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The objective of this study was to examine total exchangeable sodium, plasma-blood volume, and the status of the renin-angiotensin system in hypertensive diabetic patients with established nephropathy. We also evaluated hypertensive patients with diabetes who were free of clinically apparent nephropathy or other diabetic complications. Total exchangeable sodium (by 24Na dilution) was expressed as percentage predicted. Subjects were studied as inpatients receiving unrestricted sodium intake and in stable metabolic control. Total exchangeable sodium was 100 +/- 2% in controls (n = 42), higher (p less than 0.01) at 108 +/- 2% in normotensive patients with diabetes (n = 30), and higher still (p less than 0.005) in hypertensive patients with diabetic nephropathy (n = 16) 118 +/- 4% (p less than 0.05 vs normotensive diabetics). The value correlated with blood pressure only in diabetics with nephropathy (r = 0.61, p less than 0.01). Plasma renin activity, and blood and plasma volumes were similar in nephropathic diabetics and controls. Hypertensive patients with maturity-onset (type II) diabetes free of nephropathy (n = 18) were compared with nondiabetic controls (n = 16) and normotensive patients with type II diabetes (n = 18) of similar age. Total exchangeable sodium in the controls was 100 +/- 3%, higher (p less than 0.01) in normotensive diabetics at 109 +/- 2%, but not significantly elevated in hypertensive diabetics at 106 +/- 2%. Again, blood and plasma volumes did not differ among the groups. Plasma renin activity was suppressed (p less than 0.01) to a comparable degree in both normotensive and hypertensive patients with type II diabetes.(ABSTRACT TRUNCATED AT 250 WORDS)

The response to a 21 infusion of physiological saline infusion was studied in 7 male uncomplicated insulin-dependent diabetics and in 7 non-diabetic male controls. The urinary sodium excretion in the diabetics in each of the 4 hr following the infusion was approximately half that of the controls. The total induced sodium excretion in controls was 34 +/- 4 mmols (mean +/- SEM) but only 14 +/- 4 mmols in the diabetics (p less than 0.005). The hourly creatinine clearance rate was higher in diabetics than in controls indicating a mechanism of reduced sodium excretion via enhanced tubular reabsorption rather than impaired filtration. This propensity to sodium retention in diabetics may play a role in the tendency to cardiovascular and renal complications.

SUMMARY Melatonin profiles were studied in five males with cytogenetic and clinical features of the fragile-X syndrome including megalo-orchidia and macrogenitosomia. In comparison with age-matched normal controls, the fragile-X group showed lower melatonin values and a significant impairment of the nocturnal rise in this hormone. Melatonin deficiency may thus be responsible for some of the phenotypic features of this disorder.

Background The PCK1 gene, encoding cytosolic phosphoenolpyruvate carboxykinase (PEPCK-C), has previously been implicated as a candidate gene for type 2 diabetes (T2D) susceptibility. Rodent models demonstrate that over-expression of Pck1 can result in T2D development and a single nucleotide polymorphism (SNP) in the promoter region of human PCK1 (-232C/G) has exhibited significant association with the disease in several cohorts. Within the UK-resident South Asian population, T2D is 4 to 6 times more common than in indigenous white Caucasians. Despite this, few studies have reported on the genetic susceptibility to T2D in this ethnic group and none of these has investigated the possible effect of PCK1 variants. We therefore aimed to investigate the association between common variants of the PCK1 gene and T2D in a UK-resident South Asian population of Punjabi ancestry, originating predominantly from the Mirpur area of Azad Kashmir, Pakistan. Methods We used TaqMan assays to genotype five tagSNPs covering the PCK1 gene, including the -232C/G variant, in 903 subjects with T2D and 471 normoglycaemic controls. Results Of the variants studied, only the minor allele (G) of the -232C/G SNP demonstrated a significant association with T2D, displaying an OR of 1.21 (95% CI: 1.03 - 1.42, p = 0.019). Conclusion This study is the first to investigate the association between variants of the PCK1 gene and T2D in South Asians. Our results suggest that the -232C/G promoter polymorphism confers susceptibility to T2D in this ethnic group. Trial Registration UKADS Trial Registration: ISRCTN38297969

There are few fields in medicine in which the available facts are so little known and utilized by the practitioner as in nephritis. He continues to make the diagnosis of this disease by the finding of albuminuria. The patient's progress is measured by the amount of this albumin, and the treatment is prescribed in a similar way. There is, perhaps, a reasonable excuse for a lack of knowledge of tests of function and fine details of our modern knowledge. But there is absolutely no excuse for ignorance about those simple principles of pathologic physiology and elementary dietetics that are of immediate use to our patients. We all ought to know that in nephritis the body has more or less difficulty in handling water, salt and nitrogen. We know that if we give much water or salt these substances will be retained and the swelling increased in the edematous types of

An analysis is made of oceanographic observations taken aboard tankers over a period of one year between Key West and Cape Hatteras. The Gulf Stream is shown to have seasonal and tidal fluctuations in speed and position. Meanders, known to exist to the north, are shown to exist as far south as the Straits of Florida.