Long-course oxaliplatin-based preoperative chemoradiation versus 5 × 5 Gy and consolidation chemotherapy for cT4 or fixed cT3 rectal cancer: results of a randomized phase III study.

BACKGROUND: Improvements in local control are required when using preoperative chemoradiation for cT4 or advanced cT3 rectal cancer. There is therefore a need to explore more effective schedules. PATIENTS AND METHODS: Patients with fixed cT3 or cT4 cancer were randomized either to 5 × 5 Gy and three cycles of FOLFOX4 (group A) or to 50.4 Gy in 28 fractions combined with two 5-day cycles of bolus 5-Fu 325 mg/m(2)/day and leucovorin 20 mg/m(2)/day during the first and fifth week of irradiation along with five infusions of oxaliplatin 50 mg/m(2) once weekly (group B). The protocol was amended in 2012 to allow oxaliplatin to be then foregone in both groups. RESULTS: Of 541 entered patients, 515 were eligible for analysis; 261 in group A and 254 in group B. Preoperative treatment acute toxicity was lower in group A than group B, P = 0.006; any toxicity being, respectively, 75% versus 83%, grade III-IV 23% versus 21% and toxic deaths 1% versus 3%. R0 resection rates (primary end point) and pathological complete response rates in groups A and B were, respectively, 77% versus 71%, P = 0.07, and 16% versus 12%, P = 0.17. The median follow-up was 35 months. At 3 years, the rates of overall survival and disease-free survival in groups A and B were, respectively, 73% versus 65%, P = 0.046, and 53% versus 52%, P = 0.85, together with the cumulative incidence of local failure and distant metastases being, respectively, 22% versus 21%, P = 0.82, and 30% versus 27%, P = 0.26. Postoperative and late complications rates in group A and group B were, respectively, 29% versus 25%, P = 0.18, and 20% versus 22%, P = 0.54. CONCLUSIONS: No differences were observed in local efficacy between 5 × 5 Gy with consolidation chemotherapy and long-course chemoradiation. Nevertheless, an improved overall survival and lower acute toxicity favours the 5 × 5 Gy schedule with consolidation chemotherapy. CLINICAL TRIAL NUMBER: The trial is registered as ClinicalTrials.gov number NCT00833131.

The impact of homologous packed red blood cell transfusion on patients' survival after radical surgical treatment of colorectal cancer.

The aim of this study was to assess the impact of homologous packed red blood cell transfusion on patients' survival after radical surgical treatment of colorectal cancer. We analyzed a group of 257 colorectal cancer patients who had undergone radical operations (R0 resection) and who had been followed-up for at least 30 months. Overall survival (OS), disease specific survival (DSS), disease free survival (DFS), free of local recurrence survival (FLR) and free of metastases survival (FM) were recorded. 122 (47.5%) patients received packed red blood cells in the peri-operative period (group T), whereas 135 patients did not receive any blood (group NT). Neither group (T and NT) differed in clinical outcome, non-haemorrhagic complications, cause of death during the follow-up period, or results of surgical treatment. The fact of packed red blood cell transfusion was not significantly prognostic of outcome in Cox's multivariate analysis. Also the survival curves of 63 pairs of patients selected from groups T and NT, according to classical prognostic features, had similar courses.

Effect of pedaling rates and myosin heavy chain composition in the vastus lateralis muscle on the power generating capability during incremental cycling in humans.

