Developmental programming of a reduced nephron endowment: more than just a baby's birth weight

The risk of developing many adult-onset diseases, including hypertension, type 2 diabetes, and renal disease, is increased in low-birth-weight individuals. A potential underlying mechanism contributing to the onset of these diseases is the formation of a low nephron endowment during development. Evidence from the human, as well as many experimental animal models, has shown a strong association between low birth weight and a reduced nephron endowment. However, other animal models, particularly those in which the mother is exposed to elevated glucocorticoids for a short period, have shown a 20-40% reduction in nephron endowment without discernible changes in the birth weight of offspring. Such findings emphasize that a low birth weight is one, but certainly not the only, predictor of nephron endowment and suggests reduced nephron endowment and risk of developing adult-onset disease, even among normal-birth-weight individuals. Recognition of the dissociation between birth weight and nephron endowment is important for future studies aimed at elucidating the role of a reduced nephron endowment in the developmental programming of adult disease.

MTA1-mediated transcriptional repression of BRCA1 tumor suppressor gene

Metastasis-associated tumor antigen 1 (MTA1), a component of the nucleosome remodeling and deacetylating (NuRD) complex is routinely upregulated in several cancers. In the present study, we investigated the potential role of MTA1 in BRCA1 transcriptional repression and subsequent chromosomal instability. MTA1-NuRD complex was found to negatively regulate BRCA1 transcription by physically associating with an atypical estrogen-responsive element (ERE) on the BRCA1 promoter. Moreover, MTA1 and HDAC complex recruited to the ERE of BRCA1 promoter in an ER alpha-dependent manner. Accordingly, BRCA1 protein levels were enhanced by silencing of either MTA1 expression or by treatment with the specific histone deacetylase inhibitor trichostatin A. MTA1's strong repressive effects on BRCA1 expression was supported by our observation that cells stably overexpressing MTA1 showed centrosome amplification which has been long implicated as a phenotype for BRCA1 repression. Accordingly, overexpression of BRCA1 in cells stably over expressing MTA1 resulted in restoration of normal centrosome numbers. Together, these findings strongly implicate MTA1 in the transcriptional repression of BRCA1 leading to abnormal centrosome number and chromosomal instability.

Self-organized ZnSe quantum dots: synthesis and characterization

Self-organized ZnSe quantum dots (Q-ZnSe) were grown on indium tin oxide substrate using wet chemical technique without or in presence of copper and manganese dopants. The structural, morphological and luminescence properties of the as grown Q-dot films have been investigated, using X-ray diffraction, transmission electron microscopy, atomic force microscopy and optical and luminescence spectroscopy. Composition of the samples were analyzed using atomic absorption spectroscopy. The quantum dots have been shown to deposit in a compact, uniform and organized array on the indium tin oxide substrate. The size dependent blue shift in the experimentally determined absorption edge has been compared with the theoretical predictions based on the effective mass and tight binding approximations. It is shown that the experimentally determined absorption edges depart significantly from the theoretically calculated values. The photoluminescence properties of the undoped as well as doped Q-ZnSe have also been discussed.

Effects of dexamethasone exposure on rat metanephric development: in vitro and in vivo studies

Maternal administration of dexamethasone (DEX) for 48 h early in rat kidney development results in offspring with a reduced nephron endowment. However, the mechanism through which DEX inhibits nephrogenesis is unknown. In this study, we hypothesized that DEX may indirectly inhibit nephrogenesis by inhibiting ureteric branching morphogenesis. Whole metanephroi from embryonic day 14.5 (E14.5) rat embryos were cultured in the presence of DEX. DEX (10(-5) M) exposure for 2 days significantly inhibited ureteric branching compared with metanephroi grown in control media or DEX (10(-7) M). Culturing metanephroi for a further 3 days (in control media only) reduced total glomerular number in metanephroi previously exposed to DEX (10(-5) M) or (10(-7) M) compared with control cultures. Expression of genes known to regulate ureteric branching morphogenesis was determined by real-time PCR in metanephroi after 2 days in culture. DEX exposure in vitro decreased expression of glial cell line-derived neurotrophic factor (GDNF) and increased expression of bone morphogenetic protein-4 (BMP-4) and transforming growth factor-beta1 (TGF-beta1). Similar gene expression changes were found in E16.5 metanephroi in which the dam had been exposed to 2 days of DEX (0.2 mg.kg(-1).day(-1)) at E14.5/15.5 in vivo. However, in kidneys collected at E20.5 after in vivo exposure for 2 days, GDNF expression was increased and BMP-4 and TGF-beta1 expression decreased suggesting a biphasic response in gene expression to DEX exposure. These results show for the first time that inhibition of ureteric branching morphogenesis may be a key mechanism through which DEX exposure results in a reduced nephron endowment.

