Pelvic pain, free fluid in pelvis, and human chorionic gonadotropin serum elevation: recurrence of malignant ovarian germ-cell tumor or early pregnancy?

Conservative treatment of metastatic germ-cell tumor of the ovary does not exclude the possibility of pregnancy in the future. Serum beta-human chorionic gonadotropin (beta-hCG) serves as pregnancy test, and has also been proven to be a useful marker for ovarian germ-cell tumors. This paper is a case report of a 19-year-old patient who was admitted to a district hospital in emergency due to pelvic pain, amenorrhoea, and free fluid in the pelvis. Laboratory tests demonstrated slight increase in beta-hCG serum concentration and transvaginal ultrasound (TVUS) showed no evidence of gestational sac in the uterus. At the age of 14, the patient was diagnosed with malignant germ-cell tumor of the left ovary in FIGO Stage IV and was treated with four courses of chemotherapy according to TGM-95 protocol with etoposide, ifosfamide, and cisplatin, followed by conservative surgery and adjuvant two courses of cytostatics. The initial diagnosis was recurrence of ovarian malignancy and the patient was referred to an oncology center. Wait-and-see approach and repeated ultrasound examination confirmed a normal intrauterine pregnancy which concluded with the delivery of a healthy newborn through cesarean section.

Is hypothermia a benefit? Von Willebrand factor in pediatric cardiopulmonary bypass.

AIM: The use of cardiopulmonary bypass (CPB) is associated with the risk of development of postpump syndrome. Thrombocyte activation leads to microembolism, endothelial damage and necrosis with release of various substances, such as the von Willebrand factor (vWf). High levels of vWf increase the risk of postoperative complications and mortality. Our objective was to find a correlation between CPB and plasma levels of vWf in pediatric patients operated on for congenital heart defects. METHODS: Twenty patients with congenital heart defects (ventricular septal defect, atrial septal defect/partial anomalous pulmonary vein drainage, Bland White Garland syndrome) were operated on with the use of CPB. The arterial blood was sampled after induction of anesthesia, 5 minutes after commencing CPB, 1 hour and 3 hours after surgery. The plasma levels of vWf were measured and compared to selected clinical findings. RESULTS: There was no early mortality. There were no significant differences in CPB and aortic cross clamp times when compared in patients with various defects. vWf plasma levels were significantly elevated in all patients 1 hour and 3 hours after surgery. We found no correlation between vWf levels and type of defect, CPB duration, aortic cross clamp as well as reperfusion time. However, we were able to demonstrate that the observed elevation of vWf levels was almost 4-fold higher in patients cooled down to lower temperatures (15 patients; mean rectal value 27.64+/-0.7 degrees C) than in 5 patients (mean rectal temperature 30.74+/-1.56 degrees C) where only slight elevation was found. There were no differences in the postoperative course of these patients. All patients were discharged from hospital 10+/-3 days after operation (mean value 9 days). CONCLUSIONS: vWf plasma levels are significantly elevated after pediatric hypothermic CPB. It seems that the augmentation of vWf values could be independently associated with rate of hypothermia.

Inhibitory effect of shark liver oil on cutaneous angiogenesis induced in Balb/c mice by syngeneic sarcoma L-1, human urinary bladder and human kidney tumour cells.

The effect of shark liver oil on cutaneous angiogenesis induced in mice by intradermal grafting of tumour cells was evaluated. It was shown that this substance (Ecomer) suppressed neovascular response in mice grafted with sarcoma L-1 syngeneic cells, human kidney cancer and human urinary bladder cancer cells. In addition, strong stimulatory effect of this drug on mice blood granulocyte number and their metabolic activity was observed.

The influence of protease inhibitor on the progress of bronchial asthma.

Trasylol in a single dose 100000 i.u. was administered intravenously to 22 patients suffering from bronchial asthma. Pulmonary function was evaluated by the subjects self-comfort, physical examination, spirometric measurements (VC, FEV1, FEV1%, MCBind.) and blood gas analysis (pH PCO2, PO2, SaO2). In half of the patients after Trasylol administration, a diminished dyspnoea and bronchospasm were observed. Analysis of blood gases indicated some decrease of PCO2, and an increase of PO2 and pH. In spirometric study no statistically significant differences, either before or after Trasylol administration, were noticed. Trasylol treatment may be applied for asthmatic patients especially those with severe disturbances in gas exchange.

