Hyperdynamic circulation of cirrhotic rats: role of substance P and its relationship to nitric oxide

BACKGROUND: It has been suggested that excessive formation of nitric oxide (NO) is responsible for the hyperdynamic circulation observed in portal hypertension. Substance P is a neuropeptide partly cleared by the liver and causes vasodilatation through the activation of the endothelial NO pathway. However, there are no previously published data concerning the plasma level of substance P in cirrhotic rats and its relationship to NO. METHODS: Plasma concentrations of substance P and nitrate/nitrite (an index of NO production) were determined in control rats and cirrhotic rats with or without ascites using an enzyme-linked immununosorbent assay and a colorimetric assay, respectively. In addition, systemic and portal hemodynamics were evaluated by a thermodilution technique and catheterization. RESULTS: Cirrhotic rats with and without ascites had a lower systemic vascular resistance (2.6 +/- 0.2 and 3.9 +/- 0.4 mmHg ml(-1) x min x 100 g body weight, respectively) and higher portal pressure (14.6 +/- 0.6 and 11.3 +/- 1.8 mmHg) than control rats (6.5 +/- 0.3 mmHg x ml(-1) x min x 100 g BW and 6.8 +/- 0.2 mmHg, respectively, P < 0.05), and cirrhotic rats with ascites had the lowest systemic vascular resistance. Plasma levels of nitrate/nitrite progressively increased in relation to the severity of liver dysfunction (control rats, 2.7 +/- 0.5 nmol/ml; cirrhotic rats without ascites, 5.6 +/- 1.3 nmol/ml; cirrhotic rats with ascites, 8.3 +/- 2.2 nmol/ml; P < 0.05). Cirrhotic rats with ascites displayed higher plasma values of substance P (57.7 +/- 5.9 pg/ml) than cirrhotic rats without ascites (37.9 +/- 3.1 pg/ml, P < 0.05) and control rats (30.1 +/- 1.0 pg/ml, P < 0.05). There was no significant difference in plasma substance P values between control rats and cirrhotic rats without ascites (P > 0.05). No correlation was found between plasma levels of substance P and nitrate/nitrite (r = 0.318, P > 0.05). CONCLUSIONS: Excessive formation of NO may be responsible, at least partly, for the hemodynamic derangements in cirrhosis. Although substance P may not participate in the initiation of a hyperdynamic circulation in cirrhosis, it may contribute to the maintenance of the hyperdynamic circulation observed in cirrhotic rats with ascites.     

Retinopathy of prematurity in Frederiksborg County 1988-1990. A prospective investigation, an update

A report is given of retinopathy of prematurity findings in a Danish county (pop. 342,000) for birth years 1988-90. Out of 12,116 liveborn infants 200 were followed with eye controls during (at least) the first 3 months. In 135 gestational age and/or birth weight were below 32 weeks/1750 g. Twenty-five had ROP stage 1-2 with uneventful regression. Out of 5 with at least stage 3 ROP 2 had spontaneous regression. Three had cryotherapy; two acquired unilateral blindness, one myopia of prematurity. As part of an ongoing prospective investigation the visual results denote progress as compared to the serious results from the preceding 6 years (6 blind children). For 1982-90 the pooled ROP blindness rate amounted to 18.7/100,000 liveborn, a frequency only to be surpassed by the neighbouring Copenhagen area. Considering correct timing of cryotherapy close observation of small premature infants is recommended. At present our screening limits are 32 weeks gestational age/1750 g birth weight.     

Computer modeling of the continuous annealing furnace

A computer program to calculate the strip temperature heated in the continuous annealing furnace was developed, using the zone method for radiative heat transfer analysis with the measured gas temperature in the furnace. Using theF _E Operator, the present study considered the effects of soot and transient species, in addition to the H₂O−CO₂ gas mixture on the gas radiative heat transfer. The predicted strip temperature distribution forF _E=1.05 represented well the measured data. The maximum difference in the heat flux transfered to the strip from the combustion gas forF _E=1.0 (without soot and transient species gas radiation) and 1.05 (with soot and transient species gas radiation) was about 15%. The present study also investigated the effects of line speed and thickness variations on the strip temperature, establishing the bases for the on-line computer model.     

Congenital adrenal hyperplasia presenting as massive adrenal incidentalomas in the sixth decade of life: report of two patients with 21-hydroxylase deficiency

Divergent recommendations exist regarding the evaluation of adrenal incidentalomas. Recent data have indicated a prevalence of adrenal tumors of 71% in nonclassical congenital adrenal hyperplasia (CAH) and unmasked heterozygotes. These data expand the differential diagnosis of such incidental tumors and substantially modify the approach to their evaluation. We present two patients, female pseudohermaphrodites with the simple virilizing form of CAH and 21-hydroxylase deficiency, who functioned successfully as married phenotypic males. Both came to medical attention in the sixth decade by virtue of massive adrenal incidentalomas encountered in the evaluation of recurrent urinary tract infections. Each had a 46, XX karyotype, no palpable testes, and markedly elevated baseline levels of 17-hydroxyprogesterone (17-OH Prog) of 6086 ng/dL and 6750 ng/dL. Both responded appropriately to dexamethasone suppression with reduction of 17-OH Prog, androgens and, in the second patient, ACTH to normal or near normal levels. Histologic and autopsy examination of the first patient's tumor and computed tomographic characteristics of the second revealed a benign adenoma and myelolipoma respectively. We extend and confirm previous recommendations that CAH be included in the differential diagnosis of adrenal incidentaloma and that baseline 17-OH Prog. levels be obtained, with ACTH stimulation if necessary, to diagnose the presence of nonclassical CAH.