Ethanol, stroke, brain damage, and excitotoxicity

The N-methyl-d-aspartate (NMDA)-glutamate receptor could contribute to stroke, trauma, and alcohol-induced brain damage through activation of nitric oxide formation and excitotoxicity. In rat primary cortical cultures NMDA was more potent at activating nitric oxide formation than triggering excitotoxicity. Ethanol dose dependently inhibited both responses. In contrast, treatment of neuronal cultures with ethanol (100 mM) for 4 days significantly increased NMDA stimulated nitric oxide formation and excitotoxicity. These findings suggest that ethanol acutely inhibits but chronically causes supersensitivity to NMDA-induced excitotoxicity in neuronal cultures. To investigate ethanol's interaction with stroke induced damage models of global cerebral ischemia were studied. Transient global ischemia resulted in a loss of hippocampal CA1 pyramidal neurons over a 3- to 5-day period. Determinations of the NMDA receptor ligand binding stoichiometry or postischemic receptor binding changes did not show differences between neurons that undergo delayed neuronal death following ischemia and those that show no toxicity, for example, CA1 and dentate gyrus, respectively. Acute ethanol (3 g/kg) was found to protect against ischemia-induced CA1 hippocampal damage by lowering body temperature, but not under temperature controled conditions. These studies indicate that the factors contributing to stroke-induced brain damage are complex, although they are consistent with chronic ethanol increasing stroke-induced brain damage by increasing NMDA excitotoxicity.     

MR imaging of soft-tissue changes after percutaneous transluminal angioplasty and stent placement

A cDNA library enriched for human fetal-specific liver genes was constructed by suppressive subtractive hybridization. EST fls223 generated from this library was found to represent a novel putative serine/threonine (Ser/Thr) kinase. A full-length clone isolated for this gene encodes a protein of 396 amino acids. The amino acid sequence has 40% identity over 305 amino acids with the B1R Ser/Thr protein kinase of vaccinia virus. This gene has therefore been named VRK1 (vaccinia virus B1R kinase related kinase). VRK1 was also found to have sequence identity (62.0% over 481 nucleotides) to a database EST. A full-length clone for this EST was isolated and sequenced. Conceptual translation predicts a protein of 508 amino acids that, like VRK1, has similarity to B1R kinase (38.7% identity over 300 amino acids). This gene has been named VRK2. Comparison of VRK1 with VRK2 indicates that they encode structurally related putative Ser/Thr protein kinases. Northern analysis shows that expression of both genes is widespread and elevated in highly proliferative cells, such as testis, thymus, and fetal liver. B1R kinase is reported to be essential for DNA replication of vaccinia virus. The similarity of VRK1 and VRK2 to B1R indicates that these genes may have similar functions.     

Labial fusion in a pubertal girl: a case report

An 18-year-old virgin, pubertal girl was treated for abnormal menses and dysmenorrhea. She had no history of trauma, sexual infection, or abuse. Occlusion of the introitus of the vagina had been first diagnosed 10 years earlier. The patient presented with fusion of the labia minora in the midline, posteriorly. Her physical examination, ultrasonographic laboratory examination, and intravenous pyelogram were all normal. Following surgical treatment, she had no problems at the time of postoperative follow-up.     

Muscle-specific creatine kinase gene polymorphisms in elite endurance athletes and sedentary controls

The purpose of this study was to investigate the association between elite endurance athlete (EEA) status and two restriction fragment length polymorphisms (RFLPs) at the muscle-specific creatine kinase (CKMM) gene locus. Genomic DNA was extracted from white blood cells or lymphoblastoid cell lines of 124 unrelated Caucasian male EEA (VO2max > 73 mL.kg-1.min-1) and 115 unrelated Caucasian sedentary male controls (SCON). The genetic polymorphism at the CKMM locus was detected by the polymerase chain reaction and DNA digestion with the NcoI and TaqI restriction endonucleases. The allelic frequencies for the NcoI and TaqI RFLPs were not different (P > 0.05) between EEA and SCON subjects. The three expected genotypes for CKMM-NcoI (1170/1170 bp, 1170/985 + 185 bp, and 985 + 185/985 + 185 bp) and CKMM-TaqI (1170/1170 bp, 1170/1020 + 150 bp, and 1020 + 50/1020 + 150 bp) were observed in the EEA and SCON groups. These genotype frequencies were in Hardy-Weinberg equilibrium, but they were not significantly (P > 0.05) different between the EEA and SCON. A strong (P < 0.001) linkage disequilibrium was detected among the NcoI and TaqI RFLPs in both EEA and SCON. These findings indicate that the skeletal muscle CK-NcoI and CK-TaqI gene polymorphisms are not associated with the elite endurance athlete status.     

Analysis of post-operative hypalbuminaemia: a clinical study

OBJECTIVE: Analysis of severity, causes and relevance of hypalbuminaemia developing after surgery. SUBJECTS: Patients undergoing elective aortic surgery (n = 11) or minor extra-abdominal surgery (n = 6). METHODS: Serum albumin concentration, blood loss, nitrogen balance and complications were determined until the fifth post-operative day. The contributions of haemodilution, albumin loss, albumin catabolism and redistribution were calculated using existing formula. The relation of hypalbuminaemia to the endocrine-metabolic response was determined. RESULTS: Significant hypalbuminaemia occurred after aortic surgery, in the absence of significant complications. No haemodilution occurred. Analysis indicated that 18% of hypalbuminaemia was caused by blood loss. Only 6% could be attributed to albumin catabolism, despite a significant correlation with the endocrine-metabolic response. Seventy-seven percent of hypalbuminaemia was attributed to albumin redistribution. No hypalbuminaemia occurred after minor surgery. CONCLUSION: Post-operative hypalbuminaemia is a normal finding early after aortic surgery. It is mainly caused by albumin redistribution, not by metabolic changes.     

Utilization of healthcare resources for asthma in Singapore: demographic features and trends

This study examined the healthcare utilization patterns for asthma in Singapore, a tropical island city-state, between 1986 and 1993. Asthma was ranked fifth among principal conditions with the highest number of discharges in Singapore (2.4 discharges per 1,000 population per annum). Among the 0-14 year-olds, asthma was ranked second, only after accidents and injuries, as the condition with the highest number of discharges (5.2 per 1,000). It was estimated that there were approximately 20,000 accident and emergency (A & E) room visits for asthma per annum (7.0 visits per 1,000 population per annum). There were, however, no significant changes in the number of hospitalized or emergency room cases for asthma over the period of analysis. In the primary healthcare setting, asthma ranked 6th among the leading conditions seen by the general practitioners and government polyclinics (15 visits per 100 population per annum). Among under 15 year olds, asthma (37 visits per 100 age-adjusted population per annum) ranked as the second leading condition behind upper respiratory tract infections. This study has shown that asthma causes a significant amount of morbidity in the Singapore community.