Alpha 1-adrenergic and 5-HT2-serotonergic effects of some beta-alkoxy-beta-phenylethylamines on isolated rat thoracic aorta

1. Ten racemic beta-alkoxy-beta-phenylethylamines were found to elicit concentration-dependent contraction of the isolated rat thoracic aorta with apparent pD2 values in the 4.56-6.76 range. With one exception, which produces the same maximal contraction (Emax) as serotonin (5-HT), the Emax values attained with these compounds are lower than those produced by either 5-HT or norepinephrine (NE). 2. Pretreatment with either prazosin or ketanserin (10(-8) M) leads in most cases to decreased Emax values and slopes in the dose-response curves. Apparent serotonergic (pD2S) and adrenergic (pD2A) pD2 values going from 4.22 to 6.08 (pD2S) and from 3.87 to 5.27 (pD2A) were calculated from results obtained in the presence of prazosin or ketanserin, respectively. 3. In the 10(-7)-10(-5) M range, and in contrast with the results obtained with the previous compounds, BON [(+/-)-2-(2,5-dimethoxy-4-nitrophenyl)-2-methoxy-ethylamine] behaves as an antagonist to both 5-HT and NE (apparent pA2 = 7.08 and 7.45, respectively) in this preparation.

Six Arabidopsis thaliana homologues of the human respiratory burst oxidase (gp91phox)

An NADPH oxidase analogous to that in mammalian phagocytes has been hypothesized to produce reactive oxygen species (ROS) in the plant defence response. A. thaliana contains at least six gp91phox homologues, designated AtrbohA-F (A. thaliana Respiratory Burst Oxidase Homologues), which map to different positions. Transcripts of three of these genes can be detected in healthy plants by RNA gel blot analyses. The Atrboh gene products are closely related to gp91phox and the intron locations suggest a common evolutionary origin. A putative EF-hand Ca(2+)-binding motif in the extended N-terminal region of the Atrboh proteins suggests a direct regulatory effect of Ca2+ on the activity of the NADPH oxidase in plants.

Optimization of selenium determination in human milk and whole blood by flow injection hydride atomic absorption spectrometry

A flow injection hydride atomic absorption spectrometric (FI-HAAS) method was developed for determining selenium in human milk and whole blood after microwave digestion of the sample. The sample (2 mL human milk or 0.25 mL blood) was introduced into the microwave vessel with 1.5 mL HNO3 and 0.25 mL H2O2 and 300 W (4 min) and 600 W (4 min) were applied. The digestion was completed by heating to 140 degrees C (2-3 h). Se (VI) was reduced to Se (IV) with hydrochloric acid. The instrumental conditions for FI-HAAS (concentrations of reducing agent and carrier acid, flow rate of argon carrier gas, and sample volume injected) were optimized. The detection limit of the proposed method was 0.23 ng/mL (assay) or 115 pg Se (absolute) in biological samples (1.15 ng/mL milk, 10.4 ng/mL blood). The precision values were 5.0% for milk and 4.0% for blood. The accuracy was evaluated with 2 reference materials, National Institute of Standards and Technology Non-Fat Milk Powder (found: 104.3 +/- 7.2 ng/g, certified: 110 +/- 10 ng/g) and Whole Blood Seronorm (found: 81 +/- 7.3 ng/mL, reference: 83 +/- 4 ng/mL). The results show the suitability of the method for selenium determination in human milk and whole blood. The method was applied to whole blood samples obtained from pregnant women and to human milk.

Radionuclide imaging in orthopedic infections

In otherwise normal bone, Three Phase Bone Scintigraphy is sensitive and specific for osteomyelitis. In patients with underlying osseous abnormalities the specificity of the study is decreased. The four phase bone scan, bone/gallium scintigraphy, leukocyte imaging, leukocyte/bone and leukocyte/marrow studies have all been reported to increase specificity. The techniques, strategies, and limitations are discussed. No single study is equally useful in all situations. Labeled leukocyte imaging is of little value in vertebral osteomyelitis because this entity often presents as a nonspecific photopenic defect. The preferred technique for the spine is bone/gallium imaging. Intense uptake, on bone scintigraphy, in two adjacent vertebrae with loss of the disc space is highly suggestive of spinal osteomyelitis. Gallium not only enhances the specificity of the diagnosis but provides information about surrounding soft tissue infection. In the diabetic foot, labeled leukocyte imaging alone is sufficient to determine the presence of osteomyelitis in the fore--foot. In the midfoot and hindfoot it may be necessary to combine leukocyte scintigraphy with bone scintigraphy to precisely localize the infection. Labeled leukocytes accumulate in the uninfected neuropathic joint and preliminary data suggest that leukocyte/marrow imaging may be useful to determine the significance of such uptake. For the painful joint replacement, if infection is the primary concern, leukocyte/marrow scintigraphy should be performed initially. If any postoperative complication, regardless of type, is the concern, it is reasonable to begin with bone scintigraphy because a normal study rules strongly against any complication. An abnormal bone scan will require additional studies to more precisely determine the cause of that abnormality.

