Do high levels of serum triglycerides in pancreas graft recipients before transplantation promote graft pancreatitis?

OBJECTIVE: Graft pancreatitis is a serious complication following pancreas transplantation. The aim of this study was to evaluate the influence of pretransplant serum lipid levels on the development of graft pancreatitis among patients undergoing simultaneous pancreas and kidney transplantation (spkTx). METHODS: We reviewed data from spkTx patients engrafted between 1999 and 2002. Group 1 consisted of 10 recipients with well-established pancreas and kidney graft function without postoperative pancreatitis; group 2 5 spkTx recipients who developed fatal graft pancreatitis in the first posttransplant month. The lipid parameters evaluated within 1 hour before transplantation and after hemodialysis included total cholesterol, HDL, LDL, VLDL, triglicerides and apoproteins A and B. RESULTS: Triglycerides, apoprotein B and VLDL were significantly increased just before transplantation among patients who developed fatal pancreatitis compared to those patients with good graft function. CONCLUSION: Recipient hypertriglyceridemia promotes graft pancreatitis in previously injured pancreatic graft.

Genetic influence on blood pressure and lipid parameters in a sample of Polish twins.

We studied 76 healthy monozygotic (MZ) and same-sex dizygotic (DZ) twin pairs (mean age 35 +/- 8 years, body mass index, BMI, 23.6 +/- 3.9 kg/m2) to determine genetic and environmental contributions to systolic (SBP) and diastolic (DBP) blood pressure, heart rate (HR) and serum lipids [total cholesterol (TC), low-density lipoprotein cholesterol (LDL-chol), high-density lipoprotein cholesterol (HDL-chol) and triglycerides (TG)I. SBP, DBP and HR were measured clinically and by ambulatory blood pressure monitoring (ABPM). Parameters of the genetic models for age-, sex- and BMI-adjusted data were estimated by model fitting and path analysis technique using LISREL 8. We found significant genetic effect on SBP and DBP for both clinical and ABP measurements, ranging from 37% for night-time ambulatory DBP to 79% for daytime ambulatory SBP. Estimates of genetic effects were higher for daytime than night-time ABP values, and higher for ambulatory 24-h SBP than office SBP measurements, with the reverse true for DBP. Significant genetic effect on HR ranged from 59% for office measurements to 69% for 24-h mean values. In summary, we also found genetic effect on TC, LDL-chol and HDL-chol with estimates ranging from 36% to 64%, but not on TG. Furthermore, a shared environmental component for TG was found, estimated at 36%. We showed significant genetic effect on both office and ambulatory BP and HR, with stronger genetic effect on daytime than night-time BP. We also found genetic effect on TC and lipoprotein fractions, but no significant genetic effect on TG. Environmental factors influencing serum TG, such as alcohol consumption, may explain the apparent lack of genetic effect in this healthy, non-obese population.

[Influence of hormonal replacement therapy on bacterial vaginosis in the group of peri- and postmenopausal women]. / Wplyw hormonalnej terapii zastepczej na biocenoze pochwy kobiet w okresie okolo- i postmenopauzalnym.

The aim of the study was to evaluate microbiological biocenosis of the menopausal or postmenopausal women, and women having local hormonal therapy (Ovestin and Ortho-Gynest D). The study group consisted of 123 women (aged 45-72), who underwent clinical examination and microbiological evaluation of vaginal discharge. Miller's and Gramm's methods were used for slide staining and the culture method for growing microorganisms. Classical culture media were used as well as Rogosa culture medium and modified Weinstein medium for Lactobacillus culture in anaerobic conditions. In the microbiological studies before initiation of hormonal therapy, normal biocenosis of the vagina was found in 52 women (42.27%). The other part of the study group had abnormal vaginal biocenosis or had no microorganisms at all. During the hormonal therapy, the group of women with normal biocenosis increased to 53.65% and 62.29% after respectively 3 and 9 months of therapy. Hormonal therapy secured continuity of normal Lactobacillus morphotypes within perimenopausal period. Antimicrobial and hormonal therapies used together provided normalization of vaginal biocenosis in a shorter time. In the group of senile women, the recolonization of vaginal mucosa by Lactobacillus vaginalis was observed.

