Polymorphism of GSTM1 gene in patients with colorectal cancer and colonic polyps.

The frequency of the GSTM1 gene in patients with nonpolyposis colorectal cancer (CRC) (n = 70) and in subjects with colonic polyps (n = 27) was evaluated and compared with healthy individuals (n = 145). Patients with CRC were divided into the three groups: patients coming from the families with hereditary nonpolyposis colorectal cancer (HNPCC) (n = 17); patients with a high risk of HNPCC who were referred to as suspected of HNPCC (n = 25); patients with sporadic colorectal cancer without clinical features of hereditary tumours (n = 28). A simple polymerase chain reaction (PCR) - based assay to identify GSTM1 nulled and positive (non-nulled) genotype was used. No significant differences in frequency of nulled individuals were observed in both patients with HNPCC and patients suspected of HNPCC as well as in subjects with colonic polyps. The most interesting observation was made in the group of patients with sporadic CRC. Twenty individuals (71.4 %) of the group were GSTM 1 deficient which was significantly different from the control population (p < 0.04). The above data indicate that the absence of the GSTM1 gene is associated with a greater risk of sporadic colorectal cancer. There is an increase in the overall risk of approximately 2.5 as compared with the control population.

The influence of exogenous antioxidants and physical exercise on some parameters associated with production and removal of free radicals.

Metabolic processes generate chemically active forms of oxygen, among which a prominent role is played by the superoxide ion. Cells are equipped with defence systems against the effects of superoxide radicals, superoxide dismutase is the most important one. The organism depends on the delivery of exogenous antioxidants, like selenium, vitamins E and C. Physical exercise triggers the production of superoxide radicals, which can at least partly be responsible for muscular damage. This work has studied the effect of Protection Zellaktiv (Smith Kline Beecham, Fink Naturarznei GmbH), a preparation containing selenium, vitamins C, E, B2, niacin and beta-carotene on the activities of superoxide dismutase and catalase, levels of glutathione malondialdehyde selenium, iron, zinc, triglicerides, total cholesterol, HDL- and LDL-cholesterol, before and after physical exercise. Muscle status was monitored by the activities of lactic dehydrogenase and creatine kinase. Protecton Zellaktiv was administered orally for one month, the measurements were repeated and the results before and after treatment were compared. It was found that treatment diminished the levels of malondialdehyde and zinc in serum, as well as cholesterol and triglicerides. Physical exercise before treatment decreased the levels of reduced glutatione, zinc and triglycerides. As expected, the levels of selenium were increased by the preparation. Protecton Zellaktiv suppressed the production of malondialdehyde during physical exercise. The preparation had a beneficial effect on lipid levels and it is inferred that lipid peroxidation was suppressed.

[Analysis of occupational accidents in the years 1982-1994 in the Szczecin Province]. / Analiza wypadków przy pracy w latach 1982-1994 w województwie szczecinskim.

The aim of the study was to analyse the incidence of accidents at work in the Szczecin voivodship in 1982-94. In the analysis the number of workers employed in the national economy and the number of accidents were taken into account. The rate of accidents at work (the number of accidents/1,000 workers in /1000), the accident severity (the number of work disability days/the number of accidents at work), the rate of fatal accidents at work (the number of fatal accidents/1,000 workers in /1000), the rate of acute injuries (the number of severe injuries per 1,000 accidents at work) were determined. The rates of accidents at work and fatal accidents in the Szczecin voivodship were compared with the rates in the whole country during the same period. The number of workers employed throughout the period between 1982-94 maintained at almost the same level. It increased mostly in 1990 and then decreased (Table 1). The largest number of accidents was registered in 1983 and the lowest in 1994. During the period studied the number of fatal accidents and absenteeism due to accidents at work decreased, however, the rates of fatal accidents and acute injuries increased. The rate of accidents at work in the Szczecin voivodship during the years 1982-94 was higher than in the whole country.

