Do altering in ornithine decarboxylase activity and gene expression contribute to antiproliferative properties of COX inhibitors?

Two isoforms of cyclooxygenase (COX) participate in growth control; COX-1 is constitutively expressed in most cells, and COX-2 is an inducible enzyme in response to cellular stimuli. An induction of COX-2 found in neoplastic tissues results in increased cell growth, inhibition of apoptosis, activation of angiogenesis, and decreased immune responsiveness. Although both COX-1 and COX-2 inhibitors are suppressors of cell proliferation and appear to be chemopreventive agents for tumorigenesis, the molecular mechanisms mediating antiproliferative effect of COX inhibitors are still not well defined. This study contrasts and compares the effects of aspirin and celecoxib, inhibitors of COX-1 and COX-2, in rat hepatoma HTC-IR cells. The following were assessed: cell proliferation and apoptosis, ornithine decarboxylase (ODC) activity, and pattern expression of three immediate-early genes, c-myc, Egr-1, and c-fos. We have shown that the treatment of hepatocytes in vitro with the selective COX-2 inhibitor, celecoxib, was associated with induction of apoptosis and complete inhibition of cellular proliferation. Aspirin exhibited a small antiproliferative effect that was not associated with apoptosis. Treatment with celecoxib produced dose- and time-dependent decrease in ODC activity. In addition, at higher drug concentration the decrease in ODC activity was greater in proliferating than in resting cells. Much lesser inhibitory effect on ODC activity was observed in aspirin-treated cells. The two COX inhibitors did not change c-myc expression, significantly decreased the expression of Egr-1, and differentially altered expression of c-fos; aspirin did not change, but celecoxib dramatically decreased the levels of c-fos-mRNA. Our study revealed that celecoxib and aspirin share the ability to inhibit ODC activity and alter the pattern of immediate-early gene expression. It seems that some of the observed effects are likely to be related to COX-independent pathways. The precise mechanisms of action of COX inhibitors should be defined before using these drugs for cancer chemopreventive therapy.

Inflammatory bowel disease--Polish contribution.

The term "inflammatory bowel disease" includes ulcerative colitis, Lesniowski-Crohn's disease and indeterminate colitis. The history of these diseases in Poland began with Antoni Lesniowski, who in 1904 described an inflammatory tumour of the small intestine with a fistula to ascending colon. The first contemporary clinical descriptions of the main forms of inflammatory bowel disease emerged after 1960, and were made by Warsaw groups and a surgical group from Poznan. The major contributions of Polish investigators to the development of knowledge about ulcerative colitis and Lesniowski-Crohn's disease were made in the fields of immunology and genetics and in studies on kallikrein-kinin and haemostasis systems. The investigators of pathogenetic mechanisms in these diseases come from departments of gastroenterology in Warsaw, Lublin, Gdansk and Sosnowiec.

[Results of the therapy in otogenic intracranial complication in ENT Department of Voivodeship Hospital in Kalisz]. / Wyniki leczenia powiklan usznopochodnych wewnatrzczaszkowych zebranych na Oddziale Otolaryngologicznym Wojewódzkiego Szpitala Zespolonego w Kaliszu.

On the base of literature and own experience authors present very difficult problem--diagnosis and therapy of otogenic intracranial complications. In ENT Department in Kalisz during 1984-1997 6413 patients were hospitalized, 443 because of chronic purulent inflammation of media ear. We did particular analysis of kind complications in compliance with age and sex. All patients were operated and pharmacological treated. One patient died because of puncture cerebellum abscess to IV ventricle. It is 4.76% all complications and 0.22% patients hospitalized because of chronic purulent inflammation of media ear.

[Laryngeal microsurgery in materials of Woiewódzki ENT department in Kalisz]. / Mikrochirurgia wewnatrzkrtaniowa w materiale Oddzialu Otolaryngologicznego Wojewódzkiego Szpitala Zespolonego im. L. Perzyny w Kaliszu.

Basing on literature and own experience authors have presented possibilities and advantages this method. During 1994-1997 3239 patients were hospitalized, 249 because of larynx diseases. 88 (35.34%) from them were operated by Kleinssaser tool kit with control by surgical microscope. Between these patients in histological examination were found in 30 patients--changes of hypertrophy, in 23 patients--polypus vocal fold, in 17 patients cancer of larynx--early shape, in 12 patients--vocal nodulus and 2 patients--Reincke oedema, 2--laryngeal papillomas and 2--cysts of larynx. Patients with cancer of larynx were treated by partial laryngectomy. Other patients had return full function of larynx.

