Genital Tuberculosis Presenting as Acute Scrotum Mimicking Fournier's Gangrene

Genital tuberculosis usually presents as local symptoms such as lower abdominal pain and a sensation of scrotal bloating. We report a rare case of genital tuberculosis in a 46-year-old man presenting with symptoms that mimic Fournier's gangrene. He had a progressive local symptoms of scrotal tenderness, redness, swelling, and local rise in temperature. The patient underwent emergency open debridement, and pathology confirmed tuberculosis infection. Recovery was uneventful after 6 months of anti-tuberculosis drug treatment. Literature of genital tuberculosis is also reviewed.

Dissociations of the Fluocinolone Acetonide Implant: The Multicenter Uveitis Steroid Treatment (MUST) Trial and Follow-up Study

PURPOSE

To describe fluocinolone acetonide implant dissociations in the Multicenter Uveitis Steroid Treatment (MUST) Trial.

DESIGN

Randomized clinical trial with extended follow-up.

METHODS

Review of data collected on the first implant in the eye(s) of participants. Dissociation was defined as the drug pellet no longer being affixed to the strut and categorized as spontaneous or surgically related.

RESULTS

A total of 250 eyes (146 patients) had at least 1 implant placed. Median follow-up time after implant placement was 6 years (range 0.5-9.2 years). Thirty-four dissociations were reported in 30 participants. There were 22 spontaneous events in 22 participants; 6-year cumulative risk of a spontaneous dissociation was 4.8% (95% confidence interval [CI]: 2.4%-9.1%). The earliest event occurred 4.8 years after placement. Nine of 22 eyes with data had a decline in visual acuity ≥5 letters temporally related to the dissociation. Thirty-nine implant removal surgeries were performed, 33 with replacement. Twelve dissociations were noted during implant removal surgeries in 10 participants (26%, 95% CI 15%-48%); 5 of these eyes had a decline in visual acuity ≥5 letters after surgery. The time from implant placement to removal surgery was longer for the surgeries at which dissociated implants were identified than for those without one (5.7 vs 3.7 years, P < .001). Overall, visual acuity declined 15 or more letters from pre-implant values in 22% of affected eyes; declines were frequently associated with complications of uveitis or its treatment.

CONCLUSION

There is an increasing risk of dissociation of Retisert implants during follow-up; the risk is greater with removal/exchange surgeries, but the risk of both spontaneous and surgically related events increases with longevity of the implants. In 22% of affected eyes visual acuity declined by 15 letters. In the context of eyes with moderate to severe uveitis for years, this rate is not unexpected.

Transvenous embosurgery of a left sigmoid sinus dural arteriovenous fistula via a retrograde approach from the superior ophthalmic vein, cavernous and inferior petrosal sinuses

The efficacy and safety of transvenous embosurgery for sigmoid sinus dural arteriovenous fistula (DAVF) using the internal jugular vein approach is well known. Embosurgery of cavernous sinus DAVF has also been described utilizing a superior ophthalmic vein approach. The first report of a sigmoid sinus DAVF endosurgical repair via a superior ophthalmic vein approach in a patient without internal jugular vein access is presented.

Space charge effects in field emission nanodevices

Electron field emission from a single nanoemitter is a barrier tunneling, quantum mechanical process that can, therefore, be described by the well-known Fowler-Nordheim (FN) equation. At high emission current densities, however, the space charge caused by the cathode may affect the current density-voltage (J-V) characteristics predicted by the FN theory. In this study, we theoretically investigated the effect of space charge on FE nanodevices, including diode and triode structures. The J-V characteristics of FE nanodevices were obtained by analytically (diode structures) or numerically (triode structures) solving the coupled FN equation and Poisson's equation. We discuss the behavior of FE nanodiodes and nanotriodes displaying different geometries, dimensions and work functions of their emitter materials. In the high current density region, space charge plays an important role in FE nanodevices; the threshold current density of space-charge limitation is related to the electric field distributions. Besides, our theoretical results are in good agreement with the experimental results reported previously.

Synthesis design of artificial magnetic metamaterials using a genetic algorithm

In this article, we present a genetic algorithm (GA) as one branch of artificial intelligence (AI) for the optimization-design of the artificial magnetic metamaterial whose structure is automatically generated by computer through the filling element methodology. A representative design example, metamaterials with permeability of negative unity, is investigated and the optimized structures found by the GA are presented. It is also demonstrated that our approach is effective for the synthesis of functional magnetic and electric metamaterials with optimal structures. This GA-based optimization-design technique shows great versatility and applicability in the design of functional metamaterials.

Effects of silymarin on the resolution of liver fibrosis induced by carbon tetrachloride in rats

Silymarin, a standardized extract of the milk thistle (Silybum marianum), has a long tradition as a herbal remedy, and was introduced as a hepatoprotective agent a few years ago. However, the therapeutic effects of silymarin remain undefined. Carbon tetrachloride (CCl4) is a xenobiotic used extensively to induce oxidative stress and is one of the most widely used hepatic toxins for experimental induction of liver fibrosis in the laboratory. In this study, we investigated the restoration of the CCl4-induced hepatic fibrosis by high dose of silymarin in rats. After treatment with oil (as normal group; n = 6) or CCl4 [as model (n = 7) and therapeutic (n = 7) groups] by intragastric delivery for 8 weeks for the induction of liver fibrosis, the rats in the normal and model group were administered orally normal saline four times a week for 3 weeks whilst the therapeutic group received silymarin (200 mg/kg). The histopathological changes were observed with Masson staining. The results showed that the restoration of the CCl4-induced damage of liver fibrosis in the therapeutic group was significantly increased as compared to that in the model group. Moreover, silymarin significantly decreased the elevation of aspartate aminotransferase (AST), alanine aminotransferase, and alkaline phosphatase in serum, and also reversed the altered expressions of alpha-smooth muscle actin in liver tissue. Therefore, these findings indicated that silymarin may have the potential to increase the resolution of the CCl4-induced liver fibrosis in rats.

Development of an in vitro model to assess posterior capsule safety during phacoemulsification with ultrasound or AquaLase handpieces

PURPOSE

To develop a cadaver eye model that would assess posterior capsule (PC) vulnerability when different cataract removal technologies were evaluated and use the model to evaluate the relative amplitude levels required to rupture the human PC with the AquaLase handpiece (Alcon) compared with an ultrasound (US) handpiece.

SETTING

Private practice, Cincinnati, Ohio, USA.

