Effects of IL-1 beta, TNF-alpha, and TGF-beta on ciliary beat frequency of human nasal ciliated epithelial cells in vitro

Previous reports suggested that several cytokines may influence the ciliary beat of the airway ciliated epithelial cells. The aim of this study is to determine the effects of cytokines including IL-1 beta, TNF-alpha, and TGF-beta on ciliary beat frequency (CBF) of human nasal ciliated epithelial cells. CBF of cultured human nasal ciliated epithelial cells was measured 24 hours after incubating with concentrations of 0.01 ng/mL, 0.1 ng/mL, 1 ng/mL, 10 ng/mL, and 100 ng/mL of each recombinant human (rh) cytokine including rhIL-1 beta, rhTNF-alpha, and rhTGF-beta. CBF was measured with time at concentrations of 1 ng/mL of rhIL-1 beta, 10 ng/mL of TNF-alpha, and 1 ng/mL of TGF-beta solutions. CBF of the human nasal ciliated epithelial cells increased after addition of rhIL-1 beta and rhTNF-alpha. Maximum CBF was observed at 1 ng/mL of rhIL-1 beta and at 10 ng/mL of rhTNF-alpha. CBF increased progressively to 4 hours after addition of rhIL-1 beta and rhTNF-alpha. Increased CBF sustained for 24 hours and decreased by 2 days. However, no variation of CBF was observed after addition of rhTGF-beta, regardless of concentrations and time. The results of this study suggest that during acute inflammation, IL-1 beta and TNF-alpha may have a potential role in defense mechanism of human nasal epithelium by regulating CBF of the nasal ciliated epithelial cells.

High serum lipoprotein(a) levels in Korean type 2 diabetic patients with proliferative diabetic retinopathy

OBJECTIVE

To examine the possible association between serum lipoprotein(a) [Lp(a)] concentration and proliferative diabetic retinopathy (PDR) in Korean patients with type 2 diabetes.

RESEARCH DESIGN AND METHODS

A total of 412 Korean outpatients with type 2 diabetes were examined. Diabetic retinopathy was determined by an ophthalmologist using fundoscopic examination. Serum Lp(a) levels were measured by two-site sandwich enzyme-linked immunosorbent assay.

RESULTS

The patients with PDR had higher serum Lp(a) levels than those with no diabetic retinopathy or with nonproliferative diabetic retinopathy (NPDR). Multiple logistic regression analysis showed that high serum Lp(a) levels and the presence of diabetic nephropathy were independent variables having a statistically significant association with PDR.

CONCLUSIONS

Korean type 2 diabetic patients with PDR had higher serum Lp(a) levels versus those with no diabetic retinopathy or with NPDR. Although these results suggest that Lp(a) might play a role in the occlusion of retinal capillaries leading to PDR, further prospective studies are required to prove the causal relationship.

Epidemiology of eating disordered symptoms in the Korean general population using a Korean version of the Eating Attitudes Test

OBJECTIVE

The purposes of the present study were to estimate the proportion of subjects with a high score on the Korean version of Eating Attitudes Test--26 (KEAT-26), which may provide preliminary data regarding the prevalence rate of eating disorders in the Korean general population, and to further examine the sociocultural hypothesis of eating disorders.

METHOD

Using a multi-stage questionnaire sampling method, we surveyed 3062 subjects (1249 males, 1813 females) from 3896 Korean adults in a nationwide area.

RESULTS

8.5% (260/3062) of subjects scored above the cut-off on the KEAT-26. Their demographic correlates, eating traits, and other characteristics relating to general psychopathology were similar to those of patients with eating disorders and female Caucasian controls in Western countries.

DISCUSSION

These results suggest that changes in various sociocultural aspects have increased the risk of developing eating disorders in Korea, and support the sociocultural hypothesis of eating disorders.

Characterization of two frizzled8 homologues expressed in the embryonic shield and prechordal plate of zebrafish embryos

We have isolated and characterized two complete cDNA clones, Zfz8a and Zfz8b, which encode zebrafish Frizzled (Fz) homologues. The predicted protein sequences, spanning 579 and 576 amino acid residues for ZFz8a and ZFz8b, respectively, were highly homologous (78%) to each other and contained an extracellular cysteine-rich domain and seven transmembrane domains that are well conserved in Fz receptor protein members. In comparison with other Fz family members, ZFz8a and ZFz8b showed the highest homology with mouse Fz8 (MFz8), sharing 84 and 76% amino acid identity, respectively. The presence of Zfz8a and Zfz8b transcripts was detected by in situ hybridization in zebrafish embryos from the 512 cell stage, and their appearance in the future dorsal region could be observed before embryos reached the 30% epiboly stage. At shield stage, Zfz8a transcripts were expressed in both epiblast and shield whereas expression of Zfz8b was only detected in the embryonic shield. During gastrula stages, both Zfz8a and Zfz8b transcripts were found in anterior dorsal regions of the involuting mesendoderm (future prechordal plate). By the 2- to 3-somite stage, expression of both Zfz8a and Zfz8b was restricted to the prechordal plate and prospective anterior neurectoderm, although expression of the Zfz8a gene was no longer present in the most anterior portion of the prechordal plate, the polster. In one-eyed pinhead mutant embryos, which lack prechordal plate, both Zfz8a and Zfz8b transcripts were reduced, confirming the prechordal plate specificity of Zfz8a and Zfz8b gene expression. These results provide an additional evidence supporting the role of Wnt signaling in organizer-mediated axial patterning.

