Living-Donor Versus Deceased-Donor Kidney Transplantation: Comparison of Psychosocial Consequences for Recipients.

INTRODUCTION: Health benefits of a living-donor kidney transplantation are numerous and well known. There is, however, a dearth of knowledge on postoperative quality of life among the living-donor (LD) compared to deceased-donor (DD) transplant recipients. MATERIALS AND METHODS: The study involved 89 patients after renal transplantation: 48 from LDs and 41 from DDs. Interview data indirectly indicated the patients' health, whereas physiological parameters directly pinpointed the patients' health and the graft function. All study participants completed questionnaires to measure quality of life and the specificity of emotional and cognitive functioning. RESULTS: LD kidney recipients were younger than DD recipients (40 years vs. 49 years). LD and DD transplantation patients were similar in health status assessed by indirect methods (data from an interview) and direct methods (laboratory tests results). They, however, differed in their psychosocial functioning. LD patients had a greater sense of happiness (P < .01) and of self-efficacy (P = .07). Moreover, these patients were more actively involved in their social lives (P < .02) and were more satisfied with their social relationships (P = .07). LD recipients also had a higher quality of life in terms of mental functioning (P < .01) and satisfaction with their environments (P < .01). Additionally, there were significant correlations between quality of life and the quality of cognitive and emotional functioning in the group of LD recipients. The perceived impact of health on physical and professional activity and daily routines was similar in LD and DD groups. CONCLUSIONS: LD post-transplantation patients may derive greater psychosocial benefits from this form of treatment. This effect is not dependent on somatic parameters (comparable data from an interview and laboratory tests results). This study suggests that patients should be assisted by a multidisciplinary healthcare team, and receive continuous support from relatives during the post-transplantation adaptation process. This facilitates the patients' postoperative quality of life.

Effect of high-protein diet on glycolytic processes in skeletal muscles of exercising rats.

The aim of the study was to assess the effort capacity of rats subjected to combined effects of high-protein diet (protein 49%; carbohydrate 30%) and endurance training. The measure of the animal fitness was the time of running to exhaustion on a treadmill. The changes in carbohydrate content including hepatic and muscular glycogen, peripheral blood glucose concentration and activity of some glycolytic enzymes in red slow oxidative (SO) and white fast glycolytic (FG) fibres of the gastrocnemius muscle were analysed. Samples of skeletal muscles, liver and blood were taken after one month on the high-protein diet and/or physical exercise. A high protein level in the diet caused no change in the effort capacity of rats but decreased the capability of carbohydrate accumulation in the skeletal muscles. The observed disturbances of the post-exercise activity of hexokinase and pyruvate kinase (in both) types of fibres) and phosphoglycomutase (specially in FG fibres) suggest that the protein enriched died limits the extent of glycolysis processes. Despite of this the effort capacity of animals is kept on the same level as in the case of a standard diet. These results suggest that some other metabolic adaptations were developed which allow to continue the exercise.

Diurnal changes in cortisol level, neutrophil number and lyzozyme activity in foals during the first 13 weeks of life and in their lactating mothers.

In the blood of 11 foals and their lactating mothers (Standardbred) diurnal changes in the cortisol level, neutrophil number and lysozyme activity were studied during the first 13 weeks of life. The investigations began when a foal reached 7 days of age and were repeated every two weeks till 13 weeks of age. Blood samples were taken from the jugular vein every 4 hours for one day. Experiments were repeated in two following years. In the first year 6 mares and 6 foals born by these mares were examined, and in the second year--5 of the mares from the first year and the 5 new foals borne by them. All horses were kept and fed under the same conditions. Diurnal rhythm in neutrophil number and lysozyme activity was found neither in foals nor in mares. In the cortisol level a diurnal rhythm was found as early as in the first week of life of a foal as well as in the first week of lactation in mares. The mean diurnal values of cortisol level and lysozyme activity in foal blood were lower by 58% and 22%, respectively, in comparison with mares.

Influence of pregnancy and lactation on diurnal and seasonal changes in lactic acid and pyruvic acid levels and in values of pH, pCO2 and pO2 in the mare blood.

