Does physical activity improve motor function and gait in huntington disease? A systematic review and meta-analysis. / ¿La actividad física mejora la función motora y la marcha en la enfermedad de Huntington? Una revisión sistemática y metaanálisis.

INTRODUCTION: Huntington's disease (HD) is a degeneration of the brain. OBJECTIVE: To assess the evidence of the physical activity (PA) to improve motor function, gait speed, and walking endurance in individuals with HD. MATERIALS AND METHODS: Two reviewers independently screened references and selected relevant studies to identify randomized controlled trials (RCT), from MEDLINE/PubMed, CENTRAL, PEDro, Scopus, CINAHL, Web of Science databases from inception to September 2021. Two reviewers evaluated risk of bias by the PEDro scale. The primary outcome was assessed motor function, gait speed and walking endurance as a secondary outcome was evaluated activities of daily living (ADL), lower limb functionality strenght, balance, mobility and cognition function in HD. RESULTS: Eight RCT were finally included (231 individuals). Forest plots showed a positive effect for gait endurance, the mean difference (MD) was 17.40 (95% CI from 5.40 to 29.35; p = 0.004), the MD lower limb functionality strength was 1.76 (95% CI from 0.18 to 3.33; p = 0.03) favoring PA group and the MD cognition function was 1.83 (95% CI from 0.50 to 3.16; p = 0.007). No benefits were found for motor function, gait speed, ADL, balance and mobility. CONCLUSIONS: Positive effects of programs PA were observed for walking endurance lower limb functionality strenght and cognition function in low and moderate stage of HD. However, no benefits were found for motor function, gait speed, ADL, balance and mobility. All authors included aerobic exercises in their programs but is unclear if vigorous and intensive PA is optimal for individuals with HD.

TITLE: ¿La actividad física mejora la función motora y la marcha en la enfermedad de Huntington? Una revisión sistemática y metaanálisis.Introducción. La enfermedad de Huntington (EH) es una degeneración del cerebro. Objetivos. Evaluar la evidencia de la actividad física (AF) para mejorar la función motora y la marcha en las personas con EH. Materiales y métodos. Dos revisores examinaron de forma independiente las referencias y seleccionaron ensayos controlados aleatorizados en Medline/PubMed, CENTRAL, PEDro, Scopus, CINAHL y Web of Science desde el inicio hasta septiembre de 2021 y evaluaron el riesgo de sesgo mediante la escala PEDro. Las variables principales fueron la función motora y la marcha, y las secundarias, las actividades de la vida diaria (AVD), la funcionalidad (extremidades inferiores), el equilibrio, la movilidad y la función cognitiva en la EH. Resultados. Se incluyeron ocho ensayos controlados aleatorizados (231 individuos). Se observó un efecto positivo para la resistencia en la marcha, la diferencia de medias fue de 17,4 (intervalo de confianza al 95%: 5,4-29,35; p = 0,004), la diferencia de medias para la funcionalidad (extremidades inferiores) fue de 1,76 (intervalo de confianza al 95%: 0,18-3,33; p = 0,03) y la diferencia de medias para la función cognitiva fue de 1,83 (intervalo de confianza al 95%: 0,5-3,16; p = 0,007) a favor del grupo de AF. No se encontraron beneficios para la función motora, la velocidad de marcha, las AVD, el equilibrio y la movilidad. Conclusiones. Los programas de AF mejoran la resistencia en la marcha, la función cognitiva y la funcionalidad (extremidades inferiores) en la EH. Sin embargo, no se observaron efectos positivos para la función motora, la velocidad de la marcha, las AVD, el equilibrio y la movilidad. Todos los autores incluyeron ejercicios aeróbicos en sus programas, pero no está claro si la AF vigorosa e intensiva es óptima para las personas con EH.

Electrochemical surface-enhanced Raman spectroscopy (EC-SERS): a tool for the identification of polyphenolic components in natural lake pigments.

