Plasma triglyceride levels and body mass index values are the most important determinants of preβ-1 HDL concentrations in patients with various types of primary dyslipidemia

ObjectiveExperimental studies have shown that the preβ-1 subclass of high-density lipoprotein particles (preβ-1 HDL) may play an important role in the reverse cholesterol transport pathway as the initial acceptors of cellular cholesterol. The aim of the present study was the direct comparison of preβ-1 HDL values in individuals with various types of primary dyslipidemias.MethodsFour hundred and eighty-six unrelated individuals were included in the study. According to their lipid values study participants were subdivided into four groups: control group (n = 206), type IIA dyslipidemia group (n = 148), type IIB dyslipidemia group (n = 49) and type IV dyslipidemia group (n = 83).ResultsAll dyslipidemic patients displayed higher concentrations of preβ-1 HDL compared to control individuals. However, patients with dyslipidemias characterized by an abnormal catabolism of triglyceride-rich lipoproteins (such as dyslipidemias of type IIB and IV) tend to have higher preβ-1 HDL values compared to patients with hypercholesterolemia, and this increase is proportional to the degree of hypertriglyceridemia. In addition, patients with metabolic syndrome exhibited significantly higher levels of preβ-1 HDL compared to individuals that do not fulfill the criteria for the diagnosis of this syndrome. Multiple regression analysis revealed that serum triglyceride concentrations and body mass index (BMI) values were the most important determinants of preβ-1 HDL levels in our population.ConclusionAll dyslipidemic patients exhibit increased preβ-1 HDL concentrations as compared to normolipidemic individuals. Whether this increase represents a defensive mechanism against atherosclerosis or it is indicative of impaired maturation of HDL particles and thus of a defective reverse cholesterol transport mechanism remains to be established.     

Testicular adrenal rest tumors and Leydig and Sertoli cell function in boys with classical congenital adrenal hyperplasia

CONTEXT: Infertility observed in adult males with congenital adrenal hyperplasia (CAH) has been associated with testicular adrenal rest tumors (TART) that may originate during childhood. OBJECTIVE: Our objective was to describe the prevalence of TART and Sertoli and Leydig cell function in a group of boys aged 2-10 yr with CAH and to compare prevalence with that of a control group. DESIGN: From August 2005 to January 2007, 19 patients with classical CAH (CAH group) were referred from seven endocrinology centers. METHODS: We studied 19 subjects in the CAH group and, as a control group, 13 boys from the community that did not have testicular diseases. A complete physical exam was performed. High-resolution ultrasound was used to determine TART prevalence. Inhibin B and anti-Müllerian hormone were used as Sertoli cell markers. The ratio between basal testosterone levels and testosterone levels 72 h after beta-human chorionic gonadotropin (5000 U/m2) treatment [(T72- T0)/T0] was used to evaluate Leydig cell response. RESULTS: CAH and control groups were comparable in chronological age (5.9 vs. 5.6 yr; P = 0.67) and bone age/chronological age ratio (1.09 vs. 1.03; P = 0.09). TART prevalence was four of 19 (21%) in the CAH group. Lower values for inhibin B (49.2. vs. 65.2 pg/ml; P = 0.018), anti-Müllerian hormone (70.1 vs. 94.2 ng/ml; P = 0.002), and (T72- T0)/T0 (5.6 vs. 13.6; P < 0.01) were observed in the CAH group. CONCLUSION: TART in prepubertal males with classic CAH could be found during childhood. We also report differences in markers of gonadal function in a subgroup of patients, especially in those with inadequate control.     

Association of estrogen receptor-alpha gene polymorphisms with stroke risk in patients with metabolic syndrome

Objective –  The vascular protective effects of estrogens are mediated by their binding to the two known estrogen receptors. In this study, we examine the association of stroke with two common polymorphisms of the ESR1 gene in patients with metabolic syndrome.
Materials and methods –  DNA from 130 patients hospitalized for ischemic stroke and 240 healthy controls were genotyped for ESR1 Pvu II and Xba I polymorphisms.
Results –  Comparing female and male patients, it was found that CCGG diplotype is more frequent in male patients ( P  = 0.03). In addition, the AA genotype is associated with the onset of stroke at a younger age in the male patient group ( P  < 0.05).
Conclusions –  These findings suggest that Pvu II and Xba I polymorphisms may affect the age at onset of the first stroke and the probability of developing cerebrovascular disease.     

