Oral selenium improved the disease activity in patients with mild Graves' orbitopathy.

BACKGROUND: Graves' orbitopathy (GO) is the most common extrathyroidal manifestation of Graves' disease (GD), an autoimmune disorder arising from the activity of T lymphocytes against antigens that infiltrate thyroid tissue, orbital tissue and extraocular muscles. An increase in oxidative stress has been discovered in autoimmune thyroid disease, encouraging investigation into new forms of treatment. Selenium has been described as a treatment option given its antioxidant properties. The present study evaluates the decrease of progression and inflammatory signs in patients with mild GO with oral selenium supplementation. METHODS: Controlled, randomized, single center trial at an ophthalmology referral center in Mexico City. Patients at least 18years of age with mild GO according to the CAS classification were included; exclusion criteria in addition to corticosteroid treatment included smokers or selenium allergy. Each patient was randomized into one of two groups. Group A took placebo tablets which consisted of 100µg of starch twice a day for 6months, and group B took a 100µg selenium tablet twice a day for 6months. The patients from both groups were examined and evaluated using a CAS score before and after the first, third and sixth month of treatment. RESULTS: Thirty eyes of 30 patients were studied. The pretreatment values showed no statistically significant differences between groups (P>0.05). Intergroup analysis showed statistically significant differences in palpebral fissure and CAS score between the pretreatment values and six months after treatment in the selenium group (P<0.05). No differences were found in any variables in the placebo group during the study period (P>0.05). No adverse events were reported. CONCLUSIONS: This is the first study in a Mexican population demonstrating that oral selenium decreases clinical activity and stops progression in patients with mild GO.

Saliva versus serum cortisol to identify subclinical hypercortisolism in adrenal incidentalomas: simplicity versus accuracy.

PURPOSE: Subclinical hypercortisolism (SCH) leads to metabolic derangements and increased cardiovascular risk. Cortisol autonomy is defined by the overnight 1 mg dexamethasone suppression test (DST). Saliva cortisol is an easier, stress-free, and cost-effective alternative to serum cortisol. We compared 23 h and post-1 mg DST saliva with serum cortisol to identify SCH in adrenal incidentalomas (AI). METHODS: We analyzed 359 DST obtained retrospectively from 226 AI subjects (173F/53 M; 19-83 years) for saliva and serum cortisol. We used three post-DST serum cortisol cutoffs to uncover SCH: 1.8, 2.5, and 5.0 µg/dL. We determined post-DST and 23 h saliva cortisol cutoffs by ROC curve analysis and calculated their sensitivities (S) and specificities (E). RESULTS: The sensitive 1.8 µg/dL cutoff defined 137 SCH and 180 non-functioning adenomas (NFA): post-DST and 23 h saliva cortisol S/E were: 75.2%/74.4% and 59.5%/65.9%, respectively. Using the specific 5.0 µg/dL cortisol cutoff (22 SCH/295 NFA), post-DST and 23 h saliva cortisol S/E were 86.4%/83.4% and 66.7%/80.4%, respectively. Using the intermediate 2.5 µg/dL cutoff (89 SCH/228 NFA), post-DST and 23 h saliva cortisol S/E were 80.9%/68.9% and 65.5%/62.8%, respectively. CONCLUSION: Saliva cortisol showed acceptable performance only with the 5.0 µg/dL cortisol cutoff, as in overt Cushing's syndrome. Lower cutoffs (1.8 and 2.5 µg/dL) that identify larger samples of patients with poor metabolic outcomes are less accurate for screening. These results may be attributed to pre-analytical factors and inherent patient conditions. Thus, saliva cortisol cannot replace serum cortisol to identify SCH among patients with AI for screening DST.

[Management of upper eyelid retraction associated with dysthyroid orbitopathy during the acute inflammatory phase with botulinum toxin type A]. / Traitement de la rétraction palpébrale supérieure associée à l'ophtalmopathie dysthyroïdienne en phase active inflammatoire avec l'injection de toxine botulique A.

