Nephropathy of type II diabetes: evidence for hereditary factors?

Family studies point to an important genetic element in the genesis of diabetic nephropathy, but it is not known whether renal abnormalities are present prior to the onset of diabetes. To address this issue we examined all consecutive patients suffering from type II diabetes with a duration of more than 10 years who attended a diabetes outpatient clinic. Ninety-four patients had nephropathy, 307 did not. All offspring who were phenotypically normal (no hypertension, normal oral glucose tolerance, non-smoking) and agreed to participate were examined, 26 from nephropathic and 30 from non-nephropathic diabetic parents. They were compared with 30 offspring matched for age, gender and BMI from non-diabetic parents as controls. We measured urinary albumin excretion under baseline conditions and at several time points after ingestion of 300 g cooked beef and submaximal treadmill exercise, respectively. In addition, casual blood pressure, ambulatory blood pressure, urinary albumin and urinary alpha-1-microglobulin were measured. Primary renal disease was excluded by clinical examination. Under baseline conditions, median urinary albumin excretion rate (AER; microgram/min) was significantly (P < 0.005) higher in offspring of nephropathic type II diabetic patients (7.8; range 1.04 to 19.5) than in the offspring of non-nephropathic type II diabetic patients (4.8; 0.36 to 17.5) and controls (4.4; 0.16 to 18.4). Submaximal treadmill exercise caused a greater proportional increase of AER in offspring of nephropathic type II diabetics (median 16-fold) than in offspring of non-nephropathic diabetic patients (6.3-fold) or controls (4.8-fold). In offspring of nephropathic diabetic patients casual and particularly ambulatory systolic blood pressures were significantly higher, but AER was not correlated with blood pressure. In summary, higher values, albeit within the normal range, for baseline and postexercise albuminuria were noted in phenotypically normal offspring of parents with type II diabetes and nephropathy. The observation suggests that changes in transglomerular albumin traffic are demonstrable prior to the onset of diabetes and diabetic nephropathy in subjects with a potential genetic predisposition to these conditions.     

Estimation of sampling error variance in the meta-analysis of correlations: Use of average correlation in the homogeneous case.

The estimate of the population correlation used in the formula for sampling error variance of a correlation is typically the observed correlation, but in meta-analysis the average of the observed correlations can be used. For the case in which there is no variation in the study population correlations or sample sizes and the number of studies is very large, the authors found that use of the average correlation estimator is more accurate than use of the traditional, individual correlation estimator, except in those rare cases in which the uncorrected population correlation is greater than .60. For typical sample sizes, when the uncorrected population correlation is between -.40 and .40, there is virtually no error in the meta-analysis credibility interval based on the average correlation estimator. On the other hand, the amount of the error in the individual correlation estimator is qualitatively important if the sample is 25 or less and the population correlation is less than .40. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Regulation of distal esophageal mucosal blood flow: the roles of nitric oxide and substance P

BACKGROUND: An increase in esophageal mucosal blood flow (MBF) may be an important protective mechanism against mucosal injury from noxious agents that are ingested or refluxed. This study investigated the changes in MBF and the regulation thereof after intraluminal application of noxious chemical stimuli. The role, if any, of substance P (SP) and nitric oxide (NO), two potent vasodilatory substances, and the vascular distribution of SP in the distal esophagus were evaluated. METHODS: Esophageal MBF was measured in anesthetized dogs with a laser Doppler flow probe attached to manometry and pH probes. MBF was measured before and after topical application of HCl (2 ml; 1N) or capsaicin (2 ml; 0.5%) in the distal esophagus. The effects on MBF of intraarterial SP and bradykinin were also determined. Pharmacologic antagonists and denervation procedures were used to delineate the mechanisms that regulate MBF. RESULTS: Sequential luminal applications of hydrochloric acid (HCl) or a single application of capsaicin increased MBF (p < 0.01). Topical intraluminal lidocaine blocked the response to capsaicin (p > 0.2) but not to HCl (p < 0.05). Abrupt increases in MBF occurred with intraarterial SP or bradykinin (p < 0.01). Neither atropine nor truncal vagotomy blocked the increase in MBF from these peptides or noxious stimuli. The NO synthesis antagonist NG-nitro-L-arginine methyl ester (L-NAME) blocked the response to bradykinin and attenuated the response to HCl (p < 0.05). NG-nitro-L-arginine methyl ester did not affect the response to SP or capsaicin. A substance P antagonist blocked the effects of both capsaicin (p > 0.6) and SP (p > 0.1) but not that of HCl (p < 0.01) or bradykinin (p > 0.01). CONCLUSIONS: Intraluminal applications of HCl or capsaicin appear to stimulate increases in esophageal MBF by different mechanisms. HCl produces an adaptive response that appears dependent on the paracrine effect of NO. Capsaicin-sensitive neurons mediate vasodilation through SP neurotransmission, independent of extrinsic vagal or cholinergic innervation.     

