Evaluation of a small-bore needle arthroscope for diagnosis and treatment of medial coronoid disease in dogs: a pilot study with short-term assessment.

CASE HISTORY: Dogs (n = 15) that were presented to a single veterinary teaching hospital with elbow dysplasia-associated lameness between September 2021 and May 2022, and were determined to require arthroscopy based on imaging results, were prospectively recruited into the study. The median duration of lameness was 4 (min 1, max 24) months. CLINICAL FINDINGS: Various breeds were represented with a median body weight of 31.6 (min 15, max 46.4) kg and median age at presentation of 14 (min 8, max 83) months. Results of imaging modalities (CT) were consistent with medial coronoid disease with fissured or fragmented medial coronoid process in all dogs. ARTHROSCOPIC FINDINGS: Feasibility of the needle arthroscopy (NA) procedure was firstly assessed in a preliminary cadaveric study in forelimbs (n = 10) collected from 10 adult dogs euthanised for reasons unrelated to the study. Elbow exploration was performed through a medial approach beginning with NA (1.9 mm 0° angle scope) followed by standard arthroscopy (SA; 2.4 mm 30° angle scope). The quality and extent of visualisation (scored through the number of anatomical structures visualised) were recorded and statistically compared. As the cadaver study indicated that NA allowed safe inspection of all structures in medial/caudal compartments, this procedure was then used in the dogs requiring treatment. In the clinical setting, elbow exploration was successful in all dogs and the treatment (removal of osteochondral fragments) was performed without requiring conversion into SA. One month after surgery, all dogs had an improvement in their lameness score (0-5) and 12/15 dogs were no longer lame. There was a reduction in Canine Orthopaedic Index scores measured a median of 99 (min 47, max 180) days after surgery (24 (IQR 19.5-31.5)) compared to the pre-operative period (49 (IQR 46.5-57); p < 0.001). CLINICAL RELEVANCE: Needle arthroscopy-assisted removal of osteochondral fragments was performed in all dogs with satisfactory short-term clinical outcome. NA is a feasible technique for diagnosis and lesion assessment in dogs with a fissured or fragmented coronoid process. Larger clinical studies with longer follow-up are necessary to validate the NanoScope operative arthroscopy system as an alternative strategy to SA for video-assisted treatment of medial coronoid disease.

Internal border zone injury predicts the functional outcome of acute MCA stroke patients.

BACKGROUND AND PURPOSE: Classification of deep (D), superficial (S) MCA territories and their junctional vascular area (the internal border zone, IBZ) can help to identify patients most likely to benefit from aggressive reperfusion therapy after stroke. We tested the prognostic value of an IBZ injury compared to DWI-ASPECTS and infarct volume. MATERIALS AND METHODS: DW lesions of 168 patients with acute (4.2±6.5 h) MCA strokes were retrospectively examined and manually delineated. Patients with haemorrhagic transformation or other neurological diseases were excluded. Clinical data were recorded within 24 h following symptom onset and 48 h for patients who benefited from reperfusion therapy. The occurrence of an IBZ injury was determined using a standardized stereotaxic atlas. Performance to predict a good outcome (mRS<3 at 3 months) was estimated through ROC curves for DWI-ASPECTS≤6, lesion volume≥100 mL and IBZ injury. Logistic regression models were performed to estimate independent outcomes for infarct volume and IBZ injury. RESULTS: Infarcts involving the IBZ were larger (94.9±98.8 mL vs. 30.2±31.3 mL), had higher NIHSS (13.8±7.2 vs. 7.2±5.7), more frequent MCA occlusions (64.9% vs. 28.3%), and worse outcomes (mRS 3.0±1.8 vs. 1.9±1.7), and were less responsive to IVtPA (34±47% vs. 55±48% of NIHSS improvement). The area under the ROC curves was comparable between the occurrence of IBZ injury (0.651), ASPECTS≤6 (0.657) and volume≥100 mL (0.629). Logistic regression analyses showed an independent effect of an IBZ injury, especially for superficial MCA strokes and for patients who benefited from reperfusion therapy. CONCLUSION: An IBZ injury is an early and independent marker of stroke severity, functional prognosis and treatment responsiveness.