Biotransformation of 2-chloroaniline in the Fischer 344 rat: identification of urinary metabolites

1. The biotransformation of a single i.p. dose of [14C]2-chloroaniline (1.0 mmol/kg, approximately 60 microCi/rat) was investigated in the urine and faeces of the male Fischer 344 rat. 2. During 24 h, 53.1% of the administered radioactivity was eliminated into the urine, while < 1% of the radioactivity appeared in the faeces. 3. The major biotransformation pathways were para-hydroxylation and sulphate conjugation. 4-Amino-3-chlorophenyl sulphate was the major urinary metabolite comprising 31.6% of total urinary radioactivity. The para-hydroxylated metabolite, 4-amino-3-chlorophenol (10.8%), and its O-glucuronide conjugate (3.7%) were also urinary metabolites. The formation of direct conjugates of 2-chloroaniline, the N-sulphate and N-glucuronide, was significant with as much as 18.6 and 8.6%, respectively, of these metabolites excreted in the urine. The parent compound, 2-chloroaniline, accounted for 16.9% of urinary radioactivity. 4. N-Acetylated products were minor metabolites present in urine as 2-chloro-4-hydroxyacetanilide and its sulphate or glucuronide conjugate. Neither 2-chloroacetanilide nor its oxidation products, 2-chloroglycolanilide and 2-chlorooxanilic acid, were urinary metabolites.

Cell type-specific changes of the membrane properties of peripherally-axotomized dorsal root ganglion neurons in a rat model of neuropathic pain

Recent evidence indicates that neuropathic pain from partial peripheral nerve injury is maintained by electrophysiologically abnormal signals from injured sensory neurons. To gain an insight into the mechanisms underlying this electrophysiological abnormality, we examined the effects of S1 spinal nerve transection on the membrane properties of S1 dorsal root ganglion neurons one to two weeks after injury. This injury produced significant action potential broadening [40% (1 ms) in C-, 149% (1.5 ms) in A delta- and 84% (0.5 ms) in A alpha/beta-cells], which was primarily due to the enhancement of the "shoulder" appearing on the falling phase of the action potential in C- and A delta-cells and the emergence of a shoulder in A alpha/beta-cells, and significant cell-type specific changes in the time-course of the rising phase of the action potential; i.e. an increase in rise time (A delta: 35%, 0.15 ms; A alpha/beta: 13%, 0.04 ms) and a decrease in the maximal rate of rise (A delta: 17%, 77 V/s; A alpha/beta: 13%, 79 V/s). In addition, the nerve injury led to a significant reduction of the rheobase, an index of neuronal excitability, in all types of cells (by 41% in C-, 71% in A delta- and 59% in A alpha/beta-cells). The reduction of rheobase in A-cells was associated with a concomitant increase in apparent input resistance (by 269% in A delta- and 192% in A alpha/beta-cells), which was measured near the resting membrane potential. By contrast, the rheobase reduction in C-cells was associated with a concurrent depolarizing shift (approximately 4 mV) of the resting membrane potential. The nerve injury-induced reduction of rheobase was not accompanied by related change in input resistance or threshold potential in any of the cell populations. The present results indicate that chronic peripheral axotomy of dorsal root ganglion neurons, which gives rise to neuropathic pain, produces profound changes in the action potential waveform of dorsal root ganglion neurons in a cell type-specific fashion. Furthermore, the results suggest that the axotomy increases the excitability of dorsal root ganglion neurons not by altering input resistance (i.e. leak conductance) or threshold potential, but by increasing apparent input resistance near the resting membrane potential in A-cells and decreasing the resting membrane potential in C-cells.

