Oxidative stress and thyroid hormones in patients with liver diseases

BackgroundThe liver metabolizes the thyroid hormones and regulates their systemic endocrine effects so liver disease could affect thyroid hormone metabolism. Oxidative stress could play a role in the pathogenesis and progression of liver diseases. The objective of this study was to investigate serum levels of oxidative stress and antioxidant in liver diseases as prognostic markers and know the importance of these antioxidants level in relation to thyroid hormones.MethodsSerum nitric oxide (NO), malondialdehyde (MDA) and triiodothyronine (T₃), thyroxine (T₄), thyroid stimulating hormone (TSH), apolipoprotein-1 (APOA1) levels and erythrocyte reduced glutathione (GSH) level and glutathione peroxidase (GSHPx) and glutathione reductase (GR) activities were determined in 20 control subjects, 13 patients with non-alcoholic steatohepatitis (NASH), 18 patients with chronic HCV, 17 patients with compensated cirrhotic HCV and 42 patients with decompensated cirrhotic HCV.ResultsCirrhotic patients with HCV had higher NO and MDA levels while lower T₃ and erythrocyte GSH levels, and GSHPx activity than the chronic. Serum T₃ showed negative correlation with serum NO and MDA whereas positive correlation with APOA1, GSH, and GSHPx in cirrhotic patients with HCV.ConclusionThe measurement of the total T₃, NO, MDA, GSH reduced and GSHPx as biomarkers for liver diseases might be a beneficial tool, helping in monitoring the state of liver disease patients.     

Colorectal neoplasms: accuracy of US in demonstrating the depth of invasion

Six normal and 16 neoplastic colorectal specimens were examined with 8.5-MHz ultrasound (US). An articulated system facilitated precise spatial correlation between US and histologic sections. Images were blindly interpreted and then compared with histologic results. All six normal specimen showed five distinct echo layers and were distinguished from neoplastic specimens by all the observers. The central echogenic layer, corresponding to the submucosa, is useful in determining the depth of origin of a neoplasm and the presence of submucosal invasion. US had an accuracy of 92.5% in demonstrating invasion of the submucosa and 77% for invasion of the muscularis externa. For mucosal neoplasms with invasion through the muscularis externa and extension into the subserosal tissues, nearly 90% of US interpretations were correct. High-frequency US may be useful in determining the depth of invasion of mucosal tumors with respect to the submucosa and in differentiating mucosal from extramural masses.     

The reliability and clinical use of a rapid phosphatidylglycerol assay in normal and diabetic pregnancies

Lecithin phosphorus concentration, the standard fetal lung maturity test in our institution, and phosphatidylglyercol were assayed in 69, 29, and 45 amniotic fluid samples from normal (GI), gestational (GII), and insulin-dependent diabetic (GIII) women by means of thin layer chromatography and Amniostat-FLM, respectively. Lecithin phosphorus concentration greater than or equal to 0.1 mg/dl and positive or strong positive Amniostat-FLM results were considered mature. The results of both assays were concordant in 79% of the samples. The discordance rate was highest in GIII patients. In our experience, respiratory distress syndrome did not develop in neonate infants of diabetic women delivered after a mature lecithin result. With lecithin phosphorus concentration as the reference standard, the predictive value of a mature Amniostat-FLM result was 96.2%, whereas that of an immature result was 58.5%. Respiratory distress syndrome occurred in only two GIII neonates who were delivered within 72 hours of both immature lecithin and Amniostat-FLM results. These findings support the use of Aminostat-FLM as a screening test for fetal lung maturity in both normal and diabetic pregnancies. Additional tests will be necessary to evaluate further fetal lung maturity only if the results are negative.     

Crescentic glomerulonephritis in Egypt: clinical and histopathological risk factors

We followed up 128 patients with crescentic glomerulonephritis (CGN), having sufficient clinical and histopathological data for a mean period of 34 +/- 28 months. There were 49 males and 79 females, mean age 22.7 +/- 14 years. We studied the effects of clinical, laboratory and histopathological parameters on kidney function and survival at the end point of the study. Multivariate analysis indicated that serum creatinine at presentation, nephrotic range proteinuria during the follow-up period, percentage of glomeruli with crescents, percentage of fibrous crescents and absence of cellular infiltration were significant risk factors affecting kidney function at the end of the study. The only risk factor significantly correlated with mortality was serum creatinine at last follow-up.     