In this study, we have determined power output reached at maximal oxygen uptake during incremental cycling exercise (P(I, max)) performed at low and at high pedaling rates in nineteen untrained men with various myosin heavy chain composition (MyHC) in the vastus lateralis muscle. On separate days, subjects performed two incremental exercise tests until exhaustion at 60 rev min(-1) and at 120 rev min(-1). In the studied group of subjects P(I, max) reached during cycling at 60 rev min(-1) was significantly higher (p=0.0001) than that at 120 rev min(-1) (287+/-29 vs. 215+/-42 W, respectively for 60 and 120 rev min(-1)). For further comparisons, two groups of subjects (n=6, each) were selected according to MyHC composition in the vastus lateralis muscle: group H with higher MyHC II content (56.8+/-2.79 %) and group L with lower MyHC II content in this muscle (28.6+/-5.8 %). P(I, max) reached during cycling performed at 60 rev min(-1) in group H was significantly lower than in group L (p=0.03). However, during cycling at 120 rev min(-1), there was no significant difference in P(I, max) reached by both groups of subjects (p=0.38). Moreover, oxygen uptake (VO(2)), blood hydrogen ion [H(+)], plasma lactate [La(-)] and ammonia [NH(3)] concentrations determined at the four highest power outputs completed during the incremental cycling performed at 60 as well as 120 rev min(-1), in the group H were significantly higher than in group L. We have concluded that during an incremental exercise performed at low pedaling rates the subjects with lower content of MyHC II in the vastus lateralis muscle possess greater power generating capabilities than the subjects with higher content of MyHC II. Surprisingly, at high pedaling rate, power generating capabilities in the subjects with higher MyHC II content in the vastus lateralis muscle did not differ from those found in the subjects with lower content of MyHC II in this muscle, despite higher blood [H(+)], [La(-)] and [NH(3)] concentrations. This indicates that at high pedaling rates the subjects with higher percentage of MyHC II in the vastus lateralis muscle perform relatively better than the subjects with lower percentage of MyHC II in this muscle.

High content of MYHC II in vastus lateralis is accompanied by higher VO2/power output ratio during moderate intensity cycling performed both at low and at high pedalling rates.

The aim of this study was to examine the relationship between the content of various types of myosin heavy chain isoforms (MyHC) in the vastus lateralis muscle and pulmonary oxygen uptake during moderate power output incremental exercise, performed at low and at high pedalling rates. Twenty one male subjects (mean +/- SD) aged 24.1 +/- 2.8 years; body mass 72.9 +/- 7.2 kg; height 179.1 +/- 4.8 cm; BMI 22.69 +/- 1.89 kg.m(-2); VO2max 50.6 +/- 5.3 ml.kg.min(-1), participated in this study. On separate days, they performed two incremental exercise tests at 60 rev.min(-1) and at 120 rev.min(-1), until exhaustion. Gas exchange variables were measured continuously breath by breath. Blood samples were taken for measurements of plasma lactate concentration prior to the exercise test and at the end of each step of the incremental exercise. Muscle biopsies were taken from the vastus lateralis muscle, using Bergström needle, and they were analysed for the content of MyHC I and MyHC II using SDS--PAGE and two groups (n=7, each) were selected: group H with the highest content of MyHC II (60.7 % +/- 10.5 %) and group L with the lowest content of MyHC II (27.6 % +/- 6.1 %). We have found that during incremental exercise at the power output between 30-120 W, performed at 60 rev.min(-1), oxygen uptake in the group H was significantly greater than in the group L (ANCOVA, p=0.003, upward shift of the intercept in VO2/power output relationship). During cycling at the same power output but at 120 rev.min(-1), the oxygen uptake was also higher in the group H, when compared to the group L (i.e. upward shift of the intercept in VO2/power output relationship, ANCOVA, p=0.002). Moreover, the increase in pedalling rate from 60 to 120 rev.min(-1) was accompanied by a significantly higher increase of oxygen cost of cycling and by a significantly higher plasma lactate concentration in subjects from group H. We concluded that the muscle mechanical efficiency, expressed by the VO2/PO ratio, during cycling in the range of power outputs 30-120 W, performed at 60 as well as 120 rev.min(-1), is significantly lower in the individuals with the highest content of MyHC II, when compared to the individuals with the lowest content of MyHC II in the vastus lateralis.

EGFR LI and Ki-67 LI are independent prognostic parameters influencing survivals of surgically treated squamous cell lung cancer patients.

