Optimizing ischemic preconditioning for esophagogastric anastomosis: A standardized rat model to evaluate histological changes.

INTRODUCTION: A reproducible and simple model is essential for verifying gastric conduit vitality before esophagectomy. Ischemia is a major cause of esophagogastric anastomotic dehiscence and leakage. Ischemic conditioning of the stomach prior to esophageal surgery has been shown to lower the incidence of postoperative complications, including anastomotic leakage. However, the optimal timing and technique of ischemization remain uncertain. METHODS: Male Sprague-Dawley rats (n=24) were randomly divided into four groups: ischemic group - samples collected 1 hour after ischemia (I1H), ischemic group - samples collected 1 day after ischemia (I1D), ischemic group - samples collected 7 days after ischemia (I7D), and control group (C). Ischemia was induced by ligation of the left gastric (LGA) and short gastric arteries (SGA). The samples were verified using histological and macroscopic analysis, and the number and percentage of immunocompetent cells were determined. RESULTS: One hour after ischemization (I1H), ischemic denudation with mucosal erosion was observed, and the total number of eosinophils was significantly higher (p.

The Association Between Three Adipocytokines (Adiponectin, Resistin and Visfatin) And Thyroid Status in Patients With Type 2 Diabetes Mellitus and Autoimmune Thyroiditis.

Autoimmune thyroiditis (AIT) and type 2 diabetes mellitus (DM2) are the most common endocrinological diseases worldwide. Relation between these diseases explains several hypotheses. One of them is influence of some adipocytokines. This study evaluated association between three adipocytokines (adiponectin, resistin and visfatin) and thyroid and glycid status in patients with DM2 and AIT compared to the control group (CG). The group consisted of four subgroups: patients with DM2 without thyreopathies, patients with AIT on substitution therapy without diabetes and prediabetes, patients with DM2 and AIT on substitution therapy and healthy subjects as the CG. We investigated parameters of thyroid and glucose metabolism and serum levels of three adipocytokines. The mean level of resistin in the group of patients with diabetes and thyroiditis was significantly higher than in patients with thyroiditis without diabetes and than in the CG. We found a weak negative correlation between visfatin and fasting glucose levels in patients with thyroiditis without diabetes. We detected a weak negative correlation between resistin and glycated haemoglobin and a weak negative correlation between visfatin and thyroid gland volume in patients with diabetes without thyroiditis. In the CG we determined a weak positive correlation between visfatin and free thyroxin. Our results are consistent with several studies, which confirmed association between AIT and adipocytokines.

Humoral predictors of ankle-brachial index in patients with peripheral arterial disease and controls.

INTRODUCTION: Peripheral arterial disease (PAD) is a common condition due to atherosclerosis with high prevalence in population over 55 years. Although its pathophysiology is well recognized, the role of inflammatory markers is still not fully known. OBJECTIVES: The aim of the study was to assess the relation of C-reactive protein (CRP), tumor necrosis factors-alpha (TNF-alpha) and interleukin-6 (IL-6) to ankle-brachial index (ABI) and metabolic variables in patients with PAD. The second aim was to find the most significant humoral predictor of ABI. PATIENTS AND METHODS: The study groups consisted of 55 patients (36 men and 19 women) diagnosed with PAD (age 63.65 ± 6.11 years) and 34 control subjects (7 men, 27 women) of average age 59.88 ± 6.10 years with ABI > 0.9. Blood samples were analyzed for glycaemia, lipid profile and inflammatory markers (CRP, TNF-alpha and IL-6). RESULTS: A significantly higher serum total cholesterol (p = 0.04), triglycerides (p = 0.005) and lower HDL cholesterol (p < 0.0001) were found in the PAD group as compared to controls. Patients with PAD had significantly higher serum glucose (p = 0.008), CRP (p = 0.0044), IL-6 (p < 0.0001) and TNF-α (p < 0.0001) in comparison to controls. In a multiple linear regression analysis among variables log IL-6 and log HDL cholesterol were most significantly related to ABI (LW 4.75 for log IL-6, LW 4.016 for log HDL cholesterol, respectively, p < 0.01) in all subjects. CONCLUSIONS: We conclude that among traditional and humoral risk factors IL-6 is the strongest predictor of ABI. HDL cholesterol is also significant and strong predictor of decreased ABI and could be a potential biomarker of PAD in patients using lipid lowering drugs (Tab. 1, Ref. 31).

Arterial pH and blood gas values in rats under three types of general anesthesia: a chronobiological study.

