The recurrent primary retroperitoneal liposarcoma.

AIM: Describe a patient with multiple recurrences of the primary recurrent liposarcoma. CLINICAL CASE: A 60-years-old man complained of weight loss (BMI 18.4) with a palpable huge retroperitoneal tumour, which displaced left kidney, and was confirmed on USG and CT. Laboratory examination showed anaemia and pathological blood tests. Chest X-ray initially showed a negative finding. A complete transperitonealy surgical extirpation of the tumour with left side nephrectomy was performed on June 28, 2007. The tumour mass weight was 1900 g. It was lying on the posterior face of the kidney in diameters 170x120x120 mm, completely capsulated by thin grey-pink capsula with peripheral fat tissue on the section grey-pink, lobulary shaped, in ¾ parts with central necrotic changes. Histopathologically was confirmed the primary dedifferentiated (non-lipogenous) liposarcoma low grade of malignancy. Nephrectomy specimen was confirmed as age related finding. There was no evidence of positives surgical margins. Despite oncological and surgical treatment, followed repeated recurrence with eight transperitoneal surgeries in the retroperitoneum and abdomen with extirpation of the metastases, left side hemicolectomy, splenectomy and repeated extirpation tumour metastases from abdomen and radix mesenterii. Last tumour weighed 2900 grams. Patient died on January 9, 2011, after the eight surgeries on multiorgans failure due to hemorrhagic shock and persistent atrial fibrilaton by cardiopulmonary insufficiency. As a speciality, he was treated without transfusion because as Jehovah´s witness he refused blood derivates. CONCLUSION: Despite complex surgical and oncological treatment, the prognosis in patient with recurrent liposarcoma was fatal (Tab. 1, Fig. 5, Ref. 50).

Significance of lymph node micrometastasis in pancreatic cancer patients.

UNLABELLED: BACKGROUND /AIMS: The present study deals with the significance of lymph node micrometastasis in the survival rate for pancreatic cancer patients. METHODS: Between January 2006 and December 2010 at the First Department of Surgery in Kosice, a prospective trial was done in which we investigated the survival rate after radical pancreatic resection. All negative lymph nodes removed during standard radical lymphadenectomy were subjected to immunohistochemical staining to detect occult micrometastasis. A comparison of the median survival rate in groups of patients with immunohistochemistry-positive and -negative lymph nodes was performed. RESULTS: Radical pancreatic resection with standard radical lymphadenectomy was performed on 64 pancreatic cancer patients. The median survival time was 15 months. Out of the 319 histopathologically negative lymph nodes (34 patients), 134 lymph nodes were classified as immunohistochemistry positive (21 patients). The median survival rate in the group of patients with immunohistochemistry-negative lymph nodes was 23 months, but in the group of patients with immunohistochemistry-positive lymph nodes it was 14 months. There was a statistically significant difference between these 2 groups of patients (p ≤ 0.01). CONCLUSION: The immunohistochemical examination of histopathologically negative lymph nodes can lead to positive lymph node detection. The presence of lymph node micrometastasis could predict the survival rate.

[Impact of postoperative complications on survival of patients with pancreatic carcinoma]. / Vplyv pooperacných komplikácií na prezívanie pacientov s karcinómom pankreasu.