Needle arthroscopy for exploration of the elbow joint: a case series of six dogs with preliminary cadaveric study.

CASE HISTORY: Dogs (n = 6) suffering from elbow-associated lameness for a median of 3.5 (min 2, max 12) months duration requiring arthroscopic exploration according to imaging results were prospectively included in this study. CLINICAL FINDINGS: Dogs that met the inclusion criteria were of various breeds with a median body weight of 18 (min 13.2, max 34.5) kg and median age at presentation of 11 (min 6, max 96) months. Results of imaging modalities (radiographs and/or computed tomography (CT)) were consistent with developmental elbow disease in all of the dogs. ARTHROSCOPIC FINDINGS: Feasibility of the needle arthroscopy procedure was first assessed in a preliminary cadaveric study. Disease-free cadaveric forelimbs (n = 12) were collected from adult dogs (n = 6) euthanised for reasons unrelated to the present study. Elbow exploration was performed, beginning with needle arthroscopy (1 mm, 0° angle scope) followed by standard arthroscopy (2.4 mm, 30° angle scope) through a medial approach. The ease of introduction, range of motion and the quality of visualisation were assessed subjectively and the presence of iatrogenic introduction lesions and extent of field of vision (assessed by the number of anatomical structures visualised) were scored and statistically compared. Needle arthroscopy allowed inspection of all structures at risk for medial/caudal compartment disease in all joints considering the occasional need for multiple portals. In the clinical setting, elbow exploration was found to be similar to that in cadaver joints in 4/6 dogs. The lower quality of vision provided by needle arthroscopy was a limitation of the technique, and 2/6 clinical cases required conversion to standard arthroscopy for full visualisation of the joint. No introduction lesions were noted with needle arthroscopy in either the cadaveric or clinical studies. CONCLUSIONS AND CLINICAL RELEVANCE: Needle arthroscopy allowed safe visualisation of all of the structures of the medial and caudal compartment in disease-free cadaveric elbows, suggesting that needle arthroscopy is an appropriate technique for diagnosis and assessment of lesions of developmental elbow disease. However, the low quality of vision provided by the 1 mm scope, and the small diameter of the sleeve, which limited fluid inflow, combined with fragility of the device were major drawbacks that prevented consistent full exploration of the joint and detailed lesion assessment in clinical situations. Improvement of the device is thus necessary before use of the technique in clinical practice can be recommended. ABBREVIATIONS: CCD: Caudal compartment disease; CT: Computed tomography; DED: Developmental elbow disease; DJD: Degenerative joint disease; LCL: Lateral collateral ligament; LCP: Lateral coronoid process; LHC: Lateral part of the humeral condyle; MCD: Medial compartment disease; MCL: Medial collateral ligament; MCP: Medial coronoid process; MHC: Medial part of the humeral condyle; MRI: Magnetic resonance imaging.

Influence of social cognition as a mediator between cognitive reserve and psychosocial functioning in patients with first episode psychosis.

BACKGROUND: Social cognition has been associated with functional outcome in patients with first episode psychosis (FEP). Social cognition has also been associated with neurocognition and cognitive reserve. Although cognitive reserve, neurocognitive functioning, social cognition, and functional outcome are related, the direction of their associations is not clear. Therefore, the main aim of this study was to analyze the influence of social cognition as a mediator between cognitive reserve and cognitive domains on functioning in FEP both at baseline and at 2 years. METHODS: The sample of the study was composed of 282 FEP patients followed up for 2 years. To analyze whether social cognition mediates the influence of cognitive reserve and cognitive domains on functioning, a path analysis was performed. The statistical significance of any mediation effects was evaluated by bootstrap analysis. RESULTS: At baseline, as neither cognitive reserve nor the cognitive domains studied were related to functioning, the conditions for mediation were not satisfied. Nevertheless, at 2 years of follow-up, social cognition acted as a mediator between cognitive reserve and functioning. Likewise, social cognition was a mediator between verbal memory and functional outcome. The results of the bootstrap analysis confirmed these significant mediations (95% bootstrapped CI (-10.215 to -0.337) and (-4.731 to -0.605) respectively). CONCLUSIONS: Cognitive reserve and neurocognition are related to functioning, and social cognition mediates in this relationship.

