Neurosurgery in Saudi Arabia: Navigating Through Future Pathways and Students' Perspectives.

BACKGROUND: Neurosurgery is a surgical discipline that demands comprehensive knowledge in other specialties. It is regarded as one of the most competitive specialties. However, there is a new trend toward considering life-style friendly specialties. Therefore, this study aims to assess the neurosurgery perception and identify potential factors influencing such attitudes. METHODS: An observational, survey-based study was conducted on medical students at the College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia. An online-based questionnaire was administered to the participants. It consisted of 2 main parts: the first part collected demographic data, while the second part included 20 Likert scale-based questions. Pearson's χ2 test was utilized, with statistical significance set at P < 0.05. RESULTS: A total of 305 medical students from various academic years participated in the questionnaire survey, with nearly an equal gender distribution. Remarkably, a significant majority (76.72%) expressed uncertainty or disagreement regarding the adequacy of neurosurgery education during their medical studies. While a substantial portion of participants (69.5%) found neurosurgery intriguing, almost half (47.87%) indicated that they would not pursue it as their future specialty. The consideration of neurosurgery as a career path showed statistically significant differences in relation to both gender and academic year (P = 0.009 and P < 0.001, respectively). CONCLUSIONS: This study emphasizes how gender and academic year affect choosing neurosurgery as a career but notes limitations like self-reporting bias and a single-institution scope, which may affect generalizability. Future research might consider national summer training programs to engage more students in neurosurgery.

Developing the Mansoura Early Feeding Skills Assessment Scale for Preterm Infants.

Purpose: This study aimed to develop a new bedside scoring system scale that assesses preterm infants' oral feeding skills (OFS) in the neonatal intensive care unit (NICU). Methods: A literature review and critical appraisal of available oral feeding assessment tools/scores were performed. Subsequently, we developed the "Mansoura Early Feeding Skills Assessment" (MEFSA) scale, an 85-item observational measure of oral feeding skills with three main sections. Forty-one preterm infants who did not receive oral feeding but were clinically stable enough to initiate oral feeding were included in the study. Next, we applied and interpreted the MEFSA to describe and score their feeding skills. Results: Applying the MEFSA resulted in a smooth feeding transition, early start of oral feeding, full oral feeding, and discharge with a shorter period of tube feeding in preterm infants. Conclusion: The MEFSA is a successful bedside scoring system that assesses the OFS of preterm infants in the NICU.

Localization of composite prosthetic feet: manufacturing processes and production guidelines.

Amputation levels in Egypt and the surrounding neighborhood require a state intervention to localize the manufacturing of prosthetic feet. Amputations are mainly due to chronic diseases, accidents, and hostilities' casualties. The prosthetic foot type is traditionally classified according to the number of axial rotational movements, and is recently classified according to the energy activeness of the foot. The localization of this industry needs a preliminary survey of the domestic technological levels with respect to the foot type. Upon the results of this survey, the energy storage response foot has appealing metrics to proceed with its manufacturing. A prototype manufacturing chain is designed and a set of these feet with a certain commercial size of 27 is manufactured. Resin impregnation technology for carbon fiber composites is followed in this work. The feet are tested according to ISO 22,675. Based on the dimensional and mechanical results, a manufacturing value chain is proposed with the prospective resin transfer molding technology. This value chain will guarantee the required localization as well as the natural growth of this value chain with all related activities like accreditation of practices as well as manpower certification.

Diagnosis of Oral Squamous Cell Carcinoma Using Deep Neural Networks and Binary Particle Swarm Optimization on Histopathological Images: An AIoMT Approach.

Overall prediction of oral cavity squamous cell carcinoma (OCSCC) remains inadequate, as more than half of patients with oral cavity cancer are detected at later stages. It is generally accepted that the differential diagnosis of OCSCC is usually difficult and requires expertise and experience. Diagnosis from biopsy tissue is a complex process, and it is slow, costly, and prone to human error. To overcome these problems, a computer-aided diagnosis (CAD) approach was proposed in this work. A dataset comprising two categories, normal epithelium of the oral cavity (NEOR) and squamous cell carcinoma of the oral cavity (OSCC), was used. Feature extraction was performed from this dataset using four deep learning (DL) models (VGG16, AlexNet, ResNet50, and Inception V3) to realize artificial intelligence of medial things (AIoMT). Binary Particle Swarm Optimization (BPSO) was used to select the best features. The effects of Reinhard stain normalization on performance were also investigated. After the best features were extracted and selected, they were classified using the XGBoost. The best classification accuracy of 96.3% was obtained when using Inception V3 with BPSO. This approach significantly contributes to improving the diagnostic efficiency of OCSCC patients using histopathological images while reducing diagnostic costs.