PURPOSE: To evaluate the efficacy of transconjunctival botulinum toxin type A (BTX-A) in the treatment of upper eyelid retraction in the active inflammatory phase of dysthyroid orbitopathy, establish the ideal dose, and evaluate side effects. METHODS: This is a comparative, prospective study in patients with thyroid orbitopathy, conducted at the Conde Ophthalmology Institute in Valenciana, Mexico. The patients included had dysthyroid orbitopathy in the inflammatory phase, and they were treated with subconjunctival injection of botulinum toxin type A (BTX-A) in the upper eyelid. Five units (group 1) and ten units (group 2) of BTX-A, in a single subconjunctival dose were applied to the non-dominant eye. We evaluated visual acuity, margin-to-reflex distance (RPM1), crease height, ocular motility, diplopia and keratitis, before and after administration of the toxin. The patients were followed at one, 4 and 16 weeks, with the Student t-test as a statistical analysis. RESULTS: At week 4, 15 patients (100%) showed a reduced margin to reflex distance. The mean result for group 1 was -1.75mm (range -1 to -2.5mm) and group 2 was -2mm (range -1 to -4mm). Statistically significant differences were seen between pre-treatment and week 4 in both groups, but no differences between doses. Complete improvement of keratitis and lagophthalmos was observed in 5 and 2 patients, respectively. Visual acuity, ocular motility and crease height did not change in 93% of the patients. One patient (group 1) exhibited complete ptosis and vertical diplopia, which resolved spontaneously at week 6. CONCLUSION: Transconjunctival BTX-A application is safe and effective for the treatment of eyelid retraction in dysthyroid orbitopathy. No difference was found between doses. No severe side effects were reported.

The importance of protozoan bacterivory in a subtropical environment (Lobo-Broa Reservoir, SP, Brazil).

This study evaluated the importance of heterotrophic nanoflagellates (HNF) and ciliates bacterivory in a mesotrophic subtropical environment (Lobo-Broa Reservoir, Brazil) by the quantification of their ingestion rates. The in situ experiments using fluorescently labelled bacteria (FLB) were carried out bimonthly over one year (three surveys in the dry season and three in the rainy one) at the sub-surface of two sampling points that have different trophic degrees. The ingestion rates for both ciliates and HNF were higher in the meso-eutrophic region (point 2) due to the higher water temperatures, which accelerate the metabolism of protozoans and the higher bacteria densities. Concerning total protozoan bacterivory, the HNF had the greatest grazing impact on bacterial community, especially the HNF <5 µm. The data showed that HNF grazing, in addition to regulating the bacteria abundance, also induced changes to the bacterial community structure, such as increasing size and numbers of bacterial filaments. The ciliates were also important to the system bacterivory, especially in point 2, where there were high densities and ingestion rates. The protozoan bottom-up control was more important in the dry season and the top-down control was more important in the rainy season, so, these two forces are equally important to the bacterial abundance regulation in this reservoir in an annual basis.

[Vital capacity reduction in postoperative of elective craniotomy]. / Disminución de la capacidad vital en el período postoperatorio de la craneotomía electiva.

AIMS: To assess the vital capacity (VC), tidal volume, minute volume and respiratory rate during the first four postoperative days of elective craniotomy and how they are correlated with smoking, associated diseases and respiratory symptoms. PATIENTS AND METHODS: Ninety-four patients were initially evaluated for elective craniotomy and they were included in this study only if they presented normal consciousness level and spontaneous breathing at the first postoperative. The preoperative and postoperative evaluations comprised physical examination and ventilometry up to the fourth postoperative. The repeated measures analysis of variance was used to the ventilation measurements. The significance level adopted for all the statistical tests was p = 0.05. RESULTS: Sixty-two patients were included in this study. There was a 20% fall in the VC from the first to the third postoperative (p = 0.001). Patients with systemic arterial hypertension presented in the preoperative period a lower mean VC (2.59 L) than the patients without (3.28 L) (p = 0.045). Smokers presented a lower mean VC (2.65 and 1.95 L) than the nonsmokers (3.13 and 2.43 L), both in the preoperative and in the postoperative, but with no statistic significance (p = 0.090). CONCLUSION: After elective craniotomy, there is a significant decrease in VC immediately after surgery, improving gradually thereafter; there was no difference in VC between the smoking and nonsmoking patients in the pre- and postoperative as well.