INTRODUCTION: In spite of radical pancreatic resection and adjuvant therapy, the overall 5-year survival rate for patients with pancreatic cancer remains poor, ranging between 5% and 15%, with a median survival of 13 to 17 months. MATERIAL AND METHODS: Between January 2000 and December 2009, the prospective study was performed to indentify the presence of postoperative complications and to find their influence on survival rate in pancreatic cancer patients. RESULTS: Between January 2000 and December 2009, the radical pancreatic resection was performed for 102 patients suffer from pancreatic cancer, at the I. Department of Surgery University Hospital in Kosice. Pancreatoduodenectomies were performed in Child-Stulhofer modification in 59 patients, Whipple modification was performed in 31 patients, Waugh-Clagett in 2 patients, Traverso-Longmire in 2 patients, distal resection of pancreas was performed in 7 patients and one patient had made total pancreatectomy. The overall morbidity rate was 30.2% (31 patients) and mortality rate was 3.9% (4 patients). Specific (for pancreatic resection) complications were indentified in 26 patients, 25.3%. Non-specific complications were presented in 5 patients, 4.9%. Two intraoperative risk factors were found to be significantly associated with pancreatic leakage, small pancreatic duct size and soft texture of the remnant pancreas. The 5-years survival rate for patients with pancreatic cancer was in 5 patients, 4.9%, with median survival rate 15 months. In group of patients with postoperative complications median survival rate was 13 months, in group of patients without postoperative complications median survival time was 18 months. CONCLUSION: Long-term survival rate for pancreatic cancer patients is still low. The presence of postoperative complications had negative influence to survival rate in pancreatic cancer patients. Pancreatic leakage is the most afraid complications. Patients with a small pancreatic duct size or a soft pancreatic remnant were at high risk of pancreatic leakage.

[New options for pancreatic cancer diagnostics]. / Nové moznosti diagnostiky karcinómu pankreasu.

INTRODUCTION: The overall 5-year survival rate for patients with pancreatic cancer remains poor, ranging between 5% and 15%, with a median survival of 13 to 17 months. Looking for the new possibilities can identify early-stage pancreatic cancer patients. MATERIAL AND METHODS: The comparative study was performed at the I. Department of Surgery University Hospital in Kosice, between group of pancreatic cancer patients, whose were operated during 1. 1. 1996-31. 12. 2000 group A and during 1. 1. 2005-31. 12. 2009 group B. The survival rate was compared in all groups of patients and in group of patients in stages of pancreatic cancer. From 2007, there were started a trial, in which lymph nodes were observed using histopathological and immunohistochemical examination. RESULTS: In group A (1. 1. 1996-31. 12. 2000) were presented 29 patients, 5 years survival was investigated in two patients (6.8%), median survival rate was 14 months. In group B (1. 1.2005-31. 12. 2009) were presented 51 patients, no patient survival 5 years, median survival rate was 14 months. Between January 2007 and December 2009 one hundred and eight pancreatic cancer patients were treated at the I. Department of Surgery University Hospital in Kosice. The radical pancreatic resection and standard lymphadenectomy were performed in 36 patients. During standard lymphadenectomy there were found 19 patients with 119 negative lymph nodes by histopathological examination. These lymph nodes were examined by immunohistological examination, and there were found 37 lymph nodes as positive, in 6 patients. CONCLUSION: Patients in earlier stage of pancreatic cancer had better survival rates than in later stage of disease. Immunohistochemical examination of histopathologically negative lymph nodes can detect positive lymph nodes and early-stage pancreatic cancer patients can be identified.

[A rare complication following anastomosis suturing using a biofragmentable Valtrac anastomosis ring--a case review and literature overview]. / Zriedkavá komplikácia po sití anastomózy biofragmentilným prstencom Valtrac--kazuistika a prehl'ad literatúry.

The use of Valtrac Ring since 1985 has brought about the ability of easier anastomosis suturing and shortening of the operative treatment. As other methods, also Valtrac ring has its disadvantages. Authors present a case report of a complication previously not described in the literature. A 67 year old patient, after right hemicolectomy with ileotransversoanastomosis with the help of Valtrac due to adenocarcinoma, underwent a control colonoscopy six month after operation. Small polyps in colon sigmoideum, colon descendens and transverse were removed and a tissue stripe with ulceration was found during the examination. The bioptic sample was taken from this stripe. After the application of Fragmine, the patient had a massive enterorhagia, which was not even resolved by adrenaline per colonoscopy. The patient underwent re-resection of ileotrasversoanastomosis. A ring of tissue, created by circular necrosis in the place of seroserous connection of biofragmentile ring of both of the lumens, was found in the tissue sample. Stenosis of the anastomosis, dehiscence, bleeding and fistulation are described in the literature as the most common complications after Valtrac use. The incidence is comparable with complications during anastomosis sutured by hand. We would like to bring this extremely rare complication to the attention to all surgeons and gastroenterologists, who perform endoscopic examinations in patients after this surgical procedure.