METHODS

In part 1 of the study, 26 phakic human cadaver eyes were sectioned in the anteroposterior meridian. The anterior portion of the globe was placed cornea side down, and the vitreous was gently cleared from the posterior surface of the lens capsule. Ultrasound was applied directly to the central capsule after achieving a vacuum of 100 mm Hg. The power was incremented until rupture was observed. In part 2 of the study, the same procedure was repeated with 50 eye pairs. For each pair, US was randomly applied to 1 eye and AquaLase to the other. The 50 pairs were divided into 3 groups based on vacuum level: 100, 300, or 500 mm Hg.

RESULTS

Part 1 results show that at 100 mm Hg, the mean power needed to break the PC with US was 19% +/- 6% (SD). There was no correlation between time from harvest to test and rupture power (R(2) = 0.04) or between donor age and rupture power (R(2) = 0.2). When the same procedure was repeated in part 2, on average, US power ruptured the capsule at a lower power than the AquaLase magnitude at each vacuum setting. The respective means were 18.5% +/- 6.7% and 61.0% +/- 23.3% for 100 mm Hg, 15.2% +/- 5.4% and 47.1% +/- 14.5% for 300 mm Hg, and 11.8% +/- 6.5% and 20.0% +/- 9.4% for 500 mm Hg. The difference between the groups and the values within each group decreased as vacuum levels increased.

CONCLUSION

This new experimental model in a cadaver eye provides a useful method for comparing factors and techniques that contribute to PC rupture.

Vogt–Koyanagi–Harada disease presenting as optic neuritis

Vogt-Koyanagi-Harada (VKH) disease is a granulomatous multisystem inflammatory disorder that classically affects the uvea, inner ear, meninges, and skin. We report three patients who presented with initial findings suggestive of bilateral optic neuritis requiring CSF analysis and brain images. None of these patients had extraocular changes. Fluorescein angiography of the retina led to the diagnosis of VKH disease in all patients. Vogt-Koyanagi-Harada disease should be included in differential diagnosis of bilateral optic neuritis, even when extraocular manifestations of the disease are absent. In such cases, fluorescein angiography will aid diagnosis.

Vogt–Koyanagi–Harada disease diagnostic criteria

Several different sets of criteria have been proposed to establish the diagnosis of Vogt-Koyanagi-Harada disease (VKH). Various investigators have used the criteria proposed by Sugiura, those proposed by by the American Uveitis Society as well as the revised diagnostic criteria proposed by the First VKH International Workshop group. These three sets of criteria share several clinical features that are considered to be essential for establishing the diagnosis of VKH, including bilateral uveitis, meningismus, and other extraocular changes. The detection of cerebrospinal fluid pleocytosis is considered to be an absolute in the criteria proposed by Sugiura but is not required for the diagnosis of VKH by the revised diagnostic criteria. We applied the latter diagnostic criteria to 28 well-documented patients with early phase VKH and to 88 patients examined during the late phase of VKH. All of these early and late phase patients fulfilled the criteria of the revised diagnostic criteria proposed by the workshop group, indicating 100% concurrence. However, none of the above proposed criteria were prospectively validated to show the positive and negative predictive value of the proposed criteria. Such a prospective study should be undertaken to address the validity of any one or all of the above sets of VKH diagnostic criteria.

Vogt–Koyanagi–Harada disease in Hispanic patients

PURPOSE

To describe the clinical features of Vogt-Koyanagi-Harada disease (VKH) in Hispanic patients.

METHODS

Retrospective review of the records of 48 Hispanic patients diagnosed with VKH. The patients were divided into two groups: patients in the early phase of VKH (n = 11) were those who presented within 1 month after the onset of symptoms; patients in the late or chronic VKH phase (n = 37) were those who presented 6 months after onset of symptoms. Demographic data, clinical features, complications and initial and final visual acuity for each patient were recorded.

RESULTS

All 11 patients in early phase VKH presented with bilateral uveitis (100%). Meningismus was noted in six cases and auditory disturbances in three. Ocular findings for these 11 patients included exudative retinal detachment in ten patients (91%) and marked optic disc edema in one patient. In the late phase VKH, ocular findings included sunset glow fundus in 26 patients (70%), peripheral nummular scars in 27 (73%), and retinal pigment epithelium hyperplasia in seven (19%). Extraocular manifestations noted in this group of patients included vitiligo in four, poliosis in six, and alopecia in five; auditory disturbances were found in four patients. The visual acuity improved in 60-70% of the patients after treatment with corticosteroids alone or in combination with immunosuppressive agents.

CONCLUSION

Hispanic patients with VKH often present without extraocular changes during early phase of the disease. However, once the disease evolves into the chronic phase, integumentary system involvement may become apparent in some patients.

Utility of lumbar puncture in diagnosis of Vogt-Koyanagi-Harada disease

PURPOSE

To determine the significance of lumbar puncture in diagnosis of Vogt-Koyanagi-Harada disease (VKH).

METHOD

A retrospective analysis was conducted on 116 consecutive patients diagnosed with VKH. Two additional patients who presented with acute VKH were included in the analysis. Demographic characteristics, including gender, age, and ethnicity, were extracted from the medical record. The stage of disease at presentation was documented. Pertinent laboratory results and diagnostic procedures such as lumbar puncture, fluorescein angiography, and echography that contributed to the diagnosis of VKH were collected.

RESULTS

Lumbar puncture results for 10 patients were available. Eight of these patients presented with pleocytosis consistent with a diagnosis of VKH. Clinical features and fluorescein angiography confirmed the diagnosis in these patients. Both of the patients who did not exhibit cerebrospinal fluid (CSF) pleocytosis presented with headache, vision loss, and bilateral uveitis. Fluorescein angiography disclosed multiple foci of leakage at the retinal pigment epithelium level with accumulation of dye under the retina and disc leakage, confirming diagnosis of VKH.

CONCLUSION

The utility of lumbar puncture as a diagnostic criterion for VKH should be re-evaluated given that clinical features and fluorescein angiography alone often support the diagnosis. The inherent risks and complications associated with the procedure must prompt the clinician to reserve this evaluation for atypical presentations.

Incidence and prevalence of glaucoma in severe ocular surface disease

PURPOSE

To describe the incidence and prevalence of glaucoma in a patient population with severe ocular surface disease (OSD).

METHODS

A retrospective case series was compiled from all charts of patients in the Cincinnati Eye Institute/University of Cincinnati and University of Minnesota population with a diagnosis of severe OSD from 1991 to 2003. The incidence and prevalence of glaucoma in the overall patient population were identified, and stratified into disease subgroups.