Two different PABPN1 expanded alleles in a Mexican population with oculopharyngeal muscular dystrophy arising from independent founder effects.

BACKGROUND: Oculopharyngeal muscular dystrophy (OPMD) is a late onset hereditary myopathy of autosomal dominant transmission characterised by ptosis, dysphagia and limb weakness. The disease is caused by short heterozygous expansions of a (GCN)(10) triplet located in the first exon of the PABPN1 gene at chromosome 14q11.1. Most affected individuals from North America and Europe carry a mutant (GCN)(13) allele. Although evidence for a founder mutation effect has been shown in several populations with OPMD, analysis of large groups of patients from different ethnic backgrounds will help to identify the relative contribution of each allele to the disease and a possible genotype-phenotype correlation. METHODS: 22 unrelated patients with OPMD from Mexico, a previously uncharacterised population, were clinically and molecularly analysed. Detailed ophthalmological and clinical examinations were performed in each proband and molecular analysis of the PABPN1 gene was carried out by PCR amplification and allele-specific cloning/sequencing. Two single nucleotide polymorphisms (SNPs) linked to PABPN1 were determined in each individual and in a number of affected first-degree relatives. RESULTS: 15 subjects (68%) carried a mutant (GCN)(15) or (GCG)(11)(GCA)(3)(GCG) PABPN1 allele; the remaining 7 (32%) exhibited an abnormal (GCN)(13) or (GCG)(9)(GCA)(3)(GCG) allele. Analysis of two SNPs linked to PABPN1 strongly suggests that both expanded alleles originate from two independent founder effects. In addition, in this particular population the (GCN)(15) allele was associated with an earlier onset of the disease (mean 46.5 years) compared with the (GCN)(13) allele (mean 54.7 years). CONCLUSION: The results of this study suggest that OPMD in the Mexican population is mostly due to (GCG)(11) or (GCG)(9) PABPN1 expanded alleles arising from two independent founder effect mutations. These findings add to the definition of the genetic features of the disease and to the establishment of a probable genotype-phenotype correlation.

Impact of prolonged physical training on the pituitary glucocorticoid sensitivity determined by very low dose intravenous dexamethasone suppression test.

The activity of the hypothalamic-pituitary-adrenal axis is usually modulated by several stress factors, including exercise. Different responses are induced by physical training according to duration and intensity of exercise. During prolonged training, cortisol remains normal or decreased as a consequence of altered cortisol secretion, metabolism and excretion, and possibly by changes in glucocorticoid sensitivity. The aim of this study was to evaluate the impact of prolonged physical training on the glucocorticoid sensitivity. Eighteen cadets of the Air Force Academy, mean (SD) age: 18.7 (1.0) years, underwent an intensive 6-week preparatory training-period considered adequate by inducing significant changes on body composition measured by bioelectrical impedance. Measurement of individual's pituitary glucocorticoid sensitivity was done by an intravenous very low dose dexamethasone suppression test (20 microg/m (2)) that was performed before and after the training period. Cortisol levels were obtained at basal condition and 120 minutes after the dexamethasone infusion. Basal cortisol showed a significant decrease after prolonged training. The percent cortisol suppression after dexamethasone tended to be lower after the training period. Overall, our data suggest that prolonged physical training is able to reduce glucocorticoid sensitivity, which can have a beneficial impact in chronic stress conditions.