Maternal alloxan exposure induces damage in rat offspring lumbar vertebrae and protective role of arachidonic acid.

BACKGROUND: Vertebral abnormalities in offspring of diabetic mothers make major challenges worldwide and were not sufficiently studied before. AIM: To investigate the effects of alloxan-induced diabetes on rats' lumbar vertebrae, and to assess the potential beneficial impact of arachidonic acid. MATERIALS AND METHODS: Pregnant rats were randomly equally divided into four groups: control, alloxan-induced diabetes received alloxan injection 150 mg∕kg, alloxan + arachidonic acid group received arachidonic acid 10 µg∕animal then given alloxan injection, and arachidonic acid group received it, until offspring age of three weeks. Six male offspring from each group were included in this study at ages of newborn, three-week-old, two-month-old, and their body measurements were recorded. Lumbar vertebrae and pancreas specimens were examined by light microscopy, morphometry, transmission electron microscopy (TEM), and immunohistochemistry for insulin expression. RESULTS: In alloxan-induced diabetes newborn, three-week-old, and two-month-old rats, body measurements were significantly declined, histomorphometry of 6th lumbar vertebrae revealed disorganized chondrocytes, with vacuolated cytoplasm, empty lacunae, diminished matrix staining, with areas devoid of cells. TEM showed shrunken reserve and proliferative cells, with irregular nuclei, and damaged mitochondria. In contrast, alloxan + arachidonic acid group had cytoarchitecture of lumbar vertebrae that were like control group. Histomorphometry of pancreas in alloxan-induced diabetes group showed significant reduction in pancreatic islets number and surface area, damaged pancreatic islet cells appeared atrophied with apoptotic nuclei, and very weak insulin immunostaining. Whereas alloxan + arachidonic acid group displayed healthy features of pancreatic islets, which resembled control group, with strong insulin immunostaining. CONCLUSIONS: Arachidonic acid mitigated alloxan-induced diabetes by its antidiabetic activity.

Control System Development and Implementation of a CNC Laser Engraver for Environmental Use with Remote Imaging.

This article is aimed at studying the features of the control systems development for a small-sized Computer Numerical Control (CNC) portative laser engraver. The CNC is implemented in mobile maintenance and repair platforms for remote sensing of the environment where the wild environment may not allow us to access the animals and places. The proposed work in this paper is based on recent research, which shows that applying the automated CNC speeds up the processes of repair, modernizes the equipment size, and significantly reduces the economic costs; accordingly, the authors developed a block diagram of a portable CNC laser engraver. The choice of the hardware was also made, taking into account the possibility of quick replacement in the field, which reduces the repair time and the cost of the developed layout. A control system based on the selected modules was synthesized, and a stability check was carried out using MatLab tools. To check the correctness of the developed control system, the authors developed and assembled an experimental layout to illustrate the results of engraving on such a layout. Finally, the stability and sensitivity of the proposed system have been obtained and proved that the system works in a comfortable zone of stability. The obtained results show that the proposed CNC laser engraver has achieved the expected improvements (high speed, small size, short production and repairing time, minimum human influence factor, and achieving a better outcome).

Posterior pharyngeal wall augmentation in post-adenoidectomy velopharyngeal insufficiency.

PURPOSE: To assess the efficacy of posterior pharyngeal wall augmentation using septal or conchal cartilages with other bulks-according to the persistent gap and the individual anatomy of each patient-in improving velopharyngeal function in patients who acquired persistent velopharyngeal insufficiency (VPI) post-adenoidectomy. METHODS: Observational descriptive prospective case series of 24 patients (their ages ranged between 3 and 26 years) who developed persistent VPI post-adenoidectomy (more than 3 months) although they had normal speech resonance before adenoidectomy. RESULTS: The present study demonstrated that statistically significant improvement in auditory perceptual assessment (APA) was found regarding all obligatory speech disorders and unintelligibility of speech. Significant improvement was observed in the degree of velar mobility, size of the persistent gap, and the gap distance between velum and posterior pharyngeal wall at rest and during phonation in post-operative evaluation versus pre-operative. A significant change was observed in the closure pattern of the velopharyngeal port (VPP) as all patients turned to coronal closure. CONCLUSIONS: Posterior pharyngeal wall augmentation could be used in VPI post-adenoidectomy up to 7 mm and lead to better speech outcomes. Also, it revealed that using conchal and/or septal cartilage as a graft regardless of the patient's age is a safe procedure.