Application of paclitaxel-eluting metal mesh stents within the pig ureter: an experimental study

OBJECTIVE: The purpose of the present study is to compare the standard bare metal stents (BMS) with the Paclitaxel-Drug Eluting Stent (DES) in the ureter of a pig model. MATERIALS AND METHODS: We report on an experimental study with ten female pigs weighing between 25 and 30 kg. The stents were randomly placed in either the right or left ureter in each of 10 study animals, for a total of 20 stented ureters. Ten ureters were stented with an R-Stent (Orbus Medical Technologies, Hoevelaken Netherlands), and ten with a Paclitaxel-Eluting Coronary Stent (Boston Scientific, Natick, MA, USA). Patency was measured by radiograph of the nephrostomy tract, intravenous urography and virtual endoscopy at 24 hours and 21 days after the initial procedure, respectively. RESULTS: Free flow of urine through the stents into the bladder was documented in all stented ureters 24 hours after stent insertion by radiograph of the nephrostomy tract. At the 21 day follow-up examination, 5 R-Stents were found to be completely occluded and two partially stenosed, whereas no occluded stent was detected in the Paclitaxel-DES group. Pathology examination of the stents at 21 days follow-up showed that the obstructed R-Stents generated severe inflammation with metaplasia of the urothelium. The Paclitaxel-Eluting MS generated a mild inflammatory response within the ureteral lumen at the site of the stent, without hindering ureteral patency. R-stents proved to develop more hyperplasia compared to the Paclitaxel-Eluting MS. CONCLUSIONS: Paclitaxel-DES, when compared with the standard R- Stent BMS, generated less inflammation and/or hyperplasia of the surrounding tissues, thus maintaining ureteral patency. Long-term animal trials are required to further validate our results.     

The effect of fibronectin and a bone xenograft on regenerative treatment: a feasibility study

The purpose of this study was to evaluate the ability of fibronectin to augment the regenerative effects of a bovine-derived xenograft in human periodontal defects. Using a parallel arm, randomized double-blind design, 24 patients with an intrabony defect or a Class II furcation defect were randomly assigned to either the experimental group (xenograft plus fibronectin) or the control group (xenograft without fibronectin). Probing attachment level, pocket depth, and gingival recession were measured at baseline and at 12 months after surgery. Both treatment modalities resulted in attachment gain and pocket depth reduction compared with baseline values. Changes in clinical attachment were not significantly different between the groups (gain of 1.5 mm +/- 1.1 mm in the experimental group and 1.3 mm +/- 1.4 mm in the control). Pocket depth reduction was greater in the control (2.3 mm +/- 1.2 mm) than in the experimental group (2.1 mm +/- 1.9 mm). Gingival recession also was greater in the control (0.9 mm +/- 0.6 mm) than in the experimental group (0.6 +/- 1.5 mm). Subtraction radiography revealed no significant differences between the groups when measuring changes in the distance between the cementoenamel junction and the crest of the bone or in the estimated gain in mineralized tissue mass. It was concluded that a significant difference between the regenerative treatment modalities could not be demonstrated within the limitations of the study. Fibronectin appears to have a stabilizing or proliferative effect on the gingival soft tissue by promoting less postoperative gingival recession.     

Association between hostility and plasma total homocysteine concentrations in a general population sample

OBJECTIVE: The present study focuses on testing the association of hostility with plasma homocysteine levels in a general population sample. METHOD: Four hundred and ten healthy adults (200 men and 210 women), participating in a health survey in Greece, had blood samples taken for homocysteine concentrations and also completed a multidimensional hostility questionnaire, assessing direction of hostility ('extra- and intropunitive') as well as total hostility and its ingredients, i.e. urge to act out hostility, criticism of others, delusional hostility, self-criticism and delusional guilt. Multivariate relationship was tested between hostility components and homocysteine, after statistically controlling for potential confounders such as age, gender, educational status, smoking and body mass index. RESULTS: Total hostility, delusional guilt as well as extrapunitive direction of hostility were positively related to homocysteine levels. Self-criticism was negatively related to homocysteine. CONCLUSION: The study provides further evidence that particular dimensions of hostility are associated with increased plasma homocysteine levels, thus deserving a place within the spectrum of the coronary heart disease risk factors.     

Non-contact holmium:YAG laser thermal keratoplasty for hyperopia: two-year follow-up

PURPOSE: We evaluated the safety and efficacy of the non-contact holmium:YAG laser thermal keratoplasty (LTK) for the treatment of mild to moderate hyperopia without astigmatism. METHODS: A prospective, non-comparative case series included 50 eyes of 28 patients (aged > or =40 years) who had stable refraction and an astigmatic component < +0.50 diopters (D). We applied the non-contact pulsed holmium:YAG laser to treat the hyperopic spherical component using the Hyperion LTK System. All patients had minimum 12-month follow-up and 64% (18 patients) had 24-month follow-up. RESULTS: The mean age of patients was 48.4 +/- 8.23 years (range: 40 to 62 years). The preoperative hyperopic mean spherical equivalent refraction was +2.32 +/- 0.975 D (range: +1.00 to +4.75 D). Postoperatively, the subjective manifest refraction decreased from the preoperative mean value of +2.32 D to a mean -0.09 D at 1 month after surgery and regressed to +0.315 D at the last follow-up examination, resulting in a mean correction of +2.005 +/- 0.81 D at 24 months after surgery. Preoperatively, mean uncorrected visual acuity in LogMAR units was 0.798 +/- 0.353 and at 12 months after surgery, it was a mean 0.108 +/- 0.136. Keratometric power increased from 42.595 +/- 1.949 D before surgery to 44.605 +/- 1.626 D at 24 months after surgery. CONCLUSIONS: Holmium:YAG LTK was an acceptable alternative for the correction of mild to moderate hyperopia in this middle-aged population.