Aim: To evaluate the glycohemoglobin/HbA1c testing in the Republic of Croatia, with special empha... more Aim: To evaluate the glycohemoglobin/HbA1c testing in the Republic of Croatia, with special emphasis on analytical methods and clinical utilization as well as its impact on the specific health care for diabetic patients, delivered within the scope of the Croatian Model. Methods: The study was conducted during 1998 by distributing questionnaires to clinical laboratories and diabetologists at county/regional centers and Croatian Reference Diabetes Center where specialized health care for diabetic patients is delivered at the secondary and tertiary level, according to the Croatian Model. The participants were asked to answer specific questions concerning analytical aspects and clinical utilization of the glycohemoglobin/HbA1c testing as well as to communicate the comments and suggestions on the issue. Results: In Croatia, the glycohemoglobin/HbA1c testing is highly variable in terms of methodology and chemical entities reported as test result, with serious implications for the clinical validity of the test in respect to the recommended target values for glycemic control. In comparison to the prevalence of diabetes in Croatia and current recommendations, the glycohemoglobin/HbA1c testing was found to be considerably underutilized in regular monitoring of diabetic patients. Conclusion: Achievement of both better compliance to the recommendations and improved outcomes for diabetic patients via standardized and regularly available glycohemoglobin/HbA1c testing should be of highest priority for the medical and laboratory professionals involved in diabetes health care delivery in the Republic of Croatia.
Rad se bavi procjenom obuhvacenosti i ucinkovitosti mjerenja glikoziliranog hemoglobina u Republi... more Rad se bavi procjenom obuhvacenosti i ucinkovitosti mjerenja glikoziliranog hemoglobina u Republici Hrvatskoj.
To investigate factors responsible for altered insulin sensitivity in uremia, we studied 125I-ins... more To investigate factors responsible for altered insulin sensitivity in uremia, we studied 125I-insulin binding to erythrocytes in 20 uremic patients before and after dialysis. In uremic patients, predialysis binding was 50% lower in comparison with healthy controls (4.35 +/- 1.79 vs. 9.37 +/- 1.30%; p less than 0.01). Five-hour dialysis treatment resulted in a rapid increase in binding (on average to 55%; p less than 0.01). During the course of dialysis, binding to erythrocytes from 2 selected patients steadily increased in a time-dependent manner (on average 24%/h). The dialysis-induced increase in binding did not correlate with the changes in plasma insulin levels, but depended on the efficiency of dialysis as assessed by a relative decrease in plasma urea and creatinine. After an intravenous glucose load, the insulin-to-glucose ratio decreased in parallel with the increase in binding after dialysis. The results indicate that uremic plasma contains dialyzable substances which reversibly inhibit insulin binding, leading to altered insulin sensitivity.
The method of choice in the obstruction of the tear pathways is dacryocystorhinostomy (DCR). It i... more The method of choice in the obstruction of the tear pathways is dacryocystorhinostomy (DCR). It is indicated in cases of an obstruction of the lower segment of the lacrimal apparatus. It cannot be applied in cases of the obstruction of the upper segment of the tear pathways. In such pathologic conditions, the new tear pathway is formed from a part of the mucous membrane of the lateral nose wall and from a part of the mucous membrane of the septum. In a form similar to a tube, the mucous membrane of the nose will be sewn up with the mucous membrane of the conjuctiva. Direct suture is made possible by canthotomy, and, therefore, this surgery is called "Direct Cantorhinostomy".
This study has investigated the antioxidant capacity of human seminal plasma due to the presence ... more This study has investigated the antioxidant capacity of human seminal plasma due to the presence of both high and low molecular weight antioxidant factors. Methods for the measurement of superoxide dismutase-like activity (SOD-like) and total antioxidant status (TAS) were automated, and had a within-run coefficient of variation of 7.3% for SOD-like activity and 4.8% for TAS. In 69 semen samples from unselected infertile men, SOD-like activity in seminal plasma ranged from 2 to 16 U/ml, with a mean of 6.9 & 2.8 U/ml. As SOD-like activity was correlated positively with levels of citric acid (p<O.OOOl), zinc (p<0.0002) and acid phosphatase activity (p<0.0005), and there was no correlation with fructose levels, our results suggest that prostatic secretions are an important source of superoxide anion scavengers. Evaluation of SOD-like activity in infertile men with accessory sex gland infections (n = 12) showed significantly lower activity (p<0.003) compared to values found in 12 infertile men without signs of infection. The values obtained for total antioxidant status (equivalent to the antioxidant capacity of alpha-tocopherol analogue) ranged from 1.7 to 2.3 mmol/L, with a mean of 2.1 & 0.1 (n = 40), reflecting the protective activity of ascorbate, urate and albumin, and to a very low extent of glutathione and taurine. The data obtained by TAS assay correlated with fructose, a major marker of vesicular secretion (p<0.005), suggesting that low molecular weight components with .antioxidant capacity derive partly from the seminal vesicles. The results indcate that the relative contribution of antioxidant defence systems capable of counteracting the deleterious action of superoxide anions, depends on the secretory activity of accessory sex glands and is independent of excessive ROS production due to increased oxidative stress.
