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Teplan V.,Klinika Nefrologie Transplantcentra IKEM Prague | Mahrova A.,Laborator Sportovni Motoriky | Svagrova K.,Laborator Sportovni Motoriky | Racek J.,Ustav Klinicke Biochemie a Hematologie | And 3 more authors.
Vnitrni Lekarstvi | Year: 2012

Background: Levels of the endogenous nitric oxide synthase inhibitor asymmetric dimethylarginine are elevated in patients undergoing kidney transplantation and may contribute to vascular complications. In this study we tested the hypothesis that elevated asymmetric dimethylarginine can be reduced in patients after kidney transplantation by early regular physical exercise. Selected cytokines and metabolic parameters were also analysed. Methods: Plasma samples for analysis of asymmetric dimethylarginine, adiponectin, leptin, soluble leptin receptor, resistin, visfatin, CRP, TNFα and selected metabolic parameters were obtained from randomly selected sixty eight patients after kidney transplantation who agreed to participate in a supervised aerobic exercise program for six months. Samples were collected before the training began (one month after surgery with stabilized graft function) and at six months after initiation. Sixty transplant patients matched for age, sex, HLA typing, duration of previous dialysis, history of cardiovascular disease and immunosupression regimen who did not exercise regularly and did not participate in the training program were examined as controls. Results: There were no differences in elevated asymmetric dimethylarginine levels between both groups before the training program began. After six months of exercise, asymmetric dimethylarginine concentration in the exercising group I significantly decreased (3.5 ± 0.45 vs 2.11 ± 0.35 μmol/L, P < 0.01) and was also significantly lower comparing to non-exercising group II (2.11 ± 0.23 vs 3.25 ± 0.34 μmol/L, P < 0.01). We found significant changes in exercising group I: adiponectin (15.4 ± 6.6 vs 22.3 ± 6.2 mg/mL, P < 0.01), leptin (51.3 ± 11.2 vs 20.3 ± 9.2 ng/L, P < 0.01), soluble leptin receptor (24.6 ± 8.4 vs 46.1 ± 11.4 U/mL, P < 0.01), resistin (20.8 ± 10.1 vs 14.6 ± 6.4 mg/mL, P < 0.025) and visfatin (1.8 ± 0.2 vs 1.2 ± 0.01 ng/mL, P < 0.05). Blood lipids, HbA1c, CRP and TNFα were also affected by the training program. Conclusions: Elevated asymmetric dimethylarginine level, selected adipocytokines and proinflammatory cytokines in patients after kidney transplantation were significantly influenced by early regular exercise. This regimen may decrease cardiovascular risk in patients after kidney transplantation.

Babuska V.,Ustav Lekarske Chemie a Biochemie | Cedikova M.,Ustav Histologie a Embryologie | Rajdl D.,Ustav Klinicke Biochemie a Hematologie | Racek J.,Ustav Lekarske Chemie a Biochemie | And 6 more authors.
Ceska Gynekologie | Year: 2012

Objective: Follicular fluid (FF) affects oocyte development and disruption of its homeostasis has a crucial effect on egg developmental potential. The aim of this study was to compare the levels of selected oxidative stress markers in the FF of women with impaired fertility and healthy fertile oocytes donors. Design: A retrospective comparative study. Setting: Faculty of Medicine in Pilsen, Charles University in Prague; Institute of Reproductive Medicine and Endocrinology, IVF Center Prof. Zech, Pilsen. Methods: Levels of homocysteine (Hcy), malondialdehyde (MDA), glutathione peroxidase (GPx), total antioxidant capacity (AOK) and total protein (CB) were analyzed in the FF. We have analysed FF of 146 women - 74 infertile patients (mean age 31 years, SD = 4.65) and 72 healthy fertile oocyte donors (mean age 26 years, SD = 4.44). Only blood free samples were studied after pooling of all FF samples each patient. Results: The study showed a statistically significantly higher Hcy levels (p < 0.0001) in the FF of healthy fertile women compared with impaired fertility group both - comparing the two groups regardless the age and in groups of the same age range (for the age group between 20 to 29 years is p = 0.0002, for the age group between 30 to 39 years is p < 0.0001). When divided into above age ranges we found statistically significantly higher levels of MDA in the control group aged 20 to 29 years compared to same age infertile patients (p = 0.0374) and statistically significantly higher AOK in infertile women between 30 to 39 years of age compared to same age control group (p = 0.0458). Conclusion: The presence or on the contrary the absence of prooxidant parameters in the FF has an important role in the ability of conception and subsequent embryo development.

