[Bone metabolism as assessed with selected markers of bone turnover as well as densitometry analysis in patients after successful kidney transplantation]. / Metabolizm kosci u chorych po zabiegu przeszczepienia nerki w swietle wybranych markerów obrotu kostnego oraz w ocenie densytometrycznej.

The degree of advancement as well as symptoms of renal osteodystrophy improve significantly in patients after successful kidney transplantation; however bone pathology is still present even after many post-transplant years. The aim of this study was to analyze the bone densitometry in patients during different periods after kidney transplantation and to assess bone metabolism using selected biochemical markers of bone turnover in comparison to healthy controls. Study population consisted of 73 patients of mean age 41.7 +/- 12.6 years (27F, 46M) mean 34 +/- 42 months after kidney transplantation. Mean period of maintenance dialysis prior to surgery was 28.6 +/- 20.3 months. We also analyzed age- and sex-matched control group of 24 subjects. Three-point densitometry was performed with DEXA technique. Serum levels/activity of osteocalcin, C-terminal propeptide of procollagen type I (PCTP), alkaline phosphatase (AP) and its bone-specific isoform (BAP) as well as desoxypiridine (DPD) urine level were analyzed as markers of bone turnover. Serum levels/activity of all mentioned parameters were significantly increased (p < 0.001) and urine DPD--significantly decreased (p < 0.05) in patients as compared to controls. Based on DEXA technique 26% of patients were categorized as having osteoporosis, 32.9%--osteopenia and 41.1% as normal in bone densitometry. Patients with diagnosed osteoporosis spent significantly longer time with functioning graft as compared to those with normal densitometry. In addition, subjects with osteoporosis were characterized by significantly higher serum level of osteocalcin as compared to those with osteopenia and normal DEXA (42.5 +/- 19.9 vs 26.6 +/- 15 ng/ml and 42.5 +/- 19.9 vs 30.2 +/- 104 ng/ml, respectively; p < 0.05). Identical relationship was also observed for serum PTH (128 +/- 42 vs 77.2 +/- 30.4 pg/ml and 128 +/- 42 vs 81.2 +/- 232 pg/ml, respectively; p < 0.001). There was also significant difference in PCTP level in all analyzed groups (203 +/- 85, 171 +/- 69 and 137 +/- 40 ng/ml in subjects with osteoporosis, osteopenia and normal; p < 0.05 for all differences). BAP activity reduction was observed only in the latter group of patients. Results of our study led us to conclude that the prevalence of osteoporosis and osteopenia in three-point densitometry among patients with functioning graft is high. Increased serum levels/activity of osteocalcin, PCTP, AP and BAP with concomitant decrease of urine DPD elimination suggest the predominance of bone formation over the bone resorption process.

[Risk factors for occurrence of ophthalmopathy in the course of Graves-Basedow disease]. / Czynniki ryzyka wystapienia oftalmopatii w przebiegu choroby Graves-Basedowa.

Ophthalmopathy is a serious complication of Graves-Basedow disease. It is a common and the most significant symptom of this illness and usually persists even when other symptoms associated with abnormal thyroid function disappear. Despite of well-known auto-immunologic patho-genesis of ophthalmopathy it is still hard to predict when this severe complication will occur. This condition is thought to be associated with diagnosis and treatment errors. We studied the patients suffering from Graves-Basedow disease with and without ophthalmopathy. We concluded that the risk factors for ophthalmopathy were: many non-treated episodes of hyperthyroidism, delayed diagnosis and initiation of therapy, no thyroxine supplementation, improper preparation to strumectomy.

Melanotropic activity in extrahypophyseal regions of rodent brain: effect of age, hormones, and drugs.

Two or more melanotropic peptides are present in extrahypophyseal regions of mammalian brain. Previous studies showed that extrahypophyseal melanotropic activity is not influenced by hypophysectomy, adrenalectomy, or exogenous glucocorticoid. The present study investigated the possible influence of the following factors on the level of melanotropic activity in whole brain, cerebral cortex, cerebellum, midbrain, and brainstem of mouse and rat: age, sex, starvation; and of the following hormones or drugs administered by the intraperitoneal or intracerebral route: norepinephrine, dihydroxyphenylalanine, pargyline, 6-hydroxy-dopamine, alpha-methyltyrosine methyl ester, reserpine, acetylcholine, pilocarpine, atropine, serotonin, p-chlorophenylalanine, pentobarbital, pentylenetetrazol, insulin, melatonin, and cycloheximide. Only age influenced extrahypophyseal melanotropic activity. The activity per unit of tissue wet weight or of tissue protein increased in all regions progressively from birth to 1 yr of age. Extrahypophyseal melanotropic activities perunit wet weight of tissue at 50 wk averaged 4.3 times those at birth. When brain of adult rodents was fractionated by differential centrifugation, the major proportion of melanotropic activity was recovered in myelin (27-35 percent), nerve endings (20-22 percent), and mitochondria (25-30 percent). The lower activity in newborn brain resulted not onlyfrom absence of a myelin fraction, but also from lower activity at birth in nerve endings and mitochondria.