T and B lymphocytes in patients with steroid-dependent bronchial asthma during long-term treatment.

Since corticosteroids are known to be a potent factor redistributing the peripheral blood lymphocytes to other body compartments, we estimated the sub-populations of T and B lymphocytes in peripheral blood of steroid dependent asthma patients. In twenty steroid-treated asthma patients and eighteen healthy blood donors the percentage and absolute number of lymphocytes forming spontaneous rosettes with sheep red blood cells ("early" and "late" T lymphocyte marker) and mouse red blood cells (B lymphocyte marker) were determined. The asthma patients were treated with 40 or 60 mg of triamcinolone acetonide (Kenalog) i.m. for at least one year or more prior to the study. No statistically significant differences were observed in lymphocyte subpopulations between steroid-treated asthma patients and healthy blood donors.

Assessment of the VEGF, bFGF, aFGF and IL8 angiogenic activity in urinary bladder carcinoma, using the mice cutaneous angiogenesis test.

Development of new blood vessels in solid tumors depends on changes in equilibrium between angiogenic stimulators and inhibitors. Overexpression of angiogenic growth factors has been shown in bladder carcinoma. The 'mice cutaneous angiogenesis test' is a good method for assessment of the total angiogenic potential of bladder cancer tissue. The analysis of the levels of proangiogenic factors could be useful for the choice of properly directed angiogenesis inhibitors. The aim of our study was to investigate the influence of blocking some angiogenic factors on the angiogenic activity of bladder cancer tissue. Tumor tissue obtained from 12 patients with invasive bladder carcinoma was used. Cancer tissue homogenates were incubated in the presence of specific antibodies against VEGF, bFGF, Il-8 and aFGF. Cytokine levels were determined using the ELISA test. Cutaneous angiogenesis assay in Balb/c mice was performed to detect the angiogenic activity of the tumor tissue. VEGF, bFGF and Il-8 were present in all examined cancer tissues (aFGF level was not estimated). Cytokine concentration and angiogenic activity of bladder cancer tissue showed individual variation. There was no correlation between the cytokines content in tumor tissue and the ability of this tissue to induce angiogenesis. Absorption caused significant reduction in cytokines level. The reduction of angiogenic activity was observed in the cancer tissue of 1 patient after VEGF absorption, in 3 patients' tissue homogenates after incubation with anti-aFGF and in 2 patients' homogenates after bFGF absorption. There was no reduction of angiogenic activity after Il-8 absorption.

Lymphocyte mitogen-induced proliferation in patients with allergic rhinitis.

Lymphocytes play a central regulatory role in mechanisms contributing to impaired function of immune system in atopy. The aim of our study was evaluate the mitogen-induced proliferation of lymphocytes in a group of asymptomatic, seasonal allergic rhinitis patients. A highly significant lower mitogen-induced proliferation and, in contrast to other studies, significantly lower background proliferative activity of lymphocytes were found in the atopic persons, comparing to the controls. We concluded that the decreased mitogen-induced proliferation of lymphocytes observed in allergic patients reflects abnormal T cell function, which is due to the atopic status, and not only as it was believed to the antigen-induced lymphocyte activation.

Studies on stimulation and properties of antiglobulin antibodies. III. Antiglobulin antibodies with different specificity in patients with bronchial asthma complicated by suppurative catarrh of the respiratory tract.

Sera from 14 of 50 patients suffering from bronchial asthma complicated by suppurative catarrh of the respiratory tract contained antibodies to homologous and heterologous gamma-globulins. The findings were attributed to hyperimmunization causing changed in antigenic properties of antibodies. Antigenically altered antibodies can act as autoimmunogenic stimuli inducing an immune response manifested by the appearance of antibodies to autologous gamma-globulins and cross reacting with homologous and heterologous gamma-globulins.

Scoliosis: incidence and natural history. A prospective epidemiological study.

