Uncertainty in phosphorus fluxes and budgets across the U.S. long-term agroecosystem research network

Phosphorus (P) budgets can be useful tools for understanding nutrient cycling and quantifying the effectiveness of nutrient management planning and policies; however, uncertainties in agricultural nutrient budgets are not often quantitatively assessed. The objective of this study was to evaluate uncertainty in P fluxes (fertilizer/manure application, atmospheric deposition, irrigation, crop removal, surface runoff, leachate) and the propagation of these uncertainties to annual P budgets. Data from 56 cropping systems in the P-FLUX database, which spans diverse rotations and landscapes across the U.S. and Canada, were evaluated. Results showed that across cropping systems, average annual P budget was 22.4 kg P ha^-1 (range = -32.7 to 340.6 kg P ha^-1 ), with an average uncertainty of 13.1 kg P ha^-1 (range = 1.0 to 87.1 kg P ha^-1 ). Fertilizer/manure application and crop removal were the largest P fluxes across cropping systems and, as a result, accounted for the largest fraction of uncertainty in annual budgets (61 and 37%, respectively). Remaining fluxes individually accounted for <2% of the budget uncertainty. Uncertainties were large enough that determining whether P was increasing, decreasing, or not changing was inconclusive in 39% of the budgets evaluated. Findings indicate that more careful and/or direct measurements of inputs, outputs, and stocks are needed. Recommendations for minimizing uncertainty in P budgets based on the results of the study were developed. Quantifying, communicating, and constraining uncertainty in budgets among production systems and multiple geographies is critical for engaging stakeholders, developing local and national strategies for P reduction, and informing policy. This article is protected by copyright. All rights reserved.

Assessment of atrial septal defects using 3-dimensional transthoracic echocardiography prior to percutaneous device closure: first report from Bangladesh

BACKGROUND

Secundum atrial septal defect (ASD) is treated following trans-catheter closure in alternative to surgical treatment. Per-intervention selection of device size with balloon occlusive diameter (BOD) often cause tearing or enlarging, causing arrhythmias and hypotension. We assessed the suitability of percutaneous device closure for ASD using 3-dimensional transthoracic echocardiography (3DTTE).

OBJECTIVES

This study was conducted to investigate if 3DTTE could be an alternative of balloon sizing for selection of device size in atrial septal defect device closure.

DESIGN

It was a cross-sectional comparative study.

METHODS

This study was conducted at the department of Pediatric Cardiology, Bangabandhu Sheikh Mujib Medical University for a period of 2 years. Thirty-three purposively selected secundum ASD patients suitable for device closure were included in the study. Ethical permission was taken from the Institutional Review Board and written consent was taken from each patient's guardian. In this study, 3DTTE derived ASD diameter and BOD were compared with that of deployed device size using correlation analysis.

RESULTS

Out of 33 patients, 63.6% were female and 36.4% were males had a mean age of 18.07 ± 14.58 years (range 2-55 years). Mean diameter of ASD measured by 2-dimensional (2D) and 3-dimensional (3D) echocardiography were 17.09 ± 6.08 mm and 21.30 ± 6.56 mm, respectively, yielding a significant difference (p < 0.001). 3D echocardiography derived ASDs diameter were highly correlated with device size than BOD and 2D echocardiography derived diameter (2D echocardiography: r = 0.796, p = <0.001, 3D echocardiography: r = 0.960, p = <0.001, BOD: r = 0.840, p = <0.001).

CONCLUSION

3DTTE can accurately measure ASD diameter and can be used as an alternate, effective, and safe method to select device size.

Evaluation of Early Renal Involvement in Essential Hypertension by Measuring Urinary Biomarkers

Hypertensive kidney damage results in glomerular as well as tubular dysfunction. Albuminuria is a well-known marker of glomerular damage. On the other hand, urinary uromodulin is increasingly considered as a potential biomarker of early tubular dysfunction. The aim of the study was to assess glomerular and tubular function of the kidney by measuring urinary albumin and uromodulin excretion in hypertensive subjects. This cross-sectional study was conducted from July 2018 to June 2019 in Hypertension Clinic of Dhaka Medical College Hospital, Dhaka and Kidney Care and Research Centre, Sonargaon, Narayanganj, Bangladesh. In this study 122 hypertensive subjects with age >30 years, duration of hypertension <5 years, without accelerated or malignant BP, absence of dipstick proteinuria and eGFR >60ml/min were included. There were also 33 normotensive individuals included as healthy controls. Albumin-creatinine ratio (uACR mg/g), urine uromodulin-creatinine ratio (uUMODμg/g), urinary sodium-creatinine ratio (mEq/g) and potassium-creatinine ratio (mEq/g) were measured from single morning spot urine sample. Urinary uromodulin levels were measured by ELISA method. The hypertensive and normotensive subjects were age matched 49.0±12.0 vs. 48.0±11.0, years (p=NS). The mean uACR was 29.0±65.0 versus 5.6±2.7mg/g, (p<0.001) respectively. The median uUMOD in hypertensive subjects was 3.38 (1.73-9.06) and in normotensives 3.85(2.28-5.69) μg/g (p=non significant). Multivariate analysis showed significant inverse association between diastolic blood pressure and urinary uromodulin excretion. A uUMOD cut-off of 2.9 (25th percentile) showed eGFR, urinary sodium and potassium excretions were significantly lower at low uromodulin group. The glomerular involvement was found in 21.0% of hypertensive subjects as evidenced by albuminuria. No difference was observed in urinary uromodulin level between hypertensive and normotensive subjects. Low urinary uromodulin level was associated with lower eGFR, Na+ and K+ excretion which indicate simultaneous tubular and glomerular involvement.

