Possible anatomical base of snoring

Variations of the medial and inferior choanal limits may facilitate snoring. These are: 1) short vomer without crista choanalis vomeris and adaptational formations, 2) extremely concave posterior margin of the hard palate leading to disproportion between the muscular and aponeurotic part of m. tensor veli palatini and hence to a flabby soft palate especially during sleep, and 3) neonatal relation of the height and width of the choane resulting in a very large choanal region instead of relative reduction of choanal width compared to its increasing height. All these variations result in a flabby soft palate especially during sleep and may lead to formation of whirles of inspired air and snoring.     

Use of fibrin glue in obstetrics and gynecology: a review of the literature.

Most authors consider the principal advantage of FG anastomoses (compared to microsurgical anastomoses) to be shorter operating time, reduced surgical trauma to oviduct stumps, and absence of tissue ischemia. These features promote reparative regeneration and decrease adhesion formation, resulting in complete recanalization of fallopian tubes. To date, the majority of work on FG is confined to the experimental development of surgical techniques. Investigations in reconstructive gynecological surgery are quite uncommon. The physical properties of FG and the positive results of available experimental studies suggest that further development of surgical techniques using FG in obstetrics and gynecology is worthwhile.     

Fetal growth and autoimmune thyroid disease

To determine whether fetal and infant growth could influencesusceptibility to autoimmune disease in adults, the occurrenceof thyroid autoantibodies and autoimmune thyroiditis was studiedin 305 women, aged 60–71, born in Hertfordshire and forwhom details of birth weight, infant growth, and feeding wereroutinely recorded. Thyroglobulin autoantibody was detectedin 37% of the women, thyroid peroxidase autoantibody in 41%,and autoimmune thyroiditis, defined as biochemical or clinicalhypothyroidism in association with thyroid autoantibodies, in5.6%. The proportion of women with thyroglobulin and thyroidperoxidase auto antibodies fell with increasing birth weightbut was not related to weight at 1 year of age or the methodof infant feeding. The prevalence of both autoantibodies rosewith increasing adult body mass index but fell as the waistto hip ratio increased. These results demonstrate the importance of early environmentin determining the susceptibility to autoimmune thyroid disease.The contrasting effects of adult body mass index and waist tohip ratio on antibody prevalence could be explained by theirassociations with different hormonal environments.     

A prospective randomized trial of colchicine in prevention of liver cirrhosis in chronic hepatitis B patients

Background : The clinical course of chronic hepatitis B is variable. Patients with hepatic decompensation, bridging necrosis or an alpha-fetoprotein level greater than 100 ng/mL during an exacerbation of hepatitis have a high risk of developing cirrhosis. This study was conducted to evaluate the effect of colchicine in the prevention of cirrhosis in such patients.
Methods : Patients with risk factor(s) were randomized to receive either colchicine 5 mg/week or no specific treatment, the end point being development of cirrhosis.
Results : After a follow up period of 4 years, the treatment group had a marked reduction in exacerbations of acute hepatitis (32% vs. 63%/patient/year, P <0.005). Seven out of 38 patients in the treatment group and 10 out of 27 patients in the control group developed cirrhosis. The calculated cumulative incidence of cirrhosis by the end of first, second, third and fourth years in the treatment group was 8.7, 18.6, 32 and 32%, respectively. The corresponding figures in the control group were 30, 35.5, 46.3 and 73.2%, respectively, with a P -value of 0.057.
Conclusions : The results suggest that colchicine may prevent cirrhosis in chronic hepatitis B patients with risk factor(s), possibly by suppressing exacerbations of hepatitis through an anti-inflammatory effect.     

Development of an auxotrophic oral live Shigella flexneri vaccine

An oral live attenuated Shigella flexneri vaccine candidate strain was constructed by making it auxotrophic and dependent on aromatic metabolites not available in mammalian tissues. An aroD gene of Escherichia coli K12 strain NK 5131, inactivated by insertion in it of the Tn 10 transposon, was transduced using phage P1 into a virulent S. flexneri serotype Y strain (Sfl 1) isolated from a patient with bacillary dysentery. One of the transductant strains Sfl 114 was found to invade HeLa cells in vitro, to cause plaque formation in HeLa monolayers (i.e. maintain intracellular multiplication in vitro), but to be unable to cause keratoconjunctivitis in guinea-pig eyes. When the strain was fed to Macacca fascicularis monkeys it was well tolerated, excreted for 1-4 days, and found to elicit a local intestinal sIgA and serum IgA, IgM and IgG responses. Monkeys challenged with 100 ID50 dose (1 X 10(11) bacteria) of the virulent parent Sfl 1 strain were completely protected from development of diarrhoea. Coloscopy of the monkeys and the sampling of intestinal biopsies showed that the vaccine protected against the surface epithelial erosions and ulcerations seen in unimmunized monkeys. Killing of invading virulent shigellae apparently took place intracellularly in the mucosa suggesting that cellular immune mechanisms played a role in the elicited host defence. The constructed S. flexneri Sfl 114 strain has the properties of a promising shigella vaccine and will next be the subject of studies with human volunteers.     

