Biomedical subjects

J Base

Publications and source records attributed to J Base.

At least 19 recordsLinked to original sources

PubMed2002

[Fatty acid composition of serum phospholipids and the effect of insulin in patients with type 2 diabetes].

BACKGROUND: A direct relation has been found between the insulin sensitivity and fatty acid (FA) composition of serum and tissue lipids in adult humans. The aim of our study was to confirm the above relation in different groups of type 2 diabetic patients (DM2). METHODS AND RESULTS: The FA composition of serum phospholipids was measured by gas liquid chromatography at the insulin action during the two-step hyperinsulinemic isoglycemic clamp (1 and 10 mU/kg.min) in a group of 21 newly diagnosed DM2 subjects (DMN) and in 24 healthy controls (HC). The DMN group consisted of a subgroup of patients treated with hypoglycemic agents (DMH; n = 21) and a group treated with the diet only (DMD; n = 11). In diabetics, the metabolic clearance rates of glucose at either insulin level (MCRglusubmax and MCRglumax) were significantly reduced in comparison with HS (MCRglusubmax--DMN: 5.35 +/- 2.7 ml.kg-1.min-1; DMH: 5.38 +/- 2.17 ml.kg-1.min-1; DMD: 5.48 +/- 2.35 ml.kg-1.min-1; HS: 10.9 +/- 3.3 ml.kg-1.min-1; p < 0.01; and MCRglumax--DMN: 13.3 +/- 3.3 ml.kg-1.min-1; DMH: 12.5 +/- 3.0 ml.kg-1.min-1; DMD: 13.3 +/- 3.0 ml.kg-1.min-1; HS: 17.4 +/- 3.8 ml.kg-1.min-1; p < 0.05). An increased content of highly unsaturated n-6 family FA (p < 0.01), especially of the arachidonic acid (DMN: 10.98 +/- 1.79%; DMD: 10.78 +/- 1.64%; DMH: 10.97 +/- 1.70% vs HS: 8.51 +/- 1.53% (p < 0.01) was found in all groups of diabetics compared to HS, and lower levels of linoleic acid in DMN (p < 0.001), and DMH (p < 0.05) were identified. The content of saturated FA and that of monosaturated FA was comparable in HS, DMN and DMD persons. While in healthy subjects a negative correlation between MCRglu and the content of saturated FA as well as a positive association between insulin action and the ration of linoleic and arachinonic acids were found, no such relation was found in the diabetic subjects. CONCLUSIONS: Different groups type 2 diabetic patients show altered FA pattern of serum phospholipids. Changes in FA composition may play a role in the modulation of insulin action in peripheral tissues, but they cannot explain the insulin resistance in type 2 diabetic patients.

Adult↗

PubMed2001

Serum phospholipid fatty acid composition and insulin action in type 2 diabetic patients.

