Correlation of myofibrillar ATPase activity and myosin heavy chain content in ventricular and atrial myocardium of fish heart.

In the fish heart, ventricular and atrial muscles contain different isoforms of native myosin and myosin heavy chain (MyHC) but the significance of this diversity is still not known. We have analysed ventricular and atrial myocardium of six freshwater fish species (goldfish, roach, bream, rudd, perch and pike-perch) using histochemical staining for myofibrillar ATPase activity as well as non-denaturing and SDS gel electrophoreses for native myosin and MyHC content. In the range of fish species studied, the intensity of ATPase reaction was higher in the atrial myocardium than in the ventricular myocardium and the composition of native myosin isoforms differed between these two muscles. The MyHC content in the cardiac muscle showed some species-related differences. In the goldfish, both atrial and ventricular cardiac muscle contained electrophoretically similar MyHC. In the other fish species, however, the ventricular myocardium showed electrophoretically faster MyHC than that present in the atrial myocardium. These results indicate that there are consistent and characteristic species-related differences between the ventricular and atrial muscles at the level of ATPase staining and the type of MyHC expressed. The findings suggest that fish ventricular and atrial muscles may differ in their contractile properties.

The benefits of hormone replacement therapy in pre-menopausal women with oestrogen deficiency on haemodialysis.

BACKGROUND: Impaired sexual function is an important cause of depression in uraemic females. Hyperprolactinaemia is frequent, and often associated with decreased serum oestradiol concentration, which can significantly contribute to accelerated bone loss. The aim of the study was to evaluate the effect of hormone replacement therapy (HRT) on sexual function, serum 17beta-oestradiol and prolactin, and bone mineral density (BMD) in pre-menopausal women undergoing haemodialysis. METHODS: Among 63 women on haemodialysis, aged 18-45 years, 23 with secondary amenorrhoea and serum oestradiol < 30 pg/ml were enrolled into the 1 year study. They were divided into: group I (n = 13) treated with transdermal oestradiol with cyclic addition of noretisterone acetate, and control group II (n = 10). BMD was measured with dual energy X-ray absorptiometry (DEXA). RESULTS: No important changes in sexual function and hormonal profile were observed in the control group, whereas in all women from group I the treatment induced regular menses and a marked improvement of libido and sexual activity. Serum 17beta-oestradiol increased after the first month from 20.5 +/- 11.7 to 46.8 +/- 13.6 pg/ml (P < 0.001) and remained at that level until the end of the study, accompanied by a decrease of serum prolactin (from 1457 +/- 1045 to 691 +/- 116 mIU/ml after 12 months; P < 0.001). In group I, the treatment induced an increase in BMD, although significant only in L2-L4 (P < 0.05), whereas in group II a mild insignificant decrease was observed. However, a comparison of BMD values after 12 months in both groups revealed marked (P < 0.01-P < 0.05) differences at all studied sites. CONCLUSIONS: Transdermal HRT allows sustained physiological serum oestradiol concentrations in pre-menopausal women with oestrogen deficiency on haemodialysis, with the restoration of regular menses and a marked improvement in their sexual function. The treatment inhibits bone demineralization and can play an important role in the prevention of early osteoporosis in this group of patients.

[The prevention of bone mineral loss with hormonal replacement therapy in premenopausal women on dialysis with estrogen deficiency]. / Hormonalna terapia zastepcza w zapobieganiu utracie mineralu kostnego u kobiet w wieku rozrodczym z niedoborem estradiolu leczonych powtarzanymi dializami pozaustrojowymi.

In 25-30% of premenopausal dialysis women low serum estrogen concentrations are observed. This "premature menopause" can significantly contribute to accelerated bone loss. The aim of the study was to evaluate the effect of estrogen-gestagen replacement therapy on bone mineral density (BMD) in hemodialysis women with secondary to uremia estrogen deficiency. Among 20 hemodialysis women, aged 18-45 years, with serum 17 beta-estradiol < 30 pg/ml, ten (group I) received transdermal estradiol with cyclic addition of noretisterone acetate (Estracomb TTS 50/0.25), and another ten formed the control group (group II). BMD was evaluated by dual photon x-ray absorptiometry (DEXA, Lunar) in: lumbar spine (L2-L4), 1/3 distal radius and femoral neck, before and after the study. Serum 17 beta-estradiol concentrations were measured before, and after 1, 3, 6 and 12 months of the study. After one year, in group I, in which serum 17 beta-estradiol normalized already during the first month (p < 0.001), an increase of in BMD was noted, although significant only in L2-L4 (p < 0.05). In group II, no change in serum 17 beta-estradiol and mild but insignificant decrease in BMD were observed. However, a comparison of BMD values after 12 months in both groups revealed the marked differences in all studied sites (p < 0.01, p < 0.02, p < 0.05 in L4-L2, distal radius and femoral neck, respectively). The mean serum calcium, phosphate, PTH and alkaline phosphatase activity were similar in both groups and did not change during the study. In premenopausal hemodialysis women with estrogen deficiency, hormonal replacement therapy inhibits bone demineralization and can be useful in prevention of early osteoporosis.