[A rare case of foreign body in external auditory meatus]. / Nietypowe cialo obce w przewodzie sluchowym zewnetrznym.

The authors present a case of a foreign body in external auditory meatus--cement mordant. Particularly++ we have described frequency and kind of the foreign bodies which we have met for 6 years. The foreign bodies were removed in 117 persons, 3 from these were hospitalized and foreign bodies were removed in general anesthesia.

[Aneurysm of the vertebral artery as a tumor of the neck]. / Tetniak tetnicy kregowej jako guz szyi.

The authors described a case of vertebral artery aneurysm, basing on their own experience and literature. The clinical course, diagnostic difficulties and treatment were discussed. There is presented an aneurysm of the vertebral artery coexistent with rheumatoid cervical spine disease. Diagnosis must be planned in a very detailed way; biopsy should not be used. CT with angiography is best. The treatment is resection of the aneurysm or clipping vessels or occlusion by balloon in special cases.

[Surgical treatment of hearing loss in blue sclera syndrome]. / Operacyjna poprawa sluchu w zespole niebieskich twardówek.

Etiological theories given in literature, patomechanism and otosclerosis-reminding traits of the blue scleras syndrome are discussed in this paper. The operative methods of repairing conductive hypoacusia in familial blue scleras syndrome based on own research are described. The audiological results of hearing loss surgical treatment in this case are presented.

[A case of giant osteoma of the frontal sinuses]. / Przypadek olbrzymiego kostniaka zatok czolowych.

A case of giant osteoma of frontal sinus passing into anterior fossa of the skull, ethmoid and orbit at the right side in a 17-year-old boy was introduced. The osteoma has been surgically removed with neurosurgeon cooperation. Considering the large damage of bone, reconstruction of the frontal part by "Codubix" was done. Post-surgical course without complications and good cosmetic effect were obtained.

[Congenital cholesteatoma of temporal bone]. / Perlak wrodzony kosci skroniowej.

On the basis of 72 reports in the literature and own case, the authors described new theories on the pathogenesis of congenital cholesteatoma. They present differentiation of congenital and acquired cholesteatoma by cyto-, histochemical and immunohistochemical methods. They discuss methods of diagnosis and therapy. Attention has been called to diagnosis by CT and MR examinations.

Liver graft bile duct necrosis--indication for retransplantation.

The authors describe the first in Poland case of liver retransplantation in an adult recipient, in whom the indication for the procedure was bile duct necrosis following liver transplantation due to liver cirrhosis of an uncertain origin.

[Actinobacteriosis of paranasal sinuses]. / Aktynobakterioza zatok przynosowych.

On the base the review of literature and own case the authors presents diagnostic difficulties and therapy of paranasal sinuses actinobacteriosis. Actinobacteriosis of sinuses is very rare case and diagnostic analysis based on mycologic and histopathologic investigations. In our case sinuses actinobacteriosis orbital abscess complication has been noted. Antibiotic therapy and surgical treatment have been used in this case.

Long-term results of treatment of esophageal achalasia using a Starck dilator.

Retrospective analysis was carried out among 252 patients with esophageal achalasia (135 women, 117 men, mean age 41 years) who, in the years 1961-1992, underwent 333 Starck procedures. Mean period of follow-up was 11.5 years (range 6 months to 32 years). Evaluation of the procedure was based upon the analysis of actual symptoms and radiological and endoscopic examinations in a group of 247 patients (98%). 22 patients died; all except 1 of diseases unrelated to the esophagus. The data concerning the effectiveness of therapy refer to the remaining 225 patients. The first Starck procedure gave permanent and sufficient relief of symptoms in 140 patients (62.2%). Of the remaining patients, 62 persons underwent subsequent Starck procedures, the effectiveness of which was 64.9%. The total percentage of favorable results of the procedure was 84.4%. There was no fatal complication of the Starck procedure. One perforation of the esophagus, one aspiration pneumonia and 2 cases of incarceration of the Starck apparatus were observed. There was no case of esophageal cancer in the whole group. These results confirm that the Starck procedure is a safe and effective treatment for esophageal achalasia.

[Late metastasis of clear cell renal cancer to the tonsillar palate]. / Pózny przerzut raka jasnokomórkowego nerki do migdalka podniebiennego.

