Determination of serum glycated albumin and high sensitivity C - reactive protein in the insight of cardiovascular complications in diabetic chronic kidney disease patients

BackgroundLeft ventricular hypertrophy (LVH) has been proved as one among the cardiovascular complications and predominant in patients with CKD. In CKD patients, Glycated albumin (GA) express a superior marker of glycemic control than HbA1c. Nevertheless, the precision of GA for the prediction of cardiovascular diseases among the CKD population has been ineffectively reported. The present study looks at the part of GA, HbA1c in CKD to envisage vascular complications.Materials and methodsOne hundred and ninety-four patients were selected in the present study. The study has a control group (Group I, N: 52) and participants were divided into two groups based on vein diseases (Group II, N: 42; two vessels and group III, N: 100; triple vessel disease). Serum glycated albumin, hsCRP and other routine parameters were estimated in all the three groups. 2-dimensional echocardiography (2D Echo) has been done by a cardiologist to all the study patients for assessing ejection fraction and distinguish the sort of vessel diseases.ResultsGroup I compared with group II and III shown there was a significant association among blood glucose, serum creatinine, HbA1c, mean blood glucose, GA, ejection fraction and hsCRP. Additionally, observed that increased levels of HbA1c, GA and creatinine inversely related to the left ventricle ejection fraction. Notwithstanding, GA and hsCRP predict precisely the left ventricle ejection fraction than different parameters.ConclusionGA alongside hsCRP might be appropriate markers for anticipating cardiovascular diseases particularly left ventricle hypertrophy in diabetic CKD population.     

Sex differences in FSH-regulatory peptides in pubertal age boys and girls and effects of sex steroid treatment

BACKGROUND: FSH concentrations are higher in girls than in boys before puberty. We hypothesized that steroid-mediated changes in FSH-regulatory proteins underlie the sex differences in FSH secretion and pubertal timing. METHODS: FSH-regulatory proteins, LH, FSH and sex steroids were measured in five boys, 10 girls, and five girls with Turner syndrome before and during sex steroid treatment (girls, 0.05 mg/day estradiol; boys, 5 mg/day testosterone) for up to 4 weeks. Blood was obtained every 15 min from 20.00 to 08.00 h before and during sex steroid treatment. RESULTS: The mean FSH concentration was higher in girls than in boys (P = 0.0044). Activin-A concentrations were greater (P < 0.0001) and inhibin-B concentrations lower (P < 0.0001) in girls compared with boys. Steroid treatment (i) suppressed LH/FSH concentrations in all subjects; (ii) increased the mean activin-A concentration in all but the Turner girls (P = 0.001); and (iii) decreased inhibin-B concentrations in boys (P = 0.005) but not in girls. Total follistatin and follistatin 288 concentrations did not differ by sex. CONCLUSIONS: Sex steroids regulate circulating activin-A and inhibin-B concentrations in children. The lower inhibin-B and higher activin-A concentrations may explain the higher FSH and earlier onset of puberty in girls.     

Automatic measurement of long-term heart rate variability by implanted single-chamber devices

Heart rate variability (HRV) measurement is an established technology for the assessment of cardiac autonomic status. Recently 24 h HRV has been shown to correlate with disease severity in heart failure. This potentially makes continuous 24 h HRV measurement suitable for monitoring of heart-failure patients. Day-to-day 24 h measurement of HRV is, in principle, feasible when implemented using implanted devices (pacemakers and defibrillators) used in patients who are predominantly in the sinus rhythm. However, a number of such devices used in heart-failure patients are single-chamber devices, in which the distinction between sinus rhythm beats and ectopic beats is problematic. The study investigates whether a reasonably accurate 24 h HRV measurement can be achieved by automatic algorithms, suitable for implementation using implanted devices, without the need for identification of ectopic beats. A set of 5321 nominal 24 h Holter recordings of cardiac patients are used. Each of the recordings contains at least one ectopic beat; approximately 30% of the recordings have more than 1% of ectopic beats. Conventional 24 h measures of HRV, that is the SDNN, HRV index, and SDANN indices, are obtained from each recording after elimination of the ectopic beats and are approximated by HRV measures computed by the same formulas without exclusion of the ectopic beats. The SDANN values are also approximated by the standard deviation of 5 min medians of all RR intervals (SDMRR measure). The errors introduced by including the ectopic beats in the HRV computation were evaluated using the Bland-Altman statistics and by Cohen's kappa statistics investigating the precision of identifying patients with depressed and preserved 24 h HRV. The SDNN measure is very sensitive to the quality of the RR interval sequence and cannot be reasonably used without distinction between sinus rhythm and ectopic beats. The HRV index measure is marginally more acceptable when used without ectopic elimination. The SDANN is rather insensitive, and its replacement by SDMRR values leads to relative errors in the region of 2-5% that are almost independent of the number of ectopic beats included. Even in recordings with a substantial proportion of ectopic beats, a practically acceptable (kappa > 0.9) identification of depressed and preserved SDANN values is possible without ectopic elimination. Thus, continuous monitoring of 24 h HRV is technically feasible within implanted devices, provided the SDANN measure is monitored and either computed from the sequence of all RR intervals or, potentially preferably, replaced by the SDMRR measure.     

