Mating patterns of dermatophytes of diverse origin in India

The mating patterns of Trichophyton mentagrophytes var. interdigitale (74 isolates) and the Microsporum gypseum complex (17 isolates) of diverse origin and T. rubrum (25 isolates) and T. tonsurans (10 isolates) of clinical origin were studied. The results of the study showed that the teleomorph of the Indian isolates of T. mentagrophytes belong to Arthroderma vanbreuseghemii, undetermined teleomorphs of T. mentagrophytes var. interdigitale (+) mating types, and undetermined teleomorphs of T. mentagrophytes var. interdigitale indeterminate mating types. All the isolates of T. rubrum and T. tonsurans were found to be of the (-) mating type.

Minipreparation of total cellular DNA is useful as an alternative molecular marker of mitochondrial DNA for the identification of Trichophyton mentagrophytes and T. rubrum

Total cellular DNA was extracted from 18 isolates of Trichophyton mentagrophytes and six isolates of unidentified Trichophyton species taken from tinea corporis, tinea cruris and tinea pedis patients by a minipreparation method. The DNA was digested with the restriction enzymes HaeIII and MspI, followed by electrophoresis on agarose gels. The restriction enzyme profiles of the DNAs were compared with those of mitochondrial (mt) DNA extracted from reference strains of T. mentagrophytes (Arthroderma simii, A. benhamiae and A. vanbreuseghemii) and T. rubrum. All 18 T. mentagrophytes isolates showed the same DNA profiles as mtDNA from A. vanbreuseghemii. The six unidentified Trichophyton isolates exhibited DNA profiles the same as that of mtDNA from T. rubrum. Consequently, these isolates were identified as T. rubrum. In conclusion, restriction enzyme analysis of total cellular DNA prepared by the minipreparation method is considered to be useful as an alternative method of mtDNA analysis and is helpful for the identification of these dermatophyte species.

Human requirements of iodine & safe use of iodised salt

Iodine deficiency is the most common preventable cause of mental deficiency. Remarkable success has been achieved by the use of iodised salt to correct this deficiency in many industrialised countries since 1920. The Government of India has adopted a strategy to iodise all edible salt in the country to overcome iodine deficiency. Universal salt iodisation is the principal public health measure for eliminating iodine deficiency disorders. Daily iodine intakes of up to 1000 micrograms, appear to be entirely safe. In India, the likelihood of exceeding this level is quite small. Iodised salt does not cause any side effects. Iodine in iodised salt does not carry risks for persons who are already iodine sufficient. iodisation of salt at the current level of fortification (15-30 ppm iodine) keeps intakes well within a safe daily range for all populations, irrespective of their iodine status.

Leptin levels in human and rodent: measurement of plasma leptin and ob RNA in obese and weight-reduced subjects

Leptin, the gene product of the obese gene, may play an important role in regulating body weight by signalling the size of the adipose tissue mass. Plasma leptin was found to be highly correlated with body mass index (BMI) in rodents and in 87 lean and obese humans. In humans, there was variability in plasma leptin at each BMI suggesting that there are differences in its secretion rate from fat. Weight loss due to food restriction was associated with a decrease in plasma leptin in samples from mice and obese humans.

Influence of ethacrynic acid on glutathione S-transferase pi transcript and protein half-lives in human colon cancer cells

Ethacrynic acid (EA) is a plant phenolic acid that is both an inhibitor and an inducer of glutathione S-transferase (GST) activity. To determine contributory factors in the increased GST activity caused by EA treatment, human colon carcinoma HT29 cells were compared with a cloned EA-resistant population (HT6-8) maintained in medium containing 72 microM EA. Several factors are involved in the increased expression of GST pi in HT6-8. For example, nuclear run-on experiments showed an approximately 2-fold increase in the rate of transcription of GST pi. In addition, the half-life of GST pi transcript was increased from 4.1 (wild type, HT29, HT4-1) to 8.4 hr. The half-life of GST pi protein was 1-2 hr in HT4-1 cells versus 8-9 hr in HT6-8 cells. When either human ovarian carcinoma cells (SKOV3) or human prostatic carcinoma cells (DU145) were treated with EA, the half-life of the GST pi transcript was also increased. The transcript half-lives of another thiol-metabolism enzyme, gamma-glutamylcysteine synthetase (gamma-GCS), and a phase II detoxification enzyme, dihydrodiol dehydrogenase (DDH), were also increased in HT6-8, SKOV3 and DU145 cells treated with EA. However, the half-lives of transcripts from "housekeeping genes," such as glyceraldehyde 3-phosphate dehydrogenase (G3PDH), beta-actin and beta-tubulin, were not changed in these cell lines following EA. Apparently, a number of coordinated factors are involved in EA-enhanced expression of GST pi and other detoxification enzymes.