The aim of study was to review the status of arterial pH, pO(2) and pCO(2) under general anesthesias in dependence on the light-dark (LD) cycle in spontaneously breathing rats. The experiments were performed using three- to four-month-old pentobarbital(P)-, ketamine/xylazine(K/X)- and zoletil(Z)-anesthetized female Wistar rats after a four-week adaptation to an LD cycle (12 h light:12 h dark). The animals were divided into three experimental groups according to the anesthetic agent used: P (light n=11; dark n=8); K/X (light n=13; dark n=11); and Z (light n=18; dark n=26). pH and blood gases from arterial blood were analyzed. In P anesthesia, LD differences in pH, pO(2), and pCO(2) were eliminated. In K/X anesthesia, parameters showed significant LD differences. In Z anesthesia, LD differences were detected for pH and pO(2) only. Acidosis, hypoxia, and hypercapnia have been reported for all types of anesthesia during the light period. In the dark period, except for P anesthesia, the environment was more stable and values fluctuated within normal ranges. From a chronobiological perspective, P anesthesia was not the most appropriate type of anesthesia in these rat experiments. It eliminated LD differences, and also produced a more acidic environment and more pronounced hypercapnia than K/X and Z anesthesias.

Circulating lipopolysaccharide-binding protein and carotid intima-media thickness in obstructive sleep apnea.

Circulating lipopolysaccharide-binding protein (LBP), a metabolic endotoxemia marker, was identified as an independent predictor of atherosclerosis. Although increases in carotid intima-media thickness (CIMT) were repeatedly reported in obstructive sleep apnea (OSA), neither the role of OSA in metabolic endotoxemia nor of LBP in early atherosclerosis were explored in patients with OSA. At a tertiary university hospital we investigated the relationships between OSA, LBP and CIMT in 117 men who underwent full polysomnography and CIMT assessment by B-mode ultrasound. Circulating LBP concentrations and average CIMT increased from patients without OSA to those with mild-moderate and severe OSA (from 32.1+/-10.3 to 32.3+/-10.9 to 38.1+/-10.3 microg.ml(-1), p=0.015; from 0.52+/-0.09 to 0.58+/-0.06 to 0.62+/-0.10 mm, p=0.004, respectively). Oxygen desaturation index (ODI) was a predictor of serum LBP levels independent of age, waist-to-hip ratio (WHR), smoking, hypertension, HDL cholesterol, triglycerides and fasting glucose [p (ANOVA)=0.002, r(2)=0.154], with no independent effect of the ODI*WHR interaction term on LBP. Furthermore, serum LBP predicted CIMT independently of known risk factors of atherosclerosis including obesity (p<0.001, r(2)=0.321). Our results suggest that OSA severity contributes to metabolic endotoxemia in patients with OSA independently of obesity, and that LBP might represent a contributing factor promoting early atherosclerosis in such patients.

Effect of dietary microbially produced gamma-linolenic acid and plant extracts on enzymatic and non-enzymatic antioxidants in various broiler chicken organs.

Plant extracts and fungal fermented feed with gamma-linolenic acid-rich microbial oils are perspective additives for use in animal nutrition as appetite and digestion stimulants, stimulants of physiological functions, for the prevention and treatment for certain pathological conditions, and as antioxidants. The activity of antioxidant enzymes and the level of reduced glutathione were measured in the plasma and in liver, heart and kidney mitochondria after 42 days of feeding broiler chickens both regular and combination diets. These were selected based on our previous experience. The administration of agrimony and gamma-linolenic acid resulted in a significant decrease in superoxide dismutase activity in all four bodies in contrast to plant extracts. We conclude that the decrease in activity is due to decreased production, and hence dismutation, of superoxide radicals to peroxides followed by lower activity of glutathione peroxidase, which was not seen in the case of only plant extract administration. Generally, higher glutathione reductase activity would be in response to increased demands on reduced glutathione as a cofactor for the reaction catalysed by glutathione peroxidase and the utilization of glutathione itself. However, measured levels of reduced glutathione showed no change. The results argue against any oxidative stress conditions. The application of agrimony extract appears to be suitable for the antioxidant effect against peroxidation of gamma-linolenic acid. As the efficacy of measuring the effects of diets on the oxidative stability of meat caused by selected antioxidant enzymes is rather low, additional data from the experiment will be processed to clearly assess the influence of this combination of diets.

[Is there a relationship between inflammatory markers, oxidative stress and postoperative atrial fibrillation?]. / Existuje vztah medzi zápalovými markermi, oxidacným stresom a pooperacnou fibriláciou predsiení?