The authors present a rare case of metastases from clear cell renal cancer to palate tonsillar and temporal bone. In their opinion, by patients with this dis periodical ENT-examination it's necessary. Clinical manifestations, surgical management and therapeutic results are described.

[Determination of blood glucose values with glucostix]. / Oznaczanie stezenia glukozy we krwi za pomoca testu paskowego Glucostix.

The study involved 214 patients of both sexes, including those treated at the Institute of Oncology in Gliwice and children treated for diabetes mellitus at the Diabetic++ Out-Patient Clinic in Gliwice. Blood glucose was assayed with GLUKOZA EO kit manufactured by POCh and strip test Glucostix (visually and with reflectance meter Glucometer II Ames). In case of blood glucose assays with strip tests a deviation of +/- 25% of the determined value was considered as a difference which does not affect diagnostic value. Blood glucose concentration determined visually with Glucostix test is similar or lower than that found in the laboratory. Moreover, the use of reflectance meter does not improve diagnostic value of an assay.

Metabolism of vitamin A in inflammatory bowel disease.

The aim of this study was to determine serum retinol levels in patients with inflammatory bowel disease and to attempt to elucidate the mechanism of changes in vitamin A metabolism in these disorders. It was found that in 15 patients with active ulcerative colitis, 14 patients with active Crohn's disease and in 3 operated patients with recurrent Crohn's disease serum retinol levels and retinol-binding protein were significantly lower than in controls. Concentrations of vitamin A did not depend on the localization of inflammatory bowel disease, previous ileal resections, duration of the disease or age and sex of the patients. During successful treatment of active ulcerative colitis normalization of serum retinol levels without substitution of vitamin A was observed. Repeated determinations in patients with Crohn's disease who had low serum retinol levels in an active phase of disease revealed normal vitamin A levels in an inactive phase. The absorption of vitamins A and E in patients with inflammatory bowel disease was normal. The normal serum retinol concentrations in patients with diarrhea due to irritable bowel syndrome, and in those with anorexia nervosa exclude the influence of diarrhea and body weight itself on vitamin A levels. The results of this study indicate that serum retinol levels in patients with active inflammatory bowel disease are secondary to the decreased serum retinol-binding protein concentrations, and probably depend on the increased protein catabolism in these disorders.

[Endoscopic drainage of the bile ducts]. / Endoskopowy drenaz dróg zólciowych.

Insertion of biliary endoprosthesis was attempted in 151 patients with obstructive jaundice and was successful in 124 patients (82%). The indications for the procedure were: 1) biliary and pancreatic neoplasms (79 patients) and 2) non-neoplastic diseases such as common bile duct stones or postoperative biliary strictures (45 patients). Successful drainage of bile was obtained in 95% of patients from the first group and in 93% of those from the second group. The mean survival time of patients with neoplasms was 4.5 months and the majority of them were free of jaundice and itching. In 32 patients with non-neoplastic diseases there was no recurrence of jaundice after a mean time of 20 months. Serious complications occurred in 5 patients (4%), 4 of them died (3.2%). The most frequent late complication was clogging of the endoprosthesis (19% of patients from the first group after a mean time of 5 months and in 28% of those from the second group after a mean time of 16 months). Replacement of the endoprosthesis was carried out mainly on the ambulatory basis. Endoscopic biliary stenting is an effective method of palliative biliary drainage in patients with non-operable biliary and pancreatic tumours. In high risk patients with non-neoplastic obstructive jaundice the technique may be an alternative for surgical treatment.

[Oncological supervision of patients after colonoscopic polypectomy]. / Nadzór onkologiczny nad chorymi po polipektomii sródkoloskopowej.

The high frequency of development of new adenomas in patients after colonoscopic polypectomy (30-50%) suggests the need for periodic control examinations of the whole large bowel. The diagnostic value of rectoscopy and routine diagnostic enema is limited and these methods are not suitable for periodic control of the bowel. An important method is fiberoptic sigmoidoscopy (FSS), but it is also insufficient because neoplasms are present frequently in proximal parts of the colon. The best method for evaluation of the whole colon is coloscopy, moreover, this method makes possible removal of the found polyps. In particular cases an alternative of coloscopy may be a combination of FSS and double contrast radiological examination of the colon. The frequency of control examinations of the large bowel depends primarily on the number of removed polyps. The patients after removal of a single polyp should undergo control examinations at intervals of 4-5 years. In cases with multiple adenomas removed during the first procedure or with one large adenoma (over 2 cm in diameter) should have control examinations repeated every 2-3 years.