from the BSO effect by increasing the levels of GSH and GR activity in roots and shoots. During chilling, the level of abscisic acid increased both in controls and BSO-treated seedlings and decreased after chilling in roots and shoots of the controls and in the roots of BSO-treated seedlings, but increased in their shoots. Taken together, our results show that BSO did not reduce chilling tolerance of the maize genotype analyzed by inhibiting abscisic acid accumulation but by establishing a low level of GSH. which also induced a decrease in GR activity