Objectives— Besides its predictive role in determining cardiovascular risk, C-reactive protein (CRP) may exert direct proatherogenic effects through proinflammatory properties. CRP is mainly produced by hepatocytes in response to interleukin-6 (IL-6) and is then released into the systemic circulation. 3-hydroxy-3-methylglutaryl (HMG)-coenzyme A (CoA) reductase inhibitors, or statins, significantly reduce cardiovascular events and mortality in patients with or without coronary artery disease and reduce plasma CRP levels in humans. However, the mechanism by which statins reduce plasma CRP levels remains unknown. Methods and Results— In this study, we report that statins limit both protein and RNA levels of IL-6-induced CRP in human hepatocytes. These effects are reversed by l-mevalonate and mimicked by an inhibitor of the geranylgeranyltransferase. IL-6–induced CRP production requires the binding of IL-6 to its cognate receptors, which results in activation and phosphorylation of the transcription factor ST...

Statins Reduce Interleukin-6–Induced C-Reactive Protein in Human Hepatocytes: New Evidence for Direct Antiinflammatory Effects of Statins

Neuromuscular clinicians are often asked to evaluate the diaphragm for diagnostic and prognostic purposes. Traditionally, this evaluation is accomplished through history, physical exam, fluoroscopic sniff test, nerve conduction studies, and electromyography (EMG). Nerve conduction studies and EMG in this setting are challenging, uncomfortable, and can cause serious complications, such as pneumothorax. Neuromuscular ultrasound has emerged as a non-invasive technique that can be used in the structural and functional assessment of the diaphragm. In this study we review different techniques for assessing the diaphragm using neuromuscular ultrasound and the application of these techniques to enhance diagnosis and prognosis by neuromuscular clinicians. Muscle Nerve 47:319-329, 2013

Neuromuscular Ultrasound for Evaluation of the Diaphragm

Mechanisms of statin-mediated inhibition of small G-protein function.

Besides the enormous advantages of reconstructing the amputated breast by means of a conventional TRAM flap, the main disadvantage remains the elevation of small (free TRAM) or larger (pedicled TRAM) parts of the rectus abdominis muscle. In order to overcome this disadvantage, the free Deep Inferior Epigastric Perforator (DIEP) skin flap has recently been used for breast mound reconstruction with excellent clinical results. After achieving favorable results with eight unilateral DIEP-flaps, we were challenged by an abdomen with a midline laparotomy scar. By dissecting a bilateral DIEP flap and making adjacent anastomoses to the internal mammary artery we were able to achieve sufficient flap mobility for easy free flap positioning and breast shaping. Intraoperative segmental nerve stimulation, postoperative functional abdominal wall tests and CT-scan examination showed normal abdominal muscle activity. On the basis of a case report, the technical considerations and advantages of anastomosing the bipedicled DIEP flap to the internal mammary artery are discussed.

Refinements in free flap breastreconstruction: The free bilateral deep inferior epigastric perforator flap anastomosed to the internal mammary artery

Peripheral nerve injury may result in injury without gaps or injury with gaps between nerve stumps. In the presence of a nerve defect, the placement of an autologous nerve graft is the current gold standard for nerve restoration. The clinical employment of tubes as an alternative to autogenous nerve grafts is mainly justified by the limited availability of donor tissue for nerve autografts and their related morbidity. The purpose of this review is to present an overview of the literature on the applications of nerve conduits in peripheral nerve repair. Moreover, the different steps that are involved in the design of an ideal nerve conduit for peripheral nerve repair, including the choice of biomaterial, fabrication technique, and the various potential modifications to the common hollow nerve tube, are also discussed.

https://www.thieme-connect.com/products/ejournals/pdf/10.1055/s-0032-1333316.pdf

Nerve repair by means of tubulization: past, present, future.

Reinnervation of the Paralyzed Diaphragm: Application of Nerve Surgery Techniques Following Unilateral Phrenic Nerve Injury

Osteomas are the most common tumors of the cranial vault and facial skeleton. Osteomas are usually benign in nature, commonly presenting with symptoms of facial deformity, facial pain, and headaches. Although the frontal sinus is the most frequent location of cranial osteomas, they are also occasionally seen involving only the frontal bone periosteum. This study is a retrospective series investigating the characteristics, management, and outcomes of five patients with frontal bone periosteal osteomas surgically treated with superficial osteotomies with primary closure. Medical charts were reviewed focusing on symptoms, size, radiographic findings, and disease of the periosteal osteomas. The chief complaint primarily involved a palpable deformity, which led to surgical evaluation. Radiographic studies were obtained to evaluate size and location of the frontal osteomas. Microanalysis of the specimens confirmed the presence of mature cancellous and/or cortical bone. Postoperative follow-up revealed no evidence of recurrence or complications. The superficial ostectomy technique with primary closure offers a simple, effective method for removal of frontal bone periosteal osteomas with minimal side effects.

Frontal bone periosteal osteomas.

Simvastatin suppresses LPS-induced Akt phosphorylation in the human monocyte cell line THP-1.

BackgroundMajor trauma to the spinal cord or upper extremity often results in severe sensory and motor disturbances from injuries to the brachial plexus and its insertion into the spinal cord. Functional restoration with nerve grafting neurotization and tendon transfers is the mainstay of treatment. Results may be incomplete due to a limited supply of autologous material for nerve grafts. The factors deemed most integral for success are early surgical intervention, reconstruction of all levels of injury, and maximization of the number of axonal conduits per nerve repair.ObjectiveTo report the second series of nerve allograft transplantation using cadaveric nerve graft and our experience with living-related nerve transplants.ParticipantsEight patients, seven men and one woman, average age 23 years (range 18–34), with multi-level brachial plexus injuries were selected for transplantation using either cadaveric allografts or living-related donors.MethodsGrafts were harvested and preserved in the Univ...

/pdf/nerve-allograft-transplantation-for-functional-restoration-37uwifw7ua.pdf

Tushar R. Patel

Papers

Reinnervation of the Paralyzed Diaphragm: Application of Nerve Surgery Techniques Following Unilateral Phrenic Nerve Injury

Frontal bone periosteal osteomas.

Simvastatin suppresses LPS-induced Akt phosphorylation in the human monocyte cell line THP-1.

Nerve allograft transplantation for functional restoration of the upper extremity: case series

Mevastatin suppresses lipopolysaccharide-induced Rac activation in the human monocyte cell line THP-1.