Relationships have been demonstrated between insulin sensitivity and the fatty acid (FA) composition of serum and tissue lipids in adult humans. The present study aimed to investigate the above relationships in different groups of type 2 diabetic patients (DM2). The FA composition of serum phospholipids (S-PL) measured by gas liquid chromatography and insulin action during a 2-step hyperinsulinemic isoglycemic clamp (1 and 10 mU/kg. min) were determined in 21 newly diagnosed DM2 subjects (DMN), in groups of long-term DM2 patients treated with hypoglycemic agents (DMH; n = 21) or diet alone (DMD; n = 11), and in 24 healthy subjects (HS). In diabetics, the metabolic clearance rates of glucose at both insulin levels (MCR(glu)submax and MCR(glu)max) were significantly reduced compared with HS (MCR(glu)submax DMN, 5.35 +/- 2.7 mL x kg(-1) x min(-1), DMH, 5.38 +/- 2.17 mL x kg(-1) x min(-1); DMD, 5.48 +/- 2.35 mL x kg(-1) x min(-1) v HS, 10.9 +/- 3.3 mL x kg(-1) x min(-1); P <.01; MCR(glu)max DMN, 13.3 +/- 3.3 mL x kg(-1) x min(-1); DMH, 12.5 +/- 3.0 mL x kg(-1) x min(-1); DMD, 13.3 +/- 3.0 mL x kg(-1) x min(-1) v HS, 17.4 +/- 3.8 mL x kg(-1) x min(-1); P <.05). Increased contents of highly unsaturated n-6 family FA (P <.01), arachidonic acid in particular (DMN, 10.98% +/- 1.79%; DMD, 10.78% +/- 1.64%; DMH, 10.97% +/- 1.7% v HS, 8.51% +/- 1.53%; P <.001), were found in all groups of diabetics compared with HS, while lower levels of linoleic acid were seen in DMN (P <.001) and DMH (P <.05). The contents of saturated FA and monounsaturated FA were comparable in HS, DMN, and DMD. While in HS there were significant negative correlations between MCR(glu) and the contents of saturated FA and a positive association between insulin action and proportions of linoleic and arachidonic acids, no significant relationships were found in diabetic subjects. Different groups of DM2 patients show an altered FA pattern of S-PL, which is not related to insulin action. The above data support the hypothesis that changes in FA composition may play a role in modulating insulin action in peripheral tissues, but cannot explain the insulin resistance (IR) in DM2 patients.

Adult↗

PubMed1996

[Conservative surgery in the treatment of tumors of the renal parenchyma. 10 years' experience and results].

BACKGROUND: Radical surgery is considered standard treatment of renal tumours confined to the organ without detectable multiple metastases. In some circumstances, however, imperative or elective conservative surgery is indicated. The objective of the present work was, based on the authors' experience, to define more accurately indications for conservative surgery and evaluate the rate of local relapses of tumours and the patients' survival. METHODS AND RESULTS: The method of conservative surgery was used in 58 patients (34 men, 24 women, mean age 26-76 years, range 56 years). The indications for surgery were as follows: bilateral tumour (11x), tumour in solitary kidney (4x), tumour in kidney of abnormal shape (2x), and tumour defined by a capsule growing extrarenally reaching a size up to 3 cm (39x). In small tumours, less than 3 cm, 29x enucleation was performed and 10 times resection of the kidney. In patients with a bilateral tumour, with a tumour in a solitary kidney in kidneys with an abnormal shape or functionally impaired kidneys 15x resection and 4x enucleation of the tumour was performed. On histological examination 20% of the tumours were classified as benign. One to five-year survival after operation was evaluated in patients with histologically confirmed malignant tumours. On comparison with five-year survival of patients with a malignant tumour after radical nephrectomy (patients of the authors), it was revealed that after conservative surgery 85% patients survived, while after a radical operation only 57%. This difference is according to the authors due among others to a low biological activity of small tumours, their low staging and grading. CONCLUSIONS: An imperative or elective conservative operation is beneficial in particular in patients with a small tumour and low grading. This is suggested by the higher percentage of patients surviving five years after operation without evidence of a local relapse of the tumour.

Adult↗

PubMed1996

[Bilateral renal tumors].

At the Urological Clinic in Hradec Králové in 1990-1994 320 patients with renal tumours were admitted and treated. In 12 the tumour was bilateral (3.7%), incl. 8 patients where it was synchronous and four where it was asynchronous. Only in one female patient bilateral nephrectomy was performed, in 8 patients unilateral nephrectomy and on the other side enucleation of the tumour, in two patients bilateral enucleation of the tumour and in one patient with a malignant lymphoblastic lymphoma only unilateral enucleation of the tumour and epinephrectomy. In 10 patients histological examination confirmed a renal carcinoma, in one patient a malignant lymphoblastic lymphoma, in one female patient a bilateral multifocal oncocytoma. The patients survival was not evaluated in the report.

Aged↗

PubMed1996

[Renal angiomyolipoma].

