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[Should oral rehydration solutions be standardized?].
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[Absence of an association between the C825T polymorphism of the G-protein beta 3 subunit and salt-sensitivity in essential arterial hypertension].
The genetic functional variant C for T in position 825 of the gene encoding G protein beta 3 subunit, GNB3, has been associated with enhanced G protein activation, cell growth and proliferation. This phenotype is associated with enhanced G protein activation and Na(+)-H+ exchanger activity in cells from hypertensive patients. Salt sensitivity affects approximately 50% of hypertensive patients and constitutes an intermediate phenotype determined in part by genetic factors. An association between enhanced Na(+)-H+ exchanger activity and salt sensitivity has been previously reported. The aim of the present study was to investigate the possible association between the G protein polymorphism and salt sensitivity in patients with essential hypertension. A total of 46 patients were studied and classified according to their blood pressure response to a change in sodium intake from low (20 mmol/day) to high (260 mmol/day) into salt sensitive (SS) (n = 20) and salt resistant (SR) (n = 26). GNB3 polymorphism was determined by PCR of genomic DNA and restriction digestion with BseDI. The genotypes distribution among the SS hypertensives was: 8 CC and 12 CT + TT, whereas in SR was: 10 CC and 16 CT + TT (p = 0,577). 24 h mean blood pressure response to salt in the whole group was not different among the different genotypes: CC 4.1 +/- 5.4 mmHg compared to CT + TT 2.9 +/- 6.3 mmHg (p = 0.51). There were no significant differences in the salt induced changes in plasma renin activity, aldosterone, ANP or noradrenaline among the different genotypes. These results indicate that the GNB3 C825T polymorphism has no major influence on the pressor response to salt in essential hypertension and therefore do not support its usefulness as an early genetic marker of salt sensitivity in this disease.
[Selective inhibitors of cyclooxigenase-2 (Coxibs) and cardiovascular morbidity].
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Protein tyrosine kinase and protein phosphatase signaling pathways regulate volume-sensitive chloride currents in a nonpigmented ciliary epithelial cell line.
PURPOSE: To investigate whether signaling pathways that incorporate protein tyrosine kinases and phosphatases regulate PKC-sensitive, volume-sensitive Cl(-) currents (I(Cl,vol)) in cultured rabbit nonpigmented ciliary epithelial cells. METHODS: Activation of I(Cl,vol) in response to hyposmotic stimulation was recorded with whole-cell patch-clamp techniques in the presence of pharmacologic agents that activate or block kinases and phosphatases. RESULTS: I(Cl,vol) in rabbit nonpigmented ciliary epithelial cells was identified as a PKC-sensitive, volume-sensitive Cl(-) current, because current was downregulated during cell swelling by phorbol-12-dibutyrate, a PKC activator, and the PKC inhibitors, calphostin and chelerythrine, enhanced the current. Activation of c-Src tyrosine kinases, with an Src activator peptide (EPQ(pY)EEIPI), increased I(Cl,vol) after hyposmotic stimulation, whereas the protein tyrosine kinase inhibitor, genistein, but not its inactive analogue daidzein, inhibited the current. The phosphatidylinositol-3-kinase (PI3K) inhibitor, wortmannin, inhibited I(Cl,vol). Wortmannin did not further inhibit I(Cl,vol) in cells pretreated with the protein tyrosine kinase inhibitor, genistein, but blocked enhancement of I(Cl,vol) by PKC inhibitors. The serine-threonine protein phosphatase (PP) inhibitor, okadaic acid, blocked activation of I(Cl,vol), whereas insulin, which activates PI3K and PP-1, enhanced the current. The insulin-enhanced current was also blocked by okadaic acid. I(Cl,vol) was not activated under isosmotic conditions by the simultaneous inhibition of PKC with calphostin and activation of PP-1 by insulin. CONCLUSIONS: These data show that PKC-sensitive Cl(-) currents activated in response to cell swelling in nonpigmented ciliary epithelial cells are modulated by protein tyrosine kinase, PI3K, and PP signaling pathways. Activation of PP and PKC may involve the upstream intermediaries Src tyrosine kinase and PI3K.
[Finapres and Portapres devices].
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[Prevalence of renal involvement in a population of type Ii diabetics followed up in primary care].
