Etiler'de Locanda

Taha Toros Arşivi, Dosya No: 112-Lokantalarİstanbul Kalkınma Ajansı (TR10/14/YEN/0033) İstanbul Development Agency (TR10/14/YEN/0033

Suprapatellar cyst: diagnostic and therapeutic possibillities

Suprapatelarna burza nalazi se između tetive m. kvadricepsa i distalnoga dijela natkoljenične kosti, a razvija se prije rođenja kao zasebni sinovijalni prostor proksimalno od zgloba koljena. Unatoč tome što anatomija dobro opisuje i definira supratatelarnu burzu i njezinu komunikaciju sa zglobnom šupljinom koljena, činjenica je da se u praksi ta zglobna šupljina i sinovijalna burza ipak smatraju jednim sinovijalnim prostorom, a granica između njih najčešće je više ili manje izražen sinovijalni nabor poznat kao suprapatelarna sinovijalna plika. Do petoga mjeseca fetalnog života između šupljine koljenskoga zgloba i suprapatelarne burze postoji poprečni suprapatelarni septum koji kasnije perforira i involuira, tako da se uspostavlja normalna komunikacija između šupljine burze i koljena. Jedan manji dio embrionalnog septuma kasnije može zaostati kao više ili manje izražena suprapatelarna plika. U slučaju kada suprapatelarna plika ima mali otvor s ventilnim mehanizmom ili u slučaju kompletnoga septuma, burza postaje odvojeni prostor, te potencijalno mjesto za razvoj cistične formacije, odnosno suprapatelarne ciste. U stručnoj literaturi za ovu rijetku patologiju spominju se i sinonomi kao što su suprapatelarna sinovijalna cista, suprapatelarni burzitis ili antefemoralna cista. U dijagnostici, pojedini autori koristili su ultrazvuk, artrografiju, scintigrafiju i kompjuteriziranu tomografiju. Međutim, magnetska rezonancija je u literaturi prepoznata kao “zlatni standard“ u dijagnostici cista oko koljena, upravo radi mogućnosti prikaza cistične prirode lezije, njezinoga odnosa prema drugim anatomskim strukturama, te radi utvrđivanja ostale patologije koljena. U pogledu liječenja, većina cisti oko koljena u djece nestaje spontano, te bi one općenito trebale biti liječene konzervativnim tretmanom koji obuhvaća aspiraciju i aplikaciju kortikosteroida. Operacijsko liječenje rezervirano je za velike suprapatelarne ciste koje ne reagiraju na konzervativno liječenje, odnosno one s nespecifičnim sinovitisom ili hemoragijom unutar ciste, s boli i ograničenim opsegom pokreta ili s udruženom intraartikularnom patologijom. Iako se po dostupnoj literaturi suprapatelarna cista kao iznimno rijetka patologija koljena može liječiti i otvorenom ekstirpacijom, možemo istaknuti da se može učinkovito i sigurno liječiti i artroskopskom dekompresijom uz ranu fizikalnu terapiju, bez recidiva i uz brzi funkcionalni oporavak pacijenta.The suprapatellar bursa is located between the quadriceps tendon and femur, and it develops before birth as a separate synovial compartment proximal to the knee joint. Even though the anatomy describes and defines the suprapatellar bursa and its communication with the knee joint cavity very well, the fact is that in practice joint cavity and suprapatellar bursa are still considered as one synovial area, and the border between them is a more or less expressed synovial fold also known as the suprapatellar plica. By the fifth month of fetal life, there is a suprapatellar septum between the knee joint cavity and suprapatellar bursa which later perforates and involutes in a way that a normal communication between the cavity of bursa and knee is established. A small portion of the embryonic septum can later lag as more or less expressed suprapatellar plica. In the case when the suprapatellar plica has a small communication with the valve mechanism or in the case of complete septum, the bursa becomes a separate compartment and potential place for suprapatellar cyst development. In literature, thereare synonyms for this kind of pathology such as suprapatellar synovial cyst, suprapatellar bursitis or antefemoral cyst. In diagnosis, some authors have used ultrasound, arthrography, scintigraphy and computed tomography. However, in literature, the MRI is recognized as the “gold standard” in diagnosis of knee cysts because of its ability to show the cystic nature of the lesion, its relationship with other anatomic structures, as well as to establish whether other knee pathologies are present. Considering treatment possibilities, the majority of cysts around the knee in children resolve spontaneously and should be treated conservatively covering aspiration and the application of corticosteroids. Surgical treatment is reserved for large cysts with unspecific synovitis, or with hemorrhage inside the cyst, with pain and limited range of motion, or with associated intra-articular pathology. Although, according to the available literature, the suprapatellar cyst as a very rare knee pathology is treated by an open excision. In conclusion, we can point out that it can also be effectively and safely treated by arthroscopic decompression without recurrence and followed by a fast and functional recovery of the patient