Iodised salt is safe

Iodine deficiency disorders are prevalent in all the States and Union Territories in India. Under the National Iodine Deficiency Disorders control programme, the Government of India has adopted a strategy to iodisation of all edible salt in the country which is a long term and sustainable preventive solution to eliminate iodine deficiency disorders. The benefits to be derived from universal salt iodisation are more to the population. Iodised salt is safe and does not cause any side effect.

Glyoxalase I in detoxification: studies using a glyoxalase I transfectant cell line

The glyoxalase system (glyoxalase I, glyoxalase II and GSH as cofactor) is involved in the detoxification of methylglyoxal (a byproduct of the glycolytic pathway) and other alpha-oxoaldehydes. We have transfected a 622 bp cDNA encoding human glyoxalase I into murine NIH3T3 cells. The recipient cells were shown to express elevated transcript and protein levels and a 10-fold increase in glyoxalase I enzyme activity. This was accompanied by an increased tolerance for exogenous methylglyoxal and enhanced resistance to the cytotoxic effects of two glyoxalase I inhibitors (s-p-bromobenzylglutathione diethyl ester and s-p-bromobenzylglutathione dicyclopentyl ester), a glutathione analogue [gamma-glutamyl-(S)-(benzyl)cysteinyl-(R)-(-)-phenylglycine diethyl ester] and the anti-cancer drugs mitomycin C and adriamycin. Steady-state levels of GSH were significantly lower in the transfected cells, perhaps reflecting increased flux as a consequence of elevated glyoxalase activity. This decrease did not alter the sensitivity to the alkylating agent chlorambucil. Although transfection did not affect the growth or doubling time of the NIH3T3 cells, analysis of glyoxalase I activity showed a consistent increase in tumour tissue when compared with pair-matched controls. Thus increased glyoxalase I is associated with the malignant phenotype and may also contribute to protection against the cytotoxicity of certain anti-cancer drugs.

A rapid flow cytometric assay for low-density lipoprotein receptors in human peripheral blood mononuclear cells

Receptor-dependent uptake of low density lipoproteins (LDLs) labeled with the fluorescent probe 3,3'-dioctadecylindocarbocyanine iodide (DiI) by human lymphocytes was measured by flow cytometry. Freshly isolated lymphocytes showed very little uptake, whereas the cells cultured in lipoprotein-free medium for 48 hours showed about a 10-fold increase in the uptake of DiI-LDL. The uptake was inhibited by excess unlabeled LDL, heparin, and ethyleneglycol-bis-(beta-aminoethylether)-N,N, N',N'-tetraacetic acid (EGTA) but not by acetylated LDL, and therefore it appears to be very specific. Comparative studies with iodine 125-labeled LDL showed that there is correlation between the uptake of DiI-LDL and degradation of 125I-labeled LDL by the lymphocytes. The assay was carried out with lymphocytes from several normal healthy individuals and some clinically diagnosed heterozygous familial hypercholesterolemic patients. The results indicate that this assay can be used to distinguish patients with LDL receptor-defective familial hypercholesterolemia from normal individuals.

Utility of an observation unit in the emergency department of a tertiary care hospital in India

This retrospective study was conducted to evaluate whether an observation unit (OU) attached to the emergency department (ED) of a tertiary care hospital in India is safe, is effective in minimizing hospitalization of acutely ill patients and is acceptable to the patients. Of 115,916 patients who attended the ED, 11,130 (9.6%) were observed in the OU. The average period of observation was 7.74 h. Of the patients observed, 21.3% required hospitalization, while 78.5% were discharged after treatment. Twenty-four patients left the hospital against medical advice, and three patients died in the OU. It is concluded that an OU in the ED is safe in treating acutely ill patients, is effective in reducing substantially the number of patients requiring admission to the hospital, and is acceptable to the patients.