In literature there are still opinion differences concerning the prognostic significance of epidermal growth factor receptor (EGFR) expression and proliferative potential in patients with non small cell lung cancer (NSCLC). This prompted us to study those parameters. The Ki-67 labeling index (Ki-67 LI), EGFR labeling index (EGFR LI), and mitotic index (MI) were analyzed in the group of 78 consecutive, surgically treated squamous cell lung cancer (SqCLC) patients. The expression of Ki-67 and EGFR protein was visualized on formalin fixed, paraffin embedded sections using immunohistochemistry (IHC). Mitotic index was assessed on formalin fixed, paraffin embedded sections, stained with hematoxylin and eosin using morphological criteria. Mean values of Ki-67 LI and MI were higher for G2+G3 tumors than for G1 tumors. EGFR LI was higher for G1+G2 than for G3 tumors, and for pT3 than for pT1+pT2 tumors. Patients having tumors with Ki-67 < or =28% or (EGFR LI < or =13% or EGFR LI >80%) survived significantly shorter than those having tumors with Ki-67 LI >28% or 13%< EGFR LI < or =80%. In multivariate analysis, 13%> or = EGFR LI <80% and Ki-67 LI < or =28% were independent negative prognostic parameters influencing survivals of SqCLC patients.

Capillary density and capillary-to-fibre ratio in vastus lateralis muscle of untrained and trained men.

Muscle fibre profile area (Af), volume density (Vv), capillary-to-fibre ratio (CF) and number of capillaries per fibre square millimetre (CD) were determined from needle biopsies of vastus lateralis of twenty-four male volunteers (mean +/- SD: age 25.4+/-5.8 years, height 178.6+/-5.5 cm, body mass 72.1+/-7.7 kg) of different training background. Seven subjects were untrained students (group A), nine were national and sub-national level endurance athletes (group B) with the background of 7.8+/-2.9 years of specialised training, and eight subjects were sprint-power athletes (group C) with 12.8+/-8.7 years of specialised training. Muscle biopsies of vastus lateralis were analysed histochemically for mATPase. Capillaries were visualized and counted using CD31 antibodies against endothelial cells. There were significant differences in the Vv of type I and type II muscle fibres in both trained groups, B (51.8%; 25.6%) and C (50.5%; 26.4%). However, in untrained group A that was treated as a reference group, the difference between Vv of type I and type II fibres was less prominent, nevertheless statistically significant (42.1%; 35.1%). There was also a significant difference in CF: 1.9 in group A and 2.1 in groups B and C. The number of capillaries per mm2 (CD) was 245 (group A), 308 (group B) and 325 (group C). Significant differences (P<0.05) in CF and CD, were found only between group A (1.9; 245) and both groups of trained men, B and C (2.1; 308 and 325). However, endurance athletes (group B), such as long-distance runners, cyclists and cross country skiers, did not differ from the athletes representing short term, high power output sports (group C) such as ice hockey, karate, ski-jumping, volleyball, soccer and modern dance.

Automatic feedback control of an Er-doped fiber laser with an intracavity loss modulator.

Suppression of Q-switching instabilities with an actively controlled intracavity loss modulator is demonstrated in an Er-doped waveguide laser that is mode locked with a slow saturable absorber at repetition rates of as much as 100 MHz. By automatic gain control in the feedback loop, stable mode locking is achieved over the entire parameter range of the laser. This approach renders laser stabilization independent of the characteristics of the gain medium and intracavity power. The pulse-shaping dynamics is not affected by the presence of the intracavity loss modulator.

Large-area broadband saturable Bragg reflectors by use of oxidized AlAs.

