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Učinci vanadata na stvaranje glukoze u kultiviranim hepatocitima izoliranim u štakora na dijeti bogatoj zasićenim mastima
No full textInsulin resistance is a common phenomenon in obesity and Type 2 diabetes. Common factor important for development of diabetes and insulin resistance is intake of saturated fat. Vanadate treatment improves glucose homeostasis in vivo. The aim of this study was to find out changing of hepatic glucose output in dependence of saturated fat diet and possible direct action of vanadate in cultured hepatocytes. Hepatocytes were isolated by a collagenase perfusion technique and cultured for 24 h in M 199 serum-free medium. The glucose production in hepatocytes isolated from rats on high saturated fat diet was significantly 139% higher comparable to standard controls. Glucagon 100% increased glucose production in hepatocytes from rats on standard diet and 200% in hepatocytes on saturated high fat diet. The addition vanadate significantly decreased basic glucose production and did not influence glucagon stimulated glucose production. Presence of insulin did not influence either glucagon or vanadate effect. High saturated fat diet not only increases insulin resistance but also decreases chances of successful therapy of diabetes.Inzulinska rezistencija je zajednički fenomen koji se pojavljuje u pretilosti i dijabetesu tipa 2. Zajednički faktor koji je važan za razvoj dijabetesa i inzulinske rezistencije je uzimanje zasićenih masti. Vanadate poboljšava glukoznu homeostazu in vivo. Svrha ovog rada je otkriti promjene jetrenog stvaranja i otpuštanja glukoze u ovisnosti o dijeti bogatoj zasićenim mastima i moguće direktno djelovanje vanadate u kultiviranim hepatocitima. Hepatociti su izolirani pomoću kolagenaze i kultivirani 24 sata u M 199 mediju bez dodatka seruma. Stvaranje glukoze u hepatocitima izoliranim iz štakora na visoko masnoj dijeti bogatoj zasićenim masnoćama bilo je 139% veća u usporedbi s standardnom kontrolom. Glukagon 100% povećava proizvodnju glukoze u hepatocitima dobivenim iz štakora na standardnoj dijeti, a 200% u štakora na dijeti sa zasićenim masnoćama. Vanadate je signifikantno smanjio bazičnu proizvodnju glukoze, a nije utjecao na glukagonom stimuliranu produkciju glukoze. Prisutnost inzulina nije utjecala na glukagonski kao ni na vanadate efekt. Dijeta bogata zasićenim masnoćama ne povećava samo inzulinsku rezistenciju nego također smanjuje izglede za uspješno liječenje dijabetesa
Ultrasonographic Estimation of Fetal Weight – Residents Accuracy
No full textThe aim of this retrospective study was to evaluate the accuracy of gynecology and obstetrics residents when performing ultrasonographic estimation of fetal weight. The total of 400 ultrasonographic estimations of fetal weight and corresponding neonatal weight were collected and divided into 3 groups according to physicians’ experience (junior and senior residents, staff physicians). The accuracy of fetal weight estimation correlated positively with the level of physicians’ experience. The proportional difference between ultrasound estimation and actual birth weight varied from 8.45% to 6.88% (junior residents 8.45%, senior residents 6.95%, staff physicians 6.88%). The proportion of ultrasonograhic estimates that fell within 10% of birth weight varied from 59.09% to 79.21% (junior residents 59.09%, senior residents 78.44%, staff physicians 79.21%). Senior residents reach a highly acceptable accuracy in ultrasonographic estimation of fetal weight which is comparable to staff physicians
Alopecia areata u bolesnice s graničnim poremećajem osobnosti uz istodobni poremećaj raspoloženja u obliku depresivne epizode
No full textA case is presented of a 44-year-old female patient, highly educated, suffering from borderline personality disorder with comorbid mood disorder, manifested as a depressive episode, who had been suffering from acute emotional stress for a few months. She was through the procedure of divorce, losing her children by the court decision. Over a two-month period she had lost over 90% of her hair and started treatment for alopecia areata. She was simultaneously treated by a dermatologist and a psychiatrist, and attended group psychotherapy. The impact of psychological factors in the development, evolution and therapeutic management of alopecia areata was documented in this case. Life events and intrapsychically generated stress played an important role in triggering the disease. The treatment for the concomitant psychiatric disorder had a crucial role in this case because it had a favorable effect on the patient's adaptation to her alopecia areata and social setting, and led to better dermatologic evolution of the disease.Prikazan je slučaj 44-godišnje visoko obrazovane bolesnice s graničnim poremećajem osobnosti uz istodobni poremećaj raspoloženja u obliku depresivne epizode, koja je nekoliko mjeseci proživljavala akutni emocionalni stres. Prošla je postupak razvoda braka, a sudskom joj odlukom djeca nisu dodijeljena. Kroz dva mjeseca izgubila je preko 90% kose i započela je liječenje zbog alopecie areate. Istodobno su ju liječili dermatolog i psihijatar, a pohađala je i grupnu terapiju. U ovom je slučaju dokumentiran utjecaj psiholoških čimbenika na razvoj, evoluciju i liječenje alopecie areate. životni događaji i psihički stres imali su važnu ulogu u pokretanju bolesti. Uloga liječenja u istodobnom psihičkom poremećaju bila je presudna u ovom slučaju, jer je imala pozitivan učinak na način na koji se je bolesnica prilagodila nastalom opadanju kose i društvenom okruženju, što je dovelo do boljeg dermatološkog razvoja alopecie areate