Practical experience with the implementation of an athlete's biological profile in athletics, cycling, football and swimming.

The introduction of the athlete's biological passport (ABP) has been a milestone in the fight against doping. The ABP is a collection of measurements of different biological parameters influenced by the administration of doping agents through the time and for each athlete. Two different modules have been developed and validated so far: the haematological module, which aims to identify enhancement of oxygen transport, including use of erythropoiesis-stimulating agents and any form of blood transfusion or manipulation, which became effective in 2010; and the steroidal module, which intends to detect the use of endogenous anabolic androgenic steroids when administered exogenously and other anabolic agents, which was introduced in 2014. Prior to the implementation of the haematological module, it is important to define an athlete's testing pool on whom to collect blood and/or urine in-competition and out-of-competition (for the steroidal module, this is irrelevant because all collected urine samples will be subjected to analysis for the steroidal variables) and to be compliant with the strict requirements of the World Anti-Doping Agency ABP Operating Guidelines. The established individual profile can be used either to target traditional antidoping tests (recombinant erythropoietins, or homologous blood transfusion tests for the haematological module; isotope ratio mass spectrometry (IRMS) for the steroidal module) or to support an antidoping rule violation due to the use of a forbidden substance or method. In this article, we present the experience of four major International Federations which have implemented an ABP programme, focusing on the haematological module. They constitute examples which could be followed by other antidoping organisations wishing to introduce this new, efficient and innovative antidoping tool.

Finney and Jaboulay pyloroplasties for the treatment of benign gastric outlet lesions in dogs and cats: technique and outcome in 13 cases (2015-2024).

OBJECTIVES: To describe the use, complications and outcome of Finney or Jaboulay pyloroplasties for the treatment of benign gastric outlet lesions in dogs and cats. MATERIALS AND METHODS: The medical records of dogs and cats surgically treated with Finney or Jaboulay pyloroplasty for benign gastric outflow tract disease in three institutions between January 1, 2015 and August 31, 2023 were retrospectively reviewed. RESULTS: Eight dogs and five cats were diagnosed with benign obstructive or perforating gastric outlet lesions, including chronic hypertrophic pyloric gastropathy (n = 4), perforating pyloro-duodenal peptic ulcer (4), sub-obstructive pyloro-duodenal eosinophilic sclerosing fibroplasia (2) and antral or proximal duodenal obstructive mass (3). Nine cases were treated using hand-sewn Finney pyloroplasty and four cases were treated using stapled Jaboulay pyloroplasty. No major complications were recorded. Cases were followed for a median of 16.1 [11 to 29.6] months. At the last follow-up, the outcome was excellent in all cases, with no clinical signs recorded and no medical treatment required. CLINICAL SIGNIFICANCE: This case series suggests that Finney and Jaboulay pyloroplasties were safe and effective procedures for the surgical treatment of benign obstructive or perforating gastric outlet lesions in dogs and cats.

Complete resolution of cerebral air embolism secondary to a transbronchial needle aspiration.

