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Color Doppler US is more sensitive than clinical or laboratory methods for detection of hemodialysis access stenosis. Screening with US appears to enable earlier detection and therapy.

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and Brock ton Veterans A din in istration Hospital, MassachusettsThe purpose of this study was to characterize the morphology and histochemistry of gingival tissue in diabetic patients. Because of the unique opportunity afforded by the available clinical sample, it was possible to compare and contrast the gingival tissues of diabetics with that of nondiabetics. In addition, morphologic and histochemical comparisons of tissues from patients who had the disease for long periods of time could be made with tissues from patients in whom chemical diabetes had been established for much shorter time intervals. It was hoped that the comparisons might provide significant information in regard to establishing a relatively simple testing procedure for diabetes at an early stage.The sample used consisted of 24 subjects at the Veteran's Administration Hospital, Brockton, Massachusetts. Twelve of the subjects were diabetics, with a history of the disease varying in duration from one month to 15 years. The other 12 subjects were nondiabetic controls. Complete medical histories and blood glucose levels were obtained from all patients.Biopsy specimens were obtained from the marginal gingiva of the maxillary right canine and included the free and attached gingiva. The biopsied tissues were fixed in acetic-alcoholformalin, vacuLum embedded in paraffin, and sectioned at six micrometers. Staining procedures included hematoxylin and eosin for structural evaluation, Alcian blue (pH 1.9) and Alcian blue-Feulgen for acidic mucopolysaccharides and DNA, PAS with malt diastase and distilled water controls for neutral mucopolysaccharides and glycogen, and toluidine blue (pH 4.0) with RNA-ase controls for ribonucleic acid. In addition, the following amino acid groups were demonstrated histochemically: sulfhydryl and disulfide, tryptophan, and tyrosine.Examination of sections stained with hematoxylin and eosin revealed no significant structur-al differences between the diabetic and nondiabetic subjects, except for some parakeratosis in the former group. Increased numbers of inflammatory cells were also present in the diabetics. Careful scrutiny of the subepithelial capillary bed in all subjects revealed no thickening of the vessel walls, although this finding has been occasionally reported.Study of tissues subjected to the battery of histochemical tests revealed no variations in localization and intensity of stain in any instance, with the exception of PAS-stained tissues. The intensely reactive PAS-positive material in the epithelium of diabetics was more widely distributed and more strongly stained Additional information available on request to authors.

The deleterious consequences of sympathetic activation in chronic heart failure (CHF) have been recognized for nearly 2 decades. 1 The degree of excess neurohormonal activation in this condition correlates with disease severity, is associated with progressive deterioration of cardiac function, accelerates abnormal myocardial remodeling after an infarction, and increases mortality rates. [2][3][4] In recent years, an interest in beta-adrenergic blocking agents as a therapeutic option in heart failure From the