The metabolism of cortisol by term baboon neonates (Papio papio)

The metabolism of iv administered (4-14C)cortisol (F) was examined in 3 female, spontaneously delivered, term baboons less than 24th old. Sixty and 80% of 14C was recovered in urine within 24 and 68 h,respectively. The distribution of urinary 14C was 44.7% unconjugated, 18.1% glucuronoside, 3.3% sulfate, and 24% unextractable with ethyl acetate. The metabolites were isolated by chromatography and crystallization. Eight per cent of unconjugated and 60% of glucuronoside metabolites were more polar than the cortols, the majority being unknown I (Rf 0.15), and unknown II (Rf 0.35), (csf., 6beta-ol-F), Rf 0.44, ethyl acetate-chloroofrmmethanol-water, 25:75:50:50). Unconjugated cortisol plus cortisone (E) represented less than 1% or urinary 14C and tetrahydrocortisone (THE) glucuronoside represented 1.2%. Excretion of tetrahydrocortisol (THF) and products of side-chain cleavage were negligible. Excretion of 20beta-hydroxy metabolites and 6beta-ol-F was less than or equal to 5% of urinary 14C. The cortisol production rate (mean +/- SE) calculated from the specific activity of THE was 4.95 +/- 1.92 mg/day. The glucuronoside/unconjugated 14C-ratio (0.4) contrasts with those previously reported in nonpregnant (4.0), pregnant (1.0), and postpartum (1.3) animals, indicating that the metabolic pattern in newborns is an exaggeration of that in pregnancy. In neonates, unknown I and II compensate quantitatively for decreased glucuronoside excretion. Unknowns I and II are derivatives of THF and THE, suggesting that increased hydroxylase or deficient glucuronyl transferase, rather than impaired delta4-reductase, is responsible for decreased glucuronoside excretion. The low F production rate, reduced glucuronoside formation, and increase in highly polar compounds relative to nonpregnant adults resemble the situation in humans. However, the reduction in glucuronosides is compensated for, quantitatively, by highly polar metabolites, which are extractable from baboon urine with ethyl acetate but are nonextractable from the urine fo human neonates.     

11 beta-Hydroxysteroid dehydrogenase activity in Cushing's syndrome: explaining the mineralocorticoid excess state of the ectopic adrenocorticotropin syndrome

A characteristic feature of the ectopic ACTH syndrome is a state of mineralocorticoid excess, although the etiology remains obscure. Some forms of endocrine hypertension, such as licorice ingestion, have been explained by cortisol acting as a mineralocorticoid in the setting of inhibition or deficiency of 11 beta-hydroxysteroid dehydrogenase (11 beta HSD). This enzyme is responsible for the conversion of cortisol (F) to hormonally inactive cortisone, and its activity in vivo can be inferred from the ratio of the urinary excretion of tetrahydrocortisol (THF) and its isomer (5 alpha THF) to tetrahydrocortisone. Twenty-two patients with Cushing's syndrome (11 pituitary dependent, 9 ectopic, and 2 adrenal adenomas) and 13 controls were studied. Compared to controls. Cushing's patients had a significant increase (P < 0.001) in the excretion of all principal metabolites of F, secondary to a 5- to 6-fold increase in the cortisol secretion rate [median, 34.0 (range, 13.3-327) mg/day in Cushing's vs. 6.1 (range, 2.5-10.3) mg/day in controls]. The THF plus 5 alpha THF/tetrahydrocortisone ratio was significantly increased in Cushing's syndrome regardless of etiology [mean, 1.81 (range, 1.09-9.99) in Cushing's vs. 0.81 (range, 0.51-1.47) in controls; P < 0.001), indicative of defective 11 beta HSD activity. Furthermore, compared to patients with pituitary-dependent Cushing's, this ratio was significantly higher in patients with the ectopic ACTH syndrome (4.12 vs. 1.49; P < 0.01) and was inversely correlated with serum potassium levels (r = -0.57; P = 0.01; n = 22). One explanation for the mineralocorticoid excess state of the ectopic ACTH syndrome appears to be that cortisol gains inappropriate access to the mineralocorticoid receptor through failure of its normal metabolism by 11 beta HSD. The reason for the defective 11 beta HSD activity is unclear, but it may be secondary to substrate saturation, inhibition by other adrenal steroids, or product inhibition.     