UNLABELLED: Patients with type 2 diabetes use to be managed in their primary care settings during the early stages of the disease. The main objective of the study was to determine renal impairment prevalence, and to assess its significance, within type 2 diabetics controlled by their family physicians. PATIENTS AND METHOD: Transverse observation of patients with type 2 diabetes who were the first 20 unselected cases seen by 183 family physicians from 16 of the 17 Autonomic Communities of our country. The following variables were determined: serum creatinine, glucose, and HbA1c concentrations, proteinuria (dipstick test in a first-voided morning urine sample), blood pressure levels, and associated cardiovascular disease. RESULTS: Data from 3,583 type 2 diabetic subjects were evaluated. Mean age was 64 +/- 10 years and 45% were male. A serum creatinine > or = 1.2 mg/dl was observed in 523 (15.5%) patients. Proteinuria was present in 794 (23.5%) cases, being > or = 2 + in 215 (6.5%) subjects. Patients with a serum creatinine > or = 1.2 mg/dl were older, shower higher blood pressure levels, and suffered from more cardiovascular disease (32.0 vs 19.5%) than those with a serum creatinine < 1.2 mg/dl. In a multivariate analysis, this difference continued to be significant (OR 1.47; 95% CI 1.14 to 1.90; p = 0.002. Patients with proteinuria showed a higher prevalence of cardiovascular disease (OR 1.83; 95% CI 1.47 to 2.27; p < 0.0001) than those without proteinuria. This association was continuous through no proteinuria to the > or = 2 + proteinuria (p < 0.001). Blood pressure level was > or = 140/90 mmHg in 69% of the cases, being < 130/85 mmHg in only 8% of the subjects. CONCLUSIONS: There is a high prevalence of renal impairment, approximately of 25% within type 2 diabetic patients seen at the primary care level. Optimal blood pressure level seems to be extremely infrequent bearing in mind the diagnosis of diabetes and the associated cardiovascular disease.
A clinical follow-up study of magnetically retained overdentures (Dyna-system).
This study reports on 99 magnetic retention units (root caps and minimagnets) were used to stabilise overdentures in 66 patients. Tooth mobility, root caries, periodontal health, denture function, integrity of root caps and minimagnets were evaluated 4-12 years after insertion. The results showed a marked reduction in root mobility (increased stability in 86% of the roots), but extraction of 8% of the roots. After 116 months the survival rate calculated according to Kaplan and Meier was 79% for roots, 90% for caps and 77% for minimagnets. Nine per cent of the roots demonstrated caries and 10% discoloration of the root caps.
Obstruction and normal recanalization of the ureter in the human embryo. Its relation to congenital ureteric obstruction.
In this work, after the study of 45 normal human embryos of 5-55 mm from vertex to coccyx, it is shown that the ureteric ducts, which in the first phases of development are permeable (embryos of 5-13 mm), constantly undergo a process of obstruction and posterior recanalization of their lumen, which takes place when they are from 14 to 22 mm. These processes begin in the middle zone of the ureters and progress proximally and distally until they cover its entire length, for which these ducts, which in embryos of approximately 17 mm in length form solid cords, but in the embryos of 23 mm are totally permeable. This obstructive process is found in relation to atrophy and loss of activity of the mesonephros, while that of recanalization follows the intense longitudinal growth of the ureters in this phase of development. These modifications, which the ureteric lumen normally undergoes during its embryonic development, are of great importance for correct interpretation of the pathogenic mechanism of congenital ureteric strictures and valves.
Bioinformatics and reanalysis of subtracted expressed sequence tags from the human ciliary body: Identification of novel biological functions.