Leukocyte-marrow scintigraphy in hyperostosis frontalis interna

Hyperostosis frontalis interna is the term used to describe the thickening of the frontal bones of the skull. This thickening of the frontal bones is accompanied by an increase in the diploic space which results in an increased quantity of hematopoietically active marrow. Increased frontal bone uptake of labeled leukocytes has been reported in this condition, and the symmetric appearance of this activity may suggest its benign etiology. We have encountered a case of hyperostosis frontalis interna in which the uptake of labeled leukocytes was asymmetric and marrow scintigraphy confirmed that the activity seen was due to marrow not infection.

Flow-function relation in patients with chronic coronary artery disease and reduced regional function. A positron emission tomographic and two-dimensional echocardiographic study with coronary vasodilator stress

OBJECTIVES

We sought to elucidate the flow-function relation in chronic postischemic dysfunction during vasodilator stress.

BACKGROUND

In patients with ischemia and regional dysfunction, stress echocardiography can elicit three responses in the dysfunctioning segments: no change, improvement or worsening. The physiology underlying these responses is unclear.

METHODS

Seventeen patients with ischemia and left ventricular dysfunction underwent evaluation of regional function by two-dimensional echocardiography and myocardial blood flow by positron emission tomography and 13N-ammonia. Flow (ml/min per g) and function (regional wall motion score [RWMS] from 1 = normal to 4 = dyskinetic) were evaluated both at rest and after dipyridamole (0.56 mg/kg body weight over 4 min).

RESULTS

In 45 normal segments, rest to dipyridamole flow increased from 0.83 +/- 0.22 (mean +/- 1 SD) to 1.87 +/- 0.90 (p < 0.01) with a hyperkinetic contraction pattern. Among dysfunctioning segments, responders (n = 11) showed an upsloping flow-function curve during stress (i.e., increased function [RWMS rest 2.5 +/- 0.5 vs. dipyridamole 1.2 +/- 0.4] and increased flow [rest 0.69 +/- 0.30 vs. dipyridamole 1.89 +/- 1.43, p < 0.01]); nonresponders (n = 20) had a flat flow-function curve during dipyridamole (i.e., fixed function [RWMS rest and dipyridamole 2.6 +/- 0.5] and no flow increase [rest 0.64 +/- 0.24 vs. dipyridamole 0.87 +/- 0.51, p = NS): Ischemic segments (n = 9) exhibited a downsloping flow-function curve during dipyridamole (i.e., worsened function [RWMS rest 2 +/- 0.5, dipyridamole 3.1 +/- 0.6] and no significant flow change [rest 0.67 +/- 0.29 vs. dipyridamole 0.79 +/- 0.23, p = NS]).

CONCLUSIONS

Myocardial segments with rest dysfunction and a contractile reserve elicitable by a vasodilator stress more often exhibit residual flow reserve, whereas segments with a fixed or worsening mechanical response during stress show a flat flow response.

[Hepatic granulomas in a patient with acquired hypogammaglobulinemia]

The case of a young female diagnosed with an IgG deficit and hepatic granulomas is presented. After 6 years of follow up the patient remains asymptomatic without treatment and with moderate biochemical cholestasis. The tests performed did not lead to a definitive etiologic diagnosis, therefore, according to a review of the literature, we believe that the granulomatous reactions are related with the hypogammaglobulinemia itself.

rbohA, a rice homologue of the mammalian gp91phox respiratory burst oxidase gene

It has been hypothesized that plants contain respiratory burst oxidase which, upon activation, oxidize NADPH and generate extracellular superoxide, O2.-. These proteins are proposed to play a central role in defence against pathogens. However, plant DNA sequences that encode proteins with similarity to components of respiratory burst oxidase have not previously been reported. This paper describes the complete cDNA and genomic DNA sequence of the rice rbohA (for respiratory burst oxidase homologue) gene. The predicted RbohA product is most similar to the main catalytic subunit, gp91phox, of the respiratory burst oxidase of neutrophils. Reverse transcriptase PCR detects rbohA transcripts in both roots and shoots of healthy rice plants.