The identification of natural organic pigments is important for the conservation, preservation, and historical interpretation of artwork. Due to the fugitive nature of the natural dye components in pigments, their analysis can be complicated by issues such as low concentration and sample complexity. In addition, these pigments are exceedingly diverse, and often represent complex mixtures which are difficult to analyse without a separation step. A particularly challenging class of dyes is the natural yellow polyphenols (i.e. quercetin, rhamnetin, emodin, etc.). Several techniques have been used successfully for the identification of phenolic compounds in a complex mixture, but the majority of these methods require advanced instrumentation and one or more separation steps. In addition, these methods may lack the sensitivity needed to detect minute amounts of pigment remaining in faded artwork. As a result, there is a need for innovative methods of analysis which can be applied to the interpretation of artworks containing natural dyes. In this work, cost-effective screen printed electrodes (SPEs) modified with silver nanoparticles (AgNP) were used to amplify the electrochemical SERS response of phenolic compounds. In particular, application of a voltage to the SERS substrate allows for a fine-tuning of the SERS signal, and was successfully used to separately characterize dye components in two natural yellow lake pigments, Reseda Lake and Stil de Grain. To our knowledge, this work represents the first electrochemical surface-enhanced Raman spectroscopy (EC-SERS) study of polyphenolic dye mixtures, and is the first application of EC-SERS for natural pigment analysis. This work establishes EC-SERS as a useful technique for the identification of complex natural dyes which may find potential use in the cultural heritage realm.

Lack of association of iron metabolism and Dupuytren's disease.

BACKGROUND: Iron accumulation as seen in genetic haemochromatosis is a major cause of hepatic fibrogenesis. A link between chronic liver disease and Dupuytren's disease (DD) is well established, especially in alcoholics. AIM: The aim of the present study was to test the hypothesis that iron accumulation might cause fibrosis of the palmar aponeurosis leading to DD. PATIENTS AND METHODS: We examined iron metabolism, mutations of the HFE gene, serum cholesterol, alcohol consumption, presence of chronic liver disease, diabetes and history of severe manual work in a group of 90 patients who had undergone surgery for a severe form of DD. The tissue removed during surgery was histologically examined to confirm the diagnosis of DD. For a control group, we used 33 healthy subjects with similar profiles. RESULTS: The DD group consisted of 82 men and 8 women. Chronic liver disease was found in 27% of DD patients, compared with 6.1% of control subjects (P = 0.013). A history of hand traumatization was present in 33% of DD patients vs. 15% of control subjects (P = 0.048). Excessive alcohol consumption was present in 35.5% of DD patients compared with 15.1% of controls (P = 0.029). None of the other tested parameters, including the prevalence of HFE gene mutations, showed a significant difference between the two groups. CONCLUSIONS: Iron accumulation does not play a major role in the pathogenesis of DD. However, sex, age, manual labour and alcohol consumption are risk factors for progression of DD. We observed a high incidence of chronic liver disease in patients with DD.

Effectiveness of commercially-available antibiotic-impregnated implants.

The aim of this study was to determine the effectiveness of antibiotic-impregnated implants in the prevention of bone infection. We used a model of contaminated fracture in goats to evaluate four treatment groups: no treatment, hand-made tobramycin-impregnated polymethylmethacrylate beads, commercially-available tobramycin-impregnated calcium sulphate pellets and commercially-available tobramycin-impregnated polymethylmethacrylate beads. Three weeks after intraosseous inoculation with streptomycin-resistant Staphylococcus aureus tissue cultures showed no evidence of infection in any of the antibiotic-treated groups. All of the cultures were positive in the untreated group. These results show that effective local antibiotic delivery can be obtained with both commercially-available products and with hand-made polymethylmethacrylate beads. The calcium sulphate pellets have the advantage of being bioabsorbable, thereby obviating the need for a second procedure to remove them.

Suturing of lacerations of skeletal muscle.

Our aim was to compare the biomechanical properties of suturing methods to determine a better method for the repair of lacerated skeletal muscle. We tested Kessler stitches and the combination of Mason-Allen and perimeter stitches. Individual stitches were placed in the muscle belly of quadriceps femoris from a pig cadaver and were tensioned mechanically. The maximum loads and strains were measured and failure modes recorded. The mean load and strain for the Kessler stitches were significantly less than those for combination stitches. All five Kessler stitches tore out longitudinally from the muscle. All five combination stitches did not fail but successfully elongated. Our study has shown that the better method of repair for suturing muscle is the use of combination stitches.