Gender differences in acute N-(3,5-dichlorophenyl)-2-hydroxysuccinimide (NDHS) and N-(3,5-dichlorophenyl)-2-hydroxysuccinamic acid (2-NDHSA) nephrotoxicity in Fischer 344 rats

N-(3,5-Dichlorophenyl)succinimide (NDPS) is an agricultural fungicide that induces nephrotoxicity as its major toxicity. NDPS is also a more potent nephrotoxicant in female than in male rats. The purpose of this study was to examine the nephrotoxic potential of the two NDPS metabolites N-(3,5-dichlorophenyl)-2-hydroxysuccinimide (NDHS) and N-(3,5-dichlorophenyl)-2-hydroxysuccinamic acid (2-NDHSA) in age-matched male and female Fischer 344 rats to determine if gender differences exist for the nephrotoxicity induced by the two NDPS metabolites. Rats (4 per group) were administered a single intraperitoneal (ip) injection of NDHS or 2-NDHSA (0.025 or 0.05 mmol/kg) or vehicle, and renal function was monitored for 48 h. Neither compound induced significant nephrotoxicity in male rats at the doses tested. However, in female rats both metabolites induced marked nephrotoxicity at the 0.05 mmol/kg dose level, and treatment with 0.025 mmol/kg 2-NDHSA induced some changes in renal function (transient diuresis, transient proteinuria, decreased organic ion accumulation). Little effect on renal function was induced in females by treatment with 0.025 mmol/kg NDHS. At toxic levels in female rats, the renal lesions were located primarily in the S2 and S3 segments of the proximal tubule. These results indicate that, like the parent compound, gender differences exist in the nephrotoxic potential of NDHS and 2-NDHSA. The results also suggest that in females, as in males, NDPS nephrotoxicity is mediated via NDHS and/or 2-NDHSA. However, it is not clear if the ultimate nephrotoxicant species following NDPS exposure is different in males and females or if the same ultimate nephrotoxicant species is produced in both species but handled differently by male and female kidneys. Thus, further studies are needed to determine the exact nature of the ultimate nephrotoxicant species and the mechanisms of the observed gender differences.

Effects of FFA on insulin-stimulated glucose fluxes and muscle glycogen synthase activity in rats

To examine effects of free fatty acids (FFA) on insulin-stimulated glucose fluxes, euglycemic hyperinsulinemic (86 pmol . kg-1 . min-1) clamps were performed for 5 h in conscious rats with (n = 8) or without (n = 8) lipid-heparin infusion. Glucose infusion rate required to maintain euglycemia was not different between the two groups during the first 2 h of clamps but became significantly lower with lipid-heparin infusion in the 3rd h and thereafter. To investigate changes in intracellular glucose metabolism during lipid-heparin infusion, additional clamps (n = 8 each) were performed for 1, 2, 3, or 5 h with an infusion of [3-3H]glucose. Insulin-stimulated whole body glucose utilization (Rd), glycolysis, and glycogen synthesis were estimated on the basis of tracer concentrations in plasma during the final 40 min of each clamp. Similar to changes in glucose infusion rate, Rd was not different between the two groups in the 1st and 2nd h but was significantly lower with lipid-heparin infusion in the 3rd h and thereafter. Whole body glycolysis was significantly lower with lipid-heparin infusion in all time periods, i.e., 1st, 2nd, 3rd, and 5th h of clamps. In contrast, whole body glycogen synthesis was higher with lipid-heparin infusion in the 1st and 2nd h but lower in the 5th h. Similarly, accumulation of [3H]glycogen radioactivity in muscle glycogen was significantly higher with lipid-heparin during the 1st and 2nd h but lower during the 3rd and 5th h. Glucose 6-phosphate (G-6-P) concentrations in gastrocnemius muscles were significantly higher with lipid-heparin infusion throughout the clamps. Muscle glycogen synthase (GS) activity was not altered with lipid-heparin infusion at 1, 2, and 3 h but was significantly lower at 5 h. Thus increased availability of FFA significantly reduced whole body glycolysis, but compensatory increase in skeletal muscle glycogen synthesis in association with accumulation of G-6-P masked this effect, and Rd was not affected in the early phase (within 2 h) of lipid-heparin infusion. Rd was reduced in the later phase (>2 h) of lipid-heparin infusion, when glycogen synthesis was reduced in association with reduced skeletal muscle GS activity.

Association of microalbuminuria and atherosclerotic risk factors in non-diabetic subjects in Korea

Microalbuminuria in non-diabetic subjects is reportedly associated with increased cardiovascular morbidity and mortality. The prevalence of microalbuminuria in non-diabetic subjects varies widely from 5-6% in the UK and USA to 30-55% in Finland, Mexico, or Australian Aborigines. We studied cross-sectionally 497 clinically healthy, non-diabetic subjects more than 40 years of age who were living in Seoul, Korea for the prevalence of microalbuminuria and various cardiovascular risk factors. Urinary albumin-to-creatinine ratio (UACR) was determined in morning spot urine samples. Subjects were divided into normoalbuminuria (UACR < 2 mg/mmol) and microalbuminuria (UACR > or = 2 mg/mmol) groups. A total of 61 (12.2%) out of 497 subjects were found to have microalbuminuria. Subjects with microalbuminuria had significantly higher values in age, body mass index (BMI), waist-to-hip ratio in women, systolic and diastolic blood pressure, prevalence of hypertension, plasma cholesterol and triglyceride, and fasting plasma insulin. When subjects with microalbuminuria were compared with age-, sex-, and BMI-matched controls without microalbuminuria, systolic and diastolic blood pressure, and fasting plasma insulin concentrations were higher in microalbuminuric subjects. Multiple logistic regression analysis showed that fasting plasma insulin level and systolic blood pressure were independently associated with microalbuminuria. These results indicate that the prevalence of microalbuminuria in Korean non-diabetic subjects is lower than that in Mexico and Finland, but similar to that in Caucasians from the UK and USA, or in Pima Indians. Also, microalbuminuria in Korean non-diabetic subjects is associated with atherosclerotic risk factors such as hyperinsulinemia and hypertension, suggesting that microalbuminuria in these subjects may be a feature of insulin resistance syndrome.

