Urinary porphyrin excretion in hepatitis C infection

A high prevalence of hepatitis C virus infection in porphyria cutanea tarda in some populations suggests a close link between viral hepatitis and alteration of porphyrin metabolism. Moreover, there is evidence of a role of porphyrinopathies in hepatocarcinogenesis. The aim of our study was to obtain data on the prevalence and patterns of heme metabolism alterations in patients with chronic hepatitis C virus infection. Urinary porphyrin excretion was prospectively studied in 100 consecutive outpatients with chronic hepatitis C infection without signs of photosensitivity, using an ion-pair high performance liquid chromatography method. Increased total porphyrin excretion was found in 41 patients, with predominant excretion of coproporphyrins (whole study group: mean 146 mu g/g creatinine, interquartile range 76-186; normal <150), in 10 patients excretion exceeded 300 mu g/g creatinine. In the majority of all patients studied (75/100) an increased ratio of the relatively hydrophobic coproporphyrin isomer I to isomer III was found. In just one case, urinary porphyrin pattern characteristic for chronic hepatic porphyria was present (uroporphyrin > coproporphyrin, heptacarboxyporphyrin III increased) but the total porphyrin excretion was only slightly elevated in this case. In the whole group, total urinary porphyrin excretion correlated well with serum bilirubin and was inversely correlated with albumin and thrombin time. In conclusion, secondary coproporphyrinuria occurs frequently in heptatitis C infection, whereas in Germany, preclinical porphyria cutanea tarda seems to be rare in these patients

Psychiatric and psychosocial outcome of orthotopic liver transplantation

Background. The study aimed to explore the prevalence of psychiatric disorders among orthotopic liver transplantation (OLT) recipients, and to investigate how psychiatric morbidity was linked to health-related quality of life (HRQOL). Methods: We recruited 75 patients who had undergone OLT a median of 3.8 years previously (range = 5-129 months). Psychiatric morbidity was assessed using the Structural Clinical Interview for the IDSM-III-R. Psychometric observer-rating and self-rating scales were administered to evaluate cognitive functioning (SKT), depressive symptomatology (HAMD(17)), Posttraumatic stress symptoms (PTSS-10), social support (SSS), and HRQOL (SF-36 Health Status Questionnaire). Treatment characteristics were obtained from medical records. Results: 22.7% (n = 17) of our sample had a current or probable psychiatric diagnosis according to DSM-III-R: 2.7% full posttraumatic stress disorder (PTSD) (n = 2), 2.7% major depressive disorder (MDD) comorbid to full PTSD (n = 2), 1.3% MDD comorbid to partial PTSD (n = 1), and 16% partial PTSD (n = 12). Patients with PTSD symptoms demonstrated lower cognitive performance, higher severity of depressive symptoms and more unfavorable perception of social support. OLT-related PTSD symptomatology was associated with maximal decrements in HRQOL. The duration of intensive care treatment, the number of medical complications, and the occurrence of acute rejection were positively correlated with the risk of PTSD symptoms subsequent to OLT. Conclusion: OLT-related PTSD symptomatology impairing HRQOL is a complication for a subgroup of OLT recipients. Health-care providers should be aware of the possible presence of PTSD in OLT survivors. Copyright (C) 2002 S. KargerAG, Basel

Serum proteome profiling identifies novel and powerful markers of cystic fibrosis liver disease.

Cystic Fibrosis associated liver disease (CFLD) develops in approximately 30% of CF patients. However, routine sensitive diagnostic tools for CFLD are lacking. Within this study, we aimed to identify new experimental biomarkers for the detection of CFLD. 45 CF patients were included in the study and received transient elastography. Differential regulation of 220 different serum proteins was assessed in a subgroup of patients with and without CFLD. Most interesting candidate proteins were further quantified and validated by ELISA in the whole patient cohort. To assess a potential relation of biomarker expression to the degree of hepatic fibrosis, serum biomarkers were further determined in 18 HCV patients where liver histology was available. 43 serum proteins differed at least 2-fold in patients with CFLD compared to those without liver disease as identified in proteome profiling. In ELISA quantifications, TIMP-4 and Endoglin were significantly up-regulated in patients with CFLD as diagnosed by clinical guidelines or increased liver stiffness. Pentraxin-3 was significantly decreased in patients with CFLD. Serum TIMP-4 and Endoglin showed highest values in HCV patients with liver cirrhosis compared to those with fibrosis but without cirrhosis. At a cut-off value of 6.3 kPa, transient elastography compassed a very high diagnostic accuracy and specificity for the detection of CFLD. Among the biomarkers, TIMP-4 and Endoglin exhibited a high diagnostic accuracy for CFLD. Diagnostic sensitivities and negative predictive values were increased when elastography and TIMP-4 and Endoglin were combined for the detection of CFLD. Serum TIMP-4 and Endoglin are increased in CFLD and their expression correlates with hepatic staging. Determination of TIMP-4 and Endoglin together with transient elastography can increase the sensitivity for the non-invasive diagnosis of CFLD

T lymphocytes from patients with primary biliary cirrhosis produce reduced amounts of lymphotoxin, tumor necrosis factor and interferon-gamma upon mitogen stimulation