Aplasia of the breast--reconstruction using a free tram flap.

Breast aplasia and hypoplasia are found most frequently in Poland's syndrome but may also be the consequence of damage to the germ of the mammary gland in childhood. The authors present two cases of breast aplasia in which reconstruction was implemented by free transfer of a TRAM flap. The internal mammary vessels were used as recipient vessels, the condition of which was tested before surgery by Doppler. In both instances the reconstruction was implemented at the age of 19 years, and subsequently the areolomammillary complex was created and the contralateral breast corrected to achieve symmetry. The use of autologous tissue in the form of a free TRAM flap provides, in this indication, very good results that are permanent, and the problems associated with the use of implants are eliminated.

Characterization of the lymphoid infiltrate in Hashimoto thyroiditis by immunohistochemistry and polymerase chain reaction for immunoglobulin heavy chain gene rearrangement.

A close relationship between Hashimoto thyroiditis (HT) and low-grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) has been shown. We used immunohistochemistry to study paraffin sections from 40 unselected cases of HT and scored cases according to the lymphoid infiltrate and presence of lymphoepithelial lesions (LELs). Clonality was assessed by kappa/lambda immunohistochemistry and polymerase chain reaction for immunoglobulin heavy chain gene rearrangement (IgH PCR). Histologic findings were compared with 2 cases of primary thyroid MALT-type lymphoma. In HT, the lymphoid infiltrate consisted predominantly of T cells in all cases; B cells, associated with germinal centers, did not have the appearance of marginal zone cells. All cases had identifiable T-cell LELs; immunohistochemistry confirmed inconspicuous, rare B-cell LELs in 13 of 40 cases. In all cases, plasma cells were polyclonal and IgH PCR showed a polyclonal pattern. Clinical follow-up was available for 34 patients. Lymphoma developed in none. In contrast, a B-cell predominant infiltrate of marginal zone cells was present in the MALT-type lymphomas that was not confined to germinal centers. Cytokeratin stains demonstrated severe loss of epithelial elements and destructive LELs. LELs are not, in isolation, a useful criterion for distinguishing low-grade MALT-type lymphoma of the thyroid from HT. Features associated with low-grade MALT-type lymphoma include a predominance of B cells, marked loss of epithelial elements, and destructive LELs composed of marginal zone B cells. Unselected cases of HT do not contain monoclones detectable by IgH PCR.

Detailed deletion analysis of sporadic breast tumors defines an interstitial region of allelic loss on 17q25.

Whole genome analyses of breast tumors with polymorphic markers have detected nonrandom loss of heterozygosity on multiple chromosomes, providing clues to the locations of suspected tumor suppressor genes. Tumors are thought to initiate, progress, and metastasize as mutations accumulate in multiple growth-regulatory genes; thus, identification and characterization of these genes are critical to understanding and controlling breast tumorigenesis. To map more precisely a novel breast tumor suppressor gene that has been localized previously to distal 17q, we constructed a detailed deletion map of 17q25 by analyzing eight microsatellite markers on 39 sporadic primary breast tumors. The smallest overlapping region of interstitial loss was narrowed to approximately 3 cM and included D17S937/AFM107ye3, which showed the highest percentage of allelic loss (41%). These results provide a framework from which a genomic contig will be constructed and candidate transcripts will be analyzed.

Chronic traumatic wounds of the leg.

The authors report the results of a retrospective study of the treatment of chronic defects of soft tissues and bones of the leg and foot with free muscle and musclecutaneous flaps. The study deals with the results of the use of the microsurgical techniques during the period of 11 years at the Department of Plastic Surgery of the 3rd Medical School in Prague. Discussed are the advantages and disadvantages of this technique as one the of possible therapeutic methods inclusive of the results obtained at the above mentioned department.

Treatment of defects and instable skin scars on heavily exposed parts of the leg.