[Fetal doppler flow velocimetry measurements as indications for cesarean section]. / Dopplerowskie badania przeplywowe plodu we wskazaniach do ciecia cesarskiego.

An effort was made to analyze fetal umbilical and cerebral arteries Doppler flow velocimetry patterns in pregnancies terminated with cesarean section emphasizing risk to the fetus. The flow velocimetry measurements were carried out at least 7 days prior to deliveries. The incidence of abnormal values of flow indices (SD, RI i PI) and ratio (CPR) were compared in pregnant women who delivered by cesarean section due to: I--threatening fetal distress (n = 28)--elective cesarean sections were performed on pregnant women with chronic placental insufficiency symptoms; II--fetal distress (n = 22)--emergency cesarean sections; III--obstetric indications for cesarean section (no symptoms of fetal distress were present). Increased resistance in placental circulation, and decreased resistance in cerebral vessels finally leading to reversed diastolic umbilical flow occur more often in pregnant women with chronic placental insufficiency. Umbilical factor seems to be responsible for the observed in every studied group higher incidence of abnormal flows in middle cerebral than in umbilical artery. Fetal Doppler flow velocimetry of umbilical and middle cerebral arteries allow for finding of the most proper time of high-risk pregnancy termination, hence should be considered in the elective cesarean sections.

[Concentration of serum vitamin C in workers exposed to selected physical and chemical risk factors]. / Stezenie witaminy C W surowicy krwi u pracowników narazonych na wybrane czynniki fizyczne I chemiczne.

Determination of the serum vitamin C levels may yield the information on the nutritional status of workers. Increasing community awareness of the health-enhancing nutrition patterns as an element of the promotion of lifestyles conducive to health among workers may limit a negative impact of risk factors on workers' health. The aim of this study was to analyse the levels of serum vitamin C in workers exposed to selected physical (noise, electromagnetic fields) and chemical risk factors present in the work environment. Two randomised groups of male workers, one exposed to physical factors (n = 43; mean age 39.5 +/- 8.6 yr.), and the other to chemical factors (n = 40; mean age 38.3 +/- 8.0 yr.) were included in the study. The control group was composed of male workers (n = 36; mean age 40.4 +/- 10.1 yr.) exposed neither to physical nor to chemical factors. In all subjects, the serum vitamin C levels were measured using the spectrophotometric method by Kyaw. The mean serum vitamin C levels in the workers exposed to physical and chemical factors were 30.1 (mumol/l) and 30.9 (mumol/l), respectively, and their statistical significance was lower (p < 0.01) as compared with the mean serum vitamin C levels of 39.7 (mumol/l) in the control group.

[Factors influencing the length of hospital stay of patients qualified for elective carotid endarterectomy]. / Czynniki wplywajace na dlugosc okresu hospitalizacji chorych kwalifikowanych do operacji udroznienia tetnic szyjnych.

The aim of this retrospective study was to identify the factors affecting long hospital stay of patients who underwent carotid endarterectomy. The analysis was based on 233 records of all patients operated on between 1995 and 1998. We have found that the main reasons of lengthened preoperative hospitalization were: insulin dependent diabetes and admission on the day excluding the chance of operation in a short time. Postoperatively, monitoring in intensive care unit and unfounded delay of discharge were the leading reasons of prolonged hospital stay.

[Verification of the diagnosis of Buerger's disease in outpatients]. / Weryfikacja rozpoznan ambulatoryjnych choroby Buergera.

The aim of the paper was to estimate the correctness of thromboangiitis obliterans (TAO) diagnosis in ambulatory patients. 99 patients with initial diagnosis of TAO selected from 3137 outpatients, have been examined in consulting unit for vascular diseases, from 1996 to 1998. Burger's disease has been diagnosed in 26 patients in accordance with Shionoya's criteria. Applying the point scoring system suggested by Papa et al., certain diagnosis could be made in 21 patients and probable on in 3 patients. Of the remaining patients, it is interesting to note that manual examination revealed absence of pulsation at femoral and popliteal arteries in 60% of patients and 42% of patients demonstrated atherosclerosis risk factors. On the other hand superficial thrombophlebitis and Raynaud's phenomenon have been rarely diagnosed in 5 and 18% respectively.

