Lack of association between interleukin-4 gene polymorphisms and autoimmune thyroid diseases amongst Taiwanese Chinese

Graves' disease (GD) and Hashimoto's thyroiditis (HT) are both common autoimmune diseases of the thyroid gland (AITD). The IL-4 is involved in both humoral and cellular immunity. The aim of this study was to test whether the IL-4 gene could be used as a genetic marker to predict the development of AITD amongst the Chinese population of Taiwan. For this study, a normal control group of 105 healthy subjects and two experimental groups featuring individuals afflicted with either GD (104 patients) or HT (109 patients) were examined. Polymerase chain reaction (PCR) was used to analyze the variable number of tandem repeats (VNTRs) polymorphism for the IL-4 gene intron 3 and PCR-based restriction analysis using endonuclease BsmFI was undertaken for the same gene at the promoter -590 position. We found no significant difference in the frequencies of presence of genotype and allelic variants for the IL-4 gene at both the intron 3 and the promoter regions between the normal control group and each of the two patient groups. These findings suggest that the IL-4 gene polymorphisms that arise at either intron 3 or promoter -590 positions are not suitable genetic markers for AITD among Taiwanese Chinese.

Root-ABA1 QTL affects root lodging, grain yield, and other agronomic traits in maize grown under well-watered and water-stressed conditions

A major QTL affecting root traits and leaf ABA concentration was identified in maize (Zea mays L.) and named root-ABA1. For this QTL, back-cross-derived lines (BDLs) homozygous either for the (+) or for the (-) allele increasing or decreasing, respectively, root size and leaf ABA concentration, were developed. This study was conducted to evaluate the QTL effects in various genetic backgrounds and at different water regimes. The (+/+) and (-/-) BDLs were crossed with five or 13 inbred tester lines of different origin, thus producing two sets of test-crosses that were evaluated in Italy and China, respectively. Testing was conducted under both well-watered and water-stressed conditions. In Italy, the test-crosses derived from (+/+) BDLs, as compared with those derived from (-/-) BDLs, showed, across both water regimes, higher leaf ABA concentration (on average 384 versus 351 ng g(-1) DW) and lower root lodging (28.0 versus 52.5%), and lower grain yield under water-stressed conditions (4.88 versus 6.27 Mg ha(-1)). In China, where root lodging did not occur, the test-crosses derived from (+/+) BDLs were less productive at both water regimes (on average, 6.83 versus 7.49 Mg ha(-1)). The lower grain yield of the test-crosses derived from (+/+) BDLs was due to a lower number of ears per plant and to lower kernel weight. The results indicate that the (+) root-ABA1 allele confers not only a consistently lower susceptibility to root lodging but also a lower grain yield, especially when root lodging does not occur.

Growth of Co clusters on thin films Al2O3∕NiAl(100)

We present a scanning tunnel microscopy study of Co clusters grown through vapor deposition on Al(2)O(3) thin films over NiAl(100) at different coverages and temperatures. Formation of Co clusters was observed at 90, 300, 450, and 570 K. At the three lower temperatures, we find narrow cluster size distributions and the mean sizes (with a diameter of 2.6 nm and a height of 0.7 nm) do not change significantly with the coverage and temperature, until the clusters start to coalesce. Even on 3-4-nm-wide crystalline Al(2)O(3) strips where the deposited Co atoms are confined, the same features sustain. Only at 570 K the normal growth mode where the cluster size increases with the deposition coverage is observed, although the data are less conclusive. A simple modeling of kinetic surface processes on a strip confirms the normal growth mode, but fails to show a favored size unless additional energetic constraints are applied on the cluster sizes. Increasing Co coverages to cluster coalescence, a larger preferable size (mean diameter of 3.5 nm and height of 1.4 nm) appears for growth at 450 K. These two sizes are corroborated by morphology evolution of high Co coverages deposited at 300 K and annealed to 750 K, in which the coalescence is eliminated and the two preferable geometries appear and coexist.