Broadband saturable Bragg reflectors (SBRs) are designed and fabricated by monolithic integration of semiconductor saturable absorbers with broadband Bragg mirrors. The wet oxidation of AlAs creates low-index AlxOy layers for broadband, high-index-contrast AlGaAs/AlxOy or InGaAlP/AlxOy mirrors. SBR mirror designs indicate greater than 99% reflectivity over bandwidths of 294, 466, and 563 nm for center wavelengths of 800, 1300, and 1550 nm, respectively. Highly strained and unstrained absorbers are stably integrated with the oxidized mirrors. Large-scale lateral oxidation techniques permit the fabrication of SBRs with diameters of 500 microm. Large-area, broadband SBRs are used to self-start and mode lock a variety of laser systems at wavelengths from 800 to 1550 nm.

Characteristics of myosin profile in human vastus lateralis muscle in relation to training background.

Twenty-four male volunteers (mean +/- SD: age 25.4+/-5.8 years, height 178.6+/-5.5 cm, body mass 72.1+/-7.7 kg) of different training background were investigated and classified into three groups according to their physical activity and sport discipline: untrained students (group A), national and sub-national level endurance athletes (group B, 7.8+/-2.9 years of specialised training) and sprint-power athletes (group C, 12.8+/-8.7 years of specialised training). Muscle biopsies of vastus lateralis were analysed histochemically for mATPase and SDH activities, immunohistochemically for fast and slow myosin, and electrophoretically followed by Western immunoblotting for myosin heavy chain (MyHC) composition. Significant differences (P<0.05) regarding composition of muscle fibre types and myosin heavy chains were found only between groups A (41.7+/-1.6% of MyHCI, 40.8+/-4.0% of MyHCIIA and 17.5+/-4.0% of MyHCIIX) and B (64.3+/-0.8% of MyHCI, 34.0+/-1.4% of MyHCIIA and 1.7+/-1.4% of MyHCIIX) and groups A and C (59.6+/-1.6% of MyHCI, 37.2+/-1.3% of MyHCIIA and 3.2+/-1.3% of MyHCIIX). Unexpectedly, endurance athletes (group B) such as long-distance runners, cyclists and cross country skiers, did not differ from the athletes representing short term, high power output sports (group C) such as ice hockey, karate, ski-jumping, volleyball, soccer and modern dance. Furthermore, the relative amount of the fastest MyHCIIX isoform in vastus lateralis muscle was significantly lower in the athletes from group C than in students (group A). We conclude that the myosin profile in the athletes belonging to group C was unfavourable for their sport disciplines. This could be the reason why those athletes did not reach international level despite of several years of training.

Primary angiosarcoma of the colon.

Angiosarcoma of gastrointestinal tract is extremely rare. Since 1948, we can find only six reported cases of primary colonic angiosarcoma. The review of the six reported cases and a report on the first colonic angiosarcoma to be seen in an adolescent male are presented. The treatment of the colon angiosarcoma is wide surgical excision. The prognosis is poor. Our case is the second one to be alive, more than 18 months after surgery, with no evidence of recurrent disease.

[Surgical management of retrorectal tumors]. / Prise en charge chirurgicale des tumeurs rétrorectales.

Retrorectal tumors (RRT) constitute an anatomical grouping of various tumors of different nature, both benign and malignant. The diversity of their presentation, surgical management, and prognosis are illustrated by five clinical cases. A simple categorization would distinguish vestigial tumors (whether cystic or solid), congenital nonvestigial tumors such as chordoma, and tumors of neural or bony origin. Imaging by CT scan and by MRI will usually determine the nature of the tumor and its relationship to the surrounding anatomical structures. The principle of treatment is complete removal with free margins. The surgical approach may be posterior, anterior or combined depending on the nature and the size of the lesion and on how high it is situated relative to the second sacral vertebra. Complete resection may be both difficult and bloody. Sacral segments may need to be resected either for reasons of surgical approach or to obtain clear margins. Rectal resection is rarely necessary. The prognosis of these lesions depends on the nature of the tumor and particularly on the quality and completeness of the resection.

Changes of the total antioxidative status of blood cells in the progression of stomach and large bowel cancers in patients subjected to primary radical treatment.

