Endurance Training Increases the Running Performance of Untrained Men without Changing the Mitochondrial Volume Density in the Gastrocnemius Muscle.

The activity and quantity of mitochondrial proteins and the mitochondrial volume density (MitoVD) are higher in trained muscles; however, the underlying mechanisms remain unclear. Our goal was to determine if 20 weeks' endurance training simultaneously increases running performance, the amount and activity of mitochondrial proteins, and MitoVD in the gastrocnemius muscle in humans. Eight healthy, untrained young men completed a 20-week moderate-intensity running training program. The training increased the mean speed of a 1500 m run by 14.0% (p = 0.008) and the running speed at 85% of maximal heart rate by 9.6% (p = 0.008). In the gastrocnemius muscle, training significantly increased mitochondrial dynamics markers, i.e., peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α) by 23%, mitochondrial transcription factor A (TFAM) by 29%, optic artrophy-1 (OPA1) by 31% and mitochondrial fission factor (MFF) by 44%, and voltage-dependent anion channel 1 (VDAC1) by 30%. Furthermore, training increased the amount and maximal activity of citrate synthase (CS) by 10% and 65%, respectively, and the amount and maximal activity of cytochrome c oxidase (COX) by 57% and 42%, respectively, but had no effect on the total MitoVD in the gastrocnemius muscle. We concluded that not MitoVD per se, but mitochondrial COX activity (reflecting oxidative phosphorylation activity), should be regarded as a biomarker of muscle adaptation to endurance training in beginner runners.

Preoperative radiotherapy and local excision of rectal cancer: Long-term results of a randomised study.

BACKGROUND AND PURPOSE: It is uncertain whether local control is acceptable after preoperative radiotherapy and local excision (LE). An optimal preoperative dose/fractionation schedule has not yet been established. MATERIAL AND METHODS: In a phase III study, patients with cT1-2N0M0 or borderline cT2/T3N0M0 < 4 cm rectal adenocarcinomas were randomised to receive either 5 × 5 Gy plus 1 × 4 Gy boost or chemoradiation: 50.4 Gy in 28 fractions plus 3 × 1.8 Gy boost and 5-fluorouracil with leucovorin bolus. LE was performed 6-8 weeks later. Patients with ypT0-1R0 disease were observed. Completion total mesorectal excision (CTME) was recommended for poor responders, i.e. ypT1R1/ypT2-3. RESULTS: Of 61 randomised patients, 10 were excluded leaving 51 for analysis; 29 in the short-course group and 22 in the chemoradiation group. YpT0-1R0 was observed in 66% of patients in the short-course group and in 86% in the chemoradiation group, p = 0.11. CTME was performed only in 46% of patients with ypT1R1/ypT2-3. The median follow-up was 8.7 years. Local recurrence incidences and overall survival at 10 years were respectively for the short-course group vs. the chemoradiation group 35% vs. 5%, p = 0.036 and 47% vs. 86%, p = 0.009. In total, local recurrence at 10 years was 79% for ypT1R1/T2-3 without CTME. CONCLUSIONS: This trial suggests that in the LE setting, both local recurrence and survival are worse after short-course radiotherapy than after chemoradiation. Because of the risk of bias, a confirmatory study is desirable. Lack of CTME is associated with an unacceptably high local recurrence rate.

Moderate-intensity endurance training improves endothelial glycocalyx layer integrity in healthy young men.