RESULTS

Of the 108 eyes evaluated in this study, 71 were diagnosed with glaucoma. The overall prevalence of glaucoma in patients with severe OSD is 65.7%, with a range from 42.9% to 88.4%. Analysis by subgroup shows the highest percentage of patients with concurrent glaucoma fall into the categories of aniridia and chemical injury, and the lowest was noted in those patients with autoimmune or iatrogenic OSD. Overall, the incidence of glaucoma was 20.4%, with a range of 13.6% to 60%.

CONCLUSIONS

Compared with previous studies, our results show a significantly higher prevalence of glaucoma in patients with severe OSD. This information warrants increased attention to treatment and management of OSD and concurrent glaucoma.

Color perception with AcrySof Natural and AcrySof single-piece intraocular lenses under photopic and mesopic conditions

PURPOSE

To examine color perception in patients receiving bilateral implantation of an ultraviolet (UV) and blue-light filtering intraocular lens (IOL) (AcrySof Natural SN60AT, Alcon Laboratories Inc.) or a UV-only filtering IOL (AcrySof SA60AT) and to compare the results with those in a phakic group.

SETTING

Cincinnati, Ohio, USA.

METHODS

In this prospective study, age-matched subjects who passed the Ishihara test and had visual acuities of 20/25 or better were recruited. There were 2 pseudophakic groups (bilateral SN60AT or SA60AT IOLs) and 1 phakic group. The Farnsworth-Munsell (FM) 100-hue test was administered to each subject twice under different conditions. The phakic and AcrySof Natural SN60AT groups were tested under photopic and mesopic conditions. The SA60AT subjects were further divided into subgroups (with and without yellow clip-on lenses) and tested under photopic and mesopic conditions.

RESULTS

A 1-way analysis of variance (ANOVA) of the square-root-transformed total error score showed no statistical differences (P = .637) between the treatment groups. Similarly, a 1-way ANOVA of the red-green error score (P = .729) and blue-yellow error score (P = .484) indicated no statistically significant differences between the treatment groups. The ANOVA results of the FM 100-hue test under mesopic conditions showed that the total error score in the AcrySof Natural IOL group was significantly lower (P = .046) than in the phakic group. There were no between-group differences in error scores under mesopic conditions.

CONCLUSION

The FM 100-hue testing showed no difference in color perception between subjects with AcrySof Natural IOLs and those in an age-matched phakic control group or in those with a UV-only filtering AcrySof IOL with or without yellow clip-on lenses.

A progressive anterior fibrosis syndrome in patients with postsurgical congenital aniridia

PURPOSE

To report the characteristics of a newly recognized clinical entity in congenital aniridia that we have termed aniridic fibrosis syndrome.

DESIGN

Interventional case series.

METHODS

Retrospective chart review of 155 eyes in 80 patients with congenital aniridia was carried out to identify and characterize eyes that had anterior chamber fibrosis. Histopathologic evaluation was performed in three eyes.

RESULTS

Seven eyes in six patients were identified to have aniridic fibrosis syndrome. All eyes had undergone previous intraocular anterior segment surgery, some eyes with multiple procedures. Seven eyes had undergone cataract surgery with posterior chamber intraocular lens; six eyes had undergone previous implantation of tube shunt devices, and four eyes had undergone previous penetrating keratoplasty. Clinically, the syndrome was characterized by a progressive retrolenticular and retrocorneal membrane that caused forward displacement of intraocular lenses. Surgical findings indicated that the fibrotic membrane also can involve the ciliary body and anterior retina. Histopathologic evidence from three eyes indicated that the extensive fibrotic tissue originated from the root of the rudimentary iris and entrapped the intraocular lens haptics. Endothelial decompensation that was subsequent to the formation of the aniridic fibrosis syndrome was seen in all eyes.

CONCLUSION

Aniridic fibrosis syndrome is characterized by the development of a progressive anterior chamber fibrosis. A possible mechanism that promotes the formation of this fibrotic material may be the proximity or touching of intraocular devices on immature vessels in the rudimentary iris found in aniridia. Patients with aniridia with a history of penetrating keratoplasty, intraocular lenses, and tube shunts should be monitored for aniridic fibrosis syndrome; early surgical intervention is recommended.

Anterior uveitis and iris nodules that are associated with Langerhans cell histiocytosis

PURPOSE

To describe a case of Langerhans cell histiocytosis (LCH) that involved the anterior uveal tract.

DESIGN

Interventional case report.

METHODS

A retrospective review was conducted on a patient with iris nodules and anterior uveitis in the setting of LCH. Visual acuity and clinical findings that were noted on slit lamp biomicroscopy were extracted.

RESULTS

An 18-year-old male patient with unilateral anterior segment inflammation and iris nodules experienced visual improvement from 20/200 to 20/25 after treatment with a 5-day course of topical corticosteroids. Regression of the iris nodules and anterior segment inflammation was also noted. Bone marrow aspirate confirmed recurrent, active LCH.

CONCLUSION

The clinician should include LCH in the differential diagnosis when faced with anterior segment inflammation in conjunction with iris nodules. Additionally, LCH can be treated successfully with topical corticosteroid therapy.

Development, survival and reproduction of black citrus aphid, Toxoptera aurantii (Hemiptera: Aphididae), as a function of temperature

The development, survival, and reproduction of the black citrus aphid Toxoptera aurantii (Boyer de Fonscolombe) were evaluated at ten constant temperatures (4, 7, 10, 15, 20, 25, 28, 30, 32 and 35 degrees C). Development was limited at 4 and 35 degrees C. Between 7 and 32 degrees C, developmental periods of immature stages varied from 44.2 days at 7 degrees C to 5.3 days at 28 degrees C. Overall immature development required 129.9 degree-days above 3.8 degrees C. The upper temperature thresholds of 32.3, 28.6, 29.3, 27.2, and 28.6 degrees C were determined from a non-linear biophysical model for the development of instars 1-4 and overall immature stages, respectively. Immature survivorship varied from 82.1 to 97.7% within the temperature range of 10-30 degrees C. However, immature survivorship was reduced to 26.3% at 7 degrees C and 33.1% at 32 degrees C. Mean adult longevity was the longest (44.2 days) at 15 degrees C and the shortest (6.2 days) at 32 degrees C. The predicted upper temperature limit for adult survivorship was at 32.3 degrees C. Total nymph production increased from 16.3 nymphs per female at 10 degrees C to 58.7 nymphs per female at 20 degrees C, declining to 6.1 nymphs per female at 32 degrees C. The estimation of lower and upper temperature limits for reproduction was at 8.2 and 32.5 degrees C, respectively. The population reared at 28 degrees C had the highest intrinsic rate of increase (0.394), the shortest population doubling time (1.8 days), and shortest mean generation time (9.5 days) compared with the populations reared at six other temperatures. The population reared at 20 degrees C had the highest net reproductive rate (54.6). The theoretical lower and upper temperature limits for population development, survival and reproduction were estimated at 9.4 and 30.4 degrees C, respectively. The biology of T. aurantii was also compared with three other citrus aphid species.