Depression among Medical Students of Bangladesh

Now a days depression is one of the leading cause of disabilities all over the world. Depression leads to a wide range of disorders and affects people of all communities. Medical students pass through a relatively high level of stress. Several studies revealed that anxiety and depression is significantly prevalent among medical students and often it persists even when they become physicians. The study was designed with an aim to estimate the prevalence of depression among the medical students of Bangladesh. The cross sectional descriptive type of observational study was conducted among randomly selected 399 Bangladeshi students of third year MBBS from six (6) randomly selected public medical colleges of Bangladesh from February 2017 to July 2017. Data were collected by a semi-structured self-administered questionnaire containing Beck's Depression Inventory. Data were entered and analyzed by SPSS version 20.0. Among 399 medical students, 45.6% were male and 54.4% were female. Regarding presence of depression among the medical students, 35.8% students had normal score. More than one fourth of the students (25.1%) had mild mood disturbance. Borderline clinical depression was found in 15.5% and moderate depression was found in 18.0% of the students. Severe depression was found in 5.3% students and one (0.3%) student was suffering from extreme depression. Overall 39.1% students were suffering from different levels of depression. Depression was prevalent more in female students (45.6%) than male students (31.3%). Suicidal tendency was present in 18.8% students. Among them 14.3% had thoughts of killing themselves but they would not carry them out; 3% would like to kill themselves and 1.5% would kill themselves if they had the chance. Suicidal tendency was also a bit higher in female students (19.3%) than male students (18.1%). A significant number (39.1%) of medical students of Bangladesh are suffering from depression and many of them (18.8%) have suicidal tendency which demands immediate attention of the authority. The findings of the study warrant a need for psychiatric counseling and support services for vulnerable students.

Risk Factors for Hypertension in Young Adults of Bangladesh

Hypertension is a major public health challenge to population in socio-economic and epidemiological transition. It is a risk factor for cardiovascular mortality which accounts for 20-50 per cent of all deaths. Hypertension has been recognized among young adults more frequently in recent years. Data regarding hypertension in Bangladesh is often insufficient. The purpose of the study was to find out the risk factors of hypertension in young adults of Bangladesh. The study was conducted among 322 purposively selected young adults aged 20 to 49 years attending in the outpatient department of one public and five private hospitals of Mymensingh and Dhaka division of Bangladesh during the period of January 2018 to December 2018. More than half (54.4%) of the patients were at or below the age of 40 years. Mean age of the patients was 38.7±7.8 years and 58.7% were male. Maximum patients (87.6%) were married and with variable educational and occupational status. More than three fourth of the patients (76.7%) were from urban area whereas 14.3% from rural and 9.0% were from sub-urban area. Family history of hypertension was positive in 86.6% of patients. Blood pressure was categorized according to JNC 7. About half (49.4%) of the patients were stage I hypertensive; 22.4% were stage II hypertensive and 28.3% were pre-hypertensive. The major risk factor was tobacco smoking (46.0%), obesity (29.2%), dyslipidaemia (25.2%), high salt intake 21.8% and use of chewable tobacco (13.7%). Serum creatinine was found raised in 11.5%, cardiomegaly in 2.2% and concentric left ventricular hypertrophy in 18.6% of patients. In 38.5% patients hypertension was complicated affecting heart (27.0%) and kidney (11.5%). Common comorbidities were ischaemic heart diseases (20.5%) and diabetes mellitus (13.4%). Tobacco use, obesity, dyslipidaemia and high salt intake are the major modifiable risk factors found in hypertensive young adults. In addition to medication these factors should be addressed for prevention and effective control of hypertension.

Risk of Abdominal Aortic Calcifications among End Stage Renal Disease Patients under Maintenance Haemodialysis

Calcification of soft tissue and blood vessel wall occurs more frequently in dialyzed patients. The purpose of the present study was to estimate the risk of abdominal aortic calcification among end stage renal disease patients under maintenance haemodialysis. This case-control study was carried out in the Department of Nephrology at National Institute of Kidney Diseases and Urology (NIKDU), Dhaka and National Institute of Cardiovascular Disease and Hospital (NICVD), Dhaka, Bangladesh from January 2013 to December 2014 for a period of two (02) years. Chronic kidney disease in stage 5 {CKD-5(D)} patients older than 18 years on maintenance haemodialysis (MHD) for more than 3 months were selected as case group. And same age and sex non CKD patients were considered as control group. Serum calcium, serum albumin, serum phosphate and iPTH were estimated by semi-automated biochemistry analyzer from the Department of Biochemistry of NIKDU, Dhaka and NICVD, Dhaka. Plain X-ray abdomen in lateral view was performed for all patients. Total 100 patients were enrolled for this study of which 50 patients were in end stage renal disease (ESRD) group and the rest 50 patients were in non-CKD group. Abdominal aortic calcification on X ray was present in 22(44%) patients of ESRD group and 6(12%) patients of non CKD group of population. Mean±SD serum calcium (corrected) level was significantly high (p<0.001) in ESRD patients (9.79±0.87) compared to non CKD group of population (9.13±0.70). Mean±SD of serum phosphate level was significantly higher (p<0.001) in ESRD patients (5.71±0.96) compared to non CKD group of population (4.20±0.59). However, mean±SD iPTH level showed no significant difference between ESRD (25.33±51.98) and non CKD group of population (38.53±19.52), though iPTH level remain below the target level in ESRD group. Abdominal aortic calcification is significantly higher among ESRD subjects.

Neurological status of children with congenital heart defects

Congenital heart defect (CHD) is the most common birth defect & a significant cause of childhood morbidity & mortality. Structural brain abnormalities are more common in children with CHD than general population. This study details the cognitive, motor and behavioral development of a child with congenital heart disease who is on medical management. In this retrospective descriptive study, abnormalities in neurobehavioral status of infant & children (6-42 months of age) with CHD, who are on medical management were assessed by a standardized neurobehavioral assessment test, BSID-II. Fifty-eight children were included, who were diagnosed as a case of congenital heart disease & confirmed by Colour Doppler echocardiography in the Paediatric Cardiology Department of Bangabandhu Sheikh Mujib Medical University, Bangladesh. Mean age of the children was 23±13 months (range, 6 to 42 months); M:F = 1:1.9. Among them 22(37.9%) had cyanotic and 36(62.1%) had acyanotic congenital heart disease. Neurobehavioral and neurologic abnormalities were documented in a significant number of children. BSID-II showed 23(39.7%) had delayed metal development, 24(41.4%) had motor impairment and 16(27.6%) had non-optimal behavioral performance. Interestingly, infant and young children with acyanotic congenital heart defects were more likely to demonstrate severe neurologic compromise than were those with cyanotic defects. Findings of this study suggest that the prevalence of neurobehavioral abnormalities in infants and young children with congenital heart defects has been under predicted & indicates that delay in closure (surgery/device) puts the patient at an increased risk of neuro-developmental insult.