Glucocorticoid receptor polymorphism, skin vasoconstriction, and other metabolic intermediate phenotypes in normal human subjects

Genetic variation of the glucocorticoid receptor (GR) locus is associated with differences in blood pressure. To define the intermediate phenotypes associated with this variation, we investigated the biochemical and clinical significance of a BclI restriction fragment length polymorphism of the GR locus in 64 normal male volunteers. Blood samples were genotyped as either AA (homozygous large allele; n = 6), Aa (heterozygous; n = 51), or aa (homozygous small allele, n = 7). Four primary glucocorticoid variables were measured including GR binding characteristics and glucocorticoid-sensitive lysozyme release of leukocytes in vitro and the blanching response of forearm skin to budesonide. A large number of secondary variables (urinary and plasma steroid measurements, blood pressure and indices of body fat metabolism, and routine biochemical and hematological measurements) were also considered. In vivo sensitivity to budesonide was greater in AA than aa individuals (mean +/- SE EC50 values: 13 +/- 5 and 42 +/- 10 ng; P < 0.01). In contrast, leukocytes of AA subjects tended to have lower affinity and reduced sensitivity for dexamethasone, although these effects were not statistically significant. Based on urinary steroid measurements, 11 beta-hydroxysteroid dehydrogenase activity [ratio of tetrahydrocortisol (THF) to tetrahydrocortisone (THE) metabolites] was not affected by genotype. The relative activities of 5 alpha- and 5 beta-reductase activity (allo-THF/THF + THE) appeared lower in AA than aa subjects (0.22 +/- 0.04 cf. 0.33 +/- 0.06; P < 0.005) but were not judged to be significantly different when corrected for multiple comparisons. Single and multivariate analyses were carried out to determine which variables influence GR binding characteristics and glucocorticoid responsiveness and to see whether cardiovascular risk factors (blood pressure and body fat) were influenced by glucocorticoid-dependent functions. Only 15-20% of the variations in the dissociation constant (Kd) and maximum binding capacity (Bmax) were influenced by other variables; plasma cholesterol was the most important for affinity and plasma sodium concentration for binding capacity. Multivariate analysis showed that several factors including GR genotype and urinary cortisol account for 10% of the variation of in vivo responses to glucocorticoid hormones; plasma calcium concentration was the only variable that contributed to in vitro sensitivity of leukocytes to dexamethasone. Glucocorticoid-dependent responses were of negligible importance in determining blood pressure or percentage body fat within the narrow physiological ranges of the present study. We conclude that GR genotype affects steroid sensitivity in a tissue-specific manner because of altered GR function or possibly because of linkage to a locus that controls hormone access to the receptor by influencing steroid metabolism.     

Milk production of Holstein heifers fed either alfalfa or corn silage diets at two rates of daily gain

OBJECTIVES: L-arginine exerts anti-atherosclerotic effects in hypercholesterolaemic rabbits via modulating endogenous NO production. We investigated whether L-arginine inhibits thromboxane formation in vivo and platelet aggregation ex vivo in this animal model. METHODS: The urinary excretion rates of 2,3-dinor-6-keto-PGF1 alpha (major urinary metabolite of PGI2) and 2,3-dinor-TXB2 (major urinary metabolite of thromboxane A2) were used as indicators of platelet-endothelial cell interactions in vivo. Rabbits were fed 1% cholesterol (Cholesterol group, N = 8), 1% cholesterol plus 2.25% L-arginine (Cholesterol + L-arginine, N = 8), or normal rabbit chow (Control, N = 4) for 12 weeks. Urine samples were collected in weekly intervals. At the end of the study period platelet aggregation ex vivo and endothelium-dependent and -independent vascular function of isolated aortic rings in vitro was assessed. RESULTS: Urinary 2,3-dinor-TXB2 excretion significantly increased in the cholesterol group (p < 0.05), and endogenous NO formation (measured as urinary nitrate excretion) decreased (p < 0.05). Both parameters were significantly correlated with each other (R = 0.48, p < 0.01). L-arginine partly restored urinary nitrate excretion and significantly reduced TXA2 production to values even below those in the control group (p < 0.001). Urinary 2,3-dinor-6-keto-PGF1 alpha excretion increased in early hypercholesterolaemia and returned to control values in the second half of the study period. The early increase in urinary 2,3-dinor-6-keto-PGF1 alpha excretion was attenuated by L-arginine. Platelet aggregation was significantly enhanced in cholesterol-fed rabbits and attenuated by dietary L-arginine. L-arginine also improved the impaired endothelium-dependent relaxations to ADP, and normalized the vasoconstrictor effects of 5-HT in isolated aortic rings. CONCLUSIONS: Cholesterol-feeding enhances platelet aggregation and TXA2 formation, and stimulates platelet-endothelial cell interaction in rabbits. These effects are probably due to impaired NO elaboration, as indicated by decreased urinary nitrate excretion. Chronic dietary supplementation with L-arginine elevates systemic NO elaboration and significantly increases the PGI2/TXA2 ratio. It thus beneficially influences the homeostasis between vasodilator and vasoconstrictor prostanoids in vivo.     