Cytological and biochemical studies of breast cyst fluid

We determined the biochemical composition of fluid aspirated from 52 breast cysts and classified the cysts into types I and II on the basis of the potassium-to-sodium (K/Na) ratio in the fluid. In this study, we confirmed the presence of prostate-specific antigen (PSA) in some breast cyst fluids, regardless of whether cysts were type 1 or type 2, or benign or malignant. On immunohistochemical study, we found no direct correlation between the presence of PSA and progesterone receptors, which is at odds with the results of earlier reports. Current practice in cytologic study appears to favor the examination of bloody fluid. In this study, two samples found to contain malignant cells were cloudy or turbid. We therefore recommend that all cloudy or turbid cyst fluids should be subjected to cytologic examination. This study indicated that the potassium and sodium concentrations were not the same in multiple cysts in the same individuals. In addition, apocrine cells were observed in both type 1 and type 2 cysts. Therefore, breast cyst type cannot predict the natural history of cystic changes or indicate the likelihood of cancer. The finding of malignancy in two patients with type 2 cysts also supports this argument.

Marked Hypotension Induced by Adrenaline Contained in Local Anesthetic

OBJECTIVES

Local anesthetics containing adrenaline, which often cause cardiovascular side effects, are routinely used in functional endoscopic sinus surgery (FESS) for the main purpose of hemostasis. The controversies concerning hemodynamic effects of adrenaline in local infiltration are widely discussed, but there is no definite conclusion. A prospective, randomized, double-blinded study was carried out to discover the hemodynamic effects after local infiltration of 1:200,000 adrenaline contained in 2% lidocaine under general anesthesia.

STUDY DESIGN

Seventy-six adult patients undergoing FESS during general anesthesia were allocated randomly into three groups. Group I patients (n = 26) received 2% lidocaine 2 mL with adrenaline (1:200,000), group II patients (n = 25) received saline 2 mL with adrenaline (1:200,000), and group III patients (control group, n = 25) received saline 2 mL without adrenaline for local infiltration. Electrocardiogram (ECG) and heart rate (HR) were monitored simultaneously; systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial blood pressure (MAP) were directly measured in radial artery continuously after local infiltration.

METHODS

SBP, DBP, MAP, and HR were recorded at 10 time points: before infiltration (baseline), 0.5 minutes, 1 minute, 1.5 minutes, 2 minutes, 2.5 minutes, 3 minutes, 3.5 minutes, 4 minute, and 5 minutes after infiltration.

RESULTS

Significant hemodynamic changes, particularly hypotension (P < .01), after local infiltration were observed in group I and group II compared with the baseline, but not in group III. However, there were no significant hemodynamic changes between group I and group II at the same time points (P > .05). The significant hemodynamic changes lasted no longer than 4 minutes.

CONCLUSIONS

Lidocaine (2%) or saline with adrenaline (1:200,000) does cause temporary hypotension and other hemodynamic changes during general anesthesia, which last no longer than 4 minutes. The causative mechanism is caused by the effect of adrenaline. This is a preliminary study.

Usefulness of techntium-99m hexamethylpropylene amine oxime lung scan to detect subclinical lung injury in patients with noninsulin-dependent diabetes mellitus

In this study, we employed techntium-99m hexamethylpropylene amine oxime (Tc-99m HMPAO) lung scan to detect subclinical lung injury of patients with noninsulin-dependent diabetes mellitus (NIDDM) who had normal chest X-ray findings (CXR) and pulmonary function test (PFT). The degree of pulmonary vascular endothelium damage was represented as lung/liver uptake ratios (L/L ratios) calculated by Tc-99m HMPAO lung scan. The L/L ratios of the 20 male NIDDM patients with normal CXR and PFT were compared with those of the 20 male normal controls. The results show that the L/L ratios on Tc-99m HMPAO lung scan were significantly higher in NIDDM patients than those in normal controls. Using a cutoff value of 0.50, 17 of the 20 (85%) NIDDM patients had abnormally increased L/L ratios. Our findings concluded that the pulmonary vascular endothelium damage represented as significantly increased L/L ratios on Tc-99m HMPAO lung scan in NIDDM patients with normal CXR and PFT. In addition, Tc-99m HMPAO lung scan has the potential to be a sensitive, objective, and noninvasive method to detect subclinical lung injury of patients with NIDDN, which are different from the traditional studies such as CXR or CFT.