We have studied insulin binding to erythrocyte receptors in a group of 25 nonobese, nondiabetic u... more We have studied insulin binding to erythrocyte receptors in a group of 25 nonobese, nondiabetic uremic patients undergoing maintenance hemodialysis for 2-54 months and 14 healthy controls. Erythrocytes of predialyzed uremics bind significantly less insulin than control erythrocytes (p less than 0.01). Dialysis resulted in a rapid increase of insulin binding (p less than 0.001). The concentrations of plasma insulin and glucose remained essentially unchanged during 5-hour hemodialysis and did not significantly differ from the control values. The down regulation of insulin receptors in undialyzed patients in the presence of normal plasma insulin concentration indicates that factors other than insulin itself could be responsible for insulin receptor activity during uremia. The results demonstrated that creatinine, creatine and glycocyamine have a direct suppressive effect on insulin binding of postdialyzed plasma (p less than 0.05) in concentration of 1 mmol/l. This suggested that specific uremic toxins could play an important role in the mechanisms of altered insulin binding during hemodialysis. Despite the high concentration of these compounds in blood of uremics, the only common feature for these compounds is the presence of the guanidino group in the molecule.
The authors and the publisher have exerted every effort to ensure that drug selection and dosage ... more The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the con stant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. All rights reserved. No part of this publication may be translated into other languages, repro duced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the pub lisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center (see 'Information for Readers and Sub scribers').
This study examines the in~uence of methionine!enkephalin "MENK# on stress!induced oxidative dama... more This study examines the in~uence of methionine!enkephalin "MENK# on stress!induced oxidative damage "lipid peroxidation^LPO# in mice liver homogenate\ plasma corticosterone concentration "CS# and phagocytic activity of mouse splenocytes[ The LPO value increased in the mice subjected to restraint stress and had no correlation to stress duration\ while MENK had no e}ect[ The CS concentration was enhanced after 5 h of stress and 5 h after injection of a low "1[4 mg:kg bw# dose of MENK[ However\ MENK and stress are adjunct modulators of LPO and corticosterone in vivo[ LPO was additionally elevated when MENK "09 mg:kg bw# proceeded for 1 h after the onset of stress[ However\ corticosterone concentration seems to be regulated di}erently by the same dose of MENK depending on the duration of stress i[e[ elevated in cases involving short periods of stress "1 h# and decreased in cases involving prolonged periods of stress "5 h#[ This modulation of LPO and corticosterone by 09 mg:kg bw of MENK and 1 h of restraint stress was paralleled with elevated phagocytosis[ Þ 0887 International Society for Immunopharmacology[
Met-enkephalin modulates stress-induced alterations of the immune response in mice. PHARMACOL BIO... more Met-enkephalin modulates stress-induced alterations of the immune response in mice. PHARMACOL BIOCHEM BEHAV 54(1) 277-284, 1996.-Overnight restraint stress of mice decreased ConA-driven lymphocyte proliferation, plaque-forming cell response to sheep red blood cells (SRBC), and NK activity in the spleen, but the phagocytic activity was enhanced. Injection of methionine-enkephalin (MENK), 10 mg/kg, IP, 30 min before restraint, abolished these changes (except for the NK activity) and attenuated the stress-induced elevation of glucocorticoids. However, MENK itself affected the immune responses like stress: It decreased NK activity and the PFC response and enhanced phagocytic activity. Contrary to results with stress, MENK had no effect on cell proliferation. The opioid-receptor antagonist naloxone given before restraint reversed the stress-induced enhancement of phagocytosis and the decrease of T-cell proliferation. Alterations of the immune responses induced by restraint stress seem to be mediated by at least two mechanisms: activation of the hypothalamus-pituitary-adrenal (HPA) axis and the secretion of opioid peptides. MENK injected before stress may interfere with either or both mechanisms. T or B lymphocytes seem to be affected by the activation of the HPA axis, and phagocytes by a direct opioid action, whereas NK cells seem to be under the influence of another control mechanism.