CHARACTERISTICS OF PARTICIPANTS AND NONPARTICIPANTS IN INDIVIDUAL TEST-INTERPRETATION INTERVIEWS.

THE STUDY COMPARED STUDENTS WHO REQUESTED AN INTERPRETIVE INTERVIEW AFTER A BATTERY OF TESTS WITH THOSE WHO DID NOT REQUEST AN INTERVIEW. AN INTERVIEW SAMPLE (N = 96) WAS COMPARED WITH A NONINTERVIEW SAMPLE (N = 35) USING SCORES ON THE MMPI, THE THEOLOGICAL SCHOOL INVENTORY, AND THE OHIO STATE UNIVERSITY PSYCHOLOGICAL TEST. ONLY THE MMPI COMPARISONS YIELDED SIGNIFICANT DIFFERENCES BETWEEN THE 2 GROUPS. THE INTERVIEW SAMPLE HAD LOWER SCORES ON SCALES K AND R (WELSH), AND HIGHER SCORES ON SCALES 2 (D), 5 (MF), AND A (WELSH). THE INTERVIEW SAMPLE ALSO HAD A HIGHER MEAN GRADE-POINT AVERAGE THAN THE NONINTERVIEW SAMPLE. AN EXPLANATION OF SOME OF THE OBSERVED DIFFERENCES WAS OFFERED IN TERMS OF DIFFERENCES AMONG SS ALONG THE INTROVERT-EXTRAVERT CONTINUUM. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Urinary bladder incontinence after prostatectomy. Urodynamic evaluation and results of therapy

Forty-seven males referred due to postprostatectomy urinary incontinence (34 after transurethral resection of prostatic adenoma and 13 after open suprapubic adenomectomy) were retrospectively studied. Urodynamic evaluation identified 19 (40.4%) men with incontinence due solely to sphincter incompetence, and 19 (40.4%) men, in addition to sphincter incompetence, had urinary bladder dysfunction (unstable detrusor and/or reduced bladder compliance). Seven (14.8%) men had pure bladder dysfunction as the only cause of urinary incontinence. Two patients had normal urodynamic findings (N = 2; 4.2%). Men with urinary incontinence due only to sphincter incompetence were treated by insertion of artificial sphincter devices or condom catheter drainage (lack of artificial sphincters), while others were treated pharmacologically (imipramine, propantheline, oxybutynin or their combinations ... N = 25), or by augmentation cystoplasty using ileum after unsuccessful pharmacological treatment (N = 3). Out of 25 patients with pharmacological treatment, 21 were available for the final assessment of the treatment efficacy. Eleven (52.3%) patients were "socially continent" after the treatment. It is concluded that in the assessment of the cause of postprostatectomy urinary incontinence urodynamic evaluation is mandatory, and that the treatment should be based on the results of such studies. The role of bladder dysfunction as a cause of postsurgical urinary incontinence is again strongly emphasized.     

