The influence of the low-energy defibrillating impulse on the endothelin-1 concentration in the left heart ventricle and blood serum of the healthy rabbits.

The influence of low-energy defibrillation on changes in the ET-1 levels in the myocardium and on disruptions in coronary blood flow and microcirculation being their consequence still remains unclear. Myocardial microcirculatory dysfunction is considered as a significant cause underlying myocardial dysfunction in post-cardiac arrest syndrome. This study is aimed at evaluating time-dependent changes in ET-1 levels in serum and the heart of a healthy rabbit following the application of a low-energy two-phase shock impulse. The research was conducted in 35 healthy rabbits at the age of 36 - 42 weeks and with body mass from 3200 to 4150 grams. The animals were divided in a randomized way into four groups depending on the dose of the electrical energy planned for the application during the experiment. The life parameters of the animals were monitored with the application of BeneView T5 patient monitor. The concentration of endothelin-1 in the groups was measured before, 15 and 360 minutes after the application of the low-energy double-phase straight-lined electrical impulse. A transthoracic low-energy defibrillation shock impulse causes a long-term increase in the endothelin-1 levels in the heart muscle and blood serum in a healthy rabbit. The increase in ET-1 levels results from the effect of electrical energy, independently of consequences of the ischemia/reperfusion injury. The increase in the endothelin-1 levels may lead to capillary blood flow abnormalities in the heart, contributing to the development of its dysfunction in the course of postresuscitation disease.

Impact of low-energy shock impulse on nitric oxide serum levels in healthy rabbits.

Nitric oxide (NO) has emerged as a potent effector molecule for a post-resuscitation disease as a result of the low-energy defibrillation. In this article, the authors anlysed the changes of endogenous nitric oxide levels in serum of 35 healthy rabbits after the transthoracic application of low-energy two-phase shock impulse. The animals were randomised into four groups according to the electrical energy dose to be applied during the experiment. Life parameters of the animals were monitored using the BeneViev T5 patient monitor. The nitric oxide concentration in the groups was measured before, 15 and 360 minutes after applying the low-energy two-phase linear electrical impulse. From 15 to 360 minutes the decrease in nitric oxide concentration was observed. The effect was dependent on single impulse and accumulated energy volumes. The highest decrease of NO concentration was observed in 15 minutes following the application of two electrical impulses of accumulated energy of 8 J/kg/bm. After 360 minutes following the application, a significant increase in nitric oxide levels was recorded. The changes in the nitric oxide levels in the blood serum 15 minutes after the defibrillation may initiate the vasomotor disorders as a result of the low-energy influence of the shock impulse.

Impact of sleeve gastrectomy on red blood cell aggregation: a 12-month follow-up study.

OBJECTIVE: To investigate the effects of weight loss due to laparoscopic sleeve gastrectomy (LSG) on erythrocyte aggregation and the relationship of anthropometric and plasmatic factors, such as plasma viscosity, fibrinogen and lipids, with erythrocyte aggregation. DESIGN AND SUBJECTS: The RBC aggregation and kinetics of the red blood cell aggregation were performed by the Laser-assisted Optical Rotational Cell Analyser (LORCA). Before the LSG and 6 and 12 months after the LSG, we evaluated the aggregation index (AI), amplitude (AMP) and aggregation half-time (t1/2), plasma viscosity, fibrinogen, glucose and lipids patterns in 15 non-diabetic obese subjects. RESULTS: The static and kinetic parameters of aggregation in obese patients at each time point after bariatric weight loss surgery were calculated and significant differences were observed at 12 months after surgery. AI and AMP decreased from 69.81±5.12% and 27.43±2.9 a.u. at baseline to 64.91±5.94% and 22.15±4.3 a.u. 12 months after surgery, respectively. The t1/2 increased from 1.7 (1.32-2.24) s at baseline compared with 2.02 (1.68-2.42) s at 12 months after the surgery. Plasma viscosity and fibrinogen decreased from 1.50±0.093 mPa s and 3.0±0.41 g l(-1) at baseline to 1.407±0.062 mPa s and to 2.66±0.25 g l(-1) 12 months after surgery, respectively. AI correlated positively with BMI (r=0.74, P=0.001), waist circumference (r=0.68, P=0.005), fibrinogen (r=0.52, P=0.045) and plasma viscosity (r=0.76, P=0.001) and negatively with percentages of weight lost after surgery (r=-0.54, P=0.034). Multivariate analyses found that the BMI, fibrinogen and plasma viscosity independently influenced the AI. CONCLUSION: The study demonstrated that weight loss due to restrictive bariatric surgery can beneficially affect red cell aggregation parameters. The improvement of the RBC aggregation behaviours among obese subjects with weight loss due to LSG was associated with changes in plasmatic factors, especially fibrinogen.

