Genetic association between TAP1 and TAP2 polymorphisms and ankylosing spondylitis: a systematic review and meta-analysis

Objectives

Ankylosing spondylitis (AS) is a chronic inflammatory joint disease. The transporter associated with antigen processing (TAP) has been identified to play an important role in immune response as well as the HLA-associated diseases. The aim of our meta-analysis was to investigate the contribution of TAP (TAP1 and TAP2) polymorphisms to the risk of AS.

Methods

Meta-analyses were performed between 2 polymorphisms in TAP1 (TAP1-333, -637) and 3 polymorphisms in TAP2 (TAP2-379, -565, and -665) and AS.

Results

The meta-analyses were involved with 6 studies with 415 cases and 659 controls. Significant association was found between TAP1-333Val, TAP1-637Gly, and TAP2-565Thr and AS compared with combined control group (TAP1-333Val: p = 0.009, OR = 1.40, 95% CI 1.09–1.80; TAP1-637Gly: p = 0.002, OR = 1.48, 95% CI 1.15–1.91; p = 0.03, OR = 1.38, 95% CI 1.04–1.84). Subgroup analysis shown that significant association was only found in AS when compared with HLA-B27-negative controls (TAP1-333Val: p = 0.004, OR = 1.53, 95% CI 1.14–2.06; TAP1-637Gly: p = 0.004, OR = 1.52, 95% CI 1.15–2.02; p = 0.02, OR = 1.56, 95% CI 1.09–2.24), but not in AS when compared with HLA-B27-positive controls (p > 0.05). Moreover, no significant associations were found between haplotypes in TAP1 and TAP2 in both the combined and the subgroup analyses (p > 0.05).

Conclusions

TAP1-333Val, TAP1-637Gly, and TAP2-565Thr were likely to be associated with AS.

     

Delta neutrophil index (DNI) as a novel diagnostic and prognostic marker of infection: a systematic review and meta-analysis

Objective

Delta neutrophil index (DNI) representing the number of immature granulocytes is an emerging marker used in diagnosis of infections and prediction of mortality in infected patients. The present study evaluated the diagnostic accuracy of DNI as a predictive and prognostic factor in infected patients.

Methods

We performed a PubMed search on January 1st, 2017 and identified studies that evaluated DNI as either a predictive or prognostic factor in infected patients. Studies with appropriate information to construct 2 × 2 contingency tables were extracted. We calculated pooled sensitivity and specificity. Meta-analysis of the multivariate logistic regression data set was performed to assess whether DNI functions as an independent factor.

Results

Overall, 12 articles fulfilled the inclusion criteria and a total of 499 cases and 9549 controls were examined. As a predictive factor of infection, DNI’s pooled sensitivity was 0.67 (95% CI 0.62–0.71, I ² = 86.0%) and pooled specificity was 0.94 (95% CI 0.94–0.95, I ² = 92.8%). Area under the receiver operating characteristics (ROC) curve was 0.89. As a prognostic factor for death in infected patients, DNI’s pooled sensitivity was 0.70 (95% CI 0.56–0.81, I ² = 0.0%) and pooled specificity was 0.78 (95% CI 0.73–0.83, I ² = 26.6%). Area under the ROC curve was 0.84. Meta-analysis of the multivariate logistic regression data set showed insignificant results.

Conclusions

DNI is a potentially useful diagnostic tool and predicts mortality among infected patients and should be more widely used in the clinical practice.

     

Fasting Glucose and the Risk of Depressive Symptoms: Instrumental-Variable Regression in the Cardiovascular Risk in Young Finns Study

Purpose

Type 2 diabetes (T2D) has been associated with depressive symptoms, but the causal direction of this association and the underlying mechanisms, such as increased glucose levels, remain unclear. We used instrumental-variable regression with a genetic instrument (Mendelian randomization) to examine a causal role of increased glucose concentrations in the development of depressive symptoms.

Method

Data were from the population-based Cardiovascular Risk in Young Finns Study (n = 1217). Depressive symptoms were assessed in 2012 using a modified Beck Depression Inventory (BDI-I). Fasting glucose was measured concurrently with depressive symptoms. A genetic risk score for fasting glucose (with 35 single nucleotide polymorphisms) was used as an instrumental variable for glucose.

