Cerivastatin improves insulin sensitivity and insulin secretion in early-state obese type 2 diabetes

In a double-blind, placebo-controlled, randomized crossover study, 15 stable mild hyperglycemic patients without treatment and with features of metabolic syndrome were treated with cerivastatin (0.4 mg/day) or placebo for 3 months. The insulin sensitivity index during the euglycemic-hyperinsulinemic clamp (EHC; 5.4 mmol/l; 80 mU x m(-2) x min(-1)) was increased by cerivastatin treatment (66.39 +/- 3.9 nmol x lean body mass [LBM](-1) x min(-1) x pmol(-1) x l(-1)) as compared with placebo (58.37 +/- 3.69 nmol x LBM(-1) x min(-1) x pmol(-1) x l(- 1); P < 0.01) by 13.7%. Glucose oxidation during EHC was significantly higher with statin treatment (16.1 +/- 1.37 micromol x LBM(-1) x min(-1)) as compared with placebo (14.58 +/- 1.48 micromol x LBM(-1) x min(-1); P < 0.05). During hyperinsulinemia (approximately 800 pmol/l) in EHC steady-state, lipid oxidation was significantly decreased and respiratory quotient was significantly increased with statin treatment (0.33 +/- 0.05 mg x LBM(-1) x min(- 1), 0.94 +/- 0.01) as compared with placebo (0.48 +/- 0.06 mg x LBM(-1) x min(-1), 0.91 +/- 0.01; P < 0.01 and P < 0.05, respectively). During statin treatment, the first-phase insulin response increased from 2.07 +/- 0.28 to 2.82 +/- 0.38 pmol x l(-1) x pmol(-1) (P < 0.05). The second phase of insulin responses examined by C-peptide and insulin levels averaged during the hyperglycemic clamp (20 mmol/l) was unchanged. In conclusion, this study demonstrates that 0.4 mg cerivastatin therapy improves first-phase insulin secretion and increases insulin-mediated glucose uptake and respiratory quotient in the early state of obese type 2 diabetes.

Neoadjuvant therapy of rectal carcinoma with UFT-leucovorin plus radiotherapy

BACKGROUND

The object of this phase II study was to assess the impact of preoperative external radiation therapy combined with UFT and leucovorin on tumor response, sphincter preservation and tumor control in patients with rectal carcinoma.

PATIENTS AND METHODS

Forty-one patients with resectable extraperitoneal rectal adenocarcinoma received radiation therapy and two courses of chemotherapy. Chemotherapy consisted of a 2-h infusion of 6S-steroisomer of leucovorin (6SLV) 250 mg/m2 on day 1, oral 6SLV 7.5 mg every 12 h on days 2-14, and UFT either 350 or 300 mg/m2 on days 1 to 14 every 28 days. Six additional courses of chemotherapy were given after surgery.

RESULTS

Seven of 16 patients (43%) who received 350 mg/m2/day of UFT had grade 3-4 diarrhea and two other patients (12%) had grade 3-4 dermatitis. The next 25 patients received 300 mg/m2/day of UFT and only 14% of them had grade 3-4 diarrhea. Surgery consisted of low-anterior resection in 26 patients (63%) and abdominal-perineal amputation in 15 (37%). There were six histological complete responses (15%). Downstaging occurred in 25 patients (63%). The overall survival at 3 years was 90% and the pelvic disease-free survival 92%.

CONCLUSIONS

Preoperative therapy with radiotherapy and UFT-6SLV downstaged 63% of tumors and allowed a sphincter-preserving procedure in some patients. Toxicity was moderate. This scheme is convenient because of the oral administration of chemotherapy.

4-Alkylidenyl glutamic acids, potent and selective GluR5 agonists

Twenty-four 4-alkylidene glutamic acids were synthesised and tested as potential subtype selective GluR5 and 6 ligands. It was found that a critical size of alkylidene group gave potent and selective GluR5 receptor agonists. LY339624 had Kis of 0.0326 and >100 microM on GluR5 and 6 receptors, respectively.

