Effect of diabetes mellitus and insulin on the regulation of the PepT 1 symporter in rat jejunum

This investigation focused on studying the effects of insulin-dependent diabetes mellitus and insulin treatment on absorption of glycylsarcosine (Gly-Sar) across the Sprague-Dawley rat jejunum, using in situ perfusion in a physiologic acidic microenvironment at pH 6.0. Rats were divided into five groups: normal controls in group I, normal colchicine-treated rats in group II, normal cytochalasin-treated rats in group III, streptozotocin-induced diabetic rats in group IV, and insulin-treated diabetic rats in group V. Histologic studies of the five different groups showed morphologic changes upon induction of diabetes and treatments with colchicine and cytochalasin and several variations in post-1 month diabetic rats treated with insulin. The rate of uptake of Gly-Sar was significantly reduced in the diabetic state. The comparison of colchicine-treated and cytochalasin-treated rats to the diabetic group suggests that an intact cytoskeleton and tight junctions may play a role in jejunal dipeptide absorption. In the diabetic and insulin-treated group, the dipeptide influx rate was significantly increased compared to that of the nontreated controls. The regulation of the PepT 1 symporter was further assessed by immunostaining and Western blot analyses in the normal, diabetic, and diabetic and insulin-treated groups. Our results showed that a downregulation of PepT 1 in the diabetics seemed to be due in part to the low systemic insulin levels, and not necessarily to hyperglycemia. In addition, the results suggest a probable role of systemic insulin binding at the vascular site of the jejunal epithelium, and the role that this hormone may be playing in the regulation and probably cellular trafficking of PepT1.     

Combined cilioretinal artery and hemi-retinal vein occlusion in Sturge Weber syndrome: Expanding the clinical spectrum

A 9-year-old boy with the diagnosis of Sturge-Weber Syndrome, and port-wine stain involving the right side of the face, presented with acute visual loss of the right eye. Examination revealed a high intraocular pressure and a combined cilioretinal artery and inferior hemi-retinal vein occlusion in the right eye. Systemic work-up was negative. After controlling the intraocular pressure, gradual improvement of vision was noticed with simultaneous disappearance of signs of vascular occlusion.     

Reversible Cardiomyopathy in an Adolescent with Idiopathic Aortic Cusp Ventricular Tachycardia

This report describes the case of an asymptomatic patient with a ventricular tachycardia-induced cardiomyopathy that resolved completely after successful radiofrequency ablation. This type of presentation and outcome has not been reported in the pediatric literature.     

Multiple Amplatzer septal occluder devices for multiple atrial communications: immediate and long-term follow-up results.

OBJECTIVES: We report on the feasibility, effectiveness, and long-term outcome of transcatheter closure of multiple ASD's using multiple ASO devices. BACKGROUND: Little is known about the use and long-term outcome of multiple Amplatzer Septal Occluder (ASO) devices to close multiple atrial septal defects (ASD's). METHODS: From May 1997 to June 2006, 33 patients (mean age 38.9 years and mean weight 68 kg) underwent transcatheter closure of multiple ASD's under transesophageal (TEE) or intracardiac echocardiographic (ICE) guidance. RESULTS: Unless not available, the device size chosen to be deployed was +/-2 mm larger than the stretched diameter or no more than 30-40% larger than the ICE/TEE 2D diameter. Sixty-seven devices were deployed in 33 patients. The mean diameters of the larger and smaller defects were 12.9 and 7.7 mm, and the corresponding mean balloon stretched diameters were 19.2 and 12.0 mm, respectively. The mean larger and smaller device diameters were 19.0 and 13.4 mm, respectively. The mean QP: Qs ratio was 1.8:1. The mean fluoroscopy time, and procedure time were 16.4 and 81.6 min respectively. Immediately after the procedure 15 patients had complete closure, 8 had trivial shunt, 9 had small shunt and one had large shunt. Complications included a device embolization within 24 hr and left atrial-aortic wall erosion and pericardial effusion at 2 years. The mean follow-up interval was 34.8+25.7 months. CONCLUSIONS: Device closure of multiple ASD's using multiple ASO's is safe and effective. Continued follow-up is important to assess the long-term outcome.     

