Prevalence of obesity is growing in the general population as well as among end-stage renal disease (ESRD) patients requiring dialysis. Obesity often leads to a situation when a mature outflow vein is located deeper than 6 mm and is difficult to cannulate. These obese patients usually require additional procedures to able to successfully cannulate the fistula. The available surgical options include: outflow vein elevation, liposuction, and lipectomy. We present a case of a 57-year-old obese female with ESRD and matured, deeply running, inadequate for cannulation arteriovenous fistula. We present a technique of lipectomy with wide resection of adipose tissue from superior and lateral surfaces of outflow vein. Postoperatively, the skin without the underlying adipose tissue collapses allowing easy cannulation of the long segment of outflow vein with two needles. Lipectomy of mature but deeply located outflow vein is a second-stage elective procedure. Wide resection of adipose tissue helps create easy to access cannulation zone in obese individuals.

Following absorption, polychlorinated biphenyls (PCBs) bind to albumin and are transported via blood into the target tissues. PCBs then accumulate in tissues and induce a variety of harmful chronic and developmental effects. The aim of the present study is to determine binding parameters, such as binding constant, quenching constant, and number of binding sites for three PCB congeners (PCB118, PCB126 and PCB153) in complex with human serum albumin (HSA). The binding parameters for the complexes of HSA-PCB118, HSA-PCB126, and HSA-PCB153 excited at 280 nm were compared with those excited at 295 nm. Quenching (static and dynamic) of HSA fluorescence was analyzed based on the Stern-Volmer method. Binding (Ka) constants were calculated according to the Scatchard method and analysis of non-linear regression was based on a two-component model with the Lavenberg–Marquardt algorithm. For all analyzed complexes, a single independent class of binding site for PCB congeners was found in HSA subdomain IIA. Tyrosine residues appear to play the most prominent role in binding of PCB126 to HSA, while tryptophan-214 played a dominant role in interactions of PCB153 with HSA. Among studied PCB congeners, PCB118 formed the most stable complexes with HSA. These results illustrate the importance of studies targeting the binding of PCBs to serum albumin as part of the strategy to understand and protect against toxicity of these environmental toxicants.

Human serum albumin (HSA) is the main plasma protein responsible for a distribution of drugs in the human circulatory system. The binding to HSA is one of the factors that determines both the pharmacological actions and the side effects of drugs. The derivative of heme, protoporphyrin IX (PpIX), is a hydrophobic photosensitizer widely used in photodynamic diagnosis and therapy of various malignant disorders. Using absorption and fluorescence spectroscopy, it has been demonstrated that PpIX forms complexes with HSA. Its binding sites in the tertiary structure of HSA were found in the subdomains IB and IIA. PpIX binds to HSA in one class of binding sites with the association constant of 1.68 × 10 5 M −1 and 2.30 × 10 5 M −1 for an excitation at wavelength λ ex = 280 nm and 295 nm, respectively. The binding interactions between HSA and PpIX have been studied by means of molecular docking simulation using the CLC Drug Discovery Workbench (CLC DDWB) computer program. PpIX creates a strong 'sandwich-type' complex between its highly conjugated porphine system and aromatic side chains of tryptophan and tyrosine. In summary, fluorescent studies on binding interactions between HSA and PpIX have been confirmed by the results of computer simulation.

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Introduction: Hemodialysis (HD) improves health and prolongs the life of end-stage renal disease patients, but simultaneously leads to emotional disturbances and impairs the quality of life (QOL). The study was conducted to evaluate the QOL of HD patients. The study was approved by the Regional Bioethical Committee (K.B.Cz.-0014/2017). Material and methods: The World Health Organization Questionnaire of QOL (WHOQOL-BREF) was used in this study with the formal agreement of the WHO. The associations between each patient-related and dialysis-related factor and WHOQOL-BREF domains and questions were computed. The variables were compared by the Student t-test. Results: Data were collected in August 2017 in a single access center. Sixty-nine patients, including 23 (33.3%) women, were evaluated. The factors lowering the scores for particular questions and domains of WHOQOL-BREF were senility, marriage, wrist and arm AVF, not-tunneled CVCs (vs. tunneled), and unwillingness to have a kidney graft. The factors that increased scores for particular questions and domains of WHOQOL-BREF were short dialysis, tunneled CVCs (vs. not-tunneled), and higher URR. The relations between domains and questions of WHOQOL-BREF and sex, education, months on dialysis, kidney graft in the past, fulfillment of medical recommendations, Kt/V and UF were not significant. Conclusions: Although a kidney graft is the best kidney replacement therapy, there is a large group of patients who do not want to receive this treatment. This group should be given special attention. The medical professionals in HD units should remember that patients may not feel comfortable with their disease and satisfied with their body image affected by therapy.