Effect of socio-economic status on the prevalence of dermatophytosis in Madras

A total of 462 patients living in varying socio-economic conditions were screened for tinea infection. 372/462 (70.7%) were found to be culture positive for dermatophytes. Trichophyton rubrum was the most frequently isolated dermatophyte. 35% of the infected cases were from the very low income group (group-I), 34.2% from low income group (group-II), 23.3% from middle income group (group-III) and 1.8% from moderately rich group (group-IV). Recurrent, chronic and extensive dermatophytosis were found to be most common in group-I (20.3%) and group-II (17.8%), whereas localized infections were common in group-IV (66.6%) and group-III (65.7%). Recurrence chronicity were more frequent in tinea cruris and tinea corporis. The present study suggests that group-I and group-II may be the likely reservoirs of human ringworm infections in Madras.

Minimal model for determination of insulin sensitivity: repeatability in control and obese subjects

A mathematical model was recently developed (minimal model) to estimate insulin sensitivity from the analysis of blood glucose and insulin concentration after a modified intravenous glucose tolerance test. This approach was successfully compared with the euglycemic glucose clamp in humans. In this study, we have analysed the distribution and reproducibility of this method in 10 healthy subjects and seven obese patients. We have observed a lower insulin sensitivity (SI) in obese patients (1.96 +/- 0.38 x 10(-4)/min/microU/ml) than in healthy subjects (8.19 +/- 1.16 x 10(-4)/min/microU/ml) with a small overlap between the two groups. The test was repeated twice and good repeatability was found with the method of Blank and Altman when a log transformation was applied to the data.

Helicobacter pylori in normal gastric mucosa

Since the discovery of Helicobacter pylori (H. pylori) in 1983 several studies have established relationship of H. pylori with gastritis, duodenal ulcer disease and gastric carcinoma. H. pylori infection is widely prevalent and exposure occurs at younger age in our country. Several Western studies have shown prevalence of H. pylori in normal gastric mucosa to range from 0-25%. As similar information is not available from our country we estimated the prevalence of H. pylori in histologically normal gastric mucosa. Of the 50 asymptomatic volunteers studied, 33 showed histological evidence of gastritis and 28 of these were H. pylori. We conclude that histological gastritis is very common in young asymptomatic Indians and H. pylori infection is noticed in almost 25% subjects with histologically normal gastric mucosa.

Racemization of tyrosine in the insoluble protein fraction of brunescent aging human lenses

With increase in age, proteins of the eye lens undergo covalent modifications associated with interprotein cross-linking, loss of protein solubility, generation of protein-associated pigments, and racemization of some optically active residues. Precipitated protein aggregates localized in the nucleus of brunescent lenses are modified to such an extent that they become resistant to the commonly used methods of extraction by reducing agents or detergents. Thus, little information is available on the types of protein modifications that occur in the nuclear region of the lens. Here we report the simultaneous solubilization and digestion of the entire nuclear pellet of brunescent human cataract lenses into constituent amino acids and their derivatives through protease action at neutral pH. Fractionation of the resulting hydrolyzate by reverse phase chromatography, followed by spectroscopic and biochemical analysis of one of the purified fractions, showed the presence of racemic tyrosine in the amino acid mixture. Racemization of L-amino acid residues in protein chains is associated with the aging process. This is the first report of racemization of tyrosine in any system studied so far.

The Manjakkudi experience: a camp approach towards treating alcoholics

A new approach towards treating alcoholics in a rural population is discussed in this paper. This approach is referred to as the "camp approach". The first such camp was organized in a rural place called Manjakkudi, a village located in Thanjavur District, Tamil Nadu, India. The first camp was held in 1989 and after that three more such camps were conducted in Manjakkudi over a period of 4 years. A total of 105 patients was treated in these camps. Though this treatment programme is similar to the main programme which we follow at T. T. Ranganathan Clinical Research Foundation in the city, slight modifications were made to suit the rural environment. The details of the programme are discussed in this paper. Total abstinence is the goal. This paper examines the results of the four camps conducted at Manjakkudi and attempts to gain an insight into the factors responsible for such a gratifying outcome.

Protein-associated pigments that accumulate in the brunescent eye lens. Identification of a quinoline derivative

Brunescent (dark brown) cataract is particularly prevalent in the tropics. Enzymatic digestion of the insoluble protein fraction of brunescent cataractous eye lenses from India, followed by high performance liquid chromatographic separation of the pigments and spectroscopic investigations, have led to the identification of one of the pigments as 4-hydroxyquinoline-3-[alpha-aminoacetic acid] (compound A). The 4-hydroxyquinoline moiety is shown to be a photodynamic agent that generates O2.- and leads to protein crosslinking. This suggests that the compound A may play a long-term deleterious role in situ in the lens.