Air embolism following transbronchial needle aspiration (TBNA) is extremely rare. To date, only 1 case has been described (estimated incidence: 0.02-0.07%). Here, a 70-year-old patient developed a left upper-lobe alveolar syndrome with no response to well-conducted antibiotic treatments. Conventional bronchoscopy was normal, but virtual bronchoscopy showed that the tumor was contiguous to the left B3-B4 division. During a second bronchoscopy, a TBNA was performed without bleeding, and pathology later revealed primitive lung adenocarcinoma. Immediately after the puncture, an epileptic seizure occurred with right rotation of the head and a tonic seizure of the left arm followed by left hemiplegia. A brain CT scan performed almost immediately showed no abnormalities and a chest radiography did not show any pleural or mediastinal aeric image. A few hours later, clonic seizures occurred and brain MRI showed lesions compatible with air embolisms (right gyral cortical location). Several hyperbaric therapy sessions successfully cured the neurological deficit. Despite its rarity, each practitioner of TBNA has to be aware of this side effect and its early treatment. The mechanism of such accidents remains unclear, but probably involves high bronchial pressure and venous trauma. © 2013 S. Karger AG, Basel.

Simulation of Organic Matter and Pollutant Evolution during Composting: The COP-Compost Model.

Organic pollutants (OPs) are potentially present in composts and the assessment of their content and bioaccessibility in these composts is of paramount importance. In this work, we proposed a model to simulate the behavior of OPs and the dynamic of organic C during composting. This model, named COP-Compost, includes two modules. An existing organic C module is based on the biochemical composition of the initial waste mixture and simulates the organic matter transformation during composting. An additional OP module simulates OP mineralization and the evolution of its bioaccessibility. Coupling hypotheses were proposed to describe the interactions between organic C and OP modules. The organic C module, evaluated using experimental data obtained from 4-L composting pilots, was independently tested. The COP-Compost model was evaluated during composting experiments containing four OPs representative of the major pollutants detected in compost and targeted by current and future regulations. These OPs included a polycyclic aromatic hydrocarbon (fluoranthene), two surfactants (4--nonylphenol and a linear alkylbenzene sulfonate), and an herbicide (glyphosate). Residues of C-labeled OP with different bioaccessibility were characterized by sequential extraction and quantified as soluble, sorbed, and nonextractable fractions. The model was calibrated and coupling the organic C and OP modules improved the simulation of the OP behavior and bioaccessibility during composting.

[Sneddon syndrome: a rare cause of vascular dementia]. / Le syndrome de Sneddon: une cause rare de démence vasculaire.

Few vascular dementias are diagnosed in memory clinic consultations. One type, a rare etiology, Sneddon syndrome, can lead patients to consult for an isolated memory complaint. We report the cases of two patients, aged 63 and 66 years, who presented frontocortical cognitive profile and behavior disorders. Seronegative Sneddon syndrome, complicated with dementia, was diagnosed in each case by noticing an association between, on MRI, an atrophy and several ischemic cerebrovascular accident aftermaths, and a livedo racemosa. Management of vascular risks factors improves the prognosis.

Preoperative computed tomography, surgical treatment and long-term outcomes of dogs with abscesses on migrating vegetal foreign bodies and oropharyngeal stick injuries: 39 cases (2010-2021).

OBJECTIVES: This study evaluated success rates of surgical treatment of head and neck abscesses and draining tracts for suspected migrating vegetal foreign body and oropharyngeal penetrating injuries, and compared the outcomes according to whether a vegetal foreign body was identified in preoperative computed tomography (CT) examination. MATERIALS AND METHODS: This retrospective study involved 39 dogs that underwent CT and subsequent surgical exploration of abscesses and/or draining tracts in the head and neck, in a single institution between 2010 and 2021. Recorded data included signalment, history, physical examination, CT and surgical findings. The postoperative follow-up period was at least 8 months. Cases were classified according to whether a foreign body was identified on CT or was only suspected because of the presence of cavities and/or draining tracts on CT. RESULTS: A vegetal foreign body was identified on CT in 11 of 39 cases and later confirmed at surgery in 10 cases. In 28 of 39 cases, a vegetal foreign body was not identified on CT, but in seven of these 28 cases it was found at surgery. Resolution of clinical signs was achieved in 11 of 11 cases when a vegetal foreign body was identified on CT and in 26 of 28 cases without a foreign body identified on CT. Two cases of recurrence were observed in animals in which no foreign body was detected. CLINICAL SIGNIFICANCE: In this population of dogs undergoing surgery after preoperative CT scan, we observed resolution of clinical signs after a single surgical procedure in 95% of the cases. All animals in which a foreign body was identified were cured.