Comparing dual phase Tl-201 thyroid scan and fine-needle aspiration cytology to detect follicular carcinoma

It remains difficult to pre-operatively differentiate follicular carcinoma and adenoma even under intraoperative investigations including histopathologic diagnosis of frozen sections.

METHODS

We retrospectively compared dual phase thallium (Tl-201) thyroid scan and fine-needle aspiration (FNA) cytology to detect follicular carcinoma in 12 patients with cold thyroid nodules. Fine-needle aspiration cytology results were assessed and categorized by experienced pathologists into benign, suspicious, and malignant. Dual phase Tl-201 thyroid scan including an early (10-min) image and a delayed (3-hour) image were acquired after 2 mCi (74 MBq) of Tl-201 was injected intravenously. Dual phase Tl-201 thyroid scan findings were visually interpreted as positive and negative results.

RESULTS

Based on FNA cytologic interpretation criteria, three nodules were diagnosed as benign, five nodules were diagnosed as suspicious, and four nodules were diagnosed as malignant. However, based on dual phase Tl-201 thyroid scan interpretation criteria, all of the 12 nodules could accurately diagnose as malignant.

CONCLUSIONS

We conclude that dual phase Tl-201 thyroid scan was more accurate in diagnosing follicular carcinoma when comparing with FNA cytology.

Successful treatment with weekly paclitaxel in a patient with recurrent endometrial cancer. A case report

The best treatment for recurrent endometrial cancer is still uncertain, although weekly paclitaxel has shown some promise in the management of this disease. In this report we present a patient with recurrent endometrial cancer treated with weekly paclitaxel. Serial power Doppler angiography was used to assess the effects of therapy. The response was good, suggesting that recurrent endometrial cancer may be successfully treated with weekly paclitaxel and effectively monitored with power Doppler angiography.

Tc-99m-tetrofosmin thyroid scan in patients with low I-131 thyroid uptake

Low 24-hour thyroid uptake of I-131 (I-131 uptake) is a common finding that influences evaluation of the thyroid gland.

METHODS

We studied 20 female patients aged 16-82 years with low I-131 uptake. The following causes of reduced I-131 uptake were defined as (A) six cases with subacute thyroiditis, (B) seven cases with T4 suppression therapy, and (C) seven cases with iodinated pharmaceuticals use. Thirty-minute Tc-99m tetrofosmin thyroid scan was performed within 24 hours of the I-131 thyroid study.

RESULTS

The results were correlated with neck ultrasound, serum TSH and biopsy histopathological findings. Tc-99m tetrofosmin thyroid scans revealed 10 normal thyroids, five diffuse goiters, four multinodular goitres, and one solitary thyroid nodule.

CONCLUSIONS

Our results suggest that Tc-99m tetrofosmin thyroid scans may provide additional information to diagnose thyroid pathology in patients with low 24-hour I-131 uptake.

Expression of the Recombinant Human Interleukin-11 in Pichia pastoris

Full length cDNA of human IL-11 was synthesized by DNA synthesizer. An expression plasmid, pGENYk, containing the recombinant DNA fragment, was linearized and transformed into Pichia pastoris. This recombinant gene was highly expressed in this yeast, and the expression product was purified by a three-step chromatography method. Analysis of the purified recombination protein with SDS-PAGE, Western blot and biological activities showed that the activity of the protein was the same as the Neumega expressed in E.coli.