Mosquito La protein binds to the 3' untranslated region of the positive and negative polarity dengue virus RNAs and relocates to the cytoplasm of infected cells

The untranslated regions (UTRs) of the positive and negative strand RNAs of several viruses are major binding sites for cellular and viral proteins. Human La autoantigen is one of the cellular proteins that interacts with various positive strand RNA viral genomes including that of dengue virus (DEN) within the 5'- and 3'-UTRs of positive (+) and the 3'-UTR of negative strand (-) RNA, and with the nonstructural proteins NS3 and NS5, that form DEN replicase complex. Since DEN replicates in human and mosquito cells, some functional interactions have to be conserved in both hosts. In the present report, we demonstrate that mosquito La protein interacts with the 3'-UTRs of (+) and (-) polarity viral RNAs. The localization of La protein, examined by confocal microscopy, indicates that La protein is redistributed in DEN-infected cells. Furthermore, the presence of La protein in an in vitro replication system inhibited RNA synthesis in a dose-dependent manner, suggesting that La protein plays an important role in dengue virus replicative cycle.     

Left atrial size,pressure, and v wave height in patients with isolated,severe, pure mitral regurgitation

In recent years, some concepts regarding the etiology and hemodynamics present in the syndrome of mitral regurgitation have changed. Coronary artery disease and mitral valve prolapse have replaced rheumatic heart disease as the most frequent cause of mitral regurgitation. Hemodynamic studies have shown that tall V waves in the pulmonary capillary wedge tracings are neither specific nor sensitive in detecting the presence of mitral regurgitation. In this study, we evaluated the role of various clinical, echocardiographic, and hemodynamic findings with regard to left atrial (LA) size, pressure, and V wave height. We found that the mean pulmonary capillary wedge pressure (PCW) and V wave height for the subset of patients with acute mitral regurgitation (PCW = 24.1 ± 10.9; V = 41.2 ± 20.7 mm Hg) was similar to the subset with chronic mitral regurgitation (PCW = 17.9 ± 7.5; V = 32.0 ± 18.2 mm Hg). In addition, we found that there was a significant logarithmic relationship between the LA size and the duration of the mitral regurgitation (y = 1.404 [log X] + 3.948; R = 0.678; p < 0.0005). Lastly, we found that LA size, compliance, regurgitant volume, and regurgitant valve orifice area all increase with time.     

Changes in inhibin-like bioactivity in ovulatory and atretic follicles and utero-ovarian venous blood after prostaglandin-induced luteolysis in heifers

The objectives of this study were to develop a bioassay for measuring inhibin bioactivity in untreated samples of bovine follicular fluid (BFF) and then examine changes in inhibin bioactivity in ovulatory and atretic follicles and utero-ovarian venous blood during the periovulatory period in heifers. A rat pituitary cell culture system was used to bioassay inhibin-like activity. Addition of 0.005 to 1 microliter untreated (whole), unfiltered charcoal-stripped, or filtered whole BFF to pituitary cultures caused a linear suppression of LHRH-induced FSH release but had no effect on LH secretion. Steroids in BFF did not suppress FSH secretion, since removal of steroids from BFF with charcoal did not remove the FSH-suppressive activity in BFF. Addition of ether extracts of BFF caused a slight but nonparallel suppression of FSH secretion; however, heating these extracts removed most of this suppressive activity. Removal of BFF from pituitary cultures completely restored the capacity of pituitary cultures to respond to LHRH. It was concluded that the inhibin bioassay was specific for detecting inhibin-like activity in fluids from individual follicles without interference of steroids. Within 12 h after a prostaglandin (PG) injection during the luteal phase of heifers, LH levels in serum increased 2- to 4-fold and remained at this level until the occurrence of the preovulatory gonadotropin surge. In contrast, FSH did not change before the gonadotropin surge. Inhibin bioactivity was measured in all follicles (greater than or equal to 6 mm) 0, 12, 24, 36, 48, 60, and 72 h after and in utero-ovarian venous serum 0, 24, and 36 h after PG-induced luteolysis. From 0-36 h after PG administration, inhibin-like activity increased linearly in presumed ovulatory follicles and utero-ovarian venous serum. Then, from 48-72 h after PG treatment, before the preovulatory LH surge, inhibin activity decreased in ovulatory follicles. After the surge but before ovulation, inhibin-like activity increased in ovulatory follicles. Inhibin-like activity in atretic follicles did not change after PG treatment and was lower in atretic than ovulatory follicles. Since a single hypothalamic releasing factor, LHRH, may control the secretion of LH and FSH, increased secretion of inhibin from preovulatory follicles before the preovulatory LH and FSH surges could account for the absence of a presurge rise in FSH in blood, as was observed for LH during this time in heifers. Diminished follicular production of inhibin during the gonadotropin surge could explain the preovulatory release of FSH along with LH during this time.     

