Role of nitric oxide [NO], endothelin-1 [ET-1], interleukin-1 IIL-1], and tumor necrosis factor [TNF alpha] in hemodialysis induced hypotension

Serum levels of Nitrite and Nitrate [NO2 + NO3], ET-1, IL-1 and TNF alpha have been estimated in 20 patients with end stage renal failure [ESRF] undergoing regular hemodialysis [HD] treatment in a trial to explain the hypotension occurring in some of these patients. According to the incidence of hypotension, patients were divided into GI [n=10] hypotension prone patients and GII [n=10] hypotension resistant patient [normotensives]. Clinical examination with measurement of systolic and mean arterial blood pressure was done to all cases before and after hemodialysis session. After HD, GI showed significnat increase in serum levels of [NO2 + NO3], IL-1 and TNF; where as a significant increase in serum ET-1 level was noticed. GII showed no significant change in serum level of the 4 parameters mentioned above. In hypotensive patients there was a significant positive correlation between [NO2 + NO3] and the duration of dialysis, and a significant negative correlation between [NO2 + NO3] and post dialysis systolic blood pressure, also between IL-1 and ET-1. From the previous results it could be concluded that the cascular endothelial factors studied [NO and ET-1] together with the inflammatory cytokines IL-1 and TNF contribute in the development of HD induced hypotension in ESRF subjects which is evidenced by: - The coupling of decrease of BP and increase in NO2 + NO3 level after HD in group I. - ET-I level, which is a powerful vasoconstrictor, showed a significant decrease post dialysis. - Cytokines [IL-1 and TNF alpha] levels, which are potent NO inducers, were found to be significantly increased post dialysis in group I

Some biochemical markers of bone formation and bone resorption in elderly patients with hip fracture

Serum concentrations of some biochemical markers of bone turnover were measured in 40 elderly patients who sustained hip fracture. They were 20 elderly males and 20 postmenopausal females showing different grades of radiological and histopathological osteoporosis. In addition, 20 radiologically free subjects [10 postmenopausal females, and 10 elderly males] served as controls. To all studied subjects the following bone markers were done: serum osteocalcin, serum total and bone specific alkaline phosphatase and urinary hydroxyproline.Serum total and ionized calcium, inorganic phosphorus and urinary calcium were also estimated. Markers of bone formation: osteocalcin and bone specific alkaline phosphatase were significantly increased in postmenopausal female patients and elderly male patients. Urinary hydroxyproline, a marker of bone resorption was also significantly increased in these two groups when compared to the controls. Based on some biochemical data [and not radiological] osteomalacia could be suspected in 20% of postmenopausal female patients and 15% of elderly male patients. These data are suggestive of high rate of bone turnover in such elderly patients where bone resorption exceeds bone formation leading to low skeletal mass which has an essential role in bone fracture

impact of some biliary oxidative parameters and proteins on gallbladder lithogenicity

Gallbladder bile from thirty patients undergoing elective cholecystectomy for calcular and noncalcular chronic cholecystitis were included in this study. Normal bile was also aspirated from gallbladders of 10 subjects undergoing surgery for surgical conditions not involving liver or biliary tract [control group]. The present work aimed at studying some proteins and some oxidative state parameters in gallbladder bile of normal subjects and patients with calcular and noncalcular cholecystitis and their possible contribution in gallbladder lithogenicity. Collected bile was examined for total cholesterol, bilirubin, proteins, mucoproteins and procollagen Ill peptide. Protein and glycoprotein fractionation was done by polyacrilamide gel electrophoresis. In addition some oxidative state parameters were done biliary ferritin, superoxide dismutase [SOD] glutathione and thiobarbituric acid reactive substances [TBARS]. It could be noticed that: there was an increase in total biliary proteins and mucoproteins in gall stone formers than in controls. Pronucleating glycoproteins of 130 KD and 42 KD were found in higher frequency in the calcular than noncalcular and control groups. Antinucleating 58 KD glycoprotein and 120 KD protein were found in higher frequency in controls than in calcular groups. As regards the oxidative state prameters studied, mean values for SOD, glutathione and ferritin were significantly lower in calcular and noncalcular groups when compared to control group and TBARS were significantly higher. It could be concluded that the state of increased oxidative stress in bile of calcular group and also the biliary protein pattern may contribute to the Iithogenicity of bile