PURPOSE: The ciliary body is largely known for its major roles in the regulation of aqueous humor secretion, intraocular pressure, and accommodation of the lens. In this review article we applied bioinformatics to re-examine hundreds of expressed sequence tags (ESTs) previously isolated by subtractive hybridization from a human ciliary body library [1]. The DNA sequences of these clones have been recently added to the web site of NEIBank. METHODS: DNA sequence comparisons of subtracted ESTs were performed against all entries in the last available release of the non-redundant database containing GenBank, EMBL, DDBJ and PDB sequences using the BlastN program accessed through NCBI's BLAST services on the internet (NCBI). Sequences were also compared and mapped using the Blast search program provided through the Internet by the Human Genome Project (UCSC). RESULTS: A total number of 284 independent ESTs were classified in 17 functional groups. Analysis of their relationships allowed to define the expression of five major groups of known genes: (i) protein synthesis, folding, secretion and degradation (20%); (ii) energy supply and biosynthesis (12%); (iii) contractility and cytoskeleton structure (6%); (iv) cellular signaling and cell cycle regulation (7%); and (v) nerve cell related tasks (2%), including neuropeptide processing and putative non-visual phototransduction and circadian rhythm control. The largest group contain unidentified sequences, a total of 105 sequences, accounting for 37% of ESTs. The unidentified sequences show similarity to genomic non-coding regions, or genes of unknown function. CONCLUSIONS: The most highly represented EST, correspond to myocilin, a gene involved in glaucoma. The data also confirms the secretory functions of the ciliary epithelium, and its high metabolism; the presence of a neuroendocrine peptidergic system presumably involved in the regulation of the intraocular pressure and/or aqueous humor secretion. Additional genes may be related to a non-visual phototransduction cascade and/or to circadian rhythms. Overall this initial group of subtracted ESTs can lead to uncover novel physiological functions of the ciliary body in normal and in disease, as well as novel candidate genes for ocular diseases.
[Neonate with Down syndrome and persistent condensation in the middle lobe].
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Individual thermal profiles as a basis for comfort improvement in space and other environments.
BACKGROUND: The development of individualized countermeasures to address problems in thermoregulation is of considerable importance for humans in space and other extreme environments. A methodology is presented for evaluating minimal/maximal heat flux from the total human body and specific body zones, and for assessing individual differences in the efficiency of heat exchange from these body areas. The goal is to apply this information to the design of individualized protective equipment. METHODS: A multi-compartment conductive plastic tubing liquid cooling/warming garment (LCWG) was developed. Inlet water temperatures of 8-45 degrees C were imposed sequentially to specific body areas while the remainder of the garment was maintained at 33 degrees C. RESULTS: There were significant differences in heat exchange level among body zones in both the 8 degrees and 45 degrees C temperature conditions (p < 0.001). The greatest amount of heat was absorbed/released by the following areas: thighs (8 degrees C: -2.12 +/- 0.14 kcal min(-1); 45 degrees C: +1.58 +/- 0.23); torso (8 degrees C: -2.12 +/- 0.13 kcal min(-1); 45 degrees C: +1.31 +/- 0.27); calves (8 degrees C: -1.59 +/- 0.26 kcal min(-1); 45 degrees C: +1.53 +/- 0.24); and forearms (8 degrees C: -1.67 +/- 0.29 kcal x min(-1); 45 degrees C: +1.45 +/- 0.20). These are primarily zones with relatively large muscle mass and adipose tissue. Calculation of absorption/release heat rates standardized per unit tube length and flow rate instead of zonal surface area covered showed that there was significantly greater heat transfer in the head, hands, and feet (p < 0.001). The areas in which there was considerable between-subject variability in rates of heat transfer and thus most informative for individual profile design were the torso, thighs, shoulders, and calves or forearms. CONCLUSIONS: The methodology developed is sensitive to individual differences in the process of heat exchange and variations in different body areas, depending on their size and tissue mass content. The design of individual thermal profiles is feasible for better comfort of astronauts on long-duration missions and personnel in other extreme environments.
[Hemostasis and coagulation in pneumonitis (preliminary note)].
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Eplerenone in patients with left ventricular dysfunction.
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[The role of new dihydropyridine calcium channel blockers in the treatment of hypertension].
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[Prostatic syndrome as presentation form of non-Hodgkin's lymphoma].
Description of one case of a 66 years old patient who developed prostatic syndrome with obstructive renal insufficiency. The ultrasound study showed the existence of a large prostatic mass diagnosed by means of a biopsy as a non-Hodgkin lymphoma. The thoraco-abdominal computerized tomography ruled out the presence of distant adenopathy while bone marrow biopsy did not show lymphoma infiltration. Subsequently, the patient was given polichemotherapy following a CHOP scheme. After 6 cycles, a second CT was performed that showed disappearance of the previously described prostatic mass. Chlorambucil was given as maintenance therapy. The patient remains asymptomatic and disease-free nine months after discontinuing the polichemotherapy.