Chest pain in children: an update

Chest pain is a common symptom for children and adolescents. It is the second most frequent complaint leading to referral to paediatric cardiologist, murmurs being the largest. The most common cause of chest pain prompting a child to visit a physician is idiopathic chest pain (21-59%). Other disorders are pulmonary (12-24%), psychologic (17-19%), musculoskeletal (7-16%), gastrointestinal (5-7%), cardiac (1-4%) and miscellaneous (2-4%). Most children with chest pain have normal physical findings. Careful physical examination can reveal important clues and save much unnecessary investigations. When an organic cause is found for the pain then specific treatment is commenced. Depending on the circumstances, a therapeutic trial may be warranted, for example use of an inhaled bronchodilator 15-20 minutes before exercise for suspected exercise induced asthma, use of adequate anti-reflux medication for gastro-oesophageal reflux disease or non-steroidal anti-inflammatory medication for musculoskeletal pain. Where an organic cause is not considered to be present, explanation and reassurance can reduce anxiety and decrease the severity of the symptoms. This article specifically deals with problems of chest pain in children and approach to such problems in the form of relevant investigations and management.

Lactate down-regulates cellular poly(ADP-ribose) formation in cultured human skin fibroblasts

BACKGROUND

Polyadenosine diphosphate-ribose (poly(ADP-ribose)) is a nuclear polymer which is derived from nicotinamide adenine dinucleotide (NAD(+)) catalysed by poly(ADP-ribose) polymerase 1 (PARP-1). Aside from the well known role of poly(ADP-ribosyl)ation (pADPR) in DNA repair, pADPR is also involved in other cellular processes such as apoptosis and gene expression. However, the factors that regulate the level of pADPR are not fully elucidated. In view of the fact that healing wounds contain high concentrations of lactate (10-15 mM) and exogenous lactate reduce the NAD(+) pool in cultured fibroblasts, we propose that high lactate lowers the level of nuclear pADPR.

MATERIALS AND METHODS

Neonatal human dermal fibroblasts (NHDF) were plated to subconfluence and allowed to adhere. Cells were treated with 15 mM l-lactate and pADPR production was assessed by immunofluorescence analysis using 10H antibody. Difference in pADPR production was determined by calculation of positively stained cells compared to total cell numbers. Inhibition of PARP activity was tested by treatment with 100 microM 3-aminobenzamide (3-AB). Specificity of the lactate effect on pADPR synthesis was verified by using the analogue d-lactate. The contents of nicotinamide adenine dinucleotide (NAD(+)) and its reduced form (NADH) in lactated and non-lactated cell cultures were quantified by the enzymatic cyclic assay.

RESULTS

We found that exogenous l-lactate (15 mM) can significantly depress pADPR content in cultured fibroblasts. PARP-1 activity was inhibited by 3-AB and analogue d-lactate showed no effect on pADPR synthesis. NAD(+)/NADH ratio was significantly lowered in lactated compared to non-lactated cell culture.

CONCLUSIONS

Exogenous l-lactate (15 mM) can depress pADPR content in cultured fibroblasts. In view of the fact that healing wounds contain such high concentrations of lactate, we propose that down regulation of pADPR is associated with elevated tissue repair via pADPR dependent gene expression. This observation is important in understanding the stimulation of lactate-mediated protein expression during wound healing.

Soil properties and crop productivity as influenced by flyash incorporation in soil

Field experiments were carried out during 1996-97 at Gulawathi, Muthiani and Salarpur Villages, IARI Farm, New Delhi and NCPP Campus, Dadri to evaluate changes in soil characteristics and growth of wheat (Triticum aestivum L.), mustard (Brassica juncea L.), lentil (Lence esculenta Moench.), rice (Oryza sativa L.) and maize (Zea mays L.) by varying amounts of flyash addition (up to 50t ha(-1)) in soils at sowing/transplanting time of crops. Flyash addition in areas adjoining NCPP Thermal Power Plant, Dadri, Ghaziabad, U.P. ranged from 5-12 t ha(-1)] yr(-1) in 1995-96. Shoot and root growth and yield of test crops at different locations after flyash incorporation resulted in beneficial effects of flyash addition in most cases. The silt dominant texture of flyash improved loamy sand to sandy loam textures of the surface soils at the farmers' fields. The increased growth in yield of crops with flyash incorporation was possibly due to modifications in soil moisture retention and transmission characteristics, bulk density, physico-chemical characters such as pH and EC and organic carbon content. The response of flyash addition in the soil on soil health and crop productivity needs to be evaluated on long-term sustainable aspects.

Hydrogen peroxide stimulates macrophage vascular endothelial growth factor release

Neutrophils gather at the wound site shortly after trauma and release bactericidal reactive oxygen species (ROS) and H2O2 to kill bacteria and prevent infection. Macrophages arrive at the wound in response to environmental stimuli, phagocytose foreign particles, and release vascular endothelial growth factor (VEGF), an angiogenic factor crucial for wound healing. Because oxidants are released early in inflammation and have been found to regulate transcription factors, we investigated a possible role of H2O2 in VEGF stimulation. Human U937 macrophages exposed to H2O2 and allowed to recover in H2O2-free medium rapidly showed an increase in VEGF mRNA. The H2O2-mediated mRNA increase was dose dependent, blocked by catalase, and associated with elevated VEGF in conditioned media. The increase in VEGF was also found in primary rat peritoneal macrophages and the RAW 264.7 murine macrophage cell line. Transcriptional inhibition with actinomycin D revealed no significant difference in mRNA half-life. Transient transfections with a 1.6-kb VEGF promoter-luciferase construct (Shima DT, Kuroki M, Deutsch U, Ng YS, Adamis AP, and D'Amore PA. J Biol Chem 271: 3877-3883, 1996) showed a ninefold stimulation of VEGF gene promoter activity. We concluded that H2O2 increases macrophage VEGF through an oxidant induction of VEGF promoter. This oxidant stimulation can be mediated by activated neutrophils.