[Fortification of fluid milk for the prevention and treatment of iron deficiency anemia in children under 4 years of age]

The effectiveness of the use of chelate amino acid iron fortified fluid milk in the treatment of iron deficiency in children under four years of age was studied. The 269 children included in this trial received 1 liter/day of fluid milk fortified with 3 mg of chelate amino acid iron and were evaluated at six monthly intervals. At the beginning of the study 62.3% of the children presented anemia. After 6 months, this percentage had decreased to 41.8% and at the end of one year to 26.4%. The greatest decreases occurred in the groups comprising the subjects who were of 12 to 23 months of age and those under one year of age. Among the children who presented initial hemoglobin levels under 9.5 g/dl, 59.3% were free of anemia after one year of follow-up. Of those presenting initial hemoglobin levels between 9.5 and 10.9 g/dl, 66.7% recovered from their anemia. There was also greater hematological improvement in the children that ingested over 750 ml/day of fortified milk in those families that did not share the supply of supplement among their other members and in those families that had only one child under five years of age. These findings led to the conclusion that the fortification of fluid milk is a viable and effective method for the treatment of iron deficiency in pre-school children.

[Powdered milk enriched with iron and ascorbic acid as an intervention measure for treating iron deficiency anemia in children seen at a Basic Health Care Unit]

This study was undertaken to verify the influence of the use of iron and Vitamin C fortified powdered whole milk on the hemoglobin levels of 238 children, aged 6 to 18 months, seen at a Basic Health Care Unit in the State of São Paulo. The powdered milk was fortified with 9 mg of iron (ferrous sulfate) and 65 mg of Vitamin C for each 100 g of powder. 4 kg/month were distributed to children under one year and 2 kg/month to those over one year of age. Clinical, anthropometric and hematological (hemoglobin level measurements) evaluations were performed at the onset of the study and at three month intervals after the beginning of the supplementation. At the end of the trial, there was still enough milk available to extend the intervention for a group of 39 children who had presented the worst evolution in the first six months. At the onset of the study, 72.6% of the children presented anemia. After 3 and 6 months, these percentages had decreased to 38.9% and 18.5%, respectively. Among the children that were followed-up for 9 months, their were only 2.5% who presented anemia at the end of the intervention. The highest prevalences were found in the 6 to 12 months age group and the best results in the 10 to 18 month group. There was intrafamilial dilution of the milk in 30.7% of the cases. With or without intrafamilial milk sharing, there were significant decreases in anemia occurrences with no differences between the two groups. The use of fortified milk did not affect the children nutritional condition. This study permitted the conclusion that the fortification of foodstuffs, besides being the method of election for the prevention of iron deficiency, is an excellent alternative for the treatment of and recovery from iron deficient anemia in children under two years of age.

Activities of the Wnt-1 class of secreted signaling factors are antagonized by the Wnt-5A class and by a dominant negative cadherin in early Xenopus development

When overexpressed in Xenopus embryos, Xwnt-1, -3A, -8 and -8b define a functional class of Wnts (the Wnt-1 class) that promotes duplication of the embryonic axis, whereas Xwnt-5A, -4, and -11 define a distinct class (the Wnt-5A class) that alters morphogenetic movements (Du, S., S. Purcell, J. Christian, L. McGrew, and R. Moon. 1995. Mol. Cell. Biol. 15:2625-2634). Since come embryonic cells may be exposed to signals from both functional classes of Wnt during vertebrate development, this raises the question of how the signaling pathways of these classes of Wnts might interact. To address this issue, we coexpressed various Xwnts and components of the Wnt-1 class signaling pathway in developing Xenopus embryos. Members of the Xwnt-5A class antagonized the ability of ectopic Wnt-1 class to induce goosecoid expression and a secondary axis. Interestingly, the Wnt-5A class did not block goosecoid expression or axis induction in response to overexpression of cytoplasmic components of the Wnt-1 signaling pathway, beta-catenin or a kinase-dead gsk-3, or to the unrelated secreted factor, BVg1. The ability of the Wnt-5A class to block responses to the Wnt-1 class may involve decreases in cell adhesion, since ectopic expression of Xwnt-5A leads to decreased Ca2+-dependent cell adhesion and the activity of Xwnt-5A to block Wnt-1 class signals is mimicked by a dominant negative N-cadherin. These data underscore the importance of cell adhesion in modulating the responses of embryonic cells to signaling molecules and suggest that the Wnt-5A functional class of signaling factors can interact with the Wnt-1 class in an antagonistic manner.