[Mesenteric ischemia--late diagnosis or managed disease?]. / Mezenterická ischémia--neskoro rozpoznaná diagnóza, alebo zle liecené ochorenie?

AIM: Diagnosis and therapy of mesenteric ischaemia as the cause of an acute abdomen is a serious problem because of its 60-80% mortality. The study presents experience with diagnosis and therapy of this disease and it compares its results with those in the literature. MATERIAL AND RESULTS: Throughout the years 2000-2009, there were 39 patients surgically treated with mesenteric ischaemia (17 men, 21 women, the average age 73 I 9.43). 38.46% of patients underwent resection of small and large bowel, in 33.3% only a part of small intestinum was resected, and in two cases (5.13%), the resection was combined with the embolectomy of artery mesenteric superior. In 23.1% of patients, only an explorative laparatomy was performed, because of an extended affection. Four patients were reoperated (dehiscence of anastomosis, perforation of small bowel, dehiscence of the wound, enterocutaneous fistula). 23% of patients needed ventilation because of postoperative complications such as respiratory insufficiency, sepsis and heart failure. There was 53.8% mortality. The abdominal pain (79%), vomitus (61.5%) and subileus (35.9%) predominated in the clinical picture. Leucocyts were elevated in 58.97% of patients. X ray examination showed non specific findings, and ultrasonography has proven to be successful in 42.3% of cases. CONCLUSION: Mortality of patients is significantly increased by low success rate of the depictive methods, non-specific clinical picture, co-morbidity in elderly patients and by late arrival to hospital.

[Current diagnostic and treatment options in thyroid carcinoma]. / Súcasné moznosti diagnostiky a liecby medulárneho karcinómu stítnej zl'azy.

Authors evaluated a set of 1182 patients who underwent a surgery for thyroid disease at two workplaces--1st Surgery Clinic of L. Pasteur Teaching Hospital of Kosice and ENT Department of East-Slovak Oncology Institute, a. s. of Kosice during 5 year period from the point of view of Medullary Thyroid Carcinoma. Of the given number, 9 suffered a confirmed diagnosis of Medullary Thyroid Carcinoma. Incidence and treatment results conform to available publications. The most important elements for successful treatment are considered the early diagnosis and sufficient surgical treatment. The early diagnosis is in hands of GPs and endocrinologists and is the most important regarding the success of treatment. It is useful to direct the surgical treatment into Centres where--regarding rare occurrence, seriousness of disease and specific treatment--the optimum result may be achieved.

Elastin degradation within the abdominal aortic aneurysm wall--relationship between intramural pH and adjacent thrombus formation.

BACKGROUND: The natural history of abdominal aortic aneurysm (AAA) is wall remodelling potentially leading to a final rupture. The pathogenesis of AAA appears to be multifactorial. The aim of this pilot prospective study was to assess the relationship between the thickness of the thrombus within the abdominal aortic aneurysm, intramural pH and local elastin degradation. MATERIALS AND METHODS: The AAA size, intraluminal thrombus (ILT) morphology and location were evaluated in 206 consecutive patients. Thirty patients with large AAA (aortic diameter > or = 50 mm) and adjacent ILT with the thinnest part < or = 10 mm and thickest > or = 25 mm, measured in the region of the maximum diameter of AAA, were included for further study. During AAA surgery intramural pH measurements were performed and specimens taken from both thin thrombus-covered and thick thrombus-covered wall for computerized morphometric analysis. RESULTS: Mean intramural pH value was 7.21 +/- 0.18 for the wall covered by thick ILT and 7.64 +/- 0.10 for the thin one (P < 0.001). Computerized morphometric analysis demonstrated that elastin fibres in the thin thrombus-covered wall were decreased in size (for width--P < 0.0001, for length--P < 0.13), irregularly orientated (P < 0.000001) and the amount of fibres was reduced when compared to the wall covered by thick ILT (P < 0.0004). CONCLUSION: A strong relationship between intramural pH and elastin net destruction suggests that the local alkaline status within the thin thrombus-covered part of the aneurysm wall is contributing to the elastinolytic process.