1. The diurnal changes in the levels of lactic (LA) and pyruvic (PA) acids and in values of pH, pO2 and pCO2 were studied in the blood of barren and later on in pregnant and lactating mares, throughout three subsequent years. 2. Blood samples were taken every 4 hr, for one day, each month, throughout 3 years. 3. The mares were kept and fed in the same conditions, lighting was natural. 4. In barren mares, diurnal rhythm in LA, PA, pO2 and pCO2 was found. 5. The pregnancy as well as lactation masked diurnal rhythms in parameters studied, except the LA level during lactation but then the acrophase was shifted by 3-4 hr. 6. Seasonal cyclicity was found in the values of LA, PA and pCO2 in barren mares. The pregnancy abolished cyclicity in LA level and modified the behaviour of PA and pCO2 values causing a shift of acrophases and lowering the amplitudes of the indices. 7. In the pO2 tensions no seasonal cycles were observed. 8. In the values of pH neither diurnal rhythms nor seasonal cycles throughout study years were observed.

Influence of pregnancy on diurnal and seasonal changes in cortisol, T3 and T4 levels in the mare blood serum.

1. The diurnal changes in the level of total protein, cortisol, T3 and T4 were studied in four barren and four pregnant standard-bred mares, kept and examined under the same conditions. 2. Blood samples were taken every 4 hr. for one day each month, throughout one year. 3. In barren mares, a diurnal rhythm in cortisol level (acrophase at 0530 hr in summer and at 0830 hr in winter) and in T3 level (acrophase at 1330 hr in summer and at 1800 hr in winter) was found. 4. In pregnant mares, a diurnal rhythm in cortisol level only till 5th month of pregnancy was observed. 5. A diurnal rhythm in T3 level was found throughout the pregnancy, with acrophase always at 1400 hr. 6. No diurnal rhythm in the total protein content and in the T4 level was observed. 7. In both groups of mares the seasonal cyclicity in T3 and T4 levels were found. A seasonal cyclicity in cortisol level was found only in pregnant mares. 8. Pregnancy abolished seasonal cyclicity in total protein and showed it in cortisol level. 9. Pregnancy in mares modifies diurnal rhythms as well as seasonal cycles in secretion and metabolism of the hormones studied.

Influence of pregnancy on diurnal and seasonal changes in glucose level and activity of FDPA, AlAT and AspAT in mares.

1. The diurnal changes in the glucose level and in activity of FDPA, A1AT and AspAT in four pregnant standard-bred mares were studied. 2. As a control four barren mares, were kept and examined in the same conditions. 3. Blood samples were taken every 4 hr for one day, each month, throughout pregnancy, or one year. 4. A diurnal rhythm in activity of A1AT and AspAT in barren mares was found. The pregnancy masked diurnal rhythm in activities of both transaminases. 5. No diurnal rhythm in glucose level and FDPA activity in both groups of mares was observed. 6. Seasonal cyclicity was found in all indices studied, in both groups of mares. 7. The pregnancy did not abolish cyclicity in parameters studied but modified their behaviour--causing a shift of acrophases (glucose, FDPA, AspAT) and lowering the amplitudes (FDPA, A1AT, AspAT).

Diurnal changes in lactic and pyruvic acid levels and pH values in foals during the first 13 weeks of their life and in their lactating mothers.

1. The diurnal changes in the levels of lactic (LA) and pyruvic (PA) acids and values of pH were studied in standard-bred mares and their foals, for 13 weeks of foal life, throughout 2 years. 2. The studies began when a foal was 7 days old and were repeated every 2 weeks until foals reached 13 weeks of age. 3. Blood samples were taken every 4 hr for one day, each second week. 4. In the LA, PA levels and pH values no diurnal rhythm was stated in lactating mares during study periods. 5. In foals the diurnal rhythm in LA and PA occurred in the 3rd month of their life, with the acrophase at night hours. 6. The significant correlations between foal and their mother metabolites studied were observed. 7. The environmental factors (air temperature, humidity) influence fluctuations of the amplitude in parameters studied in the horse blood.