The maize caffeic acid O-methyltransferase gene promoter is active in transgenic tobacco and maize plant tissues

The pattern of expression directed by the promoter of the maize caffeic acid O-methyltransferase (COMT) gene was studied by histochemical and fluorometric beta-glucuronidase (GUS) analysis in transgenic maize and tobacco plants. The COMT promoter directs GUS expression to the xylem and the other tissues undergoing lignification, and it responds to wounding and to elicitors. In transgenic maize plants, expression of GUS corresponds to the pattern of expression of the endogenous COMT gene as determined by northern analysis and in situ hybridization. The pattern in transgenic tobacco plants clearly shows that the maize promoter sequence is recognized by tobacco transcriptional factors, in spite of the anatomical differences and the evolutionary distance between these two species. The results suggest that the most significant promoter signals that induce the specific expression of the lignin COMT are conserved in different species.

[Recombinant alfa-2 interferon treatment of a patient with chronic hepatitis B and ulcerative colitis]

The case of a patient ulcerative colitis involving an autoimmune base who was treated with recombinant alpha-2 interferon for concomitantly presenting chronic hepatitis B in the replicative phase is reported. With this therapy unreplicative seroconversion of the disease was achieved without modification of the course of the chronic inflammatory intestinal disease (CIID) during treatment or over the posttreatment follow up period. A brief review of the literature was performed concerning the role of autoimmunity in ulcerative colitis, treatment with alpha-interferon in chronic hepatitis B and the exacerbation of autoimmune phenomena which may lead to interferon treatment. According to the evolution of this case and the review of the literature, the authors conclude that the existence of CIID does not contra-indicate the use of recombinant alpha-2 interferon in patients with chronic viral hepatitis, although special control of the disease should be carried out during the treatment period.

Sequence analysis and chromosomal localization of human Cap Z. Conserved residues within the actin-binding domain may link Cap Z to gelsolin/severin and profilin protein families

From a human retinal cDNA library, we have isolated cDNAs that are homologs for the alpha 2 and beta subunits of chicken Cap Z. The derived human alpha subunit shares 95% amino acid identity with the chicken alpha 2 subunit; the beta subunit is 99% identical to the chicken subunit residues 1-243. The remaining portion of the human beta subunit (244-272) diverges significantly with only 8 out of 29 C-terminal amino acids conserved between the two species. This lack of conservation is of particular interest because the chicken C terminus contains an actin-binding domain. Cosedimentation assays with F-actin show that human Cap Z binds actin with an affinity equal that of chicken Cap Z. These results point to the eight shared amino acids as critical for actin binding, three of which are regularly spaced leucines. These apolar residues and one outside the region of divergence align well with those residues of the actin-binding alpha-helix proposed for gelsolin segment 1. The apolar residues as well as three polar amino acids are also conserved in other capping, capping and severing, and monomer-binding proteins. Amino acid substitutions in the chicken beta subunit of the two most highly conserved leucines result in significant decreases in F-actin binding activity. The human alpha 2 gene (CAPZA2) has been mapped to chromosome 7 position q31.2-q31.3 and the beta gene (CAPZB) to chromosome 1 region p36.1.