Monolayer formation and DNA synthesis of the outer epithelial cells from pearl oyster mantle in coculture with amebocytes

OBJECTIVES: In the absence of specific symptomatology in children and neurogenic bladder disease patients, the early diagnosis of acute pyelonephritis is a challenge. The aim of the present study was to determine if dimercaptosuccinic acid (DMSA) lesion-positive (acute pyelonephritis) patients have elevated urinary alpha1-microglobulin (alpha1-MG) excretion (no false negatives) and if DMSA lesion-negative (cystitis) patients have normal urinary alpha1-MG excretion (no false positives). METHODS: A selected population of 62 children above 3 months of age with a proven urinary tract infection were administered a DMSA scan. A control scan was performed after the acute phase of the illness, and the diagnosis of pyelonephritis (n = 44) was made retrospectively. The urinary alpha1-MG was determined by immunonephelometry. RESULTS: The urinary alpha1-MG-creatinine ratio was highly sensitive (98%) and specific (100%) and correlated with the DMSA scintigraphy images. Only 1 of the 44 patients with pyelonephritis and all of the cystitis patients (n = 18) had a normal urinary alpha1-MG (<10 mg/g). The drop in absolute DMSA uptake correlated significantly (r = 0. 758, p < 0.001) with the urinary alpha1-MG-creatinine ratio. The urinary alpha1-MG-creatinine ratio was significantly higher (p < 0. 02) in bilateral than in unilateral pyelonephritis. CONCLUSION: DMSA lesion-positive (acute pyelonephritis) patients have elevated urinary alpha1-MG excretion and DMSA lesion-negative (cystitis) patients have normal urinary alpha1-MG excretion.     

Effect of sodium restriction on urinary excretion of cortisol and its metabolites in humans

The adrenal gland is involved in the control of urinary sodium excretion mainly via the secretion of the mineralocorticoid aldosterone. Although under certain conditions glucocorticoid seem to be also involved in the regulation of sodium homeostasis, there are contradictory reports on the relationship between cortisol secretion and sodium intake. Given recent findings linking regulation of physiological activity of steroids to the activity of specific enzymatic pathways, we have examined changes in urinary excretion of cortisol and its metabolites in eight healthy volunteers on a low sodium diet. Urinary steroids were measured with specific radioimmunoassays after extraction and chromatography (F and E) or after dilution (THF and THE). Excretion of cortisol (124 +/-41 nmol/day) was significantly lower on Day 2 (86 +/- 27 nmol/day, p < 0.01) and Day 7 (85 +/- 25 nmol/day, p < 0.01) of sodium restriction. On the same samples calculated ratios of THF/F (55 +/- 15; 61 +/- 22; 68 +/- 21) and E/F (2.5 +/- 0.6; 2.8 +/- 1.4; 3.0 +/- 1.3) reflecting the activity of 5 beta-reductase and 11 beta-hydroxysteroid dehydrogenase, respectively, showed significant increases in the former on both Days 2 and 7 and for the latter only on Day 7. This study supports the notion that sodium restriction decreases urinary cortisol excretion and provides evidence that increased activity of 5 beta-reductase and lowered metabolism by 11 beta-HSD are presumably the mechanisms of this decrease.     

Non-radioactive detection of K-ras mutations by nested allele specific PCR and oligonucleotide hybridization

PURPOSE: The aim of the study was to evaluate prospectively urinary alpha 1-microglobulin as a marker of proximal tubular damage following acute pyelonephritis and outflow disease of the upper urinary tract in a urological population with minimal exclusion criteria. We also measured the urinary gamma-glutamyltransferase activity, urinary albumin, urinary and serum creatinine, serum IgA and serum alpha 1-microglobulin. PATIENTS AND METHODS: We studied 483 urological patients (age: 1 to 92 years, 297 men, 186 women) excluding patients receiving nephrotoxic drugs, or suffering from type 1 diabetes or renal diseases. There were 141 patients with urinary tract infection but no fever, 36 patients with high fever of non-renal origin, 51 patients with acute pyelonephritis and 156 patients with outflow disease of the upper tract, and 99 patients were included in the reference population. RESULTS: For acute pyelonephritis, vesico-ureteral reflux, and ureteral obstruction, urinary alpha 1-microglobulin had a sensitivity of 94%, 90% and 63% respectively and a specificity of 67%, 77% and 76%. The area under the curve of the receiver operator characteristic curve was significantly (p < 0.001) higher for urinary alpha 1-microglobulin than for albumin or gamma-glutamyltransferase activity. Unexpected positive results were found in acute prostatitis. The urinary alpha 1-microglobulin was the only parameter which differentiated between acute prostatitis and pyelonephritis (p < 0.001). Creatinine clearance or age had little and gender had no influence on the urinary excretion of alpha 1-microglobulin. Urine production rate significantly increases the urinary alpha 1-microglobulin/creatinine ratio. CONCLUSION: Our results suggest that the urinary alpha 1-microglobulin/creatinine ratio is a diagnostically useful marker of tubular damage in acute pyelonephritis and vesico-ureteral reflux in the urological population. Following renal colic and chronic ureteral obstruction, a significant increase in urinary alpha 1-microglobulin excretion was observed.     