[Assessment of foveal function in eyes of patients with exudative age-related macular degeneration before and after argon laser treatment]. / Ocena funkcji dolka w oczach z wysiekowa postacia zwyrodnienia plamki zwiazanego z wiekiem pacjentów przed i po leczeniu laserem argonowym.

PURPOSE: 1. Can foveal cone electroretinogram (FCERG) be a useful diagnostic test in evaluation of efficacy of argon laser treatment in eyes with exudative (wet) age-related macular degeneration (AMD)? 2. Comparison of FCERG with visual acuity, static perimetry and fluorescein angiography results. MATERIAL AND METHODS: FCERGs were recorded from 30 eyes with mean visual acuity 0.6 (Snellen Table) of 20 patients (mean age: 61 years) with wet AMD. The fovea was stimulated with 5-degree flickering light spot (f = 31.25 Hz), surrounded by a 20-degree annulus of intensive steady retinali illuminance. FCERGs were recorded and analysed in amplitude according to the computer-aided method recently put in practice in our laboratory. FCERGs were obtained twice for each AMD patients: before and 3 months after argon laser treatment. Electrophysiological data were also compared with the results of fluorescein angiography, visual acuity and static perimetry. RESULTS: In the group of patients with wet AMD, significant increase of FCERG amplitude (p < 0.001) after laser treatment was obtained in group I (33% of analysed eyes) and there were mainly patients with extrafoveal choroidal neovascularisation (CNV). Significant decrease of FCERG amplitude (p < 0.01) was obtained in group II (67% of analysed eyes). These were mainly patients with subfoveal CNV and also with extrafoveal CNV. In both groups after laser treatment we did not receive significant changes in visual acuity and macular perimetric mean sensitivity. CONCLUSIONS: These findings suggest that foveal cone ERG can be a useful, independent from fluorescein angiography, test for objective evaluation of efficacy of argon laser treatment in patients with wet AMD, opposite to visual acuity and static perimetry (macula threshold) examinations. FCERG probably indicates patients with better or worse prognosis.

[Oscillatory potentials in electroretinographic evaluation of retinal function in insulin-dependent diabetics without retinopathy]. / Potencjaly oscylacyjne w elektroretinograficznej ocenie funkcji siatkówki u pacjentów z cukrzyca insulinozalezna bez objawów retinopatii.

PURPOSE: Can oscillatory potentials be a useful method for detection of retinal dysfunction in insulin-dependent diabetics without retinopathy? MATERIAL AND METHODS: In this study scotopic oscillatory potentials (OPs) were obtained in 35 subjects (70 eyes) with insulin-dependent diabetes without retinopathy (mean disease duration--5 years) and in 15 healthy subjects (30 eyes). This examination was performed according to the recommendations of the International Society of Clinical Electrophysiology of Vision (ISCEV). The oscillatory potentials were extracted from the maximal combined response by high-pass filtering. We analysed amplitude and peak-latencies of the first three electroretinographic oscillatory potentials O1, O2, O3, index of wavelets [sum of amplitudes (O1 + O2 + O3)] and compared with the results of the control group. RESULTS: In group of patients with insulin-dependent diabetes without retinopathy, we received statistically significant reduction of amplitude O1 (p < 0.003) and index of wavelets (p < 0.04). Reduced amplitude O1 was obtained in 10%, index of wavelets in 31.4% of analysed eyes. We didn't observe statistically significant changes in amplitudes O2, O3 and latencies O1, O2, O3. CONCLUSIONS: Our results suggest that retinal dysfunction is present in insulin-dependent diabetics without retinopathy 5 years after onset of the disease. The sum of amplitudes (O1 + O2 + O3) was the most sensitive parameter of retinal abnormalities. It seems reasonable to have more frequent ophthalmological examination of the diabetics with abnormal oscillatory potentials.

