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PINK1 is a causative gene for Parkinson’s disease and the corresponding protein has been identified as a master regulator of mitophagy—the autophagic degradation of damaged mitochondria. It interacts with Beclin1 to regulate autophagy and initiate autophagosome formation, even outside the context of mitophagy. Several other pro-survival functions of this protein have been described and indicate that it might play a role in other disorders, such as cancer and proliferative diseases. In this study, we investigated a novel anti-apoptotic function of PINK1. To do so, we used SH-SY5Y neuroblastoma cells, a neuronal model used in Parkinson’s disease and cancer studies, to characterize the pro-survival functions of PINK1 in response to the apoptosis inducer staurosporine. In this setting, we found that staurosporine induces apoptosis but not mitophagy, and we demonstrated that PINK1 protects against staurosporine-induced apoptosis by impairing the pro-apoptotic cleavage of Beclin1. Our data also show that staurosporine-induced apoptosis is preceded by a phase of enhanced autophagy, and that PINK1 in this context regulates the switch from autophagy to apoptosis. PINK1 protein levels progressively decrease after treatment, inducing this switch. The PINK1–Beclin1 interaction is crucial in exerting this function, as mutants that are unable to interact do not show the anti-apoptotic effect. We characterized a new anti-apoptotic function of PINK1 that could provide options for treatment in proliferative or neurodegenerative diseases.

Vocal changes after rhinoplasty have been poorly investigated, although this surgical procedure is nowadays one of the most requested. The production of voice largely depends on the anatomy and the size of the pyramid and the nasal cavity. The authors report 51 cases of both closed and open rhinoplasty and propose a 2-year report to analyze potential effective changes on voice.Fifty-one patients were enrolled and evaluated from September of 2012 to January of 2018. All patients were studied before and 2 years after surgery. Vocal changes were assessed with an objective and a subjective evaluation. The first one allowed to perform the measurement of the intensity and frequency of vowel sound ("a") and nasal consonant sounds ("n" and "m"). For the subjective evaluation, our modified version of Voice Handicap Index Score allowed us to evaluate every single characteristic of the personal perception of voice.The objective evaluation showed an increased frequency of production of the consonant sounds in 62% of cases and an increased frequency of production of the vowel sound in 68% of cases. The subjective evaluation allowed us to notice significant changes after surgery (Reduction rhinoplasty technique proved to induce several alterations on vocal pattern. The surgeon should always inform patients about the potential effects on the voice, particularly when such changes may produce influences on the working life.Les changements vocaux après une rhinoplastie ont fait l’objet de peu d’études, même si cette intervention est actuellement l’une des plus demandées. La production de la voix dépend largement de l’anatomie et de la dimension de la pyramide et de la fosse nasales. Les auteurs rendent compte de 51 cas de rhinoplastie fermée et ouverte et présentent un rapport sur deux ans pour analyser les changements effectifs potentiels sur la voix.Les chercheurs ont inscrit 51 patients qu’ils ont évalués entre septembre 2012 et janvier 2018. Ils ont étudié tous les sujets avant l’opération, puis deux ans après. Ils ont estimé les changements vocaux au moyen d’une évaluation objective et subjective. La première permet de mesurer l’intensité et la fréquence de la voyelle « a » et des consonnes nasales « n » et « m ». Dans le cadre de l’évaluation subjective, ils ont modifié la version du score de handicap vocal pour évaluer chaque caractéristique de la perception personnelle de la voix.L’évaluation objective a révélé une plus grande fréquence lors de la production des consonnes dans 62 % des cas et lors de la production de la voyelle dans 68 % des cas. Grâce à l’évaluation subjective, les auteurs ont remarqué des changements importants après l’opération (Il est démontré que la technique de rhinoplastie de réduction provoque plusieurs altérations du profil vocal. Le chirurgien devrait toujours informer les patients des effets potentiels de l’opération sur la voix, particulièrement lorsque ces effets peuvent avoir une incidence sur la vie professionnelle.

Extensive studies on PINK1, whose mutations are a confirmed cause of Parkinson's disease (PD), have been conducted in animal models or immortalized cell lines. These include initial ground-breaking discoveries on mitophagy, which demonstrated that PINK1 recruits Parkin on depolarized mitochondria, initiating a signalling cascade eventually resulting in their autophagic degradation. Not all features of this complex molecular pathway have been reproduced in mammalian or human neurons, undermining the hypothesis proposing mitophagy as the most relevant biochemical link between PINK1 deficiency and PD pathogenesis. Experiments in murine primary neurons examined another possible neuroprotective function of PINK1, namely its involvement in mitochondrial motility along axons and dendrites. PINK1 interacts with Miro, a component of the motor/adaptor complex binding mitochondria to microtubules and allowing their movement to and from cellular processes. Distinct subcellular pools of PINK1, cytosolic and mitochondrial, appear to regulate anterograde and retrograde transport, respectively. Technological advancements today allow researchers to de-differentiate fibroblasts into induced pluripotent stem cells and re-differentiate them into dopaminergic neurons. Few studies based on this technique address possible neuroprotective effects of PINK1, including mitophagy and mitochondrial homeostasis, but underline the need for a broader characterization of its function in neurons.

