[Oxidative stress in kidney disease patients]. / Oxidacní stres u pacientu s onemocnením ledvin.

Patients with chronic kidney disease are exposed to oxidative stress (OS) that contributes to deterioration of health. Decrease in renal excretory capacity contributes to the accumulation of pro-oxidative substances that are detrimental not only to kidney but to the whole organism including the cardiovascular system. Components of antioxidant system play an important role in the elimination of the OS. The monitoring of antioxidant levels and products of oxidative damage in these patients and the correct interpretation of relationship between these markers and the function of kidney and other organs may contribute to the more effective treatment and health improvement of the patients.

Occurrence of diabetes mellitus in spontaneous intracerebral hemorrhage.

The role of diabetes mellitus (DM) in the etiopathogenesis of spontaneous intracerebral hemorrhage (SICH) is controversial. The aim was to assess the role of DM in our SICH patients. In a hospital-based cross-section study, the occurrence of DM prior to a hemorrhagic stroke was observed in 80 SICH patients (44 males, aged 36-87 years, mean 67.1 +/- 11.9 years; 36 females, aged 56-86 years, mean 71.1 +/- 8.3 years), and in a control group (CG) of 80 age- and sex-matched patients with low back pain. All patients were treated at the Departments of Neurology and Neurosurgery, University Hospital, Olomouc, Czech Republic. Two-sample t test and Pearson's homogeneity chi(2) test were applied when assessing statistical significance. DM was found in 37.5% of SICH patients versus 22.5% of CG subjects (P < 0.05). DM occurs significantly more frequently in SICH patients in the Olomouc region of the Czech Republic when compared to the general population.

[Parameters of bone metabolism in patients with various degrees of kidney function damage]. / Parametry kostního metabolizmu u pacientu s ruzným stupnem poskození funkce ledvin.

BACKGROUND: Patients with renal failure frequently have their calcium and phosphate metabolism seriously disrupted. It may result in a skeletal malady--the renal osteopathy. Late forms of this syndrome are difficult to cure. The aim of this comparative study is to follow the relation between parameters of the bone metabolism (calcitriol, calcidiol, parathormone, calcitonin, osteocalcin, Pi, Ca--total or ionised, and others) and the degree of deterioration of the kidney function. METHODS AND RESULTS: Three groups of patients were included into the study: A-hemodialyzed patients with chronic renal failure (Ccreat = 0.07 +/- 0.02 ml/s, n = 21, age 71.0 +/- 10.6 years); B--not dialyzed patients with decreased renal function (Ccreat = 0.33 +/- 0.05 ml/s, n = 19, age 65.0 +/- 9.6 years); C--patients with normal renal function (Ccreat = 1.45 +/- 0.12 ml/s, n = 16, age 85.2 +/- 4.7 years). Calcidiol concentration [microgram/l] did not differ in individual groups (A: 11.3 +/- 4.7, B: 10.7 +/- 8.2, C: 11.7 +/- 5.7, reference limits RM: 8.9-46.7). In contrast, calcitriol concentration [ng/l] was statistically different in all studied groups (A: 1.7 +/- 2.8, B: 17.6 +/- 12.4, C: 30.6 +/- 9.1, p < 0.001, RM: 19.9-67.0) and it correlated with the degree of renal function deterioration (calcitriol vs. creatinine, r = -0.76, p < 0.001). In PTH levels (pmol/l) the group C differed significantly from groups A and B (A: 27.4 +/- 32.0, B: 23.7 +/- 16.5, C: 6.2 +/- 2.4, C vs. A, p < 0.01, C vs. B, p < 0.001, RM: 1.0-6.8). PTH concentrations correlated with osteocalcine and HCO3 (r = 0.74, r = -0.56, p < 0.001). CONCLUSIONS: Results of the tested parameters have shown that abnormalities in the bone metabolism significantly correlate with the degree of renal deterioration. It demonstrates the requirements for vitamin D metabolites supplementation for patients is needed already in the pre-dialysis stage.

[The histopathologic picture of experimental poisoning with ethylmethacrylates]. / Histopatologický obraz experimentální intoxikace ethylmethakryláty.