The effect of sun exposure on 25-hydroxyvitamin D concentrations in young healthy subjects living in the city of São Paulo, Brazil

The range of 25-hydroxyvitamin D (25OHD) concentration was determined in a young healthy population based on bone metabolism parameters and environmental and behavioral aspects. We studied 121 healthy young volunteers (49 men, 72 women) living in São Paulo (23º 34' south latitude) belonging to three occupational categories: indoor workers (N = 28), medical school students (N = 44), and resident physicians (N = 49). Fasting morning blood samples were collected once from each volunteer from August 2002 to February 2004, and 25OHD, total calcium, albumin, alkaline phosphatase, phosphorus, creatinine, intact parathyroid hormone, osteocalcin, and type I collagen carboxyterminal telopeptide were measured. Data are reported as means ± SD. Mean subject age was 24.7 ± 2.68 years and mean 25OHD level for the entire group was 78.7 ± 33.1 nM. 25OHD levels were lower (P < 0.05) among resident physicians (67.1 ± 27.0 nM) than among students (81.5 ± 35.8 nM) and workers (94.0 ± 32.6 nM), with the last two categories displaying no difference. Parathyroid hormone was higher (P < 0.05) and osteocalcin was lower (P < 0.05) among resident physicians compared to non-physicians. Solar exposure and frequency of beach outings showed a positive association with 25OHD (P < 0.001), and summer samples presented higher results than winter ones (97.8 ± 33.5 and 62.9 ± 23.5 nM, respectively). To define normal levels, parameters such as occupational activity, seasonality and habits related to solar exposure should be taken into account. Based on these data, we considered concentrations above 74.5 nM to be desired optimal 25OHD levels, which were obtained during the summer for 75 percent of the non-physicians.

The effect of sun exposure on 25-hydroxyvitamin D concentrations in young healthy subjects living in the city of São Paulo, Brazil.

The range of 25-hydroxyvitamin D (25OHD) concentration was determined in a young healthy population based on bone metabolism parameters and environmental and behavioral aspects. We studied 121 healthy young volunteers (49 men, 72 women) living in São Paulo (23 masculine 34' south latitude) belonging to three occupational categories: indoor workers (N = 28), medical school students (N = 44), and resident physicians (N = 49). Fasting morning blood samples were collected once from each volunteer from August 2002 to February 2004, and 25OHD, total calcium, albumin, alkaline phosphatase, phosphorus, creatinine, intact parathyroid hormone, osteocalcin, and type I collagen carboxyterminal telopeptide were measured. Data are reported as means +/- SD. Mean subject age was 24.7 +/- 2.68 years and mean 25OHD level for the entire group was 78.7 +/- 33.1 nM. 25OHD levels were lower (P < 0.05) among resident physicians (67.1 +/- 27.0 nM) than among students (81.5 +/- 35.8 nM) and workers (94.0 +/- 32.6 nM), with the last two categories displaying no difference. Parathyroid hormone was higher (P < 0.05) and osteocalcin was lower (P < 0.05) among resident physicians compared to non-physicians. Solar exposure and frequency of beach outings showed a positive association with 25OHD (P < 0.001), and summer samples presented higher results than winter ones (97.8 +/- 33.5 and 62.9 +/- 23.5 nM, respectively). To define normal levels, parameters such as occupational activity, seasonality and habits related to solar exposure should be taken into account. Based on these data, we considered concentrations above 74.5 nM to be desired optimal 25OHD levels, which were obtained during the summer for 75% of the non-physicians.

[Comparative study of amniotic membrane transplantation, with and without simultaneous application of mitomycin C in conjunctival fornix reconstruction]. / Estudio comparativo entre transplante de membrana amniótica con y sin aplicación simultánea de mitomicina c en reconstrucción de fondo de saco conjuntival.

