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Biomedical subjects

Peter A Brennan

Publications and source records attributed to Peter A Brennan.

At least 19 recordsLinked to original sources

Mammalian social odours: attraction and individual recognition.

Mammalian social systems rely on signals passed between individuals conveying information including sex, reproductive status, individual identity, ownership, competitive ability and health status. Many of these signals take the form of complex mixtures of molecules sensed by chemosensory systems and have important influences on a variety of behaviours that are vital for reproductive success, such as parent-offspring attachment, mate choice and territorial marking. This article aims to review the nature of these chemosensory cues and the neural pathways mediating their physiological and behavioural effects. Despite the complexities of mammalian societies, there are instances where single molecules can act as classical pheromones attracting interest and approach behaviour. Chemosignals with relatively high volatility can be used to signal at a distance and are sensed by the main olfactory system. Most mammals also possess a vomeronasal system, which is specialized to detect relatively non-volatile chemosensory cues following direct contact. Single attractant molecules are sensed by highly specific receptors using a labelled line pathway. These act alongside more complex mixtures of signals that are required to signal individual identity. There are multiple sources of such individuality chemosignals, based on the highly polymorphic genes of the major histocompatibility complex (MHC) or lipocalins such as the mouse major urinary proteins. The individual profile of volatile components that make up an individual odour signature can be sensed by the main olfactory system, as the pattern of activity across an array of broadly tuned receptor types. In addition, the vomeronasal system can respond highly selectively to non-volatile peptide ligands associated with the MHC, acting at the V2r class of vomeronasal receptor. The ability to recognize individuals or their genetic relatedness plays an important role in mammalian social behaviour. Thus robust systems for olfactory learning and recognition of chemosensory individuality have evolved, often associated with major life events, such as mating, parturition or neonatal development. These forms of learning share common features, such as increased noradrenaline evoked by somatosensory stimulation, which results in neural changes at the level of the olfactory bulb. In the main olfactory bulb, these changes are likely to refine the pattern of activity in response to the learned odour, enhancing its discrimination from those of similar odours. In the accessory olfactory bulb, memory formation is hypothesized to involve a selective inhibition, which disrupts the transmission of the learned chemosignal from the mating male. Information from the main olfactory and vomeronasal systems is integrated at the level of the corticomedial amygdala, which forms the most important pathway by which social odours mediate their behavioural and physiological effects. Recent evidence suggests that this region may also play an important role in the learning and recognition of social chemosignals.

Animals↗

Pheromonal communication in vertebrates.

Recent insights have revolutionized our understanding of the importance of chemical signals in influencing vertebrate behaviour. Previously unknown families of pheromonal signals have been identified that are expanding the traditional definition of a pheromone. Although previously regarded as functioning independently, the main olfactory and vomeronasal systems have been found to have considerable overlap in terms of the chemosignals they detect and the effects that they mediate. Studies using gene-targeted mice have revealed an unexpected diversity of chemosensory systems and their underlying cellular and molecular mechanisms. Future developments could show how the functions of the different chemosensory systems are integrated to regulate innate and learned behavioural and physiological responses to pheromones.

Animal Communication↗

An unreported variation of the course of peroneal artery during fibula flap harvest.

We describe a previously unreported anatomical variant of the peroneal artery that was found both on preoperative angiography and at operation to be related to the fibula only in its distal third. In contrast to previously reported variations, the artery began descending on the medial aspect of the fibula about 26cm from the fibular head.

Angiography↗

Nitric oxide is a factor in the stabilization of hypoxia-inducible factor-1alpha in cancer: role of free radical formation.

Widespread expression of the alpha-subunit of hypoxia-inducible factor (HIF-1alpha) was observed in samples of human oral squamous cell carcinoma. In all the cases, this was accompanied by a widespread distribution of nitric oxide (NO) synthases (NOS). Furthermore, in three human cell lines derived from human oral squamous cell carcinoma, the accumulation of HIF-1alpha was prevented either by inhibition of NOS activity with the nonspecific NOS inhibitor N(G)-monomethyl-L-arginine or by the antioxidants N-acetyl-L-cysteine and ascorbic acid. We suggest that, in certain forms of cancer, NO might be responsible for the accumulation of HIF-1alpha by a mechanism dependent on free radicals.

Carcinoma, Squamous Cell↗

Arthrocentesis for temporomandibular joint pain dysfunction syndrome.