Lactate elicits vascular endothelial growth factor from macrophages: a possible alternative to hypoxia

Macrophages respond to various stimuli to produce angiogenic factors but few mechanistic details are known. We examined the effects of hypoxia, lactate and nicotinamide on the expression of vascular endothelial growth factor by cultured macrophages. These agents were chosen because they down-regulate polyadenosine diphosphoribose levels. Following exposure, conditioned media were analyzed for vascular endothelial growth factor protein. Nicotinamide adenine dinucleotide, polyadenosine diphosphoribose, and vascular endothelial growth factor mRNA were measured in the cellular fraction. Angiogenic capacity of the conditioned media was tested in rabbit corneas and Matrigel implants. All three agents, hypoxia, lactate and nicotinamide, elicited significantly increased levels of vascular endothelial growth factor mRNA and vascular endothelial growth factor in the conditioned media, and these levels were paralleled by their angiogenic activity. Polyadenosine diphosphoribose in the cellular fraction was correspondingly depressed. Anti-vascular endothelial growth factor antibody inhibited most of the angiogenic response whereas anti-basic fibroblast growth factor antibody had little effect. We propose that redox changes associated with the alteration of cellular nicotinamide adenine dinucleotide and polyadenosine diphosphoribose are involved in lactate-mediated VEGF expression.

Detection of interleukin-6 in human dental pulp and periapical lesions

Pulpal and periapical diseases are characterized by inflammation. The cytokine IL-6 is a major mediator of the host response to tissue injury and infection. This study examined the level of interleukin-6 (IL-6) in six inflamed human pulps and six human periapical lesions of endodontic origin using ELISA. Pulp samples from eight clinically impacted teeth were used as controls. The periapical samples exhibited significant levels of IL-6 (mean = 78.1 +/- 9 pg/mg protein) as did inflamed pulpal tissues mean = 36 +/- 3.9 pg/mg protein) compared to healthy pulp mean = 0.01 +/- 0.02 pg/mg protein). These data indicated that IL-6 was produced and released locally in the inflamed pulpal and periapical lesions.

Removal of intracanal smear by doxycycline in vitro

Cleansing and shaping result in a smear layer on the instrumented canal wall surfaces. The smear layer may inhibit close contact between sealers and dentin, and inhibits diffusion of medicaments.

OBJECTIVE

This study assessed the effect of doxycycline hydrochloride (DH) on smear layer on intracanal walls.

STUDY DESIGN

Scanning electron microscopy was used to evaluate the remaining smear layer using different concentrations of DH. Single-canal palatal roots of extracted maxillary molars were irrigated with saline-15% EDTA; saline-25 mg/ml DH; saline-50 mg/ml DH; saline-100 mg/ml DH; NaOCl-15% EDTA; NaOCl-25 mg/ml DH; NaOCl-50 mg/ml DH; and NaOCl-100 mg/ml DH. The roots were fractured into halves and the amount of smear layer assessed in the middle and apical third.

RESULTS

Doxycycline-HCl of 100 mg/ml was the most effective in removing smear layer. In the saline group, 100 mg/ml of DH was more effective than EDTA. In the hypochlorite group, 50 mg/ml and 100 mg/ml of DH were more effective than EDTA (p < 0.05).

CONCLUSION

Doxycycline solution may be an effective irrigant.

Effect of socioeconomic risk factors on the difference in prevalence of diabetes between rural and urban populations in Bangladesh

OBJECTIVE

To compare the prevalence of diabetes between the poor and rich of rural and urban populations in Bangladesh.

RESEARCH DESIGN AND METHODS

A total of 1,052 subjects from urban and 1,319 from rural communities (age > or = 20 years) of different socioeconomic classes were investigated. Capillary blood glucose levels, fasting and 2 h after a 75-g glucose drink (2-h blood glucose [BG]), were measured. Height, weight, waist, hips, and blood pressure were also measured.

RESULTS

Age-adjusted (30-64 years) prevalence of NIDDM was higher in urban (7.97% with 95% CI 6.17-9.77) than in rural subjects (3.84%, CI 2.61-5.07), whereas impaired glucose tolerance (IGT) prevalence was higher in rural subjects. In either urban or rural areas, the highest prevalence of NIDDM was observed among the rich, and the lowest prevalence was observed among the poor socioeconomic classes. The rural rich had much higher prevalence of IGT than their urban counterpart (16.5 vs. 4.4%, CI 6.8-17.4). Increased age was an important risk factor for IGT and NIDDM in both rural and urban subjects, whereas the risk related to higher BMI and waist-to-hip ratio (WHR) was less significant in rural than urban subjects. Using logistic regression and adjusting for age, sex, and social class, the urban subjects had no excess risk for NIDDM. In contrast, an excess risk for glucose intolerance (2-h BG > or = 7.8 mmol/l) was observed in the rural subjects.

CONCLUSIONS

Adjusting for age, sex, and social class, the prevalence of NIDDM among urban subjects did not differ significantly from that among rural subjects. Increased age, higher socioeconomic class, and higher WHR were proven to be independent risk factors for glucose intolerance in either area.

