Circulating nucleic acids in type 1 diabetes may modulate the thymocyte turnover rate.

The autoimmunity of type 1 diabetes is associated with T-cell hyperactivity. Current study was designed to examine the effect of circulating ribonucleic acids (RNAs), isolated from type 1 diabetic patients on proliferative, apoptotic and inflammatory potential of rat thymocytes. Rat thymocytes were assayed for proliferating nuclear cell antigen (PCNA), Bcl-2, Bax and NF-κB level, using the flow cytometric and fluorometric assays. Cells were allocated into groups, treated with RNAs purified from plasma of juvenile diabetics, adult type 1 diabetic patients, control healthy children, healthy adult persons, nucleic acids and polynucleotide standards (RNA, polyC, PolyA, PolyIC, and CpG). The upregulation of PCNA and Bcl-2 protein and downregulation of Bax protein and NF-κB was shown when the thymocytes where incubated with RNA purified from plasma of juvenile type 1 diabetic patients. The dysregulation of inflammatory cascade and central tolerance may be a defect in autoimmune diseases related to innate immunity leading to corresponding alteration in adaptive immune response.

Does polyamine oxidase activity influence the oxidative metabolism of children who suffer of diabetes mellitus?

Diabetes mellitus is a metabolic disease characterized by inadequate secretion of insulin. Polyamine oxidase (PAO), a FAD-containing enzyme is involved in the biodegradation of Sp and Spd, catalyzing the oxidative deamination of Sp and Spd, resulting in production of ammonia (NH(3)), corresponding amino aldehydes and H(2)O(2). Malondialdehyde (MDA) and acrolein (CH2=CHCHO), potentially toxic agents, which induce oxidative stress in mammalian cells, are then spontaneously formed from aminoaldehydes. The main signs of oxidative stress in diabetic children were the values of HbA1c and MDA levels. Polyamines have an insulin-like action. Antiglycation property of spermine and spermidine has been recently confirmed. There are no data in the literature about plasma polyamine oxidase (PAO) activities in children with type 1 diabetes. The idea of this study was to evaluate the polyamine metabolism through the estimation of polyamine oxidase activity. We have study children with newly diagnosed type 1 diabetes mellitus (n = 35, age group of 5-16 years, as well as age-matched healthy control subjects (n = 25). The biochemical investigations were done on diabetic children who have the pathological values of glucose (9.11-17.33 mmol/l) and glycosylated Hb (7.57-14.49% HbA(1c)). The children in the control group have referent values of glucose and glycated hemoglobin (4.11-5.84 mmol/L and HbA(1c) 4.22-6.81% of the total Hb. Glucose levels in blood plasma and glycosylated hemoglobin in erythrocythes hemolysates (HbA1c) were measured by using standard laboratory methods. PAO activity in venous blood plasma and the amount of malondialdehyde (MDA) were measured by the spectrophotometric methods. PAO activity, glycemia, HbA1c and MDA were significantly increased in diabetic children compared to the control subjects. PAO activity in children with type 1 diabetes mellitus was very high. The findings of higher blood HbA(1C) and MDA levels confirm the presence of oxidant stress in children with type 1 diabetes mellitus and demonstrate that PAO activity may participate in these circumstances.

Arginase activity and magnesium levels in blood of children with diabetes mellitus.

Under physiological conditions insulin controls the metabolism of carbohydrates, lipids and proteins. Diabetes mellitus is a metabolic disease characterized by a disturbance in the intermediary metabolism of glucose and glucose-induced insulin release. Arginase (L-arginine amidinohydrolase, EC 3.5.3.1) modulates nitric oxide synthase activity by regulating intracellular L-arginine availability. In diabetes mellitus, a decrease in nitric oxide bioavailability is a central mechanism for endothelial dysfunction. The aim of our study was to assess arginase activity in the blood of children with diabetes mellitus. Blood arginase activity, serum glucose (14.155 +/- 4.197 mmol/L; p < .001) and blood HbA1c (11.222 +/- 3.186 %; p < .001), were significantly higher in diabetic children than in healthy controls, whereas the magnesium (Mg2+) level, a cofactor of many enzymes, was significantly lower (0.681 +/- 0.104 micromol; p < .001). In diabetic children, arginase activity, hyperglycemia (r = 0.143), and the HbA1, level (r = 0.381) showed a positive correlation between but a negative correlation between Mg2+ and arginase activity (r= -0.206). The higher arginase activity and the lower Mg2+' levels in diabetic children could be a consequence of reduced insulin action and increased protein catabolic processes in these pathophysiological conditions. The inverse directions of arginase activity and serum Mg2+ levels are in agreement with this concept.

Coagulation status and the presence of postoperative deep vein thrombosis in patients undergoing laparoscopic cholecystectomy.