The influence of fatty acids on theophylline binding to human serum albumin. Comparative fluorescence study.

Theophylline, popular diuretic, is used to treat asthma and bronchospasm. In blood it forms complexes with albumin, which is also the main transporter of fatty acids. The aim of the present study was to describe the influence of fatty acids (FA) on binding of theophylline (Th) to human serum albumin (HSA) in the high affinity binding sites. Binding parameters have been obtained on the basis of the fluorescence analysis. The data obtained for the complex of Th and natural human serum albumin (nHSA) obtained from blood of obese patients qualified for surgical removal of stomach was compared with our previous studies on the influence of FA on the complex of Th and commercially available defatted human serum albumin (dHSA).

Expression and localisation of kinin receptors in colorectal polyps.

Kinins increase vascular permeability as well as mitogenesis and proliferation, hence they have a potential to promote neoplasmatic transformation. In the present study we investigated the expression profile and localization of kinin B1 and B2 receptors in colorectal polyps. The biopsy samples from various polyps were obtained during endoscopy in tubular (n=18), villous (n=15) and hyperplasic polyps (n=15). The expression of genes encoding B1 and B2 was estimated by QRT-PCR TaqMan analysis. In second series B1 and B2 receptors were visualized by immunohistochemical staining in tissue specimens from colonic polyps and adjacent normal tissue. We found the highest expression of gene encoding B1 in tubular adenomas (1891 number of copies mRNA/microg total RNA+/-312 SE) which is significantly higher as compared with controls (683+/-197 SE, p<0.013). In contrast, the expression of gene for B2 was significantly increased in hyperplastic polyps (3852+/-936 SE) as compared with controls (843+/-263 SE, p<0.0016). In normal colon a well as in hyperplasic polyps B1 and B2 receptors were immunohistochemically localized in enterocytes, however in hyperplastic polyps the intensity of staining was more prominent for B2 comparing to the control group. In contrast, in tubular adenomas staining reaction for B1 was more intense than in control samples. Increased level of B1 in adenoma suggests that kinins may play a role in abnormal cellular transformation; whereas higher B2 level in hyperplasic polyp suggests its protective role. Our data may indicate that the overall effect of kinins on cellular proliferation depends on the relative level of B1 and B2 receptor expression.

Gastroduodenoscopy: a routine examination of 2,800 patients before laparoscopic cholecystectomy.

BACKGROUND: Unrecognized gastric and duodenal peptic ulcer is a common cause of epigastric pains for patients with cholelithiasis qualified for laparoscopic cholecystectomy. Undiagnosed gastric or duodenal ulcer may be the cause of persistent pains after cholecystectomy. The purpose of the study was to assess the value of a routine preoperative panendoscopy for qualifying patients to undergo laparoscopic cholecystectomy. METHODS: The study enrolled 2,800 patients treated for cholelithiasis from May 1993 to December 2002. Endoscopic examination was performed for all treated patients 1 to 4 days before their operations. RESULTS: Preoperative endoscopy showed pathologic changes in the stomach or duodenum in 1,187 (42%) of 2,800 patients qualified for laparoscopic cholecystectomy. Gastric ulcer was found in 179 patients (6.4%) duodenal ulcer in 127 patients (4.5%), gastritis in 735 patients (26.3%), polyps in 143 patients (5.1%), and cancer in 3 patients (0.1%). The surgery was postponed for patients with ulcer, and antiulcer treatment was started. In 16 patients, the symptoms associated with cholelithiasis subsided after healing of the ulcer. Cholelithiasis in these patients was asymptomatic, and a cholecystectomy was not performed. CONCLUSIONS: Panendoscopy should be a routine examination performed for each patient qualified to undergo laparoscopic cholecystectomy. For some patients with asymptomatic cholelithiasis, pain in fact is caused by peptic ulcer.

