Counteraction of type 1 diabetic alterations by engineering skeletal muscle to produce insulin: insights from transgenic mice

Insulin replacement therapy in type 1 diabetes is imperfect because proper glycemic control is not always achieved. Most patients develop microvascular, macrovascular, and neurological complications, which increase with the degree of hyperglycemia. Engineered muscle cells continuously secreting basal levels of insulin might be used to improve the efficacy of insulin treatment. Here we examined the control of glucose homeostasis in healthy and diabetic transgenic mice constitutively expressing mature human insulin in skeletal muscle. Fed transgenic mice were normoglycemic and normoinsulinemic and, after an intraperitoneal glucose tolerance test, showed increased glucose disposal. When treated with streptozotocin (STZ), transgenic mice showed increased insulinemia and reduced hyperglycemia when fed and normoglycemia and normoinsulinemia when fasted. Injection of low doses of soluble insulin restored normoglycemia in fed STZ-treated transgenic mice, while STZ-treated controls remained highly hyperglycemic, indicating that diabetic transgenic mice were more sensitive to the hypoglycemic effects of insulin. Furthermore, STZ-treated transgenic mice presented normalization of both skeletal muscle and liver glucose metabolism. These results indicate that skeletal muscle may be a key target tissue for insulin production and suggest that muscle cells secreting basal levels of insulin, in conjunction with insulin therapy, may permit tight regulation of glycemia.     

Practice in epidemiologic surveillance: between the general and the specific

This study analyses the perspectives of the organization of epidemiological surveillance (ES) in two kinds of organizations. The first is a set of undifferentiated practices; the second is a set of specific practices carried out in the local health system of Ribeir?o Preto, S?o Paulo Federal State. Both organizations are described in general terms and discussed according to the view of local health professionals and professionals of the epidemiological surveillance. This study presupposes that the decentralization should be supported by discussions regarding forms of organization among the groups involved in it. The guiding concepts of this research are nuclei and field of competence and responsibility. Seventeen professionals were the subjects of this study. Eleven participants were nurses and six were managers of the municipal health department of Ribeir?o Preto. Data was obtained from documents and semi-structured interviews, which were analyzed through the method of content analysis, theme modality. The theme "the epidemiological surveillance practice: between the general and the specific" was created according to the following signification nuclei: specific and general knowledge, and collective actions.     

A sixteen-year epidemiological profile of a pediatric intensive care unit,Brazil

OBJECTIVE: To review epidemiological data from patients admitted to a Pediatric Intensive Care Unit (PICU), Brazil, and to compare them to medical aspects associated to disease severity and mortality. Also, to profile these patients, including demographic data, disease prevalence, mortality rates and associated factors. METHODS: Retrospective data were collected from all patients admitted in a PICU of a university hospital between 1978 and 1994. Data were presented as percentages and compared using Chi-square, and calculating the relative risk (RR) with a 95% confidence interval, p<0.05. RESULTS: Of 13, 101 patients selected, most of them were boys (58.4%), younger than 12 months of age (40.4%), well-nourished (69.5%), and with clinical disease (73.1%). The general mortality rate was 7.4%. Patients aged less than 12 months showed a RR of 1.86 (CI 1.65 - 2.10; p<0.0001), while the RR of malnutrition was 2.98 (CI 2.64 - 3.36; p<0.0001). CONCLUSIONS: The epidemiological survey showed that the mortality is higher in malnourished children younger than 12 months of age. Sepsis was the most main cause of death.     

Effects of 14-methoxymetopon, a potent opioid agonist, on the responses to the tail electric stimulation test and plus-maze activity in male rats: neuroendocrine correlates

We have studied the effects of 14-methoxymetopon (HS 198), a potent opioid agonist, on the responses to the tail electric stimulation test and plus-maze activity of adult male rats. The prototype mu agonist morphine was used as the drug of reference. Besides we addressed the effects of HS 198 on the serum corticosterone levels and on serotonergic systems of discrete brain regions. Both drugs were administered subcutaneously. Morphine (5 mg/kg) and HS 198 (30 microg/kg) induced a similar effect on the nociceptive test, with both drugs significantly increasing the threshold for the vocalization afterdischarge, which is related to the emotional component of pain. In the plus-maze, morphine (5 mg/kg) and HS 198 (20 and 30 microg/kg) induced similar increases in the percentages of entries and time in the open arms, two parameters related to the anxiety state of the animals. The results indicate that HS 198 is far more potent than morphine in reducing the emotive/affective component of pain and in inducing an anxiolytic effect. HS 198 (30 microg/kg) also induced parallel increases in the serum corticosterone levels and the hypothalamic serotonin content. A possible correlation between the anxiolytic action of the drug and its effect on the hypothalamic serotonergic system is suggested.     