A critical role for Dnmt1 and DNA methylation in T cell development, function, and survival

The role of DNA methylation and of the maintenance DNA methyltransferase Dnmt1 in the epigenetic regulation of developmental stage- and cell lineage-specific gene expression in vivo is uncertain. This is addressed here through the generation of mice in which Dnmt1 was inactivated by Cre/loxP-mediated deletion at sequential stages of T cell development. Deletion of Dnmt1 in early double-negative thymocytes led to impaired survival of TCRalphabeta(+) cells and the generation of atypical CD8(+)TCRgammadelta(+) cells. Deletion of Dnmt1 in double-positive thymocytes impaired activation-induced proliferation but differentially enhanced cytokine mRNA expression by naive peripheral T cells. We conclude that Dnmt1 and DNA methylation are required for the proper expression of certain genes that define fate and determine function in T cells.

Toxic effects of six plant oils alone and in combination with controlled atmosphere on Liposcelis bostrychophila (Psocoptera: Liposcelididae)

Six plant essential oils alone as repellent and fumigant, and in combination with the controlled atmosphere against Liposcelis bostrychophila Badonnel were assessed in the laboratory. These essential oils were extracted from the leaves of six source plants: Citrus tangerina Tanaka, Citrus aurantium L., Citrus bergamia Risso et Poiteau, Pinus sylvestris L., Cupressus funebris End]., and Eucalyptus citriodora Hook. The repellency test indicated that L. bostrychophila adults were repelled by filter paper strips treated with six essential oils. Of these essential oils, the C. funebris oil was most effective followed by that of F. sylvestris, C. tangerina, C. bergamia, and E. citriodora. The average repellency of the C. aurantium oil against L. bostrychophila adults was significantly lower than other five test oils by day 14. These essential oils had a high level of toxicity in the fumigation assay against L. bostrychophila adults at both 10 and 20 ppm. When combined with two controlled atmosphere treatments (12% CO2 + 9% O2, and 10% CO2 + 5% O2, balanced N2), the toxicity of plant oils was enhanced significantly.

A triply templated artificial beta-sheet

This paper describes the design, synthesis, and structural evaluation of a compound (4) comprising three molecular templates and a peptide strand that mimics a three-stranded protein beta-sheet. Two of the templates mimic the hydrogen-bonding functionality of peptide beta-strands and serve as the top and bottom strands by embracing the peptide strand, which is located in the middle of the sheet. The remaining template holds the three strands next to each other. The synthesis of artificial beta-sheet 4 begins with the bottom template and involves the sequential addition of the middle and top strands. (1)H NMR chemical shift and NOE studies establish that this compound folds to adopt a hydrogen-bonded beta-sheetlike structure in CDCl(3) solution. Chemical shift studies indicate that triply stranded artificial beta-sheet 4 is more tightly folded than its smaller doubly stranded homologue, artificial beta-sheet 1.

Sex differences in relation to serum hepatitis B e antigen and alanine aminotransferase levels among asymptomatic hepatitis B surface antigen carriers

This study aimed to investigate sex differences in relation to hepatitis B e antigen (HBeAg) and serum alanine aminotransferase (ALT) levels in chronic asymptomatic hepatitis B virus (HBV) infection. HBeAg and ALT level were determined in 636 asymptomatic hepatitis B surface antigen carriers. There was no significant sex differences in the age-adjusted prevalence of HBeAg. Abnormal ALT level (>45 IU/l) was more frequent in carriers with HBeAg (17.5% vs 7.6%; P = 0.001). Multivariate analysis indicated that male sex (odds ratio, 2.0; 95% confidence interval, 1.1-3.6) and HBeAg (odds ratio, 2.6; 95% confidence interval, 1.6-4.3) were independent risk factors for abnormal ALT levels. Male sex and HBeAg-positivity are independent risk factors for abnormal ALT activity in chronic HBV infection. This observation may be related to sex differences in chronic HBV infection.

Significantly increased cortisol secretion in normal adrenocortical cells transfected with K-ras mutants derived from human functional adrenocortical tumors

Our previous study showed that the mutation hotspots of the K-ras proto-oncogene in human functional adrenocortical tumors are in codons 15, 16, 18, and 31, thus differing from the sites in other tumors. In addition, analyzing the K-Ras protein by a recombinant DNA technique showed that the activity of endogenic GTPase and the GTPase-activating protein (GAP)-binding ability were significantly decreased in patients with these tumors. The aim of this study was to understand whether those K-ras mutants, which were found only in human adrenocortical tumors, play an important role in these tumors. Thus, the mutant K-ras cDNA was constructed with mammalian expression vectors and transfected into normal adrenocortical cells. The amount of cortisol secreted by the transfected cells was 20 to 30 times that of normal cells. Furthermore, Northern blot analysis revealed that the expression of the three steroidogenesis-related genes P450(scc) (cholesterol side-chain cleavage enzyme), P450(C17) (17alpha-hydroxylase/17, 20-lyase), and P450(C21) (steroid 21-hydroxylase) gene increased in the transfected cells. The K-ras oncogene significantly increases cortisol secretion by normal adrenocortical cells.

Insulin and heparin suppress superoxide production in diabetic rat glomeruli stimulated with low-density lipoprotein

Patients with diabetic nephropathy frequently show increased levels of circulating low-density lipoprotein (LDL) and oxidized LDL, which have been reported to be related to the generation of oxygen-free radicals. In the present study, we evaluated the effects of insulin and heparin on the superoxide production of glomeruli, which were isolated from rats with streptozotocin-induced diabetes for one week, one month, and three months, respectively, and the glomeruli were stimulated with native and oxidized LDL. LDL was isolated from normal subjects with normolipidemia, and the superoxide was measured by using a spectrophotometer. The results demonstrated that the poorly controlled diabetic rat glomeruli showed a significantly higher production of superoxide than normal glomeruli under basal status and after stimulation, and this production increased further with the progression of diabetes. Insulin suppressed both the basal and stimulated production of superoxide in diabetic glomeruli, but not in normal glomeruli. Heparin suppressed superoxide production of diabetic glomeruli stimulated by either native or oxidized LDL, and it also partly suppressed superoxide production of normal glomeruli stimulated by oxidized LDL. Our results suggest that glomerular injury in diabetics with hyperlipidemia may be mediated through enhanced generation of oxygen-free radicals, which can be partially attenuated by insulin and heparin.