OBJECTIVE: To describe the results of amniotic membrane (AM) transplantation, using the simultaneous application of 0.02% Mitomycin C (MMC), in conjunctival fornix reconstruction. MATERIAL: We compared two groups of patients: group A, who were treated only with AM and group B, in whom MMC (0.02%) was also applied. Operative technique used: In group A, the surgical procedure involved a careful removal of the cicatricial tissue, followed by AM transplantation. In group B, following the careful removal of the cicatricial tissue, 0.02% MMC was then applied to the surgical field for 60 seconds, and this was followed by extensive irrigation with saline solution. AM transplantation was then performed. We ultimately evaluated the depth of the conjunctival fornix and ocular motility. RESULTS: Group A: eleven eyes of eleven patients were evaluated. Seven had chemical injuries, three had traumatic symblepharon and one had Stevens-Johnson syndrome. In two cases a 7 mm or greater conjunctival fornix depth was observed. In four cases the ocular motility was better than -1. Group B: Twelve eyes of twelve patients were evaluated. Seven had chemical injuries, 2 had traumatic symblepharon and 3 had Stevens-Johnson syndrome. In nine cases a 7 mm or greater conjunctival fornix depth was obtained. In 9 cases the ocular motility restriction was resolved. Poor results of fornix reconstruction, as well as ocular motility, were observed in those patients with autoimmune diseases, irrespective of the treatment used. CONCLUSIONS: The simultaneous combination of AM and MMC results in better conjunctival fornix reconstruction than with the use of AM alone.

Estudio comparativo entre trasplante de membrana amniótica con y sin aplicación simultánea de mitomicina C en reconstrucción de fondo de saco conjuntival / Comparative study of amniotic membrane transplantation, with and without simultaneous application of mitomycin C in conjunctival fornix reconstruction

Objetivo: Describir la eficacia en la reconstrucción de fondos de saco y mejoramiento de la movilidad ocular mediante el uso del transplante de membrana amniótica (MA) y la aplicación transoperatoria de Mitomicina C (MMC) al 0,02%.Material: Se han comparado dos grupos, Grupo A al cual se le realizó liberación de simbléfaron y transplante de MA y Grupo B al que además del transplante se aplicó MMC al 0,02%. Técnica: El tejido conjuntival cicatrizal fue escindido aplicando MMC 0,02% por 1 minuto y lavado exhaustivo posterior a la aplicación. Se colocó MA cubriendo el defecto (grupo A y B). Las variables medidas fueron profundidad de saco conjuntival y movilidad ocular.Resultados: Grupo A once ojos de once pacientes. Siete con quemaduras químicas, tres con simbléfaron traumático y uno con antecedente de Síndrome de Stevens-Johnson. En dos pacientes se obtuvo una profundidad de fondo de saco de 7 mm o mayor. En cuatro pacientes encontramos una limitación a la movilidad ocular menor a –1. Grupo B: Doce ojos de doce pacientes. Siete con quemaduras químicas, dos con simbléfaron traumático y tres con antecedente de síndrome de Stevens-Johnson. En nueve casos se obtuvo profundidad de fondo de saco de 7 mm o mayor. En nueve casos la restricción a la movilidad se eliminó. Los resultados más pobres en ambos grupos se obtuvieron en aquellos con trastornos autoinmunes.Conclusiones: La combinación de MA y MMC demostró resultados más favorables en la reconstrucción de fondos de saco conjuntival que cuando se empleo únicamente MA

Objective: To describe the results of amniotic membrane (AM) transplantation, using the simultaneous application of 0.02% Mitomycin C (MMC), in conjunctival fornix reconstruction. Material: We compared two groups of patients: group A, who were treated only with AM and group B, in whom MMC (0.02%) was also applied. Operative technique used: In group A, the surgical procedure involved a careful removal of the cicatricial tissue, followed by AM transplantation. In group B, following the careful removal of the cicatricial tissue, 0.02% MMC was then applied to the surgical field for 60 seconds, and this was followed by extensive irrigation with saline solution. AM transplantation was then performed. We ultimately evaluated the depth of the conjunctival fornix and ocular motility. Results: Group A: eleven eyes of eleven patients were evaluated. Seven had chemical injuries, three had traumatic symblepharon and one had Stevens-Johnson syndrome. In two cases a 7 mm or greater conjunctival fornix depth was observed. In four cases the ocular motility was better than –1. Group B: Twelve eyes of twelve patients were evaluated. Seven had chemical injuries, 2 had traumatic symblepharon and 3 had Stevens-Johnson syndrome. In nine cases a 7 mm or greater conjunctival fornix depth was obtained. In 9 cases the ocular motility restriction was resolved. Poor results of fornix reconstruction, as well as ocular motility, were observed in those patients with autoimmune diseases, irrespective of the treatment used. Conclusions: The simultaneous combination of AM and MMC results in better conjunctival fornix reconstruction than with the use of AM alone

Lymphatic system changes in diabetes mellitus: role of insulin and hyperglycemia.