Angiogenic factors for the prediction of pre-eclampsia in women with abnormal midtrimester uterine artery Doppler velocimetry

OBJECTIVE: To determine whether assessing uterine perfusion and angiogenic factors concurrently in the second trimester improves the prediction of pre-eclampsia and intrauterine growth restriction (IUGR). METHOD: Plasma levels of soluble fms-like tyrosine kinase 1 (sFlt-1) and placental growth factor (PlGF) were measured for 108 women with abnormal uterine perfusion on Doppler velocimetry in the 23rd week. Later, 33 cases of pre-eclampsia and 9 of IUGR developed. RESULTS: Compared with the plasma levels of the women whose pregnancies remained normal, sFlt-1 levels were significantly higher and PlGF levels significantly lower in the women whose pregnancies became complicated by pre-eclampsia and/or IUGR (P<0.001). The alterations were more pronounced in cases of early-onset pre-eclampsia and in cases of IUGR that necessitated delivery before 34 weeks. Using the sFlt-1/PlGF ratio, these complications could be predicted with 98% sensitivity, 95% specificity, and 93% positive predictive value. CONCLUSION: Measuring uterine perfusion and angiogenic factors concurrently in the second trimester improved the prediction of pre-eclampsia and IUGR.     

Morphological recovery in the reattached retina of the toad Bufo marinus: a new experimental model of retinal detachment

BACKGROUND: The retinal pigment epithelium (RPE) of the toad (Bufo marinus) has been used in many studies as a model for understanding its role and interaction with the neural retina. The toad's retina has been used to establish a new in vitro model of experimental retinal detachment (RD) and replacement . It has been shown that the electrophysiological measures of retinal function recovered following complete RD. The toad was chosen because its RPE is similar to the mammalian RPE . In this report, light microscopy was used to characterize the morphologic changes that occur in the RPE and neural retina following RD/replacement and to correlate these findings with recovery of electrophysiologic function. METHODS: Retinas from Bufo marinus were studied in vitro. The neural retina completely detached from the RPE and then replaced. At various times after replacement, neural retina-RPE tissues were processed for light microscopy. RESULTS: At 30 min after replacement, the subretinal space was greatly expanded, and the apical processes that normally ensheath the rod outer segments were short and no longer contacted the rod outer segments. The RPE was swollen, contained many vacuoles and the apical surface was rounded. By 2 h after replacement, the subretinal space was significantly resorbed and contained many shredded rod outer segments; RPE cells were still swollen, although less. During the next 5-10 h, the number of phagosomes in the RPE cytoplasm increased and the number of shredded rod outer segments in the subretinal space decreased. RPE cells regained their normal size and interdigitation of apical processes and rod outer segments were observed. CONCLUSIONS: These results demonstrate the re-establishment of morphological interactions between the RPE and neural retina within hours following RD/replacement. Morphological recovery coincides with recovery of electrophysiologic parameters. This is a good model to investigate the retinal pigment epithelium (RPE) and neural retina mechanisms involved in retinal adhesion and recovery from retinal detachment.     

Morbid obesity treated by gastroplasty: radionuclide gastric emptying studies

Mechanisms by which gastroplasty for morbid obesity causes weight loss are poorly understood. We studied the role of altered gastric emptying in 50 patients before surgery, 1-4 weeks after surgery, and 2-24 months after surgery using technetium-99m pentetate in water for liquid meals and a Tc-99m styrene divinylbenzene copolymer resin in oatmeal for semisolid meals. We determined the emptying half-times of the stomach before and after surgery in the proximal and distal compartments. The proximal compartment emptied promptly in the early and late postoperative periods. The distal compartment emptied liquids at rates similar to those before surgery, while the late postoperative emptying of semisolids was significantly faster. The stoma connecting the two compartments thus permits rapid transit of liquids and semisolids without delay of distal compartment emptying. No correlation was seen between the emptying half-times or changes thereof and eventual weight loss. Delayed gastric emptying is therefore not the mechanism for satiety and weight loss after gastroplasty has been performed.