The role of tumor necrosis factor receptor superfamily members in mammalian brain development, function and homeostasis

Tumor necrosis factor receptor superfamily (TNFRSF) members were initially identified as immunological mediators, and are still commonly perceived as immunological molecules. However, our understanding of the diversity of TNFRSF members' roles in mammalian physiology has grown significantly since the first discovery of TNFRp55 (TNFRSF1) in 1975. In particular, the last decade has provided evidence for important roles in brain development, function and the emergent field of neuronal homeostasis. Recent evidence suggests that TNFRSF members are expressed in an overlapping regulated pattern during neuronal development, participating in the regulation of neuronal expansion, growth, differentiation and regional pattern development. This review examines evidence for non-immunological roles of TNFRSF members in brain development, function and maintenance under normal physiological conditions. In addition, several aspects of brain function during inflammation will also be described, when illuminating and relevant to the non-immunological role of TNFRSF members. Finally, key questions in the field will be outlined.

Interventional endoscopic ultrasound

Endoscopic ultrasound (EUS) has been used in clinical practice for the past two decades, mainly for staging upper gastrointestinal tract tumours. More recently the technique has been used to guide interventional procedures, particularly EUS-guided biopsy. In this review we describe the equipment and technique required for interventional EUS. We also discuss with illustrations the current clinical applications, potential complications and developments for the future.

The value of prone imaging in CT pneumocolon

AIM

To evaluate the value of prone imaging in computed tomography pneumocolon.

MATERIALS AND METHODS

In the U.K., patients commonly undergo computed tomography (CT) pneumocolon in the supine position alone. A prospective analysis of both supine and prone CT images was performed. The degree of distension and the presence/absence of fluid/faecal residue were documented.

RESULTS

Twenty-five patients were examined in total. In all cases, all five segments of the colon were well visualized on combined assessment of supine/prone images. Diagnostic distension was obtained in all five segments of the bowel in 69% of cases in the prone position, but in only 24% of patients in the supine position. The rectum and sigmoid colon were well distended in 100 and 88%, respectively, on prone CT, but in only 58 and 35% of cases, respectively, on supine CT. Problems encountered by fluid/faecal residue were eliminated on prone CT.

CONCLUSION

Adjunctive prone pelvic CT should be performed in all patients undergoing CT pneumocolon unless the supine images can be fully reviewed and shown to be satisfactory before the patient leaves the CT department. If a single positional sequence is to be performed, then prone CT is the position of choice.

Management of ureteral strictures in renal transplants by antegrade balloon dilatation and temporary internal stenting

PURPOSE

To evaluate the efficacy of percutaneous balloon dilatation and temporary internal stenting in the treatment of transplant ureteral strictures.

METHODS

Nine patients presenting with obstructed renal transplants were treated by antegrade nephrostomy insertion, ureteroplasty, and temporary internal stenting. Following stent removal, patients were divided into two groups for analysis according to whether the obstruction occurred less than (group A) or more than (group B) 3 months following transplantation.

RESULTS

All procedures were technically successful. In group A (n = 6), all patients were successfully treated by one or two dilatations with stenting. In group B (n = 3), two patients were successfully treated by one dilatation with stenting. Overall, eight patients (89%) have had their primary or secondary stent removed successfully at a mean interval of 97.5 days after insertion, and remain well at a mean follow-up interval of 22 months.

CONCLUSION

Balloon dilatation and temporary internal stenting is a useful method for treating transplant ureteral strictures.