The Drivers of the Martian Bow Shock Location: A Statistical Analysis of Mars Atmosphere and Volatile EvolutioN and Mars Express Observations.

The Martian interaction with the solar wind leads to the formation of a bow shock upstream of the planet. The shock dynamics appear complex, due to the combined influence of external and internal drivers. The extreme ultraviolet fluxes and magnetosonic Mach number are known major drivers of the shock location, while the influence of other possible drivers is less constrained or unknown such as crustal magnetic fields, solar wind dynamic pressure, or the Interplanetary Magnetic Field (IMF) intensity, and orientation. In this study, we compare the influence of the main drivers of the Martian shock location, based on several methods and published datasets from Mars Express (MEX) and Mars Atmosphere Volatile EvolutioN (MAVEN) missions. We include here the influence of the crustal fields, extreme ultraviolet fluxes, solar wind dynamic pressure, as well as (for MAVEN, thanks to magnetic field measurements) magnetosonic Mach number and Interplanetary Magnetic Field parameters (intensity and orientation angles). The bias due to the cross-correlations among the possible drivers is investigated with a partial correlations analysis. Several model selection methods (Akaike Information Criterion and Least Absolute Shrinkage Selection Operator regression) are also used to rank the relative importance of the physical parameters. We conclude that the major drivers of the shock location are extreme ultraviolet fluxes and magnetosonic Mach number, while crustal fields and solar wind dynamic pressure are secondary drivers at a similar level. The IMF orientation also plays a significant role, with larger distances for perpendicular shocks rather than parallel shocks.

Migrating grass awn within the intraconal part of the retrobulbar space in a dog.

A 1.5-year-old MC Cardigan Welsh Corgi was presented for a right oral fistula associated with left tonsil enlargement that responded to medical treatment. A first computed tomography scan was performed and showed no signs of a foreign body. Medical treatment was continued for 2 additional weeks and the dog was free of clinical signs for 3 months. The dog was presented again for a 3-day history of anorexia and marked pain when opening the jaw. The repeat computed tomography scan revealed a migrating foreign body near the optic canal of the right eye, and surgical exploration confirmed that it was trapped within the intraconal part of the retrobulbar space, abutting the optic nerve. The foreign body was surgically removed through an osteotomy of the zygomatic bone. The dog fully recovered with no vision loss. Based on the literature search, this is the first published report describing a migrating grass awn located in the intraconal part of the retrobulbar space, abutting the optic nerve.

Assessment of a flow cytometry technique for studying signaling pathways in platelets: Monitoring of VASP phosphorylation in clinical samples.

A recently released kit (PerFix EXPOSE) was reported to improve the measurement of the degree of phosphorylation of proteins in leukocytes by flow cytometry. We tested its adaptation for platelets to monitor vasodilator-stimulated phosphoprotein (VASP) phosphorylation, which is the basis of a currently used test for the assessment of the pharmacological response to P2Y12 antagonists (PLT VASP/P2Y12). The PerFix EXPOSE kit was compared to the PLT VASP/P2Y12 kit by using blood samples drawn at 24 h post clopidogrel dose from 19 patients hospitalized for a non-cardio-embolic ischemic stroke and treated with clopidogrel monotherapy for at least five days in an observational study. The platelet PerFix method was based on adaptation of the volume of the sample, the centrifugation speed and the incubation temperature. Poor agreement between prevention by adenosine diphosphate (ADP) of PGE1-induced cAMP-mediated VASP phosphorylation and ADP induced aggregation assessed by Light Transmittance Aggregometry was found. We found a significant correlation between the PLT VASP/P2Y12 kit and the PerFix EXPOSE kit. The PerFix EXPOSE kit may also be helpful to monitor adverse effects of second-generation tyrosine kinase inhibitors on platelets.

