Splinting or surgery for carpal tunnel syndrome? Design of a randomized controlled trial [ISRCTN18853827]

Background  

Carpal tunnel syndrome is a common disorder, which can be treated with surgery or conservative options. However, there is insufficient evidence and no consensus among physicians with regard to the preferred treatment for carpal tunnel syndrome. Therefore, a randomized controlled trial is conducted to compare the short- and long-term efficacy of surgery and splinting in patients with carpal tunnel syndrome. An attempt is also made to avoid the (methodological) limitations encountered in earlier trials on the efficacy of various treatment options for carpal tunnel syndrome.     

Postsynaptic density antigens: preparation and characterization of an antiserum against postsynaptic densities

Long-term immunization of rabbits with postsynaptic densities (PSD) from bovine brain produced an antiserum specific for PSD as judged by binding to subcellular fractions and immunohistochemical location at the light and electron microscope levels. (a) The major antigens of bovine PSD preparations were three polypeptides of molecular weight 95,000 (PSD-95), 82,000 (PSD-82), and 72,000 (PSD-72), respectively. Antigen PSD-95, also present in mouse and rat PSDs was virtually absent from cytoplasm, myelin, mitochondria, and microsomes from rodent or bovine brain. Antigens PSD-82 and PSD-72 were present in all subcellular fractions from bovine brain, especially in mitochondria, but were almost absent from rodent brain. The antiserum also contained low-affinity antibodies against tubulin. (b)Immunohistochemical studies were performed in mouse and rat brain, where antigen PSD-95 accounted for 90 percent of the antiserum binding after adsorption with purified brain tubulin. At the light microscope level, antibody binding was observed only in those regions of the brain where synapses are known to be present. No reaction was observed in myelinated tracts, in the neuronal cytoplasm, or in nonneuronal cells. Strong reactivity was observed in the molecular layer of the dentate gyrus, stratum oriens and stratum radiatum of the hippocampus, and the molecular layer of the cerebellum. Experimental lesions, such as ablation of the rat entorhinal cortex or intraventricular injection of kainic acid, which led to a major loss of PSD in well- defined areas of the hippocampal formation, caused a correlative decrease in immunoreactivity in these areas. Abnormal patterns of immunohistochemical staining correlated with abnormal synaptic patterns in the cerebella of reeler and staggerer mouse mutants. (c) At the electron microscopic level, immunoreactivity was detectable only in PSD. The antibody did not bind to myelin, mitochondria or plasma membranes. (d) The results indicate that antigen PSD-95 is located predominantly or exclusively in PSD and can be used as a marker during subcellular fractionation. Other potential uses include the study of synaptogenesis, and the detection of changes in synapse number after experimental perturbations of the nervous system.     

Time-dependent thresholds for torpor initiation in the rufous hummingbird (Selasphorus rufus)

Summary Three models for torpor initiation were tested in rufous hummingbirds (Selasphorus rufus) during moult, when these birds appear to avoid the use of torpor. In model 1, the level of energy reserves at which torpor is initiated (the threshold) remains constant throughout the night. In model 2, the threshold declines throughout the night, at a constant rate equivalent to the rate at which energy reserves are depleted during torpor. In model 3, the threshold declines at a rate equivalent to the rate of energy reserve depletion during torpor for most of the night, but at a higher rate (corresponding to the rate of energy expenditure during normothermia) during the final 2 h of the night, when these birds are usually normothermic. Model 1 predicts the most frequent and longest bouts of torpor, whereas model 3 predicts the fewest and shortest bouts. To determine the thresholds for each of 12 birds, food supply was manipulated to induce entry into torpor at different times on successive nights. Threshold slopes matched the predictions of model 3 most closely. Calculations comparing observed incidence of torpor with the predictions of model 1 show that the actual, time-dependent threshold for torpor initiation resulted in a 72% reduction in the number of torpor bouts compared with the number of torpor bouts that should have been initiated by a constant threshold. The advantage of a time-dependent threshold is that, although torpor is initiated when needed to prevent energy reserves from falling below a critical level, the amount of time spent in torpor can be minimized. This may be especially important to rufous hummingbirds during the spring moult, because lowered metabolic rates during torpor probably result in decreased rates of feather replacement during the moult and may thus have consequences for thermoregulation, territorial defence, and timing of the spring migration.     

Identification and predicted sequence of a previously unrecognized small hydrophobic protein, SH, of the paramyxovirus simian virus 5.

A previously unrecognized gene (SH) has been identified on the virion RNA of the paramyxovirus simian virus 5 between the genes for the fusion protein and the hemagglutinin-neuraminidase. An SH mRNA of 292 nucleotides (plus polyadenylate residues), transcribed from the SH gene, has been identified. The SH mRNA contains a single open reading frame which encodes a polypeptide of 44 amino acids with a molecular weight of 5,012. The SH polypeptide is predicted to contain an extensive hydrophobic region. This protein has been identified in simian virus 5-infected cells, and it has been shown to be encoded by the SH mRNA by in vitro translation of size-fractionated mRNAs, hybrid-arrest translation, and hybrid-selection translation.