Somato-somatic theory of referred pain elucidates observations of referred sensations during micropigmentation of nipple-areolar complex in a cohort study on patients undergoing pedicled latissimus dorsi flap breast reconstruction.

AIM: Micropigmentation of the nipple-areolar complex is the final aesthetic step in autologous breast reconstruction. The mechanism of referred pain observed in patients during micropigmentation after a non-neurotonized pedicled latissimus dorsi flap breast reconstruction is poorly understood. METHODS: Patients undergoing micropigmentation for nipple-areolar restoration at our breast unit were included in this study. Baseline sensitivity of both breasts was recorded using a questionnaire and non-invasive Semmes-Weinstein monofilament testing. Patients experiencing local and regional referred symptoms, while undergoing micropigmentation, were identified and their clinical data were collected and analysed. Three months postoperatively, the patients completed a questionnaire pertaining to their satisfaction and future analgesic preference. RESULTS: Thirty (17.8%) patients experienced referred sensations during micropigmentation. Their symptoms ranged from "ache" (6.7%), "discomfort" (13.3%) to "deep pain" (13.3%) and were either local and/or referred to ipsilateral axilla, upper limb and back. The majority were pleased with postoperative outcomes [shape (30, 100%), size (28, 93.3%), colour match (22, 73.3%)] and a small number were not satisfied with the shape (2, 6.7%,) position (1, 3.3%) and appearance of the tattoo (1, 3.3%). CONCLUSION: Micropigmentation is a safe procedure with good patient satisfaction and low rates of complications; however, patients may experience significant local or referred symptoms. This observation can be explained by the proposed "somato-somatic" theory of referred pain and ascertains the need for use of oral and/or local anaesthetic as well as improved counselling in these patients.

Anxiety spectrum disorders are common in patients with orthostatic tremor.

BACKGROUND: Orthostatic Tremor (OT) is a rare movement disorder characterized by a sensation of unsteadiness while standing and associated with high frequency tremors. Patients with OT commonly report a fear of falling and significant limitations in everyday activities. The prevalence of psychiatric comorbidities in OT patients has not been well-studied. METHODS: Subjects were evaluated by trained psychiatry researchers using the Mini International Neuropsychiatric Interview (M.I.N.I.). The M.I.N.I is a validated screening tool for psychiatric disorders. A standardized history covering previous psychiatric symptoms and illnesses was also obtained. RESULTS: 29 OT subjects were evaluated. The mean age was 67.7 years with female preponderance (89.3%). The average disease symptom duration was 18.2 years. 58.6% of the subjects had seen a mental health professional during the course of their OT illness. 24.1% of the subjects had a past history of depression, and 10.3% reported a family history of any psychiatric condition. 37.9% of the subjects screened positive for agoraphobia. Two of 29 subjects (6.9%) were classified as having a current major depressive episode and one subject (3.4%) was at risk for suicide. CONCLUSIONS: Psychiatric comorbidities are highly prevalent in OT patients, especially anxiety-spectrum disorders. Further studies are needed to understand if psychiatric disorders appear as a secondary response to the patient's symptoms, or are a primary non-motor manifestation of OT.

Effect of STS-557 (17 alpha-cyanomethyl 17 beta-hydroxy-estra-4, 9(10)-dien-3-one) on blood hormone levels, the testis, accessory sex organs and fertility of rats.

Treatment with STS-557 (17 alpha-cyanomethyl 17 beta-hydroxy-estra-4,9(10)-dien-3-one; 10 mg kg-1 daily s.c.) for 4 weeks induced atrophy of the seminiferous tubules in adult rats with a reduction in tubule diameter and in the number of round spermatids at stage VII. Elongated spermatids were not detected. Leydig cells were atrophied from the second week of treatment with a concomitant decrease in blood levels of testosterone. The blood levels of FSH and LH were reduced from the third week of treatment. The weight of the reproductive organs was reduced after STS-557 treatment. The treatment induced sterility in 50% of rats after 2 weeks of treatment but after 4 weeks none of the treated males mated. Normal fertility and normal levels of testosterone and FSH were restored after 6 weeks and LH after 4 weeks of withdrawal of treatment. All other parameters studied recovered to pretreatment levels 6 weeks after withdrawal of treatment. STS-557 could act on the pituitary-gonadal axis (reducing gonadotrophin secretion) as well as directly affecting the Leydig cells. The consequent reduction in the blood levels of testosterone in combination with reduced gonadotrophins was presumably responsible for the suppression of spermatogenesis.

New and known species of pratylenchus filipjev, 1936 (nematoda: pratylenchidae) from haryana, India, with remarks on intraspecific variations.

Two new monosexual and one bisexual species Pratylenchus Filipjev, 1936 collected from Haryana state of India are described and illustrated. The primary distinguishing features of these species are Pratylenchus microstylus n. sp.: L = 331-458 mum, spear = 11 or 12 mum; Pratylenchus cruciferus n. sp.: L = 648-793 mum, central core of lateral fields with oblique lines, hemizonid 2-8 annules anterior to excretory pore; Pratylenchus ekrami n. sp.: spear = 11-13 mum, spermatheca oblong, post vulval uterine sac with differentiated cells, tail with 26-40 annules, males abundant. Studies on intraspecific variations of P. cruciferus, P. ekrami, and P. coffeae (Zimmermann, 1898) Goodey, 1951 revealed that spear length and value of 'V' are the least variable characters. Body length and size of post vulval uterine sac varies to varying degrees in different species. Shape of median bulb in P. ekrami, number of incisures in P. coffeae, and tail shape in P. ekrami and P. coffeae exhibit the greatest amount of intraspecific variations. P. zeae Graham, 1936 and P. thornei Sher & Allen, 1953 are the other species collected during the present studies.

Post-Infection Development of Heterodera lespedezae.

Morphological changes occurring during post-infection development and the influence of temperature on the life cycle of Heterodera lespedezae are reported. Morphological development was similar to that of H. schachtii. Each post-infection stage had a distinct styler, and fed actively. Detailed observations were made of cuticle formation and markings, esophageal glands, and reproductive system. Certain developmental phases, such as matrix deposition and oviposition, appeared to be correlated with color changes of the adult female body. The effect of temperature on nematode development was observed in a phytotron at day/night temperatures of 18/14, 18/18, 22/18, 26/22, 26/26, and 30/26 C; the optimum was 26/26 C. More time was required to complete the life cycle at the three lower temperatures than at the three higher temperatures.