Relation of body fat distribution to hyperinsulinemia in children and adolescents: the Bogalusa Heart Study

The relation of body fat distribution to plasma levels of glucose and insulin during an oral glucose tolerance test was examined in 355 Black and White school-age children. Both central and peripheral fat were similarly related to fasting, 30-min, and 1-h glucose. Unlike peripheral fat, central body fat was more strongly related to the 1-h insulin response (r = 0.35 vs 0.26); this association remained significant for central fat independent of peripheral fat (r = 0.18). The strong relation of central fat to insulin response was noted in both races and sexes but not in either sexually immature or relatively thin children. These findings indicate that, even in early life, a central body fat pattern relates positively to insulin response to glucose load. Thus, knowledge of body fat localization may help identify persons most susceptible to hyperinsulinemia in early life.     

Safety and efficacy of internal mammary artery grafts for left main coronary artery disease. A preliminary report

Questions regarding the relative safety and efficacy of internal mammary artery (IMA) grafts versus saphenous vein grafts (SVG) in patients with left main coronary artery disease (LMCAD) have not been specifically addressed in the literature. To elucidate this point, we analyzed 196 patients with LMCAD who underwent myocardial revascularization between January 1975 and December 1981, 98 by IMA and SVG and 98 by SVG, IMA was used most often to bypass the left anterior descending (LAD). Chi Square and "t" tests were performed on all demographic, cardiac and operative data comparing IMA to SVG. All results were non-significant, indicating that the two groups were comparable. Anginal pattern was progressive or unstable in 93%. IMA was used in 4 patients who were on intra-aortic balloon pump. The mean number bypass grafts per patient was 3.1. Postoperative complications were comparable for both groups, including early and late myocardial infarction. Overall operative mortality was 2.6%. Results of a survival analysis indicated no significant difference in the mortality rates of patients operated on by SVG versus IMA-SVG. Cumulative mortality rates at a mean followup of 20.5 months were 12.2% for SVG and 7.1% for IMA patients. Significant mortality risk factors were ejection fraction less than 55% (p less than 0.05); and perioperative myocardial infarction (p less than 0.001). Twenty-five patients with recurrent chest pain underwent repeat cardiac catheterization. This revealed 10 of 10 patent IMA grafts, 6 of 8 single patent SVG to LAD and 6 of 9 patent sequential vein grafts to the diagonal and LAD arteries.(ABSTRACT TRUNCATED AT 250 WORDS)     

Effects of Lactuca sativa extract on exploratory behavior pattern,locomotor activity and anxiety in mice

ObjectiveTo evaluate antianxiety property of Lactuca sativa, an important and commonly used leafy vegetable known for its medicinal properties belongs to Asteraceae family.MethodsElevated plus maze (EPM), open field test (OFT), rat exposure test, hyponeophagia and marble burying test were performed in mice models to assess the exploratory behaviour and to assess anxiolytic property of hydro-alcohol extract of Lactuca sativa. Diazepam (1 mg/kg body wt.) served as the standard anxiolytic agent for all the tests. The dried extract of the plant leaf in doses of 100, 200 and 400 mg/kg body weight was administered orally to mice for duration of 15 or 30 days and evaluated exploratory behaviour, locomotor and anxiolytic activities.ResultsTime spent and number of entries into the open arm was measured in EPM followed by total locomotor activity in OFT and latency to enter the food zone in hyponeophagia.ConclusionsThe study suggested that hydro-alcohol extract of Lactuca sativa leaves possess potent anxiolytic property.     

Widespread central nervous system cavernous malformations associated with café-au-lait skin lesions. Case report

The simultaneous presence of cavernous malformations in the brain and spinal cord is a very rare finding and is typically associated with familial cavernous malformations. Although they are uncommon, various skin lesions can manifest in patients with familial cavernous malformations. The authors report on a 60-year-old man in whom more than 100 lesions consistent in appearance with cavernous malformations, including several intramedullary spinal cord lesions, were found throughout the neuraxis. This patient also displayed prominent café-au-lait skin lesions, but had no additional signs of neurofibromatosis or other neurocutaneous disorders. Analysis of his DNA revealed a novel mutation in the KRIT1/CCM1 gene, thereby confirming the diagnosis of familial cavernous malformation. The presence of these lesions in every major compartment of this patient's central nervous system underscores their indiscriminate nature and the need to screen throughout the neuraxis in patients in whom familial cavernous malformations are suspected. The findings in this case add to the growing list of skin lesions associated with genetically confirmed familial cavernous malformations. In patients presenting with seizures, focal neurological deficits, or hemorrhagic stroke, the presence of unusual skin lesions should prompt consideration of familial cavernous malformations, and appropriate screening should be performed.     

Delayed accumulation of lens material behind the foldable intraocular lens

Foldable acrylic intraocular lenses (IOLs) are known to reduce posterior capsule opacification by preventing migration of lens epithelial cells with its square edge design and its property of tackiness. Studies have reported a mean adhesiveness to posterior capsule more than three times higher for certain acrylic foldable IOLs than polymethyl methacrylate IOLs. The authors would like to report two cases where the force of tackiness was compensated, thereby presenting with delayed accumulation of lens material in the capsular bags behind the IOL with temporary loss of vision.     

Effect of chronic undernutrition on hepatocyte insulin receptors in rats

The effect of moderate chronic undernutrition on insulin receptors was studied in male rats, pair-fed 60% of the daily food intake of ad libitum-fed littermates, for 8 weeks. Body weights of undernourished rats were consistently found to be 35% to 40% less than control littermates, with no period of growth arrest at any point in the 8-week study. The binding-displacement curves of labeled insulin to hepatocyte receptors in the two groups in the presence of unlabeled insulin were significantly different (P = .0258 after repeated measures ANOVA). Significantly lower binding was observed in hepatocytes from the undernourished group (P less than .01) at all unlabeled insulin concentrations less than 20 nmol/L. In the absence of any unlabeled insulin, specific binding was reduced from 8.8% +/- 0.7%, (mean +/- SE) in controls, to 7.4% +/- 0.3% in undernourished rats (P less than .01). Half-maximal specific hormone binding to hepatocytes was achieved at a free insulin concentration of 362 nmol/L in the control group, compared with 447 nmol/L in the undernourished group, reflecting an increase of approximately 20%. The hypoglycemic response to intravenous insulin (0.1 U/kg body weight) was tested in a parallel experiment involving seven paired littermate rats, and found to be significantly impaired in the undernourished group (P = .0041 by repeated measures ANOVA).(ABSTRACT TRUNCATED AT 250 WORDS)     

Inpatient Management of Pulmonary Embolism: Clinical Characteristics and Mortality in a High-Volume Tertiary Care Center

Journal of Thrombosis and Thrombolysis - The optimal management strategy for submassive or intermediate risk pulmonary embolism (IRPE)—anticoagulation alone versus anticoagulation plus...