Strategies to reduce the progression of renal disease in patients with type II diabetes mellitus

The incidence of diabetes mellitus has increased dramatically in Puerto Rico. On 1996, it accounted for 56.8% of all new cases admitted for dialysis. By 1998 the number increased to 59.9%, of which, 88.5% were Type 2 diabetic patients. Strategies for the reduction or prevention of renal insufficiency of Type 2 diabetic patients should include: identification of potential chronic complications, review of risk factors related to diabetic nepropathy, and the evaluation of the arterial blood pressure and renal function. The therapeutic actions which have shown reduction of proteinuria and reduction of the progression to end stage renal disease in patients with type 2 diabetes are: strict control of the arterial pressure, the use of converting enzyme inhibitors, low salt diet and control of the protein intake. It is recommended that type 2 diabetic patients with high arterial pressure, micro or macroalbuminuria and increased serum creatinine should be referred to the nephrologist as early as possible.     

Presentation of multiple oncocytic type laryngeal cysts. Clinical and histopathological findings

Oncocytic cysts are a histologically well-defined subgroup of cystic lesions of the larynx. Oncocytic cysts of the larynx are rare, clinically similar to simple laryngeal cysts, and occur as a casual finding of pathology studies. Multiple oncocytic cysts have rarely been described. Microscopic examination of laryngeal biopsies showed cysts within the lamina propria lined by oncocytic epithelium. The differential diagnosis and pathogenesis of oncocytic cysts is discussed and other laryngeal cystic lesions are reviewed.     

Harvesting, routing, and anastomosing the left internal mammary artery graft

A technique to harvest, intrapleurally route, and anastomose the left internal mammary artery is described.     

一位家庭医生的一天

我诊所的一个同事那天值班，那天下班后急诊看了一个摔倒在地并且右侧手掌先触地的12岁男孩。患者有右手腕疼痛，但没有发现明显肿胀。当即拍了X线，但没有阳性发现。2天后，病人仍有疼痛，因此来到我的诊所让我看病。     

Chick kainate binding protein lacks GTPase activity.

Chick kainate binding protein was solubilized from cerebellar membranes and purified (x19) by use of two chromatographic steps. Measurements of [3H]kainate binding and GTPase activity in the different fractions reveal a consistent decrease of GTPase activity as the purification proceeds so that no GTPase is detectable after the final purification step. This fact, in the context of the differential involvement in nucleotide recognition of some critical amino acid residues in the p-loop motif of GTPases and in the guanine nucleotide-binding sequence of ionotropic glutamate receptors, together with significant discrepancies concerning the activity of individual nucleotides, suggests that both guanine nucleotide-recognizing sequences are unlikely to be alternative expressions of the same functional domain.