Cedikova M.,Ustav Histologie a Embryologie | Babuska V.,Ustav Lekarske Chemie a Biochemie | Rajdl D.,Ustav Klinicke Biochemie a Hematologie | Zech N.H.,Institute Reprodukcni Mediciny a Endokrinologie | And 2 more authors.
Ceska Gynekologie | Year: 2012

Objective: Follicular fluid (FF) provides an important microenvironment for the development of oocytes. The biochemical composition of the FF plays critical role in the oocyte competence. The aim of our study was to compare the levels of selected hormones in FF of infertile women and healthy fertile oocyte donors. Design: Retrospective comparative study. Setting: Department of Histology and Embryology, Faculty of Medicine in Pilsen, Charles University in Prague; Department of Gynecology and Obstetrics, Charles University and University Hospital in Pilsen; Institute of Reproductive Medicine and Endocrinology, IVF Centers Prof. Zech, Plzeň. Methods: Levels of prolactin, free T3 and free T4 hormones in the FF of 146 women were analyzed. We have analysed FF of 74 infertile patients (mean age 31 years, SD = 4.65) and 72 healthy fertile oocyte donors (mean age 26 years, SD = 4.44). Only blood free samples were studied after pooling of all FF samples each patient. Levels of hormones were determined using ECLIA method (Electro-Chemi- Luminiscent Immunoassay) on the Cobas e411. Results: Results showed statistically significantly higher levels of prolactin (p=0.0006) and free T4 hormone (p=0.0246) in FF of infertile women in comparison to the group of healthy fertile oocyte donors. Conclusion: Our study confirms the presence of prolactin and thyroid hormones in FF and it can be suggested that they play a key role in the regulation of reproductive processes. The study of FF from donors and their detailed comparison with infertile patients with various gynaecological causes of infertility has great value for better understanding of regulatory mechanisms of fertility.

Kaderabkova O.,Klinika Pracovniho Lekarstvi | Machartova V.,Klinika Pracovniho Lekarstvi | Bajerova S.,Klinika Pracovniho Lekarstvi | Eechova H.,Klinika Pracovniho Lekarstvi | And 2 more authors.
Pracovni Lekarstvi | Year: 2011

Authors present a case study of a 31 year old welder with an unusual radiograph lung finding within the basic diagnosis of asthma bronchiale. The patient was examined for breathing troubles at the outpatient department of the clinic of occupational diseases. The deposits of metal mercury were proved in lungs and in the right heart. The radiograph finding indicated evaluation of the concentration of mercury in blood and urine samples. All samples showed significantly increased concentrations (Hg in blood up to 130 μg/l, Hg in urine up to 420 μg/l). The patient has not shown any signs of chronic mercury intoxication, in the course of the monitored period the clinical and radiograph findings have been stable, the mercury concentration in blood and urine has dropped after 3 years. The patient has not come to the control examination. We learnt from the general practitioner that the patient died due to dilatation cardiomyopathia proved by an autopsy. The etiology of the finding has not been clarified. Presumably it was a lung embolus caused by an i.v. application of mercury. The patient approved an i.v. application of drugs (Pervitin) with the aim of increasing work efficiency.

Pesek M.,Klinika Pneumologie a Ftizeologie | Bittenglova R.,Klinika Pneumologie a Ftizeologie | Fremundova L.,I. Interni Kllnika | Turkova-Sedlackova T.,Ustav Klinicke Biochemie a Hematologie | Dettmar P.W.,Castle Hill Hospital
Studia Pneumologica et Phthiseologica | Year: 2014

Background: Gastroesophageal reflux disease (GERD) is often found in interstitial lung disease, particularly in interstitial pulmonary fibrosis. An association has been found between GERD and progression of pulmonary changes, acute exacerbations and transplant rejection. The presence of pepsin in airway secretions may indicate the presence of GERD.Methods and Patients: In patients with progressive and symptomatic interstitial lung disease (IPP, IPF/UIP, EAA, sarcoidosis, LAM and CF), clinical examination included the use of Peptest (RDBiomed, Hull, UK). For the test, early morning fasting samples of coughed up sputum or saliva were collected. Patients with positive findings were evaluated with 24-hour esophageal pH and impedance monitoring. It was also ascertained from the patients whether they used proton pump inhibitors (PPIs) at the time of their examination.Results: The study group comprised 106 patients (40 males and 66 females) with a median age of 58 years (range, 23-86 years). There were 32 patients with IPP, 10 with IPF/UIP, 22 with EAA, 34 with sarcoidosis, 1 with LAM and 7 with CF. Out of 106 pepsin tests, 86 were positive (81 %). The rate of agreement with reflux disease detected by pH and impedance monitoring was 60 %. The frequency of positive Peptest results in patients treated with PPIs was 78.5 %.Conclusion: The results support the assumption that GERD is involved in the pathogenesis of interstitial lung disease exacerbations and progression and its presence may be revealed with tests to detect pepsin in airway secretions. Although antireflux therapy with PPIs or fundoplication may improve the prognosis of IPF patients, this approach may positively influence acid reflux but pepsin continues to remain in the airways of most patients treated with PPIs.

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