Gliding Distance of the Extensor Pollicis Longus Tendon with Respect to Wrist Positioning: Observation in the Hands of Healthy Volunteers Using High-Resolution Ultrasonography

Study DesignCross-sectional experimental bench.IntroductionOptimal tendon gliding is necessary for normal thumb function.Purpose of the StudyMeasure the gliding distance of the extensor pollicis longus (EPL) tendons during passive thumb flexion from high-resolution echo images at four wrist positions.MethodsGliding distance of the EPL tendon in zone 4 of the thumb was measured during passive flexion in four different wrist positions in 25 healthy female volunteers. Tendon gliding was evaluated from high-resolution ultrasonography in a frame-by-frame cross-correlation analysis.ResultsMean gliding distance of the EPL tendon was 1.79, 2.45, 1.09, and 1.36 mm with the wrist positioned in neutral, 30 degrees of extension, 30 degrees of flexion, and 20 degrees of ulnar deviation, respectively. There were statistically significant differences in the gliding distance of the EPL tendon among all of four wrist positions except for that between the wrist flexion and wrist ulnar deviation conditions.ConclusionsWrist extension induces the greatest magnitude EPL tendon gliding.     

Complete dependence on CD4+ cells in late asthmatic response, but limited contribution of the cells to airway remodeling in sensitized mice

It is known that the late asthmatic response (LAR), a characteristic feature of asthma, is closely associated with CD4+ Th2 cell-mediated allergic inflammation. Airway remodeling is also a pathogenesis of asthma, but literature reporting roles of CD4+ cells in the remodeling is controversial. There has been no study that simultaneously assessed the roles of CD4+ cells in both LAR and airway remodeling. Sensitized mice were intratracheally challenged with ovalbumin 4 times. Treatment with an anti-CD4 monoclonal antibody (mAb) before the 1st challenge almost completely abolished increase in CD4+ cells in the tissues after the 4th challenge. The late phase increase in airway resistance after the 4th challenge was also completely inhibited by anti-CD4 mAb. Parameters of airway remodeling, subepithelial fibrosis and epithelial thickening were attenuated by treatment, whereas the inhibition was only 30% - 40%. Bronchial smooth muscle thickening was not affected. Because interleukin (IL)-5 production as well as eosinophilia was effectively suppressed by anti-CD4 mAb, the effect of anti-IL-5 mAb was also examined, resulting in no inhibition of airway remodeling. Collectively, although the LAR was completely dependent on CD4+ cell activation, airway remodeling was only partially dependent on the cell.     

Distribution of Toxic Metals in Organs of Local Cattle, Sheep, Goat and Poultry from the West Bank, Palestinian Authority

Graphite furnace atomic absorption spectrophotometry was used to measure the concentrations of Cu, Cd, Pb, and Zn in muscles and internal organs (liver, kidneys, heart, and lungs) of cattle, sheep goat and poultry sampled from local markets in the West Bank, Palestinian Authority. Mean levels of metals (dry weight basis) during this study were as follows: Cd: 0.34–0.57 μg/g, Pb: 0.2–4.7 μg/g, Cr: 0.44–3.62 μg/g and Cu: 1.03–217.9 μg/g. Muscles and internal organs of each species were found to have statistically different metal levels. Generally, livers and kidneys were found to have the highest levels of metals and muscles the lowest levels. When compared to each other, the four animal groups either did not show any significant differences or no clear trends. Compared to results reported in the literature, our results were comparable to or less than most of the studies reported from clean sites in different countries.     

Predictors of controlled ambulatory blood pressure in treated hypertensive patients with uncontrolled office blood pressure.

Although some treated hypertensive patients have controlled 24-h ambulatory blood pressure (ABP) despite their uncontrolled office blood pressure (BP), the factors relating to the control of 24-h ABP remain unknown. We conducted a study to assess 24-h ABP and its association with other cardiovascular risk factors, including echocardiographic left ventricular hypertrophy (LVH), in elderly hypertensive patients (n =41) with uncontrolled office BP (>140/90 mmHg) during long-term medication. Although a majority of the patients had isolated elevation of office systolic BP (SBP), there was no significant relationship between office SBP and 24-h SBP, and about half of the patients had controlled 24-h ABP (125+/-8/69+/-6 mmHg). Patients with controlled 24-h ABP (125+/-8/69+/-6 mmHg) had similar office BP (150+/-6/77+/-5 vs. 150+/-7/79+/-7 mmHg), but lower left ventricular mass index (LVMI) (123+/-34 vs. 156+/-34 g/m(2)) and body mass index (BMI) (24.4+/-2.1 vs. 26.4+/-3.6 kg/m(2)) compared with those with uncontrolled 24-h ABP (149+/-13/78+/-7 mmHg). Multivariate analysis showed that LVMI and BMI were independently associated with controlled 24-h ABP, and the control status of 24-h ABP was highly dependent on the presence of LVH and obesity. Therefore, absence of LVH and obesity may be useful for predicting the level of control of 24-h ABP in treated patients whose office BP is uncontrolled without ABP measurements.     

Conditional Ror1 knockout reveals crucial involvement in lung adenocarcinoma development and identifies novel HIF-1α regulator

We previously reported that ROR1 is a crucial downstream gene for the TTF-1/NKX2-1 lineage-survival oncogene in lung adenocarcinoma, while others have found altered expression of ROR1 in multiple cancer types. Accumulated evidence therefore indicates ROR1 as an attractive molecular target, though it has yet to be determined whether targeting Ror1 can inhibit tumor development and growth in vivo. To this end, genetically engineered mice carrying homozygously floxed Ror1 alleles and an SP-C promoter–driven human mutant EGFR transgene were generated. Ror1 ablation resulted in marked retardation of tumor development and progression in association with reduced malignant characteristics and significantly better survival. Interestingly, gene set enrichment analysis identified a hypoxia-induced gene set (HALLMARK_HYPOXIA) as most significantly downregulated by Ror1 ablation in vivo, which led to findings showing that ROR1 knockdown diminished HIF-1α expression under normoxia and clearly hampered HIF-1α induction in response to hypoxia in human lung adenocarcinoma cell lines. The present results directly demonstrate the importance of Ror1 for in vivo development and progression of lung adenocarcinoma, and also identify Ror1 as a novel regulator of Hif-1α. Thus, a future study aimed at the development of a novel therapeutic targeting ROR1 for treatment of solid tumors such as seen in lung cancer, which are frequently accompanied with a hypoxic tumor microenvironment, is warranted.     

De Novo Migraine With Aura After Surgical Repair of Aortic Coarctation

Coarctation of the aorta (CoA) is reported to be associated with an increased risk for migraine. We describe here the case of a 13‐year‐old female patient who presented migraine with aura after surgical repair of CoA with a stent. As possible reasons for her condition, we postulate host responses to stent placement and/or disturbed cerebral autoregulation related to intracranial hypertension before the surgical repair and hypotension afterward, leading to hypoperfusion. This case demonstrates that de novo migraine with aura can occur after surgical repair of CoA and should be recognized as a potential complication.