Blunted pressure natriuretic response in the old rat: participation of the renal nerves

With advancing age, there is a generalized reduction in the ability of the kidney to generate a natriuretic response and, in addition, the incidence of salt-sensitive hypertension increases. One event that could link these changes is a defect that develops in the pressure natriuresis response of the old kidney. To test this possibility, we conducted studies on the anesthetized, male Sprague-Dawley rat to determine the effect of abrupt alterations of renal perfusion pressure (RPP) on urinary sodium excretion (U(Na)V). Young (3- to 5-month-old), middle-aged (11- to 13-month-old), and old (18 to 20-month-old) rats were studied, and RPP was varied by clamping the aorta during the infusion of a cocktail of vasoactive hormones that suppressed the activity of endogenous factors. The gain of the pressure natriuresis relationship was severely attenuated in the old rat compared with the young and middle-aged rats. This blunting of the pressure natriuresis relationship in the old rat was partially attenuated by acute renal denervation. This effect was not associated with marked alterations in the filtered load of sodium, implying that aging is associated with a loss of the tubular epithelial response to an acute change in RPP. These observations suggest that the blunted pressure natriuresis may have a role in the increased incidence of salt-sensitive hypertension and that increased renal nerve activity may have a contributory role.

Sensitivity of the segmental renal arterioles to angiotensin II in the aging rat

With advancing age the old rat kidney becomes tonically vasoconstricted by endogenous angiotensin II (ANGII) (C. Baylis. Am. J. Kid. Dis., (1993) 842). The present study was designed to investigate the sensitivity of the cortical glomerular microvasculature of the old rat kidney (19-22 months of age) to exogenous ANGII, using the in vivo micropuncture technique. In the baseline state, glomerular blood pressure (P(GC)) in old male rate was higher compared to young rats (4-5 months of age). During exogenous ANGII infusion (40 ng/kg/min), a significant rise in arterial blood pressure and renal vasoconstriction occurred in both young and old rats. In young rats, the ANGII induced fall in renal plasma flow (RPF) and glomerular plasma flow (QA) was accompanied by a rise in PGC and thus the glomerular hydrostatic pressure gradient, with little change in Kf. Therefore, the glomerular filtration rate (GFR) and single nephron GFR (SNGFR) were unchanged by ANGII infusion in young rate. In old rats, RPF and QA fell, a rise occurred in PGC and also a fall was seen in the glomerular capillary ultrafiltration coefficient (Kf), thus GFR and SNGFR fell significantly. The magnitude of the pressor and renal vasoconstriction response to ANGII were not affected by age; of interest, ANGII increased preglomerular and efferent arteriolar resistance (RA, RE) and PGC by similar accounts in young and old rats. SNGFR was reduced in old rats, due to the marked ANGII-induced decline in Kf. Neither absolute nor fractional proximal reabsorbtion were affected by ANGII infusion in either young or old rats. by 19-22 months of age, old rats had much more injured glomeruli than young rats. These data demonstrate that the afferent and efferent arterioles had similar sensitivity to exogenous pressor dose of ANGII in both young and old rats, but Kf was more sensitive to ANGII in old rats leading to a significant fall in SNGFR.

Sulbactam/cefoperazone versus cefotaxime for the treatment of moderate-to-severe bacterial infections: results of a randomized, controlled clinical trial

We conducted a randomized, open-label, controlled, multicenter study to compare sulbactam/cefoperazone with cefotaxime in terms of efficacy and safety for the treatment of hospitalized patients with moderate-to-severe bacterial infections. More than two-thirds of the pathogens recovered from these patients produced beta-lactamase. Two hundred-seven (88.1%) of the 235 patients enrolled completed the study and were included in the efficacy and safety evaluations. One hundred-three patients received sulbactam/cefoperazone (2-4 g/d) administered in evenly divided doses every 12 hours by a 30-minute intravenous drip; 104 patients received cefotaxime (6-12 g/d) administered in evenly divided doses every 6 or 8 hours by a 30-minute intravenous drip. The overall efficacy rates (i.e., cure or markedly improved) were 95% for the sulbactam/cefoperazone group and 90% for the cefotaxime group (P = .186), whereas the bacterial eradication rates were 85% for the sulbactam/cefoperazone group and 81% for the cefotaxime group (P = .467). Both drug regimens were well tolerated. Sulbactam/cefoperazone is effective and safe for the treatment of moderate-to-severe bacterial infections caused mainly by beta-lactamase-producing organisms.

Comparison of subcapsular and total orchiectomy for treatment of metastatic prostate cancer

OBJECTIVES

To determine whether subcapsular orchiectomy provides suboptimal treatment of metastatic prostate cancer when used to avoid the psychologic consequences of the empty scrotum that results from total orchiectomy.

