Long-term treatment of severe hypertension with minoxidil.

Minoxidil, a new potent hypotensive agent, was used as the primary antihypertensive agent in 11 patients--10 men and 1 woman aged 35 to 54 years with severe hypertension that was refractory to treatment with maximal (or maximally tolerated) doses of conventional antihypertensive agents. Six patients had severely impaired renal function and three of them were undergoing long-term hemodialysis. The patients were given 2.5 to 40 mg/d of minoxidil for periods of 2 to 29 months. All except one who was almost anuric received propranolol and diuretics. Blood pressure was controlled satisfactorily in all patients. In two patients the hypertension became partially resistant after 1 year of treatment. The main side effects were sodium retention, tachycardia and hirsutism. Renal function remained stable or improved and hemodialysis was discontinued in two patients. Minoxidil is a remarkably potent hypotensive with relatively few side effects and seems particularly advantageous in patients with chronic renal failure.     

Ganglioside GD1a is an essential coreceptor for Toll-like receptor 2 signaling in response to the B subunit of type IIb enterotoxin

Innate recognition and signaling by Toll-like receptors (TLRs) is facilitated by functionally associated coreceptors, although the cooperativity mechanisms involved are poorly understood. As a model we investigated TLR2 interactions with the GD1a ganglioside binding subunit of type IIb Escherichia coli enterotoxin (LT-IIb-B(5)). Both LT-IIb-B(5) and a GD1a binding-defective mutant (LT-IIb-B(5)(T13I)) could modestly bind to TLR2, but only the wild-type molecule displayed a dramatic increase in TLR2 binding activity in the presence of GD1a (although not in the presence of irrelevant gangliosides). Moreover, fluorescence resonance energy transfer experiments indicated that LT-IIb-B(5) induces lipid raft recruitment of TLR2 and TLR1 and their clustering with GD1a, in contrast to the GD1a binding-defective mutant, which moreover fails to activate TLR2 signaling. LT-IIb-B(5)-induced cell activation was critically dependent upon the Toll/IL-1 receptor domain-containing adaptor protein, which was induced to colocalize with TLR2 and GD1a, as shown by confocal imaging. Therefore, GD1a provides TLR2 coreceptor function by enabling the ligand to recruit, bind, and activate TLR2. These findings establish a model of TLR2 coreceptor function and, moreover, suggest novel mechanisms of adjuvanticity by non-toxic derivatives of type II enterotoxins dependent upon GD1a/TLR2 cooperative activity.     

New synapses associated with the granule-containing cells of rat sympathetic ganglia

The synapses of the rat superior cervical sympathetic ganglion were studied with both conventional and ultrastructural histochemical methods. Besides the cholinergic synapses polarized from preganglionic fibers to sympathetic ganglion neurons, two morphologically and functionally different types of synapses were observed in relation to the small granule-containing (catecholamine-containing) cells of the rat superior cervical ganglion. The first type is an efferent adrenergic synapse polarized from granule-containing cells to the dendrites of the sympathetic ganglion neurons. This type of synapse might mediate the inhibitory effects (slow inhibitory postsynaptic potentials) induced by catecholamines on the sympathetic neurons. The second type is a reciprocal type of synapse between the granule-containing cells and the cholinergic preganglionic fibers. Through such synapses, these cells could exert a modulating effect on the excitatory preganglionic fibers. Therefore, we propose that these cells, through their multiple synaptic connections, exhibit a local modulatory feedback system in the rat sympathetic ganglia and may serve as interneurons between the preganglionic and postganglionic sympathetic neurons.     

The effect of maternal Naja nigricollis envenomation on the placenta. An experimental study

The effect of maternal envenomation with N. nigricollis venom on the placental tissues was studied in mice. The venom seemed to exert a direct toxic effect on the constituent parts of the placenta. Glycogen appeared to advantage in the cells of the trophospongeal part of the placenta. Giant cells and basophilic cells were encountered around such glycogen cells. However, some giant cells showed vacuolation of the cytoplasm and pyknosis of the nuclei. The labyrinthine part of the placenta showed large and multiple small thrombi and congestion of the blood spaces. Again glycogen appeared to advantage in the syncytial cells. Non cellular exudate was also met with in such cases. The possible mechanisms of these changes were discussed.     

Human NAIP/NLRC4 and NLRP3 inflammasomes detect Salmonella type III secretion system activities to restrict intracellular bacterial replication