The management of refractory temporomandibular joint (TMJ) pain is both challenging and controversial. A number of simple, noninvasive approaches have been used in the management of this condition with variable success. In patients who fail to respond to conventional conservative measures, in a joint that is not deemed to be grossly mechanically deranged, we advocate the use of TMJ arthrocentesis. In our practice, this is followed by intra-articular morphine infusion in an attempt to give long-term pain relief. Arthrocentesis is a simple technique with minimal morbidity that can be tried instead of more invasive procedures. To date we have used arthrocentesis of the upper joint space, with intra-articular morphine injection in over 500 TMJs. Approximately 90% of patients have found the procedure beneficial, with pain often being reduced 1 year after the procedure. We recommend arthrocentesis as an effective, minimally invasive technique in patients with continuing pain in the TMJ that is unresponsive to conservative management. We additionally advocate the use of intra-articular morphine as a long acting analgesic in these patients. Although arthrocentesis is a well documented technique and there have been many studies published in relation to the use of intra-articular morphine in orthopedic surgery, further research is required, to delineate its use in the TMJ more fully.

Analgesics, Opioid↗

High division of the accessory nerve: a rare anatomical variation as a possible pitfall during neck dissection surgery.

A rare clinical variant found during neck dissection surgery is reported in which the spinal accessory nerve divided at a high level in the neck, before entering the sternocleidomastoid muscle. This case documents the need for meticulous technique in identification and dissection of the spinal accessory nerve in order to reduce the risk of postoperative morbidity.

Accessory Nerve↗

Quality of dying in head and neck cancer patients: a retrospective analysis of potential indicators of care.

OBJECTIVE: The objective of this study was to evaluate the quality of the dying experience in a cohort of head and neck cancer patients by a retrospective analysis of potential indicators of care. STUDY DESIGN: The study design included retrospective case note analysis of previously evaluated factors considered important in the care of terminally ill patients and validated indicators of care obtainable from administrative data. The documented factors were analyzed to indicate specific elements of the quality of death and dying experience. RESULTS: Pain was a common symptom (84%) and was managed successfully in all patients, with 93% receiving opioids. Management of other symptoms, except neuropsychological problems, were satisfactory. Sixty-three percent of patients died in hospital and only 22% had a relative present at the time of death. Resuscitation status was documented in only 65% of the notes, though none were admitted to the intensive care unit or underwent resuscitation. Fifty-three percent of patients were admitted as an emergency in the last month of life and bleeding was the most common cause of admission. CONCLUSION: Valuable information can be obtained from a focused retrospective analysis. The indicators evaluated suggest that biomedical aspects of care are being recognized and addressed, although there is room for improvement. Psychosocial and spiritual aspects of care were not documented and must be taken into account to assess the "complete quality of dying" experience.

Adult↗

Something in the air? New insights into mammalian pheromones.

Olfaction is the dominant sensory modality for most animals and chemosensory communication is particularly well developed in many mammals. Our understanding of this form of communication has grown rapidly over the last ten years since the identification of the first olfactory receptor genes. The subsequent cloning of genes for rodent vomeronasal receptors, which are important in pheromone detection, has revealed an unexpected diversity of around 250 receptors belonging to two structurally different classes. This review will focus on the chemical nature of mammalian pheromones and the complementary roles of the main olfactory system and vomeronasal system in mediating pheromonal responses. Recent studies using genetically modified mice and electrophysiological recordings have highlighted the complexities of chemosensory communication via the vomeronasal system and the role of this system in handling information about sex and genetic identity. Although the vomeronasal organ is often regarded as only a pheromone detector, evidence is emerging that suggests it might respond to a much broader variety of chemosignals.

Afferent Pathways↗

Aberrant expression, processing and degradation of dystroglycan in squamous cell carcinomas.

The alpha- and beta- dystroglycan (DG) proteins are involved in epithelial cell development, formation of the basement membrane and maintenance of tissue integrity. Recently, specific changes in the expression patterns of DGs have been described in some cancers. We studied the expression and localisation of alpha- and beta-DG using Western blotting, immunohistochemistry and reverse transcriptase-polymerase chain reaction analyses in samples of normal oral mucosa, oral squamous cell carcinoma (SCC) and cancer cell lines. The alpha- and beta-DG were localised in the basal layers of normal oral mucosa.However, beta-DG expression in cancer tissues showed evidence of aberrant expression, processing and degradation. alpha-DG was altered in all oral cancer samples and cell lines, despite the persistent presence of DG mRNA in cancer cells. Using matrix metalloproteinase (MMP) inhibitors, we determined that beta-DG degradation in carcinoma cell lines can be mediated by MMPs but this process is highly variable, even in cells from the same cancer type. Considering the multifaceted role of DG in epithelial development, it appears that the role of DG degradation in cancer growth and spread, although currently poorly understood, may be important.

Animals↗

Does administration of isosorbide mononitrate affect cellular proliferation in oral squamous cell carcinoma? A prospective randomized clinical study.

