Plasma concentration of Bisphenol A and leptin in patients with meningioma and glioma: A pilot study.

PURPOSE: Recent increase in incidence of meningiomas suggests the need to search for new risk factors. Leptin, a potentially pro-angiogenic and proliferative agent, could be a candidate for this role, as its expression correlates with body mass index (BMI). Because development of meningioma has also been linked to sex hormones, bisphenol A (BPA), a known xenoestrogen, can also be taken into consideration as a potential risk factor. The aim of this study was to determine plasma concentrations of both substances in patients with meningiomas and to match it to patients with gliomas - a group of brain tumors less hormone- and BMI-dependent. MATERIALS & METHODS: Concentrations of BPA and leptin were measured in plasma of 24 patients with low grade meningioma and in 29 patients with glioma, using gas chromatography-mass spectrometry (GC-MS) and ELISA kits, respectively. The concentrations of both substances in patients with neoplasms were interpreted in relation to their concentration in healthy population, published in recent reports. RESULTS: Free and conjugated BPA were present in both meningioma and glioma patients. Moreover, their concentrations far exceeded those reported in the healthy population. Nevertheless, the level of leptin revealed to be significantly higher in meningioma patients than in glioma patients. CONCLUSIONS: Occurrence of both meningioma and glioma may be accompanied by increased concentrations of leptin and BPA. Further large-scale studies are needed to clarify whether the presence of both substances may play a role in pathogenesis or influence clinical course in patients with brain neoplasms.

First microsatellite markers for the European Robin (Erithacus rubecula) and their application in analysis of parentage and genetic diversity.

The European Robin is a small passerine bird associated with woodlands of Eurasia and North Africa. Despite being relatively widespread and common, little is known of the species' breeding biology and genetic diversity. We used Next Generation Sequencing (NGS) to develop and characterize microsatellite markers for the European Robin, designing three multiplex panels to amplify 14 microsatellite loci. The level of polymorphism and its value for assessing parentage and genetic structure was estimated based on 119 individuals, including seven full families and 69 unrelated individuals form Poland's Bialowieza Primaeval Forest and an additional location in Portugal. All markers appeared to be highly variable. Analysis at the family level confirmed a Mendelian manner of inheritance in the investigated loci. Genetic data also revealed evidence for extra-pair paternity in one family. The set of markers that we developed are proven to be valuable for analysis of the breeding biology and population genetics of the European Robin.

Individual Heterozygosity Influences Arrival Times and Mating Success of Male Red-Breasted Flycatchers Ficedula parva.

We examined the relationship between individual heterozygosity of male Red-breasted Flycatchers (Ficedula parva; a small long-distance migratory, socially monogamous bird species) and their mating success, arrival time and age. Using eight polymorphic microsatellite loci, we found that male heterozygosity is related to both mating success and arrival time, but not to age. Mated and earlier arriving males had higher heterozygosity than later arrivals and bachelors, but we did not find a relationship between age and individual heterozygosity of males. To our knowledge, this is the first study to provide evidence about the relationship between individual genetic diversity and arrival time, thus arrival time could be used as a signal of individual heterozygosity and quality.

Brain tissue oxygenation during transnasal endoscopic skull base procedures.

PURPOSE: We aimed to study brain tissue oxygenation during the period of controlled reduction of arterial blood pressure - a maneuver often used in extended endoscopic skull base surgery for bloodless operative field. METHODS: Intracranial pressure, arterial blood pressure and the resultant cerebral perfusion pressure were measured during extended endoscopic skull base surgery in 5 patients with diagnosed tumors of the skull base and arterial hypertension. Simultaneously, in those patients, we measured partial pressure of oxygen in the brain parenchyma (PbtO2). RESULTS: Values of PbtO2 lower than 15 mm Hg (risk of brain ischemia) were observed in 3 patients for periods of 40 min, 110 min and 123 min, respectively. In 2 of these patients, no hypotension (mean arterial pressure <65 mm Hg) was necessary for bloodless operative field. Another 2 patients had PbtO2 above 30 mm Hg at the time when their mean arterial pressure was below 65 mm Hg. The time course of PbtO2 followed that of cerebral perfusion pressure with a time lag of 40-60 s in all patients. CONCLUSION: Moderate reduction of arterial pressure, often used to obtain bloodless operative field during extended endoscopic skull base surgery, may in patients with the medical history of arterial hypertension be associated with critically low values of partial oxygen pressure in brain tissue.