Measurement of whole body acetate turnover in healthy subjects with stable isotopes

Colonic fermentation of dietary fibres produces short-chain fatty acids (e.g. acetate, propionate). Measurements of whole body acetate turnover was used in order to estimate the production of colonic short-chain fatty acids in human subjects. However, higher flux rates for acetate have been reported in human studies with stable isotopes as compared to radioactive tracers. The reasons for this discrepancy are unclear. In this study, the stable isotope (1-13C)acetate was used and a method was developed to measure its enrichment in plasma. Variations between and within assays were less than 5%. The standard curve was linear from 0.5% to 10% enrichment. When this tracer was infused for 160 min in six healthy volunteers, acetate turnover was found to be 7.5 +/- 1 mumol kg-1 min-1, which is similar to data reported with radioactive tracers. We assumed that the higher flux rate previously observed with stable isotope tracers was related to differences in the physiological status of the subjects involved in these studies.

Evidence for presence of hyaluronan binding protein on spermatozoa and its possible involvement in sperm function

Hyaluronic acid, a major component of the extracellular matrix, plays an important role in the regulation of different cellular processes, e.g., locomotion, cell-cell interaction during morphogenesis, and differentiation. Distribution of hyaluronic acid with respect to the role of sperm hyaluronidase in sperm penetration and gamete interaction is well established. In order to elucidate this mechanism, in our current study we have identified and demonstrated, for the first time, the presence of a 68-kDa cell surface hyaluronic acid binding glycoprotein (HABP) in spermatozoa of different species (rat, mice, bull, and human) by immunoblot analysis and indirect immunofluorescence using the polyclonal antibodies raised against purified HABP. Furthermore, we were able to demonstrate a differential distribution of 68-kDa HA binding protein on the sperm head, midpiece, and tail of different species. To identify its role in sperm function, we observed its declining pattern during epididymal maturation and also the inhibition of sperm-oolemmal adherence by pretreatment of the sperms with anti-HABP antibodies. We have further observed its in vivo phosphorylation in motile spermatozoa. All our data clearly indicate that sperm hyaluronan binding protein may have a specific role in sperm maturation, motility, and fertilization processes.

Comparative study of the acute effects of resistant starch and dietary fibers on metabolic indexes in men

The effect of ingestion of the same amount (30 g) of a resistant starch (lintner) and cellulose on energy expenditure (EE), colonic fermentation (breath-hydrogen test), and blood glucose, insulin, and free fatty acid (FFA) concentrations were compared in seven healthy volunteers in a first experiment. In a second experiment the same indexes were measured in six healthy volunteers after the ingestion of diets composed of 50 g glucose alone or mixed with 30 g lintner, or cellulose, or pectin. In the first experiment no differences between lintner and cellulose were observed on the measured indexes. The notable difference was the increased apparent colonic fermentation with lintner after 6 h. In experiment 2, although insulin response was significantly lower in the pectin-added diet, the results obtained with the four different diets were not significantly different. The metabolic characteristics of lintner were closer to cellulose than to pectin. In conclusion, the acute effect of the ingestion of a resistant starch (lintner) on the measured metabolic indexes is similar to that of a known insoluble fiber--cellulose.

Gastric metaplasia and Helicobacter pylori infection in intestinal tuberculosis

BACKGROUND

Gastric metaplasia occurs in intestinal epithelium of patients with Helicobacter pylori infection as well as intestinal tuberculosis, but the relationship between the three is not clear.

SETTING

Teaching hospital.

METHODS

Staining of intestinal sections from patients with ileocecal tuberculosis for H pylori and for metaplasia.

RESULTS

Twenty seven of 92 (29.3%) patients demonstrated gastric metaplasia (superficial epithelial and pyloric gland metaplasia) in resected specimens of ileum. Gastric metaplasia was of antral type in all 27 patients. Helicobacter pylori was present in 3 of 27 (11%) patients with gastric metaplasia and was absent in all 65 patients without metaplasia.

CONCLUSION

Gastric metaplasia (both superficial epithelial and pyloric gland) occurs in one-third of patients with ileocecal tuberculosis and such mucosa is poorly colonized by H pylori.