A radioimmunometric assay for urinary alpha 2-macroglobulin

To measure urinary alpha 2-macroglobulin levels, a sensitive radioimmunometric assay was established. The least detectable level of this assay was 225 pg/ml. A linear correlation between alpha 2-macroglobulin levels and serial dilution of urine samples was found. Western blot analysis and study on column chromatography revealed that the molecular weight of alpha 2-macroglobulin in urine was identical to that of serum alpha 2-macroglobulin. The findings suggested that urinary substance detected by the present assay was truly alpha 2-macroglobulin. Timed overnight urine samples from 49 diabetic patients with retinopathy and 20 healthy controls were measured by the present assay. Patients were classified as Albustix-negative and Albustix-positive patients. The highest urinary alpha 2-macroglobulin excretion rates (alpha 2-MER) was found in Albustix-positive patients followed by Albustix-negative patients and the healthy controls. In view of the fact that the stroke radius of alpha 2-macroglobulin (88A) is larger than that of the restrictive pore (56A), the present finding suggests that leakage of alpha 2-macroglobulin in urine may be induced by defect of non-discriminatory pores in the glomerular basement membrane proposed by Deen and colleagues.     

Urinary immunoreactive interleukin-1 alpha and interleukin-6 in bacteriuric institutionalized elderly subjects

Urinary immunoreactive interleukin-1 alpha and interleukin-6 levels were measured in specimens obtained from elderly institutionalized subjects, including 67 asymptomatic subjects (51 of whom were bacteriuric), 34 with fever from nonurinary sources, 15 with bacteriuria and 9 with symptomatic urinary infection. For bacteriuric subjects urinary interleukin-1 alpha and interleukin-6 levels were measurable in 18 (35%) and 22 (43%) asymptomatic subjects, respectively, 9 (60%) and 8 (53%) with nonurinary sources of fever, respectively, and 6 (67%) and 7 (78%) with urinary infection, respectively. For subjects without bacteriuria 1 of 16 (6.3%) who were asymptomatic and 5 (25%) with nonurinary sources of fever had measurable urinary interleukin-1 alpha, and 2 (13%) and 1 (5.3%), respectively, had measurable interleukin-6. Presence of interleukin-1 alpha or interleukin-6 was significantly associated with bacteriuria for asymptomatic and symptomatic subjects. Interleukin-1 alpha or interleukin-6 quantitative levels were lower in subjects without than with bacteriuria. Quantitative levels of interleukin-6 tended to decrease for bacteriuric subjects with symptomatic infection between acute and convalescent specimens. These observations suggest that interleukin-1 alpha and interleukin-6 are produced in association with bacteriuria in some elderly subjects. Variation in local cytokine production with time and the clinical significance of these observations require further study.     

An etiologic approach to management of duodenal and gastric ulcers

The dynamics of intestinal absorption, blood concentration and distribution of thiamin, biotin, nicotinate, riboflavin, pantothenate, various folates (folic acid, folinic acid, pteroyltriglutamate), vitamins A, E, C, B12, and B6 were monitored in 12 patients by multiple simultaneous sampling of blood obtained by combined catheterization of portal vein, hepatic vein, and femoral artery after vitamin ingestion. All water-soluble vitamins proved elevated after vitamin ingestion principally in portal blood within 10 minutes as compared with hepatic and femoral blood. Elevated vitamin levels in portal blood--compared to hepatic and femoral blood--remained high even after 120 min. indicating that absorption from the gut was still progressing. In contrast, ingestion of the fat-soluble vitamins A and E evoked no elevated vitamin activity in portal blood. Within 10 min. after vitamin ingestion, all folates were converted into reduced and methylated 5-methyltetrahydrofolate (5-CH3THF) on passage through the gut. At this time, portal blood elevation of 5-CH3THF persisted before its elevation in hepatic or femoral blood. Presumably, the elevation was not due to the flushing of stored 5-CH5THF from tissues but rather of folate conversion to 5-CH3THF upon gut passage. The significance of these findings is discussed.     

