Nitric oxide (NO) is the principal mediator of penile erection. NO is synthesized by a variety of nitric oxide synthases (NOS). It has been demonstrated that a decrease in NOS activity, as observed in aging, is associated with a diminished erectile response. The objective of this study was to determine if adenoviral-mediated gene transfer of eNOS could reverse age-related erectile dysfunction in the rat. Two groups of animals were transfected with adenoviruses: (1) aged rats (60 weeks) with AdRSVbgal; and (2) aged rats (60 weeks) with AdRSVeNOS. Five days after transfection, these study animals underwent cavernosal nerve stimulation (CNS) to assess erectile function and their responses were compared with young (20 weeks) control rats. Cross-sections of the rat penises transfected with AdRSVeNOS were examined after trichrome staining. Adenoviral transduction ef®ciency of b-galactosidase reporter gene was measured by a galacto-light chemiluminescent reporter gene assay in cavernosal tissues of rats administered AdRSVbgal. The transgene expression of eNOS was examined by RT-PCR in rats transfected with AdRSVbgal and AdRSVeNOS. eNOS and iNOS protein levels were measured by Western blot analysis, and cGMP levels were assessed in cavernosal tissue by enzyme immunoassay. Adenoviral expression of the b-galactosidase reporter gene was observed in cavernosal tissue for up to 30 days, with peak expression registered at 5 days after intracavernosal administration of AdRSVbgal. Cross-sections of the rat penises transfected with the AdRSVeNOS revealed no pathological (morphological or histological) changes. Five days after administration of AdRSVeNOS, eNOS protein, mRNA and cGMP levels in the corpora cavernosa were signi®cantly increased (P`0.05), while iNOS protein levels remained unchanged (P b 0.05). In conclusion, enhanced expression of eNOS employing an adenoviral vector signi®cantly increased the erectile response to cavernosal nerve stimulation in the aged rat, similar to the response observed in younger rats. These data suggest that in vivo adenoviral gene transfer of eNOS can physiologically improve erectile function in the aged rat.
BACKGROUND: Liver cirrhosis and portal hypertension are common outcomes of chronic liver disease. Portal
hypertension leads to development of oesophageal varices (EV). Oesophageal variceal rupture is the most common
(1,2,3) dreaded complication of cirrhosis that proves to be fatal. In fact, the severity of liver disease can be correlated by the presence and grade of
varices. Currently, oesophagogastroduodenoscopy (OGD) is the gold standard investigation for detection and grading of EV's. However, it is
invasive, costly and frequently requires sedation. The aim of this study is to investigate the diagnostic performance of 2D shear wave
elastography for predicting the presence of oesophageal varices in patients with advanced chronic liver disease (CLD).
METHODS: Study population included 32 cases with CLD and 30 controls without CLD undergoing OGD from August 2019 to August
2021.Prior to undergoing OGD, liver and spleen stiffness elastography were recorded using 2D-SWE. ROC curve was used to nd the cut off
values for liver and spleen stiffness for prediction of EV.
RESULTS: Using 2D-SWE, the association between liver/ spleen stiffness and presence of EV in CLD cases was found to be statistically
signicant (p value-<0.001). The optimal cut off values obtained for prediction of EV was 12 kPa and 12.6kPa for liver and spleen respectively
(sensitivity of 81.8% and specicity of 82.5%; PPV-72%, NPV- 89.2%).
CONCLUSION: Liver and spleen stiffness values obtained by 2D-SWE were found to be a signicant predictive factor for detection of
presence of EV's in patients with CLD.
It is now well established that the target antigens of platelet auto-antibodies are the GP IIb/IIIa and GP Ib/IX receptors. In our study, it was observed that the majority of patients had antibodies directed towards the GP IIb/IIIa receptor, whereas the number of patients having antibodies directed towards the GP Ib/IX receptor was much less. Also, we found that the patients in whom the auto-antibodies are directed towards the GP IIb/IIIa receptors usually have mild bleeding. On the other hand, the patients having auto-antibodies directed towards both GP IIb/IIIa and GP Ib/IX receptors have a severe bleeding diathesis, and usually show poor prognosis to treatment with corticosteroids.
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