The analysis included 53 patients (32 men and 21 women) aged 43 to 66 years, who were subjected to radical treatment (surgical or combined) because of stomach (22 patients) or large bowel (31 patients) cancer. All the patients were included in the same model of control examinations, which considered evaluation of the erythrocytes TAS and of the Ca19-9, CEA and AFP concentrations in serum. It was confirmed that in all the patients in whom the recurrence and/or the dissemination occurred of the cancer, the average erythrocytes TAS value increased 5.5 times by comparison with the period before progression and 7 times in comparison with the patients without recurrence and/or dissemination of the cancer. Moreover it was shown that statistically significantly higher TAS values were associated with the progression of the large bowel cancer in comparison with the stomach cancer and that the blood cells TAS positively correlated with the changes of the Ca19-9, CEA and AFP concentrations in patients with progression of the cancer after radical treatment.

The influence of antineoplastic chemotherapy on the glutathione enzymes activity in the blood.

The analysis included 78 patients (42 men and 36 women) aged 48 to 67 years treated with cytostatics because of a neoplastic disease. In all the patients examined was evaluated the influence of the chemotherapy carried out on the glutathione peroxidase (GPx) and glutathione reductase (GR) activities. It was confirmed that the effect of the action on the glutathione enzymes (GE) activity of the antineoplastic chemotherapy changes depending on the duration of the treatment with cytostatics. In the end this activity settles at a high level, statistically significantly higher than that registered before the beginning of the antineoplastic treatment. The increase of the GE activity is mainly favoured by the chemotherapy following the schemes FAC (5-fluorouracyl + doxorubicin + endoxan) and PAC (cisplatin + cyclofosfamide + pharmorubicin).

Factors determining the post-operative hypo-albuminaemia in cancer patients--stepwise regression analysis.

AIM: To investigate factors influencing post-operative hypo-albuminaemia in cancer patients, with special reference to low dose albumin and/or immunoglobulins administration. PATIENTS AND METHODS: In 270 patients with malignant neoplasms, who underwent extensive chest and/or abdominal surgery, albumin concentrations on the first four postoperative days were examined. One hundred and three high-risk patients received human immunoglobulins intravenously; 44 were given albumin. Univariate and multivariate regression analyses were used to determine the factors influencing albuminaemia on the first four postoperative days. RESULTS: Mean nadir of hypo-albuminaemia occurred on the third postoperative day. In the multivariate analysis, a positive correlation was found between postoperative albuminaemia and pre-operative albuminaemia (b = 0.4919; p = 0.0000) as well as male gender (b = 2.0939; p = 0.0025). A negative correlation was found with the duration of surgery (b = -0.0416; p = 0.0212), pre-operative plasma protein (b = -0.2118, p = 0.0130) and postoperative immunoglobulin administration (b = -1.8858, p = 0.0074). CONCLUSIONS: Postoperative albuminaemia is positively correlated with pre-operative albuminaemia and male gender and negatively correlated with the duration of surgery, pre-operative proteinaemia and postoperative Ig administration.

The effect of exercise performed before and 24 hours after blood withdrawal on serum erythropoietin and growth hormone concentrations in humans.

