Tegaderm transparent dressing (3M) for the treatment of chronic exposure keratopathy

We report an effective alternative treatment of profound chronic exposure keratopathy in a proptotic eye due to intraorbital extension of basal cell carcinoma. The corneal surface gradually reepithelialized in a 6-week period after the first application of Tegaderm transparent dressing (3M, St. Paul, MN, U.S.A.) with instillation of antibiotic ointment on the ocular surface. The patient has been comfortable with an intact epithelial surface, a vascularized cornea, and nonirritated surrounding skin after changing the Tegaderm dressing daily for 15 months. There was no evidence of recurrent corneal ulceration or infiltrations. We conclude that Tegaderm represents a useful treatment of exposure keratopathy due to chronic proptosis.     

Role of HBV genotype in predicting response to lamivudine therapy in patients with chronic hepatitis B.

BACKGROUND: Predictors of response of chronic hepatitis B (CHB) to lamivudine therapy need better definition. Whether hepatitis B virus (HBV) genotypes could serve as such a predictor has not been well studied. AIM: To study the association of HBV genotypes with the outcome of lamivudine treatment in patients with CHB. METHODS: Seventy-six patients with CHB (45 HBeAg +ve) received lamivudine 100 mg/day, orally for 12 mo. Infecting HBV genotypes were determined in pre-treatment specimens using restriction fragment length polymorphism. End-of-treatment response (ETR) and sustained viral response (SVR) were defined as undetectable HBV DNA (< 0.5 pg/mL) at 12 and 18 months, respectively. RESULTS: ETR was observed in 26 (34%) and SVR in 11 (14%) patients receiving lamivudine. The pre-treatment characteristics of the responders and non-responders were comparable. Genotypes A and D were observed in 28 (37%) and 48 (63%) patients, respectively. The frequency of genotypes A and D was comparable between responders (28.6% vs. 37.5%) and non-responders (71.4% vs. 62.5%), respectively (p=ns). Of the 26 responders, SVR could be evaluated in 20 subjects; 9 (45%) relapsed and 11 achieved SVR. Patients with genotype D achieved higher SVR rate than genotype A (10 of 48, 28.8% vs. 1 of 28, 3.5% p =0.0359). CONCLUSIONS: Forty-five percent of Indian patients with CHB who achieve ETR relapse, and SVR to lamivudine therapy is achieved in 14%. Patients with genotype D achieve higher SVR rate than with genotype A.     

Type II autosomal dominant osteopetrosis

Two principal types of osteopetrosis have been distinguished. One is the dominantly inherited, relatively benign condition which is often detected radiologically in asymptomatic adults. A second type is the recessive, lethal, malignant form. Autosomal dominant osteopetrosis (ADO) has two distinct radiological subtypes known as types I and II. We report here a 23-year-old patient with ADO type II. Radiographic investigations of a skeletal survey showed generalised osteosclerosis with thickened cortex. Magnetic resonance imaging (MRI) scan disclosed osteosclerosis in superior and inferior portions of the vertebral bodies which produced a 'sandwich' appearance. The 'bone-within-bone' appearance was seen in the ileum of the patient. The vertebral bone density was found markedly elevated. The carbonic anhydrase II level was found to be normal. We discuss here the genetic etiology of this disorder.     

Diffusion tensor imaging of forearm nerves in humans

Purpose:

To implement a diffusion tensor imaging (DTI) protocol for visualization of peripheral nerves in human forearm.

Materials and Methods:

This Health Insurance Portability and Accountability Act (HIPAA)‐compliant study was approved by our Institutional Review Board and written informed consent was obtained from 10 healthy participants. T₁‐ and T₂‐weighted turbo spin echo with fat saturation, short tau inversion recovery (STIR), and DTI sequences with 21 diffusion‐encoding directions were implemented to acquire images of the forearm nerves with an 8 channel knee coil on a 3T MRI scanner. Identification of the nerves was based on T₁‐weighted, T₂‐weighted, STIR, and DTI‐derived fractional anisotropy (FA) images. Maps of the DTI‐derived indices, FA, mean diffusivity (MD), longitudinal diffusivity (λ_//), and radial diffusivity (λ_?) along the length of the nerves were generated.

Results:

DTI‐derived maps delineated the forearm nerves more clearly than images acquired with other sequences. Only ulnar and median nerves were clearly visualized on the DTI‐derived FA maps. No significant differences were observed between the left and right forearms in any of the DTI‐derived measures. Significant variation in the DTI measures was observed along the length of the nerve. Significant differences in the DTI measures were also observed between the median and ulnar nerves.

Conclusion:

DTI is superior in visualizing the median and ulnar nerves in the human forearm. The normative data could potentially help distinguish normal from diseased nerves. J. Magn. Reson. Imaging 2012;36:920–927. © 2012 Wiley Periodicals, Inc.

     

Genetic control of the immune response to haemoglobin. IV. Ly-1+ T-cells and appropriate non-H-2 genes are required for in vitro responses to alpha- and beta-subunits of human adult haemoglobin

Experiments were conducted to determine if non-H2 gene effects could be demonstrated in mice which had been primed to either the alpha-subunit or beta-subunit of human haemoglobin. It was found that C3H.SW (H-2b) and Balb/c (H-2d) mice are low responder mice to alpha-chain of a haemoglobin when compared to H-2 identical B10 (H-2b) and B10.D2(H-2d) mice. B120.S and A.SW (both H-2s) are responsive to beta-chain challenge while Balb/c mice are low responders in contrast to high responder B10.D2 mice. Ly-1+ cells were demonstrated to be required (by cell depletion experiments) for an in vitro T-cell proliferative response to either subunit. In these experiments, Ly-2+ cells were not of crucial importance.