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The speciation of trace elements in serum samples of hemodialysed patients was investigated using on-line connection of SEC and ICP-MS. The 0.02 mol/l TRIS-HCl buffer of pH 7.5 was used as mobile phase. The results of speciation as well as the total concentration data were compared with those of control group of healthy person. Alterations of total concentration were observed in case of selenium and zinc only. Iron was present in form of transferrin and ferritin, main amount of copper was bound to ceruloplasmin and selenium compounds were identified as selenoproteine P and glutathione peroxidase. The latter compound was detected in samples of control group only. The chromatograms of the other elements were similar and no substantial changes between both investigated groups were observed.

Objectives: To study the effect of different doses of hGH (biosynthetic human growth hormone--Humatrope) administration on the profile of IGFBP-3 in hypopituitary patients with GHD and to find out the extent of production of IGFBP-3 proteases, which results in the elevated biological IGF-I activity.

Study design: Ten patients (after 1. collection) were randomized according to the dose of hGH, administered within three months, into group I: 3 micrograms/kg/day and group II: 6 micrograms/kg/day. After 2. collection the doses of hGH were in both groups duplicated and administered another three months (3. collection).

Methods: RIA's were used to analyse GH, IGF-I, total IGFBP-3 and fIGF-I. The profile of IGFBP-3 forms was studied by electrophoresis with western immunoblotting.

Results: Anabolic effect of administered hGH was demonstrated by significant increase of IGF-I and total IGFBP-3 in both groups of patients. It was evident that this increase is associated with the raise of proteolytic fragment of IGFBP-3 (29 kD).

Conclusion: The increased doses of hGH change the profile of IGFBP-3 in the sense of increasing concentrations of IGFBP-3 (29 kD). As proteolytic clipping of intact IGFBP-3 is associated with the raise of fIGF-I levels in individual patients it is possible to consider 29 kD IGFBP-3 as the marker of the therapy of hGH in our study. However, the increasing tendency to fIGF-I production after 2-fold higher administration of hGH in majority of patients in the trial is not in average significant so it means that the doses of hGH administered to each individual should be optimalized.

This presentation characterizes some actual obesity problems and describes some treatment possibilities of obesity in the outpatient department. Obesity is a serious chronic disease. The prevalence of the obesity as one of the serious global problems is increasing in industrialized societies. Care for obese patients requires general approach including dietetic and behavioural parts, movement activity and pharmacotherapy. Most often we use reduction diet with limited consummation of energy and fat in outpatient department.

In this review the authors focus on the adverse GIT events during long-term treatment with non-steroid anti-inflammatory drugs, and explain pathogenesis of the NSA induced gastropathy and enteropathy. The risk groups of patients and prophylactic and therapeutic modalities are discussed. There are indices that most of the NSA gastric ulcers don't induce clinical symptoms, and massive bleeding may be the first clinical manifestation. This is why the clinical symptoms cannot be used as predictors of NSA gastropathy. It seems, on the author's clinical experience, that more than half cases of massive non-variceal bleeding from upper GIT is induced by non-steroid anti-inflammatory drugs and acetylsalicylic acid. NSA-gastropathy often presents with multifocal ulcers and erosions in the antrum of the stomach. The course of massive bleeding induced by NSA is associated with high rate of lethality.

Aim: To evaluate response of cardiovascular system in laparoscopic surgery. The main aim was: 1--comparison of healthy subjects and morbid obese population, 2--comparison of healthy subjects and cohort of patients with organic cardiopathy. Secondly we compared the influence of the operation position.

Patients and methods: Patients (n = 17) were divided into 3 subgroups:--Control group of "normal" subjects: mean age 36.8 +/- 11.2 years; BMI 25.33 +/- 3.62; BSA 1.84 +/- 0.21 m2; two men and four women; op. diagnosis: 3x cholecystectomy, 1x appendectomy, 1x inguinal herniotomy, 1x hiatal hernia operation. --Group of patients with morbid obesity: mean age 38 +/- 8.1 years; BMI 45.82 +/- 7.54!; BSA 2.66 +/- 0.32 m2; one man and five women; all of them were operated for obesity (laparoscopic gastric banding).--Group of patients with severe cardiopathy: mean age 64.0 +/- 11.55; BMI 26.4 +/- 4.09; BSA 1.89 +/- 0.23; three men and two women; card. diagnosis: 2x aortic stenosis, 1x combined aortic valvulopathy, 1x aortic stenosis with secondary mitral regurgitation, 1x secondary mitral regurgitation (both caused by coronary artery disease); op. diagnosis: 4x cholecystectomy; 1x extraction of catheter for peritoneal dialysis. The method of our examination was transesophageal echocardiography with use of omni planar sond with continual monitoring of each patient. Our data are based on repeated measurements (3x minimal for each state and each patient) before and after peritoneal cavity insufflation and third after positioning of patient (in Trendelenburg or Fowler position). Examinations were recorded and data analysed off-line. Following parameters were analysed: mean age, BMI, BSA, heart rate, mean arterial pressure (MAP), ejection fraction of left ventricle (EF), E/A ratio of transmitral flow, cardiac output (CO), cardiac index (CI), systemic (peripheral) vascular resistance (SVR) and pressure-rate-product (PRP). For statistical analysis were used: ANOVA tests, t-tests with Benforroni correction and Friedman's tests.