F2-isoprostanes and F4-neuroprostanes as markers of intracranial aneurysm development.

BACKGROUND: Intracranial aneurysms are common, occurring in about 1-2% of the population. Saccular aneurysm is a pouch-like pathological dilatation of an intracranial artery that develops when the cerebral artery wall becomes too weak to resist hemodynamic pressure and distends. OBJECTIVES: The aim of this study was to determine whether the development of intracranial aneurysms and subarachnoid hemorrhage (SAH) affects neuronal phospholipid metabolism, and what influence different invasive treatments have on brain free radical phospholipid metabolism. MATERIAL AND METHODS: The level of polyunsaturated fatty acid (PUFA) cyclization products - F2-isoprostanes and F4-neuroprostanes - was examined using liquid chromatography - mass spectrometry (LC-MS) in the plasma of patients with brain aneurysm and resulting subarachnoid hemorrhage. RESULTS: It was revealed that an aneurysm leads to the enhancement of lipid peroxidation with a significant increase in plasma F2-isoprostanes and F4-neuroprostanes (more than 3-fold and 11-fold, respectively) in comparison to healthy subjects. The rupture of an aneurysm results in hemorrhage and an additional increase in examined prostaglandin derivatives. The embolization and clipping of aneurysms contribute to a gradual restoration of metabolic homeostasis in brain cells, which is visible in the decrease in PUFA cyclization products. CONCLUSIONS: The results indicate that aneurysm development is associated with enhanced inflammation and oxidative stress, factors which favor lipid peroxidation, particularly in neurons, whose membranes are rich in docosahexaenoic acid, a precursor of F4-neuroprostanes.

Expression of N-cadherin and ß-catenin in human meningioma in correlation with peritumoral edema.

OBJECTIVE: To analyze the expression of ß-catenin and N-cadherin in large series of meningioma cases and to investigate their correlation with peritumoral brain edema (PTBE). MATERIALS AND METHODS: Study group consists of 154 patients diagnosed with intracranial meningioma divided into: low-grade (G1) and high-grade (G2 or G3) group. PTBE was graded into four groups (0, I, II, III) using Steinhoff classification. The expression of N-cadherin, ß-catenin was analyzed and graded based on the positive ratio of immunoreactivity. The results were analyzed statistically. RESULTS: 104 cases were low-grade and 50 high-grade meningiomas. PTBE was observed in 103(66.8 %) cases: 57 grade I, 44 grade II and 2 grade III. Positive N-cadherin expression was found only in the membrane of the neoplastic cells in 50(48.1%) cases of low-grade, and in 34(68%) of high-grade group. In low-grade meningioma, ß-catenin expression was observed within the cytoplasm and nucleus in 54(51.9%) cases. In high-grade meningiomas, ß-catenin expression was observed in 33(66%) tumors only within the nucleus. N-cadherin expression was observed in 36 cases with PTBE grade I, 28 with grade II and 2 with grade III. ß-catenin expression was observed in 40 cases with PTBE grade I, 24 with grade II and 2 with grade III. The results were statistically significant. CONCLUSIONS: Significant N-cadherin expression especially in high-grade meningioma group was found. ß-catenin expression was the most evident in the nucleus rather than in cytoplasm. The degree of PTBE correlated with the N-cadherin and ß-catenin expression and was the most prominent in high-grade meningioma group.

Fish introductions in the former Soviet Union: The Sevan trout (Salmo ischchan) - 80 years later.