Results

Glucose was not associated with depressive symptoms in the standard linear regression (B = ?0.04, 95% CI [?0.12, 0.04], p = .34), but the instrumental-variable regression showed an inverse association between glucose and depressive symptoms (B = ?0.43, 95% CI [?0.79, ?0.07], p = .020). The difference between the estimates of standard linear regression and instrumental-variable regression was significant (p = .026)

Conclusion

Our results suggest that the association between T2D and depressive symptoms is unlikely to be caused by increased glucose concentrations. It seems possible that T2D might be linked to depressive symptoms due to low glucose levels.

     

The Association of Sensory Responsiveness with Somatic Symptoms and Illness Anxiety

Background

Somatoform Disorders or Somatic Symptom and Related Disorders are a major public health problem.The pathophysiology underlying these disorders is not yet understood.

Purpose

The aim of this study was to explore if sensory responsiveness could contribute to a better understanding of pathophysiological mechanisms underlying two key symptoms of Somatoform Disorders, namely somatic symptoms and illness anxiety.

Methods

We measured vibrotactile perception thresholds with the HVLab Perception Meter and examined their association with somatic symptoms, illness anxiety and trait anxiety. A sample of 205 volunteers participated in the study.

Results

Sensory responsiveness was neither associated with somatic symptoms (β?=??0.01; 95 % confidence interval (CI), ?0.37, 0.39) nor trait anxiety (β?=??0.07; 95 % CI, ?0.30, 0.07). However, lower vibrotactile perception thresholds were associated with increased scores of the overall illness anxiety scale (β?=??0.65; 95 % CI, ?1.21, ?0.14) and its constituent subscale disease conviction (β?=??2.07; 95 % CI, ?3.94, ?0.43).

Conclusions

Our results suggest that increased sensory responsiveness is associated with illness anxiety and hence should be examined further as potential target within the etiopathology of somatoform disorders.

     

Polymorphism rs547984 on human chromosome 1q43 is not associated with primary open angle glaucoma in a Saudi cohort

Background

To investigate the association between polymorphism rs547984, located in close proximity to the Zona Pellucida Glycoprotein 4 (ZP4) gene on human chromosome 1q43 and primary open angle glaucoma (POAG).

Method

Polymorphism rs547984 was genotyped using Taq-Man® assay in 185 subjects comprising of 90 unrelated POAG cases and 95 controls of Saudi origin.

Results

Association analysis between cases and controls revealed no significant genotype distribution under additive (p = 0.356), dominant (p = 0.517) and recessive (p = 0.309) models. Besides, the allele frequency distribution was also found to be non-significant (p = 0.70). The minor “A” allele frequency was found to be 0.49 and 0.50 among POAG cases and controls, respectively. In addition, specific clinical indices used to assess severity of glaucoma such as intraocular pressure (IOP), cup/disc ratio and number of anti-glaucoma medication also did not show any significant genotype distribution in POAG cases.

Conclusion

Polymorphism rs547984 is neither associated with any clinical indices important for POAG such as IOP and cup/disc ratio nor is a risk factor for POAG in the Saudi cohort.

     

Replaced common hepatic artery from the superior mesenteric artery: multidetector computed tomography (MDCT) classification focused on pancreatic penetration and the course of travel

Purpose

We categorize the subtypes of the replaced common hepatic artery (RCHA) and evaluate the clinical implications.

Methods

Thirty-four cases of the RCHA were evaluated retrospectively using multidetector computed tomography. We categorized them into the three RCHA subtypes according to pancreatic penetration and the passing routes. The distance between the orifice of the superior mesenteric artery (SMA) and RCHA bifurcation (D _SMA-RCHA) was measured using advanced 3D imaging software. Analysis of variance was used to evaluate the difference in D _SMA-RCHA according to the RCHA subtype.