Significance of salivary epidermal growth factor in peptic ulcer disease in hemodialysis patients

BACKGROUND/AIMS

Hemodialysis (HD) patients are prone to developing peptic ulcers. However, of all the risk factors associated with peptic ulcers, none have been shown to be more prevalent in HD patients than in the general population. However, salivary epidermal growth factor (EGF) may play a role in peptic ulcer diseases.

METHODS

Salivary EGF levels and bioactivities were assayed in 47 maintenance HD patients and 30 normal controls, and the molecular weights of EGF were assessed using high-performance liquid chromatography (HPLC).

RESULTS

Salivary EGF levels were not different between both groups of subjects (4.2 +/- 0.34 vs. 5 +/- 0.54 ng/mg protein, NS), and HPLC revealed that salivary EGF in both groups had similar molecular weights. However, salivary EGF bioactivity was significantly depressed in the HD patients as compared to the normal controls (0.59 +/- 0.08 vs. 1.55 +/- 0.15 ng/mg protein, p < 0.01). Stepwise multiple regression showed that the low salivary EGF levels were associated with female gender (p < 0.05), while low salivary EGF bioactivity was associated with HD per se (p < 0.05). In the 22 HD patients who underwent gastric endoscopy, salivary EGF bioactivity was significantly lower in those with peptic ulcers than in those without (0.38 +/- 0.08 vs. 0.69 +/- 0.08 ng/mg protein, p < 0.05).

CONCLUSION

Decreased salivary EGF bioactivity may contribute to peptic ulcer disease among maintenance HD patients.

Tunnel study of on-road vehicle emissions and the photochemical potential in Taiwan

Motor vehicle emission factors of carbon monoxide (CO) and non-methane volatile organic compounds (NMVOCs) were calculated inside the Chung-Cheng Tunnel of Kaohsiung in Taiwan. The results were compared with those model predictions from the Mobile Taiwan 2.0 model. Individual concentrations of 21 species of NMVOCs were also determined. Photochemical potential of NMVOCs was evaluated by using the maximum incremental reactivity (MIR). Field data showed that the integrated emission factors of CO and NMVOCs for actual fleet were 6.3 and 1.5 g/veh km, respectively. The error range of these factors may be up to 45%. The predicted values by the Mobile Taiwan 2.0 model closely matched the observed data. Concentrations of isopentane, 2-methylpentane, toluene and m,p-xylene were the dominant species of NMVOCs. The ratio of maximum incremental reactivity to NMVOCs concentration was 3.9, similar to those of the studies in the US Fort McHenry and Tuscarora Tunnel.

Alteration in the expression of protein kinase C isoforms in human hepatocellular carcinoma

This study was designed to investigate the alterations of individual protein kinase C (PKC) isoforms in human liver cancer. Surgical specimens of hepatocellular carcinoma and adjacent normal tissues were extracted into cytosolic and membranous fractions. The level of membrane-bound PKCalpha in the cancer tissue was significantly lower than that in the adjacent normal tissue and consistent with the change in PKC activity. In addition, there was a significant negative correlation between PKCalpha and tumor size. In both cytosolic and membrane fractions, levels of PKCdelta and PKCzeta was significantly higher in the cancer tissue than those in the adjacent normal liver tissue. The alterations in the PKC isoforms signify their roles in the hyperproliferation in liver cancer.

Biology of Diaphorina citri (Homoptera: Psyllidae) on four host plants

The biology of the citrus psyllid Diaphorina citri Kuwayama was studied at 25 degrees C on four commonly grown citrus and related plants [rough lemon, Citrus jambhiri Lush; sour orange, C aurantium L.; grapefruit, C. paradisi Macfadyen; and orange jessamine, Murraya paniculata (L.) Jack] in the laboratory. The biological characteristics of each life stage are described. The average egg incubation periods on orange jessamine, grapefruit, rough lemon, and sour orange varied very little (4.1-4.2 d). The average nymphal developmental periods on these four host plants were essentially the same except the fifth stadium. Survival of immatures on orange jessamine, grapefruit, rough lemon, and sour orange was 75.4, 84.6, 78.3, and 68.6%, respectively. Female adults lived an average of 39.7, 39.7, 47.6, and 43.7 d on these respective host plants. The average number of eggs laid per female on grapefruit (858 eggs) was significantly more than those on other hosts (P < 0.05). The intrinsic rate of natural increase (r(m)) for D. citri on grapefruit was highest. Jackknife estimates of r(m) varied from 0.188 on grapefruit to 0.162 on orange jessamine and rough lemon. The mean population generation time on these hosts ranged from 31.6 to 34.1 d. The continuous flushes produced by orange jessamine could play an important role in maintaining high populations of this vector when the new flushes are not available in the commercial citrus groves.

Thyroid metastasis from intraductal papillary-mucinous carcinoma of the pancreas. A case report

BACKGROUND

Intraductal papillary-mucinous carcinoma (IPMC) of the pancreas is a newly identified clinicopathologic entity of the exocrine pancreas. It has been considered a slowly growing and less-aggressive carcinoma with a favorable prognosis. There have been only a few documents reporting its distant metastasis and cytologic features, with no report of thyroid metastasis until the present.

CASE

A case of IPMC occurred in a 45-year-old male, who was admitted with rapid growth and tenderness of the thyroid. Abdominal computed tomography showed the typical cystic dilatation of IPMC with adjacent organ metastasis. Fine needle aspiration of the thyroid yielded papillary fronds of carcinoma cells with nuclear pleomorphism, abundant cytoplasm and prominent nucleoli in a mucinous background. Immunohistochemical findings from the skin and thyroid characterized the papillary-mucinous carcinoma as having originated in the pancreas.

CONCLUSION

This case suggests that papillary carcinoma fronds aspirated from the thyroid should be further differentiated from the primary site and that a pleomorphic nucleus in a mucinous background is a useful feature to exclude a thyroid origin. Before this, distant metastasis of IPMC to the skin and thyroid has not been reported. The prognosis of IPMC with wide, distant metastasis at an advanced stage is poor.

Diffusion of hydrogen sulfide and methyl mercaptan onto microporous alkaline activated carbon

Activated carbon kinetic studies show that both H2S and CH3SH yielded pore diffusion coefficients from 10(-6) to 10(-8) cm2/s. Results indicated that pore structures could influence effective diffusivity. Under the same adsorbate concentration, CH3SH exhibited a greater effective pore diffusion coefficient than H2S. This may be attributed to the fact that CH3SH has both polar (-SH) and non-polar (-CH3) functional groups and dissolves into water easier, thus providing more attraction for the activated carbon surface. In addition, the saturation vapor pressure of CH3SH is lower than that of H2S. Therefore, CH3SH is easier to adsorb onto activated carbon than H2S.

