Does the Parathyroidectomy Endanger the Transplanted Kidney?

BACKGROUND: Some investigators maintain that a parathyroidectomy (PTX) performed for tertiary hyperparathyroidism may potentially cause graft malfunction or even loss of the transplanted kidney after the operation. The goal of this study was to determine if parathyroidectomy affects transplanted kidney function. METHODS: The study group consisted of 48 renal graft recipients who underwent operation due to tertiary hyperparathyroidism. Thirty-nine subtotal parathyroidectomies and 9 more selective, less than subtotal parathyroidectomies were performed. The estimated glomerular filtration rate (eGFR) was calculated retrospectively on days 2 to 3 and 4 to 5 and at 1, 3, 6, 12, 24, and 36 months after PTX; these findings were compared with preoperative values. The cumulative graft survival rate in the postoperative period was assessed. RESULTS: In the follow-up period, 4 of 48 patients returned to hemodialysis (after 1, 7, 22, and 57 months after PTX). In the first case, the patient had stopped taking the immunosuppressive drugs 1 month after PTX. Cumulative graft survival rate after PTX was 98.0% after 6 months, 96% after 12 months, and 93% after 2 and 3 years. The mean preoperative eGFR was 52 ± 17.15 mL/min/1.73 m(2), and the median was 48.28 mL/min/1.73 m(2). Overall and in the subtotal parathyroidectomy group, eGFR was significantly lower (P < .001) only on days 2 to 3. There were no differences between preoperative and postoperative eGFR values in the other follow-up periods. In the more selective, less than subtotal parathyroidectomy group, the decrease in eGFR values was nonsignificant compared with preoperative findings in the early postoperative period as well as in all follow-up periods. CONCLUSIONS: In this study, PTX did not significantly impair transplanted kidney function, but in the early postoperative period, transient reductions in graft function did occur.

Level of preparation for preventive procedures and pressure ulcer treatment in health care units from the Kujawsko-Pomorski region.

PURPOSE: Prevention of pressure ulcer development is one of the most important tasks of chronic diseases management. This diseases are the risk factors of pressure ulcer development. The effectiveness of prevention depends on medical staff work organization, material resources (e.g. dressings), training system and education. The aim of the study was to asses the level of preparation for prevention activities, risk assesment, pressure ulcer treatment and documentation in health care units from Kujawsko-Pomorski region. MATERIAL AND METHODS: This study was based on the questionnaire and was performed in 21 health care units. We assesed basic equipment of 1060 beds from internal, neurological and long-term care wards. RESULTS: The highest risk of pressure ulcer development was identified in neurological wards. Hospitalisation longer than 10 days increases the risk. The highest morbidity was presented in long-term care wards. In 50% of hospitals there was a lack of equipment and materials used for pressure ulcer management and prevention, especially pressure-reducing matresses. CONCLUSIONS: Hospitals are not well performed for effective prevention and management of pressure ulcers.

Thyroid C cell function during fasting and refeeding of young and old rats.

Age-related alterations in the structure and function of many organs often become apparent under stimulation of their function. Although the ageing process affects the regulation of mineral homeostasis, the function of thyroid C-cells that secrete calcitonin (CT) under the conditions of fasting and refeeding, a way of dietary manipulation that reveal the existence of age-related changes of follicular thyroid cells, has not been characterized. Therefore, we investigated the number of C-cells and serum CT concentration in young (4 mo) and old (26 mo) male rats fasted for 48 hours, and then refed for 4 or 24 hours. We found significantly higher number of C-cells in thyroids of old vs young rats both under basal conditions, and after fasting/refeeding. Correspondingly, serum calcitonin level was higher in fed or fasted old rats vs young ones. However, in young rats refeeding decreased, whereas in old animals increased serum concentrations of calcitonin. Thus, the control of serum calcium concentration, that was well preserved in old rats, occurs at the expense of increased serum CT level both under basal conditions, and after refeeding. These observations suggest that C-cell function is altered in ageing.

The effects of fasting and refeeding on serum parathormone and calcitonin concentrations in young and old male rats.