A prospective study was carried out of the incidence and natural history of adolescent idiopathic scoliosis in 26,947 students. Data were obtained on 1,122 students with idiopathic scoliosis. The incidence of idiopathic scoliosis was 4.5 per cent. The female-to-male ratio was 1.25:1.0 over-all, but the ratio varied directly with the severity of the curve--that is, 1:1 for curves of 6 to 10 degrees, and 5.4:1 for curves of more than 20 degrees. Progression of the curve was determined by a two-year follow-up of 603 patients. Progression was observed in 6.8 per cent of the students and in 15.4 per cent of the skeletally immature girls with scoliosis of more than 10 degrees at the initial examination. In 20 per cent of the skeletally immature children with curves of 20 degrees at the initial examination, there was no progression. Spontaneous improvement of the curve occurred in 3 per cent and was seen more frequently in curves milder than 11 degrees. Treatment was required in 2.75 students per 1,000 screened.

Growth and maturation of adolescents with idiopathic scoliosis.

The growth and maturation of 409 adolescents with idiopathic scoliosis was prospectively observed and analyzed. Growth of children with scoliosis did not appear to differ from that of their normal peers. However, when measurement of growth was corrected for skeletal age, the children with scoliosis were found to be taller and heavier. Both boys and girls with scoliosis were found to be taller and heavier. Both boys and girls with scoliosis showed a significant tendency for delay in skeletal age (P less than 0.0001), and the girls showed a significant tendency for a delay of puberty (P less than 0.0001). The late skeletal and sexual development observed for the entire series was even more apparent for the girls, for whom spinal curvature exceeded 20 degrees (P less than 0.0001). The authors urge that a menstrual history and a skeletal age determination be included in the initial examination of patients with scoliosis.

The effect of salbutamol treatment on the cellular immunity of the offspring of pregnant mice: spleen cell activity.

Preterm delivery is one of the greatest problems in obstetric care. One of the most commonly used treatments for high risk cases is salbutamol, a beta-2-adrenoceptor agonist. The aim of the present study was to determine if such treatment causes any changes in the neonatal immune system which should therefore be a concern in the care of the newborn. The experiments were performed on 4 to 5 or 6 to 7-week old female and male offspring of salbutamol-treated C3H/W inbred mice. In the first part of the study, the number of spleen cells, phenotypes and activity (phytohemagglutinin-induced proliferation, ability to induce local graft versus host reaction) were determined. We observed lowering of cell number and lowered proportions of cluster of differentiation (CD)3, CD4 and CD8 positive lymphocytes in spleens of progeny of salbutamol-treated mice. However, CD4+ to CD8+ ration was higher in the progeny of salbutamol-treated mothers than in the corresponding controls. In addition, reactivity to phytohemagglutinin and ability to induce local graft vs. host reaction were higher (popliteal lymph node test) or undisturbed (lymphocyte-induced angiogenesis test) in this group of mice.

Effect of antituberculous drugs, isoniazid, pyrazinamide and rifampicin, on chemiluminescence of the human polymorphonuclear leukocytes.

Luminol-dependent chemiluminescence (CL) was used to assay the effect of three antituberculous drugs [isoniazid (INH), pyrazinamide (PZA), rifampicin (RM)] on the production of reactive oxygen species (ROS) by polymorphonuclear leukocytes (PMN) isolated from blood of 5 healthy donors. Drugs were added directly to the medium in concentrations; INH 5 micrograms/ml, PZA 40 micrograms/ml, RM 7 micrograms/ml. These concentrations correspond to peak serum concentrations after usual doses. RM was found to inhibit FMLP (N-formyl-methionyl-leucyl -phenylalanine)-induced CL response of PMN, PZA did not influence the metabolic activity of neutrophils, and INH stimulated PMN CL.

Angiotensin-converting enzyme activity and angiomodulatory effects of sera in patients with diabetic retinopathy.