BACKGROUND: Diabetic alterations of blood vessels have been well studied, but much less is known about the lymphatic system, which plays an important role in the transport of particles and defensive responses. Accordingly, we investigated lymphatic changes in diabetic rats. METHODS: Ten, 30 or 60 days after alloxan-induced diabetes (40 mg/kg; i.v.), we studied thoracic duct lymph flow and lymphocyte output, thoracic duct lymph transport of radiotracer particles ((99m)Tc-dextran 500), lymph node uptake and scintigraphic visualization of subcutaneously injected radiotracer particles, as well as the effect of insulin administration and food deprivation. RESULTS: Diabetes significantly increased thoracic duct lymph flow and the transport of dextran from the footpad subcutaneous tissue. Abnormal lymphocyte output from the thoracic duct occurred in the first 10 days. Uptake of dextran into regional lymph nodes was decreased in diabetes. Insulin per se, although not normalizing blood sugar levels, appeared to recover thoracic duct lymphocyte output and lymph node uptake of (99m)Tc-dextran 500 without affecting the thoracic duct lymph flow or the amount of radiotracer recovered therein. Normalization of glycemia (by food deprivation) restored the lymph flow to control levels without modifying the lymphocyte output. On the other hand, under insulin-restored normoglycemic conditions, both the thoracic duct lymph flow and the lymphocyte output were normalized. CONCLUSIONS: These findings suggest that variables related to defensive mechanisms, such as lymphocyte recirculation and particles uptake into the lymph nodes can benefit from insulin treatment, whereas glycemic control can benefit transport mechanisms in the lymphatic system, such as lymph flow and lymphatic transport of particles.

Anti-inflammatory and antispasmodic activity of Ipomoea imperati (Vahl) Griseb (Convolvulaceae).

Ipomoea imperati (Convolvulaceae) lives on the sandy shores of the Brazilian coast and in other areas of the world. The anti-inflammatory activity of a methanol-water extract of the leaves of I. imperati was investigated in experimental models of acute and subchronic inflammation. Topical application of the extract (10 mg/ear) inhibited mouse ear edema induced by croton oil (89.0 +/- 1.3% by the lipid fraction with an IC50 of 3.97 mg/ear and 57.0 +/- 1.3% by the aqueous fraction with an IC50 of 3.5 mg/ear) and arachidonic acid (42.0 +/- 2.0% with an IC50 of 4.98 mg/ear and 31.0 +/- 2.0% with an IC50 of 4.72 mg/ear). Phospholipase A2, purified from Apis mellifera bee venom, was also inhibited by the extract (5.0 mg/ml lipid and aqueous fraction) in vitro in a dose-dependent manner (85% by the lipid fraction with an IC50 of 3.22 mg/ml and 25% by the aqueous fraction with an IC50 of 3.43 mg/ml). The methanol-water extract of I. imperati (1000 mg/kg) administered by the oral route also inhibited the formation of cotton pellet-induced granulomas (73.2 +/- 1.2% by the lipid fraction and 56.14 +/- 2.7% by the aqueous fraction) and did not cause gastric mucosal lesions. I. imperati extracts (10 mg/ml) also inhibited in a dose-dependent manner the muscle contractions of guinea pig ileum induced by acetylcholine and histamine (IC50 of 1.60 mg/ml for the lipid fraction and 4.12 mg/ml for the aqueous fraction). These results suggest the use of I. imperati as an anti-inflammatory and antispasmodic agent in traditional medicine.