4-Alkyl- and 4-cinnamylglutamic acid analogues are potent GluR5 kainate receptor agonists

Enantiomerically pure (2S,4R)-4-substituted glutamic acids were prepared and tested for homomeric GluR5 and GluR6 kainate subtype receptor affinity. Some of the 4-cinnamyl analogues showed high selectivity and potency (K(i) < 25 nM) for the GluR5 receptors. The greatest selectivity and potency were achieved with the 3-(2-naphthyl)prop-2-enyl compound. This compound, LY339434, has negligible activity at the AMPA and kainate receptors GluR1, -2, -4 and -6. Although, LY339434 shows agonist activity at NMDA receptors in cultural hippocampal neurons (approximate EC(50) of 2.5 microM), we consider that LY339434 should be a useful pharmacological tool for the investigation of the functional role of GluR5 kainate receptors.

Protective effect of enriched diet plus growth hormone administration on radiation-induced intestinal injury and on its evolutionary pattern in the rat

Adequate nutritional support can enhance the protective action of growth hormone in radiation-induced mucositis. Our aim is to address the evolutionary pattern of radiation injury to the small intestine of rats fed a high-protein diet and treated with growth hormone before irradiation. Male Wistar rats were fed a high-protein diet and killed two, four or seven days after irradiation. Animals were given either growth hormone or saline. The combination of growth hormone and high-protein diet reduced mortality, increased mucosal height and crypt proliferation, and reduced apoptosis from day 2 to day 7 after irradiation. Bacterial translocation was increased in rats fed the high-protein formula. Insulin-like growth factor was reduced by radiation and further reduced by the high-protein diet. The combination of growth hormone and high-protein diet protects from the damage caused by radiation to the bowel and accelerates its recovery. This effect does not seem to be mediated through insulin-like growth factor levels.

Selection of a nucleopolyhedrovirus for control of Spodoptera frugiperda (Lepidoptera: Noctuidae): structural, genetic, and biological comparison of four isolates from the Americas

Spodoptera frugiperda (J. E. Smith) (Lepidoptera: Noctuidae) is the principal pest of maize in tropical and subtropical regions of the Americas. Larvae of this species are susceptible to a nucleopolyhedrovirus (NPV) which has attracted interest as a potential biocontrol agent. Four strains of NPV isolated from infected S. frugiperda larvae in the United States, Nicaragua, and Argentina were subjected to a structural, genetic, and biological comparison to select a candidate isolate for use in biocontrol experiments in Mexico and Honduras. All isolates had an occlusion body polyhedrin protein of 32 kDa, but the virions of each isolate differed subtly in the pattern and abundance of certain structural polypeptides revealed by SDS-PAGE analysis. Restriction endonuclease analysis of viral DNA confirmed that these isolates were strains of a single virus species but showed that they were not genetically homogeneous; each isolate could be differentiated from the others using common restriction enzymes. Droplet feeding bioassays indicated that an isolate from Nicaragua (Sf-NIC) and an isolate from the United States (Sf-US) had the highest infectivity when tested against 2nd instars originating from a Honduran S. frugiperda colony. No significant differences were detected in the speed of kill of Sf-NIC (102.7 h), Sf-US (102.3 h) and Sf-AR (103.4 h), whereas that of Sf-2 (97.3 h) was significantly shorter. Additional bioassays of the Sf-NIC isolate against 2nd to 6th instars demonstrated that LC50 values increased with larval stage from 2.03 x 10(5) OBs/ml for 2nd instars to 1.84 x 10(8) OBs/ml for 5th instars. The concentration required to elicit a lethal infection of 6th instars was so high that a reliable estimate of LC50 could not be obtained. The mean time to death for each stage challenged with the Sf-NIC isolate increased with instar from an average of 102.7 h in 2nd instars to 136.9 h in 5th instars.

(2S,4S)-amino-4-(2,2-diphenylethyl)pentanedioic acid selective group 2 metabotropic glutamate receptor antagonist

(2S,4S)-2-Amino-4-(4,4-diphenylbut-1-yl)-pentane-1,5-dioic acid 1m, is a novel metabotropic glutamate receptor (mGluR) antagonist with insignificant ionotropic affinity. It is selective antagonist of negatively-coupled cAMP-linked mGluRs with no effect on phosphoinositide coupled mGluRs. A series of 4-substituted glutamic acid analogues were prepared and it was found that compound 1k is tenfold more potent than 1m. Compound 1k has neither significant affinity for ionotropic glutamate receptors nor group 1 and 3 metabotropic receptors.

