[Measurement of serum and 24-h urinary glucose amino glycans as an diagnostic marker in early hypertention]

Glucose Amino Glycans [GAG] are unbranched polysacharides, major components of the basement membrane and play a key role in their molecular organization and function, also have an important role in the pathogenesis of some diseases such as hypertension. Hypertention is probably the most important health problem in several countries. But there is not yet a reliable indicator for early diagnosis of hypertension. The goal of this study was the measurement of serum and 24-h urinary GAG as an exact and early diagnostic marker. In this case - control study, 24-h urine and serum samples collected from the 53 patients and 38 persons as matched control normotensive group. Then amount of GAG was measured with spectrophotometery method. Our findings showed that there is a direct relation between 24-h urinary GAG excretion and systolic blood pressure and it increases with increase of systolic blood pressure. Also amount of serum GAG increases in hypertensive patients in comparison with control group This study showed that the concentration of GAG in sera and 24-h of urine samples increase in systolic hypertention

Efficacy of arthrocentesis, splint therapy and MRI assessment in management of patients with temporomandibular joint disorders

To evaluate clinical biochemical and imaging assessment of the efficacy of lavage [arthrocentesis] of proinflammatory cytokines in the synovial fluid in symptomatic TMJ with or without the use of anterior repositioning splint. Radiodiagnosis Department. Faculty of Medicine, Alexandria University, Maxillofacial surgery, Prosthodentics and Oral surgery Departments, Faculty of Dentistry, Alexandria University. 20 patients [12 females and 8 males] with symptoms of TMJ pain, joint noise, limitation of joint opening, tenderness located in the articular region. all patients underwent full clinical examination and diagnostic imaging [panoramic radiographs] and MRI. patients were grouped into two; [group I] those treated by arthrocentesis of TMJ [the proinflammatory cytokines alone] and [group 2] those were treated by arthrocentesis and anterior repositioning splint therapy. arthrocentesis were done two times with interval of 6 weeks. MRI were done before treatment and after two months from treatment. the patients were divided into two groups both groups were treated with anhrocenzesis mandibular hard acrylic resin repositioning splint constructed for group 2 and was worn after arthrocentesis. clinical, biochemical and radiological imaging [MRI] evaluations were carried out to assess the efficacy of arthrocentesis [lavage] of the inflammatory cytokines in the synovial fluid of the symptomatic TMJ disc position and erosions can be fully assessed by MRI and both groups demonstrated marked clinical improvements after treatment mainly of group 2 and this match with the improvement of the disc position identified by MRI. patients with disc erosions were the least to improve. 1. the combination treatment of arthrocentesis of TMJ and mandibular repositioning splint give the advantages of pain relief and considered as the treatment modality of choice before surgical intervention to avoid the morbidity associated with surgery. 2. MRI is the only direct objective, very sensitive and accurate imaging modility to test the validity and effect as well as the prognosis of lavage [arthrocentesis] and prothesis treatment [splint therapy] of TMJ disorders. 3. erosion of the disc is a sign of bad omen in the way of anatomical repositioning of the disc after different modalities of treatment

Elevated serum glycosaminoglycans with hypomagnesemia in patients with coronary artery disease & thrombotic stroke.

Elevated levels of serum glycosaminoglycans (GAG), associated with hypomagnesemia were observed in patients of proven CAD and thrombotic stroke in Kerala. Serum lipid profile was normal in the majority of these patients, indicating that elevated serum GAG may be an even more reliable indicator of atherosclerosis than elevated serum total cholesterol or LDL cholesterol. Autopsy samples of carotid artery and aorta which had atheroma showed significantly higher GAG when compared to samples which showed no atheroma. Serum Mg levels were significantly lower in CAD and thrombotic stroke patients as compared to controls. Mg deficiency may be one of the factors involved in the increased level of GAG.