Capsaicin inhibits the production of tumor necrosis factor α by LPS-stimulated murine macrophages, RAW 264.7: a PPARγ ligand-like action as a novel mechanism

AbstractCapsaicin, a major ingredient of hot pepper, is considered to exhibit anti-inflammatory properties. Our previous study demonstrated that capsaicin inhibited the production of pro-inflammatory mediators through NF-κB inactivation in LPS-stimulated macrophages. In order to further clarify the mechanism underlying the anti-inflammatory action of capsaicin, we investigated whether capsaicin alters PPARγ activity, which regulates the production of the pro-inflammatory cytokine TNFα. Capsaicin significantly inhibited the production of TNFα by macrophages in a dose-dependent manner. Simultaneous exposure of the cells to capsaicin and PPARγ agonist troglitazone or RXR agonist LG100268 resulted in stronger inhibition of TNFα production compared to the cells treated with either capsaicin, troglitazone, or LG100268 alone. Luciferase reporter assay revealed that capsaicin induced GAL4/PPARγ chimera and full length PPARγ (PPRE) transactivations in a dose-dependent manner. Furthermore, a specific PPARγ antagonist T0070907 abrogated the inhibitory action of capsaicin on LPS-induced TNFα production by RAW 264.7 cells, indicating that capsaicin acts like a ligand for PPARγ. Our data demonstrate for the first time that the anti-inflammatory action of capsaicin may be mediated by PPARγ activation in LPS-stimulated RAW 264.7 cells

The optimal activity of a pseudozymogen form of recombinant matriptase under the mildly acidic pH and low ionic strength conditions.

Matriptase is a transmembrane serine protease that is strongly expressed in epithelial cells. The single-chain zymogen of matriptase is considered to have inherent activity, leading to its own activation (i.e. conversion to the disulphide-linked-two-chain form by cleavage after Thr-Lys-Gln-Ala-Arg614). Also, there is growing evidence that the activation of zymogen occurs at the cell surface and in relation to the acidification and lowering of ionic strength within cell-surface microenvironments. The present study aimed to provide evidence for the involvement of zymogen activity in its activation in physiologically relevant cellular contexts. For this purpose, the activity of a pseudozymogen form of recombinant matriptase (HL-matriptase zymogen) was examined using acetyl-l-Lys-l-Thr-l-Lys-l-Gln-l-Leu-l-Arg-4-methyl-coumaryl-7-amide as a substrate. HL-matriptase zymogen exhibited optimal activity toward the substrate pH approximately 6.0. The substrate hydrolysis at the pH value was hardly detected when NaCl was present at a concentration of 145 mM. In a buffer of pH 6.0 containing 5 mM NaCl, the activity of HL-matriptase zymogen was only approximately 30-times lower than that of the respective two-chain form. These findings suggest that the in vivo activation of matriptase zymogen occurs via a mechanism involving the zymogen activity

Facial EMG Activity Is Associated with Hedonic Experiences but Not Nutritional Values While Viewing Food Images

The physiological correlates of hedonic/emotional experiences to visual food stimuli are of theoretical and practical interest. Previous psychophysiological studies have shown that facial electromyography (EMG) signals were related to subjective hedonic ratings in response to food images. However, because other data showed positive correlations between hedonic ratings and objective nutritional values of food, whether the facial EMG reactions to food images could reflect the hedonic evaluation or nutritional assessment of food remains unknown. To address this issue, we measured subjective hedonic ratings (liking, wanting, valence, and arousal) and physiological signals (facial EMG of the corrugator supercilii, zygomatic major, masseter, and suprahyoid muscles, skin potential responses, and heart rates) while participants observed food images that had objective nutritional information (caloric, carbohydrate, fat, and protein contents). The results revealed that zygomatic major EMG activity was positively correlated with ratings of liking, wanting, and valence, but not with any objective nutritional value. These data indicate that facial EMG signals in response to food images reflect subjective hedonic experiences, but not objective nutritional values, associated with the food item

