Left ventricular free wall rupture after reperfusion therapy for acute myocardial infarction

We evaluated the clinical significance of angiographic indexes and pericardial involvement in predicting increased risk of free wall rupture after reperfusion therapy and found that Thrombolysis In Myocardial Infarction (TIMI) <3 flow grade after reperfusion therapy was a significant variable related to the free wall rupture. Moreover, pericardial rub was found to be a significant variable related to TIMI <3 grade flow after reperfusion, which indicates that detection of pericardial rub is one of the clinical signs that predicts inadequate anterograde flow of the infarct-related artery after reperfusion and hence, higher risk for free wall rupture.     

Sunitinib-induced nephrotic syndrome and irreversible renal dysfunction

Sunitinib, a tyrosine kinase inhibitor targeting vascular endothelial growth factor receptors (VEGFRs), has become essential for treating imatinib-resistant malignant gastrointestinal stromal tumor. Recently, several cases have been reported that showed proteinuria and kidney dysfunction to be associated with anti-VEGF therapy. Although previous reports indicated that this side-effect is reversible, it is not well understood. We present here the case of a 72-year-old man who presented with nephrotic syndrome and renal dysfunction 6 months after administration of sunitinib. Sunitinib was discontinued, and nephrotic syndrome remitted spontaneously, but renal function recovery was limited. Nine months later, a renal biopsy was performed because sunitinib was again required and pathological examination was needed. The renal biopsy showed marked endothelial cell injury with focal segmental glomerulosclerosis and accelerated VEGF expression by podocytes. Sunitinib was then given at a reduced dose. Kidney dysfunction and nephrotic syndrome are rare but serious complications of sunitinib. The present case suggests that long-term treatment with a high dose of sunitinib can cause irreversible renal dysfunction, and that low-dose treatment makes these side-effects manageable.     

Awareness of HIV/AIDS among primary school pupils in north central region of Nigeria

ObjectiveTo determine the knowledge of HIV/AIDS among primary school pupils in north central area of Nigeria.Methods2000 randomly selected primary school pupils in and around eastern part of Idoma area of Benue state were interviewed using an open-ended questionnaire. Data analysis was done with EPI-INFO 2000. The Chi-square test was used for statistical analysis and the 0.05 level of significance was adopted.ResultsA totle of 1010 males and 990 females at ages between five and sixteen years were drawn from 10 primary schools in the area. Pupils in the higher classes were more knowledgeable and sex difference was not statistically significant. Certain misconceptions were noted.ConclusionsThere is need for health education for all cadres of primary school pupils in the area, which will increase the awareness of the disease.     

Steroid production by amago salmon (Oncorhynchus rhodurus) testes at different development stages

Developmental changes in the steroidogenic capacity of amago salmon (Oncorhynchus rhodurus) testicular fragments at six different stages during spermatogenesis and spermiation were examined using 18-hr incubations. Although both basal and chum salmon gonadotropin (SGA)-induced production of 11-ketotestosterone (11-ketoT) and 17 alpha,20 beta-dihydroxy-4-pregnen-3-one (17 alpha,20 beta-diOHprog) remained relatively low in testicular fragments isolated in August (GSI 1.06; primarily spermatocytes and spermatids in the testes) and September (GSI 2.33-4.85; many spermatids and spermatozoa in the testes), 11-ketoT production was two to three times higher than 17 alpha,20 beta-diOHprog production. In mid October (GSI 4.31; primarily spermatozoa in the testes, with a few spermatids remaining), SGA greatly stimulated 11-ketoT production with no further stimulation in late October (GSI 3.54; advanced spermiation). In contrast, SGA dramatically increased 17 alpha,20 beta-diOHprog production in late October and November (GSI 3.02), coincident with the period of active spermiation. A time course study showed that SGA caused a marked increase in production of 17 alpha,20 beta-diOHprog within the first 3 hr. Testes collected in August and September produced a considerable amount of 17 alpha,20 beta-diOHprog in the presence of an exogenous precursor, 17 alpha-hydroxyprogesterone. These results indicate that a shift in steroidogenesis from 11-ketoT to 17 alpha,20 beta-diOHprog occurs in the amago salmon testis immediately prior to or during the spermiation period and further suggest that mechanisms of gonadotropin action on 17 alpha,20 beta-diOHprog production in testes differ from those of ovaries (Y. Nagahama, 1987, Dev. Growth Differ. 29, 1-12).     