Prenatal corticosterone exposure results in altered AT1/AT2, nephron deficit and hypertension in the rat offspring

Maternal treatment with the synthetic glucocorticoid, dexamethasone has been reported to result in a nephron deficit and development of hypertension in the offspring of rats. However, it is not known whether elevated maternal corticosterone (CORT), the natural glucocorticoid, has similar effects on blood pressure and nephron endowment. The present study investigated the effects of CORT (0.8 mg kg(-1) day(-1)) administration on embryonic day 14 (E14) and E15 of pregnancy on: (1) nephron number at postnatal day 30 (PN30); (2) blood pressure at PN120; and (3) receptors of the renal renin-angiotensin system (RRAS) (AT(1)Ra, AT(1)Rb and AT(2)Ra) during both embryonic (E16, E20) and adolescent (PN30) life. Plasma CORT concentrations were approximately doubled 30 min after injection. Unbiased stereological analysis revealed that maternal CORT treatment resulted in a nephron deficit of 21 and 19% in male and female offspring, respectively. Mean arterial pressures were significantly elevated in offspring of both sexes from the CORT group. Real-time PCR revealed that CORT treatment increased expression of AT(1)Ra and AT(2)R at E16, and at PN30. Expression of AT(1)Rb was downregulated in embryonic life but upregulated at PN30. We believe that these results are the first to demonstrate that maternal CORT treatment results in a nephron deficit and development of hypertension in the rat offspring. Changes in the RRAS may be contributing to these phenotypes. Critically, this study suggests that increased but physiological levels of the natural glucocorticoid can programme similar changes to those seen with pharmacological doses of the synthetic glucocorticoid. This may have important implications for women experiencing significant stress during pregnancy.

Surgical treatment of the failing heart

Heart failure is one of the leading causes of hospitalization worldwide. Currently, most therapeutic strategies are aimed at resolving the acute exacerbation of failure, resulting in a high readmission rate. Despite significant advances in the medical treatment of heart failure, the results are far from perfect. Mortality remains high and hospitalization costly. Surgical management is still required for patients with end-stage heart failure. Unfortunately, its evolution has occurred in a less structured fashion. In addition to transplantation, strategies for the treatment of heart failure currently under investigation include implantation of pacemakers, left ventricular reconstruction, mitral valve repair, coronary revascularization, cardiomyoplasty and mechanical circulatory support. In the end however, the surgical management of patients with heart failure rests on the type of underlying cardiomyopathy. Hence, care must be taken to accurately diagnose these patients as either having dilated or ischemic cardiomyopathy.

Traumatic pseudoaneurysm of the internal carotid artery presenting with oculosympathetic palsy

BACKGROUND

Blunt internal carotid artery (ICA) injury is rare but undiagnosed can have disastrous clinical consequences.

AIM

To report a late presentation of blunt ICA injury in a young male following a road traffic accident.

RESULT

A 16-year-old male presented 11 days following a head injury with a unilateral Horner's syndrome. Imaging confirmed a pseudoaneurysm of the ICA. The patient was treated with anticoagulant therapy.

CONCLUSION

Diagnosis of ICA injury requires a high index of suspicion and presentation with unusual neurological signs following blunt trauma to the head and neck requires prompt investigation.

Current Diagnosis and Management of Blunt Internal Carotid Artery Injury

BACKGROUND

Blunt carotid artery injury (BCI) is a rare but potentially devastating injury. When undiagnosed it can result in severe disability or death.

METHODS

A Medline-based literature search was performed using key words 'blunt carotid injury' and cross-referenced with further original papers obtained from the references from this search.

RESULTS AND CONCLUSIONS

The incidence of BCI is very low. However, given the serious consequences of a missed injury, recent efforts have focussed on targeted screening for this injury in trauma patients. Conventional angiography remains the investigation of choice but may be superceded in the future by non-invasive methods such as magnetic resonance angiography or CT angiography. Operative intervention is rarely required and anti-coagulation remains the treatment of choice where dissection or pseudoaneurysm is diagnosed. The role of anti-platelet therapy is currently being investigated. Endovascular management using stents has been described but medium to long term results are not yet available.

Neutrophilic eccrine hidradenitis mimicking cutaneous vasculitis in a lupus patient: a complication of cyclophosphamide

Neutrophilic eccrine hidradenitis (NEH) is an unusual self-limited skin disorder characterized by an inflammatory cell infiltrate in the deep dermis involving the eccrine sweat glands, commonly presenting as painful cutaneous nodules. NEH occurs most frequently in patients receiving chemotherapy for haematologic malignancies. We report a case of NEH masquerading as cutaneous vasculitis in a woman receiving cyclophosphamide for lupus nephritis. The association of NEH and the use of cytotoxic agents for SLE or other autoimmune diseases has not been reported previously. NEH must be considered in lupus patients receiving cytotoxic agents to avoid inappropriate use of corticosteroids or antibiotics in this self-limited condition.