[Chronic pancreatitis, indications for resection procedures and postoperative complications]. / Chronická pankreatitída, indikácie k resekcným výkonom a pooperacné komplikácie.

INTRODUCTION: During the past three decades, important advances in understanding of the pathophysiology of chronic pancreatitis improved results of major pancreatic resections. Besides Whipple procedure, Beger and Frey procedures are now frequently performed. MATERIAL AND METHODS: Between January 1996 and December 2005, the findings for 65 patients suffer from chronic pancreatitis were analyzed in this retrospective trial at the I. Department of Surgery University Hospital FN LP in Kosice. Short-term results were investigated, 30 days after surgery: pancreatic leak, billiary leak and leak from gastrointestinal anastomosis, hemorrhagic complications, delayed gastric emptying, intraabdominal absces. RESULTS: The overall mortality rate was 4.6% and morbidity rate was 36.7%. Specific (for pancreatic resection) complications were indentified in 15 patients (23%): pancreatic fistula in 4 patients (6.1%), intra-abdominal absces in 5 patients (7.7%), delayed gastric emptying in 4 patients (6.1%), intra-abdominal bleeding in one patient (1.5%) and trombosis of portal vein in one patient (1.5%). Non-specific complications were in 9 patients, 13%. CONCLUSION: An analysis of postoperative complications shows that type of pancreatic anastomosis as well as using Octreotid have no influence to pancreatic fistula. The texture of pancreas is main risk factor to develope pancreatic fistula. Incidence of postoperative complications depends on blood lose and using transfusion units.

[Laparoscopic proctocolectomy with ileal pouch-anal anastomosis]. / Laparoskopická proktokolektómia s ileo-pouch-análnou anastomózou.

INTRODUCTION: Proctocolectomy with ileal pouch-anal anastomosis (restorative proctocolectomy) became a method of choice in surgical treatment of familial adenomatous polyposis (FAP) and ulcerative colitis (UC) during last years. The improvement of laparoscopic technique in colorectal surgery permit to perform this operation by miniinvasive approach. PATIENTS AND METHOD: Authors present the informations about two patients (one with FAP and one with UC) in whom they perform the laparoscopic proctocolectomy with ileal pouch-anal anastomosis and protective loop ileostomy. RESULTS: Although authors present their first experiences with corresponding operating time (390 and 360 minutes), they noticed hopeful postoperative period with quickly return of bowel movement, early return of oral intake and rapid reconvalescence. They observed one postoperative complication--wound infection. The longer postoperative hospital stay (17 and 19 days) may be related to the consistent management of protective ileostomy and precise postoperative follow-up. CONCLUSION: Restorative proctocolectomy is possible to perform by miniinvasive approach having the adequate experiences with laparoscopic colorectal operations and open procedures for inflammatory bowel diseases. The more procedures experiences allow to consider the benefit of laparoscopic approach for patients.

[Patient quality of life following resection procedures for chronic pancreatitis]. / Kvalita zivota pacientov po resekcných výkonoch pre chronickú pankreatitídu.

