Therapeutic effect of posture in sleep apnea

Four patients with mild to moderate obstructive sleep apnea were monitored first in the supine posture to establish a diagnosis of obstructive sleep apnea (apnea indices 33, 12, 22, 36). A second polysomnogram, obtained while the patients slept in the lateral posture, showed a dramatic decrease in apnea (apnea indices 5, 0, 0.2, and 0) and snoring. Each patient had an enlarged uvula, which moved to the side in the lateral posture. We conclude that sleeping in the lateral posture may be therapeutic in some patients with obstructive sleep apneas.     

Syringomyelia-like manifestation of subacute combined degeneration.

A 32-year-old male presented with progressive weakness and numbness of both upper limbs of one-month duration. The patient had weakness and wasting of small muscles of both hands with weak grip. Sensory system revealed graded sensory loss to pain, temperature and touch in C5 to T1 distribution and vibration and joint position sense from C5 to C8 in the both upper limbs. There was areflexia in the upper limbs while there was no motor or sensory deficit in the lower limbs. The cortical potential on stimulation of posterior tibial nerve was prolonged on both sides. On MR imaging of the cervical spine there was iso to low intense lesion which was hyperintense on T2-weighted imaging along the dorsal aspect of the cord extending from C2 to C6 level. The axial images showed involvement of the posterior column. The serum vitamin B12 level was found to be low. The patient responded to parenteral cyanocobalamine therapy and the radiological lesion subsequently resolved.     

Treatment of post-cholecystectomy bile duct strictures--push or sidestep?

Management of post-cholecystectomy bile duct strictures can be complex.Traditional treatment has been surgical reconstruction. In recent years endoscopic stenting has been successful in a selected subgroup of patients with iatrogenic bile duct strictures. Adequate information about long-term results of endoscopic stenting as definite treatment for such strictures is still awaited. Surgery is a reliable and time-tested method and results of numerous studies show its long-term success in relieving biliary obstruction with minimal morbidity.     

DC‐SIGN and DC‐SIGNR polymorphic variants in Northern Asian Indians

Dendritic cell‐specific intercellular adhesion molecule‐grabbing nonintegrin‐related protein (DC‐SIGNR), along with DC‐SIGN, is suggested to facilitate HIV infection of T cells in trans through binding with HIV gp120. We studied the repeat region polymorphisms in DC‐SIGN and DC‐SIGNR in 100 healthy HIV‐1 seronegative individuals among Northern Asian Indians. Each variant polymorphism obtained by polymerase chain reaction (PCR) was confirmed by cloning and sequencing. Fifty‐four per cent of the healthy seronegative individuals were homozygous for the DC‐SIGNR 7/7 repeat. The heterozygous 7/5 variant was found in 25%, while the 5/5 homozygous genotype was found in 17% of the subjects. Allele 8 was rare and accounted for 4% of the heterozygous genotype (8/7) in the sample population. DC‐SIGN polymorphism was rare, and the genotype 7/7 was most frequent in this study population. Further studies are warranted in a large sample size including high‐risk and seropositive HIV patients to confirm the association of DC‐SIGNR polymorphisms with HIV‐1 susceptibility.     

Studies on the development of an insulin resistant rat model by chronic feeding of low magnesium high sucrose diet.

Magnesium deficiency and excess sucrose in the diet have been shown to play an important role in the development of insulin resistance. In the present study we have looked at the combined effect of a low magnesium high sucrose diet on basal glucose and insulin levels, erythrocyte insulin receptors and lipid profile in rats. For this purpose rats were divided into four groups and fed control, low magnesium, high sucrose and low magnesium high sucrose diets respectively for three months. The biochemical analysis showed a significant increase in blood glucose and triglyceride levels after one, two and three months of feeding in both the high sucrose and the low magnesium high sucrose groups, while rats fed a low magnesium diet showed a significant increase in blood glucose and triglyceride levels only after the second month. Insulin levels increased significantly in low magnesium, high sucrose and low magnesium high sucrose groups by the end of the study period. Compared to control rats, the binding of insulin to the erythrocyte insulin receptors was reduced significantly in the high sucrose and the low magnesium high sucrose groups. Cholesterol levels were found to increase significantly in the high sucrose group at the end of one month and three months of feeding. HDL-cholesterol decreased significantly in the low magnesium high sucrose group by the end of the study. Serum and RBC magnesium levels demonstrated a significant decrease in the low magnesium and the low magnesium high sucrose groups. The post heparin plasma lipoprotein lipase activity was decreased significantly in low magnesium, high sucrose and low magnesium high sucrose groups compared to control rats. These findings suggest that feeding a diet low in magnesium and high in sucrose causes insulin resistance in rats.     

Serogroup-reactive and type-specific detection of bluetongue virus antibodies using chicken scFvs in inhibition ELISAs

Two bluetongue virus (BTV) serotype 10-specific single-chain Fv chicken antibody fragments (scFvs) were evaluated in a competitive ELISA. The binding of one (F3) to purified BTV was only inhibited by antibodies against the homologous serotype. The binding of the other (F10) was blocked by antisera to each of the 24 BTV serotypes. F10 recognised VP7, a major structural protein of the BTV core, but not if the protein was directly adsorbed to a plastic surface. It did, however, bind to recombinant VP7 that had been captured from suspension by rabbit IgG. This made it possible to develop an scFv based inhibition ELISA for BTV antibodies using recombinant VP7 without prior purification. The resulting immunoassay detected antibodies to 24 BTV serotypes, but not those directed against three serotypes of the related epizootic haemorrhagic disease virus. A phage library displaying fusion peptides expressed by fragments of the BTV genome segment 7 cDNA was constructed and screened using F10. Comparing selected peptides with the amino acid sequence of VP7 showed that recognition by the scFv required at least 131 residues representing the protein's upper domain. By providing well-characterised immunological reagents, recombinant antibody technology can contribute to the development of improved immunoassays for BTV diagnosis.     

The effect of various media and probe angles on the power output of the Cyclo G6 Glaucoma Laser System

Lasers in Medical Science - To evaluate the effect of various media and Iridex MicroPulse P3 (MP3) probe angles on the power output from the Cyclo G6 Glaucoma Laser (G6) System. A laser power meter...