Prevalence of diabetes in a suburban population of Bangladesh

To determine the prevalence of diabetes and hypertension, 6847 subjects of age 15 years or older, were investigated in a suburban population in Bangladesh. Fasting and post-prandial (capillary) blood glucose (2-hPG) was estimated. According to WHO criteria the crude prevalence of impaired glucose tolerance (IGT) was 7.5% and non-insulin-dependent diabetes mellitus (NIDDM) was 4.1%. The age standardized (30-64 years) prevalence of IGT was 7.7% with 95% confidence interval (CI) 6.96-8.44 and NIDDM was 4.5%, CI 3.94-5.12. Compared with the younger subjects the older subjects (< 40 vs. > or = 40 years) showed significant association with IGT (chi2, 65.9; P < 0.001) and NIDDM (chi2, 92.0; P < 0.001). Higher BMI (< or = 22.0 vs. > 22.1) was also significantly associated with IGT (chi2, 16.6; P < 0.001) and NIDDM (chi2, 83.9; P < 0.001). The higher BMI had stronger association with NIDDM than with IGT. Lower height showed significant association only with NIDDM. The logistic regression analyses also showed that increased age, higher BMI and short stature were independent risks for NIDDM. The study showed an increased prevalence of IGT and NIDDM among the suburban population of Bangladesh and the excess risk was observed with increased age, higher BMI and short stature.

Biochemical alterations in inflammatory periodontal diseases I. Poly (ADP-ribose) synthetase activity in gingiva and gingival fibroblasts from humans with periodontitis

Periodontal diseases are characterized in part by generation of oxygen free radicals, which can cause breaks in cellular DNA strands. Repair of damaged DNA is dependent upon the synthesis of poly (ADP-ribose)(PADPR) catalyzed by PADPR synthetase, an enzyme known to be activated by the broken ends of DNA strands. We measured the activities of PADPR synthetase and of PADPR glycohydrolase, which degrades PADPRS, in gingival biopsy specimens from 16 sites with adult periodontitis and 12 clinically healthy control sites. The results indicated that sites with periodontitis displayed markedly reduced PADPR synthetase activity compared with healthy control sites, whereas PADPR glycohydrolase activity was not changed. The mean specific activity of PADPR synthetase for the diseased specimens was one-sixth of that of the healthy specimens (p < 0.001). The PADPR synthetase activity was negatively correlated with the Gingival Index (rs = -0.60), pocket depth (rs = -0.70) and bleeding upon probing (rs = -0.72). Cultured fibroblasts derived from clinically characterized healthy and diseased gingival sites reflected similar patterns of enzyme activity. The mean specific activity of PADPR synthetase for the diseased-site cultures (n = 9) was 56 +/- 7% (p < 0.001) of the cultures from healthy control sites (n = 6). These results suggest that a reduced level of PADPR synthetase activity is associated with increased inflammation and periodontal destruction, and that the ability to synthesize PADPR is compromised in adult periodontitis.

Lactate stimulation of macrophage-derived angiogenic activity is associated with inhibition of Poly(ADP-ribose) synthesis

Injury and inflammation lead to hypoxia and elevated lactate in wounds. This redox environment establishes cells in a reparative phenotype and leads macrophages to release angiogenic substances by unclear mechanisms. We investigated compounds known to modulate polyadenosine diphophoribose (pADP-R) levels in their effect on macrophage-derived angiogenic activity. Macrophages cultured from rabbit bone marrow were exposed to lactate, nicotinamide, and/or beta-nicotinamide adenine dinucleotide (NAD+). Supernatants were assayed for angiogenesis, and macrophages were analyzed for NAD+ content, poly(ADP-ribose) synthetase activity, and total (ADP-ribose)n synthesis. Lactate-, nicotinamide-, and lactate and nicotinamide-treated macrophages elicited significantly increased angiogenic activity compared with control or NAD+-treated cells. Lactate treatment decreased NAD+ content by 42 +/- 4% and (ADP-ribose)n synthesis by 37 +/- 5%. Nicotinamide reduced poly(ADP-ribose) synthetase activity and poly(ADP-ribose) synthesis. Thus, macrophage-derived angiogenic activity may be mediated by the redox environment involving NAD+ metabolites.

Decreased signal intensity of cerebral cortex on T2-weighted MR images

To define the frequency of decreased signal intensity (DSI) in cerebral cortex on T2-weighted images relative to aging and to the incidence of identifying white matter pathology, T2-weighted MR brain images of 906 patients consecutively examined between July 1989 and June 1991 were reviewed. MR images of cerebral cortex were divided into five areas: frontal lobe (F), pre- and postcentral gyri (C), parietal lobe (P), occipital lobe (O) and temporal lobe (T). Each area was separately and independently evaluated for the presence or absence of DSI. The frequency of DSI in each area was plotted against patients' ages. The severity of leukoaraiosis was evaluated in relation with DSI in each cortical area. Patients with DSI in area F numbered 61 (5.7%), in area C 236 (26.0%), in area P 174 (15.9%), in area O 428 (47.2%), and in area T 10 (1.1%). The number of patients with DSI in each area increased with age. The greater the severity of leukoaraiosis, the greater the chance of finding DSI of the cerebral cortex. The incidence of DSI in the cerebral cortex increased with the patient's age as well as with the severity of co-existent white matter pathology.

MRI of white matter changes in the Sjögren-Larsson syndrome

We report a case of Sjögren-Larsson syndrome with spastic diplegia and conduction aphasia. MRI demonstrated the white matter changes deep in the cerebral hemispheres. We analyse the MRI findings and compare the results with neuropsychological signs.

