Thiazolidinedione treatment normalizes insulin resistance and ischemic injury in the zucker Fatty rat heart

Obesity is associated with risk factors for cardiovascular disease, including insulin resistance, and can lead to cardiac hypertrophy and congestive heart failure. Here, we used the insulin-sensitizing agent rosiglitazone to investigate the cellular mechanisms linking insulin resistance in the obese Zucker rat heart with increased susceptibility to ischemic injury. Rats were treated for 7 or 14 days with 3 mg/kg per os rosiglitazone. Hearts were isolated and perfused before and during insulin stimulation or during 32 min low-flow ischemia at 0.3 ml small middle dot min(-1) small middle dot grams wet wt(-1) and reperfusion. D[2-(3)H]glucose was used as a tracer of glucose uptake, and phosphorus-31 nuclear magnetic resonance spectroscopy was used to follow energetics during ischemia. At 12 months of age, obese rat hearts were insulin resistant with decreased GLUT4 protein expression. During ischemia, glucose uptake was lower and depletion of ATP was greater in obese rat hearts, thereby significantly impairing recovery of contractile function during reperfusion. Rosiglitazone treatment normalized the insulin resistance and restored GLUT4 protein levels in obese rat hearts. Glucose uptake during ischemia was also normalized by rosiglitazone treatment, thereby preventing the greater loss of ATP and restoring recovery of contractile function to that of lean rat hearts. We conclude that rosiglitazone treatment, by normalizing glucose uptake, protected obese rat hearts from ischemic injury.     

Rapid prenatal diagnosis of trisomies 13, 18, 21 and sex chromosome anomalies by fluorescence in situ hybridization: a year's experience

The present paper summarizes our first 12 months' experiences of rapid prenatal diagnosis using commercially available diagnostic fluorescence in situ hybridization (FISH) probes for chromosomes X, Y, 13, 18 and 21. The data clearly demonstrate that the advantage of using FISH as an adjunct technique is the fast and reliable determination of the common fetal chromosomal aneuploidies; the results are available in less than 24 hours instead of the 7-14 days with standard techniques.     

Chronic lung disease and survival in 4 tertiary neonatal units

AIM: To compare mortality and respiratory morbidity in preterm infants born at 4 United Kingdom centers during 1994 and 1995. METHOD: Collection of CRIB scores, respiratory parameters and mortality rates from unit databases. RESULTS: Mortality in center A was 27% (actual number of deaths 36/135), in center B was 30% (39/130), in center C was 28% (51/182), in center D was 39% (60/156). The rate of chronic lung disease (36 week definition) in center A was 16%, in center B was 12%, in center C was 13%, in center D was 15%. The predicted number of deaths by CRIB scores in center A was 54 (95% confidence intervals 45-63), in center B was 33 (25-41), in center C was 53 (43-63), in center D was 46 (37-56). CONCLUSION: Center A had a lower than predicted mortality. Center D had a higher than predicted mortality. There is an urgent need for a national neonatal database to allow comparison between center and to identify reasons for variation in outcomes.     

Two-stage urethroplasty. Improved method for treating bulbomembranous strictures.

Twelve years' experience with a two-stage urethroplasty for the surgical management of severe and complicated urethral strictures in 200 patients is summarized. The techniques used, including a modification of the Johanson urethroplasty for bulbomembranous urethral strictures and for multiple strictures without splitting the scrotum, are discussed. The most usual complications of these procedures are reported, as well as how to deal with them, and long-term final results are given. The principles of these procedures are surgically sound, considering the pathology of the strictures. At no time after urethroplasty were urethral dilatations necessary in these 200 patients.