Primary ovarian failure caused by a solvent containing 2-bromopropane

Sixteen Korean female laborers who had been exposed to a cleaning solvent composed mainly of 2-bromopropane developed primary ovarian failure. Histologic findings from these patients' ovaries were similar to those observed in ovarian failure caused by radiation or chemotherapy, i.e., reduced number and developmental arrest of primary follicles, interstitial fibrosis and hyalinization of blood vessels. We followed their clinical course for 2 years and found that two patients recovered normal ovarian function spontaneously: one became pregnant and delivered a normal full-term baby, and the other resumed regular menstrual periods with normal hormonal values. Our observations support the idea that the increasing prevalence of ovarian failure in recent years might be due to an increase in presently unidentified environmental toxic agents.

Supraspinal involvement in the production of mechanical allodynia by spinal nerve injury in rats

This study examined whether or not the production of mechanical allodynia in a rat model of neuropathic pain required an involvement of supraspinal site(s). To this aim, we assessed the effect of spinal cord section at the L1 segment level on the mechanical allodynia sign (i.e. tail flick/twitch response), which was elicited by innocuous von Frey hair stimulation of the tail after unilateral transection of the tail-innervating nerve superior caudal trunk (SCT) at the level between the S3 and S4 spinal nerves. Cord transection or hemisection of the cord ipsilateral to the injured SCT drastically (though not completely) blocked the behavioral sign of mechanical allodynia (leaving noxious pinprick-elicited tail withdrawal reflex intact), whereas sham section or contralateral hemisection of the cord was without effect. These results suggest that the generation of mechanical allodynia following partial peripheral nerve injury involves transmission of the triggering sensory signal to a site(s) rostral to the L1 segment via an ipsilateral pathway(s).

Incidence and determinants of microalbuminuria in Koreans with type 2 diabetes

OBJECTIVE

The incidence of diabetic nephropathy in type 2 diabetes differs widely by race. Although clinical proteinuria is reportedly more common in East Asian type 2 diabetic patients than in their Caucasian counterparts, data on the incidence of microalbuminuria are not available. This study was undertaken to investigate the incidence and the determinants of microalbuminuria in Korean type 2 diabetic patients.

RESEARCH DESIGN AND METHODS

A cohort of 188 Korean type 2 diabetic patients with initial normoalbuminuria were followed prospectively for 5.5 +/- 0.9 years in an outpatient clinic of a university hospital. The incidence of elevated urinary albumin excretion (UAE) (> 20 micrograms/min) and its relationship with baseline characteristics and follow-up data were determined.

RESULTS

Of the 146 patients who finished the study, 37 showed persistently elevated UAE during follow-up, giving an incidence of 52/1,000 person-years. Age, duration of diabetes, and baseline UAE were significantly higher in the progressors than in the nonprogressors. More patients in the progressor group had retinopathy at baseline and at the end of follow-up. The mean values of fasting plasma glucose, HbA1, and systolic and diastolic blood pressure during the follow-up period were significantly higher in the progressors than in the nonprogressors. Cox proportional hazards analysis revealed that presence of retinopathy, duration of diabetes, mean fasting plasma glucose, and mean systolic blood pressure during follow-up are independent variables that have a statistically significant influence on the development of microalbuminuria.

CONCLUSIONS

The incidence of microalbuminuria in Korean type 2 diabetic patients is lower than that reported in Pima Indians with type 2 diabetes but is as high as that in Caucasians with type 1 diabetes. Presence of diabetic retinopathy, poor glycemic control, and high blood pressure are risk factors for development of microalbuminuria in Koreans with type 2 diabetes.

Amount of sympathetic sprouting in the dorsal root ganglia is not correlated to the level of sympathetic dependence of neuropathic pain in a rat model

Incomplete peripheral nerve injury often leads to neuropathic pains, some of which are relieved by sympathectomy, and results in sympathetic postganglionic nerve fiber sprouting in the dorsal root ganglion (DRG). This study was performed to see whether the sprouting in the DRG plays a key role in the sympathetic dependence of neuropathic pain. To this aim, we compared two groups of rats, both of which were subjected to unilateral transection of the inferior and superior caudal trunks at the levels between the S1 and S2, S2 and S3, and S3 and S4 spinal nerves, with respect to sympathetic fiber sprouting; one group showed neuropathic pain behaviours (i.e. mechanical and cold allodynia signs) which were very sensitive to phentolamine, alpha adrenergic blocker, and the other group exhibited no sensitivity. Immuno-histochemical staining with tyrosine hydroxylase antibody of the S1-S3 DRGs was not correlated with the sensitivity to phentolamine. These results suggest that the degree of sympathetic dependence of neuropathic pain is not a function of the extent of the sympathetic postganglionic nerve fiber sprouting in the DRG.