Increased frequency of angiotensin-converting enzyme DD genotype in patients with type 2 diabetes in Taiwan

BACKGROUND

Diabetes is one of the major causes of end-stage renal failure in the Taiwanese population. Previous studies have shown that angiotensin-converting enzyme (ACE) inhibitor can improve glucose utilization and suppress hepatic glucose production and the renin-angiotensin system may play an important role in the initiation and progression of diabetic nephropathy. Thus, ACE gene polymorphism may be associated with type 2 diabetes and diabetic nephropathy.

METHODS

To investigate the distribution of ACE-I/D genotype in type 2 diabetes and diabetic nephropathy, we examined 336 patients with type 2 diabetes (157 without nephropathy and 179 with nephropathy) and 263 age-matched normal controls. The diagnosis of nephropathy was made when daily protein loss exceeded 500 mg. ACE gene polymorphism was analysed by use of polymerase chain reaction.

RESULTS

Our study revealed that the frequency of the D allele of the ACE gene was 29.3% in normal controls. The frequency of ACE DD genotype was significantly higher in type 2 diabetics compared with normal controls (18.2 vs 9.1%, P<0.01). The frequency of ACE DD genotype in patients with diabetic nephropathy was significantly higher than in patients without nephropathy (22.3 vs 13.4%, P<0.05). To determine whether ACE gene polymorphism was associated with the severity of diabetic nephropathy, we divided patients with diabetic nephropathy into dialysis and non-dialysis groups. The frequency of ACE DD genotype in the dialysis group was significantly higher than in non-dialysis group (28.7 vs 15.3%, P<0.05).

CONCLUSION

Our results indicate that the frequency of ACE DD genotype is markedly higher in patients with type 2 diabetes, and the ACE DD genotype is significantly associated with diabetic nephropathy.

Resistance and some enzyme activities in Liposcelis bostrychophila Badonnel (Psocoptera: Liposcelididae) in relation to carbon dioxide enriched atmospheres

Two populations (S-1 and S-2) of the psocid, Liposcelis bostrychophila Badonnel were exposed to carbon dioxide enriched atmospheres. Carbon dioxide resistance developed at steady rates in these two populations during this study period. Selection with 35 and 55% CO(2) resulted in resistance development as expressed by LT(50). Resistance increased steadily under continuous selection to 4.6- and 5.3-fold by generation F(30) for S-1 and S-2, respectively. Throughout the selection process, the slopes of regression lines were always lower than that of the control. The results of biochemical assays showed that the activities of carboxyl esterase (CarE) and superoxide dismutase (SOD) in vitro increased in the selection process. Exposure to higher CO(2) content (HCC) resulted in a gradual decrease in CarE activity in both selected and control populations. Although the induction effect of CO(2) on SOD was brief, the induction times for the S-1 and S-2 were greater than those of the control. The elevated catalase (CAT) activity in association with resistance development was also evident, but no statistical correlation was found between CAT activity and HCC resistance. No significant differences were found in acid phosphatase and alkaline phosphatase activities in both selected and control populations during this study. This study demonstrated that high CarE and SOD activities were positively correlated to CO(2) resistance.

Increased renal medullary endothelin-1 synthesis in prehypertensive DOCA- and salt-treated rats

To investigate the role of renal endothelin-1 (ET-1) synthesis in water-sodium homeostasis, we measured mRNA expressions, protein levels, enzyme activity, and receptor binding of the renal ET-1 system in a DOCA- and salt-treated rat model. Male Wistar rats were divided into control and DOCA- and salt-treated (DOCA-Salt) groups. The DOCA-Salt group received 25 mg/kg body wt DOCA and was maintained on 1% NaCl drinking water. Rats were killed on days 1, 2, 4, and 10 of the experiment. Urinary ET-1-like immunoreactivity significantly increased from the second day in the DOCA-Salt group and correlated well with the urinary sodium excretion rate (r = 0.81, P < 0.001). Renal endothelin-converting enzyme (ECE) activity, ET-1, and ECE-1 mRNA expressions were significantly increased in the renal medullary area of DOCA-Salt rats. In situ hybridization and immunohistochemical studies showed that the increase in ET-1 synthesis was mainly localized in the inner medullary collecting ducts. The maximum binding of endothelin B receptor also increased from the second day in the renal medulla of the DOCA-Salt group. Our results suggest that renal medullary synthesized ET-1 may be a natriuretic factor and may participate in the intrarenal regulation of water and salt homeostasis in prehypertensive DOCA-and salt-treated rats.

Native and oxidized low-density lipoproteins enhance superoxide production from diabetic rat glomeruli

Oxygen free radicals have been implicated in mediating diabetic complications, and patients with diabetic nephropathy frequently show increased levels of circulating and oxidized low-density lipoproteins (LDL). In the present study, we measured the superoxide production of glomeruli isolated from poorly controlled diabetic (streptozotocin) rats sacrificed 1 week and 1, and 3 months after the induction of diabetes. The animals were stimulated with native and oxidized LDL isolated from normal humans with normolipidemia. The superoxide ion was measured by using a spectrophotometer. The results demonstrated that the poorly controlled diabetic rat glomeruli showed a significantly higher production of superoxide than normal glomeruli under basal conditions, and this production increased further with the progression of diabetes. Stimulation with either LDL or oxidized LDL enhanced superoxide production by diabetic glomeruli, with oxidized LDL being more potent than LDL. Our results suggest that oxidized LDL may play important roles in the pathogenesis of diabetic nephropathy through enhanced generation of oxygen free radicals.

Neuronal and endothelial nitric oxide synthase expression in outer medulla of streptozotocin-induced diabetic rat kidney

AIMS/HYPOTHESIS

Several investigations have shown that the renal medulla has a greater capacity to generate nitric oxide than the renal cortex. To further evaluate the changes of nitric oxide synthesis in the kidney, particularly in the outer medulla, in disorders involving fluid and electrolyte imbalances, we sought to determine renal nitric oxide synthase expression in the diabetic rats.

METHODS

We determined renal nitric oxide synthase mRNA and urinary nitrite/nitrate excretion in 12 normal and 12 streptozotocin-induced diabetic rats by reverse transcription-polymerase chain reaction with Southern blot hybridization and with Griess reaction, respectively. Nitric oxide synthase immunoreactivity was detected by immunohistochemistry in four normal and four diabetic rats.

