Reference values for serum nitric oxide metabolites in an adult population

ObjectivesTo determine reference values for serum nitric oxide metabolites (nitrite + nitrate = NO_x) concentrations in adult subjects.Design and methodsSerum NO_x concentration was measured, using the Griess method, in 694 non-smoking apparently healthy subjects, randomly selected from a population-based study. The International Federation of Clinical Chemistry guidelines and the robust method were used for determining reference values.ResultsThe 95% reference values for serum NO_x concentration and serum NO_x/creatinine ratio were 11.5 to 76.4 μmol/L and 0.111 to 0.729 in men and 10.1 to 65.6 μmol/L and 0.121 to 0.777 in women, respectively. With increasing body mass index, upper limits of serum NO_x and the NO_x/creatinine ratio increased in women and decreased in men. Serum NO_x levels above upper limits predicted both diabetes and metabolic syndrome in women.ConclusionsThis study reports the first set of reference values for serum NO_x concentration and NO_x/creatinine ratio in a relatively large healthy non-smoking population.     

von Willebrand factor-collagen binding activity is increased in newborns and infants

ABSTRACT. von Willebrand factor (vWF) antigen (vWF:Ag) and vWF-collagen binding activity (vWF:CBA) were measured in plasma by parallel quantitative ELISAs in normal newborns and infants ( n =71). The medians for vWF:Ag (IUjml) and vWF:CBA (Ujml), respectively, were 1.46 and 1.91 for 2-7 day-old (n = 43), 1.22 and 1.40 for 2-4 week-old (n = 14), 1.22 and 1.15 for 2-6-month-old (n = 14) infants and 0.98 and 1.08 (n = 36) in normal adults. Elevated levels of vWF:Ag, but particularly vWF:CBA were seen for up to 4 weeks of life reaching adult levels between 2 and 6 months of life. The elevated levels of the vWF parameters indicate that caution should be exercised when interpreting laboratory data and diagnosing von Willebrand disease in newborns and young infants and warrant the use of age-specific reference ranges. The efficient haemostasis observed during early neonatal life may in part be due to the increased ability of vWF to interact with collagen.     

Echocardiogram‐gated multislice spiral CT in functionally univentricular heart following long‐lasting Waterston–Cooley anastomosis

Waterston–Cooley anastomosis may be carried out in patients with tricuspid atresia to provide pulmonary perfusion. It is associated with several complications, including preferential blood flow to the right lung, hypoplasia of the left pulmonary artery, obstruction of the anatomosis or rupture of pulmonary aneurysms. We study a patient with thrombosis in the pulmonary arteries following surgical construction of a Waterston shunt in childhood. Imaging findings and clinical symptoms are discussed with emphasis on echocardiogram‐gated multislice spiral CT.     

Interval between insulin injection and breakfast in diabetes

The relationship between the insulin-breakfast interval, postprandial increase in blood glucose, and glycaemic control was studied in 58 children with diabetes. Patients recorded insulin-breakfast intervals in a home diary over a seven day period, and during a 24 hour period at the weekend provided eight serial capillary dried blood spots for glucose analysis. The highest mean blood glucose value occurred two hours after breakfast and showed a significant correlation with fructosamine concentrations. Weekend insulin-breakfast intervals ranged from 2-30 minutes, with 70% reporting intervals of less than 15 minutes. There was a significant correlation between the weekend insulin-breakfast interval and the after breakfast increase in blood glucose with a mean increment of 0.4 mmol/l in the 30 minute group and 7.2 mmol/l in the 2 minute group. Over the whole study period, children with mean insulin-breakfast intervals of two to 12 minutes had a mean fructosamine concentration of 376 mumol/l compared with 341 mumol/l in those with intervals of 15-35 minutes. This study has shown that the interval between insulin injection and breakfast significantly influences the morning postprandial rise in blood glucose and consequently short term glycaemic control. It is therefore important that patients are encouraged to leave an interval of about 30 minutes between insulin injection and breakfast.     

Overexpression of CDC7 in malignant salivary gland tumors correlates with tumor differentiation

Introduction

Cell division cycle-7 protein is a serine/threonine kinase that has a basic role in cell cycle regulation and is a potential prognostic or therapeutic target in some human cancers.

Colorectal hemangioma: radiologic findings

The authors correlated radiographs with the clinical and histologic data of 12 patients with colorectal hemangioma. All patients presented with rectal bleeding, which was chronic in seven. Phleboliths were also visible in seven cases, which correlated with chronic bleeding in five. On barium studies, three masses were soft and three produced rigid narrowing. The atypical features of rigid luminal narrowing, which might mimic a carcinoma, and hypovascularity correlated with chronic bleeding or visible phleboliths, which suggest the correct diagnosis of colorectal hemangioma.     

Possible treatment of some genetic deficiency diseases — A hypothesis

A conceptual hypothesis for the possibility of treatment of genetic deficiency diseases utilizing genetic engineering techniques is presented. It is proposed that the gene responsible for the synthesis of a protein which is missing in the patient may be inserted into the patient's stem cells using already established techniques of gene splicing and delivery. The so modified stem cells, if put back into the patient's system (e.g. bone marrow), by virtue of their ability of self multiplication are likely to start synthesizing and continue to produce missing protein. Since stem cells are also capable of differentiating into various blood cells, the nucleated blood cells are also likely to begin production of the protein whose gene was inserted into the stem cells. In this way a blood protein synthesized by any organ (e.g. liver) in normal persons may be synthesized by stem cells or their differentiated forms in the patient resulting in correction of the deficiency. Certain genetically deficient animals may be used to prove this hypothesis.