Electronic User Authentication Key for Access to HMI/SCADA via Unsecured Internet Networks.

This paper discusses the development of new hardware and software for protecting access to HMI/SCADA systems via Unprotected Internet Networks (UPN), mainly when working remotely with confidential information. Based on the analysis carried out, it is shown that the existing vulnerabilities can be exploited by cybercriminals to steal passwords and user authentication logins. Modern protection technologies based on the OTP method have been investigated. Moreover, a new concept of information security for user authentication in UPNs when working with information remotely is proposed. The structure of the electronic key and the connection diagram based on the selected hardware modules have been developed. In addition, the two-level user identification algorithms and the firmware program code for the ATmega32U4 microcontroller are considered. Finally, to show the reliability and stability of the of the developed electronic user authentication key against any unexpected software hacking, a number of experiments have been performed.

Coblation supraglottoplasty: a ten-year experience in a tertiary referral hospital.

PURPOSE: The present study aims to review the outcomes of coblation supraglottoplasty performed for children with different types of laryngomalacia, and we discuss the factors affecting these outcomes. METHODS: We retrospectively reviewed the medical records of laryngomalacia patients admitted to the Otorhinolaryngology Department, Mansoura University, from 2010 to 2020. We examined the patient's demography, symptoms, comorbidities, type of laryngomalacia, oxygen saturation, and final outcomes. RESULTS: Our study included 235 patients; 122 patients responded to medical therapy, while 113 underwent surgical management. There is a significant relation between the types and therapy they underwent (p ≤ 0.001). Larger percentage within type I underwent medical therapy. There is a statistically significant difference between the studied groups regarding age at surgery. On pairwise comparison, patients with type II had the lowest age significantly at the surgery when compared with each other individual group (p ≤ 0.001). On multivariate regression analysis, the presence of comorbid congenital heart disease, neurological comorbidities significantly increased the risk of failure of surgical intervention by 17.32 and 5.803 folds, respectively. CONCLUSIONS: Coblation supraglottoplasty is effective and safe to treat severe laryngomalacia. Different morphological types of laryngomalacia require slight surgical variations of coblation supraglottoplasty. The presence of comorbid congenital heart disease, neurological comorbidities significantly increased the risk of failure of surgical intervention.

Antioxidant and cytoprotective effects of Nigella sativa L. seeds on the testis of monosodium glutamate challenged rats.

Monosodium glutamate (MSG) is one of the most widely spread food additives that might cause male infertility. However, Nigella sativa L. seeds (NSS) could provide a solution. This study was designed to investigate the potential effects of NSS on rats ingesting MSG. To achieve this aim, adult male albino rats were randomly equally assigned into three groups for 21 days: control group received no treatment, MSG group received MSG as 30 g/kg feed, and MSG + NSS group received MSG as 30 g/kg and NSS as 30 g/kg feed. Testis histomorphometry showed marked deterioration by MSG as atrophic seminiferous tubules with degeneration of their lining cells, damaged Leydig cells and decreased germ cells number. Periodic Acid Schiff stain indicated irregular interrupted basement membranes. Glutathione reductase, superoxide dismutase 2 (SOD2), and caspase-3 immuno-expressions increased in testicular cells. Testosterone levels were significantly decreased in MSG challenged rats along with significant increase in luteinizing hormone levels, whereas NSS normalized this hormonal profile. MSG exposure also caused significantly increased lipid peroxides (LPO), glutathione-S-transferase, and total antioxidant capacity (TAC) whereas nitric oxide and SOD2 were significantly decreased. NSS succeeded in rebalance LPO and TAC and ameliorated the histoarchitectural disturbances. NSS mitigated MSG-induced testicular impairment by its antioxidant and cytoprotective activities.

Is serum endocan a sensitive biomarker for early recurrence of hepatocellular carcinoma after radiofrequency ablation?