INTRODUCTION: Surgical therapy for chronic pancreatitis is reserved for patients with intractable abdominal pain, complications of the disease, or suspected underlying carcinoma. For patients suffered from severe chronic pancreatitis, pancreatic resection can be performed safety with good postoperative results. MATERIAL AND METHODS: Between January 1996 and December 2005, the findings for 65 patients, suffer from chronic pancreatitis were analyzed in this retrospective trial at the I. Department of Surgery University Hospital FN LP in Kosice. There were investigated quality of life after pancreatic resection, using of analgetic medication, the presence of endocrine insufficiency, degree of pain relief, working ability, increase weight and BMI. RESULTS: There were investigated 44 patients, 5 patients died and 16 patients were lost to follow-up. There were pain relief in 93%, increase of BMI in 80%, working ability in 77%. Patients with no analgetic medication were in 61%, patients without readmission to hospital were in 91%. CONCLUSION: After pancreatic resection, in majority of patients were presented improvement of quality of life, decrease incidence of readmission and reoperation, increase ability to return work, decrease using of analgetics, increase weight and BMI.

Does glucose in dialysis fluid protect erythrocytes in patients with chronic renal failure?

BACKGROUND/AIMS: The aim of this study was to assess the multifaceted influence of glucose present in dialyzing fluid on erythrocytes of patients with chronic renal failure (CRF) undergoing regular hemodialysis. METHODS: A group of 44 subjects with CRF undergoing regular hemodialysis was studied. Two tests were used: osmotic fragility and resistance to the hemolytic agent saponin. The total content of isoprostane 8-iso-prostaglandin F2alpha type III (8-iPF2alpha-III) in plasma and erythrocyte's membrane were determined by the ELISA method. RESULTS: The presence of glucose in the dialysate is associated with lower intravascular hemolysis markers and high total 8-iPF2alpha-III concentrations in plasma. CONCLUSION: The presence of glucose in dialyzing fluid could protect erythrocytes. It limits hemolysis in patients with CRF, but, on the other hand, increases the oxidative processes. This kind of treatment along with other therapeutic intervention such as administration of antioxidants (e.g. alpha-tocopherol, ascorbic acid, N-acetylcysteine) could improve the condition of erythrocytes and outcome in CRF.

[The influence of laser irradiation with different power densities on incisional wound healing in healthy and diabetic rats]. / Vplyv laserového ziarenia rôznych intenzít na hojenie incíznych rán u zdravých a diabetických potkanov.

INTRODUCTION: The optimal parameters of low level laser therapy (LLLT) are still under debate. It has been documented that a dose or 5 J/cm2 would be capable to accelerate the wound healing process in patients. However, the optimal delivering form, i.e. power intensity, is unknown. Therefore, the aim of our study was to compare different power densities of LLLT. MATERIALS AND METHODS: Sixteen male Sprague-Dawley rats were included in this experiment and randomized into two groups, normal healthy group and streptozotocine induced diabetic group. In general anesthesia four full thickness skin incisions were performed under standard aseptic conditions on the back of each rat and immediately closed using intradermal running suture. Three wounds were stimulated with diode laser (wavelength: 635 nm; daily dose 5 J/cm2; power densities: 1 mW/cm2, 5 mW/cm2 and 15 mW/cm2) each with different power density while the fourth wound served as control. Six days after surgery animals were sacrificed and samples removed for histological evaluation. RESULTS: Our study demonstrated that LLLT positively influences wound healing. The most significant changes were observed in wounds stimulated at the highest power density 15 mW/cm2. Since using the highest power density the shortest time is needed to achieve the optimal daily dose of 5 J/cm2, it can be suggested that 15 mW/cm2 might be optimal parameter for such a therapy in patients.

The activity of erythrocyte sodium-proton exchanger in women with pregnancy- induced hypertension.