Changes in cellular proteins associated with the expression of human immunodeficiency virus type 1 trans-activator protein Tat

Earlier studies have revealed a distinct class of regulatory proteins known as trans-activator proteins in diverse biological systems. These proteins have been shown to act on both homologous and heterologous promoter targets. Activation of heterologous targets is speculated to be an integral part of virus-induced pathogenesis. To verify this hypothesis, stable Tat-producing human rhabdomyosarcoma (RD) cell lines were generated. These cell lines produced significant levels of functional Tat, as measured by transfection with the reporter plasmid pLTR-CAT. Tat-producing cells, although morphologically similar to the control, exhibited a slower growth rate. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) of the cellular proteins from control (tat-) and tat+ cells revealed increased quantities of 34- and 40-kD proteins along with the appearance of a new 74-kD protein in tat+ cells. Subsequent two-dimensional gel analysis revealed several additional differences. Tat+ cell lines produced two proteins of M(r) 19.5 and 44 kD anew, while proteins with M(r) 14.5, 42, and 52.5 kD were in greater abundance. Interestingly, a 26-kD protein that was originally present in the G418+/tat- (control) sample disappeared in the presence of Tat. These data support a possible modulator role for Tat in cellular gene expression.

Analysis of glyoxalase-I from normal and tumor tissue from human colon

Glyoxalase-I (Gly-I) is part of the glyoxalase system which converts methylglyoxal to D-lactic acid via an S-D-lactoylglutathione intermediate. This glutathione (GSH)-binding protein was purified from human colon tumors and corresponding normal tissue. The GSH-affinity purified fraction from normal human colon tissue showed enzyme activity of 30.6 +/- 11.5 mumol/min per mg protein, with methylglyoxal as substrate. Corresponding fractions from carcinomas showed significantly elevated Gly-I activity of 54.5 +/- 15 mumol/min per mg protein. Polyclonal antibodies made against human Gly-I cross-reacted weakly with mouse liver Gly-I but not with yeast Gly-I. Isoelectric points of Gly-I from human, mouse and yeast were determined to be 4.6, 4.9 and 7.0, respectively, by horizontal IEF. Immunohistochemical analysis confirmed the increase of Gly-I in human colon carcinoma in 16 out of 21 samples when compared to corresponding normal tissue. The elevated levels of Gly-I in colon tumors may be an indicator of the enhanced proliferative status of the neoplastic condition.

Heterotopic gastric mucosa and Helicobacter pylori infection in Meckel's diverticulum in Indian subjects

Two of twenty nine (6.8%) patients who had undergone resection of Meckel's diverticulum demonstrated heterotopic gastric mucosa. In both these patients gastric mucosa was of antral type. Remaining 27 of 29 (93.2%) patients with Meckel's diverticulum had intestinal mucosa. 9 of 29 (31%) patients with Meckel's resected were symptomatic (8 bleeding, 1 perforation) and all 9 were negative for heterotopic gastric mucosa. Helicobacter pylori (H. pylori) was absent in both patients with intestinal mucosa. Antral biopsy from 13 partial gastrectomy specimens (surgery done for carcinoma stomach) were used as methodological controls and 7 of 13 (54%) showed H. pylori colonization. We conclude that (i) incidence of gastric mucosa is 6.8% in Meckel's diverticulum in our population, (ii) presence of heterotopic gastric mucosa is unlikely to be associated with complications of Meckel's diverticulum and (iii) heterotopic mucosa in Meckel's diverticulum is not commonly colonized by H. pylori.

Cloning and characterization of human colon glyoxalase-I

Glyoxalase-I cDNA clones were isolated from a human colon cDNA library using polyclonal antibodies raised against the protein purified from human colon tissue. Positive clones were purified, subcloned, and their nucleotide sequence determined. The glyoxalase-I cDNA encodes a 184-amino acid protein with a predicted molecular weight of 20,774, corresponding to the monomeric subunit weight of the purified protein from human colon glyoxalase-I. The human enzyme showed 51% homology at the nucleotide level and 42% at the amino acid level with bacterial glyoxalase-I. Transfection of COS-1 cells with the 622-base pair cDNA containing the entire coding region cloned into a pMT2 vector produced an immunoreactive protein and an approximate 180-fold increase in glyoxalase-I enzyme activity as determined with methylglyoxal as a substrate. Transfection of a truncated cDNA lacking 94 base pairs of the 5'-coding sequence also produced an approximately 15-kDa immunoreactive protein, but with no detectable increase in enzyme activity. Northern analysis of the RNA showed an approximately 12-fold increase of the 2.2-kilobase glyoxalase-I transcript in carcinoma when compared to normal colon tissue from the same patient. Examination of colon carcinomas for the amplification of the glyoxalase-I gene by Southern blot analysis revealed no change in gene copy number. These results suggest induction of the glyoxalase-I gene expression in colon carcinomas.

