Extrarenal Effects of Aldosterone on Potassium Homeostasis

The role of aldosterone in regulating K+ excretion in the distal nephron is well established in kidney physiology. In addition to effects on the kidney, aldosterone modulates K+ and Na+ transport in salivary fluid, sweat, airway epithelia, and colonic fluid. More controversial and less well defined is the role of aldosterone in determining the internal distribution of K+ across cell membranes in non-transporting epithelia. In vivo studies have been limited by the difficulty in accurately measuring overall K+ balance and factoring in both variability and secondary changes in acid-base balance, systemic hemodynamics, and other K+-regulatory factors such as hormones and adrenergic activity. Despite these limitations, the aggregate data support a contributory role of aldosterone along with insulin and catecholamines in the normal physiologic regulation of internal K+ distribution. The authors speculate differences in tissue sensitivity to aldosterone may also contribute to differential tissue response of cardiac and skeletal muscle to conditions of total body K+ depletion.

Cigarette Smoke Extract Produces Superoxide in Aqueous Media by Reacting with Bicarbonate

The toxicity of cigarette smoke (CS) is largely attributed to its ability to generate reactive oxygen species (ROS). Reportedly, CS generates superoxide in cell culture systems by stimulating the cells to produce superoxide and through direct chemical reactions with components of the culture media. In this study, we investigated CS-induced superoxide formation in biocompatible aqueous media and its characteristics. Cigarette smoke extract (CSE) and total particulate matter (TPM) were prepared from the mainstream smoke of 3R4F reference cigarettes. CSE and TPM generated superoxide in Hank’s balanced salt solution (HBSS), Dulbecco’s modified Eagle media (DMEM), and blood plasma, but not in distilled water and phosphate-buffered saline. Each constituent of HBSS in solution was tested, and bicarbonate was found to be responsible for the superoxide generation. More than half of the superoxide formation was abolished by pretreating CSE or TPM with peroxidase, indicating that the substrates of peroxidase, presumably peroxides and peroxy acids, mainly contributed to the superoxide production. In conclusion, the presence of bicarbonate in experimental conditions should be considered carefully in studies of the biological activity of CS. Furthermore, the local amount of bicarbonate in exposed tissues may be a determinant of tissue sensitivity to oxidative damage by CS.

Didymocarpus Pedicellate: Bioactive Constituent, Their Molecular Target in Diabetes Mellitus

Didymocarpus pedicellata (Family: Gesneriaceae), is an herbal drug traditionally used in renal disorders mainly as antiurolithiatic and do not have much data on this plant, is selected for study and hereby reviewed. This review is based on compilation of data from the various researchers on their research work and other data including anti-diabetic activity of Didymocarpus pedicellata and antioxidant activity in relation with the type 2 diabetes mellitus and its cardiovascular complications. By using various scientific studies, the evidence has been demonstrated as to the antidiabetic effect of the various extract of Didymocarpus pedicellata as well as its chemical constituents including various flavonoid like chalcones which are major bioactive constituents chiefly present in Didymocarpus pedicellata. The chalcones present in these plants have various therapeutic targets for the management of type 2 diabetes like PPARg, DPP-4, a-glucosidase, PTP1B, aldose reductase, and stimulate insulin secretion and tissue sensitivity. The Didymocarpus pedicellata has also been reported to exhibit antispasmolytic, antimalarial activity and nephroprotective activity. On the basis of given evidence, it may be concluded that Didymocarpus pedicellata could be the potential target for the treatment of type 2 diabetes mellitus and can reduce the cardiovascular complication associated with diabetes mellitus.

Statistical analysis of predictors of the effectiveness of complex therapy in patients with skin scarring

The variation of indicators that characterize skin scarring increases in patients with metabolic syndrome, which may affect the effectiveness of therapeutic measures. It has been found that pathological processes in the skin scar in the initial state correlate to the greatest extent with the index of insulin resistance, the atherogenic coefficient and the coefficient of antioxidant protection. It is proved that the effectiveness of complex physiotherapy with the addition of the internal intake of medium-mineralized water «Essentuki №17» directly correlates with an increase in tissue sensitivity to insulin and the activation of antioxidant enzymes, as well as with a decrease in dyslipidemia. Linear regression equations are presented to determine significant predictors of treatment effectiveness, which can lead to the creation of individualized therapeutic programs using preformed and natural physical factors.

Tissue distribution of epirubicin after severe extravasation in humans

Purpose As critical parameter after extravasation of cytotoxic vesicants, anthracyclines were determined in removed tissue from patients requiring surgical intervention due to tissue necrosis. We monitored their distribution within the affected lesion to establish a possible dose–toxicity relation. Methods From six patients scheduled for surgery, removed tissue flaps were systematically analysed by HPLC (epirubicin: 5 subjects; doxorubicin: 1 subject). Results After extravasation, tissue concentrations were highly variable with an individual anthracycline distribution pattern ranging from a few nanograms up to 17 µg per 100 mg tissue, which indicated a substantial difference in tissue sensitivity among patients. The resection borders coincided with the extension of the erythema and guided the surgical intervention after demarcation of the lesion, which occurred usually 2 or 3 weeks after extravasation. At that time, drug was hardly detected at the resection borders. Wound drains were negative for the extravasated drugs while showing a time profile of vascular growth factors and inflammatory cytokines, which was highly similar to routine surgery. In all six patients, surgical debridement with immediate wound closure led to healing within approximately 2 weeks, when therapy was resumed in all patients with reasonable time delay. Conclusion Surgical intervention after demarcation of the extravasation lesion allows for almost uninterrupted continuation of treatment independent of the amount of extravasated anthracycline. As even minor amounts of the vesicants may trigger tissue necrosis, preventive measures merit the highest priority.