Results

Type A (n = 17, 50 %) referred to RCHA penetrating the pancreatic parenchyma, all crossing the dorsal aspect of the superior mesenteric vein (SMV). Among them, three cases were accompanied by the circumportal pancreas. Type B (n = 10, 29 %) referred to RCHA without penetration of the pancreatic parenchyma and crossing of the dorsal aspect of the main portal vein (MPV) or SMV. Type C (n = 7, 21 %) referred to RCHA without penetration of the pancreas parenchyma and crossing of the ventral aspect of the MPV or SMV. The mean D _SMA-RCHA of each subtype was as follows: type A, 3.13 cm [95 % confidence interval (CI) 2.70–3.57]; type B, 2.04 cm [95 % CI 1.40–2.68]; and type C, 2.14 cm [95 % CI 2.23–2.92]. The D _SMA-RCHA of the penetrating pancreatic parenchyma of the RCHA was significantly longer than that of the non-penetrating pancreatic parenchyma (P = 0.007).

Conclusion

Half of RCHA show penetrating the pancreatic parenchyma, which was categorized as type A, and this type A takes off from the SMA more distally than RCHA without intrapancreatic penetration.

     

Stress Underestimation and Mental Health Outcomes in Male Japanese Workers: a 1-Year Prospective Study

Purpose

Being appropriately aware of the extent of stress experienced in daily life is essential in motivating stress management behaviours. Excessive stress underestimation obstructs this process, which is expected to exert adverse effects on health. We prospectively examined associations between stress underestimation and mental health outcomes in Japanese workers.

Methods

Web-based surveys were conducted twice with an interval of 1 year on 2359 Japanese male workers. Participants were asked to complete survey items concerning stress underestimation, depressive symptoms, sickness absence, and antidepressant use.

Results

Multiple logistic regression analysis revealed that high baseline levels of ‘overgeneralization of stress’ and ‘insensitivity to stress’ were significantly associated with new-onset depressive symptoms (OR?=?2.66 [95 % CI, 1.54–4.59], p?<?.01) and antidepressant use (OR?=?4.91 [95 % CI, 1.22–19.74], p?<?.05), respectively, during the 1-year follow-up period.

Conclusions

This study clearly demonstrated that stress underestimation, including stress insensitivity and the overgeneralization of stress, could exert adverse effects on mental health.

     

Acceptability of a Touch Screen Tablet Psychosocial Survey Administered to Radiation Therapy Patients in Japan

Background

Studies in western clinical settings suggest that touch screen computer surveys are an acceptable mode of collecting information about cancer patients’ wellbeing

Purpose

We examined the acceptability of a touch screen tablet survey among cancer patients in Japan.

Methods

Eligible patients (n?=?262) attending a university hospital radiation therapy (RT) department were invited to complete a touch screen tablet survey about psychosocial communication and care. Survey consent and completion rates, the proportion and characteristics of patients who completed the touch screen survey unassisted, and patient-reported acceptability were assessed.

Results

Of 158 consenting patients (consent rate 60 % [95 % CI 54, 66 %] of eligible patients), 152 completed the touch screen computer survey (completion rate 58 % [95 % CI 52, 64 %] of eligible patients). The survey was completed without assistance by 74 % (n?=?113; 95 % CI 67, 81 %) of respondents. Older age was associated with higher odds of having assistance with survey completion (OR 1.09; 95 % CI 1.04, 1.14 %). Ninety-two percent of patients (95 % CI 86, 96 %) felt that the touch screen survey was easy to use and 95 % (95 % CI 90, 98 %) agreed or strongly agreed that they were comfortable answering the questions. Overall, 65 % (95 % CI 57, 73 %) of respondents would be willing to complete such a survey more than once while waiting for RT treatment.

Conclusions

Although patient self-reported acceptability of the touch screen survey was high, self-administered touch screen tablet surveys may not be entirely appropriate for older cancer patients or possibly for patients with lower educational attainment.

     

The Association Between Social Support,Body Mass Index and Increased Risk of Prediabetes: the Cardiovascular Risk in Young Finns Study

Purpose

The psychosocial determinants of prediabetes are poorly understood. The aims of our study were (1) to analyse the association between perceived social support in young adulthood and fasting glucose levels and prediabetes in mid-adulthood in a cohort of healthy Finns, (2) to explore whether body mass index (BMI), inflammation or depression mediate this relationship, (3) and to examine the association between social support trajectory groups and fasting glucose.

Method

A prospective design was used with an analytic sample of 1250 participants aged 3–18 years at baseline (1980) and aged 12–39 years when social support was measured. Fasting glucose and prediabetes were assessed 32 years after baseline. Linear and logistic regression was used to examine the association between social support and the outcome measures. A bootstrapping technique was used to examine mediation effects.

