Urinary lysosomal enzyme excretion in pregnant women with hypertensive disorders.

BACKGROUND: The authors assessed proximal renal tubular dysfunction and/or damage in pregnant women with various types of hypertension by measuring the three urinary lysosomal enzyme levels: N-acetyl-ß-d-glucosaminidase (NAG), arylsulfatase A and ß-glucuronidase. METHODS: The study consisted of 120 pregnant women divided into four groups: 41 women in 20th week of gestation or more, with pregnancy-induced hypertension (PIH group), 28 pregnant women after 20 weeks of pregnancy with pre-eclampsia (PE group), 21 pregnant women with chronic hypertension, identified before 20th week of pregnancy (CH group) and 30 healthy, pregnant women (healthy controls (HC) group). RESULTS: Statistical analysis showed significantly higher levels of all the three of lysosomal enzymes in the urine of patients with PE compared with the healthy pregnant women, pregnant women with PIH and the ones with chronic hypertension. Additionally, significantly higher values of NAG were found in the group of pregnant women with PIH compared with healthy pregnancies. No correlation was found between the concentration of enzymes in urine and values of blood pressure in any of the analyzed groups of pregnant women. CONCLUSIONS: The authors conclude that higher values of all the studied enzymes in PE group, in the comparison with the other groups, indicate proximal tubular damage at the cellular level. The lack of correlation between the concentration of lysosomal enzymes and blood pressure suggests that the damage to these parts of kidney is complex. In addition, mechanisms other than hypertension realizing intracellular enzymes may be involved in this process.

Association of common WRAP 53 variant with ovarian cancer risk in the Polish population.

Among many alterations within the TP53 gene the rs1042522 (C72G, p.Pro72Arg) has been associated with numerous cancers , however the results differ between populations for opposite Pro or Arg alleles. Similar thus inconclusive results are observed in ovarian cancer, which may suggest that the rs1042522 does not influence ovarian carcinogenesis directly, but might be linked to another pathogenic alteration. WRAP53 which overlaps the TP53 is required to maintain normal levels of p53 upon DNA damage, but also when altered may independently increase the risk of cancer. To evaluate the association between three SNPs located in WRAP53-TP53 region: rs1042522, rs2287497, rs2287498 and ovarian cancer risk in Polish population we genotyped 626 cases and 1,045 healthy controls. Our results provide the evidence for an association between studied SNPs and a risk of invasive ovarian cancer in Poland. We found that CC homozygotes in rs1042522 were more frequent in cancers when compared to controls (OR = 1.46, p = 0.03). Similarly in WRAP53 both TT homozygotes in rs2287497 (OR = 1.95, p = 0.03) and AA homozygotes in rs2287498 (OR = 2.65, p = 0,01) were more frequent among cases than healthy individuals. There is also a suggestive evidence that specific homozygosity of studied SNPs in TP53-WRAP53 region is significantly overrepresented in ovarian cancer patients. In conclusion SNPs in WRAP53 (rs2287497 and rs2287498) have stronger association with an ovarian cancer risk than rs1042522 in TP53.

Maternal plasma lipopolysaccharide binding protein (LBP) concentrations in pregnancy complicated by preterm premature rupture of membranes.

OBJECTIVES: To compare maternal plasma LBP concentrations in pregnancies complicated by preterm premature rupture of membranes (pPROM), and PROM at term, with their levels in uncomplicated pregnancy, and to determine whether LBP concentrations are of value in the diagnosis of subclinical intra-amniotic infection (IAI) in the prediction of the length of the pPROM-to-delivery interval, and in the prediction of neonatal congenital infection. STUDY DESIGN: Thirty-one patients with pPROM, 35 with PROM at term, 33 healthy women at preterm gestation and 35 healthy women at term were included. In the pPROM group, analysis of maternal plasma LBP concentrations with reference to leukocytosis, C-reactive protein, vaginal fluid culture, neonatal infection and pPROM-to-delivery interval was carried out. RESULTS: LBP concentrations in the four studied groups were comparable. Although in 58.1% of pPROM cases at least one laboratory parameter of infection was observed, the only difference concerned the subgroup with CRP above 10mg/L, in which LBP concentrations were higher. Comparison of LBP concentrations in patients delivered within 24 and 72h of pPROM and after these times showed no differences, or between patients who gave birth to newborns with and without congenital infection. The predictive values of these measurements were poor. CONCLUSION: The predictive value of maternal LBP determinations in the diagnostics of pPROM cases suspected of IAI is unsatisfactory. LBP measurements performed shortly after pPROM, are not of value either in the prediction of newborn's infection, or in the prognosis of latency period duration.

Retroperitoneoscopic ureterocutaneostomy as a method of urinary diversion in case of complicated urinary fistula after radiotherapy.

The case of 71-year-old woman with massive vesicovaginal and recto-vaginal fistula after radiotherapy treated with bilateral laparoscopic ureterocutaneostomy is presented. A retroperitoneoscopic access was applied. The technical aspects of the procedure are described. The interdisciplinary character of this not so rare problem is underlined. In our opinion this kind of procedure may be considered as a valuable alternative for commonly used methods of urine deviation.