Effect of early decrease in the lesion size on late brain tissue loss, synaptophysin expression and functionality after a focal brain lesion in rats.

The purpose of the present study is to determine the effects of early decrease in the lesion size on late brain tissue loss, synaptogenesis and functionality after a focal brain lesion in rats. The lesion was induced either to the cortex using the photothrombotic ischemic stroke or to the striatum using the malonate poisoning model. The cortical and striatal lesions amounted to 66-80 mm(3) at day 1 post-lesion and were reduced by 50% after the acute administration of dipyridyl (a liposoluble iron chelator) and aminoguanidine (an inhibitor of the inducible nitric oxide synthase), respectively. Loss of histologically intact tissue and synaptophysin expression as an indicator of synaptogenesis were examined at day 35 post-lesion. Both types of lesion resulted in synaptophysin upregulation in contralateral and ipsilateral cortical areas. On the contrary, brain tissue loss was greater after the striatal (-17%) than the cortical lesion (-5%). Synaptophysin expression and tissue loss were not different between drug- and vehicle-treated rats. Moreover, a set of standard neurological tests revealed a difference in deficit between the both types of lesion, yet only in the acute post-lesion stage. However, it did not distinguish between vehicle- and drug-treated rats whatever the lesion location. Our results indicate that late histological endpoints measurements are not recommended to probe the potential neuroprotective properties of a drug administered within the acute post-lesion stage. They also suggest that inhibition of cytotoxic mechanisms involved in lesion growth is of no clinical interest when it cannot lead to a long-term histological protection and/or increased synaptogenesis.

Tolerance and Long-Term Efficacy of Polyethylene Glycol 4000 (Forlax®) Compared to Lactulose in Elderly Patients with Chronic Constipation.

OBJECTIVES: To assess the tolerance and potential nutritional consequences of long-term repeated doses of PEG 4000 (10 to 30 g/day) in elderly patients with chronic constipation as compared to lactulose (10-30 g/day). DESIGN: Single blind, randomised, multicentre, parallel group comparative study. SETTING: Community-dwelling patients and nursing homes residents aged 70 years and older with a history of chronic constipation. Treatment intervention: PEG 4000 (10-30 g/day) or lactulose (10-30 g/day) for six months. ASSESSMENTS: Clinical nutritional status (Mini Nutritional Assessment), blood and stool samples were taken at baseline and after three and six months for assay of nutritional and absorption parameters. A patient diary documented digestive symptoms and adverse events were recorded. Information on efficacy (stool frequency and consistency) was collected as a secondary outcome measure. RESULTS: Of the 316 patients screened, 245 eligible patients constituted the ITT population (PEG 4000: N = 118; lactulose group: N = 127). The proportion of patients receiving PEG 4000 with abnormal levels of electrolytes, nutritional markers or vitamins did not significantly change in the six months after initiating laxative treatment and do not differ between the two groups. After a D-xylose challenge test, the proportion of patients with abnormally low xylosaemia (suggesting malabsorption) varied from 24.6% at baseline to 35.8% after six months in the PEG 4000 group and from 29.1% to 42.4% in the lactulose group, with no significant between-group or within-group differences. The proportion of patients with poor nutritional status (MNA score <17) varied from 8.5% at baseline to 9.8% after 6 months in the PEG 4000 group and from 3.9% to 5.0% in the lactulose group. No changes in stool fat or total or soluble stool nitrogen were observed in the minority of patients for whom stool analysis was performed. A significantly higher stool frequency (p <0.05) and improved stool consistency (p <0.05) was observed in the PEG 4000 group compared to the lactulose group at each monthly evaluation period. CONCLUSIONS: After six months of treatment with PEG 4000, no clinically relevant changes in biochemical and nutritional parameters and no unanticipated treatment-related adverse events were detected, demonstrating the good clinical tolerance of PEG 4000 in this population of elderly constipated patients. This tolerance was associated with a better clinical efficacy of PEG 4000 compared to lactulose.

