Cholinergic signaling at the body wall neuromuscular junction distally inhibits feeding behavior in Caenorhabditis elegans.

Complex biological functions within organisms are frequently orchestrated by systemic communication between tissues. In the model organism Caenorhabditis elegans, the pharyngeal and body wall neuromuscular junctions are two discrete structures that control feeding and locomotion, respectively. Separate, the well-defined neuromuscular circuits control these distinct tissues. Nonetheless, the emergent behaviors, feeding and locomotion, are coordinated to guarantee the efficiency of food intake. Here, we show that pharmacological hyperactivation of cholinergic transmission at the body wall muscle reduces the rate of pumping behavior. This was evidenced by a systematic screening of the effect of the cholinesterase inhibitor aldicarb on the rate of pharyngeal pumping on food in mutant worms. The screening revealed that the key determinants of the inhibitory effect of aldicarb on pharyngeal pumping are located at the body wall neuromuscular junction. In fact, the selective stimulation of the body wall muscle receptors with the agonist levamisole inhibited pumping in a lev-1-dependent fashion. Interestingly, this response was independent of unc-38, an alpha subunit of the nicotinic receptor classically expressed with lev-1 at the body wall muscle. This implies an uncharacterized lev-1-containing receptor underpins this effect. Overall, our results reveal that body wall cholinergic transmission not only controls locomotion but simultaneously inhibits feeding behavior.

Office-Based Procedures for Nasal Airway Obstruction.

Treatment of common rhinologic problems with in-office surgical procedures has increased dramatically in response to patient preference, evolving insurance patterns, and changes in coding and reimbursement. Because this is an emerging practice, there is not a lot of evidence published about how to best perform these techniques. This article provides practical advice from experienced surgeons related to logistics and anesthetic techniques for conducting in-office surgical treatment of nasal airway obstruction; an overview of office set-up and necessary equipment; and specific procedural considerations. Attention also is paid to pharmacologic issues. Logistics and clinical considerations for common office-based procedures for obstructive pathology are reviewed.

Clinical evaluation of a bioresorbable implant for medialization of the middle turbinate in sinus surgery.

BACKGROUND: During endoscopic sinus surgery (ESS), postoperative lateralization of the middle turbinate can lead to scarring and obstruction of key drainage pathways, including the osteomeatal complex. The technique of suturing the middle turbinate to the nasal septum to enhance exposure can be difficult and time consuming. This study presents the first clinical results using the Middle Turbinate Implant (MTI), a device composed of absorbable copolymer polylactide-co-glycolide and intended to medialize the middle turbinate during surgical procedures such as ESS. METHODS: The trial included 22 implantations (21 successful implantations) on 14 subjects (6 unilateral and 8 bilateral implantations). The primary outcome measure was the position of the middle turbinate at 1, 2, and 4 weeks postoperatively. The extent of tissue reaction at the site of implantation was also evaluated. RESULTS: At 1, 2, and 4 weeks postoperatively, 100% of the middle turbinates were held medially or in the neutral position with no significant synechiae present. At 1, 2, and 4 weeks postoperatively, there was either no (95%, 90%, and 95%) or mild (5%, 10%, and 5%) tissue reaction at the site of implantation. No complications were noted during implantation. CONCLUSION: The use of the bioresorbable MTI appears to be a safe and effective method of medializing the middle turbinate during ESS.