Results

Social support was associated with future glucose levels in women after adjusting for childhood socioeconomic status (SES) and youth depression (β = ?0.136, p = 0.001) and also predicted prediabetes in women after adjusting for childhood SES (β = 1.31, 95 % CI 1.02 to 1.69, p = 0.031). Both associations were attenuated after adjusting for BMI in mid-adulthood. BMI was found to mediate the relationship between social support and prediabetes in women (β for indirect effect β = 0.09, SE = 0.03, CI = 0.03 to 0.16).

Conclusion

Low perceived social support in young adulthood is associated with high fasting glucose and prediabetes in mid-adulthood in women but not men. The association between social support and prediabetes in women can be partly explained by BMI.

     

Patients’ Expectations Predict Surgery Outcomes: A Meta-Analysis

Background

Several studies indicate that patients’ presurgical expectations can influence postsurgical health outcome.

Purpose

To estimate the potential for clinical exploitation of this association, a meta-analysis of prospective studies which assess the association between patients’ presurgical expectations and postsurgical quality of life is applied to accumulate the overall effect.

Methods

We searched the databases MEDLINE, CENTRAL, and PsychINFO for English- and German-language articles published from 1980 until December 2013. Additionally, manual searches of bibliographies of retrieved articles and relevant reviews were conducted. Prospective studies measuring presurgical expectations and postsurgical quality of life in patients aging 18–65 were selected. Correlations between presurgical expectations and postsurgical quality of life were extracted or provided by the authors.

Results

The search yielded 21 prospective studies (including 2611 patients undergoing surgery) with a follow-up period ranging from 1 week to 13 years. The pooled correlations were 0.369 (95 % confidence interval (CI), 0.264 to 0.466; P for heterogeneity <0.001; random-effects model) for overall quality of life (11 studies), 0.126 (95 % CI, 0.079 to 0.172; P for heterogeneity?=?0.63; random-effects model) for physical quality of life (12 studies), and 0.208 (95 % CI, 0.113 to 0.299; P for heterogeneity <0.001; random-effects model) for mental quality of life (12 studies), indicating low to moderate associations between presurgery patients’ expectations and postsurgery quality of life.

Conclusions

These results confirm the importance of patients’ expectations in the prediction of postsurgical outcomes and underline the necessity to optimize these expectations in order to improve postoperative quality of life.

     

Work-Family Conflict Modifies the Association of Smoking and Periodontal Disease

Purpose

The aims of the study were to assess the association of periodontal loss of attachment with smoking and work-family conflict and assess whether work-family conflict modifies the association of smoking and periodontal disease.

Method

A random sample of 45–54 year olds from metropolitan Adelaide, South Australia, was surveyed by mailed self-complete questionnaire during 2004–2005. Oral examinations were performed on persons who responded to the questionnaire, providing an assessment of periodontal status.

Results

A total of 879 responded (participation rate = 43.8 %), with n = 709 oral examinations (completion rate = 80.7 %). Prevalence of periodontal loss of attachment (LOA) of 6+ mm was higher (p < 0.05) for smokers (23.8 %) compared to non-smokers (7.8 %) among employed adults. The adjusted prevalence ratio for LOA 6+ mm was prevalence ratio (PR) = 4.9 (95 % CI 2.2–8.8) for smokers, and there was a significant interaction (p < 0.05) between smoking status and work-family conflict.

Conclusion

Work-family conflict modified the association of smoking with periodontal disease. Higher levels of work interfering with family were associated with higher levels of periodontal LOA for smokers compared with non-smokers.

     

The alpha-lipoic acid derivative DHLHZn: a new therapeutic agent for acute lung injury in vivo

Objective and design

An animal experiment was performed to demonstrate the anti-inflammatory effects of an alpha-lipoic acid (ALA) derivative, dihydrolipoyl histidinate zinc complex (DHLHZn) for acute lung injury (ALI) and to investigate the mechanism of action.

Material

Rats were randomly divided into three experimental groups: control group (n = 17), DHLHZn(?) group (n = 11, ALI model rats), and DHLHZn(+) group (n = 12, ALI model rats treated by DHLHZn).