[The effect of the use of milk fortified with iron and vitamin C on hemoglobin levels and nutritional status of children under 2]

The impact of the use of fortified powdered whole milk (9 mg of iron and 65 mg of vitamin C/100 g of milk) on the hemoglobin levels of children under 2 years of age was evaluated, over a period of 6 months, in 107 children enrolled in municipal Day Care Centers (DCC) and in 228 seen at a Basic Health Care Unit (BHCU). Before the beginning of the intervention, 66.4% of the children in the DCC and 72.8% of those seen at the BHCU had hemoglobin levels under 11.0 g/dl. After 6 months of fortified milk intake, these percentages fell to 20.6% and 18.0% respectively. The average hemoglobin before the intervention was 10.3 g/dl in the DCC and 10.5 in the BHCU. After 6 months these increased to 11.6 g/dl in the populations studied. Concerning the nutritional condition, evaluated according to Gomez's criteria, 57% of the DCC children presented an improvement, 41.1% showed changes and only 1.9% became worse. In the BHCU, 11.4% presented better condition, 70.6% remained the same and 18% worsened, which demonstrated differences in response regarding improvement of nutritional condition, when fortified milk was used in closed and open environments. The authors conclude that the utilization of enriched foods is an excellent alternative in the treatment of iron deficiency in populations of children under 2 years of age.

Rapid diagnosis of ocular herpes simplex infections

BACKGROUND

The Surecell herpes (HSV) test kit is a test for detecting the presence of herpes simplex viral antigen by means of a monoclonal antibody based immunoassay. The test has proved to be highly sensitive and specific in diagnosing genital, oral, and dermatological herpes infections.

METHODS

In this study, samples from patients with ocular keratitis were evaluated by tissue cultures and the Surecell test. The eyes of New Zealand rabbits were then inoculated with HSV type 1 acute keratitis, acute Staphylococcus keratitis, and HSV type 1 postkeratitis (healed corneas). Tear film samples collected from each eye with a cotton swab were evaluated by routine culture (A-549 monolayers) and by the Surecell test with and without prior placement of the swab in Hank's medium.

RESULTS

The Surecell system had a 70% sensitivity and a 100% specificity in the detection of HSV antigen in ocular infections, and was shown to be a quick, efficient, and accurate method of testing for HSV antigen in humans.

CONCLUSION

These results from humans and rabbits indicate that the Surecell test, which requires no special equipment, can be a useful in office adjunct in the clinical diagnosis of ocular herpes simplex.

The brown midrib3 (bm3) mutation in maize occurs in the gene encoding caffeic acid O-methyltransferase

The brown midrib mutations are among the earliest described in maize. Plants containing a brown midrib mutation exhibit a reddish brown pigmentation of the leaf midrib starting when there are four to six leaves. These mutations are known to alter lignin composition and digestibility of plants and therefore constitute prime candidates in the breeding of silage maize. Here, we show that two independent brown midrib3 (bm3) mutations have resulted from structural changes in the COMT gene, which encodes the enzyme O-methyltransferase (COMT; EC 2.1.1.6), involved in lignin biosynthesis. Our results indicate that the bm3-1 allele (the reference mutant allele) has arisen from an insertional event producing a COMT mRNA altered in both size and amount. By sequencing a COMT cDNA clone obtained from bm3-1 maize, a retrotransposon with homology to the B5 element has been found to be inserted near the junction of the 3' coding region of the COMT gene intron. The second bm3 allele, bm3-2, has resulted from a deletion of part of the COMT gene. These alterations of the COMT gene were confirmed by DNA gel blot and polymerase chain reaction amplification analyses. These results clearly demonstrate that mutations at the COMT gene give a brown midrib3 phenotype. Thus, the gene genetically recognized as bm3 is the same as the one coding for COMT.

Quantitation of Cap Z in conventional actin preparations and methods for further purification of actin

Gel-filtration is commonly used to remove contaminants from conventional actin prepared by the method of Spudich and Watt. It has been shown that this procedure removes the majority of a factor that reduces the low-shear viscosity of actin. We have previously reported that this factor is Cap Z, a barbed end capping protein. We now establish that, even after gel-filtration, enough Cap Z can be present in conventionally prepared actin to affect events occurring at the barbed ends of actin filaments. We also demonstrate that the concentration of Cap Z can be reduced to more than a log below the KD for binding of Cap Z to actin by either 1) immunoabsorbtion of conventionally prepared actin with anti-Cap Z antibodies, or 2) an additional cycle of polymerization/depolymerization followed by repeat gel-filtration.

[Solitary ulcer of the rectum and granulomatous appendicitis, a casual association?]

We report a case of solitary rectal ulcer (SRU) in a patient who had been previously diagnosed of granulomatous appendicitis. Both entities were histologically confirmed. The patient is asymptomatic after appendectomy done one and a half years ago, demonstrating the low recurrence rate of granulomatous appendicitis and the silent course of solitary rectal ulcer in many patients. Both entities may be related.

