Retinol binding protein and vitamin D associations with serum antibody isotypes,serum influenza virus‐specific neutralizing activities and airway cytokine profiles

Vitamin A supports the induction of immunoglobulin (Ig)A responses at mucosal surfaces in mice, but much less is known about the influence of vitamins on antibody isotype expression in humans. To address this knowledge gap, we examined 46 residual blood samples from adults and children, some of whom were experiencing influenza virus infections of the respiratory tract. Assays were performed for retinol binding protein (RBP, a surrogate for vitamin A), vitamin D (a related vitamin) and antibody isotypes. Results showed that all but two tested samples exhibited RBP and/or vitamin D insufficiencies or deficiencies. Vitamin D correlated with blood IgM and IgG3, while RBP correlated with IgG4 and IgA. RBP also correlated positively with age and with influenza virus‐specific antibody neutralization titres. Individuals with low blood RBP levels exhibited the highest frequencies of over‐expressed cytokines and growth factors in nasal wash samples, an indication of inflamed mucosal tissues. While cause–effect relationships were not discerned, results support a hypothesis that vitamins directly influence B cell isotype expression in humans, and by so doing may help protect mucosal surfaces from respiratory viral disease.     

Contralateral force sense deficits are related to the presence of functional ankle instability.

Residual symptoms that often follow lateral ankle sprains can lead to functional ankle instability. Proprioceptive deficits have been identified as one factor that may contribute to the presence of functional ankle instability. Sixty participants were recruited to participate in the study. Seven questions were used to determine the presence of functional ankle instability in each participant. A point was added for each "yes" response to produce an index that represents an interval data scale of functional ankle instability. Contralateral force sense and active joint reposition sense were measured in all participants. Pearson product moment correlations were calculated to determine the relationship between functional ankle instability and force sense and active joint reposition sense. We found a significant relationship with force sense and functional ankle instability. Specifically, force sense variable error at both test forces (10 and 30% of maximal voluntary isometric contraction) were positively correlated to the presence of functional ankle instability, r=0.26; p相似文献   

Tibial plafond fractures treated by articulated external fixation: a randomized trial of postoperative motion versus nonmotion

OBJECTIVES: Assess whether postoperative ankle motion after fixation of a fracture of the tibial plafond, treated with articulated external fixation, leads to a better outcome when compared with similar treatment without postoperative ankle motion. DESIGN: Multicenter randomized trial. SETTING: Three Level I trauma centers. PATIENTS/PARTICIPANTS: Fifty-five patients were enrolled and entered into a Web-based database and randomized into 1 of 2 groups. Forty-one patients were evaluated at a 1-year follow-up visit, and 31 were seen at 2 years or longer after injury. INTERVENTION: Patients were treated with a hinged external fixator and limited internal fixation of the articular surface. They were divided postoperatively into two groups, 1 of which had a locked hinge and the other had a mobile hinge and a motion protocol. MAIN OUTCOME MEASUREMENTS: A general health status questionnaire, the SF-36 (short-form 36); a joint-specific ankle questionnaire, the Ankle Osteoarthritis Score (AOS); and range of motion (ROM) of the ankle joint. RESULTS: There were no significant differences between the two groups at either follow-up interval in the ankle ROM measurement, the AOS pain and disability scale, or the SF-36 physical component summary (PCS) and mental component summary (MCS) scales. CONCLUSIONS: These results indicate that treatment protocols that use long periods of cross-joint external fixation that immobilizes the ankle as definitive treatment result in similar patient outcomes compared to otherwise identical treatment protocols that incorporate and use an articulated hinge for ankle motion. However, the results should be interpreted with caution because the patient numbers were too small to detect potentially meaningful differences in outcomes and the follow-up was too short to assess for differences in the development of arthrosis.     

Ocular complications following excision of cerebellopontine angle tumours

The incidence of ocular complications in 91 patients who underwent excision of cerebellopontine angle tumours was reviewed. Facial nerve paralysis occurred postoperatively in 40 of 88 patients (45.5%). Sixty-four percent of these patients recovered; thus the final count was 86% of patients with facial nerve function following tumour removal. Patients who sustained a delayed facial paralysis recovered well. In patients who sustained an immediate paralysis when the nerve was left anatomically intact postoperatively, recovery was again excellent if paralysis was incomplete, and varied if the paralysis was complete. Not surprisingly, postoperative facial paralysis was more common in patients who had had large tumours. Corneal hypoesthesia and a poor Bell's phenomenon were the most important factors in predicting corneal complications as a result of facial nerve paralysis. Eye complications in 45% of the patients who suffered facial nerve paralysis were managed conservatively with ocular lubricants and an eye shield only; the others received some form of eyelid surgery.