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Lack of C-peptide, along with insulin, is the main feature of type 1 diabetes mellitus (DM) and is also observed in progressive β-cell loss in later stage of type 2 [...], C-peptide is a bioactive peptide with a potentially protective role in diabetes complications; however, its molecular mechanism of protection against cardiovascular damage caused by hyperglycemia-induced apoptosis remains unclear. We investigated the protective mechanism of C-peptide against hyperglycemia-induced apoptosis using human umbilical vein endothelial cells and streptozotocin diabetic mice. High glucose (33 mmol/L) induced apoptotic cell death in endothelial cells via sequential elevation of intracellular [Ca.sup.2+] and reactive oxygen species (ROS) as well as subsequent activation of transglutaminase 2 (TG2). C-peptide (1 nmol/L) prevented endothelial cell death by inhibiting protein kinase C- and NADPH oxidase--dependent intracellular ROS generation and by abolishing high glucose-induced TG2 activation, without affecting intracellular [Ca.sup.2+] levels. Consistently, in the aorta of streptozotocin diabetic mice, hyperglycemia stimulated transamidating activity and endothelial cell apoptosis that was inhibited by C-peptide replacement therapy (35 pmol/min/kg) using osmotic pumps (control and diabetes, n = 8; diabetes + Coeptide, n = 7). In addition, C-peptide prevented hyperglycemia-induced activation of transamidation activity and apoptosis in the heart and renal cortex of streptozotocin diabetic mice. Thus, Coeptide protects endothelial cells from hyperglycemia-induced apoptotic cell death by inhibiting intracellular ROS-mediated activation of TG2. Furthermore, TG2 may be a promising avenue of therapeutic investigation to treat diabetic vasculopathies. Diabetes 62:243-253, 2013

We present a rare case of a very rapidly growing stage IV ovarian endometrioid adenocarcinoma involving the uterine cervix and vagina without lymph node involvement.

Primary intestinal volvulus in a fetus without an underlying cause has been rarely reported. We report a case of fetal primary segmental volvulus of the ileum. A 27-year-old woman was referred at 32 weeks of gestation for evaluation of decreased fetal movement. A fetal ultrasound detected a single, significantly-dilated bowel loop without a vascular supply (coffee bean sign), and a fetal MRI revealed the ‘whirl-pool sign’. An emergency cesarean delivery and laparotomy revealed segmental volvulus of the ileum without any causative factors. Segmental resection resolved the condition without sequelae. Fetal primary segmental volvulus can occur without any underlying pathology, and rapid diagnosis and prompt intervention is mandatory for a good outcome.