Prevalence of diabetes and hypertension in a rural population of Bangladesh

OBJECTIVE--To determine the prevalence of non-insulin-dependent diabetes mellitus (NIDDM), impaired glucose tolerance (IGT), and hypertension in a rural community of Bangladesh. RESEARCH DESIGN AND METHODS--A cluster sampling of 1,005 subjects > 15 years of age in the rural community of Dohar was investigated. Capillary blood glucose of fasting and 2 h after 75 g oral glucose (2hBG) were estimated. World Health Organization criteria were used for diagnosis of NIDDM and IGT. Blood pressure, height, and weight were also measured. RESULTS--The crude prevalence of NIDDM was 2.1% (men 3.1, women 1.3%) and IGT was 13.3% (men 14.4, women 12.4%). Age-adjusted (30-64 years of age) prevalence was 2.23% (95% confidence interval [CI] 1.01-3.45) for NIDDM and 15.67% (95% CI 12.59-18.75) for IGT. Prevalence of hypertension with systolic blood pressure (sBP) > or = 140 mmHg was 10.5% and with diastolic blood pressure (dBP) > 90 mmHg was 9.0%. Increased age was the risk factor for NIDDM, IGT, and hypertension; whereas increased BMI showed inconsistent association with them. Relative risk for sBP with higher BMI ( < 22.0 vs. > or = 22.1) was 1.94 with CI 1.55-2.43 and for dBP it was 2.2 with CI 1.40-3.46. Correlation of sBP was significant with age, BMI, and 2hBG. Similar correlation was also observed with dBP. CONCLUSIONS--High prevalences of NIDDM, IGT, and hypertension were observed among rural subjects. Increased age was shown to be an important risk factor for all these disorders, whereas BMI-associated risk was significant with NIDDM and hypertension but not with IGT.

Blood pressure and glycemic status in relation to body mass index in a rural population of Bangladesh

A cluster sampling of five villages in Dohar thana were selected for screening of hypertension and diabetes in relation to age structure and body habitus. All the subjects over 15 years of age were enlisted for investigation. The response rate was more than 70%. Height, weight, blood pressure (BP) and capillary blood glucose (fasting and 2-hPG) were measured. Diagnostic criteria of international standard were used for hypertension and diabetes. Out of 1005 participants 106 subjects (10.5%) had systolic blood pressure (sBP) more than 140 mmHg and 9% of them had diastolic blood pressure (dBP) more than 90 mmHg. The prevalence of non-insulin-dependent diabetes mellitus (NIDDM) was 2.1% and impaired glucose tolerance (IGT) was 13.3%. The mean body mass index (BMI) of men was 20.39 (SD = 2.91) and that of women was 20.11 (SD = 2.92), having no significant difference between them. Increased age (> or = 50 yr), high BMI (> or = 23.0) and hyperglycemia (2-hPG > 7.8 mmol/L) were the risk factors for both systolic (sBP > 140 mmHg) and diastolic (dBP > 90 mmHg) hypertension. Likewise, increased age, high BMI and hypertension showed significant association with glucose intolerance. Moreover, significant correlations were observed between age and BP (sBP, r = 0.328 p < 0.001; dBP, r = 0.187 p < 0.001) BMI and BP (sBP, r = 0.193 p < 0.001; dBP, r = 0.192 p < 0.001) and 2-hPG and BP (sBP, r = 0.188 p < 0.001; dBP, r = 0.134 p < 0.001).

Alterations of fibroblast metabolism in early ligature-induced periodontitis in the cynomolgus monkey

Cellular and biochemical observations were made of fibroblasts harvested from ligature-induced periodontitis and treated gingivitis areas in four adult female cynomolgus monkeys (Macaca fascicularis) to define the changes that occur in the early periodontitis lesion. Compared with fibroblasts from the treated sites, fibroblasts from the diseased areas had a significantly higher rate of proliferation, produced about two-thirds the amount of total protein and collagen, and failed to respond to TGF-beta, which normally stimulates extracellular matrix formation in mesenchymal cells. The diseased cells were also deficient in the activity of poly(ADP-ribose) synthetase, an enzyme involved in the repair of DNA breaks such as occur from the insults of superoxide and other active radicals present in inflamed areas. Although the precise nature of these biochemical defects is not fully elucidated, they may have an important bearing on chronic periodontitis cases with a "downhill" course.

Can wound healing be a paradigm for tissue repair?

This paper is written in the hope, if not the conviction, that it will be helpful to investigators of muscle physiology and development. Its thesis is that cell growth, connective tissue matrix deposition, and angiogenesis are stimulated in wounds in response to NAD+ depletion caused by a burst in lactate generation. We surmise that muscle development may also involve this metabolic control.

A study of chondroitin sulfate iron colloid as a liver specific MR contrast agent

Chondroitin sulfate iron colloid (CSIC) is a therapeutic agent for iron deficiency anemia. The potential of CSIC to decrease liver signal intensity at magnetic resonance (MR) imaging has already been tested. Enhanced detection of liver carcinoma by CSIC at MR imaging was studied in vivo. Our purpose was to determine the time period required to obtain the maximum contrast enhancement from CSIC at different dose levels. We performed MR imaging of eight rats with hepatic carcinoma before and after CSIC administration. For all dose groups it was found that on T2-weighted images the maximum contrast to noise ratio (C/N) was at 4-8 hours after the drug administration, while on proton density-weighted images the maximum C/N was at 2-8 hours.

Multilocular cystic hemangioma: CT and MR appearance

An atypical case of multilocular cystic hemangioma is presented. A 4.5 cm multilocular cystic mass was incidentally found in a 66-year-old healthy woman on ultrasound screening. CT, MR imaging, and angiography were performed: however, the features that are characteristic of cavernous hemangioma were not obtained. The final diagnosis could not be made until surgery.

Clinical and light microscopic observations of gingivitis and early ligature-induced periodontitis in the cynomolgus monkey

Clinical and histological observations were made on gingivitis and ligature-induced periodontitis in 4 adult female cynomolgus monkeys (Macaca fascicularis) to define the changes occurring in the early periodontitis lesion. Silk ligatures were tied around selected posterior teeth and replaced weekly for 4 weeks. The changes from gingivitis to periodontitis induced by ligation, and back to a state of clinical health after ligature removal, scaling and polishing, were characterized by Plaque Index, Gingival Index, probing pocket depth, attachment loss, and histologic evaluation. A mild, chronic marginal gingivitis was the normal finding in the gingiva of posterior teeth. The inflammatory infiltrate in the connective tissue contained primarily lymphocytes. Hygienic measures once a week reduced the amount of infiltrate and the epithelial proliferation, but did not eliminate it. Placement of silk ligatures rapidly changed the clinical picture to a moderate or severe gingivitis, which presented an almost bizarre response of sulcular and oral epithelium, with an increase in polymorphonuclear neutrophil infiltration. Within 2 weeks there was significant probing attachment loss. The clinical response on removal of ligatures and plaque was almost as rapid as the onset. The animal model is useful for manipulating variables in ways not possible in the study of human periodontitis.

