Effect of ibandronate therapy on serum homocysteine and leptin in postmenopausal osteoporotic females

A significant change in serum leptin level and no change in homocysteine were observed with ibandronate treatment. No correlation of homocysteine and leptin was found with bone mass density (BMD). Results indicate that ibandronate reduces serum leptin levels but how does it help in reducing the osteoporosis. It needs to be explored.

INTRODUCTION

The current study was planned to determine the effects of ibandronate on serum homocysteine and leptin levels in postmenopausal osteoporotic females and to correlate these with BMD.

METHODS

Forty-two newly diagnosed and untreated postmenopausal osteoporotic females were selected on the basis of their BMD (BMD < -2.5) from Orthopaedic Out Patient Department of Shaikh Zayed Hospital, Lahore, Pakistan, and 36, age and BMI matched non-osteoporotic postmenopausal females, were also selected as a control group. Baseline physical and biochemical parameters were compared. In osteoporotic patients, changes in circulating leptin and homocysteine levels were studied after 6 months of therapy with ibandronate (150 mg). The collected data were analyzed on SPSS 16.

RESULTS

There was no significant difference observed in the mean value of all baseline parameters except BMD in both groups. After 6 months of treatment with ibandronate (150 mg), a significant change was observed in serum leptin levels (19.48 ± 1.60 ng/ml vs. 14.09 ± 0.85 ng/ml, p < 0.002), while no considerable change observed in serum homocysteine levels (16.22 ± 0.95 μmol/l vs. 16.80 ± 1.03 μmol/l, p < 0.63). Serum leptin was found significantly correlated with anthropometric parameters. No correlation of serum leptin and homocysteine was found with BMD (r = 0.09, p value = 0.54; r = -0.17, p value = 0.27).

CONCLUSION

Our results show that ibandronate reduces serum leptin levels while it has no effect on serum homocysteine levels. Further studies are needed to explain how the decrease in serum leptin level may help in reducing the progression of osteoporosis.

NPHP4 mutation is linked to cerebello-oculo-renal syndrome and male infertility

Nephronophthisis is the most common genetic cause of renal failure in children and young adults. It is genetically heterogeneous and can be seen in isolation or in combination with other ciliopathy phenotypes. Here we report an index case where nephronophthisis is associated with oculomotor apraxia and cerebellar abnormalities, consistent with the clinical diagnosis of cerebello-oculo-renal syndrome. Prompted by a family history of an uncle with early onset end stage renal failure and infertility, we performed semen analysis on the index. This revealed marked reduction in the count of motile sperms as well as multiple abnormalities in the head and tail. Autozygome-guided mutation analysis followed by exome sequencing and segregation analysis revealed a homozygous truncating mutation in NPHP4, indicating that mutations of this gene can on rare occasions cause cerebello-oculo-renal syndrome. Our finding of severe male infertility in a family with NPHP4 truncation is strongly supported by the mouse model and, to our knowledge, is the first reported male infertility phenotype in association with NPHP4 or any other nephrocystin in humans.

Regulated autocrine growth of CHO cells

The goal of this work was to engineer a CHO cell line capable ofautocrine growth in a fully defined protein-free medium. Thiswas accomplished by stable integration of the genes encodinginsulin-like growth factor I (IGF-I) and transferrin into thegenome of a CHO-K1 cell line. Thelac operator/repressorsystem was used to regulate the expression of the IGF-I gene with thelac operator sequence being placed upstream ofthe coding sequence for IGF-I. The expression of thelacrepressor protein was driven by a modified metallothioneinpromoter allowing repressor expression to be regulated by theculture medium. The cell line calledSuper CHO(r) (r for regulated) was able to grow in protein-free medium in an autocrine fashion with a doubling time of 20-24 hr,either attached to microcarriers or as aggregate suspensioncultures. Upon addition of metal to the culture medium, therepressor protein was produced and bound to the operatorsequences shutting down the expression of IGF-I and arrestingthe growth of the cells. Expression of the human growth hormone(hGH) gene and production of hGH was induced by the presence ofmetal ions. It was possible to release the cells from growtharrest in the presence of metal by the addition of isopropylbeta-D-thiogalactopyranoside (IPTG), which prevented bindingof the repressor to its operator sequences. The ability to growCHO cells in fully defined protein-free medium and to be able toregulate their growth rate offers a number of advantages for theuse of these cells as hosts for the production of recombinantDNA derived proteins.

Estimation of serum osteocalcin and telopeptide-C in postmenopausal osteoporotic females

A negative correlation of serum C-terminal telopeptide of type I collagen (telopeptide-C) was observed with bone mass density (BMD) in postmenopausal control (r = -0.70, p < 0.05) and osteoporotic females (r = -0.46, p < 0.05) indicating increased bone resorption in these subjects. Since telopeptide-C is a significant determinant of bone loss, it can be used, in combination with bone mass measurement, for the assessment of postmenopausal females.