The soluble serum transferin receptors in type 2 diabetic patients with proteinuria
No full textTo record the difference in the level of soluble serum transferrine receptors (sTfr) in type 2 diabetic patients with selective nephrotic proteinuria (SNP) compared to patients with nonselective nephrotic proteinuria (NNP), and confirm the thesis that the sTfr is good marker of iron status and erythropoesis in these patients. Methods. There were 63 type 2 diabetic patients with diabetic nephropathy and proteinuria included in the study. The patients were divided in to 3 groups regarding largeness and selectivity of proteinuria. Twenty-four patients had SNP, and ninteen patient had NNP. Control group constitute twenty patients with selective non-nephrotic proteinuria <2.5 g/day. In all groups were measured: erythrocyte count, hemoglobin level, mean cell volume, C reactive protein, fibrinogen level, serum iron level, total iron binding capacity, unbound iron binding capacity, iron saturation, serum ferritin, cratinine clearance, serum protein electrophoresis, proteinuria (biuret), urinary protein immunoelectrophoresis, and sTfr. The sTfr were detected in serum using ELISA techniques, and quantified in mg/L. Results. We recorded significant difference in sTfr level between NNP group and SNP group, and between NNP group and control group (NNP 2.0+/-0.8 ; SNP 2.9+/-1.8 ; control 2.7+/-1.0 ; p<0.05 ; p<0.05), and significant difference in biuret and fibrinogen level between NNP and SNP group in compare to control group (p<0.05 ; p<0.05). Conclusion. Significantly lower sTfr in NNP group in compare to SNP and controle group, and in absence of significant difference in both iron and erythropoesis markers and factors with possible negative contribution according to both of them (e.g. inflammation, stage of renal insufficiency), is probably result of loss of sTfr through heavily and largely damaged glomerular capillary membrane in NNP group. Therefore, sTfr is not good marker of iron status and erythropoesis in type 2 diabetic patients with NNP
Paralitički strabizam kao manifestacija Lyme borelioze
No full textLyme disease is a multi-system organ disorder caused by Borrelia burgdorferi. Although ocular manifestations have been reported, these remain a rare feature of the disease. This report shows a 49-years old patient that has been bitten by a tick and as consequence of which developed symptoms of the Lyme disease. In 1998 the patient was hospitalized in our Eye Clinic due to operating treatment of the paralytic strabismus (abductal nerve paralysis), as a rare feature of the Lyme disease. Postoperative squint angle was significantly reduced, but without any temporal movement. Diplopia was still present, though slightly reduced with the use of prism eyeglasses. The improvement of the quality of life was achieved, as well as the patient's satisfaction.Lyme borelioza je multisistemska bolest uzrokovana spirohetom Borrelia burgdorferi. Očne manifestacije su opisane, no njihova pojavnost je vrlo rijetka. Predmet našeg rada jest prikaz pacijentice stare 49 godina koju je 1985. godine ugrizao krpelj te je kao posljedicu istog razvila simptome Lyme borelioze. Pacijentica je 1998. godine hospitalizirana na našoj Klinici radi operativnog liječenja paralitičkog strabizma (paraliza n.abducensa), rijetke očne manifestacije Lyme borelioze. Postoperativno je kut škiljenja znatno reduciran, no još uvijek bez pokretljivosti bulbusa temporalno. Dvoslike su još uvijek prisutne, no značajno smanjene korekcijom s prizmama. Postignuto je zadovoljstvo pacijenta uz poboljšanje kvalitete života
Oxidative Stress Markers After Laparoscopic and Open Cholecystectomy
No full textBackground: Surgical injury is associated with oxidative stress, often due to ischemia/reperfusion injury. During laparoscopy, increased intra-abdominal pressure caused by pneumoperitoneum may cause splanchnic ischemia followed by reperfusion due to deflation. We measured several markers of oxidative stress in patients undergoing laparoscopic cholecystectomy (LC) versus open cholecystectomy (OC) to find if these surgical procedures result in different patterns of oxidative stress.
Methods: This prospective study enrolled 43 patients with symptomatic cholelithiasis, of whom 21 underwent open, and 22 laparoscopic, cholecystectomy. Twenty healthy adults comprised the control group. Total antioxidant status (TAS), superoxide dismutase (SOD), endogenous peroxide level (POX), oxidized low density lipoprotein (oLDL) autoantibodies (oLAb), and neopterin were measured preoperatively and on postoperative days 1, 3, and 7.