Detection of interleukin-1 beta in human periapical lesions

Interleukins are involved in modulating bone cell activity. Interleukin-1 (IL-1) has been shown to be potent stimuli of bone resorption in organ culture. This hormone-peptide is produced primarily by monocytes and macrophages. Diverse inflammatory cell types are clearly present in periapical lesions. The purpose of this study was to detect IL-1 beta activity in human periapical lesions. Eight human periapical lesions were examined for the presence of IL-1 beta. Pulp tissue of clinically impacted teeth were used as controls. Each specimen was quick-frozen and stored in liquid nitrogen. IL-1 beta activity was measured with, an IL-1 beta enzyme-linked immunosorbent assay that used monoclonal antibodies specific for IL-1 beta. Periapical samples exhibited significant activity of IL-1 beta (mean 604.4 +/- 563.0 pg/mg protein), whereas normal pulp had no activity. These results demonstrate that IL-1 beta is produced and released locally in inflammatory periapical lesions to mediate bone resorption.

Inhibition of prolyl hydroxylase by poly(ADP-ribose) and phosphoribosyl-AMP. Possible role of ADP-ribosylation in intracellular prolyl hydroxylase regulation

Poly(ADP-ribose) prepared by incubating NAD+ with rat liver nuclei inhibited the hydroxylation reaction catalyzed by purified prolyl hydroxylase (proline,2-oxoglutarate dioxygenase, EC 1.14.11.2) in vitro. Near complete inhibition of the enzyme was seen in the presence of 6 nM (ADP-Rib)18 with a Ki(app) of 1.5 nM. The monomer unit of poly(ADP-ribose), adenosine diphosphoribose (ADP-Rib), was found to be a weak inhibitor. On the other hand, poly(ADP-ribose)-derived phosphoribosyl-AMP (PRib-AMP) and its dephosphorylated product, ribosyl-ribosyl-adenine (Rib-RibA), inhibited the enzyme in nanomolar concentrations (Ki(app) 16.25 nM). The order of inhibition was (ADP-Rib)18 greater than PRib-AMP, Rib-RibA much greater than ADP-Rib. These results suggested that the 1"----2' ribosyl-ribosyl moiety in these compounds was involved in the inhibition of the enzyme. The possibility that intracellular prolyl hydroxylase is regulated by the involvement of ADP-ribosylation reactions was examined in confluent cultures of skin fibroblast treated with 20 mM lactate. The activity of prolyl hydroxylase was stimulated by 145% over that of untreated cultures. In the lactate-treated cells, the level of NAD+ was lowered and the total ADP-ribosylation of cellular proteins reduced by 40%. These observations imply that the lactate-induced activation of cellular prolyl hydroxylase is mediated by a reduction in ADP-ribosylation and that the synthesis and degradation of ADP-ribose moiety(ies) may possibly regulate prolyl hydroxylase activity in vivo.

Increased prolyl hydroxylase activity and collagen synthesis in hepatocyte cultures exposed to superoxide

Primary monolayer cultures of rat hepatocytes at confluence were exposed to an exogenously added source of superoxide, and its influence on collagen synthesis was examined. Superoxide was generated by the addition of dihydroxyfumarate to the culture medium. Exposure of hepatocytes to dihydroxyfumarate greatly stimulated the activity of prolyl hydroxylase and the synthesis of collagen. A significant increase in prolyl hydroxylase activity was observed with 5 micrograms per ml dihydroxyfumarate in 24 hr relative to that in the untreated cultures. Maximum stimulation of greater than 3-fold compared to the control value was elicited by 25 micrograms per ml dihydroxyfumarate. When scavengers of superoxide such as superoxide dismutase and Cu(Lys)2 were added in the medium, the increase in prolyl hydroxylase activity induced by dihydroxyfumarate was nearly abolished. Experiments with actinomycin D indicated that synthesis of new RNA was involved in the stimulation of prolyl hydroxylase activity. Analysis of collagen synthesis in cultures exposed to dihydroxyfumarate also showed a marked increase compared to that of the untreated cultures. The presence of superoxide dismutase in the medium significantly reduced the increase in collagen synthesis. Our results indicate that superoxide mediates the stimulation of collagen synthesis in hepatocytes. These findings may provide a possible explanation for excess collagen formation during induced liver fibrosis.

Poly(ADP-ribose) synthetase activity during bleomycin-induced lung fibrosis in hamsters

Bleomycin damages cellular DNA and is a potent inducer of pulmonary fibrosis. It has been shown to act through a superoxide-mediated mechanism. We are interested in determining the biochemical mechanisms involved in fibrosis and in this preliminary study we have examined the temporal relationship between early biochemical events associated with DNA damage and fibrosis, in lungs of hamsters after administration of 0.75 unit of bleomycin. The activities of poly(ADP-ribose) synthetase, an enzyme associated with DNA repair, inducible superoxide dismutase (SOD) and prolyl hydroxylase as well as the tissue levels of NAD+ and hydroxyproline in the lung were determined. All three enzyme activities expressed as per milligram DNA or per lung, increased upon bleomycin treatment over the saline-administered controls. Lung poly(ADP-ribose) synthetase activity which is sensitive to DNA breaks, increased first (24% over control in 1 day, P less than 0.0001), attained the maximum value on the 5th day (952% over control, P less than 0.0001), and started to decline thereafter and approached near the control value on 14th day. Bleomycin treatment induced a rapid change in the level of lung NAD+. After 1 day the level of NAD+ was reduced by 42% compared to the control (P less than 0.001), further declined to 65% (P less than 0.001) on the 3rd day, and stayed at that level until the 7th day. On the 14th day, however, the NAD+ level was still lower (29%, P less than 0.05) but approaching the value in the control animals. The activity of prolyl hydroxylase showed significant increase on the 3rd day (50% over control, P less than 0.0001) after bleomycin administration. The enzyme activity continued to increase until the end of the experiment (490% of control, P less than 0.0001, on Day 14). The content of undialyzable hydroxyproline, a marker for collagen, was also increased significantly in the lung tissue on the 3rd day (30% over control, P less than 0.05), continued to increase and reached the highest level on the 14th day (71% over control, P less than 0.001). A significant increase in the activity of SOD (19% over control, P less than 0.001) was seen on the 5th day which continued to increase and attained the highest value on Day 14 (115% over control, P less than 0.0001).(ABSTRACT TRUNCATED AT 400 WORDS)