Development and progression of diabetic retinopathy in Koreans with NIDDM

OBJECTIVE

To determine the incidence and risk factors for the development and progression of diabetic retinopathy in Korean patients with NIDDM.

RESEARCH DESIGN AND METHODS

A total of 186 patients with NIDDM who did not have proliferative diabetic retinopathy (PDR) at baseline were prospectively studied for 5.3 +/- 1.0 years in an outpatient clinic of a university hospital. The incidence and progression of diabetic retinopathy was determined by annual funduscopic examination by an ophthalmologist.

RESULTS

Of the 130 patients who were free of diabetic retinopathy at baseline, 30 developed it, giving an incidence of 44.4/1,000 person-years. Age and known duration of diabetes, mean fasting plasma glucose, and HbA1 levels during the follow-up period were higher in the patients who developed diabetic retinopathy. Of the 56 patients who had nonproliferative diabetic retinopathy at baseline, 11 developed PDR, giving an incidence of 37.5/1,000 person-years. The patients who progressed to PDR during follow-up (progressors) had a higher change of BMI and urinary albumin excretion rate at baseline and a higher mean HbA1 during the follow-up period than the nonprogressors. Cox proportional hazards analysis revealed that mean HbA1 was the only independent risk factor for both the development and progression of diabetic retinopathy.

CONCLUSIONS

The incidence of PDR in Korean NIDDM patients is comparable to that reported in other populations. Poor glycemic control is the most important risk factor for both the development and progression of diabetic retinopathy in NIDDM patients.

3,4-Dicholoroaniline acute toxicity in male Fischer 344 rats

The aromatic amine, 3,4-dichloroaniline (DCA) is an important intermediate in the chemical production of agricultural chemicals. A previous study had shown that nephrotoxicity was apparent 48 h after injection of 3,4-DCA. The purpose of this study was to examine the potential for 3,4-DCA to be toxic to the kidney, liver and urinary bladder 24 h after acute administration. Male Fischer 344 (F344) rats were injected (intraperitoneal (i.p.)) with 0.4, 0.8 or 1.0 mmol/kg 3,4-DCA hydrochloride (HCl) salt (2.5 ml/kg, 25% ethanol). Nephrotoxicity was apparent within 24 h in the 0.8 and 1.0 mmol/kg 3,4-DCA treated group and was characterized by elevated (P < 0.05) blood urea nitrogen (BUN) and kidney weight. Renal cortical slice accumulation ofp-aminohippurate (PAH) was also decreased in the 0.8 and 1.0 mmol/kg 3,4-DCA treated group relative to pair fed controls (PFC). Cellular changes were noted in the liver and bladder 24 h after 3,4-DCA administration. Plasma alanine transaminase (ALT) activity was elevated (P < 0.05) above PFC values 24 h after treatment with 0.8 or 1.0 mmol/kg indicating liver damage was apparent within 24 h. Morphological damage was apparent along the centrilobular region. Hematuria was observed in the 0.8 and 1.0 mmol/kg 3,4-DCA treated groups. Infiltration of erythrocytes and polymorphonuclear leukocytes was apparent within the urinary bladder upon examination by light microscopy. These results indicated that 3,4-DCA was toxic within 24 h and that the target tissues were the kidney, liver and urinary bladder. In vitro studies were conducted to compare the toxicity of two forms of 3,4-DCA, the free base and hydrochloride salt to determine whether chemical form contributes to renal cortical slice toxicity. Lactate dehydrogenase (LDH) release was elevated above control by 120 min exposure to 2 mM 3,4-DCA free base or hydrochloride salt. Pyruvate directed gluconeogenesis in renal slices was decreased relative to control by 0.5 mM 3,4-DCA free base and hydrochloride salt. The results from the in vitro studies indicates that the chemical form did not modify in vitro renal cortical slice toxicity.

Ruptured proximal anterior cerebral artery (A1) aneurysm located at an anomalous branching of the fronto-orbital artery--a case report

Cerebral aneurysms are occasionally associated with anomalies of cerebral arteries, that should be recognized pre- and intra-operatively. Most of the previous reports on the anomalies of the anterior cerebral artery have been concerned with hypoplasia, fenestration, and infra-optic course of the A1, variant A1 perforators or Heubner's artery, multi-channeled anterior communicating artery, and azygos anterior cerebral artery. The author experienced a patient with a ruptured proximal anterior cerebral artery (A1) aneurysm located at an anomalous origin of the fronto-orbital artery from the A1. The fronto-orbital artery normally branches off the anterior cerebral artery just distal to the anterior communicating artery (proximal A2). An anomalous branching of the fronto-orbital artery off the A1 seems very rare. This anomalous artery could be mistaken for an unusually large medial lenticulostriate artery, aberrant frontopolar artery, or the third A2. The author reviewed the literature on anomalies of the A1 and the fronto-orbital artery.