Toxic effect of hydroxyethylmethacrylate, acetoxyethylmethacrylate and diethylenglycomethacrylate were studied in rats surviving as long as 1 to 20 days after intramuscular administration. Conspicuous lesion were found only in calf muscles at the site of application. Muscle fibre necroses with inflammatory reaction occurred repeatedly in animals surviving 1-2 days. Newly formed connective tissue replacing impaired muscle fibres was found in rats surviving 5 days. Intoxication related other lesion in rat organs were not identified.

Erythrocyte sedimentation rate in glass and plastic pipettes.

In the blood collection practice there is a growing number of different closed systems. They often use plastic pipettes for testing the erythrocyte sedimentation rate (ESR) according to Westergren. Our previous experience with plastic pipettes as a part of the system Venoject II suggested that slightly higher values were obtained when compared to glass pipettes. In order to confirm these findings a special comparative trial was performed in a group of 302 blood samples. Statistical evaluation proved a significantly higher sedimentation rate in plastic pipettes. Based on the values from another group of 132 healthy adults we try to draw conclusions on the reference interval of ESR in plastic pipettes. We confirmed that no additional information can be derived from ESR values after two hours.

"Ocean-to-Ocean Project": a transcontinental external quality assessment trial in clinical chemistry realized throughout Eurasia.

More than 800 diagnostic laboratories situated throughout the Eur-Asian continent--from the Pacific Coast up to the North Sea littoral--were involved in a common survey of External Quality Assessment (EQA). It consisted of the simultaneous measurement of up to 30 analytes of 'general' clinical chemistry using the same batch of control material. The laboratories were associated in four EQA institutions: SKZL (The Netherlands), OQUASTA (Austria), SEKK (Czech Republic) and BKKSystem (Community of Independent States). The results demonstrated the feasibility of such a large-scale survey and provided a realistic idea about the state-of-the-art of laboratory diagnosis in these countries: Besides some local specific problems, such as poor quality of water or the forced use of reagents and calibrators from different sources, there are general problems hindering an efficient process of 'harmonization' in laboratory medicine, namely, the high methodological dispersion especially in the case of enzymes and of some organic analytes. At the same time there is a potential necessity for more concentrated implementation of internal quality assessment into the routine work of laboratories.

[Plasma and tissue levels of cytokines and adhesive molecules in patients before strumectomy]. / Plazmatické a tkánové koncentrace cytokinu a adhezivních molekul u pacientu pred strumektomií.

From a group of 134 patients with complete documentation before goitrectomy the authors selected 10 histologically defined cases of (A) simple colloid nodular goitre, (B) toxic parenchymatous goitre type GB and (C) autoimmune thyroiditis. Marked hormonal suppression was achieved in group B by thyrostatic therapy, as compared with A and C, the autoantibody titres (TGAb and TMAb) differentiated the groups. The authors examined the interleukin 6 concentrations and those of its soluble receptor (IL-6, IL-6R), of the tumour necrotizing factor alpha (TNF-alpha) interferon gamma (IFN-gamma) and of adhesion molecules ICAM-1 and VCAM-1. Plasma values were, except for not very significant differences, similar in all groups and ruled out a marked effect on tissue levels. The most remarkable finding in the homogenate of a peroperative excision were low IL-6, IL-6R and adhesion molecule values in group A, as compared with B and C and the absence of differences in TNF-alpha values between groups and in particular markedly higher IFN-gamma values in group B which supports theories on the etiopathogenetic role of this cytokine in GB disease. The pilot study is part of the preparation of in situ hybridization of mRNA for diagnostically usable cytokines.

[Distribution of 3H-labeled acetyl-HEMA monomer in rats]. / Distribuce 3H znaceného monomeru acetyl-HEMA u potkanu.

Original method of tritiation of acetyl-HEMA and its hydrogenated product was developed. Distribution and excretion of both compounds was examined in rat for up to 70 hrs. While the distribution in the tissues examined (liver, spleen, kidney, lung, muscle, heart, and skin) was nearly uniform, the excretion of acetyl-HEMA and its hydrogenated form differed: acetyl-HEMA in the 24. hour is excreted preferably into urine, the hydrogenated form in faeces. In addition to it the later form was absorbed from the application point (muscle) more rapidly. Distinct cumulation of activity (original compound or/and its metabolites) was observed in all tissues.

Toxicity of monomers HEMA, DEGMA and AEMA, used in synthesis of hydrogels for medical applications.