The Journal of Clinical Endocrinology & Metabolism, 1981
Insulin binding to specific erythrocyte receptors was investigated in group of 25 subjects with K... more Insulin binding to specific erythrocyte receptors was investigated in group of 25 subjects with Klinefelter&amp;amp;#39;s syndrome (47 XXY genotype) and 14 healthy male volunteers. Insulin binding was significantly decreased in Klinefelter subjects (P less than 0.01 at insulin concentrations of 0.051 and 0.136 mmol/liter); however, their fasting glucose concentration was normal (87 +/- 17), and the glucose disappearance rate was slightly increased (2.3 +/- 0.9; P less than 0.2). These data indicated a compensatory, mechanism involved in the glucose metabolism in Klinefelter&amp;amp;#39;s syndrome.
Copper-zinc Superoxide dismutase (Cu,Zn-superoxide dismutase) activity was evaluated in lymphocyt... more Copper-zinc Superoxide dismutase (Cu,Zn-superoxide dismutase) activity was evaluated in lymphocytes and polymorphonuclear cells of insulin-dependent (n = 33) and non-insulin-dependent (n = 34) diabetic patients. A commercial method for the measurement of Superoxide dismutase activity was adapted for use on a discrete analyser and evaluated for interference by other antioxidants with Superoxide anion-scavenging properties. In comparison to healthy control subjects (n = 32), a significantly lower Cu,Zn-superoxide dismutase activity was found in both lymphocytes and polymorphonuclear cells of insulin-dependent (2.08 ± 0.58 vs. 1.70 ± 0.46 U/mg protein, p < 0.05, and 1.06 ± 0.46 vs. 0.64 ± 0.40 U/mg protein, p < 0.001, respectively) and non-insulin-dependent diabetic patients (2.08 ± 0.58 vs. 1.61 ± 0.48 U/mg protein, p < 0.01, and 1.06 ± 0.46 vs. 0.53 ± 0.24 U/mg protein, p < 0.001, respectively). There was a weak, but significant negative correlation between age and Cu,Zn-superoxide dismutase activity in lymphocytes and polymorphonuclear cells (r =-0.22 and r =-0.28, p < 0.05, respectively), whereas no influence of gender, diabetes duration and glycaemic control was observed. The results indicate that diabetes mellitus could elicit a significant disturbance in Superoxide anion-scavenging potential of lymphocytes and polymorphonuclear cells.
Aim: To evaluate the glycohemoglobin/HbA1c testing in the Republic of Croatia, with special empha... more Aim: To evaluate the glycohemoglobin/HbA1c testing in the Republic of Croatia, with special emphasis on analytical methods and clinical utilization as well as its impact on the specific health care for diabetic patients, delivered within the scope of the Croatian Model. Methods: The study was conducted during 1998 by distributing questionnaires to clinical laboratories and diabetologists at county/regional centers and Croatian Reference Diabetes Center where specialized health care for diabetic patients is delivered at the secondary and tertiary level, according to the Croatian Model. The participants were asked to answer specific questions concerning analytical aspects and clinical utilization of the glycohemoglobin/HbA1c testing as well as to communicate the comments and suggestions on the issue. Results: In Croatia, the glycohemoglobin/HbA1c testing is highly variable in terms of methodology and chemical entities reported as test result, with serious implications for the clinical validity of the test in respect to the recommended target values for glycemic control. In comparison to the prevalence of diabetes in Croatia and current recommendations, the glycohemoglobin/HbA1c testing was found to be considerably underutilized in regular monitoring of diabetic patients. Conclusion: Achievement of both better compliance to the recommendations and improved outcomes for diabetic patients via standardized and regularly available glycohemoglobin/HbA1c testing should be of highest priority for the medical and laboratory professionals involved in diabetes health care delivery in the Republic of Croatia.
Rad se bavi procjenom obuhvacenosti i ucinkovitosti mjerenja glikoziliranog hemoglobina u Republi... more Rad se bavi procjenom obuhvacenosti i ucinkovitosti mjerenja glikoziliranog hemoglobina u Republici Hrvatskoj.
To investigate factors responsible for altered insulin sensitivity in uremia, we studied 125I-ins... more To investigate factors responsible for altered insulin sensitivity in uremia, we studied 125I-insulin binding to erythrocytes in 20 uremic patients before and after dialysis. In uremic patients, predialysis binding was 50% lower in comparison with healthy controls (4.35 +/- 1.79 vs. 9.37 +/- 1.30%; p less than 0.01). Five-hour dialysis treatment resulted in a rapid increase in binding (on average to 55%; p less than 0.01). During the course of dialysis, binding to erythrocytes from 2 selected patients steadily increased in a time-dependent manner (on average 24%/h). The dialysis-induced increase in binding did not correlate with the changes in plasma insulin levels, but depended on the efficiency of dialysis as assessed by a relative decrease in plasma urea and creatinine. After an intravenous glucose load, the insulin-to-glucose ratio decreased in parallel with the increase in binding after dialysis. The results indicate that uremic plasma contains dialyzable substances which reversibly inhibit insulin binding, leading to altered insulin sensitivity.