Effects of sodium sulfate on acute N-(3,5-dichlorophenyl)succinimide (NDPS) nephrotoxicity in the Fischer 344 rat

The agricultural fungicide N-(3,5-dichlorophenyl)succinimide (NDPS) induces acute polyuric renal failure in rats. Results of previous studies have suggested that NDPS may induce nephrotoxicity via conjugates of NDPS metabolites. Thus, the purpose of this study was to examine if administered sodium sulfate could alter NDPS nephrotoxicity. Male Fischer 344 rats (four rats per group) were administered a single intraperitoneal (i.p.) injection of sodium sulfate (0.035, 0.07, 0.35 or 3.5 mmol/kg) or sodium chloride (7.0 mmol/kg) 20 min before NDPS (0.2, 0.4 or 0.8 mmol/kg) or NDPS vehicle (sesame oil, 2.5 ml/kg) and renal function monitored at 24 and 48 h. High dose sodium sulfate (3.5 mmol/kg) markedly attenuated NDPS nephrotoxicity, while sodium chloride had no effect on NDPS-induced renal effects. NDPS nephrotoxicity was also attenuated by a pretreatment dose of 0.35 mmol/kg sodium sulfate, while 0.07 mmol/kg sodium sulfate pretreatment potentiated NDPS 0.2 mmol/kg to produce nephrotoxicity without markedly attenuating NDPS 0.4 mmol/kg to induce renal effects. A dose of 0.035 mmol/kg sodium sulfate did not potentiate NDPS 0.2 mmol/kg to induce nephrotoxicity. These results suggest that sulfate conjugates of NDPS metabolites might contribute to NDPS nephrotoxicity.

4-Amino-2,6-dichlorophenol nephrotoxicity in the Fischer 344 rat: protection by ascorbic acid, AT-125, and aminooxyacetic acid

A halogenated derivative of 4-aminophenol, 4-amino-2, 6-dichlorophenol (ADCP), is a potent nephrotoxicant and a weak hepatotoxicant in Fischer 344 rats. Although the mechanism of ADCP nephrotoxicity is unknown, ADCP could undergo oxidation to a reactive intermediate, such as a 4-amino-2,6-dichlorophenoxy radical or 2,6-dichloro-1,4-benzoquinoneimine, which can generate additional free radicals and/or covalently bind to cellular proteins. The toxic process might also be mediated by glutathione (GSH) conjugates of ADCP, as suggested for the mechanism of 4-aminophenol nephrotoxicity. In this study, the effects of modulators of oxidation and GSH conjugation-related metabolism or transport on ADCP-induced nephrotoxicity were examined. In one set of experiments, male Fischer 344 rats (four/group) were intraperitoneally (ip) administered ADCP (0.38 mmol/kg) only or coadministered an antioxidant, ascorbic acid (1.14 mmol/kg, ip) with ADCP. Administration of ascorbic acid markedly reduced both functional nephrotoxicity and morphological changes induced by ADCP. Administration of a gamma-glutamyltransferase (GGT) inhibitor, l-(alphaS, 5S)-alpha-amino-3-chloro-4,5-dihydroxy-5-isoxazoleacetic acid (10 mg/kg, ip), or a cysteine conjugate beta-lyase inhibitor, aminooxyacetic acid (0.5 mmol/kg, ip), 1 hr before ADCP (0.38 mmol/kg) challenge partially protected rats against ADCP nephrotoxicity. In contrast, administration of an organic anion transport inhibitor, probenecid (140 mg/kg, ip), 30 min before ADCP had little effect on ADCP nephrotoxicity. The GSH depletor, buthionine sulfoximine (890 mg/kg, ip), was given 2 hr prior to ADCP and only minimal protection was noted. In addition, the nonprotein sulfhydryl (NPSH) contents in renal cortex and liver were determined at 2 hr following the administration of ADCP only or ascorbic acid/ADCP. Ascorbic acid afforded complete prevention of the depletion of NPSH in the kidney and liver caused by ADCP administration and also prevented the elevation of renal glutathione disulfide content induced by ADCP. The results indicate that oxidation of ADCP appears to be essential to ADCP nephrotoxicity and that GSH or GSH-derived conjugates of ADCP may be partly responsible for the nephrotoxic effects of ADCP via a GGT-mediated mechanism.

