Decreased levels of PAI-1 and alpha 2-antiplasmin contribute to enhanced fibrinolytic activity in divers.

BACKGROUND: There are a number of reported cases of decompression sickness (DCS) with haemorrhages. These cases have not been sufficiently investigated and thus bleeding complications could not be directly correlated to the enhanced fibrinolysis. OBJECTIVES: The effect of hyperbaric exposition and decompression on the main components of fibrinolytic system has been measured. METHODS: Two groups of 25 male divers each were subjected to hyperbaric exposures to the pressure of either 400 kPa - group I - or 700 kPa - group II followed by a staged decompression. The divers were monitored for clinical symptoms of DCS and checked for Doppler-detected venous gas bubbles. Venous blood was drawn from divers before exposition and 15 min after decompression. The concentrations and activities of t-PA and PAI-1 as well as concentrations of PAP and alpha2-antiplasmin and activity of factor XIIa were measured. RESULTS: In all groups of divers no cases of DCS as well as detectable gas bubbles were noted. We observed elevated concentration of PAP, decreased concentration of alpha2-AP, decreased PAI-1 concentration and activity. There were no significant changes in factor XIIa activity as well as of t-PA concentration and activity. CONCLUSIONS: Hyperbaric exposition and decompression induce activation of fibrinolysis, even in the absence of detectable gas bubbles. Fibrinolytic activity increases mainly due to decrease of PAI-1 concentration and activity. Further clinical trials are necessary for the estimation of the importance of activation of fibrinolysis with decreased level of PAI-1 and alpha2-AP as a possible risk factor for bleeding in divers.

Ozonation of human blood increases sphingosine-1-phosphate in plasma.

Ozonated blood therapy is used in the treatment of several diseases, including superficial infections, burns, dental and intestinal conditions. Except that, the possibility of using ozone to sterilize blood supplies is under promising investigation. However, still little is known regarding the impact of blood ozonation, especially on biologically active serum sphinoglipids. In the present work we sought to investigate the contents of sphingolipids, such as sphingosine, sphingosine-1-phosphate (S-1-P), sphinganine, and ceramide (CER) in the plasma, after immediate and prolonged (1 h) ozonation of human whole blood. For the measurements liquid chromatography hyphenated with the mass spectrometry was applied. We demonstrated that only the content of sphingosine-1-phosphate in the plasma was increased significantly, possibly exerting its beneficial effect for various physiological and clinical events.

Phenotype of mast cells in the brain tumor. Capillary hemangioblastoma.

Mast cells (MC) are heterogenous cell population. In normal human brain they are not numerous. Increases in number of mast cells within CNS occur in certain disease states including neoplasms. In capillary hemangioblastoma several authors reported mast cells as a fourth cell type of the tumor. The aim of the present study was to examine phenotype and distribution of MC in cerebellar capillary hemangioblastoma by means of specific immunological markers. Study was performed on the tumor of ten affected individuals. Tumor specimens of seven cases were fixed in formalin and embedded in paraffin wax. Additional three tumours were fresh-frozen samples. Mast cells were identified with two monoclonal antibodies generated against tryptase and chymase. In all capillary hemangioblastomas mast cells were numerous exclusively in the tumor mass and only occasionally found in adjacent or far from the tumor located areas of the cerebellum. The cells contained tryptase and chymase. At periphery of hemangioblastomas some mast cells underwent degeneration and calcification. Our results confirm previous observations that mast cells are numerous in the capillary hemangioblastoma and show that most of these cells are tryptase/chymase phenotype (MCTC).

[Alpha-fetoprotein: diagnostic value in hepatic disorders]. / Alfa-fetoproteina--znaczenie diagnostyczne w chorobach watroby.

The serum AFP concentration in man falls rapidly after birth and its synthesis in adult life is normally repressed. However, AFP is synthesized in large amounts by human hepatocellular carcinoma in greater than 70% of patients. Elevation of serum AFP in benign hepatic diseases such as acute and chronic viral hepatitis as well as toxic liver injury is associated with small transient increases in serum AFP. Therefore, quantification of serum alpha-fetoprotein (AFP) has been widely used as a diagnostic marker for hepatocellular carcinoma. Measurement of serum AFP levels have also been used in screening populations at high risk of human hepatocellular carcinoma such as those with cirrhosis or carriers of hepatitis B virus. However the specificity of the screening test in patients with only modestly raised AFP (below 400 ng/ml) is low, and false-positive results are frequent. A wide range of overlap in the distribution of serum AFP levels between hepatocellular carcinoma and chronic liver disease patients were observed mainly among HBsAg (+) patients. Therefore the specificity and predictive value of AFP are lower in HBsAg(+) than in HBsAg(-) patients, especially when AFP is between 25 and 200 ng/ml. In patients with chronic hepatitis B, the analysis of lectin reactivity of AFP has the advantages over quantification of serum AFP to detect HCC-specific variants in serum samples with only moderate raised AFP levels. Measurement of AFP serves as an important tool in the care and management of patients with benign and malignant hepatic disorders.

[Thyroid function in children with diagnosed chronic hepatitis B treated with interferon alpha]. / Funkcja tarczycy u dzieci z rozpoznanym przewleklym zapaleniem watroby typu B leczonych IFN-alpha.

The aim of the study is to estimate thyroid function during interferon alpha therapy in children with chronic hepatitis B. 31 children aged 4-16 years were included in the study. Thyroid function was monitored by estimation of thyroid hormones (FT3, FT4, TSH) and antithyroid antibodies (TPO, ATG) concentration before and after therapy completion. In all children normal thyroid hormones and ATG concentration were found before and after therapy completion. Presence of TPO before IFN treatment in blood serum of 2 girls (6.45%) and in 4 children (12.9%) after IFN therapy were found. Clinical features of thyroid dysfunction were not observed in this group of children during IFN therapy.