BACKGROUND: Venous thromboembolism is a relevant social and health care problem because of its high incidence among patients who undergo surgery (20-30% after general surgical operations and 50-75% after orthopedic procedures), its pulmonary embolism-related mortality rate, and its long-term sequelae (postthrombotic syndrome and ulceration), which may be disabling. This study aimed to determine the coagulation status and the presence of postoperative deep vein thrombosis (DVT) in patients undergoing laparoscopic (LC) and open cholecystectomy (OC). METHODS: Prospectively, 114 patients were randomized into two groups. group 1 (58 patients undergoing LC) and group 2 (56 patients who are undergoing OC). The coagulation parameters (prothrombin time [PT], partial thromboplastin time [PTT], D-dimer, prothrombin F1 + 2, antithrombin III, and factor VII) were monitored preoperatively and during the operation, then 24 and 72 h after the operation. The patients in both groups underwent color duplex scan examination preoperatively, then 3 and 7 days after surgery to establish the presence of DVT. None of the patients in either group received thrombosis prophylaxis. RESULTS: In the LC group, postoperative DVT developed in four patients (6.9%; in the calf veins of 3 patients and in the popliteal vein of 1 patient). In the OC group, nine patients (16.07%) had postoperative DVT (in the calf veins of 7 patients and in the popliteal and femoral veins of 2 patients). The plasma levels of monitored parameters in the patients of both groups were altered, but the difference between the groups was not statistically significant. For the patients in both groups who experienced DVT, only the decrease of factor VII had statistical significance (p < 0.05). CONCLUSIONS: The incidence of postoperative DVT among the patients who underwent OC was higher than among the patients who underwent LC (p < 0.05). The decrease in factor VII among the patients who underwent surgery could be a potentially useful parameter indicating the patients at high risk for developing DVT.

[D-dimer in the early detection of deep vein thrombosis in the lower extremity]. / D-dimer u ranom otkrivanju tromboze dubokih vena donjih ekstremiteta.

Deep vein thrombosis is important social and health care problem for its high incidence, pulmonary embolism-related mortality, and long-term sequelae which may be disabling (post-thrombotic syndrome and ulceration). The aim of our work was to determine the diagnostic potential and importance of D dimer in the early detection of deep vein thrombosis of lower extremities. Prospectively we have analyzed a group of 47 patients who were admitted to vascular department of Surgical Clinic in Nis during the period from 1.8.2001. to 31.3.2003. with echosonographically verified deep vein thrombosis of no more than 48 hours of duration. D dimer was measured before anticoagulant treatment started using commercial Nycomed test. The activation of coagulation process was detected with increase in D dimer values in 44 out of 47 examined patients (93.61%). D dimer is highly sensitive diagnostic tool that should be routinely used in the patients with suspected deep vein thrombosis of leg.

[Diagnosis of renal tubular dysfunction in insulin-dependent diabetes mellitus]. / Dijagnostika disfunkcije tubula bubrega u dijabetesu melitusu zavisnom od insulina.

Urinary levels of beta 2 microglobulin (beta 2 MG) and dipeptidipeptidse IV (DPP IV) were measured in 30 insulin dependent diabetes mellitus children aged 5 to 18 years. The control group consisted of 30 healthy children. Metabolic control (HbA1C) and the duration of diabetes were directly correlated with the levels of beta 2 MG and DPP IV. Beta 2 MG urinary levels were significantly increased in the diabetic group (MV = 0.340 +/- 0.076 mg/l) as compared with the controls (MV = 0.081 +/- 0.012 mg/l, p < 0.05). These values correlated only with the duration of diabetes and not with the HbA1C. DPP IV excretion was elevated in all diabetic patients (MV = 6.40 +/- 0.83 j/l). Significant correlations were not identified between urinary DPPIV excretion and the duration of diabetes and metabolic control.

[Immune complexes in diabetes mellitus]. / Imunski kompleksi u dijabetesu melitusu.

Research in recent years has documented more exactly the genetic and immunopathogenetic basis of insulin-dependent diabetes mellitus. Also, in some genetically susceptible subjects, a triggering event activates both cellular and humoral immunity, with diminishing of b cellular mass. Early intervention to prevent diabetes development as well as to prevent microvascular complications is identification of individuals in whom autoimmunity has been activated. One of the non-specific tests is a screening test for the detection of circulating immune complexes /CIC/ by precipitating tests using polyethylene glycol it was performed in series of healthy, insulin-dependent and non-insulin dependent diabetic subjects. Highly increased precitability was seen in a great percentage of pathological sera. In spite of the non-specific method for immune complexes detection, positive results obtained by PEG method generally presumed that diabetes represent immune complex disease.