Insulin resistance and vitamin D deficiency in patients with chronic kidney disease stage 2-3

Vitamin D status and the relationship between serum 25(OH) vitamin D concentrations and the components of insulin resistance were examined in 120 patients with chronic kidney disease stage 2 and 3. Insulin sensitivity/resistance was calculated by the quantitative insulin sensitivity check index (QUICKI). In this analysis, the prevalence of insulin resistance was 42 %. Only 17 % of patients had serum 25(OH) vitamin D concentration in the recommended range (>/=30 ng/ml), 42 % suffered from vitamin D insufficiency and 41 % had moderate vitamin D deficiency. Insulin resistance significantly correlated with serum 25(OH)D and 1,25(OH)(2)D concentrations, renal function and protein excretion rate. Our results support the increasing evidence that vitamin D deficiency may be one of the factors participating in the development of insulin resistance already in the early stages of chronic kidney disease.     

P-aminohippurate accumulation in kidney cortex slices: stimulation by dicarboxylates, amino acids and their oxoanalogues.

The effect of various amino acids and oxoacids on the accumulation of PAH in rat kidney cortex slices was determined. The following compounds were found to increase the PAH tissue to medium ratio (T/MPAH): a) dicarboxylic acids: glutarate, 2-oxoglutarate and oxaloacetate, b) amino acids: glutamate, isoleucine, leucine, valine, methionine, tryptophane, histidine, threonine and glycine, c) monocarboxylates: hydroxymethionine, oxovaline, oxoisoleucine and oxoleucine. There were no marked concentration/effect differences to glycine, glutamate, glutarate and oxovaline. Ouabain inhibited T/MPAH only slightly, but abolished its increase by pyruvate, 2-oxoglutarate and histidine. Oxygen hyposaturation abolished the T/MPAH increase caused by 2-oxoglutarate, pyruvate, glutamate and histidine. It is concluded that various substrates stimulating the organic anion transport system (OATS) do so namely by improving the energy supply, although the direct participation of dicarboxylates in OATS could be of relevance namely in short-lasting variations.     

Serum hippurate and its excretion in conservatively treated and dialysed patients with chronic renal failure.

54 healthy volunteers or patients with normal kidney and liver function, 17 patients with decreased kidney function and 12 dialysed patients were evaluated for their serum hippurate accumulation and kidney excretion. It was found that there was an inverse relationship between serum hippurate and the clearance of endogenous creatinine (CCr) and a free relationship between fractional excretion of hippurate and CCr. The excretory capacity in residual nephrons was increased. This was caused by the greater glomerular filtration load which increased up to 25 times and tubular secretion which increased 7 times in dialysed patients. The relative contribution of glomerular filtration to hippurate excretion rose from about 20% in controls to almost 50% in dialysed patients. True kidney adaptation was localized in the organic anion transport system of proximal tubules.     

Matching lung volume data sets--a novel approach

There is a significant demand in matching CT datasets of the lung. The increasing number of CT slices per examination due to the higher resolution of modern CT scanners and the need for quantification of the progress of disease and healing processes in follow-up studies. A volunteer's lung was scanned by the means of multidetector CT in two different states of ventilation. The necessary lung structures for the matching procedure like lung surface and branching points were segmented. A thin-plate spline method was used to calculate the matched lung volume. The preliminary results show an average error of 2 voxel, i.e. 2mm. The calculation of the transformation matrix takes about one second on a conventional PC, which is considerably faster than other methods described in literature. The method described may be apt to be introduced in radiological practice when it comes to compare high resolution CT scans in follow-up studies quantitatively.     

Effect of cerebrocrast, a new long-acting compound on blood glucose and insulin levels in rats when administered before and after STZ-induced diabetes mellitus

Insulin-dependent diabetes mellitus (IDDM) is an autoimmune disease that is characterized by selective destruction of insulin secreting pancreatic islets beta-cells. The formation of cytokines (IL-1beta, IL-6, TNF-alpha, etc.) leads to extensive morphological damage of beta-cells, DNA fragmentation, decrease of glucose oxidation, impaired glucose-insulin secretion and decreased insulin action and proinsulin biosynthesis. We examined the protective effect of a 1,4-dihydropyridine (DHP) derivative cerebrocrast (synthesized in the Latvian Institute of Organic Synthesis) on pancreatic beta-cells in rats possessing diabetes induced with the autoimmunogenic compound streptozotocin (STZ). Cerebrocrast administration at doses of 0.05 and 0.5 mg/kg body weight (p.o.) 1 h or 3 days prior to STZ as well as at 24 and 48 h after STZ administration partially prevented pancreatic beta-cells from the toxic effects of STZ, and delayed the development of hyperglycaemia. Administration of cerebrocrast starting 48 h after STZ-induced diabetes in rats for 3 consecutive days at doses of 0.05 and 0.5 mg/kg body weight (p.o.) significantly decreased blood glucose level, and the effect remained 10 days after the last administration. Moreover, in these rats, cerebrocrast evoked an increase of serum immunoreactive insulin (IRI) level during 7 diabetic days as compared to both the control normal rats and the STZ-induced diabetic control rats. The STZ-induced diabetic rats that received cerebrocrast had a significantly high serum IRI level from the 14th to 21st diabetic days in comparison with the STZ-induced diabetic control.The IRI level in serum as well as the glucose disposal rate were significantly increased after stimulation of pancreatic beta-cells with glucose in normal rats that received cerebrocrast, administered 60 min before glucose. Glucose disposal rate in STZ-induced diabetic rats as a result of cerebrocrast administration was also increased in comparison with STZ-diabetic control rats. Administration of cerebrocrast in combination with insulin intensified the effect of insulin. The hypoglycaemic effect of cerebrocrast primarily can be explained by its immunomodulative properties. Moreover, cerebrocrast can act through extrapancreatic mechanisms that favour the expression of glucose transporters, de novo insulin receptors formation in several cell membranes as well as glucose uptake.     

Trigonometric analysis of the Human Median Sagittal Plane and its applications in reconstruction and phylogeny

By means of a new method of measurement which defines a total of eight measuring points along the median sagittal plane of the skull, methodical aspects are explained. The advantages of this method consist in its easy use and exact reproducibility of the calculated data thus obtained. On account of the fact that it permits to obtain the median sagittal plane of the skull by means of points of a cartesian system of coordinate, phylogenetic comparison, standardisable on optional points of reference respectively planes of reference is possible. The specific trigonometric construction enables extensive interpretation of single angles, distances and parts of surface, the amount of detail of which exceeds that of method in use.