METHODS

We compared testosterone and prostate-specific antigen levels and survival of 37 patients who underwent total orchiectomy and 37 patients who underwent subcapsular orchiectomy for metastatic prostate cancer.

RESULTS

The two groups of 37 patients were similar by clinical parameters. Postoperatively, testosterone levels were 21 +/- 11 ng/dL for subcapsular versus 21 +/- 9 ng/dL for total orchiectomy patients. Tumor response was similar in the two groups when assessed by prostate-specific antigen measured 3 weeks, 6 months, and 1, 2, and 3 years postoperatively. Survival was similar when assessed using Kaplan-Meier analysis (P = 0.76).

CONCLUSIONS

Subcapsular orchiectomy is a viable option for treatment of metastatic prostate cancer.

Nuclear morphometry in automatic biopsy and radical prostatectomy specimens of prostatic carcinoma. A comparison

Nuclear shape analysis performed upon prostatectomy specimens of prostatic carcinoma distinguished individual patients with good and poor prognoses. In order to be useful for prognosis assessment preoperatively, nuclear morphometry must be measured on needle biopsy specimens. We compared nuclear morphometry on automatic biopsy and radical prostatectomy specimens in 20 patients with prostatic carcinoma. Nuclear size was smaller (paired Student t test, P < .0001) in biopsy specimens (perimeter 17.0 +/- SD 4.9 microns, area 29.9 +/- 6.6 microns2) than in prostatectomy specimens (perimeter 24.6 +/- 4.4 microns, area 48.2 +/- 8.7 microns2). Nuclear shape was more abnormal in automatic biopsy specimens (nuclear roundness factor 82.0 +/- 18.8, ellipticity 90.5 +/- 27.7) than in surgical specimens (nuclear roundness factor 43.5 +/- 8.8, ellipticity 54.0 +/- 14.7) (P < .0001). Study of specimens obtained by automatic biopsy preoperatively and automatic biopsy of the prostatectomy specimens at various steps of processing revealed that nuclear swelling and rounding occurred after 2-24 hours of formalin fixation. Automatic prostate biopsies may more accurately reflect true nuclear morphometry and should be studied for preoperative prognosis prediction in patients with clinically localized prostatic carcinoma.

Nuclear shape analysis for the assessment of local invasion and metastases in clinically localized prostate carcinoma

BACKGROUND

Nuclear shape analysis of histologic sections from radical prostatectomy specimens has retrospectively predicted outcome in patients with clinically localized prostate carcinoma. If outcome could be predicted preoperatively by nuclear shape analysis, patients might be selected better for definitive surgical therapy. Morphometric analysis of preoperative biopsies, however, has not correlated positively with values obtained from analysis of prostatectomy specimens.

METHODS

The nuclear shapes of histologic specimens of 20 organ-confined carcinomas, 10 periprostatic fat-invasive carcinomas, 10 seminal vesicle-invasive carcinomas, and 12 lymph node-metastatic carcinomas from 52 patients who had undergone radical prostatectomy for clinically localized disease were evaluated.

RESULTS

Nuclei from areas of extraprostatic invasion or regional lymph node metastases were less round than those from the corresponding intraprostatic portion of the tumor (nuclear roundness factor (mean +/- SD) PPF, 51.2 +/- 3.1 vs. 31.2 +/- 3.2; SV, 52.4 +/- 4.1 vs. 31.6 +/- 2.5; and LN, 57.3 +/- 3.1 vs. 36.4 +/- 1.8; paired Student's t tests, P < 0.001). Cells sampled from the periphery of organ-confined tumors had a greater nuclear roundness factor (49.1 +/- 1.5) than did those sampled from the center (34.5 +/- 2.0; P < 0.001) or randomly throughout the tumor (37.8 +/- 1.6; P < 0.001). Nuclear roundness factors for all extraprostatic tumor foci and for peripheral tumor cells in organ-confined disease were similar (analysis of variance, P > 0.05). The intraprostatic portions of randomly sampled primary tumors had similar nuclear roundness factors, regardless of pathologic stage (P > 0.05). Among organ-confined carcinomas, nuclear shape was unrelated to tumor volume.

CONCLUSIONS

Pathologic stage in clinically localized prostate carcinoma cannot be determined by the nuclear shape profiles of intraprostatic tumor cells. Thus, patients with a poor prognosis or high pathologic stage can be recognized only when samples for morphometric analysis include high proportions of nuclei from the extra-prostatic carcinoma and nuclei from the periphery of organ-confined carcinoma that may not be sampled routinely by prostate biopsy.