Acceptor proteins of rat prostate residual chromatin

The androgen acceptor sites of the rat prostate residual chromatin (2 M NaCl insoluble fraction of chromatin) have been determined by steroid exchange assay, binding of translocated androgen-receptor complex in vitro, and solubilization of the acceptor protein(s) from the residual chromatin. Binding of [3H]dihydrotestosterone to the residual chromatin was saturable, displaying high affinity (Kd = 3.1 nM) and low capacity (6.3 nmol/mg of protein). The binding of [3H]dihydrotestosterone by the residual chromatin was androgen specific, as shown by steroid competition experiments. Intrachromatin binding study of translocated 5 alpha-[3H]dihydrotestosterone-receptor indicated that the residual chromatin contained 31% of the total chromatin-bound androgen, thus representing one of the major chromatin-androgen binding sites. The results suggested the presence of acceptor molecules in the residual chromatin with which the androgen-receptor interacted. To ascertain this, the residual chromatin was extracted with phenol, and the phenol-solubilized protein(s) was (were) assayed for acceptor activity by interaction with [3H]dihydrotestosterone-receptor complex. Comparison of phenol-solubilized residual proteins from rat prostate, spleen, and chicken erythrocyte indicated that [3H]dihydrotestosterone-receptor complex bound tissue specifically to the prostate residual protein and that the interaction required the presence of DNA. The possible importance of the residual DNA was examined by reannealing with cloned cDNAs coding for the subunit components of prostatic binding protein, an androgen-regulated oligomeric protein in rat prostate. The rates of reassociation kinetics of the residual DNA with the cDNAs were faster than with total DNA, equivalent to a 3-fold enrichment in prostatic binding protein coding sequences. The high salt resistant residual chromatin acceptor(s) thus appear(s) to be preferentially associated with androgen-activated genes.

Identifications, classification, and evolution of the vertebrate alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) receptor subunit genes

The AMPA receptor (AMPAR), a pharmacologically defined ionotropic glutamate receptor, mediates fast excitatory synaptic transmission in the vertebrate central nervous system. Mammalian and avian AMPARs are assembled from the products of four genes (GRIA1-GRIA4) conserved in their translated sequences and gene organizations. Teleost fish also express AMPAR subunits; however, the AMPAR genes have not been extensively investigated in lower vertebrates. To elucidate the evolution of vertebrate AMPAR genes, reverse-transcriptase PCR-based surveys of subunits expressed in the brains of eight nonmammalian vertebrates were performed. The newly cloned vertebrate AMPAR subunits were classified by their sequence identities to the mammalian AMPAR subunits. The results of molecular and phylogenetic analyses indicated that the members of the AMPAR gene family increased from two in the jawless hagfish to four in the tetrapods and the shark and to more than four in the teleost fish. The sizes of AMPAR gene families correlate well with those of many multigene families observed in various vertebrates. Moreover, all vertebrates expressed at least one AMPAR subunit bearing an arginine (R) at the Q/R site, at which no invertebrate glutamate receptor subunit has been found to have an R residue, suggesting that the low calcium-permeable AMPARs appeared at early evolutionary stages of vertebrate central nervous systems. Uniquely, the loop 1 (L1) regions between hydrophobic domain 1 and hydrophobic domain 2 of the hagfish putative GRIA2 and all the teleost GRIA1 subunits were much longer than those of the remaining known ionotropic glutamate receptor subunits. The length and sequence of the L1 of teleost GRIA1 subunits were heterogeneous, suggesting that the amino acid residues in L1 were not highly selected.

Cholesterol does not induce segregation of liquid-ordered domains in bilayers modeling the inner leaflet of the plasma membrane

A fluorescence-quenching method has been used to assess the potential formation of segregated liquid-ordered domains in lipid bilayers combining cholesterol with mixtures of amino and choline phospholipids like those found in the cytoplasmic leaflet of the mammalian cell plasma membrane. When present in proportions >20-30 mol %, different saturated phospholipids show a strong proclivity to form segregated domains when combined with unsaturated phospholipids and cholesterol, in a manner that is only weakly affected by the nature of the phospholipid headgroups. By contrast, mixtures containing purely unsaturated phospholipids and cholesterol do not exhibit detectable segregation of domains, even in systems whose components differ in headgroup structure, mono- versus polyunsaturation and/or acyl chain heterogeneity. These results indicate that mixtures of phospholipids resembling those found in the inner leaflet of the plasma membrane do not spontaneously form segregated liquid-ordered domains. Instead, our findings suggest that factors extrinsic to the inner-monolayer lipids themselves (e.g., transbilayer penetration of long sphingolipid acyl chains) would be essential to confer a distinctive, more highly ordered organization to the cytoplasmic leaflet of "lipid raft" structures in animal cell membranes.

