Angiotensinogen t235 and angiotensin-converting enzyme insertion/deletion polymorphisms associated with the development of posttransplantation diabetes mellitus in renal allograft recipients

Background

Genetic polymorphisms of the renin-angiotensin system (RAS) have been reported to play an important role in the pathogenesis of diabetes mellitus and hypertension. In addition, a close association has been reported between RAS and the progression of both diabetes and hypertension. But the role of RAS on the development of posttransplantation diabetes mellitus (PTDM) is not known. For this purpose we investigated the association of polymorphisms in the genes for angiotensin-converting enzyme (ACE) and angiotensinogen (AGT) with the development of PTDM.

Methods

Genotyping for ACE insertion/deletion (I/D) and AGT M235T polymorphisms was performed in 50 patients who underwent renal transplantation during a 5-year period. Group 1 consisted of 23 recipients who developed PTDM and group 2 consisted of 27 recipients that did not have PTDM.

Results

Of 50 patients, 13 (26%) showed the ACE DD, 21 (42%) the ACE ID, and 16 the ACE II genotype. The frequencies of AGT MM, AGT MT, and AGT TT were 0, 54%, and 46%, respectively. Compared with group 2, there were high frequencies of the AGT TT genotype in group 1 recipients (P < .001). In addition the ACE DD genotype was found significantly higher in group 1 patients compared with group 2 patients (P = .001).

Conclusion

The high frequencies of the AGT TT genotype and ACE DD genotype in recipients may contribute to the high prevalence of PTDM. Our data suggest a synergistic effect between the ACE and AGT polymorphism in the risk of PTDM, but to support this theory a larger patient group must be studied.     

Rapamycin prevents interstitial fibrosis in renal allografts through decreasing angiogenesis and inflammation

Rapamycin (RPM) has antiangiogenic and antiproliferative effects on cells. The aim of this study was to evaluate the mechanism of RPM as a novel antifibrotic agent by assessing its effect on interstitial fibrosis (IF). Among 60 renal transplant recipients, group 1 patients (n = 20) were treated with RPM and group 2 (n = 40), with cyclosporine. The proportions of infiltrating macrophages and lymphocytes in the interstitium were evaluated in 1-year biopsies. The microvessels were highlightened with CD34. After an initial biopsy, the development of diffuse IF over 18 months was evaluated by follow-up biopsies. The mean microvessel density (MVD) was significantly lower among group 1 (69.3 ± 16) versus group 2 (96.5 ± 30; P < .001). The proportions of macrophages and lymphocytes were lower in group 1 compared to group 2 biopsies (P < .001 for both). Fourteen (35%) group 2 and only 2 (10%) group 1 cases developed IF over 18 months (P < .05). The mean MVD in the initial biopsy was 75.6 ± 18 in cases that did not versus 120 ± 28 among those who did develop IF (P < .001). The amount of interstitial inflammation was greater among patients who did compared with cases who did not develop IF (P < .01). The overall 1-, 3-, and 5-year graft survival rates for group 1 were 95%, 95%, and 89% versus 95%, 65%, and 45% for group 2 patients, respectively (P < .001). RPM-treated patients showed a lower incidence of diffuse IF, which can be explained by antiproliferative and antiangiogenic effects of RPM. In conclusion, RPM therapy displayed an independently positive impact on long-term graft survival.     

Insomnia and cardiorespiratory fitness in a middle-aged population: the SCAPIS pilot study

Sleep and Breathing - The relationship between insomnia and cardiorespiratory fitness (CRF), a well-established risk factor for cardiovascular disease, has not been extensively studied. We aimed to...     

An in vitro comparison of diagnostic abilities of conventional radiography, storage phosphor, and cone beam computed tomography to determine occlusal and approximal caries

Aim

The aim of this study was to compare conventional radiography, storage phosphor plate, and cone beam computed tomography for in vitro determination of occlusal and approximal caries.

Methods

A total of 72 extracted human premolar and molar teeth were selected. Teeth were radiographed with conventional intraoral radiography, a storage phosphor plate system, and cone beam computed tomography and evaluated by two observers. The teeth were then separated and examined with a stereomicroscope and a scanner at approximately 8× magnification.

Results

CBCT was statistically superior to conventional radiography and phosphor plate for determining occlusal caries. No significant difference from CBCT, conventional radiography and the phosphor plate system for determining approximal caries was found.

Conclusion

The CBCT system may be used as an auxiliary method for the detection of caries.     

Elongated styloid process associated with nevoid basal cell carcinoma syndrome

This article presents a case with nevoid basal cell carcinoma syndrome (NBCCS) and an elongated styloid process. Basal cell carcinoma syndrome, also known as Gorlin-Goltz syndrome, is an autosomal dominant inherited syndrome manifested by multiple defects involving the skin, nervous system, eyes, endocrine system, and bones. Elongated styloid process or calcified stylohyoid ligament cause craniofacial or cervical pain. The actual cause of elongation of the styloid process or the calcification of the stylohyoid ligament is unclear. The cause of elongation of styloid process in this case may be the calcification induced by NBCCS. This report is the first case presentation of NBCCS with elongated styloid process. Elongated styloid process might be described as an anomaly of an NBCCS.     

Eosinophilic granuloma: resolution of lesion after biopsy

Langerhans cell histiocytosis is a collective term used to describe a group of enigmatic proliferative disorders. Three disease variants include eosinophilic granuloma, Letterer-Siwe disease, and Hand-Schuller-Christian syndrome. Eosinophilic granuloma is reported to be the most benign type of the triad. In this report, a 7-year-old child with an eosinophilic granuloma of the left side of her mandible is presented. There was a painless, hard, tender mass arising from the left side of the molar region. Panoramic radiographs showed a radiolucent area at the molar region. The lesion was resolved 2 weeks after the biopsy. The 1.5 years of radiographic and clinical follow-up was satisfactory.     

Effect of physical and physicochemical surface treatment methods on the tensile strength of CAD/CAM-fabricated zirconia posts and cores luted to root canals

This study investigated the effect of surface treatments on the retentive strength of zirconia posts and cores to root canals. Maxillary central incisors (n = 40) were treated endodontically, obturated, and post spaces were prepared. Zirconia posts and cores (n = 40) were obtained and assigned randomly to four groups (n = 10 per group; control, sandblasting, tribochemical silica coating, and tribochemical silica coating + silanization). Posts were cemented adhesively, and tensile force was applied. All treatment methods increased the tensile strength of zirconia posts and cores compared to the control group (P = .034). No significant difference was found between treatment methods. Failure types varied depending on the surface treatment method.