Defining small bowel strictures

BACKGROUND

Strictures of the intestine can be difficult to detect despite current radiological techniques.

AIM

To review our experience with a new Foley catheter technique.

METHOD

Three cases are reviewed in which a Foley catheter was used to identify a fibrous stricture.

RESULTS

A Foley catheter with an inflated 10ml balloon inserted through an enterotomy successfully identified the site of stricture in three cases of fibrous stricture obstruction.

CONCLUSION

A Foley catheter inserted through an enterotomy is a useful method of identifying fibrous strictures.

Comparative study between IMRT with NOMOS BEAK and linac-based radiosurgery in the treatment of intracranial lesions

A comparative study was undertaken to examine intracranial irradiation using intensity-modulation radiation therapy (IMRT) and linear accelerator-based radiosurgery. The IMRT was examined using the Peacock system with a BEAK attachment. A clinical case involving a metastatic brain lesion, treated with 3 radiosurgery isocenters, was planned for IMRT. The radiosurgery was planned using the Leibinger planning system. The IMRT was planned using the CORVUS planning system. The CORVUS planning system uses an inverse planning algorithm, a recent development in radiotherapy. Isodose distributions and dose volume histograms were generated and compared. Analysis of the dosimetry shows that the dose conformity and homogeneity within the target using the RTOG guidelines are superior for IMRT. The advantages of IMRT using inverse planning system include the ease of planning and execution of treatment, especially for cases that involve concave targets that require multiple isocenters using radiosurgery.

In vitro high frequency regeneration of plantlets of Vigna mungo and their ex vitro growth

Of the five explants of V. mungo var. T9 used, the excised shoot tips gave best response with regard to offshoot formation followed by the embryonal axis explants. While a treatment comprising 0.5 mgL(-1) BAP, 0.5 mgL(-1) 2iP and 0.1 mgL(-1) NAA induced differentiation of an average 10 offshoots in shoot tip explants, only 3 offshoots were formed in the explants of embryonal axis in a treatment containing 0.5 mgL(-1) BAP and 0.1 mgL(-1) NAA, found optimum for them. Multiple shoots differentiated when explants with earlier regenerated and growing offshoots were first cultured in a treatment containing 0.1 mgL(-1) BAP, 0.25 mgL(-1) IAA and 5 mgL(-1) CCC and then subcultured in the same treatment but having only 1 mgL(-1) CCC. The isolated shoots rooted in 0.5 mgL(-1) IAA resulted in the formation of complete plantlets of an average height of 15 cm in 20 days. The in vitro-regenerated plants grew normally under field conditions and came to flowering as well.

Statistical mechanics of prion diseases

We present a two-dimensional, lattice based, protein-level statistical mechanical model for prion diseases (e.g., mad cow disease) with concomitant prion protein misfolding and aggregation. Our studies lead us to the hypothesis that the observed broad incubation time distribution in epidemiological data reflect fluctuation dominated growth seeded by a few nanometer scale aggregates, while much narrower incubation time distributions for innoculated lab animals arise from statistical self-averaging. We model "species barriers" to prion infection and assess a related treatment protocol.

Designing a medical Web site

BACKGROUND

A web site is a valuable shop window for any medical unit with something to sell or something to say.

AIMS

The aim of this report is to outline the basic steps of web page design for the individual or unit with limited financial resources.

METHODS

There are two ways of designing a web site. A reputable web design company can be employed, but this is usually expensive. Alternatively, a web site can be designed in-house using commercial software, following a few simple steps. The basic requirements are a personal computer, software that is available on most computers and access to a few peripheral items of hardware. An outline of the page design should first be put down on paper. This can be transferred to a computer file using a web page design program. This file is then sent to a server for publication on the World Wide Web (WWW).

CONCLUSION

Designing and publishing a web page can take time and effort, but the rewards can be great and the results will reflect the message and motto of the unit.

Dosimetric study of the narrow beams of 60Co teletherapy unit for stereotactic radiosurgery

This study explores the possibility of using a telecobalt unit for radiosurgery. A dosimetric study was performed for the narrow beam of Cobalt 60 (60Co) unit with circular radiation fields in diameters of 11, 17, 20, 27, 32, 35, 40, and 44 mm. Percentage depth dose and off-axis ratio were measured with ion chamber and radiographic film. The tissue air ratio values derived from measurements agreed well with the calculated values for all cone sizes and depths, ranging from the depth of maximum ionization of 24 cm in water. A quantitative evaluation of treatment plans with 60Co and 6-MV photon beams was carried out. The penumbra of the narrow beam of 60Co was larger than that of the 6-MV beam by 1.3 mm on average. This difference in penumbra can be attributed to the large source size of 60Co units. The feasibility of using narrow-beam 60Co for stereotactic radiosurgery/radiotherapy is discussed.