Partitioning of lipidated peptide sequences into liquid-ordered lipid domains in model and biological membranes

We have used a fluorescence assay and detergent fractionation to examine the partitioning of different fluorescent lipidated peptides, with sequences and lipid substituents matching those found in various classes of lipidated cellular proteins, into liquid-ordered (raft-like) domains in lipid bilayers. Peptides incorporating isoprenyl groups, or multiple unsaturated acyl chains, show negligible affinity for liquid-ordered domains in mixed-phase liquid-ordered/liquid-disordered (l(o)/l(d)) bilayers composed of dipalmitoylphosphatidylcholine, a spin-labeled unsaturated phosphatidylcholine, and cholesterol. By contrast, peptides incorporating multiple S- and/or N-acyl chains, or a cholesterol residue plus an N-terminal palmitoyl chain, show significant partitioning into liquid-ordered domains under the same conditions. Interestingly, the affinity of a lipidated peptide for l(o) domains can be strongly influenced, not only by the structures of the lipid substituents but also by the nature and the positions of their attachment to the peptide chain. These results are well correlated with those obtained from parallel assays based on low-temperature detergent fractionation. Using the latter approach, we further demonstrate that a truly minimal l(o) domain partitioning motif [myristoylGlyCys(palmitoyl)-] can mediate efficient incorporation into the "raft" fraction of COS-7 cell membranes.

Synthesis and photodynamic action of diphenyl-2,3-dihydroxychlorin: a potential tumor photosensitizer

The synthesis, photophysical properties of diphenyl-2,3-dihydroxychlorin (DPCOH) and its photocytotoxicity to tumor cells are described. DPCOH exhibits photodynamic activity in terms of type I and type II mechanisms under irradiation. The quantum yield of (1)O(2) in CHCl(3) is 0.7. For the photocytotoxicity to tumor cells, DPCOH proved to be 200 times more potent than HPD, and the dark toxicity is low (dark IC(90)>32 microg/mL).

[Gene expression changes after heat shock by cDNA array analysis]

OBJECTIVE

To study gene expression changes of cells in response to heat stress, we isolated total RNA from Jurkat cells before and after heat shock treatment.

METHODS

cDNA was labeled with alpha-32P-dATP during reverse transcription of RNA and then used as probe to cDNA expression array. Autoradiogram images were analyzed by ESTblot software.

RESULTS

After heat shock, the expression level of some forty genes increased while that of sixteen genes decreased. In addition to the elevated expression of heat shock genes, expression of c-Jun and CLK-1 increased most remarkably. The genes with notably decreased expression were integrin alpha-4 and transforming growth factor beta. The elevated expression of c-Jun and hsp90 alpha was further confirmed by Northern blot analysis.

CONCLUSIONS

The expression of some genes in Jurkat cells changes after heat shock treatment. Heat shock induces elevated expression of hsp, c-Jun, CLK-1 gene while decreases expression of integrin alpha-4 and transforming growth factor beta.

Neurotoxic effect of high dose of L-(+)-2-amino-3-phosphonopropionic acid in rats after intracaudatal injection

AIM

To investigate neurotoxic effect of L-(+)-2-amino-3-phosphonopropionic acid (L-AP3), a partial agonist/antagonist of metabotropic glutamate receptors (mGluRs), and explore the underlying mechanisms.

METHODS

Consciousness and behavior of rats were evaluated after injection of L-AP3, D-(+)-2-amino-3-phosphonopropionic acid (D-AP3, an isomer of L-AP3) or L-(+)-2-amino-4-phosphonobutyric acid (L-AP4, an agonist of mGluRs) into right caudatum. Brain water, Na+, K+, and Ca2+ contents as well as the permeability of blood brain barrier (BBB) were determined 6 h after treatment of these chemicals. Histological changes at the same time point were also observed.