The Soviet Union played the leading role in fish introductions in Eurasia. However, only 3% of all introductions prior to 1978 gave a commercial benefit. One of the noteworthy examples appears to be the Sevan trout (Salmo ischchan Kessler, 1877)-an endemic salmonid of Lake Sevan in Armenia. This species has been introduced to Kirghizstan, Kazakhstan, and Uzbekistan, however, only the Kirghiz population has persisted in relatively high numbers. In this paper we provide the first extensive molecular study of S. ischchan using samples from the native population from Lake Sevan and three hatcheries in Armenia, as well as from the population introduced to Lake Issyk Kul in Kirghizstan. The Kirghiz population has been isolated since the introductions took place in 1930 and 1936. Our results, based on 11 nuclear microsatellites and a 905 bp fragment of the mitochondrial control region suggest that hatcheries have maintained genetic variability by way of ongoing translocations of individuals from Lake Sevan. Simultaneously, significant Garza-Williamson M-values suggest that bottlenecks could have reduced the genetic variability of the wild populations in the past. This hypothesis is supported by historical data, indicating highly manipulated water-level regulations and poaching as two main factors that dramatically impact fish abundance in the lake. On the other hand, a similar situation has been observed in Kirghizstan, but this population likely rebounded from small population size faster than the other populations examined. The Kirghiz population is significantly genetically differentiated from the other groups and have morphological features and biological attributes not observed in the source population. Genetic data imply that the effective population size in the native population is lower than that found in the introduced population, suggesting that some active protection of the Lake Sevan population may be needed urgently.

Conservation genetics of the capercaillie in Poland - Delineation of conservation units.

The capercaillie (Tetrao urogallus) is one of Poland's most endangered bird species, with an estimated population of 380-500 individuals in four isolated areas. To study these natural populations in Poland further, more than 900 non-invasive genetic samples were collected, along with samples from 59 birds representing large, continuous populations in Sweden and Russia; and from two centres in Poland breeding capercaillie. Microsatellite polymorphism at nine loci was then analysed to estimate within-population genetic diversity and genetic differentiation among populations. The results confirmed that isolation of populations and recent decreases in their sizes have reduced genetic diversity among capercaillie in Poland, with all the country's natural populations found to be experiencing the genetic after-effects of demographic bottlenecks. The results of analyses of genetic differentiation and structure further suggest the presence of a 'lowland' cluster (encompassing birds of the Augustowska and Solska Primaeval Forests in Poland, and of Sweden and Russia), and a Carpathian cluster. Capercaillie from Sweden and Russia are also found to differ markedly. The Polish lowland populations seem more closely related to birds from Scandinavia. Our genetic analysis also indicates that the stocks at breeding centres are of a high genetic diversity effectively reflecting the origins of founder individuals, though identification of ancestry requires further study in the case of some birds. Overall, the results sustain the conclusion that the Polish populations of capercaillie from the Carpathians and the lowlands should be treated as independent Management Units (MUs). This is to say that the breeding lines associated with these two sources should be maintained separately at breeding centres. The high level of genetic differentiation of birds from the Solska Primaeval Forest suggests that this population should also be assigned the status of independent MU.

The diagnostic value of alcohol dehydrogenase (ADH) isoenzymes and aldehyde dehydrogenase (ALDH) measurement in the sera of patients with brain tumor.

INTRODUCTION: Alcohol dehydrogenase (ADH) isoenzymes and aldehyde dehydrogenase (ALDH) exist in the brain. Alcohol dehydrogenase and ALDH are also present in brain tumor cells. Moreover, the activity of class I isoenzymes was significantly higher in cancer than healthy brain cells. The activity of these enzymes in tumor tissue is reflected in the serum and could thus be helpful for diagnostics of brain neoplasms. The aim of this study was to investigate the potential role of ADH and ALDH as markers for brain tumors. MATERIAL AND METHODS: Serum samples were taken for routine biochemical investigation from 115 patients suffering from brain tumors (65 glioblastomas, 50 meningiomas). For the measurement of the activity of class I and II ADH isoenzymes and ALDH activity, fluorometric methods were used. The total ADH activity and activity of class III and IV isoenzymes were measured by the photometric method. RESULTS: There was a significant increase in the activity of ADH I isoenzyme and ADH total in the sera of brain tumor patients compared to the controls. The diagnostic sensitivity for ADH I was 78%, specificity 85%, and positive and negative predictive values were 86% and 76% respectively. The sensitivity and specificity of ADH I increased with the stage of the carcinoma. Area under receiver-operating characteristic curve for ADH I was 0.71. CONCLUSIONS: The results suggest a potential role for ADH I as a marker for brain tumor.

Correlation of leptin receptor expression with BMI in differential grades of human meningiomas.