PURPOSE: There has been much interest in the role that the signaling molecule nitric oxide (NO) plays in cancer. NO has both tumor-promoting and tumor-inhibiting effects that are dependent on its local tissue concentration. In animal studies, the administration of exogenous NO has reduced both tumor growth and dissemination, and in vitro NO administration causes death of oral cancer cell lines. We evaluated the oral administration of the NO donor drug isosorbide mononitrate (ISMO) on cellular proliferation in patients with oral squamous cell carcinoma. MATERIALS AND METHODS: A prospective randomized double-blind study was performed on 31 patients with biopsy-confirmed oral squamous cell carcinoma. Following incisional biopsy, patients were randomized to receive either ISMO (at a dose of 20 mg twice a day) or placebo tablets for 2 weeks before definitive resection. Cellular proliferation was compared between biopsy and resection specimens, using the immunohistochemical marker Ki-67. RESULTS: No statistical difference was found between Ki-67 indices in initial biopsy and resection specimens after ISMO (P =.23) or placebo (P =.5) administration. There were no obvious clinical changes seen in the tumor during the clinical trial as a result of ISMO administration. CONCLUSION: Although high concentrations of NO are cytotoxic, it is unlikely that administration of NO at an increased dose would be useful in the management of oral cancer because this would result in unacceptable systemic side effects. The possible manipulation of NO in oral cancer is discussed.

Adult↗

The nose knows who's who: chemosensory individuality and mate recognition in mice.

Individual recognition is an important component of behaviors, such as mate choice and maternal bonding that are vital for reproductive success. This article highlights recent developments in our understanding of the chemosensory cues and the neural pathways involved in individuality discrimination in rodents. There appear to be several types of chemosensory signal of individuality that are influenced by the highly polymorphic families of major histocompatibility complex (MHC) proteins or major urinary proteins (MUPs). Both have the capability of binding small molecules and may influence the individual profile of these chemosignals in biological fluids such as urine, skin secretions, or saliva. Moreover, these proteins, or peptides associated with them, can be taken up into the vomeronasal organ (VNO) where they can potentially interact directly with the vomeronasal receptors. This is particularly interesting given the expression of major histocompatibility complex Ib proteins by the V2R class of vomeronasal receptor and the highly selective responses of accessory olfactory bulb (AOB) mitral cells to strain identity. These findings are consistent with the role of the vomeronasal system in mediating individual discrimination that allows mate recognition in the context of the pregnancy block effect. This is hypothesized to involve a selective increase in the inhibitory control of mitral cells in the accessory olfactory bulb at the first level of processing of the vomeronasal stimulus.

Animals↗

Vertical ramus osteotomy combined with a parasymphyseal mandibulotomy for improved access to the parapharyngeal space.

BACKGROUND: A number of procedures have been described that facilitate access to the parapharyngeal space. Their use may be limited because of restricted access or postoperative morbidity. METHODS: We describe the use of two mandibular osteotomies to greatly enhance the exposure of the parapharyngeal space, with possible access up to the skull base. RESULTS: We have performed this procedure in three cases with minimal postoperative morbidity and no neurologic deficit or occlusal disturbances. CONCLUSIONS: We have found that the osteotomies described provide far better exposure to this area than a single mandibular osteotomy alone. Furthermore, it avoids a facial scar.

Humans↗

Colonization of the cleft nasal floor by anaerobic oral flora in patients with oronasal fistulae.

OBJECTIVES: Aerobic oral bacteria only rarely colonize the cleft nasal floor in patients with patent oronasal fistula. There are no studies that have investigated whether anaerobic oral flora colonize this site and whether attempting to culture them is useful for assessing the patency of oronasal fistulae in the clinic. DESIGN: A prospective study of 13 patients with cleft with patent unilateral oronasal fistulae. Microbiological culture swabs were taken from the oral cavity and both nasal floors, with the unaffected side being used as a control. Following aerobic and anaerobic culture, bacterial isolates were identified and compared. MAIN OUTCOME MEASURE: A significant growth of anaerobic oral bacteria from the cleft nasal floor when compared with the unaffected side. RESULTS: Aerobic oral flora was cultured from the oral cavity in all 13 patients. A light growth of aerobic oral flora was found in the cleft nasal floor in two patients, and anaerobic oral flora was cultured from the cleft nasal floor in the same two patients. No statistical correlation was found between growth of anaerobic flora and the cleft nasal floor (p =.48). CONCLUSIONS: Like aerobic oral flora, anaerobic oral bacteria would appear to only rarely colonize the cleft nasal floor in patients with oronasal fistulae. This additional investigation does not appear to be helpful in the assessment of oronasal fistulae in the clinic.

Adolescent↗