NEED FOR ACHIEVEMENT IN NEGRO, WHITE, AND PUERTO RICAN CHILDREN.

COMPARED N ACH OF NEGRO, WHITE, AND PUERTO RICAN 5TH AND 7TH GRADERS IN LOW SOCIOECONOMIC AREAS OF A LARGE NEW ENGLAND CITY. THE N ACH TESTS CONSISTED OF 6 TOPIC SENTENCES ABOUT WHICH SS WROTE STORIES. F TESTS OF N ACH SCORES REVEALED NO SIGNIFICANT DIFFERENCES. THESE RESULTS CONTRAST WITH THE AUTHOR'S A.D. MINGIONE'S (SEE39:4) PREVIOUS STUDY IN WHICH WHITE CHILDREN HAD HIGHER N ACH SCORES THAN NEGRO CHILDREN AND 7TH GRADERS SCORED HIGHER THAN 5TH GRADERS. THERE WERE MORE WORDS PER STORY, GREATER VARIETY OF STORY THEMES, AND MORE STORIES CONCERNING FEMALES WRITTEN BY BOTH BOYS AND GIRLS THAN IN THE PREVIOUS STUDY, WHEN THE STORIES WERE WRITTEN IN RESPONSE TO LINE DRAWINGS OF PEOPLE. SCHOOL GRADES AND GROUP INTELLIGENCE TEST SCORES DID NOT CORRELATE WITH N ACH SCORES IN THIS STUDY. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Enhanced lipid peroxidation in patients positive for antiphospholipid antibodies

The mechanism leading to the formation of antiphospholipid antibodies (aPL) is still unknown. Because an in vitro study suggested that aPL may derive from pro-oxidant conditions, we sought a relationship between aPL and isoprostanes, indices of lipid peroxidation in vivo. Thirty patients with systemic lupus erythematosus have been studied. Seventeen (56.6%) were positive for aPL because they had lupus anticoagulant and/or high titer of anticardiolipin antibodies (aCL). Plasma levels of tumor necrosis factor (TNF ) and urinary excretion of two isoprostanes, 8-epi-PGF2alpha and IPF2alpha -I, free radical catalyzed oxidation products of arachidonic acid, were measured. Patients with systemic lupus erythematosus had higher urinary excretion of 8-epi-PGF2alpha and IPF2alpha -I than controls; urinary excretion of the two isoprostanes was highly correlated (Rho = 0.74, P < .0001). Urinary 8-epi-PGF2alpha was highly correlated with both aCL titer (Rho = 0. 70, P < .0001) and TNF (Rho = 0.84, P < .0001), a measure of disease severity. Excretion of this isoprostane was also higher in those patients who exhibited aPL (P < .0001). Comparable correlations were observed with the isoprostane IPF2alpha -I. No difference of 8-epi-PGF2alpha was observed between patients with and without previous history of thrombosis. This study, showing the existence of a close association between aPL and increased in vivo lipid peroxidation, supports the hypothesis that these antibodies may result from pro-oxidative conditions and suggests that inflammation may play an important role.     

Administration to humans of ORG 21465, a water soluble steroid i.v. anaesthetic agent

Early diagnosis of kidney and urothelial cancer requires some new sensitive and specific methods. In this study the diagnostic use of serum alpha 1-acid glycoprotein (alpha 1-AG), coeruloplasmin, alpha 1-antitrypsin (alpha 1-AT), alpha 2-macroglobulin (alpha 2-MG) and albumin in patients with kidney, urinary bladder and upper tract urothelial cancer was evaluated. In kidney cancer patients the serum levels of alpha 1-AG, coeruloplasmin and alpha 1-AT were significantly increased over the controls (p < 0.001), however, albumin was decreased (p < 0.005). Sensitivity was relatively high for alpha 1-AG (85%), albumin (85%) and alpha 1-AT (77%). In patients with urinary tract urothelial cancer alpha 1-AG, alpha 1-AT and coeruloplasmin were also increased but not as much as in kidney cancer. Sensitivity of alpha 1-AG (63%), albumin (75%) and alpha 1-AT (66%) was also lower than in kidney cancer. This study has established the relative importance of alpha 1-AT and albumin determination in patients with kidney as well as with urothelial cancer.     