INTRODUCTION: Atrial fibrillation (AF) is one of the most common complications following heart surgery. The aim of this work was to verify the relationship between inflammatory markers, oxidative stress and postoperative arrhythmia. METHODS: 45 patients with ischemic heart disease (12 women and 33 men, mean age 62.3 ± 9.4 years) underwent surgical myocardial revascularization. The extracorporeal circulation (ECC) was used in 30 patients, without ECC was 15 patients. During the first 3 postoperative days was determining the incidence and duration of the AF, laboratory markers of inflammation (CRP, leukocytes, TNFα), malondialdehyde (MDA). RESULTS: Demographic data and associated disease were in this patients similar. The incidence of AF we documented in 30 patients (66.7%). In patients with postoperative AF were significantly higher levels of inflammatory markers (leukocytes 13.6 ± 3.6 vs 11.3 ± 3.6; 14.7 ± 3.9 vs 12.5 ± 2.9; 13.7 ± 4.1 vs 11.4 ± 13.7; p 0.05; CRP 138.1 ± 41.1 vs 69.9 ± 25.8; p 0.001; TNFα 11.3 ± 14.3 vs 8.7 ± 3.6; 12.1 ± 14.5 vs 8.7 ± 3.1; p 0.05) compared with patients who were free from AF. Values of MDA were not significantly different. CONCLUSION: Patients with post-operative atrial fibrillation were higher levels of inflammatory markers compared with patients with sinus rhythm but no significant differences in the levels of oxidative stress.

Genes of intestinal Escherichia coli and their relation to the inflammatory activity in patients with ulcerative colitis and Crohn's disease.

Escherichia coli gene fimA was the most frequent gene that occurred in the intestine of all investigated groups. All subjects with fimA gene had significantly higher values of tumor necrosis factor alpha (TNF-α) and CRP than those with other E. coli genes. There was also a tendency to increased serum interleukin (IL)-6 levels in patients carrying the fimA gene; however, no relation was observed to serum IL-8 and IL-10. Patients with Crohn's disease had significantly higher IL-6 than those with ulcerative colitis (UC) and controls. The highest levels of TNF-α were detected in the UC group. There were no significant differences in serum IL-8 and IL-10 between all three groups. The presence of E. coli gene fimA in the large bowel of patients with IBD is related to the immunological activity of the disease which may be important from the aspect of therapeutical strategy.

The effect of probiotic microorganisms and bioactive compounds on chemically induced carcinogenesis in rats.

Diet interventions and natural bioactive supplements have now been extensively studied to reduce risks of colon cancer, which is one of the major public health problem throughout the world. The objective of our investigation was to study the effects of probiotic, prebiotic, nutritional plant extract, and plant oil on selected biochemical and immunological parameters in rats with colon cancer induced by N,N dimethylhydrazine (DMH). Male and female Wistar albino rats were were fed by a high-fat (HF) diet (10% fat in the diet) and were divided into 9 groups: Control group; PRO group - HF diet supplemented with probiotic Lactobacillus plantarum to provide 3 x 109 c.f.u. of strain/1 ml of medium; PRE group - HF diet supplemented with inulin enriched with oligofructose (2% of HF diet); HES group - HF diet supplemented with plant extract of Aesculus hippocastanum L. (1% of HF diet); OIL group - HF diet comprised Linioleum virginale (2% of HF diet); and combination of probiotic microorganisms and bioactive compounds in the groups - PRO-PRE, PRO-HES, PRO-OIL, PRE-OIL. Carcinogenesis was initiated with subcutaneous injection of DMH (20 mg/kg) two times at week interval and dietary treatments were continued for the six weeks. Application of probiotic microorganisms and bioactive compounds in all treated groups significantly decreased the activities of bacterial enzymes (p<0.001), the fecal bile acids concentration (p<0.01; p<0.001) and significantly increased serum TNFalpha level (p<0.001) in comparison to the control rats. The number of coliforms was reduced in PRO, PRO-PRE, PRO-OIL and PRE-OIL groups and significantly higher count of lactobacilli (p<0.05) was observed in PRO-PRE, PRO-OIL and PRE-OIL groups in compare with the controls. In conclusion, the results of this study indicate that probiotic microorganisms and bioactive compounds could exert a preventive effect on colon carcinogenesis induced by DMH.

Use of probiotics for prevention of radiation-induced diarrhea.

Probiotics can be applied in therapy and mainly in prevention of many civilization disorders. Experimental studies in animal models and clinical trials of patients with inflammatory bowel disease (IBD) have consistently shown that the use of probiotic organisms may effectively down-modulate the severity of intestinal inflammation by altering the composition and metabolic and functional properties of indigenous flora of the gut. Previous studies showed a protective effect of probiotic administration after radiation therapy, and probiotic may play an important role in the pathogenesis of radiation enteropathy. These studies indicate that probiotics may decrease the risk of accumulated reactive oxygen species (ROS) in host organisms and could potentially be used as probiotic food supplements to reduce oxidative stress (Tab. 2, Ref. 47). Full Text (Free, PDF) www.bmj.sk.

Adrenal incidentalomas and the metabolic syndrome--are there any differences between adenoma and hyperplasia?