[Hormonal replacement therapy and lipid metabolism in women on hemodialysis with secondary to uremia estrogen deficiency]. / Hormonalna terapia zastepcza a gospodarka lipidowa u kobiet dializowanych z wtórnym do mocznicy niedoborem estrogenów.

UNLABELLED: It has been reported that postmenopausal women taking hormonal replacement therapy (HRT) are at reduced risk for cardiovascular disease mainly because of favorable changes in serum LDL- and HDL-cholesterol. However, the therapy is also known to increase hepatic triglyceride production. Cardiovascular events are the leading cause of death in patients on dialysis and lipid abnormalities are common. The aim of the study was to evaluate the influence of HRT on lipid metabolism in premenopausal women undergoing hemodialysis with premature oestrogen withdrawal. 25 hemodialyzed women, aged 37 +/- 9 years (19-44 years) with serum 17 beta-estradiol < 30 pg/ml were divided into: group I (n = 13) treated with transdermal HRT (estradiol with cyclic norethisterone acetate--Estracomb TTS 50/0.25; Novartis), and control group II (n = 12). Before the treatment serum LDL-cholesterol concentrations were increased in 24% and serum triglycerides in 40% of patients, whereas HDL-cholesterol was decreased in 72% of patients. During one year, in group I a noticeable, 15% increase in serum HDL-cholesterol was observed from 0.90 +/- 0.23 to 1.04 +/- 0.19 mmol/l (34.8 +/- 8.8 to 39.8 +/- 7.4 mg/100 ml; p < 0.01). It was parallel to the increase in serum 17 beta-estradiol concentrations (from 20.5 +/- 8.91 to 50.3 +/- 17.20 pg/ml; p < 0.01). Serum LDL-cholesterol and triglycerides did not change significantly. In the control group all those values remained unchanged. CONCLUSIONS: In hemodialysis women with premature estrogen deficiency the transdermal cyclic HRT leads to the clinically important increase in serum HDL-cholesterol without significant changes in serum triglyceride concentrations and could be beneficial in reducing cardiovascular risk in this population.

[Treatment of severe uremic hyperparathyroidism using a method for percutaneous injection of the parathyroid glands with ethanol]. / Leczenie ciezkiej mocznicowej nadczynnosci przytarczyc metoda przezskórnego ostrzykiwania gruczolaków alkoholem etylowym.

The results of recent studies suggest that uremic patients with large parathyroid hyperplasia are often resistant to active vitamin D3 therapy. Percutaneous ethanol injection has become an interesting option in such cases, although there are only a few publications on that subject. In this work we would like to present our experience with this method. 20 patients with serum iPTH > 400 pg/ml and 1-4 hyperplastic parathyroids (mean volume 1.07) underwent 56 percutaneous ethanol injection sessions under ultrasonographic guidance. In 9 patients a marked (> 75%), long-term (12-24 months) decrease in serum iPTH was achieved; lesser (> 50%) reduction in parathyroid activity persisted for 36-42 months in 5 out of 9 patients observed in this period. In almost every patient a significant reduction of alphacalcidol dose was possible. Our data confirm that percutaneous ethanol injection therapy is a useful and safe adjunct in severe uremic hyperparathyroidism treatment strategy which allows to restore the responsiveness to active vitamin D3 metabolites.

Erythropoietin treatment in patients on maintenance haemodialysis in dialysis centers of South-East region of Poland--present state.

South-East region of Poland includes six voivodeships, with about 3.6 mln of inhabitants. Nine dialysis centers work in this region with 273 places to perform maintenance haemodialysis outside Lublin, and 53 places in Lublin Clinic Center. The aim of this paper was to analyse the state of r-Hu EPO treatment in chronic dialysis patients. We would like to compare the treatment possibilities in the clinic unit with other haemodialysis units of our region and with data from Western Europe that we know from EDTA report. Simultaneously we decided to estimate real possibilities of iron treatment monitoring. As it is well known correct management of iron supplementation treatment, allows for the significant reduction of r-Hu EPO administration.