Brain-derived neurotrophic factor of the cerebral microvasculature: a forgotten and nitric oxide-dependent contributor of brain-derived neurotrophic factor in the brain.

AIM: Evidence that brain-derived neurotrophic factor (BDNF), a neurotrophin largely involved in cognition, is expressed by cerebral endothelial cells led us to explore in rats the contribution of the cerebral microvasculature to BDNF found in brain tissue and the link between cerebrovascular nitric oxide (NO) and BDNF production. METHODS: Brain BDNF protein levels were measured before and after in situ removal of the cerebral endothelium that was achieved by brain perfusion with a 0.2% CHAPS (3-[(3-cholamidopropyl) dimethylammonio]-1-propane sulphonate) solution. BDNF protein and mRNA levels as well as levels of endothelial NO synthase phosphorylated at serine 1177 (P-eNOSser1177 ) were measured in cerebral microvessel-enriched fractions. These fractions were also exposed to glycerol trinitrate. Hypertension (spontaneously hypertensive rats) and physical exercise training were used as experimental approaches to modulate cerebrovascular endothelial NO production. RESULTS: CHAPS perfusion resulted in a marked decrease in brain BDNF levels. Hypertension decreased and exercise increased P-eNOSser1177 and BDNF protein levels. However, BDNF mRNA levels that were increased by exercise did not change after hypertension. Finally, in vitro exposure of cerebral microvessel-enriched fractions to glycerol trinitrate enhanced BDNF production. CONCLUSION: These data reveal that BDNF levels measured in brain homogenates correspond for a large part to BDNF present in cerebral endothelial cells and that cerebrovascular BDNF production is dependent on cerebrovascular endothelial eNOS activity. They provide a paradigm shift in the cellular source of brain BDNF and suggest a new approach to improve our understanding of the link between endothelial function and cognition.

[Tinnitus and temporomandibular joint: State of the art]. / Acouphènes et articulation temporo-mandibulaire : état des connaissances.

Tinnitus has been described in temporomandibular joint dysfunction for a long time. Yet, other disorders, such as hearing loss, stress, anxiety and depression, play a major role in the pathophysiology of tinnitus. Temporomandibular joint dysfunctions seem to increase the risk of tinnitus in patients with other predisposing factors. Especially somatosensory tinnitus, which is characterized by sound modulations with neck or mandible movements, is frequently associated with temporomandibular joint dysfunction, but it is not pathognomonic of such a disorder. In such cases, functional therapy of the temporomandibular joint should be part of the multidisciplinary rehabilitation of patients with tinnitus.

Complete amino-acid sequence of the beta-subunit of VTX from venom of the stonefish (Synanceia verrucosa) as identified from cDNA cloning experiments.

A cDNA encoding a subunit of the verrucotoxin (VTX) has been identified from a cDNA library derived from stonefish venom glands. It encodes a polypeptide of 708 amino-acid residues, followed by a 3'-untranslated region of 895 bp long. The ORF contains the complete mature sequence of the beta-subunit of the VTX, as inferred from both the presence of an identical N-terminus sequence and 96% homology among the 506 amino terminus residues found in the partial sequence of the beta-subunit of the stonustoxin from Synanceia horrida (Ghadessy, F.J., Jeyaseelan, K., Chung, M.C.M., Khoo, H.E., and Yuen, R. (1994) Toxicon 32, 1684-1688). Upstream the mature sequence, we noticed the presence of an incomplete peptide of a 13 amino acids, whose unusual primary structure supports the idea of the existence of a propeptide and/or of a new secretion signal.