Aberrant neovascularization plays a crucial role in ocular complications in diabetic patients. Sera from these patients contain high levels of angiostimulatory factors, the most important of which is vascular endothelial growth factor (VEGF). Many authors have described elevation of angiotensin-converting enzyme (ACE) activity in the sera of diabetic patients. It is important to determine the possible relationship between these two phenomena. We studied ACE serum activity and VEGF concentrations in patients with type 1 and type 2 diabetes and retinopathy We also investigated the effect of their sera on cutaneous angiogenesis induced in mice by grafting healthy human mononuclear blood leukocytes. We found a negative correlation between the angiostimulatory effect and ACE level in the sera of patients with type 1 diabetes and no correlation between these two parameters in patients with type 2 diabetes. VEGF concentrations were lower and ACE activity was significantly higher in the sera of patients with type 1 diabetes than in the sera of those with type 2 diabetes.

Multiple effects of theobromine on fetus development and postnatal status of the immune system.

Caffeine and its active derivative, theobromine, are probably the most frequently ingested pharmacologically active substances. Considering their uninhibited transport via the placental barrier as well as immature enzymatic activities and metabolic pathways in embryos and infants resulting in the longer half-life of methyloxanthines and their accumulation, unrestrained uptake of these substances might result in noticeably more pronounced biological effects during pregnancy and the postnatal period. Our previous studies have shown that methyloxanthines are significant inhibitors of angiogenic growth factors production and angiogenesis itself. We have hypothesized that increased uptake of these substances might affect embryonal angiogenesis and, later in the postnatal period, maturation and functional activity of the offspring's immune system. The study was performed on 2-month-old Balb/c mice fed theobromine 2 or 6 mg/day during pregnancy and lactation. On day 18 of pregnancy the number and weight of embryos were assessed as was their tissue angiogenic activity, using the cutaneous angiogenesis assay. In the group of 4-week-old sucklings, body and spleen were weighed together with the trunk, and tail and limb length were measured. Six weeks after birth the splenocytes' mitogen-induced activity and their ability to induce graft-versus-host reaction as well as the humoral response to SRBC antigen were evaluated. Content of theobromine in the embryos' tissue was estimated by high liquid performance chromatography (HPLC). Theobromine feeding resulted in significant inhibition of embryo growth as assessed by their weight and decreased angiogenic activity of their tissue. The theobromine content in embryo tissue from treated groups was higher than in the controls, and the difference was close to significant. In the postnatal period the discrepancies in the treated 4-week-old group's development were also observed in the significantly shorter limbs in comparison to the controls. Moreover in the treated group of 6-week-old sucklings, considerable variations in the immune system's functional activity were registered as far as cellular and immune response were concerned. Respectively, the splenocytes' mitogen-induced proliferative activity was significantly suppressed while the graft-versus-host reaction was up-regulated, and the serum antibodies titer was elevated in correspondence to the observed spleen enlargement. We concluded that a theobromine-enriched diet affects progeny development in both prenatal and postnatal periods. Consequently, particular attention should be paid to the reduction of theobromine consumption, and most probably that of other methyloxanthines, during pregnancy and lactation.

Immunomodulatory effect of shikonin derivatives isolated from Lithospermum canescens on cellular and humoral immunity in Balb/c mice.

The immunomodulatory activity of acetylshikonin (ACS) and isobutyrylshikonin (IBS) was studied in female and male inbred Balb/c mice, and in F1 hybrids (Balb/c x C3H). ACS and IBS were isolated from Lithospermum canescens Lehm. (Boraginaceae) roots. Splenocytes from mice fed 40 microg of ACS had higher proliferative potential in cultures with PHA than corresponding controls and also higher migratory in vitro activity than splenocytes obtained from control animals. ACS at a 40 microg daily dose stimulated G-v-H reaction but inhibited it at a 200 microg dose. IBS at a 40 microg dose significantly increased humoral response.

[Circulating immune complexes in hypertrophic cardiomyopathy and ischemic heart disease]. / Krazace kompleksy immunologiczne w kardiomiopatii przerostowej i chorobie niedokrwiennej serca.