On the holistic approach in cancer biology: tumor necrosis factor, colon cancer cells, chaos theory and complexity.

TNFalpha plays a role in the pathogenesis of septic shock, inflammatory diseases, autoimmune diseases, graft rejection reaction, acute, and chronic respiratory inefficiency among others. Its activity depends on the type of target cells and different regulating factors, but the effect of biological activity is conditioned by specific receptors such as p55 (type I, TNF R55) and p75 (type II, TNF R75). The aim of the study was to answer the following questions: 1) Is it possible to apply elements of non-linear dynamics to assess the level of expression of TNF, TNFRI, TNFRII genes in tumor cells, pathologically unchanged tissue and metastatically changed lymph nodes? 2) Is theoretically anticipated variability of cytokine and its receptors in colorectal carcinoma cells and the immediate vicinity justified in the developed mathematical model? The research material--specimens taken from tumor, unchanged tissue and metastatic lymph nodes--were histopathologically and molecularly analysed. Results of the molecular research were used to develop a mathematical model using the basic studies on the theory of chaos and biological system modelling.

Genetic disregulation of gene coding tumor necrosis factor alpha receptors (TNFalpha Rs) in colorectal cancer cells.

The expression of TNF ligand by malignant cells might be a mechanism for tumour immune escape. Genetic disregulation of gene coding TNF receptors was observed in neoplastic disease by an increased number of receptors on tumour cells and ligand-receptor activity. It might cause tumour proliferation and metastatic potential. Structure of TNF receptors influences TNF activity in vivo and structure of TNF R2 gene may suggest post-transcription modification based on alternative splicing. The aim of the study was to analyse the expression of gene coding TNF receptors R2 and R2/R7 (without exon 7) by estimation of mRNA expression of colorectal cancer cells in comparison with surrounding tissue free from neoplastic infiltration and searched for differently spliced TNFalphaR2/R7 isoforms. The study included fifty four patients with histopathologically confirmed adenocarcinoma (Stage III according to the AJC TNM Classification). Tissue samples removed from the tumour region were obtained from colorectal cancer patients undergoing surgical treatment. The samples were divided into two parts. The first one--was routinely examined histopathologically, the second one--was used for RNA extraction and the number of TNF and its receptors mRNA copies were subsequently quantified. The TNF and TNFRII genes expression were estimated based on the number of mRNA copies on 1 microg total RNA. The presence of TNFR2 and TNFR2/R7 isoforms in tumour, normal and metastatic cells was observed. The highest number of mRNA TNF copies and over expressed TNF genes were investigated and significantly noticed in metastatic cells (lymph nodes). The decreased number of TNFR2/R7 mRNA copies in metastatic lymph nodes secondarily influenced the decreased TNF soluble receptors' concentration. In conclusion, the genetic disregulation observed in neoplastic disease usually concerns dysfunction of cytokines receptor genes.

[Laparoscopic excision of huge spleen in a 5-year-old boy with hypersplenism]. / Laparoskopowe usuniecie olbrzymiej sledziony u 5-letniego chlopca z powodu hipersplenizmu.

Minimally invasive surgery has been recently gaining acceptance as an alternative to "open" surgery. The benefits of video-surgery consist of minor surgical trauma of tissues, shorter hospital stay, quicker return to full activity and better cosmetic effect compared to traditional splenectomy. Less peritoneal adhesions after laparoscopic splenectomy decreases also the risk of strangulation ileus in the future. Authors present laparoscopic splenectomy in 5 year-old boy with hypersplenism. Technical details, intraoperative difficulties, immediate and late outcome were described. The early results, advantages and disadvantages were also discussed.

[Palliative procedures in advanced stomach cancer]. / Zabiegi paliatywne w zaawansowanym raku zoladka.

Gastric carcinoma still occurs in the advanced form, despite easier availability of endoscopic examinations. Symptoms, location and the degree of progression of gastric carcinoma in 186 patients treated between 1980-1997 were presented in the paper. Curative partial gastrectomy was carried out in 69 patients. The palliative procedure of partial gastrectomy, gastroenterostomy shunt and trophic fistula was carried out 117 patients. Attention was paid to the most recent methods of treatment which, hopefully, improve the results of the treatment of advanced gastric carcinoma.