Effect of a protein-sparing diet on responses to exercise in obese subjects

We have studied muscular work efficiency and VO2 peak in seven obese individuals (body mass index: 38.9 +/- 5.8 kg.m-2) before and after twelve days of a low-caloric diet (protein-sparing modified fast) providing about 2460 kJ/day. Respiratory gas exchanges were measured at rest and during an exercise protocol through a rubber mask connected to a pneumotachograph and a mass spectrometer. A significant reduction in body mass was observed with the diet therapy (109 +/- 12 vs 105 +/- 14 kg; p < 0.02). No significant differences were observed in VO2 peak (1.78 +/- 0.32 vs 1.88 +/- 0.43 l/min, p > 0.05) and work efficiency (26 +/- 5 vs 24 +/- 4%, p > 0.05), after the diet protocol. It is concluded that the low-caloric diet used had no effect on muscular work efficiency.

Short term effect of an aldose reductase inhibitor on urinary albumin excretion rate (UAER) and glomerular filtration rate (GFR) in type 1 diabetic patients with incipient nephropathy

OBJECTIVE

Increased activity of the enzyme aldose reductase in the polyol pathway, occurring with hyperglucaemia, has been implicated in the development of late diabetic complications. The effect of an aldose reductase inhibitor (Ponalrestat) on renal function in type 1 diabetes with incipient nephropathy (urinary albumin excretion rate > 20 micrograms.min-1) was evaluated.

RESEARCH DESIGN AND METHODS

Thirty Type 1 diabetic patients (age: 34.4 +/- 3.1 yrs; diabetes duration 13.1 +/- 1.3 yrs) were treated with 600 mg of Ponalrestat per day for 3 months using a randomized double blind placebo controlled crossover design. Urinary albumin excretion rate and glomerular filtration rate were measured.

RESULTS

Twenty three patients completed the entire study. Compared to placebo, there was no significant change in urinary albumin excretion rate and glomerular filtration rate during the Ponalrestat treatment period. Blood pressure and HbA1 were also unchanged during the placebo and Ponalrestat periods. Treatment with Ponalrestat appeared to be safe and there were no side effects.

CONCLUSION

We conclude that three months aldose reductase inhibition with Ponalrestat had no effect on urinary albumin excretion rate and glomerular filtration rate in Type 1 diabetic patients with incipient nephropathy.

Effects of a combination of bedtime intermediate-acting insulin and glibenclamide in type 2 (non-insulin-dependent) diabetic patients with secondary failure to respond to oral hypoglycaemic agents

The effect of a subcutaneous injection of an intermediate-acting insulin at bedtime combined with glibenclamide has been evaluated in 16 non-insulin-diabetic patients with secondary failure to respond to oral agents. The patients showed poor metabolic control (HbA1 greater than 11%) after two months on diet and glibenclamide treatment (15 mg.day-1). For 3 months the glibenclamide was continued together with an injection of an intermediate-acting insulin at bedtime in order to maintain fasting blood glucose under 120 mg.dl-1. A significant reduction in fasting blood glucose and HbA1 (15.50 vs 10.35%) and fructosamine (2.03 vs 1.69 mmol.l-1) was observed (230 to 141 mg.dl-1) at a mean insulin dose of 0.28 U.kg-1. The peak blood glucose after a standard test meal was also significantly improved (290 vs 203 mg.dl-1). Two months after the bedtime insulin injection had been withdrawn, only one patient was still being treated with oral agents alone. Except for another patient who dropped out, all the others had to be treated again with insulin because their fasting blood glucose exceeded 180 mg.dl-1. It is concluded that a single subcutaneous injection of an intermediate-acting insulin at bedtime combined with glibenclamide improved fasting and post-meal blood glucose concentrations in non-insulin-dependent patients resistant to diet and oral hypoglycaemic treatment. Almost all of the patients relapsed after insulin was withdrawn.