In the present experiment we have studied the effect of exercise performed before and 24 h after withdrawal of 450 ml of blood on the serum erythropoietin and growth hormone (GH) levels, in humans. Twelve male subjects (x +/- SD) aged 23.2 +/- 2.6 y, with a body mass of 74.8 +/- 7.2 kg, height 178.0 +/- 7.6 cm, BMI 23.6 +/- 2.1 kg x m(-2), VO2 max 2937 +/- 324 ml x min(-1), participated in this study. The subjects performed twice an incremental exercise test until exhaustion, separated by a period of about 7 - 10 days. The second test was performed 24 h after withdrawal of 450 ml of blood (honorary blood donation). In the control study we found no effect of the incremental exercise on the serum erythropoietin concentration, which amounted to 14.24 +/- 7.66 mU x ml(-1) at rest and 14.97 +/- 6.07 mU x ml(-1) at the end of the incremental test. Serum GH level in the control study rose considerably from 0.158 +/- 0.024 nmol x l(-1) at rest to 1.523 +/- 0.336 nmol x l(-1) at the end of exercise and returned to initial value 2 h after the exercise. During the experiment performed 24 h after withdrawal of 450 ml of blood the serum erythropoietin concentration at rest was significantly elevated (p < 0.01) in relation to the control measurement (amounting to 24.85 +/- 13.60 mU x ml(-1)) and at the end of the incremental exercise a tendency towards further elevation (p = 0.09) in erythropoietin concentration up to 28.32 +/- 14.51 mU x m(-1) was observed. Serum GH level during the experiment after blood withdrawal was similar to that in control test and exercise caused a rise in the GH level to 1.056 +/- 0.52 nmol x l(-1), significantly less than in control test, but this increment fell to control value 2 h after exercise. The elevated level of erythropoietin 24 h after blood withdrawal was accompanied by a significant increase (p < 0.015) in blood hydrogen ion concentration [H +] b at rest from 48.2 +/- 2.8 nmol x l(-1) in the control study to 52.9 +/- 4.5 nmol x l(-1) after blood donation. No effect of blood withdrawal on pre-exercise level of plasma lactate concentration, end-tidal O2 and end-tidal CO2 was found. We concluded that withdrawal of 450 ml of blood, within 24 hours significantly increased serum erythropoietin concentration and caused non-lactic acidosis. A single bout of maximal incremental exercise, performed before and 24 hours after blood withdrawal, had no effect on serum erythropoietin concentration in humans but the exercise-induced increase in serum GH concentration performed after blood withdrawal tended to be lower than in the control study.

Attosecond active synchronization of passively mode-locked lasers by balanced cross correlation.

A balanced cross correlator, the optical equivalent of a balanced microwave phase detector, is demonstrated. Its use in synchronizing an octave-spanning Ti:sapphire laser and a 30-fs Cr:forsterite laser yields 300-attosecond timing jitter measured from 10 mHz to 2.3 MHz. The spectral overlap between the two lasers is strong enough to permit direct detection of the difference in carrier-envelope offset frequency between the two lasers.

Cavitated tumor as a clinical subentity in squamous cell lung cancer patients.

Cavity in lung cancer patients is usually attributed to worse prognosis, which could be caused by diagnostic difficulties and late surgery. The aim of this study is to identify cavity as clinical subentity in squamous cell lung cancer (SqCLC) patients. 1094 patients with I0 - III0 of SqCLC underwent surgery with the purpose of radical lobectomy or pneumonectomy. The patients were divided into two groups: 100 patients with cavity (cSqCLC) and 994 with solid tumor (sSqCLC). The clinical, histological and prognostic features were compared for the both groups. The Cox multivariate analysis of the prognostic factors was performed. The survival curves for both groups were compared. cSqCLC patients showed lower body mass and more frequent hemoptoe. They had larger tumors, located peripherically, rarer nodal involvement and atelectasis. Despite the similar cancer stage and the exploratory thoracotomies ratio, cSqCLC patients lived shorter. The survival curves for both groups were different: in all population, for patients after radical surgery and even after exploratory thoracotomy. We conclude that the cavitation in SqCLC patients can be regarded as a separate subentity related to worse prognosis.

MyHC II content in the vastus lateralis m. quadricipitis femoris is positively correlated with the magnitude of the non-linear increase in the VO2 / power output relationship in humans.