BACKGROUND AND AIM OF THE WORK: Hepatocellular cancer (HCC) is one of the common liver cancers and considered to be the sixth most commonly occurring cancer in the world and the second leading cause of death among cancer patients. More recent studies on HCC showed that the elevated serum endocan level was a predictive factor of recurrence after radiofrequency ablation. The aim of this study is to evaluate the serum endocan level as a prognostic biomarker for recurrence of HCC after percutaneous radiofrequency ablation. PATIENTS AND METHODS: Analytic-prospective study was carried out in Suez Canal University Hospitals. The study was carried out on 80 patients classified into three groups: group 1 (control group) consisted of 20 apparently healthy persons; group 2 consisted of 20 patients with liver cirrhosis; and group 3 consisted of 40 treatment-naive HCC patients who were prepared for radiofrequency ablation. All HCC patients (who were confirmed to have complete ablation after RF) were followed up by using triphasic abdominal CT, serum AFP and serum endocan assessment at 3 and 6 months after radiofrequency ablation. RESULTS: Our study revealed a high level of serum endocan in the HCC group with a statistically significant difference (<0.001) between the three groups. HCC patients had a higher level of serum endocan (6.2 ± 2.25) followed by an liver cirrhosis group (2.0 ± 1.29) and then the control group (1.0 ± 0.3). The serum endocan level had a positive correlation with recurrence of HCC (P < 0.0001). There was a positive correlation between serum endocan and serum alanine transferase (P = 0.02), and a positive correlation between serum endocan and the number of tumors (P = 0.01). CONCLUSION: Serum endocan is considered as a prognostic biomarker for tumor recurrence in HCC patients after radiofrequency ablation.

Is Doppler/Dopplex ultrasonography reliable in the assessment of percutaneous ablative therapies of hepatocellular carcinoma: a prospective cross-sectional study.

INTRODUCTION: After hepatocellular carcinoma (HCC) interventional therapies, noninvasive vascular diagnostic imaging [duplex, Color/power Doppler ultrasonography, and triphasic computed tomography (CT)] determines the lesion complete/incomplete ablation. The aim was to analyze the usefulness of duplex, color/power Doppler ultrasonography in HCC ablation after percutaneous ablative therapies (PATs). METHODS: We included 30 patients with 33 HCCs subjected to duplex/Doppler ultrasonography, ultrasound-guided fine-needle aspiration cytology (FNAC), and triphasic CT, all these before and after PATs. RESULTS: One week after treatment ended, out of 21 lesions with pretreatment positive color-Doppler, signals disappeared in 19 (90.5%) lesions. Out of 29 lesions with pretreatment positive power-Doppler, signals disappeared in 24 (82.8%). Out of 13 lesions with pretreatment intralesional power/duplex arterial signals, signals disappeared in eight (61.5%). There was a significant correlation (P < 0.05) between power-Doppler arterial signals and FNAC. Before HCC ablation, power-Doppler demonstrated a sensitivity 40% and specificity 96% in HCC detection in relation to FNAC, it had a sensitivity 60% and specificity 85% in HCC detection compared to triphasic CT. After HCC ablation, power-Doppler had a sensitivity and specificity of 100% in viable malignancy detection in relation to FNAC. Power-Doppler had a sensitivity 89% and specificity 93% in residual malignancy detection in relation to triphasic CT. CONCLUSION: Power-Doppler is a good positive test as intralesional arterial signals in a cirrhotic liver lesion is highly suggestive of HCC. Power-Doppler was sensitive in HCC ablation assessment in pretreatment positive cases only. Both triphasic CT and duplex/Doppler are complementary and the use of different diagnostic modalities after ablation is mandatory.

Effects of Ginko biloba leaf extract on the neurogenesis of the hippocampal dentate gyrus in the elderly mice.

Aging is associated with reduced hippocampal neurogenesis, which may in turn contribute to cognitive impairment. We assessed the effect of Ginkgo biloba (Gb) on hippocampal neurogenesis in elderly male mice using immunohistochemistry. We used anti-caspase-3 as a marker of apoptosis, anti-GFAP as a marker of neural stem cells, anti-Ki-67 as a specific marker for cellular proliferation and anti-doublecortin (DCX) to detect newly born neurons in the hippocampal dentate gyrus (DG) of aged male mice. The 24-month-old male mice were divided into two groups: a control group treated with distilled water and a group fed with Gb at a dose of 100 mg/kg once daily for 28 days. A sharp decrease in apoptotic cells in Gb-treated compared to nontreated mice was observed by anti-csapase-3 immunostaining. A large number of GFAP+ve cells was found in the subgranular zone of the DG of Gb-treated mice, suggesting an increase in the pool of neural stem cells by Gb treatment. There was also an increase in Ki-67 immunoreactive cells, indicating increased cell proliferation in the DG in the Gb-treated compared to nontreated group. A significant increase in newborn DCX+ve neurons with well-developed tertiary dendrites was also found in the Gb-treated compared to nontreated group. Using Western blot analysis, the expression of DCX protein in the Gb group was also significantly increased compared to the control. The results support a beneficial role of Gb on hippocampal neurogenesis in the context of brain aging.

