Prostaglandins E1, E2, and D2 induce dark-adaptive retinomotor movements in teleost retinal cones and RPE.

In teleosts, retinomotor movements of photoreceptors and retinal pigment epithelium are regulated both by light and by an endogenous circadian rhythm. Light induces cones to contract, rods to elongate and RPE cells to disperse their pigment granules into their long apical projections; darkness induces opposite movements. When fish are maintained in prolonged constant darkness, appropriate movements nonetheless occur at subjective dusk and dawn. To explore the mechanisms of this light and circadian regulation, we have been investigating effects of several extracellular messengers known to be present in retina on retinomotor movements in the green sunfish (Lepomis cyanellus). Here we report that prostaglandin E1 (PGE1) can induce movements characteristic of dark onset (or night) in both cones and RPE in isolated light-adapted retinas in the light; ie, PGE1 induces cone elongation and RPE pigment granule aggregation. The extent of PGE1-induced cone and RPE movements were dose-dependent with maximal movement occurring at 250-500 nM; higher concentrations were not as effective. Incubations with PGE2 and PGD2 also induced dark-adaptive cone and RPE retinomotor movements, but PGF2 alpha did not. Further observations suggest that prostaglandins may play a role in mediating the induction of cone and RPE movements by dark onset: dark-induced movements were inhibited by pretreating light-adapted isolated retinas before dark culture with agents which inhibit endogenous prostaglandin synthesis. Both indomethicin (50 microM) and acetylsalicylic acid (50 microM), two inhibitors of the cyclooxygenase component of specific prostaglandin synthase, inhibited dark-induced cone elongation and pigment aggregation in cultured sunfish retinas. Another cyclooxygenase inhibitor, ibuprofen (50 microM) had no effect. Together the effectiveness of PGE1 inducing dark-adaptive movement and the inhibition of dark adaptive movement by cyclooxygenase inhibitors suggest that prostaglandins may play a role in vivo in mediating the induction of dark-adapted RPE and cone retinomotor movements by dark onset.

Dietary protein intake and nutritional status in patients with renal transplant.

BACKGROUND: Uremic patients on regular dialysis treatment (RDT) obtain and maintain with difficulty an adequate nutritional status. Successful kidney transplantation allows remarkable rehabilitation of patients with end-stage renal disease previously on RDT. However, information concerning the role of dietary protein restriction in the treatment of patients with chronic transplant rejection is scarce. PATIENTS AND METHODS: The role of dietary protein restriction in the treatment of patients with chronic transplant rejection was studied over 10 years in 42 patients with a kidney transplant to examine longterm renal and nutritional responses to dietary protein on graft renal function. In these patients, renal function was checked monthly, clinical evaluation and anthropometric measurements studied, nutritional status and all patients' diets were recorded. RESULTS: In 18 of these patients, biochemical signs of renal failure were found. A diet with 35 Kcal/kg and 0.7 - 0.8 grams of protein/Kg was instituted. Renal function studied every six months for 10 years showed improvement or stabilization. The low protein diet was associated with a significant reduction in 24-hour urinary protein excretion, without any change in blood pressure. Protein restriction was not associated with changes in serum protein. CONCLUSIONS: Our long-term study suggests that moderate protein intake may improve the course of chronic rejection and that restriction in protein intake may be a useful strategy in slowing the progression of renal disease in chronic rejection.

Posterior chamber intraocular lens use in children.

PURPOSE: The authors report on the efficacy of intraocular lens implantation during pediatric cataract surgery and the results of a consecutive series of intraocular lens implantation in children. METHODS: Twenty-one children underwent implantation of intraocular lenses in 23 eyes. Twenty-one surgeries were primary implantation immediately following anterior lensectomy. Two surgeries were secondary implantations. Primary posterior capsulectomy was performed in 18 of 21 primary implantations. All but two eyes underwent a primary anterior vitrectomy. Topical prednisolone acetate was administered in all cases. Oral prednisone was administered in 17 of 23 cases. Pre- and postoperative visual acuity, cycloplegic refraction, and postoperative complications related to inflammation such as intraocular lens (IOL) capture, IOL decentration, and posterior capsule opacification were examined. RESULTS: Eighteen of 23 eyes have achieved a visual acuity of 20/40 or better. None of the cases in which oral prednisone was used developed complications related to postoperative inflammation. One of the six cases (17%) in which oral prednisone was not used developed such complications. CONCLUSION: Intracular lens implantation accompanied by primary posterior capsulectomy, anterior vitrectomy, and management of postoperative inflammation appears to provide appropriate and safe optical rehabilitation in children.

Positive inotropic effect of K-canrenoate: an investigation in anaesthetized dogs, untreated or treated with digitalis.

Potassium canrenoate (KCR) is widely used in cardiac patients as an aldosterone antagonist, antiarrhythmic and diuretic drug. According to experimental and clinical studies it can also elicit an inotropic action. It is not clear, however, whether this inotropic activity occurs in the absence of any treatment or after the myocardial contractility has already been improved with digitalis. In order to evaluate a possible interaction of this drug with digitalis we administered KCR intravenously to 41 anaesthetized dogs either untreated or treated with digitalis, in which aortic and left ventricular pressures were recorded and myocardial contractility was evaluated by calculating in real time the first derivative of ventricular pressure (Formula: see text) max and two other contractility indexes (Formula: see text) max and V.max. The results obtained showed that KCR given at doses of 10, 20 and 30 mg/kg i.v. did not elicit any inotropic effect in dogs not previously digitalized. 100 mg/kg i.v. first depressed cardiac contractility and then increased it. After cardiac performance had been improved by digitalis, KCR further increased all contractility indexes significantly. These results could explain previous observations that no inotropic effect was observed in human subjects not treated with digitalis after treatment with KCR.