Primary biliary cirrhosis (PBC) is considered an autoimmune disease characterized by destruction of small intrahepatic bile ducts by lymphocytes. Altered functions of these lymphocytes might reflect an abnormal immune response leading to tissue damage. We investigated lymphokine secretion by mitogen-stimulated T lymphocytes from the liver biopsies of patients with PBC and for comparison also peripheral blood. In PBC, diminished synthesis of lymphotoxin (TNFP), tumor necrosis factor (TNFa) and interferon-y (IFIVy) was found both in T-cell lines from liver tissue and in peripheral blood. The reduction was most prominent for TNFP in early histological stages of PBC, and appeared to be a stable phenomenon when T cells were tested after long-term tissue culture. Analysis of mRNA levels indicates a possible link between reduced TNFP production and a defect in interleukin-2 transcription. The data suggest that diminished lymphokine production in patients with PBC may play ;In important role in the immanopathogenesis of this disease

Association of Hepatitis C Virus—Specific CD8+ T Cells with Viral Clearance in Acute Hepatitis C

CD8+ T lymphocytes play a major role in antiviral immune defense. Their significance for acute hepatitis C is unclear. Our aim was to correlate the CD8+ T cell response with the outcome of infection. Eighteen patients with acute hepatitis C and 19 normal donors were studied. Hepatitis C virus (HCV)—specific CD8+ T cells were identified in the enzyme-linked immunospot assay by their interferon-γ (IFN-γ) production after specific stimulation. The highest numbers of IFN-γ—producing HCV-specific CD8+ T cells were found in patients with acute hepatitis C and a self-limited course of disease during the first 6 months after onset of disease, but these numbers dropped thereafter to undetectable levels. The differences in responsiveness between patients with self-limited disease versus patients with a chronic course were statistically significant (P < .001). Our data show that the number of IFN—γ-producing HCV-specific CD8+ T cells during the first 6 months after onset of disease is associated with eradication of the HCV infectio

Project technology of production hooped components and structural design tools

Diplomová práce, vypracovaná v rámci inženýrského studia oboru 2307, předkládá návrh výroby ohýbané součásti. Materiál součásti je ocel ČSN 15 130. Kusová až malosériová výroba. Na základě literární studie problematiky ohybu trubek bylo navrženo ohýbání metodou navíjení. Pro tuto metodu byla navržena mechanická ohýbačka s pomocným ramenem pro potřebu ohýbání s trnem a přesné výroby prostorových ohybů.This diploma thesis has been elaborated within the Master's study of department 2307 that submits a production hooped component. The material of the component is steel ČSN 15 130. Single – part as far as small–lot production. On the basis of the literary study problems bend tubing was sugested the method: rotary draw bending. For this method was sugested mechanical bending machine with mandrel support arm, for bending with mandrel and exact bends in three – dimensional.

First aid provided by persons after spine and spinal cord injury

Name: First aid provided by persons after spine and spinal cord injury The aim of the work: The aim of my bachelor thesis is to find out the practical possibilities of first aid in people after spine and spinal cord injury. Next task was to find out if the people tied to a wheelchair are able to provide first aid with sufficient quality. Methodology of the work: I have used three methods of data collection. The first method to identify personal history and basic theoretical knowledge in monitored group was an survey inquiry. The second method was an uncontrolled conversation to which I found additional information. The third method of data collection was observation, where I followed the practical possibilities, procedures and first aid technique in solving selected life threatening situations in individuals. Results of the work: Based on observations, I have found that all probands are able to evaluate the state of consciousness, to pass through the airways, and are able to provide first aid for strangulation by a foreign object and stopping breathing of the child within 1 year. I also found that probes with lesion height to Th7 are able to place the adult patient in a stabilized position and, if necessary, to initiate the resuscitation of an individual who is unconscious and does not breathe...Název práce: První pomoc poskytovaná osobami po poranění páteře a míchy Cíle práce: Cílem mé bakalářské práce je zjistit jaké jsou praktické možnosti při poskytování první pomoci u osob po poranění páteře a míchy. Dále pak zjistit, zdali jedinci upoutaní na invalidní vozík jsou schopni dostatečně kvalitně poskytnout první pomoc. Metodika práce: V práci jsem použil tři metody sběru dat. První metodou, která sloužila ke zjištění osobní anamnézy a základních teoretických znalostí u sledovaného souboru, bylo anketní šetření. Druhou metodou byl neřízený rozhovor, kterým jsem zjistil doplňující informace. Třetí metodou sběru dat bylo pozorování, kde jsem sledoval praktické možnosti, postupy a techniku první pomoci při řešení vybraných život ohrožujících situací u jednotlivých probandů. Výsledky práce: Na základě pozorování jsem zjistil, že všichni probandi jsou schopni vyhodnotit stav vědomí, zprůchodnit dýchací cesty a jsou schopni poskytnout první pomoc při dušení cizím tělesem a při zástavě dechu u dítěte do 1 roku. Dále jsem zjistil, že probandi s výškou léze do Th7 jsou schopni uložit dospělého pacienta do stabilizované polohy a popřípadě zahájit resuscitaci jedince, který je v bezvědomí a nedýchá pravidelně. Dle získaných výsledků z testu teoretických znalostí bylo zjištěno, že všichni jedinci mají...Zdravotní TV a tělovýchovné lékařstvíFaculty of Physical Education and SportFakulta tělesné výchovy a sport

Measuring of air valves and difusers

Diplomová práce je zaměřena na problematiku distribuce vzduchu v obytných budo-vách. Její hlavní část se věnuje experimentálnímu zkoušení koncových elementů pomocí kouřové zkoušky. Dosažené výsledky jsou aplikovány na návrh vzduchotechniky v pasivním rodinném domě. Dále je navrhnuto sálavé vytápění a energetická optimalizace v programu PHPP.This master thesis is focused on the issue of air distribution in residential buildings. The main part of thesis is devoted to experimental testing of diffusers by a smoke test. Achieved results are applied to design of air conditioning in passive house. Radiant heating and energy optimalization in PHPP are also proposed.