Complaints of neuropathic pain, noxious cervical plexus neuropathy and neck tightness are reported by patients who undergo neck dissection: an institutional study and narrative review.

There exists a subgroup of patients who undergo neck dissection (ND) who postoperatively complain of either neuropathic pain, dysaesthesia and/or discomfort that is located within the dermatomal distribution of the cervical plexus. The purpose of our study was to determine the prevalence, characteristic, and demographics of these symptoms in our patient cohort. We undertook a retrospective randomised observational cohort study of 105 patients who had undergone ND. The primary predictor variable was the undertaking of a ND. The secondary outcome variable was the complaint of either neuropathic pain or a noxious neuropathy, at a minimum of twelve months after surgery. A recognised symptom questionnaire and a visual analogue score was employed for the purpose of the study. A descriptive and statistical analysis was applied to the assembled data. Twenty patients (19%) complained of either spontaneous (n=9) or evoked (n=11) neuropathic pain that occurred within the surgical site. In addition, 71 patients (68%) described an altered sensation in the dermatomal distribution of the great auricular or tranverse cervical nerves while 70 patients (67%) described the feeling of 'neck tightness'. There were no characteristics of the study cohort that underpinned these results. Neuropathic pain can occur following ND. This can cause distress to a small but defined group of patients. Despite its importance, we found a paucity of studies in the literature that have investigated neuropathic pain following ND. We believe this condition requires more research attention and clinical awareness.

Hypoxia- and radiation-activated Cre/loxP 'molecular switch' vectors for gene therapy of cancer.

Although a significant negative prognostic factor, tumor hypoxia can be exploited for gene therapy. To maximize targeting within the tumor mass, we have developed synthetic gene promoters containing hypoxia-responsive elements (HREs) from the erythropoietin (Epo) gene as well as radiation-responsive CArG elements from the early growth response (Egr) 1 gene. Furthermore, to achieve high and sustained expression of the suicide gene herpes simplex virus thymidine kinase (HSVtk), our gene therapy vectors contain an expression amplification system, or 'molecular switch', based on Cre/loxP recombination. In human glioma and breast adenocarcinoma cells exposed to hypoxia and/or radiation, the HRE/CArG promoter rapidly activated Cre recombinase expression leading to selective and sustained HSVtk synthesis. Killing of transfected tumor cells was measured after incubation with the prodrug ganciclovir (GCV; converted by HSVtk into a cytotoxin). In vitro, higher and more selective GCV-mediated toxicity was achieved with the switch vectors, when compared with the same inducible promoters driving HSVtk expression directly. In tumor xenografts implanted in nude mice, the HRE/CArG-switch induced significant growth delay and tumor eradication. In conclusion, hypoxia- and radiation-activated 'molecular switch' vectors represent a promising strategy for both targeted and effective gene therapy of solid tumors.

The medication life.

The therapist conducting psychodynamic psychotherapy often recommends medication for the patient, but the medication is frequently treated as separate from the therapy and not worth exploring. By not inviting the patient's and our own feelings about medication into the treatment dialogue, we may solicit the development of split transference, the loss of important unconscious material, and noncompliance. Much like a patient's dream life, the medication life is rich in detail that may be fruitfully used to gain information about the patient's experience, strengthen the alliance, and improve treatment outcome.

P2Y purinoceptors inhibit exocytosis in adrenal chromaffin cells via modulation of voltage-operated calcium channels.

We have used combined membrane capacitance measurements (C(m)) and voltage-clamp recordings to examine the mechanisms underlying modulation of stimulus-secretion coupling by a G(i/o)-coupled purinoceptor (P2Y) in adrenal chromaffin cells. P2Y purinoceptors respond to extracellular ATP and are thought to provide an important inhibitory feedback regulation of catecholamine release from central and sympathetic neurons. Inhibition of neurosecretion by other G(i/o)-protein-coupled receptors may occur by either inhibition of voltage-operated Ca(2+) channels or modulation of the exocytotic machinery itself. In this study, we show that the P2Y purinoceptor agonist 2-methylthio ATP (2-MeSATP) significantly inhibits Ca(2+) entry and changes in C(m) evoked by single 200 msec depolarizations or a train of 20 msec depolarizations (2.5 Hz). We found that P2Y modulation of secretion declines during a train such that only approximately 50% of the modulatory effect remains at the end of a train. The inhibition of both Ca(2+) entry and DeltaC(m) are also attenuated by large depolarizing prepulses and treatment with pertussis toxin. Inhibition of N-type, and to lesser extent P/Q-type, Ca(2+) channels contribute to the modulation of exocytosis by 2-MeSATP. The Ca(2+)-dependence of exocytosis triggered by either single pulses or trains of depolarizations was unaffected by 2-MeSATP. When Ca(2+) channels were bypassed and exocytosis was evoked by flash photolysis of caged Ca(2+), the inhibitory effect of 2-MeSATP was not observed. Collectively, these data suggest that inhibition of exocytosis by G(i/o)-coupled P2Y purinoceptors results from inhibition of Ca(2+) channels and the Ca(2+) signal controlling exocytosis rather than a direct effect on the secretory machinery.