Management of the complications of ureterointestinal reimplantation in urinary diversion

OBJECTIVE: To analyze our experience in the management of complications of ureteroenteric reimplantation in patients undergoing urinary diversion by endourological techniques or open surgery, in order to identify a useful algorithm that takes the oncologic prognosis into account, as well as the probability of success. METHODS: A retrospective study was conducted on 136 patients who had undergone urinary diversion from 1987-1998. Of these, 126 had transitional cell carcinoma, two had infiltrating carcinoma, two had a benign condition and 6 had undergone urinary diversion for patient comfort without cystectomy. The following techniques were utilized: cutaneous ureteroileostomy or Bricker technique (104 patients), Mainz neobladder (10 patients), ileal neobladder (15 patients), colonic conduit (5 patients) and cutaneous ureter (2 patients). RESULTS: Overall, 56 patients (41%) had some type of alteration at the ureteroenteric reimplantation site, but only 36 (26%) required intervention. The reimplantation techniques utilized were: the Bricker direct ureteroileostomy (26 patients), Le Duc (6 patients), Leadbetter (3 patients), and the direct cutaneous technique (1 patient). Patient mean age was 67 years (range 53-80). There were 35 males and one female. Seven patients required immediate reimplantation due to a persistent urinary fistula and 29 had late obstruction (more than 3 months), accounting for 21.3% of the cases undergoing urinary diversion. The antegrade endourological approach was utilized in 24 patients (5 nephrostomy alone and 19 stent or balloon dilatation). Dilatation was performed palliatively in 6 cases with extensive tumor spread. Permanent success was achieved in 5 cases (38%) and in spite of the initial success, there were 4 reobstructions. Open surgery was performed in 24 patients (66% of the complicated reimplantations); 5 of these patients had another pathology that warranted laparotomy, 7 required reimplantation early due to a fistula and two patients with a nonfunctioning kidney underwent nephrectomy. Ureteral replacement using the ileum was performed in 4 patients and direct reimplantation to the primary loop was performed in 6 patients. Good surgical results were consistently achieved. CONCLUSIONS: The complication rate of ureteral reimplantation is high in patients undergoing urinary diversion. Endourology has an important role in these cases, particularly in patients with a poor prognosis. Surgery achieves the best results. Although they may entail difficulty, complex cases such as extensive ureteral necrosis can be managed successfully.     

A comparative assessment of TLC overlay technique and microwell adsorption assay in the examination of influenza A and Sendai virus specificities towards oligosaccharides and sialic acid linkages of gangliosides

Influenza A and Sendai viruses bind to neolacto-series gangliosides isolated from human granulocytes. Differences in receptor specificity of influenza viruses A/PR/8/34 (H1N1), A/X-31 (H3N2), and parainfluenza Sendai virus (HNF1, Z-strain) were determined by two direct solid phase binding assays: the overlay technique, which combines high-resolution in the separation of gangliosides on thin-layer chromatograms with direct binding; and the microwell adsorption assay as a convenient binding assay which is performed in microtitre wells to estimate the avidity of binding to an isolated ganglioside. Both methods were applied for comparative binding studies. Viruses were found to exhibit specificity for oligosaccharides and sialic acids as well as for chain length of the neutral carbohydrate backbone, whereas differing fatty acids (C24:1 and C16:0) in the ceramide portion had no impact on virus adsorption. Terminal sialyloligosaccharides Neu5Ac alpha 2-3Gal beta 1-4Glc-R of GM3, and Neu5Ac alpha 2-3Gal beta 1-4GlcNAc-R as well as Neu5Ac alpha 2-6Gal beta 1-4GlcNAc-R of neolacto-series gangliosides with nLcOse4Cer and nLcOse6Cer backbone, exhibited significant specific receptor activity towards the different viruses. To compare the data revealed from both test systems, values of virus binding were ascertained by a non-parametric statistical approach based on rank correlation. The rank correlation coefficient rs was calculated according to Spearman from each virus binding towards GM3, IV3Neu5Ac-nLcOse4Cer, IV6Neu5Ac-nLcOse4Cer and VI3Neu5Ac-nLcOse6SCer. The rank correlation coefficients 0.74, 0.95 and 0.92, which were determined for A/PR/8/34 (H1N1), A/X-31 (H3N2) and Sendai virus (HNF1, Z-strain), respectively, indicated that both assays generate highly correlated experimental data.(ABSTRACT TRUNCATED AT 250 WORDS)     