Evaluation of Tc-99m(V) DMSA for imaging inflammatory lesions: An experimental study

The present study evaluated^99mTc(V) DMSA as an agent for the visualization of inflammatory lesions in comparison to^99mTc(HI) DMSA and^99mTc-HIG. All three radiopharmaceuticals were prepared with commercial kits.^99mTc(V) DMSA was prepared at neutral pH by the addition of first bicarbonate and then pertechnetate to the kit contents. The labeling efficiency was 99% as determined by ITLC. Abscesses were induced by i.m. injection of 50 μl turpentine into the right thighs of 36 Swiss albino mice. Six days later 3.7 MBq of each radiopharmaceutical was i.v. administered to 12 mice. The mice were sacrificed at 1,3,6 and 24 h later. Scintigrams were obtained with a gamma camera. The abscesses were better visualized on scintigrams with^99mTc(V) DMSA compared to^99mTc(III) DMSA, starting at 1 h. The animals were dissected and the organs were removed, weighed and the radioactivity determined with a gamma counter. The abscess to other tissue ratios were higher with^99mTc(V) DMSA than the other radiopharmaceuticals. The max. abscess/muscle ratios were 9.46 ± 3.20 (24 h), 4.19 ± 1.39 (6 h) and 5.98 ± 1.17 (24 h) and max. abscess/blood ratios were 6.22 ± 1.41, 4.09 ± 0.84 and 0.914 ± 0.351 all at 24 h for^99mTc(V) DMSA,^99mTc(III) DMSA and^99mTc-HIG, respectively. Experimental arthritis was produced in 6 New Zealand white rabbits by intra-articular injection of ovalbumin. Four days later 37 MBq of^99mTc(V) DMSA and^99mTc-HIG were each i.v. administered to 3 rabbits. Scintigrams obtained at 1, 3, 6, and 24 h clearly demonstrated arthritic joints. ROFs over arthritic joints were compared to contralateral normal joints (A/C). The max. A/C ratios were 2.10 ± 0.31 (3 h) and 2.92 ± 0.99 (24 h) for^99mTc(V) DMSA and^99mTc-HIG, respectively. Our results indicated the feasibility of imaging inflammatory lesions with^99mTc(V) DMSA.     

The binding of blood-borne estrogens in normal vegetarian and omnivorous women and the risk of breast cancer

Serial blood samples were taken at two-hour intervals over a 24-hour period from 25 premenopausal vegetarians (12 vegans and 13 ovolactovegetarians) and from 21 omnivorous controls. All members of the former group had been on a vegetarian diet for a minimum of three years. The mean proportion of estradiol unbound to blood proteins was similar in both vegetarians (1.26%) and meat eaters (1.16%). However, the amount bound to albumin was significantly raised in vegetarians (50.1% vs. 43.1%, p less than 0.009), whereas that bound to sex hormone-binding globulin (SHBG) was correspondingly lower (48.7% vs. 55.8%, p = 0.01). Mean levels of SHBG were similar in vegetarians (59.9 nmole/l) and omnivores (62.0 nmole/l), as was the total amount of free fatty acid (0.42 mmole/l for both). Within the vegetarian group, no differences were detected between vegans and ovolactovegetarians.     

Linseed and cod liver oil induce rapid growth in a 7-year-old girl with N-3- fatty acid deficiency

N-3 fatty acid deficiency is described in a 7-year-old girl who had been fed solely by gastric tube from the age of 3 years. She had received the same nutrient during the last 22 months, supplying 16.2% of calories from linoleate and 0.07% from alpha-linolenate. She weighed 9.5 kg at the age of 3, and 10.3 kg at the start of the study, the weight being constant the last 15 months. She was now supplemented daily with 1.2 ml of a linseed- and cod liver-oil mixture (5:1, v/v), thereby increasing her alpha-linolenate intake to 0.71% and total N-3 fatty acids to 0.74% of total energy. Two months later, her rate of weight gain was 0.43 kg/month. After 5 months, the fatty acid supplement was changed to 7.5 ml of cod liver oil daily, thereby changing alpha-linolenate and total N-3 acid intake to 0.10% and 1.3% of total energy, respectively. Her rate of weight gain now increased to 0.64 kg/month, and her length increased from 117 to 122 cm in 5 months. The results indicate that the optimal dietary requirement for N-3 fatty acids in this child is higher than 0.74%, and extrapolation estimated the optimal requirement to be 1.1%-1.2% of total calories. The results suggest that N-3 fatty acids are required for normal growth in man.     

Case Control Study of Chronic Bronchitis in glass Bangle Workers

Eighty-nine cases of chronic bronchitis were matched against167 asymptomatic controls from the glass bangle industry ofFirozabad. Factors of age, social status, smoking habit andduration of exposure were studied. Duration of exposure wasfound to be a factor contributing significantly to the causationof disease. Requests for reprints should be addressed to: Dr B. N. Gupta, Division of Epidemilogy, Industrial Toxicology Research Centre, Mahatma Gandhi Marg, Lucknow P.O. Box 80, 226001, India