Nasal mucociliary transport and ciliary ultrastructure in cystic fibrosis. A comparative study with healthy volunteers

Cystic fibrosis (CF) is a deadly hereditary disease that produces an abnormally thick, viscous and abundant secretion in the respiratory tract. This secretion in turn leads to the development of recurrent respiratory infections and irreversible lung damage. We have studied nasal mucociliary transport by means of an isotopic technique in 12 patients with CF and in 12 healthy volunteers. Nasal mucociliary transport was repeated at 12-18 months in the patients. In five randomly selected patients ciliary ultrastructure was studied. The velocity of nasal mucociliary transport was significantly slower than in healthy persons (P < 0.001) and no significant differences were observed in both studies (P < 0.05). No significant differences were either observed in the CF group between the homo- and heterozygotes (P < 0.5), or in those six patients infected by Pseudomonas aeruginosa (P < 0.05). Ciliary ultrastructure was normal in one patient. In another patient the sample showed no cilia, while the remaining three exhibited changes similar to those observed in chronic respiratory infections: supernumerary peripheral tubules, ciliary disorientation and ciliary complexes.

Effect of lead on bone development and bone mass: a morphometric, densitometric, and histomorphometric study in growing rats

The effect of exposure to lead on the longitudinal development of bone and on bone mass was studied in rats. A group of 35, 50-day-old female Wistar rats was divided into a control group of 15 rats and an experimental group of 20 rats fed a diet supplemented with 17 mg of lead acetate per kg feed for 50 days. Total body bone densitometry (TBBMC) was performed the day before ending the 50-day experiment. On day 50, all rats were killed and their right femur and 5th lumbar vertebra were dissected. The bones were cleaned of soft tissue and femoral length and vertebral length were measured with a caliper and all bones were weighed on a precision scale. Final body weight (P < 0.05), TBBMC (P < 0.005), and femur weight (P < 0.005) were significantly lower in the control group. Femur length did not differ between groups, but the length of the 5th lumbar vertebra was greater in the control group (P < 0.05). Histomorphometry of the femur showed that Cn-BV/TV, Tb-N, Tb-Th were lower (P < 0.05 in all) and Tb-Sp was higher (P < 0.05) in the group given the lead-supplemented diet. These findings suggested lead-induced inhibition of axial bone development and a histomorphometric decrease in bone mass, produced mainly by enhanced resorption, and a densitometric increase in bone mass, produced by lead accumulation in bone.

Effect of lead on bone and cartilage in sexually mature rats: a morphometric and histomorphometry study

The effect of exposure to lead on the longitudinal development of the femur and of its cartilage growth plate was studied in rats. A group of forty-five 50-day-old female Wistar rats was divided into a control group of 20 rats and an experimental group of 25 rats fed a diet supplemented with 17 mg of lead acetate per kilogram of feed for 50 days. On Day 50 all rats were killed and their right femurs were dissected. The femurs were cleaned of soft tissue and femoral lengths were measured with a Vernier caliper and thickness of growth cartilage (GPC-Th micron) by histomorphometry. Final body weights were significantly (P < 0.05) lower in the control group than in the rats given the lead-supplemented diet. Femur length did not differ between groups. Histomorphometry of the femur showed that the thickness of growth cartilage was higher (P < 0.05) in the control group. These findings suggested lead-induced inhibition of growth plate development. The growth plate may be one of the key target tissues accounting for the adverse effects of chronic lead exposure on skeletal development.

Clinical and ultrastructural correlations in nasal mucociliary function observed in children with recurrent airways infections

A study was made of 106 children between 1 and 15 years of age (mean 6 years) with recurrent upper and lower airways infections since birth. Nasal mucociliary transport (NMT) velocity was determined in all subjects by the Tc99m-labeled seroalbumin technique. In 42 children, NMT was found to be altered. In this group of patients the technique was repeated in a period of between 1 and 2 years later. In 23 cases (55%) transport had normalized, while in 19 (45%) it remained altered. Recurrent pneumonia and constant rhinorrhea were more frequent in this group. Situs inversus was only detected in 2 of these patients. Pathology showed ciliary ultrastructure, the absence of dynein arms and microtubule alterations. The absence of cilia was observed in some patients. Normal cilia were also encountered in children with persistently altered nasal mucociliary transport.