Radiotherapy versus radiochemotherapy with cisplatin in treatment of cervical cancer.

AIM: To compare effects of concomitant radiochemotherapy (RCTh) and radiotherapy (RTh) alone in patients with cervical carcinoma and with 36-months follow-up analysis. MATERIAL AND METHODS: 106 stage IIA-IVA cervical carcinoma women were divided in two groups. RCTh group was treated with teleradiotherapy (50.4 Gy/T), intracavitary brachytherapy (46 Gy), and iv cisplatin (40 mg/m(2)). RTh group was treated with pelvic teletherapy (52-54 Gy/T) and intracavitary brachytherapy (50-55 Gy). RESULTS: In RCTh group absorbed radiation dose was significantly lower (50.4 vs. 52.7 Gy) and the duration of treatment was significantly shorter (45.1 days vs. 47.8 days). There were no statistical differences in both groups in survival (59% in RCTh group vs. 56% in RTh group), response to treatment (86% vs. 90%), local recurrence (42% vs. 49%) metastasis occurrence (21% vs. 17%), anemia (40% vs. 26%), early postradiation reactions in intestines (77% vs. 65%) and bladder (71% vs. 61%) as well as in incidence of rectovaginal (10% vs. 4%) and vesicovaginal formation of fistulas (6% vs. 4%), respectively. There were significant differences between two groups in: nausea (77% vs. 6%), vomiting (65% vs. 3.7%), leucopenia (69% vs. 26%) and thrombocytopenia (35% vs. 9%), and late postradiation bladder effects (94% vs. 74%). RCTh patients with anemia had lower 36-months survival rates (42% vs. 71%), more frequent local recurrences (77% vs. 31%) and metastasis-free survival rates (61% vs. 90%) than RCTh patients without anemia. CONCLUSIONS: RCTh gives better treatment results in patients without than in patients with anemia and higher overall survival rates than RTh in patients without anemia. The only clinical prognostic factor for advance cervical carcinoma is the clinical stage of the disease.

[An analysis of factor influencing the outcome of patients with locally advanced larynx cancer]. / Analiza czynników rokowniczych u chorych z miejscowo zaawansowanym rakiem krtani.

PURPOSE: Results of treatment of locally advanced larynx cancer T3-4No-4 are unsatisfied. The aim of study is analysis of risk factors. METHODS AND MATERIALS: 112 patiens with larynx cancer after radical surgical treatment had postoperative radiotherapy (conventional or accelarated). RESULTS: The 3-year overall survival (OS) was 58%. Margin status and numer of risk factors had impast on OS. The 3-year locoregional control (LRC) was 80%. Number of risk factors, level of hemoglobin, overall tratment time and dose were significantly associated with LRC. Incidence of distant metastases was asssociated with G3 suamous cell carcinoma and index of nalignancy H. Glanz.

[Estimation of treatment results and side-effects in patients with invasive uterine cervix cancer stage IIB-IVA treated with concurrent radiochemotherapy]. / Ocena wyników leczenia i odczynów popromiennych u chorych z inwazyjnym rakiem szyjki macicy w stopniu zaawansowania IIB-IVA leczonych skojarzona metoda radiochemioterapii.

PURPOSE: The aim of the study was a comparison between two treatment methods of uterine cervix cancer--concurrent radiochemoterapy (RT + CHTH) and radiotherapy (RT). The group of 106 patients, suffering from advanced uterine cervix cancer, was analysed. 52 patients underwent treatment with concomitant radiochemioterapy, while 54 patients only radiotherapy. The factors influencing treatment results were analysed. Analysis of overall survival, time to local relapse and time to distant metastasis were analysed. MATERIAL AND METHODS: An analysis was performed depending on deferent clinical parameters: stage, localization and diameter of the tumor, infiltration of vagina fornicis, depth and bilateral vs unilateral infiltration ofparametrials, anaemia, performance status and value of kerma. Occurence of early and late side-effects was analysed. RESULTS: Frequency of persisting tumor after treatment depended on stage, and kerma. It did not differ between groups. Analysis of overall survival, local relapse free-time and distant metastasis free-time showed no deference between groups. Radiochemotherapy gave better results in the group of patients without anemia. In multivariate analysis only stage showed to be an independent prognostic factor for risk of death, local relapse and distant metastasis. Side-effects (nausea, vomits, leucopenia, thrombocytopenia, early side effects from intestine and bladder; and late side effects from bladder) were observed more frequently in the group treated with radiochemotherapy; the difference was statistically significant. There was no difference between both groups in the frequency of recto-vaginal and vesicovaginal fistulas. CONCLUSIONS: 1. Radiochemotherapy compared with radiotherapy shows better results in patients with advanced uterine cervix cancer, if there is no anemia. 2. Radiochemotherapy increases the frequency of early and late side-effects, it could impact negatively the quality of life during and after treatment. 3. Stage of disease was the main prognostic factor in uterine cervix carcinoma, independently of the treatment scheme that was used.