Value of microwave ablation in treatment of large lesions of hepatocellular carcinoma.

OBJECTIVE: Thermal ablative therapies continue to be favored as a safe and effective treatment for patients with non-resectable hepatocellular carcinoma (HCC). Percutaneous microwave ablative therapy, which is a relatively new technique, has the advantage in providing faster ablation of large tumors. This study aimed to evaluate microwave ablation in the treatment of large HCC (5-7 cm) and to assess its effect on local tumor progression, prognostic outcome and patients' survival. METHODS: In all, 26 patients with large HCC lesions (5-7 cm) were managed in the multidisciplinary clinic of Kasr Al Ainy University hospital using microwave ablation. The treatment was performed with the patient under conscious sedation and analgesia and ultrasonography-guided using an HS AMICA microwave machine operating at frequency of 2450 MHz and a power up to 100 W. Multiple needle insertions were made in one or two sessions according to the size of the lesion. The complete ablation rate, local tumor progression and patients' overall survival were analyzed, and the efficacy and safety of MWA was evaluated. RESULTS: Complete ablation was achieved in 19/26 (73.1%). Local tumor progression was recorded in five treated lesions (19.2%). Distant tumor progression within the liver was recorded in six patients (23.1%), with a mean survival of 21.5 months. No procedure-related major complications or deaths were observed. CONCLUSIONS: Percutaneous microwave ablation is safe and effective in the treatment of large HCC tumors. Patients' survival and local tumor control were acceptable.

Co-Application of Corticosterone and Growth Hormone Upregulates NR2B Protein and Increases the NR2B:NR2A Ratio and Synaptic Transmission in the Hippocampus.

OBJECTIVES: This in vitro study aimed to investigate the possible mechanism underlying the protective effect of growth hormone (GH) on hippocampal function during periods of heightened glucocorticoid exposure. METHODS: This study was conducted between January and June 2005 at the Joan C. Edwards School of Medicine, Marshall University, in Huntington, West Virginia, USA. The effects of the co-application of GH and corticosterone (CORT) were tested at different concentrations on the field excitatory postsynaptic potentials (fEPSPs) of the hippocampal slices of rats in two different age groups. Changes in the protein expression of N-methyl-D-aspartate receptor (NMDAR) subunits NR1, NR2B and NR2A were measured in hippocampal brain slices treated with either artificial cerebrospinal fluid (ACSF), low doses of CORT alone or both CORT and GH for three hours. RESULTS: The co-application of CORT and GH was found to have an additive effect on hippocampal synaptic transmission compared to either drug alone. Furthermore, the combined use of low concentrations of GH and CORT was found to have significantly higher effects on the enhancement of fEPSPs in older rats compared to young ones. Both GH and CORT enhanced the protein expression of the NR2A subunit. Simultaneous exposure to low concentrations of GH and CORT significantly enhanced NR2B expression and increased the NR2B:NR2A ratio. In contrast, perfusion with CORT alone caused significant suppression in the NR1 and NR2B protein expression and a decrease in the NR2B:NR2A ratio. CONCLUSION: These results suggest that NMDARs provide a potential target for mediating the GH potential protective effect against stress and age-related memory and cognitive impairment.

The role of a total contact insole in diminishing foot pressures following partial first ray amputation in diabetic patients.

BACKGROUND: In diabetic subjects, reulcerations following first ray amputations are particularly frequent. Treatment usually includes an in-shoe intervention to reduce plantar pressure. OBJECTIVE: To investigate the effects of a total contact insole on the plantar pressure reduction in patients with partial first ray amputations. MATERIAL AND METHODS: Twenty diabetic subjects (mean age 60 years, mean body mass index 27kg/m(2)) with partial first ray amputation of one foot. Plantar pressure data was recorded using Matscan system (Tekscan vers. 6.34, Boston, USA) while standing and taking a step for three conditions (shoe, shoe with total contact insole, and shoe with flat insole). Plantar pressures were determined at the five metatarsal areas, mid foot area and medial and lateral heel areas. RESULTS: Pressures diminished significantly (P<0.05) in tested areas using the total contact insole while standing and walking. While using the flat insole, significant pressure changes were only seen while walking (P<0.05) (P<0.05). A highly significant change in pressures with the total contact insoles during walking in all areas except for the M1 area (P<0.001) as compared to that of flat insole. CONCLUSION: The conforming total contact insole showed significant reduction in plantar pressures in patients with first ray amputation.