Stimulation of poly(ADP-ribose) synthetase activity in the lungs of mice exposed to a low level of ozone

Toxic effects of O3 are mediated through the formation of free radicals, which can cause DNA strand breaks. Cellular DNA repair is dependent upon the formation of poly(ADP-ribose) (polyADPR) catalyzed by polyADPR synthetase. In order to evaluate whether O3 exposure inflicted DNA damage in lung tissue, we measured the activity of polyADPR synthetase (known to be activated in response to DNA damage) in mouse lungs after exposure to 0.45 ppm (882 micrograms/m3) O3 for up to 7 days. The enzyme activity was stimulated with O3 exposure relative to unexposed controls, showing a 20% (P less than 0.05) increase at Day 5 and 42% (P less than 0.001) at Day 7 of O3 exposure. In addition, the activity of superoxide dismutase (SOD), known to be stimulated in response to production of superoxide anion (.O2-), was measured as an indicator of free radical involvement. Relative to unexposed controls, the SOD activity in exposed animal lungs increased to the peak level at Day 5 (48%, P less than 0.001) and then declined at Day 7 of O3 exposure but was still higher than controls (17%, P less than 0.05). When animals, after 5 days of O3 exposure, were allowed to recover in filtered room air, the activities of both enzymes declined to their respective control values in 6 days. These results suggest a possible temporal relationship between O3 injury and the activities of polyADPR synthetase and a free radical scavenging enzyme, SOD. The stimulation of polyADPR synthetase activity with O3 exposure, reflecting a response to lung cellular DNA repair, may be a sensitive indicator for assessing DNA damage in oxidant injury.

Increased aryl hydrocarbon hydroxylase and prolyl hydroxylase activities in lung organ cultures exposed to benzo[a]pyrene

Exposure of neo-natal rat lungs in organ culture to 10--25 microM benzo[a]pyrene (BaP) elevated the activities of aryl hydrocarbon hydroxylase (AHH) and prolyl hydroxylase (PH). Pyrene, a non-carcinogenic hydrocarbon did not elicit this response. Prolyl hydroxylase is an indicator of collagen synthesis and increased PH activity in the lungs reflects increased collagen synthesis. Our studies suggest that the earliest events in BaP-induced lung injury may include altered collagen metabolism.

Macromolecular synthesis in organ cultures of neonatal rat lung

Organ cultures of newborn rat lungs synthesize and accumulate DNA, RNA, collagen and noncollagenous proteins almost at a linear rate for at least 5 days. During this period the synthesis of collagen consistently exceeds the synthesis of noncollagenous proteins in a pattern similar to neonatal lung growth in vivo. Although some morphological characteristics of lung architecture are distorted after culture, fundamental structural similarities to lungs growing in intact animals are retained. When these cultures are maintained in atmospheres rich in oxygen, increased collagen synthesis is observed, a response similar to that of lungs in intact animals exposed to high oxygen concentrations in vivo. Our studies suggest that lung organ cultures may be a suitable system for investigating the biochemical aspects of lung tissue-environmental interaction.

Ozone interaction with rodent lung. III. Oxidation of reduced glutathione and formation of mixed disulfides between protein and nonprotein sulfhydryls

Nonprotein sulfhydryls (NPSH), a major source of cellular reducing substances, were examined in lung tissue after short-term exposure of rats to O3. While the NPSH level was unaffected by low-level exposures (e.g., 0.8 ppm for up to 24 h or 1.5 ppm for up to 8 h), it was significantly lowered by higher exposure regimens (e.g., 25 per cent after 2 ppm for 8 h and 49 per cent after 4 ppm for 6 h). After exposure to 4 ppm O3 for 6 h the level of reduced glutathione (GSH), which accounted for approximately 90 per cent of NPSH in the lung, decreased 40 per cent but without a rise in the level of oxidized gluathione (GSSG). Treatment of lung homogenate with borohydride led to recovery of NPSH in exposed lungs to control values, suggesting that NPSH or GSH oxidation during in vivo O3 exposure resulted in formation of mixed disulfides with other sulfhydryl (SH) groups of lung tissue. Extracts of borohydride-treated particulate and supernatant fractions of lung homogenate were analyzed for NPSH by paper chromatography. From this analysis GSH appeared to be the only NPSH bound to lung tissue proteins via mixed disulfide linkage. The formation of mixed disulfides appeared to be a transient phenomenon. Immediately after a 4-h exposure to 3 ppm O3 the level of mixed disulfides was small (15 per cent of the total NPSH) but attained a peak (equivalent to 0.6 mumol NPSH/lung) after a recovery for 24 h. However, the level diminished considerably within 48 h of recovery.

Aplastic anemia associated with lithium therapy

A case is reported of fatal aplastic anemia developing in a 50-year-old woman who received lithium carbonate in the generally accepted dosage for a manic-depressive disorder. The serum lithium had been determined at regular intervals and never exceeded what is considered a safe level. Patients for whom lithium is prescribed should have periodic hematologic examinations.

Effect of shape of medication in treatment of anxiety states

In the clinical evaluation of drug treatment, medical practitioners have long appreciated the fact that the response does not merely reflect the pharmacological effect of the drug. The manner in which the treatment is presented to the patient by his therapist is important and there is ample proof in the literature of the therapeutic effects of inert substances—the so-called placebo effects (1, 2). In psychiatric practice particularly, the halo effects of such factors are of considerable importance.