Quality of life following percutaneous transluminal angioplasty for claudication

Basal cell carcinoma (BCC) is the most common type of skin cancer and the incidence of BCC is expected to rise, with increased demand on dermatology resources. Little is known of the effect on people's lives of having skin cancer. The aim of this study was to quantify the handicap caused gy basal cell carcinomas before and after therapy. Forty-four patients (22 males, mean age = 65 yrs, range = 35-81 yrs) with 48 BCCs were recruited and 37 patients completed the study. Each patient completed the UK Sickness Impact Profile (UKSIP) and the Dermatology Life Quality Index (DLQI) at the initial visit to the dermatology clinic, 1 week after treatment and 3 months after treatment. Lesions had been present for a mean of 25 months (range = 1-240 months), their mean diameter was 9.6mm (range = 3-35mm) and the sites were head and neck (79%), trunk (17%) and limbs (4%). There was no relationship between the quality of life score and size of lesion. Overall the scores at presentation were very low, rising 1 week after treatment and falling to below the initial scores at 3 months (mean UKSIP 0.4%, 0.7%, 0.13%; mean DLQI 5.3% 8.7%, 1.2%). BCCs cause little handicap. This may explain the delay in seeking medical attention and should be considered in planning public health education about BCCs.     

The role of dopamine in the mechanism of the regulation of the digestive-transport functions of the enterocyte membrane during stress

The L-DOPA and sulpiridinum effects on the enzymatic transporting function of the enterocytes' membrane, were studied in rats under stress. The L-DOPA was shown to hinder the absorption rate of glucose, whereas sulpiridinum was shown to suppress the main enzymes excepting snerase and alkaline phosphatase, to increase the monomeric and hydrolysate glucose transport. The L-DOPA seems to play a modifying role in the regulation and integration of the digestive-transporting function of the enterocytes' membrane in rats under stress.     

Wide-band symmetrical analog multiplier IC for coherentoptical-fiber receivers operating up to 10 Gb/s

A versatile analog four-quadrant multiplier IC with large bandwidth (DC to 6 GHz and 10 Gb/s) and large dynamic range is presented. It was mainly developed for differential-phase-shift-keying (DPSK) phase demodulator and polarization diversity receivers in coherent optical-fiber transmission systems. The circuit consumes 450 mW and only needs a single power supply of -5 V. The circuit principle used allows exact symmetry with respect to both linear inputs, which reduced multiplication errors. In the intended application, especially, the time jitter and the offset voltage of the output pulse patterns are reduced to negligible values. The IC was realized in a 1.25-μm double-polysilicon bipolar technology     

Homogenization of hardness distribution and distortion in high pressure gas quenching

Quenching with gases rather than oil or other liquid media has the advantages of reducing the risks concerning health and environment, while simultaneously homogenizing the quenching results and minimizing distortion due to a wide range of possible process parameter variations and the pure convective heat transfer. In this contribution, a coupled solution for increasing homogenization of quenching results within high pressure gas quenching will be presented. In the first stage, an experimental test facility was set up for flow investigations and in the second stage a numerical simulation model was generated. The numerical and experimental results of the flow through the chamber were compared for several boundary conditions. Finally, after complete verification of the simulation, the model may be used to assist in parameter variation for optimization of homogeneous high pressure gas quenching.