Plasma fibrinogen as a risk factor for restenosis after percutaneous transluminal renal angioplasty in patients with atherosclerotic renal artery stenosis.

BACKGROUND: In contrast to those for coronary restenosis, the data regarding the risk factors for renal restenosis are limited. OBJECTIVE: To evaluate potential humoral risk factors for restenosis after percutaneous transluminal renal angioplasty (PTRA). METHODS: We studied 27 patients aged 54+/-10 years with atherosclerotic renal artery stenosis in a 1-year prospective follow-up. Restenosis (confirmed by angiography) occurred in eight patients 1-6 months after PTRA. We detected no Doppler ultrasound evidence of restenosis in 19 patients throughout 1 year. Blood studies were done before PTRA for all patients, at the time of diagnosis of restenosis and, for those without restenosis, after 1 year. including determinations of fibrinogen, lipids, platelets and leukocytes. RESULTS: The mean level of fibrinogen in patients who experienced restenosis was higher than that in those who did not (450+/-150 mg% versus 337+/-57 mg%, P < 0.01) and remained unchanged for both groups during follow-up. The other parameters did not differ between the groups before PTRA and did not change over time, with the exception of platelet count in patients who did not experience restenosis, which had decreased from 253+/-93G/l to 200+/-63G/l (P < 0.01) 1 year after PTRA. The logistic multiple regression analysis disclosed that an increment of fibrinogen level by 100 mg% was linked with an odds ratio for restenosis of 3.2 (95% confidence interval 1.1-9.8). CONCLUSIONS: Restenosis was associated with higher than normal levels of fibrinogen before PTRA. A high plasma fibrinogen level might play a role in the development of restenosis after PTRA.

[Microbiological evaluation of the vagina in women being screened for inflammatory and precancerous conditions of female genitalia]. / Ocena stanu mikrobiologicznego pochwy kobiet zglaszajacych sie do badan profilaktycznych w celu wykrywania stanów zapalnych i przednowotworowych zenskiego narzadu plciowego.

The aim of this work was to study the microbiology of vaginal secretion in 3665 (19 to 72 year old) women investigated in the screening programme for inflammatory and malignant diseases. Microbiological examinations of the vaginal contents were carried out using direct preparations (Miller and Gram methods) and different media for cultures. Normal biocenosis (I and II grade of cleanliness) of the vagina was observed in 40.74% investigated patients. Abnormal biocenosis was classified as early, advanced and chronic state infections. In our study we present data on isolated strains of saprophytic organisms and pathogens including yeasts and Trichomonas vaginalis in early and chronic infections. There were homogeneous and mixed infections. The role of the physiological Lactobacillus species inhibiting development of pathogenic flora is suggestive of beneficial influence on the vaginal environment. Candidiasis of the vagina was identified in 11.35% examined women. High percentage Candida growth was found together with Lactobacillus vaginalis. It is noteworthy that trichomoniasis was less frequent compared to our previous reports. Totally we were able to isolate 2597 strains of bacteria. Bacteria type of abnormal biocenosis was found in 46.82%. The data from this study indicated that microbiological pictures (stained acc. to both Miller and Gram methods) are still of importance for the evaluation of vaginal contents. The second significant factor in microbiology of human vagina is the role of culture. This role of cultures for microbiologic studies of vaginal contents is beyond any doubt.

Hemorrheological indices, catecholamines, neuropeptide Y and serotonin in patients with essential hypertension.

Hemorrheological and humoral abnormalities and excessive platelet activity can predict the development of cardiovascular complications in patients with essential hypertension. A study was conducted to assess the influence of gender on these factors and the interrelations between changes in hemorrheology and the sympatho-adrenal system in 54 patients (18 women, 36 men) with essential hypertension (aged 39.6 +/- 9.7 years) and 25 healthy volunteers (10 women, 15 men; aged 36.0 +/- 7.2 years). A decrease in erythrocyte deformability (p < 0.01) was found in the hypertensive men compared with the hypertensive women. Hematocrit (p < 0.01), blood viscosity at the shear rates of 0.3 s-1 (p < 0.01) and 6 s-1 (p < 0.01), plasma viscosity (p < 0.01), erythrocyte aggregation (p < 0.01), and neuropeptide Y (p < 0.02) concentrations were higher in the hypertensive men than in the hypertensive women. A positive correlation between blood fibrinogen and serotonin was found in the pooled hypertensive group and in the hypertensive men (p < 0.01) and between blood viscosity (shear rate 6 s-1) and neuropeptide Y in the pooled hypertensive group (p < 0.01). Neuropeptide Y correlated with filtration time of 1 mL blood in the hypertensive men (p < 0.05) and in the pooled normotensive group (p < 0.01) and with beta-thromboglobulin in the hypertensive women (p < 0.001). A positive correlation was also found in the hypertensive men between erythrocyte and platelet aggregation (p < 0.01) and between beta-thromboglobulin and adrenaline (p < 0.01). Hemorrheological and humoral abnormalities are more pronounced in men than in women with essential hypertension and may contribute to the increased incidence of cardiovascular events in men.