RESULTS

Neuronal and endothelial nitric oxide synthase mRNA were 3.5-fold and 1.8-fold increased in the outer medulla of 12 diabetic rats with no difference found in the cortex and inner medulla when compared with 12 normal rats. Urinary nitrite/nitrate excretion was significantly increased from the first week after diabetic induction. In normal rats, immunohistochemical studies showed positive neuronal and endothelial nitric oxide synthase immunostaining in almost all segments of renal tubules. Diabetic rats had the greatest enhancement of immunostaining for neuronal and endothelial nitric oxide synthase in the proximal straight tubule and medullary thick ascending limb.

CONCLUSION/INTERPRETATION

Our results indicate that increases in neuronal and endothelial nitric oxide synthase synthesis in the kidney, particularly in the outer medulla, possibly play an important part in the adaptation of renal function to hyperglycaemia and hyperosmolality in diabetes.

Reactive oxygen species enhances endothelin-1 production of diabetic rat glomeruli in vitro and in vivo

Both reactive oxygen species (ROS) and endothelin-1 (ET- 1) have been implicated in the pathophysiology of diabetic nephropathy. The interrelationship between them, however, has not been documented in this disease. To determine whether ROS regulates ET-1 production in diabetic kidneys, we examined the in vitro and in vivo effects of ROS donors and scavengers on ET-1 production of diabetic rat glomeruli. For in vitro study, the glomeruli were isolated with a sieving method from streptozotocin-induced diabetic rats and killed at 1 week, 1 month, and 3 months, respectively. Superoxide was measured by a spectrophotometer, and ET-1 was measured by radioimmunoassay. The results demonstrated that the basal production levels of superoxide and ET-1 were higher in diabetic glomeruli than in normal glomeruli in vitro. There was a positive correlation between the production of superoxide and ET-1 in diabetic glomeruli. The basal ET-1 production was markedly attenuated by ROS scavengers including superoxide dismutase, catalase, dimethyl sulfoxide, and deferoxamine in diabetic glomeruli. Exogenous ROS generated by xanthine/xanthine oxidase significantly enhanced ET-1 generation by both diabetic and normal glomeruli. A high glucose concentration (500 mg/dL) in vitro increased ET-1 production by normal glomeruli but not diabetic glomeruli, and insulin partly suppressed ET- 1 production by diabetic glomeruli. The in vivo study demonstrated that when diabetic rats were injected daily with superoxide dismutase or catalase after diabetes was induced, the basal production of ET-1 was markedly attenuated after 1 week and 1 month, respectively. These results indicate that exogenously or endogenously derived ROS can enhance ET-1 production by diabetic rat glomeruli and that ROS scavengers suppress ET- 1 production both in vitro and in vivo. The effects of ROS on ET-1 production of diabetic glomeruli may be partly caused by the effect of hyperglycemia or insulin deficiency.

Decreased GTPase activity of K-ras mutants deriving from human functional adrenocortical tumours

Our previous studies have shown that seven out of 15 patients with adrenocortical tumours contained K-ras gene mutation. In addition, the mutation type was a multiple-site mutation, and the hot spots were located at codons 15, 16, 18 and 31, which were different from those reported before (codons 12, 13 and 61). To understand whether the mutation hot spots in human adrenocortical tumours were associated with activation of K-Ras oncogene and the alterations of its biocharacteristics, mutant K-Ras genes were cloned from tumour tissues and then constructed with expression vector pBKCMV. Mutant K-Ras genes were expressed at high levels in Escherichia coli and the resultant K-Ras proteins were shown to be functional with respect to their well-known specific, high-affinity, GDP/GTP binding. The purified K-Ras protein from E. coli were then measured for their intrinsic GTPase activity and the GTPase activity in the presence of GTPase-activating protein for Ras. The results showed that the wild-type cellular K-Ras protein (p21BN) exhibits about ten times higher intrinsic GTPase activity than the activated protein (p21BM3) encoded by mutant K-Ras gene, which mutated at codon 60. With regards to the codon 15, 16, 18 and 31 mutant K-Ras proteins (p21BM2), the GTPase activity in the presence of GAP is much lower than that of the normal K-Ras protein, whereas the intrinsic GTPase activity is nearly the same as that of the normal K-Ras protein. These results indicated that mutations at these hot spots of K-Ras gene were indeed activated K-Ras oncogene in adrenocortical tumours; however, their association with tumors needs further experiments to prove.

Meaning of filial piety in the Chinese parent-child relationship: implications for culturally competent health care

To work with Chinese/Chinese-American clients more effectively, health care providers must know how to work with them within their value system of filial piety. This paper focuses on Chinese parent-child relationships with respect to this value system from the perspective of young adult Chinese immigrants in the United States. Using an ethnographic approach, in-depth interviews were conducted with six immigrants from Taiwan. Domain analysis and content analysis revealed ten domains, five of which are reported in this paper. The findings suggest that filial piety continues to operate in Chinese immigrant families. Implications for cross-cultural health care and research are addressed.

Fatal outcome after ingestion of star fruit (Averrhoa carambola) in uremic patients

Clinical outcome of dialysis patients after eating star fruit (Averrhoa carambola) varies, but it may be fatal. In the past 10 years, 20 such patients were treated in our hospital when they developed clinical symptoms after eating the fruit or drinking star fruit juice. Their initial presentations included sudden-onset limb numbness, muscle weakness, intractable hiccups, consciousness disturbance of various degrees, and seizure. No other major events that might be responsible for these symptoms could be identified. Eight patients died, including one patient with a serum creatinine level of 6.4 mg/dL who had not yet begun dialysis. The clinical manifestations of the survivors were similar to those who died except for consciousness disturbance and seizure. Death occurred within 5 days despite emergent hemodialysis and intensive medical care. The survivors' symptoms usually became less severe after supportive treatment, and these patients subsequently recovered without obvious sequelae. The purpose of this article is to report that patients with renal failure who ingest star fruit may develop neurological symptoms and also run the risk for death in severe cases. Mortality may also occur in patients with chronic renal failure not yet undergoing dialysis.

Pyrolysis kinetics and residue characteristics of petrochemical industrial sludge

This study investigated the pyrolysis characteristics of sludge from wastewater treatment plants in the petrochemical industry and focused on the pyrolysis kinetics, elemental composition of residue, and volatile organic compounds (VOCs) of exhaust gas. As pyrolysis temperature increased to 773 K, the increasing rate of crude oil production tended to a stable condition. The result indicated that the optimal temperature of crude oil and water mixed production was 773 K. When pyrolysis temperature increased from 673 to 973 K, carbon, oxygen, nitrogen, and hydrogen concentrations of residue decreased and the sulfur concentration of residue increased. The concentrations of benzene, toluene,ethylbenzene, and styrene increased by the increasing pyrolysis temperature. We found that the reaction order of sludge pyrolysis was 2.5 and the activation energy of the reaction was 11.06 kJ/mol. We believe that our pyrolysis system is transitional between devolatilization and combustion.