Background Synkinesis represents involuntary muscular movements that occur in association with voluntary contraction of other muscle groups. Oculonasal synkinesis is a rare phenomenon. Objectives In a series of videos, the authors present clinical findings and surgical correction of oculonasal synkinesis. Methods Two women who underwent surgical procedures to correct oculonasal synkinesis were evaluated in a prospective study. One patient presented with bilateral synkinesis after 2 previous rhinoplasties. She underwent open rhinoplasty in our office. The other patient had unilateral synkinesis of the left side and received endonasal rhinoplasty. Results The patients' mean age was 27.5 years, and follow-up was conducted for 6 months. Both patients experienced complete, stable resolution of synkinesis after surgical correction. No complications were recorded. Conclusions Patients with oculonasal synkinesis may not notice it preoperatively and may regard these muscle movements as an unfavorable result of rhinoplasty. Therefore, careful preoperative evaluation is crucial.

Depuis le rapport preliminaire publie en 2004 sur la technique originale de stabilisation de l’instabilite scapho-lunaire par transfert dynamique de l’extenseur carpi radialis brevis sur le pole distal du scaphoide, nous avons utilise cette technique pour le traitement de l’instabilite sacpho-lunaire post-traumatique chez 26 patients. Seulement 19 de ces patients ont pu etre evalues a distance. Au total, 14 hommes et 5 femmes, âges entre 16 et 62 ans, dont le follow-up varie entre 13 ans et 12 mois ont ete evalues sur la base de la recuperation de la force, de la mobilite du poignet et de la persistance ou la disparition de la douleur. Les auteurs rapportent les resultats de cette technique qui peut se reveler tres efficace, sur le 19 cas operes 6 cas ont eu un excellent resultât avec retour aux activites precedentes recuperant un poignet proche de la normale. Trois patients pratiquant sport a tres haut niveau ont pu retourner a la competition 6 mois apres l’intervention. Les auteurs insistent sur les indications de cette technique sur la base de l’etat clinique preoperatoires. Anciennete de la lesion, facilite de la reduction de la luxation et profil du patient sont les facteurs qui semblent le plus influencer les resultats.

Microsurgical procedures require rapid and atraumatic dissection of vessels. The authors have tried to schematize the most common variations of the palmar arteries, dividing the thumb into three segments, delimited from the MCP and interphalangeal flexion crease. If a vascular anastomosis has to be carried out in the first segment, the arteries that intersect the palmar surface of such a region do not generally hold much interest for the surgeon as far as size and constancy are concerned. One therefore can avoid frustration while searching in vain for such an artery by starting dissection in the dorsal compartment, where there is a much better chance of finding an artery suitable in every aspect. In replanting a thumb in the second segment, the ulnar collateral artery should be the artery that is looked for first, because it is usually the biggest, the most superficial, and nearly always is composed of a single trunk (Fig. [figure: see text] 18). Let us not forget, however, that the contralateral artery can frequently have all the necessary requirements for an adequate anastomosis. In the third segment, the layout of the vessels is rather difficult to schematize; if it is true that the inverted Y or H shape can make a microanastomosis easier in cases of distal reimplantation (Fig. 19), it is also true that such a pattern is impossible to foresee, and, therefore, the interest of such classification is more academic than practical. Skin loss coverage at the thumb level greatly differs from the that of fingers. In the past few years, a multitude of useful new flaps has been presented by different authors. Their accomplishment (especially those of the last generation, who base their survival on extremely fine vascular axes) presupposes an adequate knowledge of surgical and microsurgical anatomy. Surgeons dealing with this type of pathology should be capable of performing all of the possible flaps because each may be indicated in specific situations.

Keeping crew members in good health is a major factor in the success or failure of long-duration manned space missions. Among the many possible agents that can affect the crew's general well-being, stress is certainly one of the most critical because of its implications on human health and performance, both physical and mental. Nevertheless, very few studies have been performed on this fundamental issue and none of them has addressed it in its entirity, considering its diverse physical and psychological aspects. In this work, a descriptive model is proposed to expound the mechanism and sequence of events which mediate stress. A critical analysis of the information provided by past manned spaceflights and by dedicated research performed in analogous environments is presented, and an extrapolation of the available data on human stress in such extreme conditions is proposed. Both internal and external stressors have been identified, at physical and psychosocial levels, thus providing the basis for their early detection and preventive reduction. The possible negative consequences of stress that may lead to disease in crewmembers are described. Finally, the most effective instruments which may be of help in reducing space-related human stress and treating its negative consequences are suggested.

