Retinopathy in type 2 diabetic patients with microalbuminuria.

OBJECTIVE: To determine the prevalence of retinopathy in type 2 diabetic patients with micoalbuminuria and to evaluate the association of risk factors with prevalence of retinopathy in these patients. MATERIAL AND METHODS: A fundus examination of 137 patients suffering from type 2 diabetes mellitus with microalbuminuria was done, with direct ophthalmoscope/ binocular indirect ophthalmoscope after dilating the pupils with 1 % tropicamide eye drops. Retinal changes were graded as no retinopathy, non-proliferative retinopathy, proliferative retinopathy and maculopathy. The association of the duration of diabetes, control of diabetes, hypertension, hyperlipidemia, smoking, obesity and peripheral neuropathy was assessed with the prevalence of retinopathy in these patents. RESULTS: The mean age of the patients was 58 years (range 35 - 79 years); 62 % were females, and 49.6 % were Chinese. Diabetic retinopathy was seen in 36.5 % of the patients - non proliferative in 29.2 %, proliferative in 7.3 % and maculopathy in 5.1 % of patients. A longer duration of diabetes (p = 0.002), poor control of diabetes (p = 0.002), presence of hypertension (p = 0.03), and presence of peripheral neuropathy (p = 0.001) were significantly associated with the prevalence of retinopathy; while hyperlipidemia (p = 0.29), smoking (p = 0.43) and obesity (p = 0.43) were not associated with retinopathy. CONCLUSION: Retinopathy was seen in 36.5 % of type 2 diabetic patients with microalbuminuria; 7.3 % had proliferative retinopathy and 5.1 % maculopathy (both sight threatening changes). All diabetic patients with microalbuminuria should be screened for retinopathy so that treatment can be instituted in the required patients to prevent ocular morbidity/ blindness.

Electron energy loss spectra near structural defects in TiN and TiC.

In this study, we use first principles multiple scattering calculations on atomic clusters to show how the carbon and nitrogen K-edge fine structures are modified in the vicinity of structural defects in TiN and TiC. Changes in the electron energy loss spectra are due to changes in the atomic structure of the first atomic shells around the absorbing atom. Two different kinds of defects, which both modify the structure of these atomic shells, are investigated here. In a first part, we describe a method which correctly takes into account the statistical spatial distribution of nitrogen vacancies in a TiN cluster. We study the influence of vacancy concentration on the shape of the nitrogen K-edge spectra and we find that vacancies mainly affect the height of the second peak of the spectra. This peak decreases when the number of vacancies in the second nitrogen shell increases. In a second part, we study the carbon K-edge spectrum modification near stacking faults in TiC. Two different stacking faults are studied. These two-dimensional defects are responsible for changes in the position of the carbon as well as titanium atoms of the atomic shells centered on the absorbing carbon atom. The shape of the spectra is strongly modified near the stacking faults and several peaks are affected by these modifications. We show that these fine structure modifications only concern the very first carbon atomic layers near the two-dimensional defects.

Changes in immunological properties of neutrophil alkaline phosphatase in trisomy 21 pregnancies.

Immunoreactivity, cytochemical, immunocytochemical characteristics and subcellular distribution of neutrophil alkaline phosphatase (NAP) were investigated in blood and/or smear samples from 18 women aged 23-46 years (mean 32.5 years) with trisomy 21 fetuses (17-21 weeks) and 28 women aged 20-42 years (mean 31 years) with normal fetuses (17-22 weeks). Immunochemical NAP investigations were carried out in 8 pathological and 8 normal pregnancies; cytochemical and immunocytochemical procedures were carried out in 18 pregnant women with trisomy 21 fetuses and 28 controls. NAP from women with trisomy 21 fetuses is characterized by: (1) a significant decrease in reactivity with anti-liver-type alkaline phosphatase (AP) and anti-NAP antisera; (2) low or very slight reactivity with antiplacental or anti-intestinal antibodies; (3) marked dispersion of NAP lead citrate reaction products or anti-NAP antibody colloidal gold-labelling in neutrophil cytoplasms, as detected by electron microscopy. This subcellular AP distribution (extramembranous) is different from that of normal NAP sites associated with plasma membrane, nuclear membrane and secretory vesicles. The NAP immunochemical and cytochemical characteristics suggest that neutrophils of a woman with a trisomy 21 fetus contain two AP isoenzymes: the liver/bone type and an atypical AP.

Nuclear localization and characterization of alkaline phosphatase in neutrophils from normal controls and pregnant women.

There were controversial data concerning localization of alkaline phosphatase (AP) in neutrophil nuclei under physiological conditions. In this context, the AP pattern has been determined on nuclei preparations from normal human neutrophils. Blood cells were isolated from 10 healthy adults and from 3 women in the third trimester of an uncomplicated pregnancy. Purity of nuclear suspension was checked by electron microscopy and assay of organelle marker enzymes. Electron microscope cytochemistry and immunocytochemistry studies were carried out on WBC. Enzyme characterization was performed by the usual biochemical procedures. AP was found in nuclear preparations from four of ten normal controls. When present, AP was detected in approximately two-thirds of the nuclei examined, representing an average of 20% of the total cell activity. Conversely, a large amount of nucleus-bound enzyme (55% of total AP activity) was recognized in all pregnant women samples. Biochemical and immunological characteristics clearly differentiate AP forms in the two groups of subjects. Normal controls have an heterogeneous enzyme pattern. AP positive preparations contain a mixture of isoenzymes: a prominent heat labile form and a relatively heat stable minor component. The heat stable fraction displays some properties similar to those previously described in leukocyte AP. Pregnant women express a unique very heat labile isoenzyme identical in its main characteristics to the early placental type.