Evaluation of Retinal Nerve Fiber Layer Thickness and Optic Nerve Head Parameters in Obstructive Sleep Apnoea Patients

PurposeTo study the retinal nerve fiber layer (RNFL) thickness and optic nerve head (ONH) parameters in obstructive sleep apnoea (OSA) patients and their relationship with severity of the disease.MethodsA cross-sectional, hospital-based study. Fifty-four OSA subjects and 54 controls were recruited. Candidate that fulfil the criteria with normal ocular examinations then proceed with spectrum domain Cirrus optical coherence tomography examinations. ONH parameters and RNFL thickness were evaluated. Apnoea-hypopnoea index (AHI) of the OSA group were obtained from the medical record.ResultsIn OSA, mean of average RNFL thickness was 93.87 μm, standard deviation (SD) = 9.17, p = 0.008 (p < 0.05) while superior RNFL thickness was 113.59 μm, SD = 16.29, p ≤ 0.001 (p < 0.05). RNFL thickness fairly correlate with severity of the disease (AHI), superior RNFL with R = 0.293, R² = 0.087, p = 0.030 (p < 0.05), and nasal RNFL R = 0.292, R² = 0.085, p = 0.032. No significant difference and correlation observed on ONH parameters. In control group, mean of average RNFL thickness was 98.96 μm, SD = 10.50, p = 0.008 (p < 0.05) while superior RNFL thickness was 125.76 μm, SD = 14.93, p ≤ 0.001 (p < 0.05).ConclusionsThe mean of the average and superior RNFL thickness were significantly lower in the OSA group compare to control. Regression analysis showed RNFL thickness having significantly linear relationship with the AHI, specifically involving the superior and nasal quadrant.     

A single-nucleotide polymorphism in the human ITGB3 gene is associated with the platelet-specific alloantigen Vaa (HPA-17bw) involved in fetal maternal alloimmune thrombocytopenia

BACKGROUND: The previously reported platelet (PLT)-specific antigen, Va^a, was defined by an alloantibody detected in the serum sample of a mother who delivered an infant displaying symptoms of severe fetal maternal alloimmune thrombocytopenia (FMAIT). This PLT antigen was localized to the integrin αIIbβ3 (GPIIbIIIa) but its genetic basis was not defined.
STUDY DESIGN AND METHODS: Genomic ITGA2B (αIIb) and ITGB3 (β3) DNA from a Va^a-positive individual were sequenced to identify potential polymorphisms underlying the Va^a antigen. Recombinant β3 integrin carrying the putative mutation was then used to assess serologic reactivity with the original maternal Va^a antiserum.
RESULTS: A single-nucleotide polymorphism (SNP; C622>T) in exon 5 of ITGB3 resulting in the replacement of threonine with methionine at residue 195 of the mature β3 was identified. Calmodulin-tagged soluble recombinant β3 encoding Met195 was produced in S2 cells and found to react specifically with the Va^a antiserum.
CONCLUSION: With the use of a combination of DNA sequencing and recombinant antigen expression, the molecular basis of the PLT-specific Va^a antigen (HPA-17bw), a low-frequency antigen implicated in FMAIT, has been resolved. These data further demonstrate the value of using recombinant β3 peptides for the detection of rare but clinically relevant antibodies.     

Protective effect of blood transfusions on postoperative recurrence of Crohn's disease in parous women

