Enzyme clearance in intermittent hemofiltration in patients with acute renal failure

AIM: To characterize elimination of some enzymes in intermittent hemofiltration (HF) in patients with acute renal failure (ARF). MATERIAL AND METHODS: 22 patients with oliguric ARF have undergone 52 procedures of intermittent HF. Before the procedure and after it the activity of enzymes (AA, AP, ACE, LAP, GGT, GDG, AlAT, AsAT, CPG, LDG) was measured in the samples of plasma and filtrate. RESULTS: Besides ACE and AlAT, all the enzymes concentrations were elevated in all the patients. HF did not change significantly the enzymes activity. Most of the enzymes were eliminated from the blood. In some samples the enzymes activity was low or absent. CONCLUSION: Further studies are necessary to answer questions aroused by the findings.     

Paratesticular cystadenomas with ovarian stroma,metaplastic serous müllerian epithelium,and male adnexal tumor of probable wolffian origin: A series of 5 hitherto poorly recognized testicular tumors

We present 5 paratesticular tumors, which manifested ovarian-type stroma and various serous müllerian epithelial structures including serous fallopian-like epithelium and proliferations closely mimicking cystic serous borderline tumors of the ovary. In addition, 3 of the tumors in our series revealed a solid epithelial component, which was morphologically and immunohistochemically similar to so called “female adnexal tumor of probable wolffian origin,” which is a rare neoplasm described so far only in the female genital tract, retroperitoneum, and the pelvic cavity. In analogy with mixed epithelial and stromal tumors of the kidney, which are renal neoplasms producing ovarian-type stroma, we suggest to designate the above paratesticular tumors containing ovarian-type stroma as “mixed epithelial and stromal tumors of the paratestis with features of cystic serous borderline tumor” (cases 1 and 2) and “mixed epithelial and stromal tumors of the paratestis with male adnexal tumor of probable wolffian origin” (cases 3-5).     

The DL1 repeats in the genome of Diphyllobothrium latum

Diphyllobothrium latum is a widespread intestinal parasite, which has a great clinical relevance, but there are no sequences of its nuclear genome. In this paper, a repetitive element in the D. latum genome is firstly described. The adult D. latum was obtained in the result of expulsion from intestinum of a patient suffering from diphyllobothriasis. Genomic DNA was isolated from several proglottids of this individual. PstI restriction products of D. latum genomic DNA were sequenced. Polymerase chain reaction (PCR) amplification of these products using genomic DNA and selected primers was carried out. Thereby a cluster of a repetitive element, called DL1, was discovered. For precise identification of a beginning and an end of the repeat, a product of PCR amplification of D. latum genomic DNA with one specific primer was sequenced. In discussion, several evidences that DL1 repeat is a member of the SINE family of retroposons were adduced.     

Mechanism of action of endotoxins in chronic renal failure

Altogether 76 patients with terminal chronic renal failure (CRF) were examined for the intensity of endogenous intoxication and its action mechanism in blood serum. To determine the degree of intoxication, use was made of neuromuscular preparations of Rana temporaria. In order to study the action mechanism of the toxic substances of uremic genesis, a study was made of the effect of CRF patients' blood serum on the conduction of bilayer lipid membranes. All the patients underwent adequate hemodialysis with respect to nitrous residues. It is established that substances occurring in CRF patients' blood serum possess neurotoxic properties at the basis of which there lie their channel-former action on the excitable membranes of the nerve cells. The data obtained correlate well with the clinical status of the patients. The conventional programmed hemodialysis turned out ineffective in the relief of the syndrome of uremic endogenous intoxication. This confirms the role in endogenous intoxication of the substances with medium molecular weight, which are removed poorly via the common dialysis membranes.     

Ectopic sebaceous glands in the vagina.

We report a case of ectopic sebaceous glands in the upper third of the posterior wall of the vagina of a 49-year-old woman. This is, to our knowledge, the first fully documented case report of their occurrence in the vagina. The review of the literature and possible embryologic origin are discussed.     

The use of selective cytopheresis following cardioplegia during open heart surgery

The analysis of 20 operations on the open heart performed with selective cytopheresis (apparatus PK-0.5) or without it has demonstrated that in pharmacological and ice-chip cardioplegia the technique to a great extent prevents the loss of the patient's own blood removed with cardioplegic solution and makes it possible to reduce donor blood consumption by 27%. The course of the postoperative period improves considerably: blood loss is reduced, the recovery of blood cellular composition becomes more intensive. Cardioplegia performed in combination with selective cytopheresis does not exclude certain protein loss (up to 15 g/l during one session), which confirms the necessity of adequate homeostasis correction with protein blood preparations.     

Effectiveness of a prospective physician self-audit transfusion- monitoring system

BACKGROUND: The purpose of this study was to search for a more effective transfusion-monitoring system than the existing system of retrospective peer review. STUDY DESIGN AND METHODS: This research used a study-control, preintervention and postintervention design, to evaluate the effectiveness of a prospective physician self-audit transfusion-monitoring system that functioned without the direct involvement of transfusion service physicians. This research also evaluated the effectiveness of issuing to physicians a memo with transfusion guidelines. Three process indicators were used to assess physician behavior at various stages of the blood-ordering process: 1) the number of crossmatches ordered per admission, 2) the transfusion-to- crossmatch ratio, and 3) the number of blood units returned to the laboratory after physician self-auditing. The study used two outcome indicators to reflect overall blood utilization: 1) the percentage of patients who received red cell transfusions and 2) the number of blood units transfused per recipient each month. RESULTS: The prospective physician self-audit system implemented at the study hospital did not reverse physician transfusion decisions, and the process of issuing to physicians a memo with transfusion guidelines at the control hospital failed to reduce blood usage. However, a transient reduction in blood utilization was observed at the study hospital. CONCLUSION: The reduction was hypothesized to be due to a Hawthorne effect, in which observed behavior is affected by the subject's awareness of the research study.