The sartans are coming!

The 3(rd) International Symposium on Angiotensin II Antagonism was held in London February 28-March 2, 2000, and was accompanied by a number of company-sponsored symposia discussing "sartan" drugs. The advent of these angiotensin II receptor antagonists in the 1990s was welcomed with much enthusiasm owing to their reduced side effect profiles in comparison with members of other classes of antihypertensive drugs. Losartan and valsartan had previously been combined successfully with hydrochlorothiazide. A new sartan combination--candesartan cilexetil + hydrochlorothiazide--was announced during the meeting and new clinical trial data were presented. There are a number of questions that still need answers with respect to the role of the sartans in areas other than hypertension; help in answering at least some of these questions should be provided soon by the results of several megastudies that are currently under way.

A novel quantitative method for 3D measurement of Parkinsonian tremor

OBJECTIVE

To demonstrate the usefulness of a three dimensional (3D) motion analysis system for the quantitative measurement of tremor in patients with Parkinson's disease (PD).

METHODS

Six PD patients with hand tremors were studied using a system that employed 3D electromagnetic position sensors to measure the actual, cumulative displacement of the tremoring finger. Patients were studied in different hand positions and activating conditions before and 30, 60, 90 and 120 min after intake of Pramipexole, a dopamine agonist known to reduce tremor. Tremor amplitude and frequency, before and after drug intake, were compared using Mann-Whitney U test and Wilcoxon rank test, respectively.

RESULTS

The motion analysis system allowed discrimination of tremor related events from movement artifact and allowed the calculation of real world movement of the finger tremor despite altered hand positions and orientation. Average 3D tremor frequency ranged from 3.71 to 4.34 Hz. Median tremor amplitude (total distance traveled per 5 s interval) decreased with drug from 4.9 to 1.6 cm for resting tremor, 4.5 to 3.7 cm for postural tremor, 3.4 to 3.3 cm for precision tremor, 10.2 to 3.3 cm for tapping activation and 108.6 to 5.7 cm for counting activation.

CONCLUSIONS

Our method of 3D analysis provides a robust, single quantitative measure of tremor amplitude that is intuitive and likely to reflect the functional impact of tremor. This methodology should be useful in comparing tremor across patients and in measuring the efficacy of therapeutic interventions.

Immunodeficiency and the gut: clues to the role of the immune system in gastrointestinal disease

Gastrointestinal disease occurs in a high proportion of patients with primary immunodeficiency. While enteric infections are responsible for the gastrointestinal pathology in many individuals, it is now clear that infection alone is not sufficient to explain the gut pathology found in many immunodeficiencies. This article focuses on recent developments in this field and highlights the insights gained in understanding the complex relationship between immunodeficiency and the gut.

Simultaneous genotyping for all three known structural mutations in the human mannose-binding lectin gene

We describe a rapid and simple method for genotyping the three known structural mutations within exon 1 of the mannan-binding lectin (MBL) gene. A PCR-amplifiable synthetic DNA (Universal Heteroduplex Generator) was annealed to genomic PCR product from exon 1 to generate unique DNA heteroduplexes for each mutation. Heteroduplexes were then resolved by non-denaturing polyacrylamide gel electrophoresis. The technique was initially validated with previously typed samples and then applied to previously untyped samples with the results confirmed by DNA sequencing.

Haptoglobin typing of bloodstains using horizontal discontinuous polyacrylamide gel electrophoresis

A horizontal electrophoresis method using a discontinuous polyacrylamide gel to identify haptoglobin polymorphs is described. Improvements over the traditional vertical gel method include less sample required, easy gel preparation, and shortened run time. Additionally, vertical electrophoresis equipment, which can be technically challenging, is not needed. Caucasian, Black and Hispanic databases, each created from 100 autopsy blood samples from the New York City Medical Examiner's Office, are also presented.