[Effects of Tripterygiitotorum in the treatment of insulin dependent diabetes mellitus with islet transplantation]

The therapeutical efficacy of islet transplantation in treating insulin-dependent diabetes mellitus (IDDM) patients is marked for a short time and the long-term efficacy is unsatisfactory. So 30 IDDM patients given tripterygiitotorum (T II) were compared with 24 IDDM patients without using any immunosuppressive agents after islet transplantation.

RESULTS

prior to transplantation both the numbers of T lymphocyte subpopulations such as CD2, CD4, CD8 and the concentrations of C-peptide in all IDDM patients were lowered; after transplantation the numbers of CD2, CD4 were significantly elevated (P < 0.01), the ratio of CD4/CD8 in control group was higher than that in TII group (P < 0.01), while the concentration of C-peptide were greatly increased (normal: 2.24 +/- 0.34; before transplantation: 0.21 +/- 0.01; 15 days after transplantation: 3.24 +/- 1.2 ng/ml). The peak value of C-peptide in TII group began decreasing half a year after transplantation and it gradually dropped to the baseline level. The dose of insulin all were significantly reduced, and 3 patients stopped altogether. Half a year after transplantation TII group remained stable for the requirement of insulin, whereas the control group gradually increased the dose of insulin. (1) Islet transplantation could adjust the immunological disorder in IDDM patients, increase the numbers of T lymphocyte subset such as CD2, CD4, CD8 while the chronic immuno-rejective response occurred. (2) T II inhibited both the numbers and function of T lymphocyte subpopulation and normalized the ratio of CD4/CD8. (3) TII prolonged the survival time of grafts in IDDM patients and suppressed immunological rejection.(ABSTRACT TRUNCATED AT 250 WORDS)

[An experimental study on photosensitization of cultured human cells with hypocrellin A]

The photosensitive effects of hypocrellin A on cultured HeLa cells were studied by the methods of immunofluorescence cytochemistry, flow cytometry and others. The results showed that, in the presence of 3.66 mumol/L hypocrellin A, illumination of HeLa cells with visible light, the morphology was changed and the microvilli on the cells were disappeared; the proliferation of the cells decreased with increasing irradiated dose and this effect seemed more sensitive in tumor cells than in normal cells; the increased population of cycle cells at S phase but decreased at G1 phase were observed by FCM; the photodamage effect of hypocrellin A induced the sparse distribution of cytoplasmic microtubles and almost disappearance of the fluorescence intensity of MTOC, they were observed in HeLa cells as shown by immunofluoresent microscopy. All the aforesaid results indicated that photosensitization of hypocrellin A inhibits cells growth, resulting from the damage in cell membrane and cytoskeleton and S phase delay of the cell cycle.

[Determination of antibody of Borrelia burgdorferi in the serum of patients with sarcoidosis and its significance]

The level of antibody of Borrelia Burgdorferi in the serum of 40 patient, 23 with sarcoidosis and 17 without sarcoidosis was determined by using ELISA method. Antibody of BB was positive in the serum of 18 patients with sarcoidosis (78.3%). It is possible that sarcoidosis might be a disease of autoimmune abnormality and antibody of BB in the serum an auto-antibody resulting from the stimuli of certain unknown antigens. Cross reactivity may be present between the serological tests for sarcoidosis and those for rheumatic disease, tuberculosis, tumour and Lyme disease. But another case might be that antigen of BB is a mixture. Different antibodies of different disease react with different component of antigen of BB. Therefore, antibody of BB can not be considered as a specific test in the diagnosis of sarcoidosis.

[Quantitatively study of voice onset time-Glottal stop]

To quantitatively evaluate the acoustic characteristics of glottal stop, pronunciation of/ka/in 10 normal subjects and 14 patients with cleft palates were analyzed by sound spectrography and 20 msec in all normal articulation of /ka/ with an average time of 44.6 msec.In the test group of /ka/ demonstrated an average time of 20.8 msec.The inverse correlation ship between VOT and the psyco-acoustical judgment for the degree of distortion was demonstrated to be significant.

CT scanning of spinal injuries

Ninety-one patients with spinal injuries were studied by CT scanning. A comprehensive classification of spinal injuries was proposed according to the mechanism of trauma, the concept of three-column anatomical structure of the spine and the degree of spinal canal stenosis. CT scanning was advantageous in the diagnosis of spinal injuries such as clear detection of the three-column anatomical structure of the spine and spinal canal, demonstration of fracture lines in all 3 planes, determination of the amount of displacement of bony fragment into the spinal canal, assessment of spinal stability or instability, and restricted movement of the patient. The key points in general CT diagnosis, its role and limitation in the diagnosis of spinal injuries were discussed. The authors conclude that combined comprehensive classification of spine injuries is helpful in planning suitable treatment for the patient and predicting prognosis.