An isotopic study of nasal mucociliary transport in newborns: preliminary investigation

The diagnosis of primary ciliary dyskinesia (PCD) depends on electron microscopic examination of cilia obtained from mucosal biopsies of the nasal turbinates or the trachea. This is an invasive, time-consuming, and expensive technique. The low incidence of this abnormality, the large number of infants and children with suggestive symptoms, and the lack of a reliable screening test make the decision to proceed with diagnostic biopsy a common problem in recurrent or chronic respiratory pediatric conditions. To improve this situation early in infancy, nasal mucociliary transport was evaluated in 10 normal newborns using the Tc-99m-labeled seroalbumin technique, and the results obtained were compared with those corresponding to a newborn with Kartagener's syndrome. Transport velocity in normal newborns was similar to that observed in older children and in adults, in contrast to the tracer immobility seen in the affected newborn. This technique is simple, safe, objective, and well tolerated in this age group and might be used as an early screening test to ruling out PCD.

[Nasal mucociliary function in children with recurrent infections of the airways]

Nasal mucociliary function has been studied in 21 children suffering recurrent airway infections. Previously, cystic fibrosis, immune deficits and allergy were discharged. 38 per cent of these patients had alterations in the mucociliary transport and in this group, it was observed an increase of bronchiectasis, permanent rhinorrhea and serous otitis media.

[Evaluation of methods for the detection of syncytial respiratory virus in nasopharyngeal secretions]

The screening for respiratory syncytial virus (RSV) in nasopharyngeal secretions with enzyme immunoassay (ELISA) and indirect immunofluorescence (IIF) has been evaluated in infants and young children with acute respiratory infection. Both methods were compared with viral isolation in HEp-2 cells and the investigation of fluorescent foci in cell cultures inoculated by centrifugation. 226 samples were evaluated by IFF, 182 of which were also evaluated by ELISA while 158 were inoculated into cell cultures. 20.35% of samples were positive with IFF and 19.23% with ELISA. Isolation of RSV was obtained in 25 of the samples inoculated into HEp-2 cells (15.8%). The cytopathic effect took a mean of 5.4 days to develop. The investigation of fluorescent foci in centrifugated cultures allowed to detect 76% of positive samples 24 hours after centrifugation and 84% of positive samples 48 hours after it. Considering the viral isolation as the reference method, IIF and ELISA had a 88% and 76% sensitivity, respectively, with very similar specifities (90.2% and 91.7%).

Enterotoxigenic Escherichia coli O153:H45 from an outbreak of diarrhoea in Spain

Enterotoxigenic Escherichia coli (ETEC) strains belonging to a characteristic serobiotype, O153:H45 ST+, were isolated from an outbreak of neonatal diarrhoea in Valencia, Spain. The restriction of the geographical location of this clone to South America and Spain is discussed.

[Treatment of type-b H. influenzae meningitis resistant to ampicillin and chloramphenicol]

Three cases of H. influenzae type b meningitis with resistance to ampicillin and cloramphenicol are described. All infants were treated with new cephalosporin derivates. CSF sterilization was achieved in all patients. Clinical evolution was good in the two old infants treated with cefotaxime, nevertheless younger infant treated with cephoxitin developed serious neurologic and psychologic sequelae. H. influenzae b was erradicated of a carrier mother after four days of rifampicin therapy. Finding of multiple-resistance H. influenzae type b meningitis and therapeutics problems are emphasized by authors.

[Immunity in hypothyroid children (author's transl)]

For a long time investigators have focused attention on the relationship between specific immunity and hormones. In the present paper, authors investigated on 26 children, 9 males and 17 females, from 9 months to 14 and 10/12 years old, with primary hypothyroidism. All patients were in substitutive treatment. The following studies were done to all the patients: serum IgG, IgA, IgM and complement. Blood lymphocyte counts, percentages of B and T lymphocytes, as well as the response of lymphocytes to PHA. Skin tests were also carried out: tuberculin, candidin and streptokinase-streptodornase. All results obtained in both, hypothyroid and control groups fell within the range of normal age-matched values for our laboratory, and by results of statistics studies carried out they were considered of little significance, except the percentage of circulating B lymphocytes that was lower in hypothyroid group (p less than or equal to 0.01).

[Glycogenosis type I. Therapy (author's transl)]

Two new patients of glucogenosis type I, fed with a special diet, are described. Various indicated treatments to correct metabolic alterations of the disease were revised (diet, drugs, surgery). Different forms of therapy are compared according with results obtained. Metabolic acidosis and hypoglycemia improved. Growing rate and hyperlypemia did not improved. Uricemic acid levels with alopurinol got normal. Possible implications of this results are discussed.