Anti-inflammatory and antispasmodic activity of Ipomoea imperati (Vahl) Griseb (Convolvulaceae)

Ipomoea imperati (Convolvulaceae) lives on the sandy shores of the Brazilian coast and in other areas of the world. The anti-inflammatory activity of a methanol-water extract of the leaves of I. imperati was investigated in experimental models of acute and subchronic inflammation. Topical application of the extract (10 mg/ear) inhibited mouse ear edema induced by croton oil (89.0 ± 1.3 percent by the lipid fraction with an IC50 of 3.97 mg/ear and 57.0 ± 1.3 percent by the aqueous fraction with an IC50 of 3.5 mg/ear) and arachidonic acid (42.0 ± 2.0 percent with an IC50 of 4.98 mg/ear and 31.0 ± 2.0 percent with an IC50 of 4.72 mg/ear). Phospholipase A2, purified from Apis mellifera bee venom, was also inhibited by the extract (5.0 mg/ml lipid and aqueous fraction) in vitro in a dose-dependent manner (85 percent by the lipid fraction with an IC50 of 3.22 mg/ml and 25 percent by the aqueous fraction with an IC50 of 3.43 mg/ml). The methanol-water extract of I. imperati (1000 mg/kg) administered by the oral route also inhibited the formation of cotton pellet-induced granulomas (73.2 ± 1.2 percent by the lipid fraction and 56.14 ± 2.7 percent by the aqueous fraction) and did not cause gastric mucosal lesions. I. imperati extracts (10 mg/ml) also inhibited in a dose-dependent manner the muscle contractions of guinea pig ileum induced by acetylcholine and histamine (IC50 of 1.60 mg/ml for the lipid fraction and 4.12 mg/ml for the aqueous fraction). These results suggest the use of I. imperati as an anti-inflammatory and antispasmodic agent in traditional medicine

Pre-parturition profile of steroids and prostaglandin in cows with or without foetal membrane retention.

Retained foetal membranes in cattle is one of the most common complications associated to the reduction in milk yield and impaired fertility in dairy cattle. In order to determine some endocrine mechanisms controlling parturition and delivery of foetal membranes, plasma concentrations of steroids and prostanoids were determined in 20 healthy Holstein cows. Samples were taken within the interval of 5 days pre-parturition to 12h after calving. Progesterone (P4) levels were similar in cows with (PR) and without (NPR) placental retention. While the estradiol-17beta (E2) peak at parturition was lower in PR than in NPR cows, cortisol levels were greater in PR cows 12 and 24h pre-parturition. The Prostaglandin F2alpha metabolite (PGFM) levels were higher at parturition in NPR compared with the PR group, but 12h later, these levels in the PR group increased so that concentrations were greater as compared with NPR cows. The Prostaglandin E2 metabolite (PGEM), 24, 48 and 72 h pre-parturition, were higher in PR cows. However, the PGFM:PGEM ratio was greater in cows up NPR at all time when included, indicating the importance of higher levels of Prostaglandin F2alpha (PGF2alpha) than Prostaglandin E2 (PGE2) for normal placental delivery. In conclusion, placental retention was related to both estrogen and PGF2alpha deficiency, which may be a consequence of metabolic stress leading to PGE2 and maternal cortisol synthesis before parturition.

Correlation between UVB irradiation and the proportion of cataract--an epidemiological study based on a nationwide patient survey in Japan.

Among the multiple factors affecting the human eye in work environment, ultraviolet B irradiation (UVB) has received much attention recently. To provide a clear information for the association between cataract and UVB irradiation, the prevalence data from the Patient Survey and UVB estimates in all the 47 prefectures in Japan were used to examine the relationship between cataract and UVB. In analyzing the relationship, we controlled possible effect modifiers; which were aged, that is 65 years old (yo.) or older, population per ophthalmologist, proportions of all the patients among the aged population and proportion of very elderly population (75 yo. or older) among the aged population. A sex-specific logistic regression analysis revealed that the adjusted odds ratio in women was 1.118 with a 95% confidence interval of 1.058-1.183. However, the adjusted odds ratio in men was not statistically significant (1.048 with 95% confidence interval 0.968-1.135). The unstable results of this study may be largely due to the non-definitive estimation of UVB exposure that this kind of study should be repeated when more valid UVB estimates is available.

