Effects of the calcium antagonist felodipine on renal haemodynamics, tubular sodium handling, and blood pressure in cyclosporin-treated dermatological patients

BACKGROUND: Deterioration of renal function and rise in blood pressure are clinically important side-effects of cyclosporin (CsA) treatment. Calcium antagonists may have a renoprotective effect against CsA nephrotoxicity. PURPOSE: To investigate the effect of the dihydropyridine calcium-channel blocker felodipine on renal haemodynamics, tubular sodium handling, and blood pressure in CsA- treated patients with no primary renal disease, 18 patients with various CsA-treated dermatological diseases were allocated to receive either felodipine 5 mg (extended release tablets) once daily for 4 weeks followed by placebo for 4 weeks, or vice versa, in a prospective, randomized, double-blind study. The patients were investigated before treatment and at the end of each treatment period. RESULTS: After felodipine, both glomerular filtration rate (GFR) and renal plasma flow (RPF) were significantly higher compared to placebo (89.4 +/- 17.5 (mean +/- SD) vs 79.0 +/- 15.9 ml/min and 412.0 +/- 107.6 vs 326.1 +/- 78.0 ml/min respectively, P < 0.001 for both), and filtration fraction (FF) was lower (0.22 +/- 0.03 vs 0.25 +/- 0.03, P < 0.001). Both systolic and diastolic blood pressure were lower after felodipine compared to placebo (116 +/- 11/71 +/- 7 vs 133 +/- 18/83 +/- 10 mmHg, P < 0.001 for both). Furthermore, proximal output of sodium, i.e. fractional excretion of lithium, was higher after felodipine (26.9 +/- 7.3% vs 20.4 +/- 5.5%, P < 0.001) as well as total sodium excretion (0.33 +/- 0.19 vs 0.19 +/- 0.08 mmol/min, P < 0.001). CONCLUSIONS: It is concluded, that felodipine 5 mg once daily for 4 weeks increased GFR, RPF, and sodium excretion in cyclosporin-treated dermatological patients with no primary renal disease. Furthermore, felodipine lowers blood pressure in these patients. The effects of felodipine may be due to an antagonizing effect against CsA-induced nephrotoxicity.      

Heart-lung transplantation: the postoperative chest radiograph

The postoperative chest radiographs of 10 patients who had undergone heart-lung transplantation at Stanford University Medical Center were evaluated and compared with those of 10 consecutive cardiac transplantation patients and 10 consecutive coronary artery bypass graft patients. In the second week after surgery, we observed an interstitial radiographic pattern in the heart-lung transplantation patients but not in the other two patient populations. This pattern, which did not correspond with any clinical evidence of infection, rejection, fluid overload, or oxygen toxicity, may represent the reimplantation response described in dogs and primates following transplantation of a single lung. This response may be related to the interruption of bronchial circulation, the denervation of both lungs, and the lymphatic interruption that occur during transplantation. It may also be related to the obligatory period of ischemia that is incurred during implantation.     

Radiographic parenchymal opacity, matching perfusion defect, and normal ventilation: a sign of pulmonary embolism? Work in progress

By conventional criteria, perfusion defects that correspond to radiographic parenchymal opacities of similar size have less diagnostic significance for pulmonary embolism (PE) than perfusion defects in areas that are radiographically clear, regardless of the findings on ventilation scan. It was proposed that the demonstration of normal ventilation in areas with matched radiographic opacity and perfusion defects does support the diagnosis of PE. To test this hypothesis, a retrospective review was done of selected cases from a consecutive series of 85 pulmonary angiography studies. Cases were reviewed if the following criteria were met: chest radiography, ventilation-perfusion scintigraphy, and angiography of the relevant regions had all been performed within 24 hours of one another, and there was a radiographic opacity corresponding to the perfusion defect. Sixteen cases fulfilled these criteria. Six patients had normal ventilation in the regions of the radiographic infiltrate and perfusion defect, and all had PE. No patient had an area of opacity and perfusion defect and normal ventilation without PE.     

Hyperoxia retards growth and induces apoptosis and loss of glands and blood vessels in DMBA-induced rat mammary tumors

Background  

This study investigated the effects of hyperoxic treatment on growth, angiogenesis, apoptosis, general morphology and gene expression in DMBA-induced rat mammary tumors.     

Estrogen-induced microsatellite DNA alterations are associated with Syrian hamster kidney tumorigenesis

Exposure to estrogens is associated with an increase in cancers, including malignancies of the breast and uterus in humans, and of the kidney in hamsters. DNA damage induced by metabolic activation of estrogen has been postulated to result in gene mutations critical for the development of estrogen-induced kidney tumors in hamsters. As part of our examination of the genetic consequences of estrogen-induced DNA damage, we searched for estrogen-induced alterations in microsatellite DNA, a frequent site of mutation in tumors. Genomic DNA isolated from kidney of hamsters treated with estradiol, from estrogen-induced kidney tumors and from untreated age-matched controls, was examined by Southern blot analysis with three multi-locus oligonucleotide probes: (GACA)4, (CAC)6 and (CAG)6. Alterations in DNA fragments containing GACA and CAC tandem repeats were detected in kidney DNA of hamsters treated with hormone for 3 and 4 months, whereas no such effects were seen in control animals. In estrogen-induced tumors, microsatellite alterations were observed in fragments that contain these same two repeat sequences and also CAG repeat sequences. The induction of microsatellite alterations by estradiol in kidney DNA preceding estrogen-induced renal malignancy may play a role in hormone-induced tumorigenesis.      

Occurrence of Clinostomum complanatum in Aphanius dispar (Actinoptrygii: Cyprinodontidae) collected from Mehran River,Hormuzgan Province,South of Iran

Objective

To investigate the possibility of Aphanius dispar (A.dispar) acting as intermediate host for Clinostomum complanatum (C. complanatum), from Mehran River, Hormuzgan Province of Iran.

Methods

During a biological study of A. dispar in Mehran River, Hormuzgan Province, South of Iran, a total of 97 fish specimens were collected in 24 January 2006.

Results

4 specimens (4.12%) including 1 male and 3 female were found infected with C. complanatum metacercaria. These metacercaria were coiled in the epiderm on the body surface of infected fishes. The infection is known as yellow spot disease. The parasite abundance, intensity and prevalence were 0.05%, 1.25% and 4.12%, respectively. The infection was higher in females than males.

Conclusions

To the best of our knowledge, this is the first report on occurrence of C. complanatum metacercaria in A. dispar in Iran.