Nicotine modulates the spontaneous synaptic activity in cultured embryonic rat spinal cord interneurons

The nicotine-induced modulation of the synaptic activity was studied in cultured spinal cord neurons from embryonic rats, using the patch-clamp technique, alone or in combination with Ca(2+) imaging. Morphologically, neurons could be divided into two populations: multipolar nerve cells and bipolar, spindle-shaped neurons. Neurons were predominantly GABAergic, with approximately 70% of bipolar cells and 60% of multipolar cells positive for GABA immunostaining. Nicotine (Nic) did not affect the activity of the spontaneous postsynaptic current (sPSC) in multipolar neurons, whereas bipolar cells responded to Nic applications with an enhancement of both inhibitory and excitatory synaptic activity (threefold for 100 microM Nic). No change in the mean event amplitude was observed. The increase of sPSC frequency was detectable at 1-10 microM Nic, and was prevented by dihydro-beta-erythroidine (DHbetaE) but not by alpha-bungarotoxin. Choline, a selective alpha7-nAChR agonist, did not mimic the Nic action. Simultaneous treatment with inhibitors of ionotropic glutamate receptors, CNQX (20 microM) and AP5 (20 microM), completely blocked the excitatory sPSC activity but did not prevent the Nic-induced enhancement of inhibitory sPSC activity. Tetrodotoxin (1 microM) reduced the basal spontaneous activity but did not block the Nic-induced effects on bipolar neurons. In a subset of bipolar neurons (12%) exposed to AP5 and CNQX, Nic activated DHbetaE-sensitive inward currents, associated with an elevation of cytosolic Ca(2+) ([Ca(2+)](i)). Our results provide the first evidence of modulation of both excitatory and inhibitory neurotransmitter release in embryonic spinal cord interneurons by non-alpha7-containing nicotinic receptors.     

Transgenic mice expressing a pH and Cl- sensing yellow-fluorescent protein under the control of a potassium channel promoter

During the last few years a variety of genetically encodable optical probes that monitor physiological parameters such as local pH, Ca2+, Cl-, or transmembrane voltage have been developed. These sensors are based on variants of green-fluorescent protein (GFP) and can be synthesized by mammalian cells after transfection with cDNA. To use these sensor proteins in intact brain tissue, specific promoters are needed that drive protein expression at a sufficiently high expression level in distinct neuronal subpopulations. Here we investigated whether the promoter sequence of a particular potassium channel may be useful for this purpose. We produced transgenic mouse lines carrying the gene for enhanced yellow-fluorescent protein (EYFP), a yellow-green pH- and Cl- sensitive variant of GFP, under control of the Kv3.1 K+ channel promoter (pKv3.1). Transgenic mouse lines displayed high levels of EYFP expression, identified by confocal microscopy, in adult cerebellar granule cells, interneurons of the cerebral cortex, and in neurons of hippocampus and thalamus. Furthermore, using living cerebellar slices we demonstrate that expression levels of EYFP are sufficient to report intracellular pH and Cl- concentration using imaging techniques and conditions analogous to those used with conventional ion-sensitive dyes. We conclude that transgenic mice expressing GFP-derived sensors under the control of cell-type specific promoters, provide a unique opportunity for functional characterization of defined subsets of neurons.     

ATP suppresses activity in slowly adapting but not rapidly adapting mechanoreceptors in toad skin

To test the possible role of ATP in transducing or modulating touch sensation, an isolated skin-nerve preparation from the toad, Bufo marinus, perfused on the inner side, was used to examine the effects of ATP on slowly adapting (SA) and rapidly adapting (RA) mechanoreceptors, identified by ramp and hold indentation of the skin. ATP (1-50 mM) did not generate impulse activity in either SA or RA mechanoreceptors nor increase their responses to mechanical stimulation. Instead, ATP (> or =5 mM) reversibly and selectively suppressed impulse discharge from SA mechanoreceptors. Our results indicate that while ATP may modulate the responses of specific touch receptors, it is not involved in transducing touch into nerve impulses.