Treatment

Lipopolysaccharides (LPS, 10 mg/kg) were administered intratracheally in the DHLHZn(?) group and the DHLHZn(+) group. For the DHLHZn(+) group, DHLHZn (100 mg/kg) was administered intraperitoneally 2 h prior to LPS administration.

Methods

Four hours after LPS administration, bronchoalveolar lavage fluid (BALF) and lung tissue were collected. The findings were analyzed using the Mann–Whitney U test.

Results

Total number of cells, number of neutrophils and lymphocytes, levels of various inflammatory cytokines, and NF-kB p65 concentration of BALF were significantly lower in the DHLHZn(+) group than in the DHLHZn(?) group (p < 0.05). ALI pathology scores were significantly lower in the DHLHZn(+) group than in the DHLHZn(?) group (p < 0.001).

Conclusions

Anti-inflammatory effects of DHLHZn for ALI were demonstrated by BALF and histopathological findings. The mechanism of action of DHLHZn was considered to be via inhibition of the NF-kB signaling pathway. DHLHZn is thus suggested to be a new prophylactic agent for ALI.

     

The <Emphasis Type="Italic">PTPN22</Emphasis> R263Q polymorphism confers protection against systemic lupus erythematosus and rheumatoid arthritis,while <Emphasis Type="Italic">PTPN22</Emphasis> R620W confers susceptibility to Graves’ disease in a Mexican population

Objective

The functional PTPN22 R620W polymorphism (rs2476601) is clearly associated with susceptibility to several autoimmune diseases (ADs). However, the PTPN22 R263Q polymorphism (rs33996649) has been scarcely explored in different ADs. Here we aimed to examine the associations of the PTPN22 R620W and R263Q polymorphisms with susceptibility to or protection against rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and Graves’ disease (GD) among Mexican patients.

Methods

We conducted a case–control study including 876 patients (405 with SLE, 388 with RA, and 83 with GD) and 336 healthy control individuals. PTPN22 genotypes were determined using the TaqMan 5′ allele discrimination assay.

Results

PTPN22 R620W was associated with GD susceptibility (OR 4.3, p = 0.004), but was not associated with SLE (OR 1.8, p = 0.19). We previously demonstrated that this polymorphism is associated with RA susceptibility (OR 4.17, p = 0.00036). Moreover, PTPN22 R263Q was associated with protection against SLE (OR 0.09, p = 004) and RA (OR 0.28, p = 0.045), but was not associated with GD.

Conclusions

Our data provide the first demonstration that PTPN22 R620W confers GD susceptibility among Latin-American patients. Moreover, this is the second report documenting the association of PTPN22 R263Q with protection against SLE and RA.

     

Minocycline affects human neutrophil respiratory burst and transendothelial migration

Objective

This study aimed at investigating the in vitro activity of minocycline and doxycycline on human polymorphonuclear (h-PMN) cell function.

Methods

h-PMNs were isolated from whole venous blood of healthy subjects; PMN oxidative burst was measured by monitoring ROS-induced oxidation of luminol and transendothelial migration was studied by measuring PMN migration through a monolayer of human umbilical vein endothelial cells. Differences between multiple groups were determined by ANOVA followed by Tukey’s multiple comparison test; Student’s t test for unpaired data for two groups.

Results

Minocycline (1–300 µM) concentration dependently and significantly inhibited oxidative burst of h-PMNs stimulated with 100 nM fMLP. Ten micromolar concentrations, which are superimposable to C _max following a standard oral dose of minocycline, promoted a 29.8 ± 4 % inhibition of respiratory burst (P < 0.001; n = 6). Doxycycline inhibited ROS production with a lesser extent and at higher concentrations. 10–100 µM minocycline impaired PMN transendothelial migration, with maximal effect at 100 µM (42.5 ± 7 %, inhibition, n = 5, P < 0.001).

Conclusions

These results added new insight into anti-inflammatory effects of minocycline exerted on innate immune h-PMN cell function.

     

Impact of malignancy on <Emphasis Type="Italic">Clostridium difficile</Emphasis> infection

Purpose

The purpose of this study was to investigate the impact of malignancy and chemotherapy on the clinical and microbiological characteristics of Clostridium difficile infections (CDI).

Methods

CDI patients with a history of malignancy within 5 years were defined as the cancer group. The characteristics of the patients were compared according to the presence of malignancy.