BACKGROUND: Hypertension that develops after 20 gestational weeks and is defined as pregnancy-induced hypertension (PIH). The main cause of PIH is vasoconstriction and the thickening of vascular media, which decreases vascular capacity and increases peripheral resistance. One of the theories postulated to explain this phenomenon is that a transmembrane sodium transport disorder causes an increase in intracellular sodium concentration. In the latest literature, special attention is paid to the role of the increased intracellular sodium concentration in the pathogenesis of essential hypertension (EH). One of the best documented phenotypes for EH is the increased activity of the sodium-proton exchanger (NHE). The aim of this study was to assess if increased NHE activity could be the mechanism responsible for the development of PIH. SUBJECTS AND METHODS: The study included 30 women: 10 pregnant women with PIH after gestational week 30, 10 women with physiological pregnancy after 30 gestational weeks, and 10 healthy non-pregnant women. NHE activity was determined according to Orlov's method as amiloride-sensitive H(+) efflux from acid-loaded cells. RESULTS: The NHE activity in the group of women with PIH was significantly higher than that in women with physiological pregnancy: 10.09 +/- 1.65 vs. 6.81 +/- 2.3 mmol/L RBC/h (p < 0.049) and in the group of non-pregnant women: 10.09 +/- 1.65 vs. 7.56 +/- 1.66 mmol/L RBC/h (p < 0.029). Erythrocyte NHE activity did not differ in the group of women with physiological pregnancy and in the group of non-pregnant women. CONCLUSION: These results seem to suggest that erythrocyte NHE activity is elevated in PIH pregnancies.

Ischaemic-reperfusion damage of tissue and critical limb ischaemia.

Recently, the quality of the critical limb ischaemia therapy (CLI) has evidently increased due to the development of the surgical techniques, material and endovascular methods. Most vascular surgeons, in their effort to help patients, advocate an active approach to re-vascularisation also in those patients who in the past had to undergo primary amputation. The fact that the best results of re-vascularisation are referred from large specialised centres cannot be contested. One of the expected causes of re-vascularisation failure (local or complex) is also ischaemic-reperfusion damage (IRD) of the tissue (Fig. 3, Ref 27).

[Effect of laser irradiation of diode laser on healing of surgical wounds in rats]. / Vplyv laserového ziarenia diódového lasera na hojenie chirurgických rán u potkanov.

The aim of this work was to continue in previous study, which concerns biostimulation of skin wound healing evaluated after 24, 48, 120, 168 hours and so complete the chronological continuance of the process during the first seven days. Male, Sprague-Dawley rats (n=21) were used for the experiment. The rats were divided into 3 groups of 7 animals. In general anaesthesia (combination of xylazine, ketamine and tramadol) under aseptic condition two 3,5 cm long parallel skin incisions were performed on the left and right side of the rats spine and immediately sutured. The left wounds were daily stimulated with the diode laser (670 nm). The right wounds were not stimulated and served as control. The specimens of skin wounds were removed for histological evaluation 72, 96 and 144 hours after surgery. The biological specimens were stained with hematoxylin and eosin and histopathologically evaluated. In summary, in our histomorphological study of the influence of laser irradiation on primary wound healing evaluated after 72, 96 and 144 hours was concluded, that the healing of stimulated wounds was accelerated in comparison with controls. The histological evaluation showed earlier regress of inflammatory phase, faster finishing of reepithelization and acceleration in maturation phase. Presented experimental study completes the previous study and achieves the positive effect of biostimulation on all phases of skin wound healing in vivo.

Exchange of unsaturated fatty acids between adipose tissue and atherosclerotic plaque studied with artificial neural networks.