Results and discussion: In comparison of normal and obese patients statistically significant differences were found (after exclusion of BMI and BSA) in cardiac output values, after recalculation on body surface (cardiac index) remained only non-significant trend to fall. Differences between control group and group of cardiacs were also non significant with exclusion of E/A ratio of transmitral flow. This result we explain by pseudonormalization. All 17 operations were successfully done without any complication.

Conclusions: Our data were obtained on relatively small cohort of patients but the number of patients was respected by statistics and results might be borderline but significant. Laparoscopic gastric band (operation is done in semi-sitting position) in morbid obese patients is well tolerated without any differences in comparison to healthy populatio

In our previous work [7] we demonstrated that the bisphosphonate pamidronate lowered the bone blood flow of non-castrated female rats and inhibited the increase in bone blood flow after oophorectomy (OOX). In this paper we present the results of two similar experiments but also with the estimation of IGF-I in blood. The blood flow in the bones of female rats was estimated by means of 85-Sr microsphere technique (NEN, USA), the blood level of IGF-I was ascertained with Rat IGF-I RIA Kit (DSL, USA). Both experiments A and B were performed on female rats according to the same experimental scheme: group I--sham-operated controls, group II--OOX (four weeks before the experiment), group III--pamidronate (Aredia, CIBA-Giegy, 0.6 mg i.p. three days in the week, for four weeks), group IV--OOX + pamidronate. The results of both experiments can be summarized as follows:--it was confirmed again that OOX rises the circulatory indicators in the bones as well as the blood level of IGF-I;--pamidronate suppresses the increase in bone blood flow after OOX;--pamidronate does not unequivocally influence the level of IGF-I in blood. Thus, it is very probable that IGF-I plays a role in the increase of bone blood flow after OOX. However, it is still not clear how the deficiency of estrogens influences the blood level of IGF-I. The mode of action of pamidronate on the bone blood flow--mainly elevated after OOX--is not clear as well.

The nutritional status of a selected population--859 male members of the Fire Rescue Service from 12 districts in the Czech Republic--was assessed in 1997 and 1998. The study provides extensive information on selected anthropometrical and biochemical parameters, especially on those, which are generally used as risk indices for the origin and development of cardiovascular disease (CVD): body mass index (BMI), body fat percentage (b. fat), waist circumference (waist), serum concentrations of total cholesterol (Tchol), HDL- and LDL-cholesterol (HDL-chol, LDL-chol), triacylglyceroles (TAG) and the atherogenic index (AI). As far as lipid parameters were concerned, increased serum levels were estimated in 30.4% (TAG), 54% (Tchol) and 60.9% (LDL-chol) of volunteers. Decreased serum levels of HDL-chol were found in 38.2% of volunteers. An AI higher than 3.5 a.u. was calculated for 79.9% of all subjects in study while an AI higher than 5.0 a.u. was calculated for 45.3% of all subjects. An AI higher than 3.5 a.u. was found in 62% of males with normal weight, in 85% of overweight males and in 92% of obese males. The results of the study proved the considerable prevalence of the overweightness and obesity in the male population group that was followed: according to the calculated BMI, 49.5% of volunteers were estimated to be overweight and 16.3% to be obese. The study concept made it possible to reveal the relationships among the anthropometrical and biochemical parameters followed. The correlation matrix documents a statistically significant dependence among the BMI or waist values and the serum concentrations of Tchol, LDL-chol, TAG and AI. A significant negative correlation was found between the HDL-chol serum concentration and the BMI or waist values. The variance analysis results (the estimated lipid parameter values were divided into groups according to BMI and waist categories) document a statistically significant increase in serum Tchol, LDL-chol, TAG and AI in age categories over 35 years in comparison with the category of men under 25 years of age. For Tchol and LDL-chol a statistically significant increase had already been found in the 25-35 year age category. In comparison with the normal weight category, Tchol serum levels and AI values were statistically significantly higher in both the overweight and obese categories. Statistically significant increase was proven for the TAG and LDL-chol serum levels in both the overweight II. gr. and obese categories. A statistically significant decrease in comparison with the normal weight category was found in the HDL-chol serum levels of both the overweight and obesity categories. In the same way, an increase in Tchol and LDL-chol, TAG serum concentrations and AI values in higher and high risk CVD categories (according to the waist circumference value) was found in comparison with the low CVD risk category.

A number of prognostic scoring systems for patients with myelodysplastic syndrome (MDS) have been introduced since FAB classification of the MDS in 1982. Recently, the International Prognostic Scoring System (IPSS), published in 1997 by Greenberg et al. [9] is based on the percentage of bone marrow (BM) blasts, cytogenetic abnormalities and number of cytopenias. We applied criteria of the IPSS on 205 patients (pts) with primary MDS (RA = 82, RARS = 49, RAEB = 42, RAEB-t = 8, CMML = 24 pts). IPSS discriminated within each of the FAB-subgroups: RA pts were present in low risk and intermediate (Int) I and II risk subgroups, RARS pts were separated into low and Int I, RAEB were distributed predominantly between Int I and Int II risk groups, RAEB-t in high-risk group, and CMML pts were distributed in all groups. In contrary to Greenberg's group of the MDS patients there are only three risk-groups in our study: low risk (score 0-0.5), intermediate (1-2) and high risk (> 2); the median survival and the risk of the evolution to the acute leukemia (p = 0.0001) are significantly different.