Meningioma is one of the most common primary brain tumor, especially in postmenopausal women. The most important risk factors include radiation, primary head injury or genetic alterations, however it is currently unclear why postmenopausal women are predominantly affected. The aim of the present study was to evaluate leptin receptor (LEPR) expression and body mass index (BMI) in patients with meningiomas of differential grades. Specimens of 158 meningiomas were classified as either G1 (low-grade meningiomas, n=114) or G2/G3 (high-grade meningiomas, n=44). Immunohistochemistry was performed to assess LEPR expression. The mean BMIs of the female and male patient groups were 28.43±5.29 and 23.93±4.66, respectively. Mean BMI was significantly higher in the female group, by ~4.50 kg/m2. Patient age significantly correlated with LEPR expression, with the highly positive (++) and positive (+) groups having mean ages of 62.3±12.07 and 52.3±13.04, respectively. A strong positive correlation (r=0.73) was observed between leptin receptor expression and BMI, with the LEPR (++) group having a mean BMI of 30.11±4.49, compared to 22.12±2.48 for the LEPR (+) group. Furthermore, in the low-grade meningioma group, mean BMI was higher in female patients than male patients (28.13±5.54 and 25.38±4.57, respectively; P=0.01). Additionally, there was strong positive correlation between BMI and leptin receptor expression in the low-grade meningioma group (r=0.69). For the high-grade meningioma group, mean BMI was 29.49±4.26 and 21.76±3.98 in female and male patients, respectively, and LEPR expression strongly correlated with BMI in this group (r=0.80). The present study demonstrates a correlation between patient BMI, age, and LEPR expression status in low- and high-grade meningiomas. Our results indicate that in addition to endogenous hormones, such as estrogen or progesterone, or fatty tissue-associated proinflammatory cytokines, LEPR expression status may be a risk factor for meningioma growth and progression.

Survivin, caspase-3 and MIB-1 expression in astrocytic tumors of various grades.

PURPOSE: Gliomas are the most common primary brain tumors. The etiology is still unclear and the progression from low to high-grade gliomas is frequent. The molecular mechanisms are quite established, however the heterogeneity of glioblastomas force the scientist to look for the new therapeutic targets. The aim of the study was to evaluate the caspase-3 and survivin expression in correlation with MIB-1 expression in gliomas of various grade to assess the apoptosis in gliomas and to determinate new possible targets for the future therapy. MATERIAL AND METHODS: We identified 131 patients with a histopathological diagnosis of astrocytic tumors (diffuse astrocytoma, anaplastic astrocytoma and glioblastoma). The evaluation of caspase-3, survivin and MIB-1 expression was done using immunohistochemical methods. RESULTS: Caspase-3 and survivin expression was observed both in low- and high-grade astrocytomas. The differences in expression were the most evident in glioblastoma group. All primary glioblastomas (31 cases) expressed caspase-3. In secondary glioblastoma group only 17 out of 30 specimens were positive for caspase-3. Survivin expression was observed in 80.6% primary glioblastomas and in all examined secondary glioblastomas and the staining was strong and diffuse in all cases. MIB-1 expression was low in diffuse astrocytomas (DA) and ranged between 1 and 5%. In anaplastic astrocytoma group it was ranged between 5 and 10% and the highest percentage of the positive cells was observed in glioblastoma cases and ranged from 10% even to 30%. The most evident MIB-1 expression was observed in the cells surrounding the pathological blood vessels and necrosis. CONCLUSIONS: The high incidence of survivin and caspase-3 expression in diffuse and anaplastic astrocytoma cases may suggest, that the regulation between pro- and antiapoptotic proteins may play an important role in tumor growth and progression. The overexpression of survivin and MIB-1 expression in glioblastoma cases also may confirm the theory about the important role of anti-apoptotic and proliferation processes in glioblastoma progression and as such may be potential therapeutic targets.

Spatial patterns of extra-pair paternity in a waterbird colony: separating the effects of nesting density and nest site location.