[Evaluation of using statistical methods in selected national medical journals]. / Ocena stosowania metod statystycznych w wybranych krajowych czasopismach medycznych.

The paper covers the performed evaluation of frequency with which the statistical methods were applied in analyzed works having been published in six selected, national medical journals in the years 1988-1992. For analysis the following journals were chosen, namely: Klinika Oczna, Medycyna Pracy, Pediatria Polska, Polski Tygodnik Lekarski, Roczniki Panstwowego Zakladu Higieny, Zdrowie Publiczne. Appropriate number of works up to the average in the remaining medical journals was randomly selected from respective volumes of Pol. Tyg. Lek. The studies did not include works wherein the statistical analysis was not implemented, which referred both to national and international publications. That exemption was also extended to review papers, casuistic ones, reviews of books, handbooks, monographies, reports from scientific congresses, as well as papers on historical topics. The number of works was defined in each volume. Next, analysis was performed to establish the mode of finding out a suitable sample in respective studies, differentiating two categories: random and target selections. Attention was also paid to the presence of control sample in the individual works. In the analysis attention was also focussed on the existence of sample characteristics, setting up three categories: complete, partial and lacking. In evaluating the analyzed works an effort was made to present the results of studies in tables and figures (Tab. 1, 3). Analysis was accomplished with regard to the rate of employing statistical methods in analyzed works in relevant volumes of six selected, national medical journals for the years 1988-1992, simultaneously determining the number of works, in which no statistical methods were used. Concurrently the frequency of applying the individual statistical methods was analyzed in the scrutinized works. Prominence was given to fundamental statistical methods in the field of descriptive statistics (measures of position, measures of dispersion) as well as most important methods of mathematical statistics such as parametric tests of significance, analysis of variance (in single and dual classifications). non-parametric tests of significance, correlation and regression. The works, in which use was made of either multiple correlation or multiple regression or else more complex methods of studying the relationship for two or more numbers of variables, were incorporated into the works whose statistical methods were constituted by correlation and regression as well as other methods, e.g. statistical methods being used in epidemiology (coefficients of incidence and morbidity, standardization of coefficients, survival tables) factor analysis conducted by Jacobi-Hotellng's method, taxonomic methods and others. On the basis of the performed studies it has been established that the frequency of employing statistical methods in the six selected national, medical journals in the years 1988-1992 was 61.1-66.0% of the analyzed works (Tab. 3), and they generally were almost similar to the frequency provided in English language medical journals. On a whole, no significant differences were disclosed in the frequency of applied statistical methods (Tab. 4) as well as in frequency of random tests (Tab. 3) in the analyzed works, appearing in the medical journals in respective years 1988-1992. The most frequently used statistical methods in analyzed works for 1988-1992 were the measures of position 44.2-55.6% and measures of dispersion 32.5-38.5% as well as parametric tests of significance 26.3-33.1% of the works analyzed (Tab. 4). For the purpose of increasing the frequency and reliability of the used statistical methods, the didactics should be widened in the field of biostatistics at medical studies and postgraduation training designed for physicians and scientific-didactic workers.

[Effectiveness of acidified fluoride solutions in prevention of dental caries in school children]. / Skutecznosc zakwaszonych roztworów fluorków w profilaktyce próchnicy zebów u dzieci szkolnych.

The purpose of the study was assessment of the influence of locally applied acidified fluoride solutions on the condition of teeth of school children living in a town district with fluoridated drinking water and in another district without fluoridation of drinking water. Acidified fluoride solutions were applied locally by brushing--5 procedures at two-week intervals in the first and second year of the experiment. The condition of teeth was assessed calculating the indices CMF and CMFp. In the light of the obtained results it may be said that the externally applied acidified solutions of fluorides had an approximately evident effectiveness in prevention of caries both in children drinking fluoridated or non-fluoridated water.