In this study we have examined the relationship between the content of different isoforms of MyHC in the vastus lateralis m. quadricipitis femoris and the VO2 / power output relationship during incremental cycling exercise. Twenty-one male subjects: aged 24.0 +/- 2.5 years, body mass 73.0 +/- 7.2 kg, height 179 +/- 5 cm, BMI 22.78 +/- 1.84 kg x m(-2), VO2(max) 3697 +/- 390 ml x min(-1), 50.9 +/- 5.2 ml x kg(-1) x min(-1), participated in this experiment. The subjects performed an incremental exercise test until exhaustion. The exercise test started at power output of 30 W, followed by an increase amounting to 30 W every 3 minutes. The pedalling rate was maintained at 60 rev x min(-1). Gas exchange variables were measured continuously using breath-by-breath system Oxycon Jaeger. At the end of each step blood samples were taken for lactate concentration. Muscle biopsy samples taken from the vastus lateralis m. quadricipitis femoris, using the Bergstrom needle, were analysed for the content of different MyHC (I, IIa, IIx) using SDS-PAGE and Western blotting. The pre-exercise VO2, as a mean value of six-minute measurements, expressed both in ml x min(-1), and in ml x kg(-1) x min(-1), was positively correlated with the content of MyHC II in the vastus lateralis (p < 0.01). We have also found that the pre-exercise values of VO2 in the group of subjects with a high proportion of MyHC II (59.9 +/- 11.2 %) were significantly higher (p < 0.02, when VO2 was expressed in ml x min(-1), and p < 0.01 when VO2 was expressed in ml x kg(-1) x min(-1)) than in the group with low content of MyHC II (27.5 +/- 6.0 %) in the vastus lateralis. Moreover, we have found a significant negative correlation (r = -0.562, p < 0.01) between the slope in the VO2/PO relationship below the lactate threshold (LT) and the content of MyHC IIa in the vastus lateralis. The most interesting finding of our study was that the magnitude of the non-linear increase in the VO2 / power output relationship present above the LT was positively correlated ( r = 0.510, p < 0.02) with the content of MyHC II in the vastus lateralis. Our results show, that there is no simple relationship between the content of different types of MyHC in the vastus lateralis and the oxygen cost of work during incremental exercise test. Individuals with a high content of MyHC II in the vastus lateralis m. quadricipitisfemoris consume more oxygen in the pre-exercise conditions than subjects with a low content of MyHC II in their muscles. Subjects with a high content of MyHC II require a smaller increase in VO2 for maintaining a linear increase in power output up to the lactate threshold (lower slope in this relationship), but after exceeding the LT, they consume more oxygen above that expected from the linear relationship below the LT, than the subjects with a low content of MyHC II in their muscles. Therefore, non-linear increase in the VO2 / power output relationship, present above the LT, is more pronounced in subjects with a higher content of MyHC II in the vastus lateralis m. quadricipitis femoris.

[The role of ultrasonographic evaluation of uterine cervix length and dilation for diagnosis and management of twin pregnancy]. / Rola ultrasonograficznej oceny dlugosci szyjki macicy i jej rozwarcia w diagnostyce i prowadzeniu ciazy blizniaczej.

OBJECTIVE: This study assesses ultrasonographic parameters concerning cervix length and cervical canal width of women with bigeminal pregnancy. The parameters mentioned proved to be useful while taking a right therapeutical decision i.e. using tocolysis or surgical treatment (cerclage). MATERIALS AND METHODS: This study included 52 women with bigeminal pregnancy. There were 14 women with the first pregnancy and 38 with the second and more pregnancies--ranging from 18 to 35 years of age. The negative obstetrics past and non-invasive treatment as well as surgical treatment were taken into consideration. 43 women were diagnosed using ultrasonographic examination. The cervix length and cervical canal width were checked every 7-14 days. In 9 of them the cerclage was done. RESULTS: In the group of women with cerclage 66.6% of pregnancies ended before the 37th week. The mean pregnancy duration was 29.4 weeks. 46.3% of infants were discharged in satisfactory condition. In the other group (tocolysis) 54.8% of pregnancies ended before 37th week. The mean pregnancy duration was 34.2 weeks. 72.7% of infants were discharged in satisfactory condition. CONCLUSIONS: The assessment of the length of the cervix and the width of the cervical canal in the bigeminal pregnancy by the case examination is performed in order to take proper therapeutical decisions i.e. tocolysis or surgical treatment.