The authors report a series of 41 patients subjected to a transfer of the sensitive fasciocutaneous flap to a defect or to instable skin scars on the leg. Described are immediate as well as longterm surgical results in relation to the sensitivity of the transferred flap and the condition of the donnor site of the flap.

Autografts from the foot for reconstruction of the scapholunate interosseous ligament.

A cadaveric study was undertaken to identify a potential autograft for use in repairing the ruptured scapholunate interosseous ligament. Three ligament complexes (the dorsal metatarsal ligament of the fourth and fifth metatarsals, a dorsal tarsometatarsal ligament, and the dorsal calcaneocuboid ligament) were chosen as autograft candidates. The scapholunate interosseous ligament and the three autograft candidates were harvested as bone-ligament-bone complexes from matched hands and feet of six fresh-frozen male cadavers (age, 51-68 years). The complexes were elongated using a servohydraulic testing machine at a constant grip-to-grip rate of 0.1 mm/s until failure. Stiffness and strength values were calculated and compared for each ligament complex. Analysis indicated that the stiffness values for the tarsometatarsal ligament and the scapholunate interosseous ligament were not statistically different, while such values for the other two autografts were significantly less. The strength values of all three autografts were significantly less than those of the scapholunate interosseous ligament. This study indicates that of the potential autografts tested, the tarsometatarsal ligament is biomechanically most similar to the intact scapholunate interosseous ligament.

Ten years of replantation surgery at the Department of Plastic Surgery, Charles University Hospital, Prague.

The authors present results of the ten years replantation surgery centre at the department of plastic surgery in Prague. The presented series of patients includes 393 persons operated on because of amputation or ischaemic injury to the region of the upper extremity. The number of replantations and revascularisations in the individual years is analysed, as well as the age of the patients, type of injury, mechanism of injury and operation results.

Multiple uses of the free radial forearm flap.

Presenting clinical cases, the authors show the variety of possible uses of the free radial forearm flap. They employ this sensory flap at sites of increased load such as the area of the planta pedis and in thumb reconstruction. Other potential uses include oesophageal and penile reconstruction.

Effects of agrobacterial oncogenes in kidney vetch (Anthyllis vulneraria L.).

Kidney vetch seedlings were induced to form hairy roots by inoculating their mesocotyls with the wild-type strain 15834 of Agrobacterium rhizogenes or with the A. tumefaciens strain C58C1 containing a binary vector system (the pRiA4b as a helper and the vector pCB1346 bearing a pTiC58-derived isopentenyl transferase gene (ipt, cytokinin biosynthetic gene) under control of its native regulatory sequences). Transgenic lines of three distinct phenotypes were selected: (i) Typically, the pRi15834-transformed tissues were stabilized in vitro and maintained for long periods as aseptic, fast-growing, hormone-independent, plagiotropic hairy root cultures which never regenerated shoots and lost the ability to synthesize opines. Their genomic DNA contained both the TL- and the TR-DNA. (ii) One of the HR-lines transgenic for the T-DNA of pRi15834 (named 52AV34) started to regenerate spontaneously into teratomous shoots. The shoots were found to produce opines and both the TL and TR parts of T-DNA were found to be partly deleted and/or rearranged. They contained phytohormones in similar levels as those found in seed-born shoots. (iii) A practically identical morphogenic response as in the line 52AV34 was observed in the clone 27AV46. However, its shooty, dark-green, slow-growing teratomas were proven to be kanamycin-resistant, opine-producing, and double-transformed by the pRiA4b sequences and the ipt gene. They over-produced auxins as well as cytokinins (mainly indoleacetylaspartic acid and ribosides of zeatin and isopentenyladenine).

Use of the free jejunal loop to replace cervical oesophagus in an experiment.

The paper presents the results of experimental studies exploring the possibility to replace the cervical oesophagus with a free intestinal loop. The experiments were carried out in dogs and cervical oesophagus replacement was performed using a jejunal loop. Nutrition was provided by mesenteric vessels anastomosed by means of a microsurgical operative technique. The intestinal segment was subsequently used to replace the resected segment of the cervical oesophagus. The results of our experiments indicate this new operative technique can be used in clinical practice.