The method of choice in the obstruction of the tear pathways is dacryocystorhinostomy (DCR). It i... more The method of choice in the obstruction of the tear pathways is dacryocystorhinostomy (DCR). It is indicated in cases of an obstruction of the lower segment of the lacrimal apparatus. It cannot be applied in cases of the obstruction of the upper segment of the tear pathways. In such pathologic conditions, the new tear pathway is formed from a part of the mucous membrane of the lateral nose wall and from a part of the mucous membrane of the septum. In a form similar to a tube, the mucous membrane of the nose will be sewn up with the mucous membrane of the conjuctiva. Direct suture is made possible by canthotomy, and, therefore, this surgery is called "Direct Cantorhinostomy".
This study has investigated the antioxidant capacity of human seminal plasma due to the presence ... more This study has investigated the antioxidant capacity of human seminal plasma due to the presence of both high and low molecular weight antioxidant factors. Methods for the measurement of superoxide dismutase-like activity (SOD-like) and total antioxidant status (TAS) were automated, and had a within-run coefficient of variation of 7.3% for SOD-like activity and 4.8% for TAS. In 69 semen samples from unselected infertile men, SOD-like activity in seminal plasma ranged from 2 to 16 U/ml, with a mean of 6.9 & 2.8 U/ml. As SOD-like activity was correlated positively with levels of citric acid (p<O.OOOl), zinc (p<0.0002) and acid phosphatase activity (p<0.0005), and there was no correlation with fructose levels, our results suggest that prostatic secretions are an important source of superoxide anion scavengers. Evaluation of SOD-like activity in infertile men with accessory sex gland infections (n = 12) showed significantly lower activity (p<0.003) compared to values found in 12 infertile men without signs of infection. The values obtained for total antioxidant status (equivalent to the antioxidant capacity of alpha-tocopherol analogue) ranged from 1.7 to 2.3 mmol/L, with a mean of 2.1 & 0.1 (n = 40), reflecting the protective activity of ascorbate, urate and albumin, and to a very low extent of glutathione and taurine. The data obtained by TAS assay correlated with fructose, a major marker of vesicular secretion (p<0.005), suggesting that low molecular weight components with .antioxidant capacity derive partly from the seminal vesicles. The results indcate that the relative contribution of antioxidant defence systems capable of counteracting the deleterious action of superoxide anions, depends on the secretory activity of accessory sex glands and is independent of excessive ROS production due to increased oxidative stress.
We have studied insulin binding to erythrocyte receptors in a group of 25 nonobese, nondiabetic u... more We have studied insulin binding to erythrocyte receptors in a group of 25 nonobese, nondiabetic uremic patients undergoing maintenance hemodialysis for 2-54 months and 14 healthy controls. Erythrocytes of predialyzed uremics bind significantly less insulin than control erythrocytes (p less than 0.01). Dialysis resulted in a rapid increase of insulin binding (p less than 0.001). The concentrations of plasma insulin and glucose remained essentially unchanged during 5-hour hemodialysis and did not significantly differ from the control values. The down regulation of insulin receptors in undialyzed patients in the presence of normal plasma insulin concentration indicates that factors other than insulin itself could be responsible for insulin receptor activity during uremia. The results demonstrated that creatinine, creatine and glycocyamine have a direct suppressive effect on insulin binding of postdialyzed plasma (p less than 0.05) in concentration of 1 mmol/l. This suggested that specific uremic toxins could play an important role in the mechanisms of altered insulin binding during hemodialysis. Despite the high concentration of these compounds in blood of uremics, the only common feature for these compounds is the presence of the guanidino group in the molecule.
The authors and the publisher have exerted every effort to ensure that drug selection and dosage ... more The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the con stant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. All rights reserved. No part of this publication may be translated into other languages, repro duced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the pub lisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center (see 'Information for Readers and Sub scribers').