The authors present their own experience as well as data from the literature concerning the diagnosis and treatment of renal angiomyolipomas. In a group of 320 patients hospitalised at the Urological Clinic in 1990-1994 these tumours were diagnosed before surgery and confirmed by histological examination in 7 patients (2.2%). The group comprised three men and four women, mean age 51.7 years. Only one female patient had classical manifestations of tuberous sclerosis, the remaining patients did not have manifestations of tuberous sclerosis. Two patients were admitted with symptoms of haemorrhage into the retroperitoneum, three suffered from pain on pressure in the side and in two patients the tumour was revealed incidentally during US examination. Four patients were subjected to nephrectomy, in two enucleation of the tumour was performed and in one female patient with classical manifestations of tuberous sclerosis with a bilateral tumour conservative treatment was applied.

Angiomyolipoma↗

PubMed1996

[Bilateral multifocal oncocytoma of the kidney].

The author presents the case-history of a 26-year-old female patient with bilateral multifocal renal oncocytoma detected incidentally after termination of pregnancy. Enucleation of three tumourous nodes was performed on the right side and nephrectomy on the left side. After four years a relapse was recorded in the remaining parenchyma of the right kidney. The patient does not suffer from renal insufficiency so far.

Adenoma, Oxyphilic↗

PubMed1995

Extraadrenal pheochromocytoma.

During 35 years we operated on 44 patients with pheochromocytoma, 16 of them had extraadrenal tumors (36%). We operated on 8 men and 8 women. In 5 men there was primary extraadrenal tumor, the same in 7 women. In 3 men and in one woman we operated on recurrence of tumor on another site. Mean age of the whole group was 38.3 years, in patients with recurrence the mean age was 44 years. Time distance between primary tumor and relapse was 3 to 16 years. We operated on 6 tumors on the right side, 10 on the left side. Paragangliomas on the right side were localized as follows: three tumors were under the vena cava, one tumor was dispersed multifocally, two tumors were localized before the vena cava. On the left side there was the following distribution of tumors: two tumors beneath the bifurcation of the aorta, 5 tumors paraaortally, one tumor on the wall of the aorta in the region of renal arteries, three tumors were localized in the hilus of the kidney.

Adult↗

PubMed1995

[Tocolysis and fatty acids].

To six pregnant female rats Wistar strain the beta-mimetic tocolytic preparation (Partusisten-Boehringer) was administered by the s.c. route on the 19th, 20th and 21st day of pregnancy-0.1 mg per 250 mg body weight. The above dose corresponds to clinical practice and was divided into two parts: half the amount was administered between 8 and 9 a.m., the second half between 1 and 2 p.m. To pregnant controls (mean weight 340 g) saline was administered in an analogous way. On the 22nd day of pregnancy the females with a mean weight of 330 g were sacrificed by decapitation and concurrently with collection of mixed blood the calva was opened and on a cooled block the grey matter of the brain cortex was isolated. From the foetuses pooled blood samples (from 4-5 foetuses) and samples of the CNS were collected. From each foetus 0.5 ml blood was examined. The fatty acid spectrum was assessed by gas chromatography in Base's modification (1978). It was revealed that that administration of the tocolytic to pregnant females affected most the spectrum of unsaturated fatty acids of the n-3 series. In the initial there was a statistically significant increase of linolenic acid C 18:3 n-3 values in the serum as well as in the cerebral cortex as compared with controls. In two other acids, C 18:4 and C 20:4 on the other hand, a marked drop occurred.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1995

Bleeding to adrenal glands in adults.

At the Department of Urology in Hradec Králové five patients were treated in 1991 to 1993 with bleeding to the adrenal glands. We present our reports of these patients and stress the difficulty of preoperative diagnosis.

Adrenal Gland Diseases↗

PubMed1995

Bleeding to adrenal gland in adults.

Adrenal Gland Diseases↗

PubMed1995

[Conservative surgical treatment of kidney tumors: indications, techniques, results].

