role of vascular endothelial growth factor [VEGF] in development of diabetic micro vascular complications

The aim of this study to determine serum level of VEGF in patients with Diabetic Micro vascular and macrovascular complication as Diabetic Nephropathy, retinopathy and cardiovascular insufficiency mainly acute myocardial infarction. Fifty individuals were investigated. 10 apparently healthy persons [4 females and 6 males] as control group, 20 maturity onsets diabetic patients [non-insulin dependent] with diabetic nephropathy [8 females and 12 males], 10 maturity onset diabetic patients [non-insulin dependant] with diabetic retinopathy [4 female and 6 males] and 10 maturity onset diabetic patients [non-insulin dependant] with acute myocardial infarction [4 female and 6 male]. Serum level of VEGF was measured in those patients and correlated with different clinical and laboratory investigations. Serum level of VEGF was significantly high in diabetic patient with micro-vascular complication "629.75 +/- 317.07' compared with healthy control 139.75 +/- 12.97". Serum level of VEGF was significantly high in patients with Diabetic riephropathy "553 +/- 232.03", compared with healthy control "139.4 +/- 12.97". Serum level of VEGF was significantly high in patients with diabetic retinopathy "507 +/- 327" compared with healthy control "139.4 +/- 12.97". Serum level of VEGF was significantly high in diabetic patients with acute myocardial infaction "807 +/- 316.01" compared with healthy control "139.4 +/- 12.97". There was significant positive correlation between serum VEGF, serum creatinine and microablumjnuria. These Data suggest that VEGF plays control role in mediating micro vascular pathology in Diabetes. VEGF may be one of the markers and risk factors for micro-albuminuria and incipient diabetic Nephropathy. There was significant correlation between VEGF level and recent acute myocardial infarction, which may postulate that VEGF serve a salutary role in hypoxic myocardial tissue of coronary artery disease by promoting development of collateral circulation

Chemical ablation of the bladder urothelium and intestinal de-epithelialization in augmentation cystoplasty: An experimental study

To determine the chemical de-epithelialization effect of protamine sulphate and urea treatments on the bladder epithelium and mucosa of the ileal segments used in augmentation cystoplasty using segment. Three groups of dogs [5 dogs in each one] were used in the study. All groups underwent augmentation cystoplasty using ileal segment. The first one [Group I] was a control group with no treatments after operation, the bladder was filled with normal saline and emptied after 30 minutes and the catheter was removed. The second group [Group II] was treated through infusion of the augmented bladder by 5 mg/ml protamine sulphate for 15 minutes. The bladder was emptied and filled with urea at concentration of 100 gm/L solution for 15 minutes then emptied, and the catheter is removed. The third group [Group III] was infused with the two drugs but in a double concentration. Biopsies from the intestinal and bladder segments were taken immediately after augmentation cystoplasty and after an interval of one month and evaluated microscopically for epithelial changes. At the same time, 24-hour urine was collected for determination of urine mucoprotins among the studied groups. Serum electrolytes; urea nitrogen and creatinine were within normal values in all groups of the study. The use of protamine sulphate and urea as chemical de-epithelialization agents for the bowel segment had led to atrophy of the mucosal villi and decrease number of goblet cells significantly so decreasing the absorptive capacity of the villi and secretory capacity of the goblet cells. Mucoprotein measurement immediate and at one month postoperatively showed that there was insignificant difference in mucoprotein in urine of 24 hours immediate postoperative between all groups. On the other hand, there was a significant difference between all groups after one month. Also, mucoprotein secretion in Group II was significantly less than that of Group I [P < 0.05]. While as regard mucoprotein secretion in Group III, the decrease was highly significant than that in Groups I and II [P < 0.001]. De-epithelializatjon of both the bladder and intestinal segments occurred promptly by using protamine sulphate and urea. This is supposed to be followed by reepithelialization by transitional epithelium later on. These results were confirmed by the decreased mucoprotein secretion in urine. This approach may be of possible use as a chemical ablation for the intestinal mucosa used in the augmentation cystoplasty or ileal neobladder and as a possible treatment alternate for bladder carcinoma in situ