This study examines the in~uence of methionine!enkephalin "MENK# on stress!induced oxidative dama... more This study examines the in~uence of methionine!enkephalin "MENK# on stress!induced oxidative damage "lipid peroxidation^LPO# in mice liver homogenate\ plasma corticosterone concentration "CS# and phagocytic activity of mouse splenocytes[ The LPO value increased in the mice subjected to restraint stress and had no correlation to stress duration\ while MENK had no e}ect[ The CS concentration was enhanced after 5 h of stress and 5 h after injection of a low "1[4 mg:kg bw# dose of MENK[ However\ MENK and stress are adjunct modulators of LPO and corticosterone in vivo[ LPO was additionally elevated when MENK "09 mg:kg bw# proceeded for 1 h after the onset of stress[ However\ corticosterone concentration seems to be regulated di}erently by the same dose of MENK depending on the duration of stress i[e[ elevated in cases involving short periods of stress "1 h# and decreased in cases involving prolonged periods of stress "5 h#[ This modulation of LPO and corticosterone by 09 mg:kg bw of MENK and 1 h of restraint stress was paralleled with elevated phagocytosis[ Þ 0887 International Society for Immunopharmacology[
Met-enkephalin modulates stress-induced alterations of the immune response in mice. PHARMACOL BIO... more Met-enkephalin modulates stress-induced alterations of the immune response in mice. PHARMACOL BIOCHEM BEHAV 54(1) 277-284, 1996.-Overnight restraint stress of mice decreased ConA-driven lymphocyte proliferation, plaque-forming cell response to sheep red blood cells (SRBC), and NK activity in the spleen, but the phagocytic activity was enhanced. Injection of methionine-enkephalin (MENK), 10 mg/kg, IP, 30 min before restraint, abolished these changes (except for the NK activity) and attenuated the stress-induced elevation of glucocorticoids. However, MENK itself affected the immune responses like stress: It decreased NK activity and the PFC response and enhanced phagocytic activity. Contrary to results with stress, MENK had no effect on cell proliferation. The opioid-receptor antagonist naloxone given before restraint reversed the stress-induced enhancement of phagocytosis and the decrease of T-cell proliferation. Alterations of the immune responses induced by restraint stress seem to be mediated by at least two mechanisms: activation of the hypothalamus-pituitary-adrenal (HPA) axis and the secretion of opioid peptides. MENK injected before stress may interfere with either or both mechanisms. T or B lymphocytes seem to be affected by the activation of the HPA axis, and phagocytes by a direct opioid action, whereas NK cells seem to be under the influence of another control mechanism.
The Journal of Clinical Endocrinology & Metabolism, 1981
Insulin binding to specific erythrocyte receptors was investigated in group of 25 subjects with K... more Insulin binding to specific erythrocyte receptors was investigated in group of 25 subjects with Klinefelter&amp;amp;#39;s syndrome (47 XXY genotype) and 14 healthy male volunteers. Insulin binding was significantly decreased in Klinefelter subjects (P less than 0.01 at insulin concentrations of 0.051 and 0.136 mmol/liter); however, their fasting glucose concentration was normal (87 +/- 17), and the glucose disappearance rate was slightly increased (2.3 +/- 0.9; P less than 0.2). These data indicated a compensatory, mechanism involved in the glucose metabolism in Klinefelter&amp;amp;#39;s syndrome.
Copper-zinc Superoxide dismutase (Cu,Zn-superoxide dismutase) activity was evaluated in lymphocyt... more Copper-zinc Superoxide dismutase (Cu,Zn-superoxide dismutase) activity was evaluated in lymphocytes and polymorphonuclear cells of insulin-dependent (n = 33) and non-insulin-dependent (n = 34) diabetic patients. A commercial method for the measurement of Superoxide dismutase activity was adapted for use on a discrete analyser and evaluated for interference by other antioxidants with Superoxide anion-scavenging properties. In comparison to healthy control subjects (n = 32), a significantly lower Cu,Zn-superoxide dismutase activity was found in both lymphocytes and polymorphonuclear cells of insulin-dependent (2.08 ± 0.58 vs. 1.70 ± 0.46 U/mg protein, p < 0.05, and 1.06 ± 0.46 vs. 0.64 ± 0.40 U/mg protein, p < 0.001, respectively) and non-insulin-dependent diabetic patients (2.08 ± 0.58 vs. 1.61 ± 0.48 U/mg protein, p < 0.01, and 1.06 ± 0.46 vs. 0.53 ± 0.24 U/mg protein, p < 0.001, respectively). There was a weak, but significant negative correlation between age and Cu,Zn-superoxide dismutase activity in lymphocytes and polymorphonuclear cells (r =-0.22 and r =-0.28, p < 0.05, respectively), whereas no influence of gender, diabetes duration and glycaemic control was observed. The results indicate that diabetes mellitus could elicit a significant disturbance in Superoxide anion-scavenging potential of lymphocytes and polymorphonuclear cells.
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