Implications of naturally occurring variations in arterial glycosaminoglycans for the pathogenesis of atherosclerosis

Proteoglycans and their constituent glycosaminoglycan (GAG) side chains participate in the pathogenesis of atherosclerosis by holding and modifying plasma lipoproteins (LDL). Of the GAGs existing in arteries, only chondroitin sulfate and dermatan sulfate interact with LDL.In addition, these LDL-binding GAGs show some naturally occurring variations that have direct consequences to their participation in atherogenesis. These variations are: (1) Polydispersity: GAGs normally vary widely in molecular weight and in human aortas there are longer chains of chondroitin sulfate/dermatan sulfate presenting stronger affinity to LDL; (2) Ageing: steric factors play a role in GAG-LDL interaction, and with ageing there is an increase in the relative content of the 6-sulfated isomer of aortic chondroitin sulfate; this isomer binds to LDL, whereas the 4-sulfated isomer does not: (3) Anatomic heterogeneity: The risk to develop atherosclerotic lesions is different among arteries, and the composition and LDL binding affinity of chondroitin sulfate/dermatan sulfate from normal arteries correlate with their susceptibility to atherosclerosis. The participation of GAGs in atherosclerosis should therefore be viewed as variable.

Fibronectin, glycosaminoglycans and vessel wall thickness in diabetic micro-angiopathy before and after control of diabetic state

This work was conducted to evaluate the role of fibronectin [FN] and glycosaminoglycans [GAG] in diabetic vascular complications and to study the effect of different modalities of treatment of diabetes on microangiopathy. Plasma, FN, 24-hours urinary GAG, and capillary and arteriolar wall thickness in skeletal muscle biopsy specimens were measured in 15 control subjects and 45 diabetic patients classified according to their line of treatment into insulin group, glipizide group and gliclazide group. The patients were further subdivided into diabetics with and diabetics without microvasular complications [retinopathy and or nephropathy]. At the beginning of the study, the mean values of plasma FN, urinary GAG and percentage wall thickness of muscle capillaries and arterioles for each of the patient groups were significantly higher than those for control group [P<0.01 for all parameters in all groups]. By the end of one year therapy with control of hyperglycemia, plasma FN level decreased significantly in non complicated orally treated patients [P<0.01 in glipizide subgroup and P<0.05 in gliclazide subgroup], while urinary GAG had decreased significantly in all non complicated diabetics [P<0.05]. We observed, also a significant decrease in muscle capillary and arteriolar wall thickness in both non complicated, insulin [P<0.05] and glipizide [P<0.01] treated subgroups. Finally, a significant positive correlation was observed between both plasma FN and percentage wall thickness of muscle capillaries and arterioles in all patient groups at the beginning of the study and in orally treated groups one year after therapy. We concluded that thickening of skeletal muscle capillary and arteriolar wall and elevated plasma FN levels could be used as early indicators of diabetic microangiopathy. Also raised levels of FN and GAG may have a role in the pathogenesis of diabetic microangiopathy. Finally we found in this study that glipizide had better effect concerning diabetic microangiopathy than insulin and gliclazide

Glicosaminoglicanos plasmáticos em portadores de coronariopatia e hiperlipidemia / Plasma glycosaminoglycans in patients with coronary disease and hyperlipidemia

Com o objetivo de verificar se as concentraçöes séricas de lípides sanguíneos influenciam quantitativa e/ou qualitativamente os glicosaminoglicanos (GAG) circulantes, os autores analisaram estas substâncias em 14 indivíduos hiperlipidêmicos (13 com hiperlipidemia mista e 1 com hipercolesterolemia)tendo como controle 12 indivíduos normolipidêmicos (6 acima e 6 abaixo de 40 anos). Os GAG foram estudados em relaçäo a seu teor de sulfataçäo (GAG-HS-altamente sulfatados; GAG-LS-com baixa sulfataçäo) e pela separaçäo e quantificaçäo de seus componentes dermatan, heparan e condroitin sulfatos (condroitin 4 e condroitin 6-sulfato). Näo foram observadas diferenças significativas dos GAG e de suas fraçöes quando confrontados indivíduos normo e hiperlipidêmicos tanto do ponto de vista quantitativo quanto qualitativo. Também näo foram observadas relaçöes de dependência entre os valores das variáveis do perfil lipídico e das fraçöes de GAG. Os autores concluem que os fatores ambientais e/ou genéticos que determinam elevaçäo dos lípides circulantes näo atuam sobre os GAG plasmáticos