Sequence analysis in the E1 region of adenovirus type 4 DNA

Adenovirus type 4 (Ad4) is the sole member of adenovirus group E based on overall DNA sequence homology, restriction endonuclease cleavage patterns, and the size of capsid proteins. We cloned the BamHI-F fragment from the left end of Ad4 in pUC13-1 between the SalI and BamHI sites in order to carry out the structural analysis of the E1A region of Ad4. The complete sequence of the BamHI-F fragment (2042 bp) has been determined. From the DNA sequence, the splice sites for the putative 12 S and 13 S mRNAs, encoded by the E1A region of Ad4 were deduced. If protein synthesis initiates at the first available AUG triplet (position 575), these 12 S and 13 S mRNAs would code for polypeptides containing 226 and 257 amino acids, respectively. Comparison of Ad4- and Ad7-13 S mRNA-coded polypeptides indicates that there is 57% homology, whereas the homology is only 38% with Ad12 and 31% with Ad2-13 S mRNA-coded polypeptides. The structural analysis in the E1 region of Ad4 also includes the coding region for the E1B 19-kDa protein. Ad4 and Ad7 shows 65% homology in the coding regions for E1B 19-kDa protein. Comparison of the DNA sequence of Ad4 with those of Ad2, Ad7, and Ad12 by using a dot matrix computer program and by Southern hybridization revealed that Ad4 bears a stronger homology with Ad7 than with Ad2 and Ad12 in this region. Hydropathy plots and alignments of the putative polypeptides coded by this region in Ad4 with those from the corresponding regions of different serotypes to reveal the highly conserved domains also support the above conclusion.     

Modeling of springback on air bending process of interstitial free steel sheet using multiple regression analysis

This paper describes the development of regression based mathematical models for the prediction of springback in air bending process of interstitial free (IF) steel sheet. Punch travel (d), strain hardening exponent (n), punch radius (r _p), punch velocity (v _p) and width of the sheet (w) have been considered as input parameters and springback as output parameter to develop the model. Based on experimental results, various regression models namely, linear, linear-square, linear-interaction and quadratic terms for the springback prediction were developed for IF steel sheets. It is found that, the results obtained from the quadratic model are accurate in prediction of springback than others.     

Cyclophosphamide modulates CD4+ T cells into a T helper type 2 phenotype and reverses increased IFN-gamma production of CD8+ T cells in secondary progressive multiple sclerosis

Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system considered to be mediated by T helper type-1 cells. Several agents have been found to modify the disease course of MS, including interferon-beta1 (IFN-beta1), glatiramer acetate mitoxantrone. We have employed pulse therapy with cyclophosphamide in a selected group of patients with actively progressive disease. Chemokine receptors have been found to differentiate between polarized T helper type-1 (Th1) and type-2 (Th2) lymphocytes. The chemokine receptors CCR5 and CXCR3 are expressed primarily on Th1 cells and CCR3, CCR4 and CCR8 on Th2 cells. Previous studies of the expression of chemokine receptors in MS have shown that active MS plaques are infiltrated by CCR5(+) and CXCR3(+) T cells. Some of these T cells may express both CCR5 and CXCR3. These T cells are major producers of IFN-gamma, which worsens the clinical condition of patients with MS. We previously found that patients with MS had a high proportion of CXCR3(+) T cells and that those with chronic progressive MS had a high proportion of CCR5(+) T cells in their peripheral blood. We report here that in patients with secondary progressive MS, cyclophosphamide induces a marked increase in the percentage of CCR4(+) T cells that produce high levels of IL-4 and reverses the increase in the percentages of IFN-gamma-producing CCR5(+) and CXCR3(+) CD8(+) T cells. Furthermore, therapy with cyclophosphamide increases IL-4-producing CD4(+) T cells and reverses the increase in IFN-gamma-producing CD8(+) T cells. Our study shows that cyclophosphamide has immunomodulatory properties besides its suppressive effects, and that chemokine receptors can be important tools both for understanding the immune dysregulation in MS and for monitoring response to therapy.     

Partial flap during laser in-situ keratomileusis: pathogenesis and timing of retreatment

PURPOSE: To report the timing of retreatment and clinical outcomes in patients with a partial corneal flap during laser in-situ keratomileusis (LASIK), and to describe the causes of this complication. METHODS: Retrospective review of case records of four patients (4 eyes) who had a partial corneal flap during LASIK. RESULTS: The mean age of the four patients was 23 +/- 4.7 years, and mean preoperative spherical equivalent (SE) refraction was -9.1 +/- 3.1 D (range, -5.5 to -13 D). A 160 microns corneal flap was attempted during the initial treatment. Retreatment with a 180 microns corneal flap was performed at a mean of 5.1 +/- 1.6 weeks (range, 4 to 7.5 weeks) after the initial procedure. There were no intraoperative complications during retreatment. Post-LASIK mean SE refraction was -1.0 +/- 1.1 D (range, +0.38 to -2.0 D), after a mean follow up of 19 +/- 15.7 weeks (range, 7 to 42 weeks). Best spectacle-corrected visual acuity decreased in one eye from 6/5 to 6/6 and was maintained in the others. CONCLUSION: LASIK retreatment can be performed as early as one month after a partial flap, if the refraction is stable and a thicker corneal flap is created.