A PSYCHOPHYSICAL DETERMINATION OF EQUITABLE PAYMENT: A METHODOLOGICAL STUDY.

EXPLORED THE PRACTICALITY OF USING PSYCHOPHYSICAL METHODS TO DETERMINE RANGES FOR PAYMENT PLANS. THRESHOLDS OF PERCEIVED EQUITABLE PAYMENT (PSE) AND THE JUST MEANINGFUL DIFFERENCE (JMD) OF PAYMENT WERE DETERMINED BY AN ADAPTATION OF THE PSYCHOPHYSICAL METHOD OF LIMITS. PSE AND JMD WERE SIGNIFICANTLY GREATER FOR JUNIOR EXECUTIVES (N = 20) THAN FOR SECRETARIES (N = 52) OF AN ACADEMIC INSTITUTION. THE RESPECTIVE WEBER RATIOS, K (THE PROPORTIONATE MEANINGFUL ADDITIONS TO THE BASE SALARY), WERE NOT SIGNIFICANTLY DIFFERENT. THERE WERE NO SIGNIFICANT DIFFERENCES BETWEEN 2 SECRETARIAL SUBGROUPS IN JMD AND K, BUT THERE WAS A DIFFERENCE IN PSE. THE RELEVANCE OF THIS METHOD TO EQUITY THEORY IS DISCUSSED. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of purine compounds on the isolated aorta of the frog Rana temporaria

1. In the isolated aorta of the frog, Rana temporaria, adenosine concentration-dependently, endothelium-independently relaxed adrenaline pre-constricted vessels. None of the adenosine analogues including D-5'-(N-ethylcarboxamide) adenosine (NECA), R- and S-N6-(2-phenylisopropyl) adenosine (R-and S-PIA) and 2-chloroadenosine (2-CA), or the more selective A1, A2 and A3 agonists cyclopentyladenosine (CPA), CGS 21680 and N6-(3-iodobenzyl) adenosine-5'-N-methylcarboxamide (IB-MECA) respectively, had any effect. 2. The non-selective adenosine antagonist, 8-p-sulphophenyl-theophylline (8-pSPT; 30 microM) failed to inhibit adenosine relaxations, as did NG-nitro-L-arginine methyl ester (L-NAME; 0.1 mM) and indomethacin (30 microM). 3. Adenosine 5'-triphosphate (ATP), alpha, beta-methylene ATP (alpha, beta-MeATP), beta, gamma-methylene ATP (beta, gamma-MeATP), 2-methylthio ATP (2-MeSATP) and uridine 5'-triphosphate (UTP) all concentration-dependently contracted the frog aorta. ATP and alpha, beta-MeATP were equipotent and more potent than UTP and beta, gamma-MeATP; 2-MeSATP had little activity. 4. The P2-purinoceptor antagonist, suramin (0.1 mM) inhibited contractions to alpha, beta-MeATP but not to ATP. Pyridoxalphosphate-6-azophenyl-2',4'-disulphonic acid (PPADS; 30 microM) also inhibited contractions to alpha, beta-MeATP but not to ATP. Contractions to ATP were, however, inhibited by indomethacin (30 microM). 5. In conclusion, in the frog aorta there appears to be a novel subclass of P1-purinoceptor mediating vasodilatation, although like the A3 subclass it is not blocked by methylxanthines; a P2-purinoceptor mediates vasconstriction which resembles a P2x subtype, based on the agonist potency of alpha, beta-MeATP being more potent than 2-MeSATP (UTP has moderate activity) and PPADS is an effective antagonist. There is no evidence for the presence of a P2y-purinoceptor, mediating vasodilatation, in this preparation.