Correlation between anthropometric measurements of the oropharyngeal area and severity of apnea in patients with snoring and obstructive sleep apnea

The aim of this study was to investigate the relationship between severity of apnea and anthropometric oropharyngeal measurements in patients with snoring and obstructive sleep apnea. A total of 22 patients complaining of snoring and apneic spell during sleep were evaluated by polysomnographic and anthropometric measurements of the oropharyngeal area. The horizontal width of the uvula at the mid-point and the length of the uvula were measured using a T-shaped ruler. The distance between the anterior pillars, posterior pillars and retromolar raphes were also measured. The correlation between these anthropometric measurements and polysomnographic parameters including the respiratory disturbance index (RDI) and the lowest arterial O2 saturation level (lowest SaO2) of the patients were analyzed. Of the anthropometric measurements, the horizontal width of the uvula showed a significant correlation with RDI and lowest SaO2. The results of the present study indicate that patients with broader uvula may have severer sleep apnea and that anthropometric oropharyngeal measurements may give additional information to polysomnographic findings for selecting surgical candidates.

NMDA receptors are important for both mechanical and thermal allodynia from peripheral nerve injury in rats

Previous studies showed that heat-hyperalgesia and mechanical allodynia produced by chronic constrictive injury of the sciatic nerve were differentially sensitive to the NMDA receptor antagonist dextrorphan and to morphine and other opioid receptor agonists. These results support the hypothesis that different kinds of neuropathic pain symptoms are caused by different pathological mechanisms. In the present study we determined whether mechanical and thermal allodynia produced by unilateral transection of the 'superior' caudal trunk which innervates the tail in rats were differentially sensitive to the non-competitive NMDA receptor antagonist MK-801. Injection of MK-801 (0.3 mg/kg, i.p.) prior to nerve injury delayed the emergence of both types of allodynia; the antagonist-treated rats exhibited neither mechanical nor thermal allodynia at least for 4 days after the injury, whereas untreated control rats exhibited clear signs of allodynia from the first day after the injury. MK-801 injection on post-injury day 14, when the allodynia was near peak severity, suppressed temporarily both the mechanical and thermal allodynia. These results suggest that the mechanical and thermal allodynia from partial denervation of the tail are both dependent on NMDA receptors in their induction and maintenance. Thus, our results do not support the notion that different pathological mechanisms underlie different modalities of neuropathic pain from partial peripheral nerve injury.

Characterization of methemoglobin formation induced by 3,5-dichloroaniline, 4-amino-2,6-dichlorophenol and 3,5-dichlorophenylhydroxylamine

3,5-Dichloroaniline is an intermediate in the production of certain fungicides. This study characterized the capacity of 3,5-dichloroaniline and two putative metabolites to induce methemoglobin formation. In vivo intraperitoneal (i.p.) administration of 0.8 mmol/kg 3,5-dichloroaniline resulted in elevated (P < 0.05) methemoglobin levels at 2 and 4 h after injection and returned to control values within 8 h. In vitro methemoglobin generation was monitored in washed erythrocytes incubated for 60 min at 37 degrees C with 4 and 8 mM 3,5-dichloroaniline. Methemoglobin generation in vitro was higher (P < 0.05) than control values in erythrocytes incubated for 30 min with 0.2-0.6 mM 4-amino-2,6-dichlorophenol or 5-100 microM 3,5-dichlorophenylhydroxylamine. The in vitro methemoglobin generating capacity in decreasing order was: 3,5-dichlorophenylhydroxylamine > 4-amino-2,6-dichlorophenol > > 3,5-dichloroaniline. The results of the in vitro studies further indicated that none of the compounds tested induced lipid peroxidation. Erythrocytes incubated with 5-100 microM 3,5-dichlorophenylhydroxylamine in vitro were associated with depletion of glutathione. These results indicated that: (a) 3,5-dichloroaniline and its metabolites can induce methemoglobin formation; (b) the N-hydroxy metabolite was the most potent inducer of hemoglobin oxidation and (c) glutathione depletion was associated with methemoglobin formation by 3,5-dichlorophenylhydroxylamine.

Past and current obesity in Koreans with non-insulin-dependent diabetes mellitus

To determine the prevalence of past and current obesity among patients with non-insulin-dependent diabetes mellitus (NIDDM) and to define the clinical characteristics of non-obese NIDDM patients in South Korea, we studied a cross-section of 749 NIDDM patients and a group of age- and sex-matched control subjects. Current height, weight and waist-to-hip ratio (WHR), the history of weight changes and the family history of diabetes were recorded. Obesity was defined as body mass index (BMI) > 25 kg/m2. The maximum lifetime BMI of diabetic patients was significantly higher than that of control subjects (P < 0.001). Compared with control subjects, current BMI was higher in diabetic women (P < 0.001) but not in diabetic men. In contrast, WHR of both diabetic men and women were significantly higher than those of controls (P < 0.05). BMI and WHR correlated significantly with fasting C-peptide levels and log-triglyceride levels in NIDDM patients. As a whole, 72% of the South Korean NIDDM patients had a history of past obesity as assessed by their maximum weight, while only 38% of them were currently obese. Compared with obese patients, non-obese patients were characterized by lower fasting serum C-peptide levels (P < 0.001), a higher percentage of insulin treatment (P < 0.05), lower maximum BMI (P < 0.001) and more pronounced weight loss from the time at their maximum weight (P < 0.001). In summary, increased upper body adiposity and a history of past obesity were associated with NIDDM in South Korea. Although most South Korean NIDDM patients were previously obese, many of them were currently not obese. Lower maximum BMI, lower serum C-peptide levels and a higher percentage of insulin treatment in non-obese NIDDM patients suggest that the capacity to increase insulin secretion in response to increasing weight gain is rather limited in these patients.

