Basement membrane and connective tissue proteins in early lesions of Kaposi's sarcoma associated with AIDS

Nearly one-third of all young homosexual men diagnosed as having acquired immune-deficiency syndrome (AIDS) develop a disseminated form of dermal Kaposi's sarcoma (KS). Although the histogenesis of KS cells is unclear, certain evidence suggests that the aberrant cells are of endothelial derivation. We have examined the presence and distribution of connective tissue-specific and basement membrane-specific macromolecules by indirect immunofluorescence and immunoperoxidase staining of frozen sections in early cutaneous lesions of KS from individuals with AIDS. The KS cells typically line the spaces between collagen bundles of the reticular dermis. When stained for the connective tissue-specific glycoprotein fibronectin, all Kaposi's sarcoma lesions showed an intense staining pattern, revealing a complex array of linear deposits of antigen that outlined the exterior surface of the collagen bundles. Antibodies to laminin and type IV collagen, both basement membrane-specific macromolecules, produced an intense staining pattern similar to that found with the anti-fibronectin antiserum, indicating that all 3 antigens are closely codistributed. In contrast, antibodies to type I collagen, the major collagen of the dermis, uniformly stained the collagen bundles in the KS lesions and in the normal control skin. Antiserum to factor VIII-associated antigen, an antigen specific to blood vascular endothelium, frequently stained the KS lesions but the staining pattern was diffuse and of variable intensity. The results suggest that KS cells are derived from the endothelium of the blood microvasculature and maintain their secretory phenotype of secreting basement membrane-specific macromolecules.     

Dependent Behavior in Patients with Medication-Overuse Headache

Two thirds of patients with medication-overuse headache (MOH) fulfilled criteria for dependence on acute symptomatic treatments for pain, not exclusive of psychoactive medications, based on the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders. Several questionnaires have been used to assess dependent behavior in patients with MOH. Findings regarding underlying psychological profiles of dependence and MOH are not consistent. Nevertheless, several neuroimaging, genetic, and neurobiological studies support the existence of the common pathophysiological features of dependence and MOH and suggest a link between them. This review highlights recent studies on the relationship between dependence and MOH. This issue is important because it implies a treatment strategy in managing patients with MOH by providing the treatment of dependence.     

Urinary glutathione-S-transferase in cisplatin nephrotoxicity in the rat

Rats given a single toxic dose of cisplatin all developed detectable glutathione-S-transferase activity in their urine between the third and fifth day after injection of cisplatin, simultaneously with the decreased urine osmolality and increased urine volume characteristic of cisplatin nephrotoxicity. Peak urinary glutathione-S-transferase levels occurred at the same time as maximal serum creatinine levels, and there was a significant statistical correlation between these two variables. These findings suggest that urinary glutathione-S-transferase activity is a marker for proximal renal tubular injury from cisplatin.     

Effect of low fat-high carbohydrate diets in hypertensive patients with non-insulin-dependent diabetes mellitus

Effects of variations in dietary fat and carbohydrate content on various aspects of glucose, insulin, and lipoprotein metabolism were evaluated in 11 patients with hypertension, who also had non-insulin-dependent diabetes mellitus (NIDDM). All of these patients were being treated with sulfonylureas, thiazides, and beta-adrenergic receptor antagonists. The comparison diets contained either 40 or 60% of total calories as carbohydrate, with reciprocal changes in fat content from 40 to 20%. The diets were consumed in a random order for 15 days in a crossover experimental design. The ratio of polyunsaturated to saturated fat and total cholesterol intake were held constant in the two diets. Plasma glucose and insulin concentrations were significantly (P less than .001) elevated throughout the day when patients consumed the 60% carbohydrate diet. Fasting plasma total and very-low-density lipoprotein (VLDL) and triglyceride (TG) concentrations increased by 30% (P less than .001) after 15 days on the 60% carbohydrate diet. Total plasma cholesterol concentrations were similar on both diets, as were low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol concentrations.