Results: POX values decreased significantly on postoperative day 1 in the OC (P<0.01), but not in the LC, group. On postoperative day 7, POX values were higher than preoperatively in both groups (P<0.01) with no difference between the LC and OC groups. Significant postoperative elevations of oLAb and neopterin levels were observed only on postoperative day 7 in the OC group. There were no changes of oLAb and neopterin levels in the LC group. TAS and SOD levels did not change after either LC or OC.
Conclusion: Cholecystectomy, either open or laparoscopic, caused only moderate oxidative stress. Open cholecystectomy caused changes of oLAb and neopterin, suggesting more severe oxidative stress, and a possible role of reactive oxygen species in the healing of the laparotomic wound
Effects of Troglitazone and Insulin on Glucose Production in Cultured Hepatocytes Isolated from Rats on High Fat Diet
No full textIncreased dietary fat intake in general, and saturated fat specifically, will lead to the impairment of insulin action. The aim of this study was to find out the changes in hepatic glucose output in dependence of fat diet and a possible direct action of insulin and troglitazone in hepatocytes. Hepatocytes were isolated by a collagenase perfusion technique and cultured for 24 h in M 199 serum-free medium. The glucose production in hepatocytes isolated from rats on high fat diet (unsaturated fat) was 79% higher compared to control and even 139% higher than in rats on high-fat diet (saturated fat). Troglitazone significantly decreased the glucose production in hepatocytes obtained from rats on unsaturated fat diet. The troglitazone in presence of insulin totally normalized glucose production but also only in hepatocytes obtained from rats on unsaturated-fat diet. The troglitazone showed an insulinomimetic as well as insulin-sensitizing effect but only in rats on unsaturated-fat diet
Reaktivna i klonska trombocitoza: citokini i reaktanti akutne faze
No full textPlatelets are acute phase reactants that increase in response to various stimuli, including systemic infections, inflammatory conditions, bleeding, and tumors. This is called reactive or secondary thrombocytosis, which is a benign form of thrombocytosis. Clonal thrombocytosis is an unregulated abnormality of platelet production due to clonal expansion of bone marrow progenitor cells. Secondary thrombocytosis may be due to the overproduction of proinflammatory cytokines such as interleukin-1 (IL-1), IL-6, and IL-11, which occurs in chronic inflammatory, infectious and malignant states. The presence of elevated IL-1, IL-6, C-reactive protein and granulocyte-macrophage colony-stimulating factor in individuals with this condition suggests that these cytokines may be involved in reactive thrombocytosis.Trombociti su reaktanti akutne faze i njihov se broj povećava kao odgovor na različite podražaje, uključujući sistemske infekcije, upalna stanja, krvarenja i tumore. To se naziva reaktivnom ili sekundarnom trombocitozom, što je benigni oblik trombocitoze. Esencijalna trombocitoza je nenormalna proizvodnja trombocita uzrokovana klonskom ekspanzijom progenitorske stanice koštane srži. Sekundarna trombocitoza može biti uzrokovana prekomjernom proizvodnjom proupalnih citokina, kao što su interleukin 1 (IL-1), IL-6, IL-11, koji se javljaju u kroničnim upalnim, infektivnim i malignim stanjima. Prisutnost povišenih vrijednosti IL-1, IL-6, C-reaktivnog proteina i granulocitno-makrofagnog faktora stimulacije rasta u pojedinaca s ovim stanjem ukazuje kako bi ovi citokini mogli biti upleteni u reaktivnu trombocitozu
Rapid Decrease in High Titer of Factor VIII Inhibitors upon Immunosuppressive Treatment in Severe Postpartum Acquired Hemophilia A
No full textA 25-year-old woman was diagnosed with acquired hemophilia caused by factor VIII (FVIII) inhibitors two months after normal delivery of her first child. She presented with severe spontaneous bleeding in the right forearm and distal part of the right leg. After venipuncture for diagnostic purposes, severe hematoma developed, affecting the whole left arm and shoulder. The diagnosis of acquired hemophilia was confirmed by the presence of FVIII inhibitors (Bethesda units=76), low activity of factor VIII (5%), and prolonged activated partial thromboplastin time (APTT=89 s). The treatment with fresh frozen plasma, cryoprecipitate, red blood cells concentrate, methylprednisolone (3 mg/kg/day for 8 days, then 1mg/kg/day), and cyclophosphamide (150 mg/day for 5 days, then 100 mg/day)was followed by the regression of hematomas and normalization of APTT and FVIII activity. The titer of FVIII inhibitors rapidly decreased and total disappearance of antibodies was achieved after 15 days. To the best of our knowledge, this is the shortest time to the disappearance of inhibitors to FVIII in postpartum acquired hemophilia ever reported. Transient reappearance of inhibitors occurred 10months later and also promptly reacted to the same therapy. In the follow-up period of 4 years, the patient had two more pregnancies with no clinical and laboratory signs of illness recurrence. This case indicates important role of immunosuppressive therapy, which can rapidly induce a remission of this rare condition and be life-saving if introduced early in the course of illness and in doses higher than usually recommended