Acute toxicity parameters (lethal doses) were evaluated and calculated after i.m. and i.p. administration of 2-hydroxyethyl methacrylate (HEMA), 2-(hydroxyethoxy)ethyl methacrylate (DEGMA) and 2-(acetoxy)ethyl methacrylate (AEMA) to rats. Our previous findings were revisited and corrected. Based on preceding standardization and physiological values study, some clinical chemical and hematological markers of in vivo subacute i.m. toxicity were followed. Hematological parameters revealed to be of low sensitivity to the toxic influence. Clinical chemical tests suggest the prevalent muscle cell injury.

Can chemiluminescent immunoanalysis of thyroid hormones stand for a reference method?

Some analytical properties of chemiluminescent immunoassays (ChLIA) for the estimation of total triiodothyronine (T3), total thyroxine (T4) and thyrotropine (TSH) in serum were studied and compared with radioimmunoanalysis (RIA) as a reference method. Measurement range of ChLIA for T3 is lower, for T4 is equivalent and for TSH is greater than by RIA methods. Analytical sensitivity of ChLIA is better for all three analytes. Also precision of ChLIA is much better. ChLIA method seems to be more resistant to lipaemia. When compared to secondary reference materials, i.e. to commercial control sera, higher accuracy can be evaluated. However, adjustment of the control sera and analytical methods to different primary standards and calibrators, resulting in disagreement of results with asigned values, seems to be evident. With respect to the accuracy of ChLIA further study should be performed involving primary standards. Other interferences except of lipaemia, which we refer to in our work, and problems of specificity also need to be elucidated.

The importance of uric acid examination.

Uric acid is the end product of purine metabolism in man. The findings of human pathological levels of uric acid in serum and urine have in most patients serious clinical implications. This paper summarizes aspects of uric acid examination in clinical biochemistry laboratory. The clinical consequences of pathological levels of uric acid are shown. Uric acid is a useful diagnostic tool as screening for most of purine metabolic disorders. The importance of uric acid measurement in plasma and urine with respect of metabolic disorders is highlighted. Not only gout and renal stones are indications to send blood to the laboratory for uric acid examination. Also familial nephritis, neurological abnormalities with mental retardation are reasons to know uric acid levels in blood and urine. The results underline the importance of urinary uric acid investigation, which is often quite overlooked, and is helpful in differential diagnosis of gout. This work is dedicated to Professor Jan Horbaczewsky and his 110th anniversary of the opening of lessons in medical chemistry at the Czech medical faculty of Charles University in Prague.

Control serum for therapeutic drug monitoring.

New control material EXAPHARM (IMUNA s.p., Sarisské Michalany, Slovakia) for therapeutic drug monitoring (TDM) was evaluated. It is produced in two types: Exapharm AED containing 6 antiepileptic drugs and Exapharm CARD with 4 cardiac and antiasthmatic drugs. Both contain horse serum as a matrix, which is different in some parameters from human serum. Our results approved an outstanding stability and inter-bottle homogeneity of the material. Evidence was presented that no interferences occur in high performance liquid chromatography (HPLC) under the conditions described. It is concluded, that this control serum is very suitable for TDM by HPLC.

High-performance liquid chromatographic determination of creatinine in serum, and a correlation of the results with those of the Jaffé and enzymic methods.

A high-performance liquid chromatographic method for the determination of creatinine in control sera is reported, based on its separation from deproteinated serum components on the ion-exchange material HEMA Bio 1000 SB and ultraviolet detection at 230 nm. Groups of eleven to fourteen samples of human serum and several control materials were simultaneously analysed by the Jaffé, enzymic ultraviolet and enzymic peroxidase aminophenazone methods. Another group (52-115 sera) was analysed for correlations with spectrophotometric methods. The precision of the chromatographic method ranges between 2.0 and 1.0% (relative standard deviation) for serum creatinine concentrations of 115.1 to 471 mumol/l, respectively. A very good accuracy was found in analyses of reference materials Kontrollogen-L and -LP. Some results of analyses of the other control sera were higher and the other lower than those obtained by the Jaffé and enzymic methods, because both interferences and enzyme inhibitors were encountered. Correlations between the chromatographic and spectrophotometric methods were good.