Intra-arterial delivery of triolein emulsion increases vascular permeability in skeletal muscles of rabbits

<p>Abstract</p> <p>Background</p> <p>To test the hypothesis that triolein emulsion will increase vascular permeability of skeletal muscle.</p> <p>Methods</p> <p>Triolein emulsion was infused into the superficial femoral artery in rabbits (triolein group, n = 12). As a control, saline was infused (saline group, n = 18). Pre- and post-contrast T1-weighted MR images were obtained two hours after infusion. The MR images were qualitatively and quantitatively evaluated by assessing the contrast enhancement of the ipsilateral muscles. Histologic examination was performed in all rabbits.</p> <p>Results</p> <p>The ipsilateral muscles of the rabbits in the triolein group showed contrast enhancement, as opposed to in the ipsilateral muscles of the rabbits in the saline group. The contrast enhancement of the lesions was statistically significant (p < 0.001). Histologic findings showed that most examination areas of the triolein and saline groups had a normal appearance.</p> <p>Conclusion</p> <p>Rabbit thigh muscle revealed significantly increased vascular permeability with triolein emulsion; this was clearly demonstrated on the postcontrast MR images.</p

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to &lt;90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], &gt;300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of &lt;15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P&lt;0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P&lt;0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Saccadic adaptation in lateral medullary and cerebellar infarction

To determine the adaptive capability of saccadic eye movements, and its association with enduring saccadic dysmetria in cerebellar and lateral medullary infarction (LMI), we investigated saccadic accuracy and adaptation in 15 patients with cerebellar or lateral medullary infarction, compared with those of 7 patients with diffuse cerebellar atrophy and 11 normal subjects. Saccade adaptation was elicited by a 37.5% backward target step during the primary saccade in both horizontal directions. Horizontal preadaptive saccadic gains were decreased in patients with cerebellar infarction, and contralesionally in patients with LMI. In contrast, adaptive saccadic gain change was reduced in patients with diffuse cerebellar atrophy and cerebellar infarction. Saccadic hypometria and reduced saccadic adaptability were dissociated in the majority of the patients with cerebellar infarctions; seven of the eight patients with cerebellar infarction showed saccadic hypometria and only three of them showed reduced saccadic adaptation, uni- or bilaterally in two with bilateral infarctions and ipsilesionally in one with unilateral infarction. The most commonly affected structure on MRI was the cerebellar hemisphere in the patients either with saccadic hypometria or with reduced saccadic adaptation. All patients with unilateral LMI exhibited normal saccadic gain adaptation in both directions, including those patients with enduring saccadic ipsipulsion. Our results suggest that the cerebellar hemispheres as well as the dorsal vermis and fastigial nucleus may be involved in the control of saccadic accuracy and adaptation. Reduced saccadic adaptation and persisting dysmetria are not tightly linked to each other in the cerebellar or lateral medullary lesions

Association of Handgrip Strength with Dietary Intake in the Korean Population: Findings Based on the Seventh Korea National Health and Nutrition Examination Survey (KNHANES VII-1), 2016

To evaluate associations between handgrip strength (HGS) and dietary nutrients, this study of a representative Korean population of 1553 adults aged &ge;60 years (706 men and 847 women) analyzed data from the Korea National Health and Nutrition Examination Survey (2016). HGS was measured in both hands three times using a digital grip strength dynamometer. Dietary intake data were collected by the 24-h recall method through computer-assisted personal interviews. The study population had a mean age of 70.1 years, body mass index (BMI) of 24.2 kg/m2, and HGS of 35.7 kg in men, 21.2 kg in women. Total energy (r = 0.411), protein (r = 0.217), polyunsaturated fatty acid (PUFA) (r = 0.269), fiber (r = 0.272), and vitamin C (r = 0.098) were positively correlated with HGS. In multivariable regression analysis, PUFA (&beta; = 0.083) and vitamin C (&beta; = 0.003) were positively associated with HGS among women. Fiber (&beta; = 0.071) and vitamin C (&beta; = 0.006) showed a positive association with HGS among men. Community-dwelling older men and women with higher levels of PUFA, fiber, and vitamin C in their diet were more likely to have greater HGS even after adjusting for age, total calorie intake, BMI, chronic diseases and health-related habits