Immunohistochemical localization of glutathione S-transferases alpha, mu, and pi in normal tissue and carcinomas from human colon

Analysis of the heterogeneity of glutathione S-transferase (GST) isozyme expression was carried out by immunohistochemical evaluation of human colon biopsy tissue from 30 patients. Using polyclonal antibodies specific for the GST alpha, mu and pi families of isozymes, an increased expression of pi was found in 21/30 carcinoma specimens compared to their pair-matched controls. This isozyme was the most prevalent in all colon samples. GST mu was expressed at reduced levels in 20/30 carcinoma specimens when compared to normal. GST alpha showed no consistent change. Analysis of the immunostaining in different cell types showed that the highest intensity stain for all isozymes was in the columnar epithelial cells. These cells were primarily responsible for the proportional changes in GST pi and mu between carcinoma and normal tissues. In addition, goblet (crypt), endothelial and muscle cells stained positively. In the lamina propria, lymphocytes and phagocytes stained positively, while fibroblasts, plasma cells and leukocytes were negative. Endocrine cells were also negative. The differential expression of GST pi and mu, confirming biochemical data, supports the potential utility of GST pi as a carcinoma marker.

Mono and dual therapy for Helicobacter pylori associated gastritis

Sixty patients with Helicobacter Pylori positive non ulcer dyspepsia were randomly allocated to one of the following treatment groups: Group I--norfloxacin 400 mg bid for 10 days, Group II--amoxycillin 500 mg bid plus tinidazole 500 mg bid for 15 days, Group III--colloidal bismuth subcitrate (CBS) 240 mg bid for 4 weeks. H pylori elimination was achieved in 14%, 81%, and 62% in Groups I, II and III respectively. Eradication of H pylori was not observed in Groups I and II, but was achieved in 25% of patients in Group III. Antral gastritis improved in 69% in Group II and 50% in Group III. We conclude that norfloxacin is not effective in H pylori infection. A combination of amoxycillin and tinidazole is highly effective in H pylori elimination with improvement in associated gastritis, but H pylori eradication is not observed with this therapy. CBS is also effective in H pylori elimination though H pylori eradication is achieved in only 25%.

Rapid regulation of apolipoprotein A-I secretion in HepG2 cells by a factor associated with bovine high-density lipoproteins

The effect of fetal bovine serum (FBS) on the secretion of apolipoprotein A-I (apo A-I) by HepG2 cells was studied. The cells incubated with FBS always secreted more apo A-I than the cells incubated with serum-free medium. The changes in the rate of apo A-I secretion were observed within 1 h after addition or depletion of serum. The high-density lipoproteins (HDL) or the lipoprotein-deficient serum (LPDS) obtained from FBS also stimulated apo A-I secretion rapidly to the same level as obtained with FBS. Addition of low-density lipoproteins did not have any effect. The rate of general protein synthesis was not affected by short-term incubations with or without serum or HDL. The rate of apolipoprotein E secretion by these cells did not change significantly, parallel to the changes in apo A-I secretion in the presence or absence of FBS. It is concluded that serum may have a factor that plays a specific role in the regulation of apo A-I secretion by the liver cells and this factor is associated with the HDL fraction.

Effect of long-acting somatostatin analog (SMS 201-995) on high glomerular filtration rate in insulin dependent diabetic patients

Increased glomerular filtration rate (GFR) is considered to be a determinant factor in the pathogeny of diabetic nephropathy. In this study we analyzed the effect of a long-acting somatostatin analog (SMS 201-995) on high GFR in type I diabetes patients. Five subjects were involved in a cross-over double blind study. All the patients had a high GFR (205 +/- 18 ml/min/1.73 m2). They were randomly submitted to a 10-hour night i.v. infusion of SMS 201-995 at a rate of 8 g/min and placebo. GFR was measured using a blood 99mTc-DTPA decay curve during the last hour of infusion. After 10-hour SMS 201-995 treatment, no statistical change was observed in GFR. However, a slight decrease was noted in four of the five subjects (183.07 +/- 22.31 vs 202.83 +/- 13.23 ml/min/1.73 m2). GFR was higher only for the patient who presented with a mild hypoglycemic reaction during the infusion, which may increase glomerular filtration by itself. All the other parameters measured remained unchanged.