Tuning posture to body load: decreases in load produce discrete sensory signals in the legs of freely standing cockroaches.

Decreases in load are important cues in the control of posture and walking. We recorded activities of the tibial campaniform sensilla, receptors that monitor forces as strains in the exoskeleton, in the middle legs of freely moving cockroaches. Small magnets were attached to the thorax and body load was changed by applying currents to a coil below the substrate. Body position was monitored by video recording. The tibial sensilla are organized into proximal and distal subgroups that have different response properties and reflex effects: proximal sensilla excite extensor motoneurons while distal receptors inhibit extensor firing. Sudden load decreases elicited bursts from distal sensilla, while increased load excited proximal receptors. The onset of sensory discharges closely approximated the time of peak velocity of body movement in both load decreases and increases. Firing of distal sensilla rapidly adapted to sustained unloading, while proximal sensilla discharged tonically to load increases. Load decreases of small amplitude or at low rates produced only inhibition of proximal activity while decrements of larger size or rate elicited distal firing. These response properties may provide discrete signals that either modulate excitatory extensor drive during small load variations or inhibit support prior to compensatory stepping or initiation of swing.

Common motor mechanisms support body load in serially homologous legs of cockroaches in posture and walking.

We studied the mechanisms underlying support of body load in posture and walking in serially homologous legs of cockroaches. Activities of the trochanteral extensor muscle in the front or middle legs were recorded neurographically while animals were videotaped. Body load was increased via magnets attached to the thorax and varied through a coil below the substrate. In posture, tonic firing of the slow trochanteral extensor motoneuron (Ds) in each leg was strongly modulated by changing body load. Rapid load increases produced decreases in body height and sharp increments in extensor firing. The peak of extensor activity more closely approximated the maximum velocity of body displacement than the body position. In walking, extensor bursts in front and middle legs were initiated during swing and continued into the stance phase. Moderate tonic increases in body load elicited similar, specific, phase dependent changes in both legs: extensor firing was not altered in swing but was higher after foot placement in stance. These motor adjustments to load are not anticipatory but apparently depend upon sensory feedback. These data are consistent with previous findings in the hind legs and support the idea that body load is countered by common motor mechanisms in serially homologous legs.

Intracellular calcium ion response to glucose in beta-cells of calbindin-D28k nullmutant mice and in betaHC13 cells overexpressing calbindin-D28k.

This article describes studies on the glucose-induced responses of intracellular Ca2+ concentration ([Ca2+]i), insulin release, and redistribution of calbindin-D28k, a calcium-binding regulatory protein, in beta-cells of pancreatic islets of calbindin-D28k knockout (KO) and wild-type mice (C57BL6) as well as in betaHC-13 control cells and betaHC-13 CaBP40 cells (beta-cell line overexpressing calbindin-D28k). Upon increasing the glucose concentration from 2.8 to 30 mM, islets of KO mice showed a significantly greater increase in [Ca2+]i (mean increase in [Ca2+]i, i.e., delta[Ca2+]i, was 296 nM) compared with wild-type mice (delta[Ca2+]i = 97 nM). betaHC-13 CaBP40 cells showed little change in [Ca2+]i upon elevation of glucose from 5.5 to 32.7 mM, whereas betaHC-13 control cells exhibited significant increases in [Ca2+]i, (delta[Ca2+]i = 510 nM). Similarly, upon addition of 30 mM glucose, the rate of insulin release increased from 25.2 (basal rate) to 145.2 pg/mL/min in betaHC-13 control cells, whereas in betaHC-13 CaBP40 cells the rate of insulin release was only 27.5 pg/mL/min in high glucose. Thus, levels of calbindin-D28k in beta-cells affect both [Ca2+]i and insulin secretion in response to glucose. The three-dimensional reconstruct of confocal immunofluorescent images showed that glucose caused redistribution of calbindin-D28k resulting in co-localization in the region of L-type voltage-dependent calcium channels (VDCC). This co-localization may be an important regulatory function concerning Ca2+ influx via L-type VDCC and exocytosis of insulin granules.