The linoleic C18:2 (n-6) and linolenic C18:3 (n-3) are recognized as essential components of the diet. Free radical peroxidation of essential fatty acids (EFAs) present in lipoproteins produces oxidized low-density lipoproteins which play a critical role in the development of atherosclerosis. The accumulation of EFAs in the vascular wall and correlations between their content in the adipose tissue and atherosclerotic plaque have been confirmed. The present study was undertaken to determine the usefulness of a neural network for studying the exchange between tissues of linoleic, alpha-linolenic, and arachidonic acids-three fatty acids with a well-understood metabolism. Atheromatous plaques, adipose tissue, and serum were obtained from 31 patients who underwent surgery due to atherosclerotic stenosis of the abdominal aorta, iliac or femoral arteries. Fatty acids were extracted and separated as methyl esters using gas chromatography. Statistical analysis was done with STATISTICA neural networks package. Several correlations reported previously were corroborated and factors modifying the content of individual EFAs in adipose tissue and atherosclerotic plaque were revealed. Artificial neural networks (ANNs) were used to determine factors modifying the content of linoleic, alpha-linolenic, and arachidonic acids in human atheromatous plaques. The mechanism of exchange of some fatty acids between the adipose tissue, atheromatous plaque, and plasma is discussed. The results provide evidence for an effective mechanism of tissue uptake and turnover of linoleic acid. Reduced plasma levels of this acid are compensated by release from adipose tissue and atheromatous plaque. While alpha-linolenic acid is continuously taken up by the plaque, adipose tissue absorbs this acid to a certain level only. The dynamics of exchange of arachidonic acid between adipose tissue and atheromatous plaque reflects a minor role for adipose tissue in determining plaque content of this acid, suggesting that "de novo" synthesis is the chief source of arachidonic acid in plaques.

Adrenal myelolipoma. 6 cases and a review of the literature.

Adrenal myelolipoma is an uncommon, benign and hormonally inactive tumor. Most lesions are asymptomatic and usually are discovered incidentally at autopsy studies. Authors report on 6 patients (5 women, 1 man) with adrenal myelolipomas (5 right, 1 left), analyze their morphological findings and association with an adrenal hormonal overproduction. Five of the patients underwent surgery because of tumor size, in 3 of them histological evaluation confirmed myelolipoma and in 2 cases an adrenocortical adenoma with foci of myelolipoma. All the patients were asymptomatic and in 4 cases hormonal overproduction was not found. One female patient has oveproduction of dehydroepiandrosteron-sulphate (DHEAS) indicating a 3beta hydroxylase deficiency in this tumor and 1 patient has primary aldosteronism with a histological finding of an association of adrenocortical adenoma with foci of myelolipoma. Neither Cushings syndrome nor congenital adrenal hyperplasia were present in our group of patients.

Aldosterone-producing adenoma associated with foci of myelolipoma.

The simultaneous occurrence of adrenal myelolipoma and endocrine disorders is rare. Myelolipomas have occasionally been found in patients with Cushing's syndrome, pheochromocytoma and hyperthyroidism. A recently published study described one well-documented case of adrenal adenoma and myelolipoma in a patient with Conn's syndrome. In this report the patient had a one-year history of treated hyperthyroidism and diagnosed aldosterone-producing adenoma. A disseminated adrenal myelolipoma was found within the adrenocortical adenoma. To our knowledge this histological finding has not been previously reported in association with both Conn's syndrome and hyperthyroidism.

The influence of oxidative stress on permeability of capillary vessels in the cheek pouch of hamsters with alloxan-induced diabetes.

BACKGROUND: The aim of the study was to assess the influence of oxidative stress on the increase of permeability of capillary vessels in animals with alloxan-induced diabetes. MATERIAL AND METHODS: The studies were performed in microcirculation system of hamster cheek pouch. After the blockade of histamine receptors and administration of diamine oxidase (DAO) and histamine into circulation fluorescein angiography was done. In addition, the influence of superoxide dismutase, aminoguanidine (DAO inhibitor) and trascolan (protease inhibitor) on vascular permeability caused by superoxide radical generation in DAO/histamine system was assessed. RESULTS: The number of extravasal leakages in the group receiving HA and DAO was significantly higher (p < 0.001) than in the groups receiving potential vascular "sealers", e.g. SOD, aminoguanidine or trascolan. In the group receiving aminoguanidine the number of leakages was significantly lower (p < 0.05) compared to the group receiving SOD or trascolan. CONCLUSIONS: The protective effect of aminoguanidine, superoxide dismutase or trascolan decreasing the vascular permeability, suggests that the increased vascular permeability is a result of superoxide radical generation by diamine oxidase.