Unconscious Affective Responses to Food

Affective or hedonic responses to food are crucial for humans, both advantageously (e.g., enhancing survival) and disadvantageously (e.g., promoting overeating and lifestyle-related disease). Although previous psychological studies have reported evidence of unconscious cognitive and behavioral processing related to food, it remains unknown whether affective reactions to food can be triggered unconsciously and its relationship with daily eating behaviors. We investigated these issues by using the subliminal affective priming paradigm. Photographs of food or corresponding mosaic images were presented in the peripheral visual field for 33 ms. Target photos of faces with emotionally neutral expressions were then presented, and participants rated their preferences for the faces. Eating behaviors were also assessed using questionnaires. The food images, relative to the mosaics, increased participants' preference for subsequent target faces. Furthermore, the difference in the preference induced by food versus mosaic images was positively correlated with the tendency to engage in external eating. These results suggest that unconscious affective reactions are elicited by the sight of food and that these responses contribute to daily eating behaviors related to overeating

Inhibition of fatty acid oxidation activates transforming growth factor-beta in cerebrospinal fluid and decreases spontaneous motor activity.

We have previously reported that transforming growth factor (TGF)-beta in the cerebrospinal fluid (CSF) is involved in the mechanism underlying the regulation of spontaneous motor activity (SMA) by the central nervous system after exercise. However, it remained unclear what physiological condition triggers the activation of TGF-beta. We hypothesized that the shortage of energy derived from fatty acid (FA) oxidation observed in the early phase of exercise activated TGF-beta in the CSF. To test this hypothesis, we investigated whether mercaptoacetate (MA), an inhibitor of FA oxidation, could induce an activation of TGF-beta in the CSF and a decrease in SMA. Intraperitoneal (i.p.) administration of MA activated TGF-beta in CSF in rats and depressed SMA; 2-deoxyglucose, an inhibitor of carbohydrate oxidation, on the other hand, depressed SMA but failed to activate CSF TGF-beta. Intracisternal administration of anti-TGF-beta antibody abolished the depressive effect of MA on SMA. We also found that the depression of SMA and the activation of TGF-beta in the CSF by i.p. MA administration were eliminated by vagotomy. Our data suggest that TGF-beta in the CSF is activated by the inhibition of FA oxidation via the vagus nerve and that this subsequently induces depression of SMA

Combined pharmacological activation of AMPK and PPARδ potentiates the effects of exercise in trained mice.

The combined activation of the cellular energy sensor AMP‐activated protein kinase (AMPK) and the nuclear transcription factor peroxisome proliferator‐activated receptor delta (PPARδ) has been demonstrated to improve endurance and muscle function by mimicking the effects of exercise training. However, their combined pharmacological activation with exercise training has not been explored. Balb/c mice were trained on a treadmill and administered both the AMPK activator AICAR and the PPARδ agonist GW0742 for 4 weeks. AICAR treatment potentiated endurance, but the combination of AICAR and GW0742 further potentiated endurance and increased all running parameters significantly relative to exercised and nonexercised groups (138–179% and 355% increase in running time, respectively). Despite the lack of change in basal whole‐body metabolism, a significant shift to fat as the main energy source with a decline in carbohydrate utilization was observed upon indirect calorimetry analysis at the period near exhaustion. Increased energy substrates before exercise, and elevated muscle nonesterified fatty acids (NEFA) and elevated muscle glycogen at exhaustion were observed together with increased PDK4 mRNA expression. Citrate synthase activity was elevated in AICAR‐treated groups, while PGC‐1α protein level tended to be increased in GW0742‐treated groups. At exhaustion, Pgc1a was robustly upregulated together with Pdk4, Cd36, and Lpl in the muscle. A robust upregulation of Pgc1a and a downregulation in Chrebp were observed in the liver. Our data show that combined pharmacological activation of AMPK and PPARδ potentiates endurance in trained mice by transcriptional changes in muscle and liver, increased available energy substrates, delayed hypoglycemia through glycogen sparing accompanied by increased NEFA availability, and improved substrate shift from carbohydrate to fat