Centres of avian colonies are usually associated with reduced predation risk and, thus, attract individuals of high quality, while poor-quality individuals are relegated to peripheral zones. Assuming that the incidence of extra-pair paternity (EPP) is dependent on individual quality, we could expect lower incidence of extra-pair offspring in the central parts of colonies. On the other hand, central pairs often nest in higher densities, which might increase EPP rate. To test these hypotheses, we sampled 124 great cormorant Phalacarocorax carbo sinensis chicks from 30 broods from different zones of a colony and genotyped them at seven highly polymorphic microsatellite loci. Sibship reconstruction confirmed the presence of at least one extra-pair chick in 30.0 % of broods. We found that EPP varied significantly between the zones of the colony, with higher incidence of extra-pair broods in the peripheral zone (53.3 vs. 6.7 % of broods). Centre-edge difference in EPP was consistent with the expected distribution of pair quality and suggested that poor-quality peripheral females were more likely to solicit extra-pair interactions, possibly to gain 'good genes' for their offspring. By contrast, we found no evidence for density dependence in EPP rate, indicating that likelihood of raising extra-pair offspring was not constrained by limited availability of local males. The results indicate that spatial randomization of sampling within avian colonies is critical to obtain robust estimations of EPP for non-solitary species. To our knowledge, this study provides the first evidence for the centre-edge difference in EPP within a breeding colony of birds.

Neurobiochemical markers of brain ischemia in patients subjected to endoscopic skull base surgery under controlled hypotension.

BACKGROUND: Previous studies showed that moderate hypotension used to control bleeding during extensive endoscopic skull base procedures may cause a decrease in blood flow velocity (BFV) in the middle cerebral artery (MCA). We assessed possible metabolic consequences of reduction of arterial pressure applied in endoscopic skull base operations. METHODS: The serum concentrations of neuron specific enolase (NSE) and S-100 protein were measured in 15 patients operated on with reduced hemodynamic parameters (hypotensive group) and in 10 individuals operated on under normotensive conditions (normotensive group). Concentrations of NSE and S-100 were assessed preoperatively, as well as 24 h and 48 h postsurgery. Blood flow velocity in the MCA was evaluated with transcranial color Doppler sonography. RESULTS: An increase in NSE concentration was demonstrated in 5 out of 6 patients from the hypotensive group in whom BFV in the MCA dropped below normal reference range during surgery. An association between both phenomena was confirmed on statistical analysis. Neither the rise of S-100 concentration nor postoperative neurological deficits were detected in any of the studied individuals. CONCLUSIONS: Controlled hypotension during skull base procedures can result in postoperative increase in NSE serum concentration, a phenomenon suggestive for a degree of brain ischemia. Noticeably, the rise of NSE level occurs in subjects in whom BFV in the MCA decreased below normal reference limit during the surgery. Although neither S-100 protein level increase nor neurological deficits were detected postoperatively, further studies of the safety of hypotension applied during endoscopic skull base operations are warranted.

Local Heterozygosity Effects on Nestling Growth and Condition in the Great Cormorant.

Under inbreeding, heterozygosity at neutral genetic markers is likely to reflect genome-wide heterozygosity and, thus, is expected to correlate with fitness. There is, however, growing evidence that some of heterozygosity-fitness correlations (HFCs) can be explained by 'local effects', where noncoding loci are at linkage disequilibrium with functional genes. The aim of this study was to investigate correlations between heterozygosity at seven microsatellite loci and two fitness-related traits, nestling growth rate and nutritional condition, in a recently bottlenecked population of great cormorant Phalacrocorax carbo sinensis. We found that heterozygosity was positively associated with both nestling traits at the between-brood level, but the individual (within-brood) effects of heterozygosity were non-significant. We also found that only one locus per trait was primarily responsible for the significant multi-locus HFCs, suggesting a linkage disequilibrium with non-identified functional loci. The results give support for 'local effect' hypothesis, confirming that HFCs may not only be interpreted as evidence of inbreeding and that genetic associations between functional and selectively neutral markers could be much more common in natural populations than previously thought.

A European Concern? Genetic Structure and Expansion of Golden Jackals (Canis aureus) in Europe and the Caucasus.