Results

Of 580 patients with CDI, 159 (27.4 %) belonged to the cancer group and 421 (72.6 %) to the non-cancer group. More of the patients in the cancer group than those in the non-cancer group had been hospitalized within the prior 2 months (P?<?0.001). Leukocytosis was more common in the non-cancer group (P?=?0.034), while infection by PCR ribotype 017 strains was more common in the cancer group, with marginal significance (P?=?0.07). Recurrence was more frequent in the cancer group (20.4 % vs. 9.5 %, P =0.005) and cancer was an independent risk factor for recurrence of CDI (OR?=?2.66, 95 % CI 1.34-5.29, P =0.005). Age also contributed to the recurrence of CDI (OR?=?1.03, 95 % CI 1.00-1.06, P =0.026).

Conclusions

Malignancy and age are independent risk factors for recurrence of CDI. Cancer patients require careful observation for recurrence after treatment of CDI.

     

Hylan G-F 20 Versus Low Molecular Weight Hyaluronic Acids for Knee Osteoarthritis: A Meta-Analysis

Background

Hyaluronic acid injection has been reported to decrease pain compared with baseline levels in knee joint osteoarthritis. Hylan G-F 20 is distinguished from the other products by its chemical structure and relatively higher molecular weight. Many trials have compared hylan G-F 20 and low molecular weight hyaluronic acids (LMWHAs); however, their relative efficacy and safety are still debated.

Objective

The aim was to compare the effectiveness and safety of intra-articular injection of hylan G-F 20 and LMWHA in the treatment of knee joint osteoarthritis.

Methods

A comprehensive search of the literature up to February 2016 was performed; multiple databases were searched with ‘Synvisc’ or ‘hylan’ or ‘hyaluronan’ as free word terms. The pain-related outcomes and treatment-related adverse events from intent-to-treat analyzed studies were pooled for meta-analysis; other functional outcomes were included in the qualitative analysis.

Results

Twenty trials with a total of 3034 patients and 3153 knees were included, with a pooled dropout rate of 7.2 %. The pooled pain-related outcomes at 2 to 3 months reached a statistically significant difference in favor of hylan G-F 20 (I ² = 88 %; random effects; P = 0.02), and the significance still existed with exclusion (in order to eliminate heterogeneity) of the three studies that most favored hylan G-F 20 (I ² = 51 %; fixed effect; P = 0.03). No significant difference was reached for other group and subgroup analyses. No significant difference was reached in comparing the patients with treatment-related adverse events (seven trials; 2025 patients; P = 0.13) or the treatment-related adverse events (six trials; 1633 patients; P = 0.14).

Conclusion

According to the current results, limited evidence showed a superior effect favoring hylan G-F 20 over LMWHA in the period from 2 to 3 months post-injection for pain-related outcomes. There was no evidence of increased risk of treatment-related adverse events for hylan G-F 20 injections.

     

Public support for pictorial warnings on cigarette packs: an experimental study of US smokers

Background

Understanding factors that influence public support for “nudging” policies, like pictorial cigarette pack warnings, may offer insight about how to increase such support. We sought to examine factors that influence smokers’ support for requiring pictorial warnings on cigarette packs.

Methods

In 2014 and 2015, we randomly assigned 2149 adult US smokers to receive either pictorial warnings or text-only warnings on their cigarette packs for 4 weeks. The outcome examined in the current study was support for a policy requiring pictorial warnings on cigarette packs in the US.

Results

Support for pictorial warnings was high at baseline (mean: 3.2 out of 4). Exposure to pictorial warnings increased policy support at week 4 (β = .05, p = .03). This effect was explained by increases in perceived message effectiveness (p < .001) and reported conversations about policy support (p < .001). Message reactance (i.e., an oppositional reaction to the warning) partially diminished the impact of pictorial warnings on policy support (p < .001).

Conclusions

Exposing people to a new policy through implementation could increase public support for that policy by increasing perceived effectiveness and by prompting conversations about the policy. Reactance may partially weaken the effect of policy exposure on public support.

     

Analysis of the position of the branches of the ulnar nerve in Guyon’s canal using high-resolution MRI in positions adopted by cyclists

Purpose

To study variations in the anatomical relationships of the branches of the ulnar nerve in Guyon’s canal relative to the hamulus of hamate (HH) in a grip encountered among cyclists.

