[PI-3 kinase/AKT/PKB signal transduction pathway in kidneys mediates angiotensin II-induced hypertension]. / PPI-3 kinaza/AKT/PKB put transdukcije signala u bubregu posreduje razvoj angiotenzin II-inducirane hipertenzije.

INTRODUCTION: The activation of PI-3 kinase/AKT/PKB signal transduction pathway has implicated in the cell growth regulation and proliferation. AIM: To determine a role of PI-3 kinase/AKT/PKB signal transduction pathway in the kidney of Angiotensin II-induced hypertensive rats. METHODS: NZW (New Zealand White) rats have been infused by Angiotensin II using osmotic minipump for six days (n = 8). Control group was untreated rats (n = 6). PI-3 inase and AKT/PKB activities were measured in the presence or absence of different inhibitors. RESULTS: Angiotensin II elevated mean arterial blood pressure (MABP) to 182 +/- 2 mm Hg (p < 0.001) vs untreated control rats (95 +/- 3 mm Hg). Ras-GTPase and PI-3 Kinase activities were elevated in angiotensin II-treated group. Ras inhibitors FPT III and BMS/191563 attenuated MABP to 122 +/- 2 and 127 +/- 4 mm Hg (p < 0.05) and abolished Ras-GTPase and PI-3 Kinase activities. AKT/PKB activity followed the PI-3 kinase activity. CONCLUSION: PI-3 kinase/AKT/PKB signal transduction pathway in the kidney is activated and mediates Angiotesin II-induced hypertension.

[Disorders of diastolic function in patients on hemodialysis]. / Poremecaji dijastolne funkcije u pacijenata na hemodijalizi.

INTRODUCTION: Impaired cardiac function is frequently present in patients on maintenance haemodialysis. AIM: To assess the left ventricular diastolic function in patients on haemodialysis. MATERIAL AND METHODS: We used 2D and pulsed wave Doppler echocardiography to evaluate the left ventricular diastolic function in 40 patients on haemodialysis and compared those to healthy controls. RESULTS: Majority of Doppler parameters were changed in patients on haemodialysis. Diastolic dysfunction was present in 77.5% patients. In comparison to the healthy controls haemodialysis patients showed significant increase in peak velocity of late diastolic filling, (A wave, 76.82 +/- 23.76 cm/s vs. 58.46 +/- 9.65 cm/s p < 0.001) and reduction in the E/A ratio (1.00 +/- 0.26 vs. 1.26 +/- 0.31 p < 0.001). CONCLUSION: There was significant impairment in left ventricular diastolic function in patients on haemodialysis.

[Review of immunosuppressive drugs in organ transplantation]. / Prikaz imunosupresivnih lijekova u transplantaciji organa.

In transplantation method, efforts should be made to prevent the patient immunological reaction against the transplantation antigen. In the same time, the patient general immunological reactivity must be kept. With the increasing need for transplantation the interest for new immunosuppressive drugs has become greater. The use of immunosuppressive drugs have dated since early 1950 (azatioprin and steroids). 1960 there was the appearance of the polyclonal ALG/ATG. In 1970 the true advance has been the discovery of the first selective immunosuppressive-cyclosporin (second generation). The third generation of immunosuppressive drugs with high specific place of action, has become available now (tacrolimus, thymoglobulin, zenepax, rapamune). The purpose of this paper was to show the different groups of immunosuppressive drugs, taking into account a different place of effects and different mechanisms of their immunosuppressive action. The aim of the immunosuppressive drugs combination is to achieve the optimal immunosuppression with minimal side-effects.

[Morphologic changes in the interventricular septum and the posterior wall of the left ventricle in patients on hemodialysis]. / Morfoloske promjene interventrikularnog septuma i straznjeg zida lijevog ventrikula u pacijenata na hemodijalizi.

Left ventricular hypertrophy is dominant finding in patients with chronic renal failure. In our work we have analysed the interventricular septum and left ventricular posterior wall in thirty patients on chronic hemodialysis, using an echocardiography. Increased thickness of interventricular septum and left ventricular posterior wall were found in 70% patients. We have also confirmed correlation between these parameters and value of systolic arterial blood pressure. Echocardiography is very useful and powerful method for the assessment of morphological cardiac disorders in patients on hemodialysis.

[Hepatotoxicity of cyclosporine in patients with kidney transplants]. / Ispitivanje hepatotoksicnosti ciklosporina u pacijenata sa transplantiranim bubrezima.