INTRODUCTION

The aim of this study was to find out the significance of serum osteocalcin, a marker of bone formation, and C-terminal telopeptide of type I collagen, a marker of bone resorption, in evaluating osteoporotic patients and to find out their relationship with bone mass density.

METHODS

One hundred and fifty (150) females; 50 premenopausal (age=31.13 +/- 1.29), 50 postmenopausal (age = 54.36 +/- 0.81) and 50 postmenopausal osteoporotic patients (age = 58.6 +/- 0.701) were included in this study. The postmenopausal subjects, with and without osteoporosis, were selected from different osteoporotic clinics and healthy premenopausal females were selected from general population. Height, weight, BMI, waist/hip ratio, age at menarche, years since menopause in case of postmenopausal women, history of disease, and fracture, if any, were recorded. BMD assessment was done on calcaneous by peripheral ultrasound bone densitometery on Sahara Clinical Bone Sonometer and T-scores were calculated. Serum levels of osteocalcin and C-terminal telopeptide of type I collagen and calcium were measured.

RESULTS

A lower BMD in postmenopausal subjects, with and without osteoporosis (p < 0.001), indicating increased bone loss with aging and menopause, was observed. A negative correlation was found between age and BMD (r = -0.67, p < 0.05). No correlation was found between osteocalcin and BMD among these groups, suggesting heterogeneity of osteocalcin fragments in serum that limits its significance in the evaluation of osteoporosis. A positive correlation was found between osteocalcin and telopeptide-C (r = 0.26, p < 0.05). A positive correlation of telopeptide-C with age (r = 0.45, p < 0.05) and a negative correlation with BMD (r = -0.46, p < 0.05) was observed indicating increased bone resorption in postmenopausal control and postmenopausal osteoporotic patients.

CONCLUSION

C-terminal telopeptide of type I collagen appears to be a significant determinant of bone loss and may be used as a valuable tool in the assessment of postmenopausal osteoporotic patients.

Survival advantage in patients treated with high-dose interleukin-2 (HDIL2) for metastatic renal cell carcinoma (mRCC)

e16039

Background: A prognostic index developed at MSKCC(Memorial-Sloan-Kettering Cancer Center) relates to survival in mRCC patients (pts) treated with interferon. We evaluated 79 pts treated first line with HDIL2 to see if this prognostic index is applicable. Eligibility for HDIL2 was based on cardiopulmonary screening and performance status (PS). Method: Medical records were analyzed retrospectively from 2000–2008. Pts were categorized into favorable, intermediate & poor risk category according to MSKCC prognostic index, which includes time from diagnosis to treatment, serum calcium & LDH, hemoglobin and PS. Median survival (OS) & median progression free survival (PFS) were compared between risk categories. Results were evaluated taking into consideration potential confounders such as subsequent treatment with tyrosine kinase inhibitors (TKI) & time from nephrectomy to metastasis interval of more than 1 year. Statistical analysis utilized SPSS. Results: 29 pts (36.7%) were treated with TKIs subsequently and this had no impact on median OS compared to those not receiving TKIs. 19 pts (24%) had nephrectomy to metastasis interval of more than 1 year and this also did not impact on OS analysis compared to those with shorter time to metastasis. Poor risk group was not analyzed due to small sample size. Conclusions: Median OS for mRCC pts eligible for and treated with HDIL2 as first line therapy exceeds reports of other first line treatment, either cytokines or TKIs. The survival advantage occurs regardless of being in either favorable or intermediate risk category and this benefit is not confounded by subsequent treatment with TKIs or nephrectomy to treatment interval more than 1 year. HDIL2 pts requires good PS and organ function, but 72% were intermediate risk pts. Thus, MSKCC risk categories do not predict for HDIL2 treatment outcome. HDIL2 should still be considered as a first line agent for mRCC, in the era of TKIs, as long as patients meet the eligibility criteria, as it infers survival advantage. [Table: see text]

[Table: see text]

Short communication: new alleles of the bovine kappa-casein gene revealed by resequencing and haplotype inference analysis

We tested the hypothesis that extensive undiscovered genetic diversity exists in important functional genes from domestic and wild cattle species (Bos spp.). We resequenced 483 bp of a key exon (exon IV) from the kappa (kappa)-casein gene (CSN3) for a panel of samples of domestic cattle from 8 countries and a close relative species, the gayal (Bos frontalis). Six single nucleotide polymorphisms were identified. Haplotype inference revealed 12 haplotypes, of which 8 were newly discovered. Among these 8 new haplotypes, 5 differed by one nonsynonymous mutation and 3 differed by one silent mutation from previously well-characterized CSN3 alleles. From those, one was shared by the gayal and Zebu, was different from CSN3*B at position Ile136Thr, and showed a close phylogenetic relationship with the banteng, gaur, and yak. The other 7 new haplotypes were detected in our panel of worldwide local cattle breeds but were absent from previously reported commercial breeds. These results support the hypothesis that genetic diversity at the coding region of CSN3 has been underestimated. This study also highlights how important it is to resequence functionally important genes in worldwide local cattle breeds, many of which are threatened by extinction or replacement by commercial breeds.

