Factors Associated with Changes in Brain Atrophy during a Three-Year Observation in Elderly Diabetic Patients: Effect of Renal Impairment on Hippocampal Atrophy.

BACKGROUND/AIMS: We conducted a 3-year longitudinal study concerning factors associated with changes in brain atrophy in elderly diabetic patients. METHODS: We evaluated hippocampal and global brain atrophy using automatic voxel-based morphometry of structural magnetic resonance images, 4 cognitive function tests, and cerebral small vessel disease (SVD) in 66 diabetic patients. RESULTS: During the 3-year follow-up, hippocampal and global brain atrophy advanced, and cognitive functions worsened. For changes in hippocampal atrophy, changes in estimated glomerular filtration rate (eGFR), albuminuria, and being an ApoE ε4 carrier were independent factors; change in the number of silent brain infarctions was an independent factor for changes in global brain atrophy. A significant association of changes in eGFR and albuminuria with hippocampal atrophy remained after adjusting for confounders including SVD. Both types of brain atrophy at baseline were significantly correlated with cognitive impairment at baseline and especially associated with changes in delayed word recall during the follow-up after adjusting for confounders. CONCLUSION: Changes in eGFR and albuminuria during follow-up were independent risk factors for hippocampal atrophy, which was associated with decline in delayed word recall, suggesting that management of chronic kidney disease may prevent the progression of hippocampal atrophy.

Effects of application method on skin penetration of carboxyfluorescein incorporated in liposomes.

We investigated the skin penetration of liposomes under two different application conditions; occluded and large application amount (1 ml/cm(2)), and open and small application amount (10 mul/cm(2)). Liposomes containing fluorescence-labeled phospholipids or carboxyfluorescein (CF) were used. In application under occluded conditions, phospholipids showed no penetration, even in the stratum corneum (SC). CF penetration in the skin after application of liposome was no different that after application of CF solution. In contrast, phospholipids penetrated the skin, particularly the SC and hair follicles, under open conditions. CF in liposome showed enhanced penetration in the SC and epidermis, but not in the dermis. On observation of the drying process, CF recrystallized from solution, but this did not occur with CF incorporated into liposome. It is possible that crystallization of CF is prevented by encapsulation in liposome, or that penetration occurs more readily with liposome.