Combining skin and olfactory α-synuclein seed amplification assays (SAA)-towards biomarker-driven phenotyping in synucleinopathies.

Seed amplification assays (SAA) are becoming commonly used in synucleinopathies to detect α-synuclein aggregates. Studies in Parkinson's disease (PD) and isolated REM-sleep behavior disorder (iRBD) have shown a considerably lower sensitivity in the olfactory epithelium than in CSF or skin. To get an insight into α-synuclein (α-syn) distribution within the nervous system and reasons for low sensitivity, we compared SAA assessment of nasal brushings and skin biopsies in PD (n = 27) and iRBD patients (n = 18) and unaffected controls (n = 30). α-syn misfolding was overall found less commonly in the olfactory epithelium than in the skin, which could be partially explained by the nasal brushing matrix exerting an inhibitory effect on aggregation. Importantly, the α-syn distribution was not uniform: there was a higher deposition of misfolded α-syn across all sampled tissues in the iRBD cohort compared to PD (supporting the notion of RBD as a marker of a more malignant subtype of synucleinopathy) and in a subgroup of PD patients, misfolded α-syn was detectable only in the olfactory epithelium, suggestive of the recently proposed brain-first PD subtype. Assaying α-syn of diverse origins, such as olfactory (part of the central nervous system) and skin (peripheral nervous system), could increase diagnostic accuracy and allow better stratification of patients.

1H NMR detection of mobile lipids as a marker for apoptosis: the case of anticancer drug-loaded liposomes and polymeric micelles.

Cultured cancer cells undergoing apoptosis show an increase in the NMR signal at a chemical shift of 1.3 ppm (-CH2-) corresponding to the so-called "mobile lipids" (ML) originating from the mobile acyl chains in triacylglycerides. A single NMR spectrum can provide an overview of the cellular metabolic changes caused by anticancer drugs providing qualitative and quantitative information on cellular metabolites. With this in mind, we studied the appearance of ML resonance in BT-20 and MCF-7 human breast cancer cells after their exposure to paclitaxel-loaded liposomes and polymeric micelles as a method to follow the apoptotic activity initiated by drug-loaded pharmaceutical nanocarriers. BT-20 and MCF-7 cells were incubated with 1.5 microg/mL paclitaxel-loaded liposomes or micelles for 24, 48, and 72 h in DMEM medium. Empty liposomes and micelles and untreated cells were used as controls. The progression of apoptosis induced in cancer cells by drug-loaded nanocarriers was readily detectable by NMR with a markedly increased area of the ML peak at 1.3 ppm. The presence of liposome- and micelle-forming materials did not induce or interfere with the increase in ML signals. Thus, the use of NMR for the detection of ML as a marker of apoptosis can be successfully applied to the study of pharmacological effects of anticancer drugs loaded into pharmaceutical nanocarriers.

Double gallbladder originating from left hepatic duct: a case report and review of literature.

BACKGROUND: Double gallbladder is a rare anomaly of the biliary tract. Double gallbladder arising from the left hepatic duct was previously reported only once in the literature. CASE REPORT: A case of symptomatic cholelithiasis in a double gallbladder, diagnosed on preoperative ultrasound, computed tomography (CT) and endoscopic retrograde cholangiopancreatogram (ERCP) is reported. At laparoscopic cholangiography via the accessory gallbladder no accessory cystic duct was visualized. After conversion to open cholecystectomy, the duplicated gallbladder was found to arise directly from the left hepatic duct; it was resected and the duct repaired. CONCLUSIONS: We emphasize that a careful intraoperative cholangiographic evaluation of the accessory gallbladder is mandatory in order to prevent inadvertent injury to bile ducts, since a large variety of ductal abnormality may exist.

Wandering spleen with torsion in a geriatric patient. Report of an unusual case with a brief review of the clinical picture and management.

Wandering spleen is a rare condition that is extremely uncommon in the elderly. A case of wandering spleen with torsion in a 73-year-old female is described in detail. Our patient's presentation is unusual because in 1972, during a total hysterectomy, she had no evidence of a wandering spleen. Preoperative technetium-99 radionuclide liver-spleen studies were utilized to minimize the potential for vascular difficulties. Splenectomy was the treatment of choice for this condition and was performed to avoid splenic infarction. A review of the literature and etiologic considerations are discussed.