Up-regulation of adrenal cortical and medullary atrial natriuretic peptide and gene expression in rats with deoxycorticosterone acetate-salt treatment

Our previous study demonstrated that human adrenal medulla is a site of atrial natriuretic peptide (ANP) synthesis. To further evaluate the role of adrenal ANP in body fluid homeostasis, we investigated the changes in adrenal ANP in rats receiving deoxycorticosterone acetate (DOCA)-salt treatment. In situ hybridization and immunohistochemical study showed that adrenal ANP messenger RNA (mRNA) and ANP-like immunoreactivities (ANP-LI) were mainly localized in the zona glomerulosa and medulla of vehicle-treated rats. DOCA-salt treatment activated ANP mRNA and peptide expression in all adrenal zones, especially in the zona fasciculata/reticularis from 12 h to the entire 8-day study period. Using a semiquantitative RT-PCR technique, the relative quantities of ANP mRNA in the adrenals of the DOCA-salt-treated group were significantly increased from 1 to 8 days, whereas the adrenal weights of DOCA-salt-treated rats were significantly decreased from day 2 to day 8. Our results are the first to indicate that ANP is synthesized not only in the adrenal medulla but also in the adrenal cortex and their syntheses are markedly increased in DOCA-salt-treated rats. These results imply that adrenal ANP may participate in the intraadrenal regulation of adrenal function on water-electrolyte homeostasis in an autocrine or paracrine manner.

Increased nitric oxide synthase mRNA expression in the renal medulla of water-deprived rats

Increased nitric oxide synthase mRNA expression in the renal medulla of water-deprived rats.

BACKGROUND

Experiments were performed to investigate whether renal nitric oxide synthase (NOS) mRNA and protein expression are responsive to the alteration of body volume.

METHODS

Four days of water deprivation (WD) was initiated in 16 male Wistar rats, and 16 normal rats (NC) served as the control group. Neuronal NOS (nNOS), endothelial NOS (eNOS), and inducible NOS (iNOS) mRNAs and immunoreactivity were measured by reverse transcription-polymerase chain reaction (RT-PCR) followed by Southern blot hybridization and immunohistochemistry, respectively. Plasma angiotensin II, vasopressin, and atrial natriuretic peptide (ANP) concentrations were measured by radioimmunoassay.

RESULTS

The four-day WD increased plasma sodium and osmolality levels, but severely decreased daily urine sodium excretion and urine volume. Plasma angiotensin II and vasopressin concentrations were increased, but the plasma ANP level was significantly decreased in WD rats. nNOS, eNOS, and iNOS mRNA levels were increased by 5.2-, 3.3-, and 3. 4-fold in the outer medulla and 1.7-, 1.5-, and 1.8-fold in the inner medulla, whereas no significant difference was found in the renal cortex of WD rats as compared with NC rats. Additionally, immunohistochemistry revealed that the immunostaining intensity of nNOS, eNOS, and iNOS was clearly enhanced in the medullary thick ascending limb, proximal straight tubule, inner medullary collecting duct, and proximal convoluted tubule in WD rats. Kidney angiotensin II content as well as renin mRNA levels in renal cortex, outer medulla, and inner medulla in WD rats were apparently increased.

CONCLUSIONS

Our results indicate that the increases of nNOS, eNOS, and iNOS synthesis in the kidney, particularly in the renal medulla, may have a role in the adaptation of renal function to volume depletion in the face of an increase of systemic and intrarenal vasoconstrictive substances.

Increased urinary endothelin-1 excretion in newly diagnosed type 2 diabetic patients

To investigate whether urinary and plasma endothelin (ET)-1 concentrations are responsive to the alteration of intravascular blood volume in uncontrolled diabetic patients, we determined urinary ET-1 excretion and plasma ET-1 concentration in 42 newly diagnosed type 2 diabetic patients and 38 normal subjects. Mean fasting plasma glucose value (12.8 +/- 0.72 mmol l-1) and plasma renin activity (PRA, 2.80 +/- 0.44 ng ml-1 hr-1) in diabetic patients were significantly higher as compared to normal controls (mean plasma glucose value: 5.2 +/- 0.83 mmol l-1; mean PRA value: 1.34 +/- 0.17 ng ml-1 hr-1), whereas plasma ET-1 value (1.33 +/- 0.07 pmol l-1) was not significantly different from that (1.29 +/- 0.06 pmol l-1) of normal controls. Mean urinary ET-1 excretion level (7.53 +/- 0.74 nmol mol-1 creatinine) was significantly higher than that (5.36 +/- 0.37 nmol mol-1 creatinine) of normal controls. Urinary ET-1 excretion was correlated with plasma glucose value (r = 0.360, p < 0.05) and PRA value (r = 0.381, p < 0.05). Urinary ET-1 excretion rate (5.17 +/- 0.37 nmol mol-1 creatinine) and PRA value (1.42 +/- 0.18 ng ml-1 hr-1) declined to normal levels when mean plasma glucose value decreased to the level of 7.1 +/- 0.39 mmol l-1 in diabetic patients after 4 months of glycemic control. Our results indicated that renal-derived ET-1 was responsive to the alteration of intravascular blood volume in untreated newly diagnosed type 2 diabetic patients.

Induction of heat shock protein 70 protects mesangial cells against oxidative injury

The heat shock response is an immediate cellular response to elevated temperatures and other types of injury that consists of the synthesis of so-called heat shock protein (hsp). This study was designed to investigate the production and the protective role of the 70 kDa hsp (hsp70) in cultured rat mesangial cells. When mesangial cells undergo thermal (45 degrees C, 15 min) stimulation, they express hsp70 mRNA expression and increased hsp70 protein production. Following this, Northern blots show an enhanced gene expression of hsp70 at one hour that reached a maximum by 12 hours after heat shock. The hsp70 protein production, estimated by Western blots, was detectable 12 hours after heat shock and reached a maximum by 36 hours. Oxidative injury generated by xanthine and xanthine oxidase inhibited cell survival and cellular proliferation, as measured by trypan blue exclusion and [3H]-labeled thymidine uptake. It did not affect hsp70 mRNA expression. Furthermore, when mesangial cells were preconditioned by heat shock, subsequent oxidative injury caused less inhibition of cell survival and cellular proliferation. Pretreatment of cells with quercetin, a transcription inhibitor, abolished the protective effect of heat shock on subsequent oxidative injury. We conclude that heat shock, not oxidative injury, induces hsp70 in mesangial cells, and this induction of hsp70 protects mesangial cells against subsequent oxidative injury.