Glycemic Control Comparative of Metformin and Glimepiride in Monotherapy of Type 2 Diabetes Mellitus Patient at Islamic Jemursari Hospital Surabaya in 2018

Introduction: Type 2 diabetes mellitus is caused by decreased tissue sensitivity to insulin. The prevalence of diabetes in the world has almost doubled since 1980, from 4.7% to 8.5% in adult population. Early diagnosis and treatment aimed at normalizing glycemic control are very important. The objective of this study was to evaluate and compare glycemic control of metformin and glimepiride in monotherapy of type 2 diabetes mellitus patients at Islamic Jemursari Hospital Surabaya. Method: This was a retrospective observational study using secondary data (medical record), include glycemic control (RPG) before and two months after receiving therapy of outpatients’ type 2 diabetes mellitus with metformin or glimepiride therapy in 2018. 96 samples were found that fit the inclusion criteria. The data were analyzed by Mann-Whitney test. Result: Most patients were female, aged 50-69 years old, and dosage of metformin therapy 1500 mg/day or glimepiride therapy 2 mg/day. There was no significant difference (p>0.05) of glycemic control (RPG) of metformin compared to glimepiride therapies in type 2 diabetes mellitus patients at Islamic Jemursari Hospital Surabaya in 2018. Conclusion: Metformin and glimepiride were not significantly different in glycemic control (RPG). There were patients with RPG >200 mg/dl after two months of metformin or glimepiride therapy.

Real-Time High-Resolution MRI Endoscopy at up to 10 Frames per Second

Objective. Atherosclerosis is a leading cause of mortality and morbidity. Optical endoscopy, ultrasound, and X-ray offer minimally invasive imaging assessments but have limited sensitivity for characterizing disease and therapeutic response. Magnetic resonance imaging (MRI) endoscopy is a newer idea employing tiny catheter-mounted detectors connected to the MRI scanner. It can see through vessel walls and provide soft-tissue sensitivity, but its slow imaging speed limits practical applications. Our goal is high-resolution MRI endoscopy with real-time imaging speeds comparable to existing modalities. Methods. Intravascular (3 mm) transmit-receive MRI endoscopes were fabricated for highly undersampled radial-projection MRI in a clinical 3-tesla MRI scanner. Iterative nonlinear reconstruction was accelerated using graphics processor units connected via a single ethernet cable to achieve true real-time endoscopy visualization at the scanner. MRI endoscopy was performed at 6-10 frames/sec and 200-300 μm resolution in human arterial specimens and porcine vessels ex vivo and in vivo and compared with fully sampled 0.3 frames/sec and three-dimensional reference scans using mutual information (MI) and structural similarity (3-SSIM) indices. Results. High-speed MRI endoscopy at 6-10 frames/sec was consistent with fully sampled MRI endoscopy and histology, with feasibility demonstrated in vivo in a large animal model. A 20-30-fold speed-up vs. 0.3 frames/sec reference scans came at a cost of ~7% in MI and ~45% in 3-SSIM, with reduced motion sensitivity. Conclusion. High-resolution MRI endoscopy can now be performed at frame rates comparable to those of X-ray and optical endoscopy and could provide an alternative to existing modalities, with MRI’s advantages of soft-tissue sensitivity and lack of ionizing radiation.

Detection of involved margins in breast specimens with X-ray phase-contrast computed tomography

Margins of wide local excisions in breast conserving surgery are tested through histology, which can delay results by days and lead to second operations. Detection of margin involvement intraoperatively would allow the removal of additional tissue during the same intervention. X-ray phase contrast imaging (XPCI) provides soft tissue sensitivity superior to conventional X-rays: we propose its use to detect margin involvement intraoperatively. We have developed a system that can perform phase-based computed tomography (CT) scans in minutes, used it to image 101 specimens approximately half of which contained neoplastic lesions, and compared results against those of a commercial system. Histological analysis was carried out on all specimens and used as the gold standard. XPCI-CT showed higher sensitivity (83%, 95% CI 69–92%) than conventional specimen imaging (32%, 95% CI 20–49%) for detection of lesions at margin, and comparable specificity (83%, 95% CI 70–92% vs 86%, 95% CI 73–93%). Within the limits of this study, in particular that specimens obtained from surplus tissue typically contain small lesions which makes detection more difficult for both methods, we believe it likely that the observed increase in sensitivity will lead to a comparable reduction in the number of re-operations.

ENDOCRINE FUNCTION OF ADIPOSE TISSUE (LITERATURE REVIEW)

Adipose tissue serves not only as a place for the accumulation and storage of triacylglycerides as energy substrates, but also produces many hormone-like substances, mediators, cytokines, chemokines that act at the local and systemic level and aff ect metabolism, regulate tissue sensitivity to insulin, reproductive and the immune system. The review presents the current results of scientifi c research on the problem of the physiological role of biologically active substances produced by adipose tissue and their participation in the development of metabolic disorders.