NEW FINDINGS: What is the central question of this study? The main aim of the present study was to determine the effect of prolonged moderate-intensity endurance training on the endothelial glycocalyx layer integrity in relationship to the training-induced changes in oxidative stress and antioxidant defence in humans. What is the main finding and its importance? We have shown, for the first time, a protective effect of prolonged moderate-intensity endurance training on endothelial glycocalyx layer integrity, as judged by significantly lower basal and end-exercise serum concentrations of glycocalyx damage markers, i.e. syndecan-1 and heparan sulfate, accompanied by attenuation of oxidative stress and enhancement of antioxidant defence after training in previously untrained healthy young men. In this study, we evaluated the effect of 20 weeks of moderate-intensity endurance training (ET) on the endothelial glycocalyx layer integrity in relationship to the training-induced changes in antioxidant defence. Eleven healthy young, untrained men performed an incremental cycling exercise bout until exhaustion before and after 20 weeks of ET. Endurance training consisted of 40 min sessions, mainly of moderate intensity (∼50% of maximal oxygen uptake), performed four times per week. Venous blood samples were taken at rest and at the end of the maximal exercise test. Muscle biopsies from vastus lateralis were taken before and after the training. Endurance training resulted in a significant increase in physical capacity (P < 0.05) as reflected by an increase in power output reached at the lactate threshold and at maximal oxygen uptake. Training led to a decrease (P < 0.05) in basal and end-exercise concentrations of blood markers of glycocalyx damage (syndecan-1 and heparan sulfate). The lowering of glycocalyx shedding after the ET was accompanied by an attenuation of oxidative stress, as evidenced by a decrease in the basal plasma concentration of isoprostanes, and by an increase in antioxidant defence, reflected by an enhancement in superoxide dismutase 2 protein content in vastus lateralis (P < 0.05). In contrast, training did not induce a significant increase in basal nitrite/nitrate plasma concentration (P > 0.05). Moderate-intensity ET exerts a pronounced protective effect on endothelial glycocalyx integrity at rest and during exercise, probably through an improvement of antioxidant defence that may represent the vasoprotective mechanisms highly responsive to moderate-intensity endurance training.

[Modern principles of surgical treatment of breast cancer]. / Wspólczesne zasady chirurgicznego leczenia chorych na raka piersi.

A rapid increase in the incidence of breast cancer (BC) has been observed since the mid-20th century in Poland. It is accompanied by a slower but steady increase in mortality. BC is the most common malignancy in women in Poland and in the world. In 2012, the reported 17,000 new cases of BC in Poland. The incidence of breast cancer increases, but significantly improves the prognosis of women in recent years. 5-year survival is currently closer to 80% in Poland. Improving the prognosis is associated with two factors: the earlier detection and more effective cancer treatment. Mammography screening increased the detection of cancer in the early stages. Thanks to the use of all methods of cancer treatment (surgery, radiotherapy, chemotherapy, hormonal therapy) resulted in a significant treatment effect. BC has become a chronic disease.

Neoadjuvant treatment for unresectable rectal cancer: an interim analysis of a multicentre randomized study.

PURPOSE: To present an interim analysis of the trial comparing two neoadjuvant therapies for unresectable rectal cancer. METHODS: Patients with fixed cT3 or cT4 or locally recurrent rectal cancer without distant metastases were randomized to either 5 × 5 Gy and 3 courses of FOLFOX4 (schedule I) or 50.4 Gy delivered in 28 fractions given simultaneously with 5-Fu, leucovorin and oxaliplatin (schedule II). Surgery in both groups was performed 12 weeks after the beginning of radiation and 6 weeks after neoadjuvant treatment. RESULTS: 49 patients were treated according to schedule I and 48 according to schedule II. Grade III+ acute toxicity was observed in 26% of patients in group I and in 25% in group II. There were two toxic deaths, both in group II. The microscopically radical resection (primary endpoint) rate was 73% in group I and 71% in group II. Overall and severe postoperative complications were recorded in 27% and 9% of patients vs. 16% and 7%, respectively. Pathological complete response was observed in 21% of the patients in group I and in 9% in group II. CONCLUSIONS: The interim analysis revealed no major differences in acute toxicity and local efficacy between the two evaluated strategies.

[Solitary fibrous tumor of the pleura (SFTP) hidden in the pleural effusion]. / Umiejscowiony wlóknisty guz oplucnej (SFTP) ukryty w wysieku oplucnowym.

UNLABELLED: The patient with a non-malignant type of solitary fibrous tumor of the pleura (SFTP) has been presented as an example; this tumor manifested itself in long-lasting pleural effusion. The tumor, submerged in the liquid, with the diameter of 16 cm, was invisible in standard and computer X-rays of the chest. The tumor was found and removed during the thoracotomy. The patient has been alive for 9 years, without symptoms of the disease since the operation was performed. CONCLUSIONS: 1. The source of one-sided exudation can be a non-malignant SFTP. 2. Tumor submerged in the liquid can be invisible on standard and computer pictures of the chest.