At the Urological Department in Hradec Králové the authors operated in 1989-1993 287 patients with renal tumours, in 45 of them a conservative procedure was used (15.6%). The group comprises 29 men and 16 women, mean age 56.5 years. The contralateral kidney was normal in 29 patients (64%), in 5 patients nephrectomy was performed on account of carcinoma and in 9 patients (20%) the second kidney was hypofunctional (hydronephrosis, cysts). In two patients a conservative procedure was used on account of malignity of the blood. In 33 patients the tumour was enucleated (73.3%), in 12 the upper or lower pole of the kidney was resected. In 6 patients the tumour was in the first clinical stage, but in four already in T 3a (imperative indication). Twenty-seven tumours were evaluated by the histologist as medium differentiated, 2 of 35 as poorly differentiated. Thirty-five tumours were carcinomas (77.7%), 8 were adenomas, one was angiomyolipoma and in one instance the scar after PEC was removed which was not reliably diagnosed before surgery. The preoperative examination comprised also immunological examination which, however, was not made in two patients. The immunologist evaluated the criteria as favourable in 21 patients (60%), as risky in 12, incl. 6 were immunotherapy was administered. One patient developed a urinous fistula which healed on a stent. During the investigation period no local relapse was observed.

Female↗

PubMed1995

[Blunt injury of the kidney--personal experience and present views on its therapy].

Between 1972 to 1994 there were admitted 105 patients with blunt trauma of the kidney, 89 men and 16 women with median age 32 years. In 53 patients the left kidney was affected and in 52 of them the right side was injured. According to the grade of trauma we evaluated in 77 patients a contusion (73.3%), by 16 patients a laceration (15.2%), in 11 patients a rupture of the kidney with fragmentation of the parenchyma and in one the renal artery was injured. The mechanism leading to the blunt trauma of the kidney was following: traffic accident in 52 patients (49.5%), during sport in 20 patients (19.5%). 16 patients were injured in own home (9.5%) and 7 patients in work (6.7%). In 28 patients the trauma of the kidney was serious, by 5 of them we have done nephrectomy (17.8%), in two suture of the parenchyma (7.1%) and in further two patients heminephrectomy. After considering clinical status, grade of hypovolemic shock and finding on CT scan we prefer lately conservative steps in the treatment serious trauma of the kidney.

Adolescent↗

PubMed1994

[Adrenal gland hemorrhage in adulthood].

The author presents five case-histories of haemorrhage into the adrenal in adult age. He emphasizes specially the difficulty of preoperative diagnosis.

Adrenal Gland Diseases↗

PubMed1994

[Long-term results of therapy in patients with retroperitoneal fibrosis].

In 1972-1991 at the urological clinic in Hradec Králové 13 patients with retroperitoneal fibrosis were treated. In six idiopathic fibrosis, primary fibrosis (morbus Ormond) was involved. By surgery only one patient with the primary disease was treated, five patients with secondary fibrosis only conservatively (by nephrostomy, by introduction of an ureteral endoprosthesis and prednisone administration 1200-1500 mg in total). Seven patients, incl. five with primary fibrosis, had combined treatment, an open operation with subsequent administration of prednisone. All remained under dispensary care of the clinic. During check-up examinations renal function and congestion in the urinary pathways was examined. In morbus Ormond treatment was successful in 83% of the patients (one patient died from myocardial infarction on the fifth day after operation); in patients with the secondary disease treatment was successful in 60%.

Adult↗

PubMed1994

Conservative surgery for renal cell carcinoma--indications, technique and results.

At the Department of urology in Hradec Králové between 1989-1993 287 patients with a tumor of the kidney were operated on, in 45 of them (15.6%) conservatively. In this set there are 29 men and 16 women with the mean age 56.5 years. In 29 patients the contralateral kidney was normal (64%), 5 patients underwent nephrectomy for renal cell carcinoma, in 9 patients the opposite kidney was hypofunctionalised (hydronephrosis, cysts). In two patients the conservative approach was used for reasons of another type of malignancy (haematological). In 33 (73.3%) patients enucleation, in 12 patients resection of the lower or upper pole were done. The tumor was classified as T 1 stage in 6 patients, but in 4 patients already as T 3a (in patients with imperative indication). In 35 patients the tumor was moderately differentiated, in two ones with histologically confirmed renal cell carcinomas the tumors were poorly differentiated, in 8 patients there were histologically adenomas, in one angiomyolipoma and in another case scar after PCN (percutaneous nephrolithotomy). Preoperative examination included immunological examination, this was not done in two patients. Good results were obtained in 21 patients (60%), 12 patients were in high risk and 6 of them received immunotherapy. As an early complication one patient had urinary fistula, which resolved after introduction of stent. Relapse of malignancy in the screening period was not noticed.