[Evaluation of blood rheology indices in patients with pheochromocytoma]. / Ocena wskazników reologicznych krwi u chorych z pheochromocytoma.

Investigated group consisted of 28 patients (21 female and 7 male) with pheochromocytoma in mean age of 39.9 +/- 13 years, while control group comprised 25 healthy volunteers in mean age 36.0 +/- 7.2 years. Following parameters were determined: plasma and blood viscosity, erythrocyte and platelets aggregation, erythrocyte deformability, hematocrit, beta-thromboglobulin plasma concentration, plasma fibrinogen concentration, lipids concentration, noradrenaline, adrenaline, serotonin, neuropeptide Y plasma concentrations. Plasma fibrinogen and beta-thromboglobulin were increased in pheochromocytoma before surgery after pharmacological treatment and also after excision of the tumor. Whereas altered erythrocyte deformability before any treatment, only. Plasma neuropeptide Y concentration was higher in pheochromocytoma before surgery and after pharmacological treatment. There was no correlation between plasma catecholamines, plasma fibrinogen, beta-thromboglobulin, and erythrocyte deformability. Our results suggest that rheological abnormalities observed in patients with pheochromocytoma may contribute to vascular complications in this subjects. Sympathetic nervous system seems to influence indirectly observed rheological abnormalities.

[Influence of chronic ketanserin therapy on blood pressure and certain humoral and metabolic factors in patients with mild to moderate primary essential hypertension]. / Wplyw przewleklego leczenia ketanseryna na zachowanie sie cisnienia tetniczego oraz wybrane wskazniki humoralne i metaboliczne u chorych z lagodnym i umiarkowanym nadcisnieniem tetniczym pierwotnym.

Ketanserin, a serotonin-2-receptor antagonist, was administered to 16 patients with mild to moderate essential hypertension in randomized single-blind placebo controlled study. After 2 weeks of placebo administration ketanserin 60 mg daily was given for 3 weeks. In 7 patients the normalization of blood pressure was obtained and they were given the same daily dose of ketanserin for another 3 weeks. In the remaining 9 patients the dose of ketanserin was increased to 120 mg daily for the same period; in one additional case blood pressure decreased to normal. In the whole group the decrease of diastolic pressure was statistically significant comparing to placebo period. Ketanserin therapy did not influence serum free serotonin concentration, but the hypotensive effect was greater in patients with lower serotonin blood levels. Serum aldosterone concentration decreased in the initial period of treatment; the decrease was more pronounced in patients who responded to therapy. In this subgroup of patients diastolic blood pressure correlated positively with plasma renin activity. Ketanserin lowered serum adrenaline concentration, particularly in patients with good response to therapy. There was also decrease of total cholesterol concentration without any significant changes in HDL--cholesterol fraction. The authors conclude that oral chronic ketanserin treatment is an effective therapy in essential hypertension and that its effectiveness is greater in patients with lower serum serotonin levels. The hypotensive effect of the drug may be connected with lower sympathetic activity and with changes in renin-angiotensin-aldosterone system. Ketanserin is well tolerated and exerts beneficial effect on lipid metabolism.

[Use of direct and serologic methods to detect Chlamydia trachomatis infections in cervix uteri of women]. / Wykrywalnosc badaniami bezposrednimi i serologicznymi zakazen Chlamydia trachomatis szyjki macicy kobiet.