Treatment with a consensus peptide based on amino acid sequences in autoantibodies prevents T cell activation by autoantigens and delays disease onset in murine lupus

OBJECTIVE

To test the hypothesis that an artificial peptide, based on an algorithm describing T cell stimulatory sequences from the VH regions of murine IgG antibodies to DNA, is an effective tolerogen in vivo in the (NZB/NZW)F1 (BWF1) mouse model of systemic lupus erythematosus.

METHODS

Using proliferative T cell responses to 439 Ig peptides, an algorithm was constructed that describes the amino acid sequences likely to stimulate BWF1 T cells. Stimulatory (pConsensus [pCONS]) or nonstimulatory (pNegative [pNEG]) peptides were synthesized. Groups of 10-week-old (healthy) or 20-week-old (diseased) BWF1 mice received monthly intravenous injections of 1,000 microg of peptide or saline. Ex vivo splenic T cell responses and in vivo clinical effects were measured.

RESULTS

Tolerance was induced by pCONS, but not by pNEG, with respect to ex vivo T cell proliferation and T cell help for antibodies to DNA. T cell help for IgG anti-DNA was impaired not only after T cell stimulation by pCONS but also after stimulation by some peptides from nucleosomal and Ro antigens. Treatment with pCONS significantly delayed the onset of nephritis and inhibited increases in the plasma levels of total IgG, IgG antibodies to DNA, nucleosome, cardiolipin, interferon-gamma, and interleukin-4. In contrast, antibody responses to an exogenous antigen were not impaired. Survival was significantly prolonged in both healthy and diseased mice treated with pCONS.

CONCLUSION

Induction of immune tolerance in response to treatment with pCONS in autoreactive T cell helper populations is highly effective in delaying the appearance of multiple autoantibodies, cytokine increases, and nephritis in BWF1 mice, and dramatically prolongs survival. A striking effect is the ability of the peptide to tolerize T cell help for anti-DNA that is induced by multiple, structurally unrelated self antigens.

High-energy magnon dispersion and multimagnon continuum in the two-dimensional Heisenberg antiferromagnet

We use quantum Monte Carlo simulations and numerical analytic continuation to study high-energy spin excitations in the two-dimensional S = 1/2 Heisenberg antiferromagnet at low temperature. We present results for both the transverse (x) and longitudinal (z) dynamic spin structure factors Sx,z(q,omega) at q = (pi,0) and (pi/2, pi/2). Linear spin-wave theory predicts no dispersion on the line connecting these momenta. Our calculations show that in fact the magnon energy at (pi,0) is 10% lower than at (pi/2, pi/2). We also discuss the transverse and longitudinal multimagnon continua and their relevance to neutron scattering experiments.

Strong-coupling expansions for multiparticle excitations: continuum and bound states

We present a new linked cluster expansion for calculating properties of multiparticle excitation spectra to high orders. We use it to obtain the two-particle spectra for systems of coupled spin-half dimers. We find that even for weakly coupled dimers the spectrum is very rich, consisting of many bound states. The number of bound states depends on both geometry of coupling and frustration. Many of the bound states can only be seen by going to sufficiently high orders in the perturbation theory, showing the extended character of the pair attraction.

The potential use of peptides and vaccination to treat systemic lupus erythematosus

Studies in humans and mice with systemic lupus erythematosus (SLE) suggest that the development of autoantibodies and disease is dependent on T helper (Th) cells. This review highlights recent efforts to identify the antigens that activate such autoreactive Th cells. Various laboratories are using different approaches to identify the autoantigenic epitopes, which appear to be derived from diverse sources such as nucleosome core histones, ribonucleoproteins, and immunoglobulin variable regions. Identification of the putative autoantigenic epitopes has raised the possibility of peptide-specific vaccination as therapy for SLE. Indeed, vaccination of prenephritic lupus-susceptible mice with such peptides delays the development of autoantibodies and nephritis, and prolongs survival. Recent data suggest that peptide treatment can also influence established disease in older lupus mice. These studies offer new hope for a similar treatment approach in patients with SLE. Studies have begun to identify T cell epitopes in human disease.

Exact demonstration of magnetization plateaus and first-order dimer-Neel phase transitions in a modified shastry-sutherland model for SrCu2(BO3)(2)

We study a generalized Shastry-Sutherland model for the material SrCu2(BO3)(2). Along a line in the parameter space, we show rigorously that the model has a first-order phase transition between dimerized and Neel-ordered ground states. Furthermore, when a magnetic field is applied in the dimerized phase, magnetization plateaus develop at commensurate values of the magnetization. We also discuss various aspects of the phase diagram and properties of this model away from this exactly soluble line, which include gap-closing continuous transitions between dimerized and magnetically ordered phases.