MaryBugbee2LynnFairbanks2 YongKe1 ThomasOshiro1 Paul Martin3 FawzyFawzy2 OBJECTIVE.Our objective was to assess the metabolite levels (myo-inositol SUBJECTS AND METHODS.A stimulated-echo sequence was used to localize a sin gle voxel in the parietal region. Seventeenpatients and 13 healthy volunteers were investi gated. Nine of the 17 patients also were investigated after liver transplantation. A battery of neuropsychologic tests also was administered to patients to assessfrontal, memory, and mo tor functions.RESULTS. Before liver transplantation, significant reductions in mI:Cr (5 1%) and Cho:Cr (I I%) and a significant increase in Glx:Cr (20%) were observed in patients compared with the respective ratios in healthy subjects. Patients also were significantly impaired on neuro psychologic tests measuring frontal and motor performance, but not memory. Impairment on the frontal index showed a significant correlation with mI:Cr levels; likewise, performance on the motor index showed a significant correlation with serum ammonia levels before transplan tation. MR spectroscopy after liver transplantation showed changes in the metabolite ratios compared with the pretransplantation status. Even though the Glx:Cr ratios decreased after transplantation, the mI:Cr ratio remained lower than those of healthy subjects. CONCLUSION.The relationship of changes in the metabolite ratios recorded from a voxel in the posteromedial parietal lobe to the neuropsychologic findings before and after liver transplantation is a major finding.

Serum baseline levels of MMP-3 are strong prognostic markers of disease activity, and act well as an early predictor of progressive joint damage in recent-onset RA disease.

Constant increase in the incidence of type-1 diabetes (T1-DM) has made it necessary to have new markers for the early detection of diabetic nephropathy (DN). One of the markers that could be helpful in detecting functional alterations in renal hemodynamics is assessment of the renal resistive index (RI) by using renal Doppler. We studied 25 patients with T1-DM (Group-A), which comprised of 15 females and 10 males, with a mean age of 10.8 ± 2.2 years and duration of diabetes of 5 ± 1.1 years. A control group (Group-B) comprising 20 healthy children, 12 females and eight males with mean age of 11.6 ± 2 years, was also studied. The following parameters were studied in the two groups: age, serum creatinine, albumin excretion rate (AER), glomerular filtration rate (GFR), glycosylated hemoglobin (HbA1c) and mean renal RI of both kidneys. We found an increase in the mean RI in diabetic patients versus healthy children; the mean RI in Group-A was 0.64 ± 0.55 while it was 0.58 ± 0.0.28 in Group-B (P <0.000). This increase in RI had a positive correlation with duration of the disease, GFR and HbA1c levels, but there was no correlation with serum creatinine or AER. We conclude that RI is increased early in TI-DM, and it can be a predictor of DN.

The objective of the present study is to investigate if there is a potential association between the single-nucleotide polymorphisms (SNPs) of the tumor necrosis factor alpha gene (TNF-α -308G/A, rs1800629) and the susceptibility to and severity of early-onset knee osteoarthritis in the Egyptian female population. Genotype distributions and allelic frequencies of TNF-α -308G/A polymorphism were investigated in 210 knee osteoarthritis (OA) patients and 210 age-, sex-, and ethnicity-matched healthy controls (HC). Polymerase chain reaction-restricted fragment length polymorphism (PCR-RFLP) amplifications were implemented to determine TNF-α -308G/A SNP. Serum and synovial fluid levels of TNF-α, besides ESR and CRP, as laboratory markers for inflammation, were estimated for all patients and HC. Plain X-ray as well as MRI knee was done for grading of OA. Disease severity was estimated by Western Ontario and McMaster University Osteoarthritis scores. Percentages of TNF-α-G308A genotypes GG, AG, and AA were 85.7, 11.9, and 2.4% in OA patients and 54.7, 39.1, and 6.2% in controls, respectively. The frequencies of the GG genotype and G allele were significantly higher in subjects with knee OA than in HC (P = 0.04 and P < 0.001, respectively). Logistic regression analysis showed that the GG genotype and G allele are independently associated with increased risk for knee OA (odds ratio = 3.13, 95% confidence interval = 1.04-9.39, P = 0.04 for GG genotype, and odds ratio = 3.81, 95% confidence interval = 2.52-5.76, P = 0.001 for G allele). There is a close relationship between TNF-α-G308A polymorphism and individual susceptibility to and severity of early-onset knee OA in the Egyptian females.

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