[X-ray computer tomography findings of brain and skull bone epidermoid cyst]

Brain and skull bone epidermoid cysts were confirmed by CT and operation in 32 cases (29 in brain, 3 in skull bone and scalp). Typical CT findings of epidermoid cyst were unenhanced hypodense areas with well-defined margin, closed contact with cisterns, and without surrounding edema. CT findings of atypical location and differential diagnosis are discussed.

Five-year follow-up of immune response to hepatitis B vaccine in juveniles

The persistence of anti-HBs was investigated in 95 juveniles who received plasma-derived HBV vaccine (vaccine group) and 63 counterparts who got anti-HBs from natural HBV infection (infection group) for a period of five years. The positive rates of anti-HBs from the first to fifth year in the vaccine group are 97.89%, 98.95%, 81.05%, 78.95% and 72.63% respectively with one recipient remaining anti-HBs negative after being immunized with three dosages of 10 micrograms plasma-derived HBV vaccine in 0, 1st, 2nd month and the mean S/N values (GMV) are 30.94, 22.18, 13.61, 12.02 and 9.18 respectively. There are 26 recipients whose anti-HBs turned from positive to negative at the end of the study with a negative rate of 27.37%. The S/N GMVs in the infection group are 36.37, 27.33, 24.08 at the first, third and fifth year of the study, respectively. Both the S/N GMV and negative rate are lower than that of the vaccine group (P < 0.01). No one was found to have positive HBsAg or elevated ALT in both groups. Questions such as immune dosage, immune program and booster immunization in juvenile population are discussed.

[Effect of insulin therapy on abnormal bone and mineral metabolism in chronic streptozotocin-induced diabetic rat]

By use of histomorphometry and photon and physical, calcium homeostasis, bone morphology, bone mass and bone growth were studied in freely fed control, streptozotocin-induced diabetic, long-term and short-term insulin treated diabetic rats 14 weeks after the induction of diabetes. We conclude that untreated chronic streptozotocin-induced diabetic rat could result in abnormal bone and mineral metabolism, which is characterized by hypercalciuria, hyperphosphaturia and hyperphosphatemia, significant bone loss and growth arrest. The extent of bone loss correlated with the duration of the disease process. The anatomical basis of bone mass reduction is the diminution of osteoblasts activity which results in reduction of bone formation and insufficient bone calcification and relative increment of osteoclasts activity. Thus, bone resorption overweight bone formation leading to a negative balance of bone remodeling. The effect of PTH and CT on bone changes in diabetic rats can't be affirmed in our experiments. It is probable that metabolic disorder and/or insulin deficiency has a direct effect on bone changes. Insulin therapy started earlier in the course can prevent and somewhat later can completely normalize the altered skeletal morphology of diabetic rats. Whether this result is due to direct effect of insulin on skeletal tissue or through the correction of metabolic disorder remains to be resolved.

Characteristic changes of DNA stemlines during hepatocarcinogenesis in rats

DNA stemlines of hepatocellular carcinoma (HCC) model of adult Wistar rats established by diethylnitrosamine were quantitatively measured by flow cytometry. The cancer-inducing course was divided into four stages, eg, precirrhosis stage, cirrhosis stage, early cancer stage and cancer progression stage. The advantageous DNA stemline of hepatocytes of normal adult Wistar rats was tetraploid (4C). It was from the cirrhosis stage that atavistic proliferation of hepatocytes with diploid (2C) DNA stemline started and replaced 4C hepatocytes, resulting in a new advantageous population. The features of early cancer stage were formation of HCC with 2C DNA stemline, whereas during the cancer progression stage, HCC cells with aneuploid (AN) DNA stemline presented the advantageous growth. The study clearly shows the change pattern of DNA stemline during the course of hepatocarcinogenesis from 4C-2C-AN, which is believed to be the biokinetic mechanism of the development and progression of HCC.

A study on the ecological habit of Armigeres subalbatus in Dawa area of the Mengshan Mountain in Shandong Province

Armigeres subalbatus (A.s.) was reported in Shandong Province for the first time in 1965 and found in five counties of south Shandong including Pingyi, Linyi etc. in 1986. In Dawa area of the Mengshan mountain A.s. alults could be found in the first ten days of May, which increased in number in July, and become the dominant species in mosquito colonies in Aug. and Sept., then decreased gradually in number in Oct. and disappeared in Nov. There were two peaks of activity and blood-sucking behavior during the 24 hours of a day, one at dusk and the other at dawn. When the temperature dropped to 16 degrees C and below in the last ten days of Oct., the wigglers began their diapause period. The survival ratio reached 90.5% after 12 h freezing at -5 degrees C and none survived after 60 hours freezing. When the temperature rose to 17 degrees C and above the over-winterting larvae developed into adults, which could suck blood only at the temperature above 17.5 degrees C.