In the first continent-wide study of the golden jackal (Canis aureus), we characterised its population genetic structure and attempted to identify the origin of European populations. This provided a unique insight into genetic characteristics of a native carnivore population with rapid large-scale expansion. We analysed 15 microsatellite markers and a 406 base-pair fragment of the mitochondrial control region. Bayesian-based and principal components methods were applied to evaluate whether the geographical grouping of samples corresponded with genetic groups. Our analysis revealed low levels of genetic diversity, reflecting the unique history of the golden jackal among Europe's native carnivores. The results suggest ongoing gene flow between south-eastern Europe and the Caucasus, with both contributing to the Baltic population, which appeared only recently. The population from the Peloponnese Peninsula in southern Greece forms a common genetic cluster with samples from south-eastern Europe (ΔK approach in STRUCTURE, Principal Components Analysis [PCA]), although the results based on BAPS and the estimated likelihood in STRUCTURE indicate that Peloponnesian jackals may represent a distinct population. Moreover, analyses of population structure also suggest either genetic distinctiveness of the island population from Samos near the coast of Asia Minor (BAPS, most STRUCTURE, PCA), or possibly its connection with the Caucasus population (one analysis in STRUCTURE). We speculate from our results that ancient Mediterranean jackal populations have persisted to the present day, and have merged with jackals colonising from Asia. These data also suggest that new populations of the golden jackal may be founded by long-distance dispersal, and thus should not be treated as an invasive alien species, i.e. an organism that is "non-native to an ecosystem, and which may cause economic or environmental harm or adversely affect human health". These insights into the genetic structure and ancestry of Baltic jackals have important implications for management and conservation of jackals in Europe. The golden jackal is listed as an Annex V species in the EU Habitats Directive and as such, considering also the results presented here, should be legally protected in all EU member states.

Expression of MMP-9 and VEGF in meningiomas and their correlation with peritumoral brain edema.

Meningiomas constitute up to 13% of all intracranial tumors. The predictive factors for meningioma have not been unambiguously defined; however some limited data suggest that the expression of matrix metalloproteinases (MMPs) and vascular endothelial growth factor (VEGF) may be associated with the presence of peritumoral brain edema (PTBE) and worse clinical outcome. The aim of this study was to analyze the expressions of MMP-9 and VEGF in a group of meningiomas of various grades and to study associations between these two markers and PTBE. The study included patients with supratentorial meningiomas. The patients were divided into low- (G1) and high-grade meningiomas (G2 and G3). PTBE was assessed on MRI. The expressions of VEGF and MMP-9 were determined immunohistochemically. The expression of MMP-9 was observed significantly more often in G3 meningiomas than in lower grade tumors. The presence of stage II or III PTBE was associated with a significant increase in MMP-9 expression. The expression of VEGF did not differ across the PTBE stages. Our findings point to a significant role of MMP-9 and VEGF in the pathogenesis of peritumoral brain edema in low- and high-grade meningiomas.

Influence of smoking cigarettes on cerebral blood flow parameters.

INTRODUCTION: While chronic cigarette smoking can lead to increased risk of stroke, the acute effects of smoking have not been established. We studied the changes in blood flow parameters in the major cerebral arteries caused by smoking one cigarette. METHOD: Using transcranial color-coded sonography (TCCS), we studied the anterior cerebral artery (ACA), middle cerebral artery (MCA), posterior cerebral artery (PCA), and the internal carotid artery (ICA) of 36 healthy male volunteers before and after they smoked one cigarette. RESULTS: Blood flow velocity increased to a different degree in all but one of the arteries examined after participants smoked a single cigarette: The end diastolic velocity increased significantly by 7.8% in the PCA, 8% in the ACA, and 14.4% in the MCA. The peak systolic velocity increased significantly by 7.5% in the MCA. Blood flow velocity remained unchanged in the ICA only. Blood pressure and heart rate increased as did the flow velocity ratio for the MCA/ICA. The pulsatility index decreased after smoking from 0.92 ± 0.13 to 0.87 ± 0.14 in the MCA, 0.93 ± 0.15 to 0.87 ± 0.13 in the ACA, and 0.95 ± 0.17 to 0.89 ± 0.16 in the PCA. CONCLUSIONS: The results suggest that the direct effect of smoking on cerebral circulation includes peripheral vasodilatation with possible constriction of the main trunk of the basal cerebral arteries.

Endoscopic drainage of orbital abscesses aided with intraoperative sonography.