Serum iron parameters in patients with alcoholic and chronic cirrhosis and hepatitis.

BACKGROUND: The aim of our study was to asses the serum iron status of patients with various forms of hepatitis and cirrhosis of the liver and to determine the correlation between the degree of hepatocyte damage and the status of serum iron parameters. MATERIAL AND METHODS: The study involved 136 subjects with chronic viral hepatitis type C (group I, n=71) and type B (group II, n=29), alcoholic cirrhosis of the liver (group III, n=15), postinflammatory cirrhosis of the liver (group IV, n=13), and alcoholic hepatitis (group V, n=8). In all these patients, serum alanine (ALT) and aspartate (AST) aminotransferase activity were used as a secondary measure of necroinflammatory activity. The serum iron status measurements included iron concentration (Fe), total iron-binding capacity (TIBC), transferrin saturation, and ferritin concentration. RESULTS: Our study results led us to conclude that the mean value of serum iron concentration did not differ significantly among the analysed groups (p>0.05). The transferrin value - estimated as the total iron-binding capacity (TIBC) - was significantly lower in alcoholic cirrhosis of the liver in comparison to both chronic hepatitis C (p<0.004) and chronic hepatitis B (p<0.04). The transferrin saturation was statistically the higher in group III in comparison with both group I (p<0.0031) and group II (p<0.024). Serum ferritin was significantly higher in cirrhotic patients regardless of etiology, in comparison with patients with chronic viral hepatitis (p<0.045). We found correlation between an increase of both AST and ALT and a higher level of ferritin in patients with chronic hepatitis type C (p<0.005, p<0.02) and type B (p<0.05, p<0.03) and alcoholic hepatitis (p<0.05). CONCLUSIONS: In the course of chronic liver diseases we may observe slight irregularities in iron status relating to both the serum and store pool of this element. The most significant disturbances are seen in patients with alcoholic cirrhosis of the liver.

Electro-oculogram in patients with neurofibromatosis type 1.

PURPOSE: The electro-oculogram (EOG) is a powerful test to evaluate the functional status of the retinal pigment epithelium (RPE). Clinically detectable changes of the RPE desribed in neurofibromatosis type 1 (NF-1) patients include combined hamartoma of the retina/RPE and congenital hypertrophy of the RPE. The goal of this study was to determine whether the function of RPE as measured by EOG is also changed in individuals with NF-1. PATIENTS: Studies were undertaken in 20 patients with clinically diagnosed NF-1 and compared to 16 normal healthy controls. METHODS: Standard EOG and flash ERG recordings were performed in accordance with International Society for Clinical Electrophysiology of Vision (ISCEV) standards. RESULTS: In NF-1 patients the Arden indexes of the EOG test were significantly higher primarily due to the lower values of dark troughs. Supernormal EOGs were present in 60% of NF-1 patients in comparison to the control group mean +2 SD. No one patient showed so high abnormalities during flash ERG examination. CONCLUSIONS: Dysfunction of the RPE may be characteristic feature of individuals with NF- 1.

N-acetylation and hydroxylation polymorphisms in type II diabetics with microvascular disturbances.

The N-acetylation and hydroxylation (CYP2D6) genetic polymorphisms were assessed in 43 healthy subjects and in 84 type II (non-insulin-dependent) diabetics. The proportions of slow and fast acetylators as well as poor and extensive metabolisers in a group of diabetics suffering from microvascular disturbances (nephropathy, retinopathy and neuropathy) were compared with the control group and with diabetics without such complications. Sulphadimidine was used as a probe for polymorphic acetylation and debrisoquine for CYP2D6. Debrisoquine and its 4-OH metabolite were assayed by means of HPLC, and sulphadimidine using a modified Bratton-Marshall procedure. The frequency of the slow phenotype (63%) was significantly higher in diabetics with microvascular disturbances than in patients without diabetic complications (P < 0.005). In patients with type II diabetes (84), only the extensive phenotype of hydroxylation was observed.