In this study we have analyzed the liver transaminases levels in the 15 patients after kidney transplantation. All these patients have taken immunosuppressive cyclosporine therapy. The transaminases levels were determined by using the method Bergmayer kinetic ultraviolet test on the apparatus Tehnicon-Opera. The well known fact is the liver intoxication the same as kidney intoxication, if patients take cyclosporine for a long time. The average of the grafts in these patients were 9 years (ages between 1 and 16). The liver transaminases level was normal in all of groups of patients except for one who had high liver transaminases levels. After the correction cyclosporine therapy in the patient, the liver transaminases levels were normal. There was no possibility for monitoring of cyclosporine during the war, so the patients were determining the dose of cyclosporine on their own without any consulting with doctors. The most reliable method of cyclosporine applications is its determination, every day monitoring, and dosing by monitoring, which means concentrations in the reference values.

[Effect of hemodialysis on functional parameters of the left ventricle]. / Uticaj hemodijalize na funkcionalne parametre lijevog ventrikula.

Many cardiac functional disorders are developed in chronic renal failure. The aim of our work was the echocardiographic assessment of left ventricular functional parameters in patients on haemodialysis. We observed that left ventricular end-diastolic volume, left ventricular end-systolic volume and stroke volume significantly decreased after haemodialysis. Left ventricular ejection fraction increased after haemodialysis, but not significantly. Systolic and diastolic blood pressure decreased significantly after haemodialysis while heart rate increased significantly. During the haemodialysis, many haemodynamic changes are observed. Analysis of cardiac functional status is essential before the haemodialysis starts.

[Serum cyclosporine levels in patients after kidney transplantation]. / Vrijednosti ciklosporina u serumu pacijenata poslije bubrezne transplantacije.

In this study we have analyzed the cyclosporine levels in patients after kidney transplantation. The cyclosporine levels are determined by using fluorescence polarization immune-assay and monoclonal whole blood test. We analyzed nine patients with transplanted kidneys who were on specific immunosuppressive cyclosporine therapy. The cyclosporine determination was performed in these patients three times in the span of 14 to 29 days. The cyclosporine levels in seven patients were in reference interval between 100 and 300 ng/ml of whole blood. In the first determination the values in two patients were out of reference interval, one value was lower, and the other one was higher then reference interval. In second determination after dose correction in patients who had lower cyclosporin level the new level was normal and the other patient cyclosporine value was lower then in the first determination, but still a little higher then reference values.

[Evaluation of monitoring the efficacy of phenobarbital as an anticonvulsant agents using the fluorescence-polarization immunoassay]. / Procjena efikasnosti monitoringa fenobarbitona kao antikonvulzivnog agensa, primjenom fluorescentno-polarizacijskog imunoeseja.

Estimation of the monitoring efficiency of Phenobarbital as anti seizure agent was performed by using fluorescence-polarization immunoassay on analyzer ABBOTT TDx. Determined values have shown that Phenobarbital monitoring is extremely important in the prevention of epileptic seizures, especially considering its ability to induce a microsomal drug-metabolizing system.

[Clinical and histologic findings in patients with renal amyloidosis]. / Klinicki i histoloski nalazi u pacijenata sa renalnom amiloidozom.

Renal amyloidosis is a rare disease when compared to other kidney diseases. During the period of last fifteen years, at the Institute of Nephrology and Immunology in Sarajevo renal amyloidosis was diagnosed with 15 patients. The disease occurred more often with men than with women. Only during 1988, renal amyloidosis was revealed and followed up with five patients. The most common clinical manifestations of renal amyloidosis are nephrotic syndrome and chronic renal failure, with respective laboratory findings. Using immunofluorescent analysis of the kidney biopsy material, we discovered deposits of immunoglobulins of different intensity and deposits of lambda and kappa light chains of immunoglobulins. The intensity of lambda light chains is greater than that of kappa chains. The analysis of light microscopy showed nodular mesangial deposits and deposits along GBM without proliferation. The diagnosis of amyloidosis was confirmed by staining of amyloid. Application of therapy for amyloidosis was without any effect. Although renal amyloidosis is a rare disease, we want to point out disease as being an etiologic factor in nephrotic syndrome.

[Detection of glomerular basement membrane antibodies using the ELISA enzyme assay]. / Dokazivanje antitijela protiv GBM enzimatskim esejom--ELISA.

The intention of this work is to show the usefulness of use of enzymatic essay in the anti-body detection against GBM in the serum of the Patient with linear deposits of IgG. Full success was obtained. Maximal sensibility of test sensibility and reproduction, as well as the advantage that tests are simply enough for the empiric application in everyday clinical practice was achieved through multiplied vibration of anti-bodies. Test were done 30 patients in the Immunology Laboratory of the Institute for Nephrology in Sarajevo.