BACKGROUND AND PURPOSE: Accurate localization and adequate visualization of the superiorly or inferiorly located subperiosteal orbital abscesses or intraorbital abscess is difficult with transnasal endoscopic approach. Sonography is a well-known and effective tool for evaluation of orbital pathologies but no paper documenting intraoperative application of this method in orbital abscess surgery has been published to date. MATERIAL AND METHODS: We present a series of 12 patients in whom orbital abscesses were drained endoscopically with an aid of neuronavigation and intraoperative ultrasonography. The abscesses were localized subperiosteally in the medial (n=6), superior (n=2) or inferior (n=1) part of the orbit whereas in 3 patients the abscess was localized in the intraconal space. RESULTS: According to intraoperative sonographic imaging complete drainage of the abscess was achieved in 11 out of 12 patients and no complications occurred. Intraoperative sonography helped to limit opening of the orbital wall in the medial subperiosteal abscesses, enabled check-up for completeness of drainage of the far extending pouches in the superior and inferior subperiosteal abscesses and enabled visualization of the tip of surgical instrument when reaching deeply located intraorbital abscesses. CONCLUSIONS: Intraoperative ultrasonography facilitates the endoscopic management of orbital abscesses, especially those which are difficult to reach due to subperiosteal location in the superior and inferior parts of the orbit, or abscesses localized intraorbitally.

The activity of alcohol dehydrogenase (ADH) isoenzymes and aldehyde dehydrogenase (ALDH) in the sera of patients with brain cancer.

Human brain tissue contains various alcohol dehydrogenase (ADH) isoenzymes and possess also aldehyde dehydrogenase (ALDH) activity. In our last experiments we have shown that ADH and ALDH are present also in the brain tumour cells. Moreover the activities of total ADH and class I isoenzymes were significantly higher in cancer tissue than healthy cells. It can suggests that these changes may be reflected by enzyme activity in the serum of patients with brain cancer. Serum samples were taken for routine biochemical investigation from 62 patients suffering from brain cancer (36 glioblastoma, 26 meningioma). For the measurement of the activity of class I and II ADH isoenzymes and ALDH activity, the fluorometric methods were used. The total ADH activity and activity of class III and IV isoenzymes were measured by the photometric method. A statistically significant increase of class I alcohol dehydrogenase isoenzymes was found in the sera of patients with brain cancer. The median activity of this class isoenzyme in the patients group increased about 24 % in the comparison to the control level. The total alcohol dehydrogenase activity was also significantly higher (26 %) among patients with brain tumour than healthy ones. The activities of other tested ADH isoenzymes and total ALDH were unchanged. The increase of the activity of total ADH and class I alcohol dehydrogenase isoenzyme in the sera of patients with brain cancer seems to be caused by the release of this isoenzyme from tumour's cells.

Blood flow velocity in the middle cerebral artery during transnasal endoscopic skull base surgery performed in controlled hypotension.

BACKGROUND AND PURPOSE: To assess blood flow velocity in the middle cerebral artery (MCA) during transnasal endoscopic procedures performed with decreased hemodynamic parameters. MATERIALS AND METHODS: In 40 patients who underwent endoscopic skull base surgery in controlled hypotension (studied group) and in 13 patients operated without reduction of hemodynamic parameters (control group), blood flow velocity in MCA was assessed with transcranial color Doppler sonography. RESULTS: Blood flow velocity in MCA remained within the range of age-specific reference values in all patients before operation. It decreased significantly in both groups after induction of anesthesia and then dropped even further in studied group of patients when hemodynamic parameters were reduced; the systolic velocity fell below the normal reference values in 25% of patients, the mean velocity in 50% and the diastolic velocity in 57% of patients. The diastolic velocity was much more heavily influenced by diminished hemodynamic parameters than systolic velocity in the studied group as opposed to the control group where reduction of blood flow velocity pertained equally systolic and diastolic velocity. CONCLUSION: During transnasal endoscopic procedures performed in moderate hypotension, in addition to significant drop of blood flow velocity to values well below the normal reference range, a divergent reduction of systolic and diastolic velocity was detected. Since divergent systolic and diastolic velocity may indicate an early phase of cerebral autoregulation compromise, and the decrease of mean blood flow velocity in MCA corresponds with a decrease of cerebral blood flow, further investigations in this field seem warranted.