Investigation included 254 women (18-75 years of age). In this number, 74 patients constituted a group with pathological changes in cervix uteri, while 180 women were seemingly healthy. The material was evaluated by a method of direct immunofluorescence (IF) with monoclonal antibody serum and a culture on McCoy cells. Antibodies in blood serum was detected by an immunoenzymatic test ELISA. Out of total number of 256 patients tested, elementary bodies of C. trachomatis were found in cylindrical cells of cervix uteri by the IF test in 54 (21.25%) of women. Analogical percentage of positive results was obtained by application of culture on McCoy cells. Positive serological results were found in 70 patients (27.55%). In group of 75 patients infected with C. trachomatis, 33 cases (44.59%) were confirmed by application of IF and cell culture, whereas positive serological results were found in 39 (52.70%) of investigated patients. In the group of seemingly healthy women in 11.60% elementary bodies of C. trachomatis were detected and in 17.22% of cases serological results were positive.

[Biocenosis of vagina in women in light of microbiological examinations of vaginal content]. / Biocenoza pochwy kobiet w swietle mikrobiologicznych badan tresci pochwowej.

The study was aimed at microbiological evaluation of vaginal environment in 6810 women (19-75 years of age). Diagnostic procedure was applied according to accepted scheme, including basic and selected methods. Evaluation was performed by investigation of fresh (Miller's method) and fixed (Gram method) smears of vaginal content of pregnant women, women in childbirth and in women not pregnant, as well in the menopause and the old age. Microbiological pictures of vaginal content were classified according to modified procedure of Manu Af Heurlin. At the same time, cultures were carried on enriched and differentiating media in aerobic and anaerobic conditions. Microbiological investigations of vaginal content permitted for establishment of physiological status of vaginal environment or normal biocenosis of vagina in 3910 (57.4%) of tested patients. Disturbed biocenosis was present in 2900 (42.6%) of women and this included very serious disturbances of biocenosis in 1077 patients. In disturbed biocenosis of vagina, sexually transmissible microorganisms were main cause.

[Effect of long-term prazosin treatment on certain humoral and metabolic factors in patients with primary hypertension]. / Wplyw dlugotrwalego leczenia prazosyna na niektóre wskazniki humoralne i metaboliczne u chorych na nadcisnienie tetnicze pierwotne.

An effect of the long-term prazosin therapy on sympathetic activity, renin plasma activity and beta-endorphin and lipid blood levels was investigated in 23 patients with the primary arterial blood hypertension. Group A included 18 patients treated with prazosin, and group B - 5 patients treated with prazosin combined with propranolol. Mean daily dose of prazosin in group A was 3.0-10.0 +/- 1.3 mg in different phases of therapy whereas in group B mean daily dose of prazosin was 3.0-6.5 +/- 1.8 mg and propranolol 50-80 mg. Significant decrease in diastolic and systolic blood pressure (p < 0.01) was achieved in both groups. Additionally significant decrease in pulse rate (p < 0.01) was seen in group B. It was found that prazosin produced significant increase in plasma noradrenaline in group A and decrease in 4-hydroxy-3-methoxyglycol excretion with the urine (p < 0.05) in both groups. Moreover, negative correlation between a decrease in blood pressure (diastolic) and noradrenaline excretion with the urine (p < 0.05) was noted in group A. No effect of prazosin therapy on plasma renin activity, beta-endorphin and lipids blood levels was observed in both groups. These results suggest that prazosin therapy in patients with the primary blood hypertension exerts an effect on sympathetic activity and does not change plasma renin activity or blood beta-endorphin and lipids levels.

Platelet activity, prostacycline metabolite, plasma lipids and sympathoadrenal activity in patients with borderline hypertension and a positive family history of hypertension.

The study included 30 patients with borderline essential hypertension (HPT) (21 with a positive family history of hypertension, mean age 24.6 years, 9 with a negative family history, mean age 27.2 years) and 10 normotensive controls (mean age 27.5 years). In all of them 24-hour urinary noradrenaline (NA) and adrenaline (A) excretion was assayed. Blood levels of NA, A and dopamine, the prostacycline metabolite 6-keto-PGF1 alpha, beta-thromboglobulin, cholesterol, triglycerides and HDL cholesterol were measured, LDL cholesterol was calculated according to the Friedewald equation. Besides, lecithin cholesterol acyltransferase activity was assayed. Patients with HPT and a positive family history had elevated sympathetic and platelet activity and diminished 6-keto-PGF1 alpha blood levels. Their HDL cholesterol level was significantly lower than that of healthy controls. In patients with HPT and a positive family history of HPT the atherogenic index (total cholesterol to HDL cholesterol ratio) was highest, but did not differ significantly from that in other groups. The assessment of the examined humoral factors indicates that patients with borderline HPT with genetic predisposition to high blood pressure have a humoral profile different from that of patients without genetic predisposition. These findings suggest the importance of genetic factors in the development of essential HPT.