[Participation of neutrophils in pathophysiology of unstable angina pectoris]. / Udzial granulocytów w patofizjologii niestabilnej dlawicy piersiowej.

A role of neutrophils in pathophysiology of ischemic heart disease is described to show some destructive actions and eventual clinical complications. Immunobiochemical reactions are presented to describe mechanisms of inflammation and ischemia.

[Clinical consequences and diagnosis of congenital alpha 1-antitrypsin deficiency]. / Kliniczne nastepstwa i diagnostyka wrodzonego niedoboru alpha 1-antytrypsyny.

alpha 1-Antitrypsin deficiency is associated with predisposition to developing liver cirrhosis in early childhood and emphysema in adult life. One of the common variants PiZ leads to accumulation of the abnormal protein in hepatocytes and cell damage. Emphysema is a consequence of the protease-antiprotease imbalance. Understanding of the mechanism of disease allows early diagnostics and therapeutic intervention.

[Estimation of platelet counts and their morphological parameters in patients infected by borrelia burgdorferi]. / Ocena liczby plytek i ich parametrów morfologicznych u chorych zakazonych Borrelia burgdorferi.

Platelet counts and their morphologic parameters in patients with Lyme borreliosis before and after antibiotic therapy (4 weeks of treatment) were estimated. 30 patients aged 17-60, x = 41 were evaluated: 7 with Erythema migrans, 3 patients with neuroborreliosis in the from Lymphocytic meningitis and 20 ones with Lyme arthritis. Control group consisted of 19 healthy persons aged 34-52, x = 43. Hematologic analyser Coulter MAXM was used for testing PLT, MPV, PCT and PDW. The results indicated that patients with Lyme boreliosis have decreasing platelet count with simultaneously increasing their volume in comparison with healthy control. It may result from the involement of platelets in defense mechanisms of infected host. The decrease of platelet count after the antibiotic treatment in comparison with the control group may be the reflection of influence of antibiotic treatment on thrombopoesis.

[Immune response and diagnostic aspects during Toxoplasma gondii infection]. / Aspekty odpowiedzi immunologicznej w toksoplazmozie oraz jej implikacje diagnostyczne.

Toxoplasmosis is a common and generally benign disease in immunocompetent persons caused by Toxoplasma gondii, which is an intestinal coccidian parasite of felines. Diagnosis of toxoplasmosis is mainly based on the results of serological tests detecting anti-T. gondii specific antibodies, but T lymphocytes and cytokines they produce play a crucial role in determining the outcome of parasitic infection in terms of both protective immunity and immunopathology.

Trimix instead of air, decreases the effect of short-term hyperbaric exposures on platelet and fibrinolysis activation.

PURPOSE: Short-term and saturated simulated dives followed by decompression with air, cause a decrease in platelet count and increased activation of fibrinolysis. The aim of this study was to determine whether short-term dives with trimix as a breathing mixture induce the activation of platelets, and/or fibrinolysis. MATERIAL AND METHODS: 30 male divers were subjected to short-term hyperbaric exposures to 0.7 MPa. Thirty divers used air and then the same divers used trimix as a breathing mixture. RESULTS: The mean platelet count dropped significantly after decompression only in the group breathing air. The number of CD62P positive platelets and the amount of platelet-derived micro particles were statistically significant higher after decompression in both exposures. The number of CD61 positive platelets increased significantly only in the group breathing air. We observed a significant decrease of factor XII and fibrinogen concentrations after decompression only in the group breathing air. A significant increase in the concentration of plasminantiplasmin complex in both groups was detected. CONCLUSIONS: Short-term hyperbaric exposure and decompression performed according to current safety standards activates platelets and the fibrinolytic system. Trimix protects divers from a reduction in the amount of platelets, fibrinogen and factor XII in the course of these exposures.

The effect of continuous-flow automated plateletpheresis on fibrinolytic activity of donor plasma.

Blood circulating in extracorporeal circuit of the apheresis sets has a contact with an artificial surface. The data on the influence of plateletpheresis on fibrinolytic activity are very limited and difficult to interpret. The aim of our study was to estimate the effect of plateletpheresis on the activation of fibrinolysis. Plateletpheresis was performed in 17 healthy blood donors using continuous-flow cell separator COM.TEC (Fresenius, Bad Homburg, Germany). Before and after plateletpheresis, blood samples were taken and markers of fibrinolysis (PAP, t-PA, PAI-1) as well as factor XII activity have been measured. We observed statistically significant decrease in t-PA and factor XII activities after plateletpheresis. There were no significant changes in concentrations of t-PA, PAI-1 and PAP as well as PAI-1 activity after plateletpheresis. Plateletpheresis performed by COM.TEC cell separator has very little, if any, effect on the activation of fibrinolysis. The mechanism of the inhibition of t-PA activity needs further investigations.

[Granules of neutrophils]. / Ziarnistosci granulocytów obojetnochlonnych.

The exocytosis of cytoplasmic granules plays a most important role in the regulation of many neutrophils functions: adhesion, phagocytosis, killing of bacteria and interaction with endothelial cells. Neutrophils contain following types of granules: azurophilic (primary) granules, specific (secondary) granules, gelatinase-rich tertiary granules and secretory vesicles. Neutrophil granules may be classified on the basis of their size, morphology, density or with reference to a given protein.