Hypoglycemic drugs.

There are an estimated 14 million individuals in the United States with diabetes mellitus. These individuals suffer a very high incidence of podiatric complications. This article focuses on the pharmacologic agents used in the management of hyperglycemia in the patient with diabetes mellitus, including insulin and sulfonylureas.     

Fused vesical calculi

A case is described in which a patient, who initially presented with five separate bladder calculi, was found to have had coalescence of three calculi to produce a large stone. This may be one mechanism in the development of a giant vesical calculus.     

Molecular Pharmacology of Topiramate: Managing Seizures and Preventing Migraine

Topiramate is a neuromodulatory compound with stabilizing properties that was initially introduced for the management of partial seizures. Topiramate has been demonstrated to modify several receptor-gated and voltage-sensitive ion channels, including voltage-activated Na⁺ and Ca²⁺ channels and non-NMDA receptors. These receptors have been implicated in the pathophysiology of both epilepsy and migraine. The pharmacological mechanisms of action for topiramate that may explain its antiepileptic and migraine preventive activities will be discussed in this review. In addition, the potential relationship between the molecular activities of topiramate and its efficacy in epilepsy and migraine prevention will be emphasized.     

Effects of continuous darkness on ERG correlates of disc shedding in rabbit retina.

The electroretinogram (ERG) was recorded in the dark from photo-entrained albino rabbits, using a constant-intensity, 500-nm, 50- or 100-msec stimulus at 1-min intervals. Under these conditions, the b-wave of the ERG was previously shown to decrease in amplitude at the time of the morning rod photoreceptor disc shedding event. We have extended our observations to rabbits housed in continuous darkness. The present data show that in constant darkness the change in retinal sensitivity continues to occur, but with a period slightly less than 24 hr. Unilateral dark adaptation, achieved by eyepatching, alters the timing of the event only in the retina of the occluded eye. Thus, the change in retinal sensitivity shares the characteristics of endogenous rhythmicity and intraocular control that have been demonstrated by histologic methods for mammalian rod disc shedding. We also report elongation of rod outer segments in some regions of the albino rabbit retina after continuous darkness.     

A comparison of tympanic thermometer readings to pulmonary artery catheter core temperature recordings

The purpose of this study was to determine the accuracy of FirstTemp (Intelligent Medical Systems, Carlsbad, CA) tympanic thermometer readings compared with core body temperatures obtained via pulmonary artery catheter (PAC). Five measurements were obtained on 19 cardiovascular surgery patients. Tympanic thermometer measurements tended to be higher than PAC measurements. However, most of the differences were not clinically significant. Differences found between right and left ear measurements were most likely due to poor measurement technique. When the correct technique is used, nurses can be confident that tympanic temperature readings are clinically accurate.     

Reduction of glutathione is associated with growth restriction and enlargement of bovine pulmonary artery endothelial cells produced by transforming growth factor-beta 1.

In addition to inhibiting proliferation and causing enlargement of bovine pulmonary artery endothelial cells in culture, porcine platelet transforming growth factor-beta 1 (TGF-beta 1) (2 ng/ml) lowered glutathione (GSH) of these cells by 48% after 96 h in culture when GSH levels were normalized for cell counts. This lowering of cellular GSH was more marked when corrections were made for approximated cell volume. TGF-beta 1 produced only moderate inhibition of pulmonary artery smooth muscle cell proliferation and did not significantly reduce the GSH content of these cells, even at concentrations as high as 8 ng/ml. Elevation of GSH of endothelial cells above control levels by 0.05 mM diethylmaleate or 1 mM cystine prevented the inhibition of cellular proliferation produced by TGF-beta 1. Lowering cellular GSH levels by approximately 85% for 24 to 72 h with 0.01 mM buthionine sulfoximine (BSO) in the absence of TGF-beta 1 had no effect on proliferation or size of the endothelial cells. However, 0.01 mM BSO potentiated the inhibitory effect of TGF-beta 1 on endothelial cell proliferation and in combination with TGF-beta 1 caused cellular detachment at low endothelial cell densities. Thus, although TGF-beta 1 lowers the level of endothelial cellular GSH, this in itself does not appear to account for the inhibition of proliferation and enlargement of these cells produced by TGF-beta 1. Rather, the combination of another unidentified action of TGF-beta 1 in the presence of reduced cellular GSH likely accounts for these effects.