RESULTS

Rats treated with L-AP3 600 nmol but not 60 nmol became somnolentia. Inject ion of L-AP3 600 nmol induced a great increase of brain water, Na+, and Ca2+ contents, and a decrease of brain K+ content (P < 0.01). Meanwhile, the permeability of BBB was also increased (P < 0.01). Electron microscopic study revealed remarkable swelling of astrocytes and degenerative changes of neurons in chemical-treated caudatum. The neurotoxic effect of L-AP3 was not mimicked by D-AP3 or L-AP4 (P < 0.05). DL-2-Amino-5-phosphonovaleric acid, an antagonist of N-methyl-D-aspartate (NMDA) receptors, attenuated the changes induced by L-AP3 (P < 0.05), whereas (+/-)-alpha-methyl-(4-carboxyphenyl)glycine, a non-subtype specific antagonist of mGluRs, failed to block the effect of L-AP3.

CONCLUSION

Intracaudatal injection of L-AP3 induced neurotoxic effect characterized by vasogenic brain edema, neuronal degeneration, and high brain Ca2+ content. Neurotoxic effect of L-AP3 was stereoselective and might be mediated by phospholipase C activation and partially involvement of NMDA receptors.

[Purification and characterization of recombinant human interleukin 11 which expressed by Pichia pastoris]

This study first time report a method to purify the rhIL-11 which expressed by Pichia pastoris. rhIL-11 was secreted into the supernatant and collected by centrifugation. The purity of rhIL-11 reached 97% through the steps of ultrafiltration, SP Sepharose FF, Phenyl Sepharose HP and Sephadex G25. Analysis of SDS-PAGE, Western-blotting, IEF, RP-HPLC, Mass spectrometer, N and C terminus amino acid sequence and bioactivity was conducted. All the analysis results proved that the rhIL-11 expressed by Pichia pastoris was the same as Neumeg which was expressed in E. coli with fusion expression system. So it is possibly a cheaper and easier method to produce rhIL-11 for clinical use.

[The protective effect of puerarin on cultured rat cerebral cortical astrocytes]

AIM

To study the effects of puerarin (Pue) on impairment of rat astrocytes in primary cell culture induced by oxygen-glucose deprivation (OGD) or sodium glutamate (Glu).

METHODS

Astrocyte damage induced by (OGD), Glu or (+/-)-1-aminocyclopentane-trans-1,3-dicarboxylic acid (trans-ACPD), as well as the action of Pue was measured by determining the intracellular water space (as measured by 3-O-methyl-[1- 3H]D-glucose uptake) of astrocytes and the leakage of lactate dehydrogenase (LDH) from astrocytes.

RESULTS

Following the exposure to OGD for 5 h, 0.5 mmol/L Glu or 1 mmol/L trans-ACPD for 1 h, the astrocyte volume and LDH leakage from astrocytes were increased. 0.1 mmol/L Pue, when co-incubated with OGD, Glu or trans-ACPD, reduced astrocytic swelling and the LDH leakage.

CONCLUSION

Pue had protective effects on astrocytes damaged by OGD, Glu or trans-ACPD.

Multiple globules in a cystic ovarian teratoma

OBJECTIVE

To describe the characteristic imaging findings of multiple globules and globules-fluid level in a cystic ovarian teratoma.

DESIGN

Descriptive case study.

SETTING

Mackay Memorial Hospital and National Yang-Ming University, Taipei, Taiwan, Republic of China.

PATIENT(S)

A 20-year-old woman with left abdominal discomfort and a palpable mass on the left side of the distended abdomen.

INTERVENTION(S)

Surgical removal of a 10-cm cystic ovarian teratoma that contained chocolate-like fluid and multiple spheroid mobile globules consisting of yellowish sebaceous debris and fine hair shafts.

MAIN OUTCOME MEASURE(S)

Plain abdominal radiography, ultrasonography, and computed tomography (CT).

RESULT(S)

Plain abdominal radiography revealed no calcification in the mass. The first sonographic examination showed no movement by positional change of multiple rounded echogenic masses ranging from 0.5 cm to 2 cm in diameter, but the second CT examination done after the patient had spent some time lying down showed that the rounded masses arrayed in the upper portion of the cyst and displayed the characteristic level of globules-fluid. Thus, the differential diagnosis was multiple mobile globules in a cystic ovarian tumor.