Perforated caecal volvulus: an unusual complication after anterior resection for colorectal carcinoma

AIM

To discuss an unusual and rare complication of perforated caecal volvulus (CV) following open anterior resection.

METHODS

A retrospective review of the case notes of a patient.

RESULTS

CV is a well known but rare cause of bowel obstruction. Chronic constipation, distal colonic obstruction and post-operative ileus are potentially aggravating factors for the development of CV in anatomically susceptible patients. The anatomical susceptibility for CV was noticed during the first operation but prophylactic caecopexy was not performed due to lack of evidence in the literature. This patient developed CV after anterior resection and subsequently underwent a second laparotmy for right hemicolectomy.

CONCLUSION

CV is a known but rare case of postoperative bowel obstruction. The role of prophylactic caecopexy could be discussed in order to avoid the development of postoperative CV in anatomically susceptible patients.

To study hypoactive sexual desire disorder in a fragile X carrier female successfully treated with local testosterone application

There is still considerable controversy concerning the role of androgen therapy for hypoactive sexual desire disorder in females. Clinical trials have shown that exogenous testosterone therapy improves arousability, sexual desire and fantasy, frequency of sexual activity and orgasm, and satisfaction and pleasure from the sexual act. We report our experience of 36-year-old fragile X carrier female presented to our department with low sex drive and subjectively poor arousal for the past 1 year. We decided to treat her with local testosterone in a pump form (1% 5 g twice a week). She responded very well to the treatment, and in 3 weeks her libido and sexual functions improved dramatically. We decided to continue the same treatment for almost 1 year following up her free and total testosterone, complete lipid profiles, liver functions and complete blood picture every 3 months. During the whole course of treatment, she had mild facial acne, which was resolved in 2 months after completing treatment with testosterone. This is our first and only case of this syndrome with low sexual desire disorder treated with local testosterone in a pump form. Based upon our 1 year follow-up, low-dose testosterone is a safe and effective approach in treating hypoactive sexual desire disorder in a fragile X carrier female, provided the patient is monitored every 3 months for blood counts, lipid profiles, liver functions and free and total testosterone levels.

Cold atoms in non-Abelian gauge potentials: from the Hofstadter "moth" to lattice gauge theory

We demonstrate how to create artificial external non-Abelian gauge potentials acting on cold atoms in optical lattices. The method employs atoms with k internal states, and laser assisted state sensitive tunneling, described by unitary k x k matrices. The single-particle dynamics in the case of intense U2 vector potentials lead to a generalized Hofstadter butterfly spectrum which shows a complex mothlike structure. We discuss the possibility to realize non-Abelian interferometry (Aharonov-Bohm effect) and to study many-body dynamics of ultracold matter in external lattice gauge fields.

Optimal scheme for estimating a pure qubit state via local measurements

We present the optimal scheme for estimating a pure qubit state by means of local measurements on N identical copies. We give explicit examples for low N. For large N, we show that the fidelity saturates the collective measurement bound up to order 1/N. When the signal state lays on a meridian of the Bloch sphere, we show that this can be achieved without classical communication.

Aligning reference frames with quantum states

We analyze the problem of sending, in a single transmission, the information required to specify an orthogonal trihedron or reference frame through a quantum channel made out of N elementary spins. We analytically obtain the optimal strategy, i.e., the best encoding state and the best measurement. For large N, we show that the average error goes to zero linearly in 1/N. Finally, we discuss the construction of finite optimal measurements.

Optimal strategies for sending information through A quantum channel

Quantum states can be used to encode the information contained in a direction, i.e., in a unit vector. We present the best encoding procedure when the quantum state is made up of N spins (qubits). We find that the quality of this optimal procedure, which we quantify in terms of the fidelity, depends solely on the dimension of the encoding space. We also investigate the use of spatial rotations on a quantum state, which provide a natural and less demanding encoding. In this case we prove that the fidelity is directly related to the largest zeros of the Legendre and Jacobi polynomials. We also discuss our results in terms of the information gain.