[Trichomonas vaginitis at different life stages of women]. / Rzesistkowica pochwowa w róznych okresach zycia organizmu zenskiego.

Using of fresh slides and culture T. vaginalis was found in 1094 persons (3.20%). It has been seen the morphological differentiation of T. vaginalis connected with the age, physiological state of macroorganisms and the clinic picture of trichomoniasis. In vivo, the spheroidal as well as ameboid forms of T. vaginalis were observed. The latter ones, characteristic in acute trichomoniasis, were often seen in pregnant women. On the other hand, nonmobile round-shaped forms of T. vaginalis occurred in vaginal contents of girls, women in child-bed and old (5 years after menopause) women. It seems, that morphologically + variability of T. vaginalis depends on changes of specific environment of human vagina, which is very sensitive to hormonal+ responses. It may be considered as adaptation of parasite to different biological conditions of vaginal environment.

[Intracellular electrolytes and selected biochemical parameters in patients with borderline arterial hypertension and positive family history of hypertension]. / Elektrolity wewnatrzkomórkowe i wybrane parametry biochemiczne u chorych na nadcisnienie tetnicze graniczne i z dodatnim wywiadem rodzinnym w kierunku nadcisnienia.

The studies involved 22 patients with borderline hypertension and familial history of the arterial blood hypertension (mean age 24.6 years) and 9 patients without familial history of hypertension (mean age 22.2 years). Control group included 10 healthy volunteers (mean age 27.5 years). Erythrocyte Na+ and K+ levels, daily secretion of noradrenaline (NA), adrenaline (A) and dopamine (DA), prostacyclin metabolite 6-keto-PGF1 alpha, beta-thromboglobulin levels (beta-TG), triglyceride cholesterol, and HDL-cholesterol were determined in all examined subjects. Friedewald's equation was used to calculate LDL-cholesterol. Moreover, LCAT activity was measured. An increase in erythrocyte Na+, increased sympathetic activity, excessive platelet activity and decreased 6-keto-PGF1 alpha levels were found in the group of hypertensive patients with familial history of the arterial blood hypertension. HDL-cholesterol was significantly lower in these patients than in the control group. Atherogenic index (cholesterol/HDL-cholesterol ratio) was the highest in the hypertensive patients with familial history of the arterial blood hypertension. The difference was insignificant, however. Patients with the borderline hypertension and familial predisposition to this disease differ from the hypertensive patients without familial history of the arterial hypertension in humoral profile suggesting a contribution of the genetic factors to the development of the arterial blood hypertension.

[Effect of long-term treatment with guanfacine on selected humoral metabolic indices in patients with primary hypertension]. / Wplyw przewleklego leczenia guanfacyna na wybrane wskazniki humoralne i metaboliczne u chorych z nadcisnieniem tetniczym pierwotnym.

An effect of the treatment with guanfacine on the activity of the adreno-sympathetic system, beta-thromboglobulin, beta-endorphin, and blood lipids was studied in 30 patients with the primary arterial blood hypertension. It was found that guanfacine significantly decreases plasma noradrenaline, adrenaline, and dopamine. Moreover, it decreases the excretion of noradrenaline, adrenaline and 4-hydroxy-3-methoxy-phenylglycol. These effects correlate with the drop in both systolic and diastolic blood pressure. A decrease in plasma renin activity was also observed. It correlated with the blood pressure drops. Guanfacine increased beta-endorphin levels while beta-thromboglobulin, total cholesterol and triglycerides levels remained unaffected. The authors suggest that the hypotensive effect of guanfacine is related to the decrease in adreno-sympathetic system activity and plasma renin activity and no effect on the erythrocyte activity and lipids metabolism.