BACKGROUND: Perioperative blood transfusion (BT) appeared to have adverse effects on survival after surgery for malignant tumors while pretransplantation BT suppressed allograft rejection. Interest grew in the effect of BT on postoperative recurrence of Crohn's disease. STUDY DESIGN AND METHODS: To determine the effect of perioperative BT on the recurrence of Crohn's disease after primary surgery, the medical histories of 148 patients with Crohn's disease, 62 males and 86 females (49 nonparous and 37 parous), were reviewed. Eighty-seven patients received perioperative BT. RESULTS: Overall, perioperative BT showed no effect on recurrence. Patients with Crohn's disease limited to the ileum had a better prognosis with regard to recurrence than did patients with Crohn's disease located in the colon or located in both ileum and colon, but the difference was not significant. Perioperative transfusion seemed to protect against recurrent disease after colon resection, which might be explained by the fact that colon resections, which often necessitate perioperative BT, generally result in a shorter bowel segment at risk for recurrent disease. Overall, parous women showed a worse prognosis than nonparous females and men (p = 0.022). Transfusions had a beneficial effect in parous women (p = 0.068) and, after correction for type of operation, this beneficial effect was significant (p = 0.026). After perioperative BT, parous women had a similar prognosis with respect to recurrent Crohn's disease as nonparous females and men. CONCLUSION: Perioperative BT has a beneficial effect on the postoperative recurrence of Crohn's disease in parous women.     

CXCL12 is essential for migration of activated Langerhans cells from epidermis to dermis

The initial step in Langerhans cell (LC) migration from the epidermis to the lymph node involves migration of maturing LC into the dermis. Here, we investigated the migration of LC out of the epidermis after exposure of the skin to contact allergens. Ex vivo intact human skin, epidermal sheets, and LC derived from the MUTZ-3 cell line (MUTZ-LC) were used to determine whether dermal fibroblasts play a role in mediating LC migration towards the dermis. Exposure of epidermal sheets or MUTZ-LC to allergens (nickel sulphate, 2,4-dinitrochlorobenzene, and cinnamaldehyde) or a cytokine maturation cocktail resulted in LC migration towards dermal fibroblasts. This was due to upregulation of CXCR4 on maturing LC and secretion of CXCL12/stromal derived factor-1 chemokine by fibroblasts. Neutralizing antibodies to either CXCL12 or CXCR4 completely blocked migration. Injection of CXCL12 neutralizing antibodies into intact human skin totally inhibited LC migration into the dermis. In contrast, neutralizing antibodies to CCL19/CCL21 did not inhibit migration into the dermis. We describe a novel and essential role of dermis-derived CXCL12 in initiating migration of maturing human LC to the dermis thus permitting their further journey to the draining lymph nodes.     

斩龙剑中新苯丙素甙的结构鉴定

从玄参科植物斩龙剑(Veronivastrum sibirica (L.)Pennell.)的根部分得九种化学成分,分别为斩龙剑甙A(sibiriosideA,Ⅰ)斩龙剑甙B(sibiriosideB,Ⅱ),异阿魏酸(isoferulicacid,Ⅲ),6-(4-methoxyferulpol)mioporoside(Ⅳ),scrophularioside(Ⅴ),6-O-阿魏酰梓醇(6-O-trans-feruloylcatalpol,Ⅵ),阿魏酸(ferulicacid,Ⅶ),胡萝卜甾醇(daucosterol,Ⅷ)和β-谷甾醇(Ⅸ)。其中斩龙剑甙A和斩龙剑甙B为新苯丙素甙化合物,应用波谱分析和理化数据测定,确定了它们的结构。     

Transient side shift of cluster headache attacks after unilateral greater occipital nerve injection

Attacks of cluster headache (CH) are usually side-locked in most, but not all, patients. In a few patients, the side may alternate between or, rarely, within cluster episodes. We observed seven cases in whom the side of CH attacks temporarily shifted immediately or shortly after unilateral injection of the greater occipital nerve (GON) with corticosteroids. In five patients with previously side-locked CH attacks and in two patients with previously side-alternating CH attacks, a side shift for several weeks occurred immediately (N = 6) or shortly (N = 1) after GON injection. We concluded that unilateral GON injections might cause a transient side shift of CH attacks through inhibition of the ipsilateral hypothalamic attack generator causing relative overactivity of the contralateral side. The potential benefit of bilateral GON injection in patients who experienced a side shift after unilateral injection should be formally investigated.