Reducing Maternal Mortality from Direct Obstetric Causes during 2013 in Sudan

Despite the worldwide commitment to improve maternal health, measuring, monitoring and comparing mortality estimates remain a challenge. This study was done to assess maternal mortality from direct obstetric causes （obstetric haemorrhage, hypertensive disorders and sepsis） after suitable interventions in Sudan during 2013. Facility and community-based MDR （maternal death review） was conducted in Sudan since 2009. National and states＇ MDRCs （Maternal Death Review Committees） were established. A focal person for each state, health facility and locality was nominated. Notification of MD （maternal deaths） was done by telephone, followed by review of all notified maternal deaths using a structured format. Recommendations for reducing MM （maternal mortality） from obstetric haemorrhage, hypertensive disorders and sepsis have been generated. Management protocols, training of care providers and availing of necessary requirements for these cases have been approved and implemented in all states. Reported MD were reviewed and analyzed using SPSS, version 18.0 and the resulting MMR （maternal mortality ratio） was compared with years 2010-2012 to assess improvement. During 2013, 1,110 maternal deaths were notified, out of 645,881 LB （live births）. MMR was 172/100,000 LB, with different variation between states. Facility maternal deaths were 937 （84.4%） and community deaths were 173 （15.6%）. Direct obstetric deaths were 678 （61. I%）, mainly due to haemorrhage 311 （28.0%）, hypertensive disorders 116 （10.5%） and sepsis 110 （9.9%）. Indirect causes were 432 （38.9%）, mainly due to hepatitis and anemia. Most of the hospital deaths 707 （75.5%） were admitted late from home and 559 （59.7%） died within 24 hours. MDs from hypertensive disorders and sepsis decreased significantly, while MDs from haemorrhage are persistently high compared to 2010-2012. Home delivery, late presentation, unavailability of blood and poor referral system, are the main factors behind maternal death     

Chromium-picolinate induced ocular changes: Protective role of ascorbic acid

Chromium-picolinate (Cr-picolinate) is a popular nutritional supplement; however its safety has been questioned with regard to its ability to act as a clastogen. The aim of the present work was to evaluate the biochemical, histological and morphological changes in the cornea and lens following oral administration of Cr-picolinate and the possible protective effect of Vitamin C. Ninety male Sprague-Dawley rats were divided into five groups included the control group, the groups treated with Cr-picolinate (0.8 and 1.5 mg/100 g b.w.) alone or in combination with Vitamin C (0.5 mg/100 g b.w.) for 8 weeks. The results indicated that the high dose of Cr-picolinate induced a significant decrease in SOD, GSH, Na(+)-, K(+)-ATPase levels, and a significant increase in MDA level. Severe morphological and histological changes in the cornea and lens accompanied with a decrease in the total soluble protein of the lens homogenate and changes in the crystalline fractions in lens. Vitamin C supplementation succeeded to restore these changes to great extent. It could be concluded that consumption of Cr-picolinate for a long time induced several hazards to cornea and lens. Supplementation with extra amounts of Vitamin C may be useful to restrain the Cr-picolinate induced ocular changes.     

Flow-injection chemiluminescent determination of cefprozil using Tris (2,2'-bipyridyl) ruthenium (II)-permanganate system

A rapid and sensitive chemiluminescence (CL) method using flow-injection (FI) has been developed for the determination of a second generation cephalosporin, cefprozil. The method is based on the CL reaction of cefprozil with acidic potassium permanganate and tris (2,2'-bipyridyl) ruthenium (II), Ru (bipy)3(2+). The CL intensity is greatly enhanced when quinine sulfate is used as a sensitizer. After optimization of the different experimental parameters, a calibration graph was obtained over a concentration range of 0.1-3.0 microg ml(-1) with minimum detectability of 0.005 microgml(-1) (S/N=3). The correlation coefficient was 0.9998 (n=6) with a relative standard deviation (%R.S.D.) of 1.63% for 2.0 microgml(-1). The proposed method was successfully applied to commercial tablets. The average percentage recovery (n=6) was 99.9+/-1.40.