Plasma 17α,20β-dihydroxy-4-pregnen-3-one levels during sexual maturation of amago salmon (Oncorhynchus rhodurus): Correlation with plasma gonadotropin and in vitro production by ovarian follicles

Plasma gonadotropin (GtH) and 17α,20β-dihydroxy-4-pregnen-3-one (17α,20β-diOH-prog) levels were assessed by radioimmunoassay during the sexual maturation of female amago salmon (Oncorhynchus rhodurus). Both GtH and 17α,20β-diOHprog levels were low in vitellogenic females (June to September) and in those with full-grown immature oocytes and were elevated in mature and ovulated females to 40 ng/ml for GtH and 50–70 ng/ml for 17α,20β-diOHprog. In vitro production of 17α,20β-diOHprog by ovarian follicles and its stimulation by partially purified chinook salmon gonadotropin (SG-G100) was examined monthly using 18 hr incubations. In June and July, levels were too low to detect (less than 30 pg/ml) in media from all treatment groups. In August and September, SG-G100 at a concentration of 1 μg/ml stimulated low levels of production (0.2–0.3 ng/ml). Full-grown, immature follicles in October showed a dose-response production of 17α,20β-diOHprog, avaraging over 10 ng/ml when incubated with 1 μg/ml SG-G100. Postovulatory follicles (1–2 days after ovulation) produced large amounts of 17α,20β-diOHprog, averaging over 100 ng/ml with 1 μg/ml SG-G100. These results are discussed in relation to previous work on amago salmon and other species and together indicate that 17α,20β-diOHprog is the major steroid responsible for oocyte maturation in amago salmon, produced as the follicular mediator of gonadotropin.     

Involvement of 3',5'-cyclic adenosine monophosphate in the control of follicular steroidogenesis of amago salmon (Oncorhynchus rhodurus)

The role of cAMP in the control of follicular steroidogenesis of amago salmon (Oncorhynchus rhodurus) was studied using in vitro incubation of isolated thecal and granulosa layers. Particular attention was paid to the role of cAMP in the shift in the steroidogenic responses of follicle layers to gonadotropin (partially purified chum salmon gonadotropin, SGA) during oogenesis. First, the effects of SGA and forskolin, an activator of adenylate cyclase, on intratissue accumulation of cAMP were determined using isolated thecal and granulosa layers from various stages of development. Regardless of the stage of development, SGA and forskolin stimulated cAMP formation in both layers within 1 hr of incubation. Second, the effects of SGA, forskolin, dibutyryl cAMP, and inhibitors of phosphodiesterase on testosterone and 17 alpha-hydroxyprogesterone production by thecal layers and on the activities of aromatase and 20 beta-hydroxysteroid dehydrogenase in granulosa layers from follicles of various developmental stages were investigated. All steroidogenic actions of SGA were mimicked by those agents known to raise the cellular level of cAMP. These results provide evidence that the steroidogenic actions of gonadotropin in both thecal and granulosa layers depend on increased intracellular cAMP, and they further suggest that a change in cellular events at a step(s) subsequent to cAMP production is involved in regulating the shift in the steroidogenic responses of follicle layers to gonadotropin.     

Effect of ticlopidine on platelet-derived microparticles in patients with connective tissue diseases

We evaluated the plasma concentrations of platelet activation markers and platelet-derived microparticles (PMP) in patients with connective tissue diseases complaining of peripheral circulation disorders (n = 16) and studied the effect of ticlopidine hydrochloride (ticlopidine) on PMP generation. There were significant differences in the levels of PMP and a platelet activation marker between before and after treatment with ticlopidine (PMP: 695 +/- 393 vs. 354 +/- 206/10(4) platelets, p < 0. 01; platelet CD63: 9.13 +/- 5.64 vs. 5.22 +/- 2.74%, p < 0.05). On the other hand, markers of vascular endothelium, such as vascular endothelium-derived small vesicles and serum thrombomodulin levels, were not affected by the administration of ticlopidine. Levels of cytokines and soluble adhesion molecules remained unchanged by ticlopidine administration. These findings suggest that ticlopidine may be useful for the inhibition of PMP-dependent vascular damage in patients with connective tissue diseases complaining of peripheral circulation disorders.