[Treatment with prophylactic doses of ferrous sulphate as an intervention measure in the campaign++ against iron deficiency in children cared for in basic health units]

The efficacy of medical prophylaxis in the fight against iron deficiency anemia in 620 children aged from four to thirty-six months, attended in two health units of the municipality of S. Paulo, Brazil, was tested. First, the children's blood was tested for hemoglobin level and electrophoresis. Then they received daily doses of iron sulphate in the form of drops, corresponding to 12 mg/day of elementary iron, over a 30-day period. Afterwards, they were asked to return for re-evaluation. Twenty-five percent of children under 6 months presented hemoglobin levels under 11.0 g/dl. The highest occurrences of anemia were detected among children aged 9 to 11 months (49.5%) and in the age bracket between 12 and 23 months (50.4%). After the established period, only 37.4% of the children with anemia and 52.4% of children who did not present anaemia returned for further evaluation. Of the 299 evaluated, only 157 (52.5%) had taken the medication correctly. Frequency of hemoglobin inferior to 9.5 g/dl dropped from 17.1% at the beginning to 8.1% at the end of the intervention. On the other hand, the percentage of children with hemoglobin above 12.0 g/dl increased from 13.4% to 33.4%. Those children who took their iron supplements correctly registered a significantly higher drop in the number of cases of anemia than that observed in those who had not taken the supplement correctly. The great majority (80.3%) did not present any side effects of medication.(ABSTRACT TRUNCATED AT 250 WORDS)

[Anemia in children under 2 years in basic health care units in the State of São Paulo, Brazil]

The present study sought to determine the prevalence of anemia in 2,992 children, aged between 6 and 23 months, who voluntarily attended 160 Basis Health Care Units, located in 63 cities of the 5 Regional Health Coordinating areas of the State of S. Paulo, Brazil. Blood samples were collected by venous puncture and hemoglobin was measured by the cianometahemoglobin method. The WHO criteria for the diagnosis of anemia (Hb < 11.0 g/dl) were used: 59.1% of the children were shown to be anemic, with prevalence varying from 47.8% to 68.7% in the 5 RHCs. RHC 1, which comprises the Greater S. Paulo Region, presented a prevalence of anemia significantly lower than the other 4 RHCs, which cover the rest of the State. Hemoglobin levels 9.5 g/dl were found in 25.1% of the children. Anemia was more frequent in male children in male children, in those born, with a weight of less than 3,000 gr, in those who were breastfed for less than 2 months and in those that who presented some degree of energy deficient proteic malnutrition, according to Gomez's criteria. This is the first of a series of 4 articles whose purpose is the determining the prevalence of anemia in the State of S. Paulo and of testing the intervention alternatives with a view to curtailing the incidence of this pathology which today is the most prevalent nutritional disturbance in the world.

Effect of intradialytic parenteral nutrition on mortality rates in end-stage renal disease care

Several studies have now demonstrated that low serum albumin and/or low protein catabolic rates correlate with increased risk of death in the chronic hemodialysis patient. A study involving 81 patients receiving thrice-weekly hemodialysis treatments and who had either a low serum albumin and/or protein catabolic rate was conducted to compare the effect of intradialytic parenteral nutrition (IDPN) on mortality rates. Fifty patients received IDPN and 31 patients did not. Thirty-eight of the patients were black (47%), 34 were white (42%), and 9 were Hispanic (11%). The study included 33 diabetic patients (41%), 20 of whom received IDPN. Nondiabetic patients received an average of 725 kcal/hemodialysis treatment and diabetic patients received an average of 670 kcal/hemodialysis treatment. The average length of treatment was 9 months. The results of the study revealed a better survival rate (64% v 52%) for patients treated with IDPN. Using Cox analysis, the IDPN-treated group had a significantly better survival rate (P < 0.01). Serum albumin increased by 12% in the survivors. There was no difference in survival when considered separately for diabetic and nondiabetic patients who received IDPN (mortality rate for diabetics: 50% for treated patients and 54% for untreated patients; mortality rate for nondiabetics: 26% for treated patients and 44% for untreated patients). However, the nondiabetic treated patients had the lowest mortality rates. In conclusion, correction of hypoalbuminemia by IDPN significantly reduced mortality rates overall.