In 32 patients (pts) with hypertrophic cardiomyopathy (HC), 20 pts with ischaemic heart disease (IHD) and 30 healthy controls, the levels of circulating immune complexes (CIC), immunoglobulins A, G and M, C3c and C4 components of the complement, as well as haemolytic activity of the complement were measured. CIC were assessed using two different methods: a) precipitation with 3% polyethylene glycol with subsequent spectrophotometric measurement of protein content in the precipitate, and b) binding with J-125 labelled staphylococcal +protein ++ A. Pts with HC showed a statistically significant increase in concentration of IgM and the immune complexes (shown with both methods) together with a decrease in C4 and hemolytic activity of the complement. In addition an analysis carried out for each individual patient showed that in some cases an increase in immune complexes concentration was paralleled by a decrease in IgG, C4 and haemolytic activity of the complement. This may suggest that in these pts activation of the complement through the classical pathway can occur. In pts with IHD an increase in immune complexes concentration was demonstrated by precipitation method only. Immune globulines and complement components were within limits for the control group. This suggests that in IHD the complement system is not engaged. Our findings indicate that in HC mechanisms other than those present in myocardial ischaemia must be engaged in inducing changes in the immune system.

The influence of Eleuterococcus senticosus on cellular and humoral immunological response of mice.

The influence of Eleuterococcus senticosus on cellular and humoral immune response was evaluated. The experiments were performed on animal models (Balb/c mice and F1 crossbreeds Balb/cxC3H). It was shown that Eleuterococcus has immunomodulatory properties. This substance enhanced the cellular response of the mouse immunological system (chemokinetic activity of mice spleen cells, GvH reaction). A stimulatory effect of Eleuterococcus on the humoral response (antibody production) was also observed. Eleuterococcus did not augment the angiogenic activity of human renal carcinoma cells.

Inhibitory effect of Greenland shark liver oil combined with squalen and arctic birch ashes on angiogenesis and L-1 sarcoma growth in Balb/c mice.

Sharks have been claimed to be resistant to cancer and oil from their livers have been used in Scandinavian folk medicine as anti-tumor drug. Shark liver oil contains 40% or more of squalene. Fish liver oil is also rich in squalene and polyunsaturated n-3 fatty acids. The aim of this work was to determine the anti-angiogenic and anti-tumor effects of these substances, together with another Scandinavian traditional remedy--arctic birch ashes--in Balb/c mice after transplantation of syngeneic L-1 sarcoma. All substances tested, alone or in combinations, significantly diminished cutaneous angiogenesis induced by tumor cells, and tumor growth.

Chocolate feeding of pregnant mice influences length of limbs of their progeny.

UNLABELLED: We previously reported the inhibitory effect of various methyloxantines and phenolic compounds on tumor-induced angiogenesis and the production of angiogenic growth factors. The aim of the present work was to evaluate the effect of chocolate (CH), food containing substantial amounts of methyloxantine theobromine and polyphenols (mainly catechins), given to mice during pregnancy and the lactation period, on weight of organs, length of limbs, and bone vascular endothelial growth factor (VEGF) concentration (tested by ELISA), in 4-week old offspring. The study was performed on 2-month old Balb/c mice fed during pregnancy and lactation 400 mg of CH daily. Content of polyphenols (catechines) and theobromine in the chocolate was estimated by high liquid perforance chromatography (HPLC). Concentration of VEGF was tested by ELISA. Feeding pregnant mice chocolate produced the following effects: decrease of relative length of limbs and thigh bones in 4-week old progeny and decrease in VEGF content of offspring femoral bones. CONCLUSION: attention should be paid to possible unwanted effects of catechine- and methyloxantine-rich food and beverages during pregnancy and lactation. 200 mg of chocolate per mouse corresponds to 100 g per person.

[Evaluation of bone loss in postmenopausal women during the first 5 years after menopause]. / Ocena utraty tkanki kostnej u kobiet w ciagu pierwszych 5 lat po menopauzie.

Aim of the trial was estimation of the degree of bone loss in first 5 years of menopause. 184 postmenopausal women were evaluated. Bone status was assessed by using quantitative ultrasound. Both parameters decreased in term of 1-5 years of menopause, what was especially expressed in first 2-3 years of menopause. Densitometric values were lower in comparison to British, French and Japan women population. Also dynamic of bone loss was greater in Polish women population. Results confirm necessity of early prevention of osteoporosis in postmenopausal women.