Vitamin D receptor gene polymorphism: correlation with bone mineral density in a Brazilian population with insulin-dependent diabetes mellitus.

Patients with insulin-dependent diabetes mellitus (IDDM) are at higher risk of developing osteoporosis. Among the genetic factors related to the development of osteoporosis, a possible association between vitamin D receptor (VDR) gene polymorphism and bone mineral density (BMD) has been described in some populations. We characterized the VDR gene polymorphism in a healthy adult Brazilian population and in a group of patients with IDDM and correlated these findings with densitometric values in both groups. The Brazilian population is characterized by an important racial heterogeneity and therefore is considered an ethnically heterogeneous population. We recruited 94 healthy adult Brazilian volunteers (63 women and 31 men), mean (+/- SD) age 32.4 +/- 6.5 years (range 18-49 years), and 78 patients with IDDM (33 women and 45 men) diagnosed before 18 years of age, mean (+/- SD) age 23.3 +/- 5.5 years (range 18-39 years). VDR genotype was assessed by polymerase chain reaction amplification followed by BsmI digestion on DNA isolated from peripheral blood leukocytes. Statistical analysis included Bonferroni t-test to compare densitometric values within different genotypes in both groups and multiple regression analysis of bone density adjusted for potential confounding factors. The IDDM group had a lower BMD compared with the control group. The VDR genotype distribution in the control group was 43 Bb (45.7%), 39 bb (41.5%) and 12 BB (12.8%). This distribution did not differ from that observed in the IDDM group: 39 Bb (50%), 26 bb (33.3%) and 13 BB (16.7%). In the IDDM group, patients with the Bb genotype had a higher body weight when compared with the BB genotype (p = 0.02). However, when diabetic patients were controlled for age, sex and body mass index, BB genotype was associated with a lower mean BMD at lumbar spine and femoral neck than in Bb and bb patients. BB patients had a shorter duration of IDDM than bb and Bb patients. These findings suggest a small influence of VDR gene polymorphism on BMD of a racially heterogeneous population with IDDM.

Arthroscopic meniscectomy for discoid lateral meniscus in children.

We reviewed the cases of forty-six children who were less than fifteen years old and in whom total, subtotal, or partial arthroscopic meniscectomy was performed for symptomatic discoid lateral meniscus in fifty-three knees. The average length of follow-up was 31.2 months. A meniscal tear was evident in each knee. The extent of the meniscectomy depended on the site and shape of the tear, as did the symptoms and signs. We tried to establish the width of partial meniscectomy of a discoid meniscus that would prevent new tears.

Immunologic abnormality in a group of Macaca arctoides with high mortality due to atypical mycobacterial and other disease processes.

Of 54 Macaca arctoides, 44 died during the 2.5 years after their assignment to a common cage. Although early deaths were due to trauma, acute gastric dilatation, and shigellosis; latter deaths were the result of a variety of uncommon diseases including atypical mycobacterial disease, malignant lymphoma, protozoan encephalomyelitis, and other necrotizing and inflammatory lesions. Atypical mycobacterial disease due to Mycobacterium avium intracellular serotypes was the most frequent single disease agent recognized (33% [18 macaques]). This disease began in the ileum and large intestine with subsequent systemic involvement. An abnormality of host response to infective agents, in general, was indicated by the unusually high occurrence of this disease, as well as other disease processes. Morphologic evaluation of lymphoid organs revealed decreased cellularity of follicles and decreased numbers of plasma cells in all macaques, whereas T cell-dependent areas varied from hypocellular to hypercellular with 5 macaques with malignant lymphoma. The spontaneous erythrocyte rosette-forming subpopulation of T cells was decreased in peripheral blood, but was increased in lymph nodes containing atypical mycobacterial lesions. Serum immunoglobulin value decreased progressively in diseased macaques. A basic abnormality of T-cell subpopulations controlling other components of host response was suspected. Macrophages from lesions that contain mycobacterial organisms did not phagocytize latex beads normally in vitro, whereas monocytes in the blood of the same macaques were capable of in vitro phagocytosis.