Cranial hemophilic pseudotumor: case report

OBJECTIVE AND IMPORTANCE

Hemophilic pseudotumor is a rare complication of hemophilia, occurring in 1 to 2% of patients with severe hemophilia. Its principal sites of occurrence are the long bones and the pelvis. Only one case of this tumor occurring in the cranium has been previously reported.

CLINICAL PRESENTATION

We report a case of cranial hemophilic pseudotumor involving the diploe of the right parietal vault. A 29-year-old man with severe hemophilia (Factor VIII, 0.8% of normal activity) presented with an unsightly scalp protrusion measuring 5 x 5 x 2 cm and tingling discomfort in the left arm. About 5 years before admission, he noted a walnut-sized, nontender mass in the right parietal area that had enlarged slightly after minor head trauma. Tingling discomfort developed as the manifestation of the compression of the parietal lobe in the 2 to 3 months after the head trauma.

INTERVENTION

Under proper factor replacement therapy, surgery was undertaken for excision and tissue diagnosis. Histological examination of the content in the diploe revealed old blood coagulum.

CONCLUSION

Postoperatively, the tingling discomfort in the arm resolved completely. To our knowledge, this is the second case of the cranial hemophilic pseudotumor in the English literature. Diagnosis and management of cranial hemophilic pseudotumor are presented with a review of the literature.

Experimentally induced Chiari-like malformation with myeloschisis in chick embryos

Though several pathogenetic theories concerning the frequent association of Chiari malformation and hydrocephalus with myeloschisis have been suggested, none of them explains all the aspects of the disorder. To investigate whether myeloschisis is the direct cause of Chiari malformation and hydrocephalus or these conditions are the results of another basic event, we observed the morphological changes of the posterior cranial fossa and its components in the chick embryos with surgically induced myeloschisis. To make myeloschistic lesions, we opened the neural tube for a length of 9-11 somites in Hamburger and Hamilton stage 16-19 chick embryos. They were divided into cervicothoracic (C-T) and lumbosacral(L-S) groups according to the area of incision. The embryos were re-incubated until postoperative day 11. In the control group, embryos were incubated with the eggshell window open as their experimental counterparts. The survival rates of each group were as follows; 11% (9 survivors/85 operated embryos), 8% (7/83), and 17% (10/60) in the C-T, L-S and control groups, respectively. Myeloschisis positive rates were 100% in the operated groups and 0% in the control group. The heads of embryos were sectioned along the sagittal plane to observe the morphological changes in the posterior cranial fossa and its components. Of the survivors, five in the C-T group, two in the L-S group and six in the control group were available for light microscopic inspection. In the majority of embryos with myeloschisis, without difference between the C-T and L-S groups, the fourth ventricles were smaller than those of the control group and the subarachnoid spaces in the posterior cranial fossa were also narrower. In embryos with severe changes, the cerebellum displaced downward comparing with that of the control embryos. No evidence of hydrocephalus was present Though not always typical, morphological changes similar to Chiari malformation were observed in chick embryos with surgically induced myeloschisis. It suggests a strong direct causal relationship between the two conditions and supports the theories of derangements in cerebrospinal fluid dynamics rather than those of primary mesenchymal or neural origin as a pathogenetic mechanism of Chiari malformation.

Effect of decreasing plasma free fatty acids by acipimox on hepatic glucose metabolism in normal rats

Increased availability of free fatty acids (FFA) may play a role in the pathogenesis of insulin resistance in the liver. We examined the effects of an antilipolytic nicotinic acid analog (acipimox) on hepatic glucose metabolism in basal and hyperinsulinemic states in normal rats. Acipimox decreased plasma FFA levels profoundly and enhanced the ability of insulin to suppress hepatic glucose production (HGP) and to stimulate peripheral glucose utilization. In the basal state, acipimox inhibited hepatic gluconeogenesis. However, this inhibition was not associated with the change in overall HGP due to the compensatory increase in hepatic glycogenolysis that might occur as a consequence of decreased hepatic glucose-6-phosphate (G-6-P) and/or plasma insulin levels with acipimox. These results support the contention that FFA are an important determinant of insulin action in the liver, and suggest the existence of intrahepatic autoregulatory and/or hormonal regulatory processes for constant HGP in the basal state.