Authors evaluated the prevalence of symptoms of the metabolic syndrome and insulin resistance in 25 patients with adrenal incidentalomas (10 men, 15 women) of the mean age 57.9+/-15 years. 15 patients had adrenal adenoma determined by CT or MR scan and 10 had unilateral or bilateral hyperplasia. The prevalence of obesity was 72%, arterial hypertension 60%, diabetes mellitus or impaired glucose tolerance 28%, hyperlipidemia 56% and hyperuricemia 20%, respectively, which is more frequent occurrence than that in normal human population. Patients with adrenal adenomas had mildly but significantly higher body mass index (BMI, p<0.05) and insulin resistance calculated as HOMA IR (p<0.05) and FIRI (p<0.05) and significantly higher values of serum ferritin (p<0.01). Plasma cortisol values were slightly but not significantly higher in the group with adrenal adenomas. Authors conclude that adrenal adenomas are probably more related to the metabolic syndrome than adrenal hyperplasia.

Smokers--vitamin C--hypercholesterolaemia.

Cigarette smoking is one of the major public health problems of our times. Smokers are damaged by free radicals formed during smoking. The antioxidant capacity of smokers is reduced. Vitamin C (ascorbic acid) deficiency in heavy smokers with a total cholesterol more than 6.7 mmol/l ranges from 35-55%. It is mediated by smoking, by its low dietary intake by preferential high dietary intake of saturated and unsaturated fats. Vitamin C is an important water soluble antioxidant, therefore its intake can at least partially reduce the unfavourable effect of smoking caused by the attack of free radicals on the organism when smokers are unable to quit smoking.

Humoral mechanisms in the pathogenesis of postprandial hypotension in patients with essential hypertension.

OBJECTIVE: To examine the role of catecholamines and insulin in the development of postprandial hypotension (PPH) in hypertensive patients. PATIENTS: Forty patients with essential hypertension (25 men, 15 women, mean age 68 +/- 2 years). METHOD: Blood pressure and heart rate were recorded in all subjects immediately after a 1903 kJ test meal and at 15-minute intervals for up to 1 hour after the meal. At these time points, circulating levels of norepinephrine, epinephrine, dopamine and C-peptide were measured. RESULTS: Twenty-three patients (58%) had PPH. By 15 minutes norepinephrine had significantly increased in PPH-negative subjects while it rose more slowly in PPH-positive patients and peaked by 45 minutes after the meal. Norepinephrine levels in 15 minutes were lower in PPH-positive than in PPH-negative ones (159.8 +/- 9.7 vs. 212.3 +/- 21.1 pg/ml, p = 0.01). Epinephrine levels rose only in PPH-negative subjects and did not differ significantly at the different time points. However, the area under curve analysis showed significantly lower epinephrine values in PPH-positive subjects (2903 + 247 pg.min.ml-1 vs. 3710 + 284 pg.min.ml-1, p = 0.03). Dopamine increased in both groups, although it was lower in subjects with PPH during the entire study (15 minutes: 68.6 +/- 3.7 vs. 93.7 +/- 11.7 pg/ml, p = 0.02; 30 minutes: 68.8 +/- 3.7 vs. 86.1 +/- 7.7 pg/ml, p = 0.03; 45 minutes: 60.5 +/- 4.2 vs. 79.7 +/- 5.2 pg/ml, p = 0.006). The postprandial C-peptide response did not differ between patients with PPH and those without PPH. CONCLUSIONS: In patients with essential hypertension, a marked decline in postprandial systolic blood pressure is associated with lower postprandial levels of norepinephrine, epinephrine and dopamine as compared to subjects without postprandial hypotension. This indicates that impaired sympatho-adrenal activation after ingestion of a meal may contribute to the development of PPH. Insulin appears not to be involved in the pathogenesis of postprandial hypotension.

[Passive smoking as a risk factor for allergic diseases in children]. / Pasívne fajcenie ako rizikový faktor alergických ochorení u detí.

The authors examined anamnestically, by interdermal tests with tobacco extract, by assessment of serum IgE and thiocyanates in saliva (according to David and Densen) 234 children with allergic diseases (rhinitis pollinosa, asthma bronchiale, dermorespiratory syndrome). They revealed a high ratio of positive tests in passive smokers (71.8% of the tested children), as compared with children not exposed to smoking (16.1% of the tested children). With advancing age of the probands the ratio of positive tests increased. The authors observed a significant difference in IgE concentrations in passive smokers of all age groups of children with the exception of those aged 1 to 3 years as compared with those not exposed to tobacco smoke. They found also significant differences in the thiocyanates concentrations in saliva between exposed and non-exposed children (223 and 126.4 mumol/l resp.). With regard to the above facts it is important to prevent exposure of predisposed as well as healthy children to cigarette smoke.