CONCLUSION(S)

This case indicates that fatty masses need time to float upward in the fluid matrix of a cystic ovarian teratoma. This delayed effect should be considered when an ovarian cyst with multiple rounded echogenic masses is diagnosed by ultrasonography, CT, or magnetic resonance imaging.

Comparison of the metabolic effects of metformin and troglitazone on fructose-induced insulin resistance in male Sprague-Dawley rats

BACKGROUND AND PURPOSE

Insulin resistance is a hallmark of the development of type 2 diabetes. Metformin and troglitazone are oral antidiabetic agents used to reduce insulin resistance. The aim of this study was to compare the metabolic effects of these two drugs in fructose-induced insulin-resistant rodents.

METHODS

Male Sprague-Dawley rats were allocated to receive one of the following four treatments for 6 weeks: normal rat chow (control group, n = 7), high-fructose diet (fructose group, n = 7), high-fructose diet plus metformin (metformin group, n = 8), or high-fructose diet plus troglitazone (troglitazone group, n = 8). Systolic blood pressure (SBP), insulin, free fatty acid (FFA), and triglyceride concentrations were measured as parameters of insulin resistance. Leptin concentration was also measured in the four groups.

RESULTS

The fructose group developed significantly elevated SBP, hyperinsulinemia, and hypertriglyceridemia without significant change in body weight or leptin concentration compared with the control group. The metformin group had significantly reduced body weight (397.9 +/- 40.9 vs 470.1 +/- 59.6 g, p < 0.05), insulin concentration (14.8 +/- 10.5 vs 48.4 +/- 15.2 microU/mL, p < 0.05), triglyceride concentration (75.3 +/- 65.5 vs 250.1 +/- 95.7 mg/dL, p < 0.05), and leptin concentration (3.1 +/- 1.5 vs 6.9 +/- 2.0 ng/mL, p < 0.05) without significant change in SBP (147.8 +/- 5.8 vs 152.4 +/- 13.0 mm Hg, p > 0.05) compared with the fructose group. The troglitazone group had significantly reduced SBP (137.8 +/- 9.2 vs 152.4 +/- 13.0 mm Hg, p < 0.05), insulin concentration (15.0 +/- 13.6 vs 48.4 +/- 15.2 microU/mL, p < 0.05), FFA concentration (38.9 +/- 22.7 vs 78.7 +/- 24.6 mg/dL, p < 0.05), triglyceride concentration (67.6 +/- 32.4 vs 250.1 +/- 95.7 mg/dL, p < 0.05), and leptin concentration (4.4 +/- 2.0 vs 6.9 +/- 2.0 ng/mL, p < 0.05) without significant change in body weight (452.5 +/- 32.8 vs 470.1 +/- 59.6 g, p > 0.05) compared with the fructose group. The metabolic effects of metformin and troglitazone on insulin, FFA, triglyceride, and leptin concentrations were not significantly different. However, metformin treatment resulted in significantly lower body weight (397.9 +/- 40.9 vs 452.5 +/- 32.8 g) and troglitazone treatment in significantly lower SBP (137.8 +/- 9.2 vs 147.8 +/- 5.8 mm Hg) compared to the fructose group, after adjusting for basal values (p < 0.05).

CONCLUSIONS

Both metformin and troglitazone were comparably effective in reducing insulin resistance. Metformin treatment caused body weight reduction but was not effective in reducing SBP. Troglitazone treatment lowered SBP but did not reduce body weight.

Low triglyceride levels affect calculation of low-density lipoprotein cholesterol values

The Friedewald formula for the calculation of low-density lipoprotein cholesterol (LDL-C) values is fairly accurate provided the triglyceride value is less than 400 mg/dL. It is not clear whether the estimation is also valid in the presence of low triglyceride and high cholesterol levels. We describe herein a patient with a low triglyceride value of approximately 50 mg/dL, a high cholesterol level, and a discrepant LDL-C level. The LDL-C level using the Friedewald calculation turned out to be much higher than the LDL-C level using direct measurement. We, therefore, suggest that in the presence of low triglyceride and high cholesterol levels, the LDL-C level should be measured directly instead of using the Friedewald calculation.