Diurnal changes in the haemoglobin level, red blood cell number and mean corpuscular haemoglobin in foals during the first 13 weeks of life and in their lactating mothers.

1. In six foals and their mothers (of Standard breed) diurnal changes in the haemoglobin level, red blood cell number and mean corpuscular haemoglobin during the first 13 weeks of foal life were studied. 2. Studies begun when a foal reached 7 days of age and were repeated every two weeks till 13 weeks of foal life. Blood was taken every 6 hr in foals and every 4 hr in mares. 3. No diurnal rhythmicity in parameters studied either in foals or in mares was found. 4. Decrease of haemoglobin level in lactating mares (14.0-12.5 g/100 ml) without changes in red blood cell number were observed. Mean corpuscular haemoglobin changed distinctly from one study day to another. 5. In foals were stated: significantly higher haemoglobin level and erythrocyte number and lower mean corpuscular haemoglobin than in mares.

Development of diurnal rhythm in some metabolic parameters in foals.

1. The development of diurnal rhythm activity of FDPA, AspAT and A1AT and in levels of cortisol, T3 and T4 was observed in the blood serum of six foals. 2. The studies began when a foal was 7 days old and were repeated every month until foals reached 1 year of age. Blood samples were taken every 4 hr for one day each month. 3. As a control group four barren mares were used, kept and examined in the same conditions. 4. In mature mares, diurnal rhythms in activity of A1AT (acrophase at 2200 hr), AspAt (2400 hr) and cortisol (0630 hr) but in T3 only in summer months (acrophase at 0100 hr) were observed. 5. During the first 6 months of foal life, significantly higher mean levels of FDPA, A1AT, T3 and T4 than in control mares were found. 6. The cortisol level in foals was half as much as that of mature mares throughout the year. 7. In foals the diurnal rhythm in A1AT activity occurred in the 5th month and in AspAt--in the 12th month (acrophase at 2400 hr), but in cortisol levels it was developed already in the second month of foal life (acrophase at 0830 hr).

A study of diurnal changes in cortisol and glucose levels and FDPA activity in foals during the first 13 weeks of life and in their lactating mothers.

1. In six standard-bred mares and their foals diurnal changes in the cortisol and glucose levels and in FDPA activity were studies for 13 weeks of foal life. 2. In the cortisol level diurnal rhythm was found in the 3rd, 7th and 11th week of foal life and in the 11th week of lactation in mares. 3. In mares the mean diurnal cortisol level changed from 32 ng/ml in the first week to 57 in the 11th week and in foals from 24 in the first week to 16 ng/ml in the 11th week. 4. In the glucose level no diurnal rhythm was observed. 5. In mares the mean diurnal glucose level after parturition was about 58 mg/100 ml and increased to 83-85 mg/100 ml. In foals it changed from 105 to 128 mg/100 ml. 6. In the activity of FDPA no diurnal rhythm was observed. 7. The mean activity of FDPA changed in mares from 3.3 to 4.4 U and in foals from 5.7 to 7.5 U.

Fluostigmine effect on glycogen level in the skeletal muscle.

Fluostigmine in a dose not producing evident toxicity reduced the glycogen content in the gastrocnemius muscle in rats, with a consequent decrease of glycogen utilization during contractions of the muscle induced with direct tetanic stimuli. Administration of atropine or atropine with obidoxime failed to change this effect of fluostigmine. The authors suggest that the effect is not due to disturbances of the cholinergic system function.

The effect of natural training and electrostimulation on changes of alanine transaminase and aspartate transaminase activity in rat skeletal muscles.

Wistar rats were trained on a moving track or/and had stimulation of the crural muscles with electric current of 50 Hz frequency for 14 days. Dramatic changes were observed in the activity of alanine transaminase (AlAT) and aspartate transaminase (AspAT), which was particularly pronounced during 16 days of follow-up after completion of training and stimulation. Persisting high activity of the enzymes in the white muscle fibres exceeding 2-3 times the control values showed a significant effect of electrostimulation on the metabolism of amino acids enabling the muscles to obtain energy for contraction from non-glycolytic source.