Materials and methods

Forty-seven wrist examinations were performed on a 3-T MRI (soft antenna, 16 channels) in propeller sequence in the plane perpendicular to the carpus in 28 healthy volunteers in three cycling positions (neutral, hyperextension and ulnar deviation). The positions and distance between the superficial (SB) and deep (DB) branches of the ulnar nerve with respect to the HH were determined on the section passing through the HH.

Results

The mean distances between the SB (d _s) and DP (d _p) and HH were 2.4 and 0.6 mm, respectively. The d _s in hyperextension and ulnar deviation were 2.2 mm (P = 0.3) and 3 mm (P = 0.07), respectively. The d _p in hyperextension and ulnar deviation were 0.3 mm (P = 0.02) and 0.5 mm (P = 0.15), respectively. Hyperextended, 60 % of SB and 40 % of DB were close to the HH, and 26 % of DB came directly in contact with it. In ulnar deviation, 30 % of SB and 29 % of DB approached HH, and 47 % of DB were in contact with it.

Conclusion

This study shows that SB and DB positions of the ulnar nerve vary with respect to the HH depending on the position of the wrist, and such differences may promote Guyon’s canal syndrome in cyclists.

     

Promoter –2518 single nucleotide polymorphism of monocyte chemoattractant protein-1 is associated with clinical severity in Behçet’s disease

Objective

We investigated whether promoter –2518 single nucleotide polymorphism (SNP) of the monocyte chemoattractant protein-1 (MCP-1) gene contributes to susceptibility and clinical features or severity in Behçet’s disease (BD) patients.

Methods

One hundred and thirty-two BD patients and 113 healthy subjects, matched by sex and age, were enrolled. Promoter –2518 polymorphism of the MCP-1 gene was analyzed using automated sequencing. Clinical severity in BD patients was classified into mild, moderate, and severe features and assessed by total severity scores. Clinical features and severity was also compared according to genotypes using either the chi-squared or Fisher’s exact test and Mann–Whitney test, as indicated.

Results

There were no significant differences in alleles (G allele vs. A allele, p = 0.845) and genotypes with –2518 SNP (GG vs. GA vs. AA, p = 0.916) between BD patients and controls. No clinical features were associated with genotypes with –2518 polymorphism of MCP-1. However, the frequency of either GA or AA genotype in patients with moderate lesions and moderate to severe lesions was significantly increased compared with that in patients with the GG genotype (p = 0.044 and p = 0.038, respectively). Total severity scores in the AA genotype were higher than those in the GG and GA genotypes (p = 0.039 and p = 0.003, respectively). Moreover, patients with either the GA or AA genotype had higher scores than those with the GG genotype (p = 0.041).

Conclusions

This study demonstrated that genotypes with A allele with –2518 polymorphism of the MCP-1 gene might have increased risk of severity of clinical features, but not susceptibility to BD.

     

The use of dielectric blood coagulometry in the evaluation of coagulability in patients with peripheral arterial disease

Background

Platelets and coagulation proteins contribute to the development of peripheral arterial disease, especially atherosclerotic disease. Several experimental studies have proven a significant correlation between hypercoagulability and atherosclerosis. We used dielectric blood coagulometry, which was initially designed to evaluate the coagulable status, to examine the coagulability of peripheral arterial disease patients, and investigated the factors that were significantly correlated with the results.

Methods

We performed dielectric blood coagulometry in 49 peripheral arterial disease patients. In addition, we recorded the patients’ demographic information, including the presence of comorbidities, hemodynamic status, and laboratory findings. To investigate coagulability, we calculated the T_max value, which indicates the time from recalcification to maximum normalized permittivity.

Results

The T_max values of diabetes mellitus patients were significantly lower than those of non-diabetic patients (1 MHz, P = 0.010; 10 MHz, 0.011). Furthermore, the T_max value was statistically correlated with the activated partial thromboplastin time (1 MHz, ρ = 0.286, P = 0.048; 10 MHz, ρ = 0.301, P = 0.037).

Conclusions

Dielectric blood coagulometry detected the hypercoagulable status in diabetes mellitus patients, and reflected their level of coagulability, which was also evaluated by the activated partial thromboplastin time.