Although fasting and refeeding reveal the existence of age-related changes in carbohydrate and lipid metabolism, the effects of aging on mineral metabolism in refed animals are unknown. We therefore investigated hormonal regulation of calcium metabolism in young (4 months) and old (26 months) male rats fasted for 48 hours and then refed for 4 or 24 hours. Serum concentrations of total and ionized calcium and parathormone were similar in control young and old rats. Serum calcitonin level was higher, and the concentrations of albumin and inorganic phosphate and alkaline phosphatase activity were lower in fed old rats. In young fasted rats, the serum ionized and total calcium was decreased, and phosphate concentration was increased. In old rats, fasting resulted in the increase of serum parathormone level. Fasting reduced serum alkaline phosphatase activity to a similar extent in both age groups. In young rats, refeeding for 24h normalized serum calcium and phosphate levels and alkaline phosphatase activity, and decreased serum concentrations of PTH and calcitonin. In old refed rats, serum calcitonin concentration was raised by 77% compared to fed or fasted animals, whereas parathormone levels were normalized. Our results indicate that old fasted or refed rats maintain normal serum calcium concentration in a different way than young animals, possibly through the increase in serum levels of parathormone and/or calcitonin. Thus, dietary manipulations such as fasting and refeeding constitute an interesting model for the investigation of the effects of aging on the hormonal regulation of serum calcium level.

Adhesion of L1210 cells to sulfonated styrene copolymer surfaces: imaging of F-actin AND alpha-actinin.

The static adhesion of living L1210 cells to sulfonated copolymer surfaces of different sulfonic group content and the actin cytoskeleton organization in the adhering cells were studied. The strength of the cell-substratum interaction was estimated by determining the relative number of cells remaining adherent despite experiencing a shearing force equal to 1.25 x 10(-11) N caused by the laminar flow of the medium. The cell-substratum interaction took place in a medium with or without serum. The distribution of F-actin and alpha-actinin in the adhering cells was determined in sequences of fluorescent images of cell optical slices with the use of a computer method of cell image analysis. It was shown that the surface sulfonic groups affect not only the rate and strength of cell-substratum adhesion but also the F-actin and alpha-actinin distribution (in the cell regions near the substratum surface) in cells adhering in the medium containing serum. These proteins, concentrated in the tips of microvilli, were observed as dots. The distinctness (discernibleness) and sizes of these dots depend on the surface content of sulfonic groups. F-actin is located at the periphery of the cells in cells adhering in the medium without serum and alpha-actinin is concentrated in small dots at the periphery and in the central part of the cells.

The method of moments as applied to the study of granulocytes' shape and movement.

The paper presents an approach to the quantitative analysis of the shape and motion of migrating granulocytes based on the method of moments. A computer image analysis system and a specially designed program were used. The following features of cells and cell locomotion have been calculated: the cell centre of gravity and its coordinates, the cell displacement, the main cell axis, the coefficient describing cell elongation and the parameters of cell orientation. In order to evaluate the above approach under various conditions, comparative experiments were performed using the media of different viscosity and various positions of the plane on which the granulocytes were migrating. The cell shape and locomotion parameters estimated in various series of experiments indicate that the method may be generally useful and is able to detect not only major features of cell shape and movement, but also their relatively slight variations. The experiments performed in basic (typical) conditions revealed that the main axis of the majority of cells (about 60%) does not deviate from the global direction of migration by an angle greater than 30 degrees; about 10% of cells move with the main axis perpendicular to this direction. The broader frontal part of granulocytes is directed forward with regard to the global movement direction in 58% of cells, whereas 28% of the cells move with the tail pointing forward. The results of joint analysis of the cell shape and motion have confirmed statistically some well known features of migrating granulocytes.(ABSTRACT TRUNCATED AT 250 WORDS)

Adhesive and motile properties of Lewis lung carcinoma LL2 lines.

The cell substrate adhesion of the Lewis lung carcinoma in vitro maintained sublines (LL2 basic line, WGA-resistant LL2-8, and Aleuria aurantia-resistant LL2-AAA) has been studied by a hydrodynamic method using various shearing forces generated by the medium flow. The force of adhesion of the LL2 cells is about 10(-12) N to 10(-11) N with statistically significant differences between various sublines: it is the highest for LL2-AAA cells, intermediate for LL2 cells and the smallest for LL2-8 cells. In another series of experiments the distribution of the number of single cells and multicellular aggregates in the suspensions of LL2 cells together with the effect of gravitational sedimentation were examined. When the LL2 cells are incubated in 37 degrees C they display active motile behaviour which consists in forming cell-surface extensions of various shapes and duration (from a few seconds to several minutes and more). The displacement of the whole cells (locomotion) has not been observed. The results of the study on adhesion and motility of LL2 cells are discussed from the point of view of their metastatic properties, cell-membrane structure and mechanisms of malignant invasion.