Theuseoftheanconeusmuscleinthetreatmentofchroniclateral epicondylitis (CLE), recurrences, and infection ispresented. In chronic lateral epicondylitis, a wide degen-erativearea ofepicondyletendonisnotfrequentlyfound,but when it occurs, its treatment is quite difficult. Recur-rences of CLE and superficial or articular infections ofthe radiohumeral joint after surgical treatment or corti-sone infiltrations are 2 more major conditions in whichthe use of anconeus muscle transposition demonstratedto be a promising technique. The procedure is widely de-scribed based on personal experience of 13 cases, 8 ofwhich were CLE (group 1), and 5 recurrences and infec-tion (group 2). Rotation of this muscle close to the epi-condyle makes it possible to cover the epicondyle boneandtheexposedradiohumeraljointinallcases.Addition-alsurgicaltimeusuallyrequiresonlyanextra15minutes.At the mean follow-up of 74 and 55 months, all the pa-tients of the first group were painless, and the patients ofthe second group showed a decrease in pain from 9 to 3.Patients of the 2 groups returned to their previous workwith a complete recovery of elbow range of motion andgrip strength.Keywords:chroniclateralepicondylitis,anconeusmuscle,recurrence, infection

The dominance of the radial or ulnar artery at the forearm level and their contributions to the circulation of the hand remain a matter of contention. Therefore, the authors proposed to investigate the predominance of one of these arteries first by anatomic studies on 40 fresh cadaver upper extremities, and then by dynamic studies. The dynamic studies included color Doppler sonography in 22 individuals (44 hands) and five-channel plethysmography in 40 individuals (40 right hands). It was found that the ulnar artery is dominant at the elbow, but after originating its collateral branches, the radial artery becomes the dominant artery in the distal forearm and, consequently, constitutes the major source of vascularization to the hand. The ulnar artery is rarely dominant at the forearm level and is physiologically less important. Therefore, there is no hemodynamic reason to prefer the radial artery to the ulnar artery for any invasive maneuvers.

Over the recent years, end-to-side neurorrhaphy has reemerged in the literature for reconstructive nerve surgery. Another technique, in which interest has remained continuous during the last century, is direct nerve implantation into muscle belly, so-called direct muscle neurotization (DMN). In this work, the authors present a new technique to recover muscle innervation through direct nerve implantation into muscle belly, by means of a nerve graft, and sutured with end-to-side neurorrhaphy. They carried out experiments on 20 Wistar rats divided into two groups. In Group 1 (10 rats), on the right side, the peroneal nerve was sutured to the tibial nerve with end-to-side neurorrhaphy. Subsequently, the terminal branches of the same nerve were implanted in the anterior tibial muscle (ATM). On the left side, the peroneal nerve was severed, and the ATM completely denervated. In Group 2 (10 rats), on the right side, the same technique was used as in first group. On the left side, the normal innervation of the ATM was maintained. After 4 months, all muscles and nerves were harvested and evaluations carried out on the morphologic aspect, weight, and histology of the ATM, as well as the histology of the nerves. The authors analyzed the results, which demonstrated good reinnervation of the muscles deprived of any nerve connection.

The authors review the latest theories of peripheral nerve regeneration and repair. They present their research on nerve regeneration including the alterations in the mother cell body, and in the distal part of the axon, and the time required to reach the best production of amino acids for cytoskeleton reconstruction. Other research of particular interest which is presented regards the chemotactic arrangement of motor and sensory axons inside a vein. This research has shown that the axons are able to find their way to the appropriate (sensory or motor) distal endoneural tubes. Adoption phenomena are also presented. The discussion of surgery includes the type (suture, glueing, grafts, tubulization) and the time of surgical repair. Timing and repair strategies are related to the site of the lesion (which can require that a greater or smaller amount of cytoskeleton be reconstructed), the type of the injury, the state of surrounding tissues, the age of the patients, injuries to muscles, tendons, bones, vessels and skin. A scheme of strategy is proposed.

Actinic brachial plexus lesions after mastectomy have been treated in 67 cases. Thirty-nine cases have been operated on, 31 of which by means of a free microvascular transfer of the greater omentum. Indications and contraindications of the procedure are discussed, as well as the types of anatomic-pathologic lesions that have been found, and the surgical technique that has been modified and improved over time is presented. Results indicate that free microvascular greater omentum transfer following neurolysis is currently the best method for relief of pain.