Salmonella enterica serovar Typhimurium is a Gram-negative pathogen that uses two distinct type III secretion systems (T3SSs), termed Salmonella pathogenicity island (SPI)-1 and SPI-2, to deliver virulence factors into the host cell. The SPI-1 T3SS enables Salmonella to invade host cells, while the SPI-2 T3SS facilitates Salmonella’s intracellular survival. In mice, a family of cytosolic immune sensors, including NAIP1, NAIP2, and NAIP5/6, recognizes the SPI-1 T3SS needle, inner rod, and flagellin proteins, respectively. Ligand recognition triggers assembly of the NAIP/NLRC4 inflammasome, which mediates caspase-1 activation, IL-1 family cytokine secretion, and pyroptosis of infected cells. In contrast to mice, humans encode a single NAIP that broadly recognizes all three ligands. The role of NAIP/NLRC4 or other inflammasomes during Salmonella infection of human macrophages is unclear. We find that although the NAIP/NLRC4 inflammasome is essential for detecting T3SS ligands in human macrophages, it is partially required for responses to infection, as Salmonella also activated the NLRP3 and CASP4/5 inflammasomes. Importantly, we demonstrate that combinatorial NAIP/NLRC4 and NLRP3 inflammasome activation restricts Salmonella replication in human macrophages. In contrast to SPI-1, the SPI-2 T3SS inner rod is not sensed by human or murine NAIPs, which is thought to allow Salmonella to evade host recognition and replicate intracellularly. Intriguingly, we find that human NAIP detects the SPI-2 T3SS needle protein. Critically, in the absence of both flagellin and the SPI-1 T3SS, the NAIP/NLRC4 inflammasome still controlled intracellular Salmonella burden. These findings reveal that recognition of Salmonella SPI-1 and SPI-2 T3SSs and engagement of both the NAIP/NLRC4 and NLRP3 inflammasomes control Salmonella infection in human macrophages.     

The Salford Lung Study protocol: a pragmatic,randomised phase III real-world effectiveness trial in chronic obstructive pulmonary disease

Background

New treatments need to be evaluated in real-world clinical practice to account for co-morbidities, adherence and polypharmacy.

Methods

Patients with chronic obstructive pulmonary disease (COPD), ≥40 years old, with exacerbation in the previous 3 years are randomised 1:1 to once-daily fluticasone furoate 100 μg/vilanterol 25 μg in a novel dry-powder inhaler versus continuing their existing therapy. The primary endpoint is the mean annual rate of COPD exacerbations; an electronic medical record allows real-time collection and monitoring of endpoint and safety data.

Conclusions

The Salford Lung Study is the world’s first pragmatic randomised controlled trial of a pre-licensed medication in COPD.

Trial registration

Clinicaltrials.gov identifier {"type":"clinical-trial","attrs":{"text":"NCT01551758","term_id":"NCT01551758"}}NCT01551758.     

Effect of food on development,reproduction and survival ofChiropturopoda bakeri (Acarina: Uropodidae)

Chiropturopoda bakeri Zaher and Afifi was found in organic manure on the farm of the Faculty of Agriculture, Cairo University at Giza. The duration of its developmental stages, feeding habits and reproduction were determined. Food type greatly affected fecundity and rate of reproduction. Statistical analysis proved that an animal dict (larvae of house and vinegar flies) was more suitable than fungi for increasing reproductive potentiality at 30°C.     

Hypoglycémie spontanée et insuffisance rénale chronique.

Although glucose intolerance occurs as a consequence of chronic renal failure, improvement of a diabetic state by deterioration of renal function is a well known phenomenon. Recently occasional cases of spontaneous hypoglycemia in patients with chronic renal failure have been reported; two such cases and the results of metabolic studies are described in this paper. Pituitary, thyroid and adrenal function appeared to be normal. The results of an oral glucose tolerance test were normal; an appropriate insulin response was demonstrated in one patient, and a slightly elevated basal insulin value with a delayed insulin response to oral administration of glucose was demonstrated in the other. An insulin tolerance test did not support the hypothesis of increased insulin sensitivity as a factor, and the growth hormone response to hypoglycemia was normal. An intravenous glucagon test caused a subnormal increase in plasma glucose concentration, and the intravenous administration of tolbutamide produced hypoglycemia without an increase insulin sensitivity as a factor, and the growth hormone response to hypoglycemia was normal. An intravenous glucagon test caused a subnormal increase in plasma glucose concnetration, and the intravenous administration of tolbutamide produced hypoglycemia without an increase in insulin values. The plasma alanine concentration was low and the proinsulin/insulin ratio was increased. The origin of this hypoglycemia is not clear but is probably multifactorial. However, low hepatic glycogen stores and inadequate gluconeogenesis due to substrate deficiency seem to be involved.     

Comparative microscopical study of the gall bladder mucosa.

The gall bladder from 6 Psammophis sibilans, 10 Bufo regularis and 10 Albino mice were extracted and prepared for microscopic examination. It was found that the mucosa of Psammophis sibilans consisted of ovoid and polygonal cells which were occasionally binucleated cells with darkly stained nuclei and occasionally pear-shaped cells with vesicular nuclei and fine processes. These cells were arranged in three layers. Apossible explanation for the different types of cells encountered and their arrangement was given. The gall bladder mucosa of Bufo regularis and Albino mouse were thrown into folds covered with simple columnar epithelium. However, the epithelium of the frog was higher than that of the mouse, with the nuclei situated midway between basement membrane and the lumen. Vacuolated cells were detected in the gall bladder mucosa of the mouse. The significance of the mucosal folds was discussed.