Racial differences in women's desires to be thin.

The goal of this research was to attempt to understand why white women are more prone to develop eating disorders than black women. Using self-reports, we found that white women chose a significantly thinner ideal body size than did black women, and expressed more concern than black women with weight and dieting. White women also experienced greater social pressure to be thin than did black women. White men indicated less desire than black men to date a women with a heavier than ideal body size, and white men felt they would more likely be ridiculed than did black men if they did date a woman who was larger than the ideal. The results suggest that black women experience eating disorders less than white women at least in part because they experience less pressure to be thin.

Flow cytometric characterization and sorting of cultured Brassica napus microspores.

A flow cytometric procedure was used to characterize and sort embryogenic Brassica napus microspore cultures. Embryogenic microspores continued to increase in size throughout the culture period and fluoresced when stained with fluoresecein diacetate (FDA). However, most of the cells in culture (greater than 95%) lost their viability over the culture period and the correlation between the percentage viable cells in a culture and the productivity of the culture was not significant until day 3. By sorting large fluorescent cells on day 1 and day 3 of the culture period populations of cells that were 7-18-fold more embryogenic than sorted mixed cells were obtained. The flow cytometric procedure would be useful for rapidly assessing the effects of a large variety of culture and media conditions on embryogenesis is rapeseed microspore cultures. Furthermore, the populations of potentially embryogenic microspores isolated by flow cytometry might be useful for studies of the early cellular and molecular changes that occur during androgenesis in rapeseed.

The combination of polima cms and cytoplasmic triazine resistance in Brassica napus.

Protoplast fusion was used to combine cytoplasmic triazine resistance (ctr) and Polima type cytoplasmic male sterility (cms) in Brassica napus. The cybrids produced constitute the major biological input required for the production of commercial single-cross hybrid rapeseed bearing cytoplasmic triazine resistance. The results also indicate that Polima cms is associated with the mitochondrial genome.

Changes in germination and respiratory potential of embryos of dormant Grand Rapids lettuce seeds during long-term imbibed storage, and related changes in the endosperm.

Grand Rapids lettuce (Lactuca sativa L.) seeds were stored in an imbibed state for up to two years. Embryos dissected from stored seeds showed a progressive loss with time in their ability to germinate on polyethylene glycol (PEG) solutions. Little germination of dissected embryos from one-month imbibed seeds occurred on-6 bar PEG but only after four months of storage did the dissected embryos fail to germinate on-4 bar PEG. After two years storage 30% of dissected embryos still were able to germinate on-2 bar PEG. This loss of germination potential, which may be a symptom of the development of an embryo dormancy, could be reversed by N(6)-benzyladenine (BA) and red light (R) applied together or separately to dissected embryos. Two weeks of chilling of 12-month imbibed seeds restored sensitivity to R and a 48-h BA pretreatment prior to R resulted in germination rates similar to those of seeds emerging from primary dormancy. There was loss of embryo control of endo-ß-mannanase activity after two weeks of storage even though the endosperms themselves retained their capacity for enzyme synthesis for six more weeks. Eventually, then, endo-ß-mannanase synthesis is not possible because of inherent changes in both the embryo and endosperm, although each tissue undergoes changes at its own rate. Oxygen uptake by embryos dissected from two-month imbibed seeds did not increase to the same extent as embryos dissected from freshly imbibed seeds. In intact seeds germinating from a skotodormant state, oxygen uptake increased at a time coincident with radicle protrusion, but did not achieve the levels of uptake of those seeds germinating from a primary dormant state. The decline in uptake of oxygen by secondary dormant seeds is the result of a lowered respiratory capability of the embryo itself, rather than of changes in permeability of the surrounding structures.

Long-term storage of dormant Grand Rapids lettuce seeds in the imbibed state: physiological and metabolic changes.

Grand Rapids lettuce (Lactuca sativa L.) seeds retained their viability for up to ten months when maintained in the fully imbibed state on moist filter paper at 25°C in darkness. The ability of red light (R) to promote their germination was essentially lost within one week from the start of imbibition; sensitivity to gibberellic acid was retained for two weeks longer. Seeds which did not respond to either treatment had entered the state of secondary dormancy (skotodormancy). This could be relieved at all times by a combination of benzyladenine and R applied to the intact seed, or by isolation of the embryo and incubation on water. Protein synthesis increased initially following imbibition but declined after 72 h to a constant low level. Respiration declined over the first week of storage in the imbibed state to a much-reduced steady level. Cotyledonary lipid declined between four and ten months of storage but the axial lipid remained unchanged. Sucrose in the embryo increased after five months, but no changes in glucose, galactose, fructose or mannose were found. The total N content of the cotyledons declined over the first three months of storage in the imbibed state, with a concomitant rise in axial N; the latter declined slowly thereafter. Basal α-galactosidase (EC 3.2.1.22) activity decreased over seven months, but the phytochrome-induced component could not be raised by a 15-min R treatment even after one month. Germination induced by R and benzyladenine was achieved at later times without a rise in α-galactosidase levels.