Association Between CNDP1 Genotype and Diabetic Nephropathy Is Sex Specific

OBJECTIVE-The 5-5 homozygous CNDP1 (carnosinase) genotype is associated with a reduced risk of diabetic nephropathy. We investigated whether this association is sex specific and independent of susceptibility for type 2 diabetes. RESEARCH DESIGN AND METHODS-Three separate groups of 114, 90, and 66 patients with type 2 diabetes and diabetic nephropathy were included in this study and compared with 93 patients with type 2 diabetes for >15 years without diabetic nephropathy and 472 population control subjects. The diabetes control group was used to determine an association in the three patient groups separately, and the population control group was used to estimate the genotype risk [odds ratio (CI)] for the population in a pooled analysis. The population control subjects were also compared with 562 patients with type 2 diabetes without diabetic nephropathy to determine whether the association was independent of type 2 diabetes. The CNDP1 genotype was determined by fragment analysis after PCR amplification. RESULTS-The frequency of the 5-5 homozygous genotype was 28, 36, and 41% in the three diabetic nephropathy patient groups and 43 and 42% in the diabetic and population control subjects, respectively. The 5-5 homozygous genotype occurred significantly less frequently in women in all three patient groups compared with diabetic control subjects. The genotype risk for the population was estimated to be 0.5 (0.30-0.68) in women and 1.2 (0.77-1.69) in men. The 562 patients with type 2 diabetes without diabetic nephropathy did not differ from the general population (P = 0.23). CONCLUSIONS-This study suggests that the association between the CNDP1 gene and diabetic nephropathy is sex specific and independent of susceptibility for type 2 diabetes. Diabetes 59:1555-1559, 201

Ex vivo magnetic resonance imaging of pretransplant human donor liver. Clinical experience in 66 cases

Magnetic resonance imaging (MRI) was performed on 66 cold-stored human donor livers. Spin echo images were obtained with a clinical whole body MRI system. Various parenchymal and vascular abnormalities were found. An unexpected finding was the abundant presence of intrahepatic air. Although the majority of parenchymal abnormalities that were found would not have precluded transplantation, the rationale of pretransplant MRI was to prevent the introduction of unidentified pathology into the recipient. Guided by the MR images, lesions in the isolated organ can be easily located for biopsy and resection. Unnecessary or inadequate therapeutic interventions after transplantation can thus be avoided. In addition, the visualization of the hepatic veins with their confluence appears to be useful in split-liver procedures

Comparison of continuous non-invasive finger arterial pressure monitoring with conventional intermittent automated arm arterial pressure measurement in patients under general anaesthesia

Background: For a majority of patients undergoing anaesthesia for general surgery, mean arterial pressure (MAP) is only measured intermittently by arm cuff oscillometry (MAP(iNIAP)). In contrast, the Nexfin (R) device provides continuous non-invasive measurement of MAP (MAP(cNIAP)) using a finger cuff. We explored the agreement of MAP(cNIAP) and MAP(iNIAP) with the gold standard: continuous invasive MAP measurement by placement of a radial artery catheter (MAP(invasive)). Methods: In a total of 120 patients undergoing elective general surgery and clinically requiring MAP(invasive) measurement, MAP(iNIAP) and MAP(cNIAP) were measured in a 30 min time period at an arbitrary moment during surgery with stable haemodynamics. MAP(iNIAP) was measured every 5 min. Results: Data from 112 patients were analysed. Compared with MAP(invasive), modified Bland-Altman analysis revealed a bias (SD) of 2 (9) mm Hg for MAP(cNIAP) and -2 (12) mm Hg for MAP(iNIAP). Percentage errors for MAP(cNIAP) and MAP(iNIAP) were 22% and 32%, respectively. Conclusions: In a haemodynamically stable phase in patients undergoing general anaesthesia, the agreement with invasive MAP of continuous non-invasive measurement using a finger cuff was not inferior to the agreement of intermittent arm cuff oscillometry. Continuous measurements using a finger cuff can interchangeably be used as an alternative for intermittent arm cuff oscillometry in haemodynamically stable patients, with the advantage of beat-to-beat haemodynamic monitoring

On the principles underlying the diagnosis of brain tumours--a survey article

A survey is given of the principles underlying the diagnosis of brain tumours. Traditionally diagnosis and localization of brain tumours have been based upon morphological criteria. Currently unsurpassed levels in imaging of anatomical details and topographical relations by the techniques of computed tomography (CT) and magnetic resonance imaging (MRI) have been achieved. The techniques of positron emission tomography (PET) and of magnetic resonance spectroscopy (MRS), which depict also metabolic and blood flow aspects, provide a refinement of our knowledge on the metabolism, structure and pathophysiological relations of a tumour to the surrounding parenchyma. Recent advances in the recording of function-related changes of the cerebral electro-magnetic field allow a better definition of critical functional areas.</p