Carcinoma, Renal Cell↗

PubMed1993

Metabolic effects of omega-3 fatty acids in type 2 (non-insulin-dependent) diabetic patients.

The metabolic effects of a 3-week dietary supplement of a fish oil concentrate was examined in mildly obese, normotriglyceridemic men with non-insulin-dependent diabetes mellitus (NIDDM) treated with hypoglycemic agents (n = 20). Patients were randomized into two groups, receiving 15 ml per day of fish oil (Martens Oil, Norway) containing 3.1 g of omega-3 fatty acids (FA) (n = 10) or placebo (n = 10). Whereas fish oil led to the expected increase in the ratio of omega-3 to omega-6 FA in serum phospholipids, reflecting the increase in omega-3 FA intake, it did not alter fasting or mixed meal stimulated blood glucose, plasma insulin, and C-peptide concentrations. No changes in insulin action were noted, estimated by the metabolic clearance rates of glucose at plasma insulin levels of approximately 100 microU/ml and 1,400 microU/ml during a hyperinsulinemic, isoglycemic clamp; no changes were seen in insulin binding to erythrocytes. We conclude that during short-term administration, no adverse effects of low dose fish oil on glucose homeostasis were found in mildly obese NIDDM patients treated with oral hypoglycemic agents.

Adult↗

PubMed1993

[Glucose utilization and risk of hyperglycemia during simultaneous administration of branched-chain amino acids and fat emulsions in healthy persons].

In order to evaluate the effect of substrate competition on glucose utilization, we studied 8 healthy volunteers under three different conditions: 1. Hyperinsulinemic (75 a 550 microU/ml) euglycemic (5 mmol/1) clamp (HEC). 2. HEC with Nutramin VLI infusion given at a rate of 2 ml/kg.h. 3. HEC with infusion of Nutramin VLI (2 ml/kg.h) and Intralipid (0.15 g of fat/kg.h). Glucose utilization was evaluated as the glucose disposal rate during HEC. We have found, that Nutramin VLI given alone or with Intralipid does not significantly decrease glucose utilization at insulinemia of about 75 and 550 microU/ml. We conclude that simultaneous administration of substrates during parenteral nutrition at standard rates does not raise the risk of hyperglycemia in healthy men.

Adult↗

PubMed1993

[Serum fatty acids in premature neonates].

In the past we have published several papers concerning the evolution of large spectrum of fatty acids in the brain or in the blood-serum in rats or in human newborns (and their mothers just after the delivery). Therefore we realized this study: the blood-serum spectrum of fatty acids in the healthy human newborns (n = 32) was compared with the spectrum of fatty acids detected in the blood-serum of human premature neonates (n = 22). The birth-weight in the control group was 3,882, in the premature neonates 2,137 g only. Fatty acids were measured as methylesters (FAME) using the method of gas chromatography and absolutely the same methodological approach as in our previous studies (33, 22, 23). The results were computed by biocybernet. dep. of Physiological institute and the statistics were evaluated by Mann-Whitney U test. It was established that the premature neonates show a distinct greater content (expressed in percentage) of saturated fatty acids and a smaller share of polyenoic FA (PUFA). A further marked difference consists in a significant lower of the n-3 FA and consequently a higher n-6/n-3 index. In premature neonates a significant increase of caprylic acid and arachidonic acid in the blood-serum was detected. The significance of described changes in the participation of single fatty acids in the premature neonates for their maturation, structural evolution especially of the brain cells and for therapy, is discussed.

Fatty Acids↗