[Metastases of the melanoma to the intestine]. / Przerzuty czerniaka do jelit.

The cases of 4 patients with primary skin melanoma, who underwent resection of the small intestine due to the intestinal metastases, are presented. Two patients died as a result of metastases after intestinal resection; the other two have been alive for a year and 10 years without any symptoms of the disease. The presence of the melanoma metastases to the intestine can be suspected in patients with anaemia caused by bleeding into the lumen of an intestine, ileus, rapid weight loss or noticeable tumor in the abdomen. The resection of intestine with metastases should be chosen as a safe method, which allows good palliation; it also offers the chance for a longer life.

Clinical significance of biological differences between cavitated and solid form of squamous cell lung cancer.

Recently, Kolodziejski et al. [Kolodziejski LS, Dyczek S, Duda K, Goralczyk KJ, Wysocki MW, Lobaziewicz W. Cavitated tumor as a clinical subentity in squamous cell lung cancer patients. Neoplasma 2003;50:66--73] have shown, that patients with cavitated form of squamous cell lung cancer (c-SqCLC) treated by surgery had shorter survival than patients with solid form (s-SqCLC) despite having similar stage, histological features and causes of deaths. Therefore, we decided to check if tumour biological features are responsible for the difference in patients' response. The aim of the study was to assess tumour proliferation rate (MIB-1 labelling index, MIB-1 LI), tumour proliferation pattern and expression of epidermal growth factor receptor (EGFR labelling index, EGFR LI) in solid and cavitated SqCLCs. A total of 81 patients with SqCLC were analysed; 18 c-qCLC (with cavity identified at X-ray examination) and 63 s-SqCLC. Expression of Ki-67 protein (MIB-1 LI) and proliferation pattern based on this staining and EGFR LI was visualized in formalin-fixed paraffin-embedded sections, using immunohistochemistry. s-SqCLC showed faster proliferation than c-SqCLC. Mean MIB-1 LI for the first group was higher-39.2% (range, 12.7--65.6) than for the second group--26.1% (range, 7.1--45.6) (P=0.000). In c-SqCLC subgroup, eight tumours with intermediate type of proliferation, six with random and four with mixed pattern were identified. However, in the s-SqCLC there were 18 with intermediate, 22 with random and 22 with mixed type of proliferation. The difference between architecture of proliferation and histological grade was seen (P=0.040). Mean EGFR LI did not differ between c-SqCLC (31.1%) and s-SqCLC (29.3%); however, median value was non-significantly lower for c-SqCLC (14.0%) than in s-SqCLC (21.0%). Univariate Kaplan-Meier analysis revealed that patients with s-SqCLC and a lower pTNM, faster tumour proliferation (MIB-1 LI>39%) and 13%

Full-thickness chest wall resection for recurrence of breast malignancy.

We present outcomes in 13 consecutive patients with solitary, local chest wall recurrence subsequent to mastectomy for breast malignancy who were operated on in 1983--2001. All patients underwent full-thickness chest wall resection (FTCWR) and immediate reconstruction. The mean chest wall defect area was 108 cm(2). The choice of reconstruction method was individualized. The reconstruction was accomplished with the patient's own tissues, in three cases supported by artificial mesh. Most commonly we used the contralateral breast or myocutaneous flap. We did not observe postoperative complications. The tissues used for the reconstruction provided sufficient stiffness of the rib cage. In all specimens the surgical margins were negative. The estimated 5-year survival after excision of recurrent tumor is 62%. FTCWR with immediate reconstruction with soft tissues should be considered in patients with local solitary recurrence after mastectomy for breast malignancy. This option offers good long-term results and minimal morbidity.

[Effect of incremental cycling exercise performed before and 24 hours after blood withdrawal on the concentration of morphologic elements of blood in young health men]. / Wplyw jednorazowego intensywnego wysilku fizycznego, wykonanego przed i po upuscie krwi, na poziom wybranych wskazników hematologicznych u mlodych, zdrowych mezczyzn.

The aim of this study was to evaluate the effect of incremental cycling exercise test performed before and 24 hours after blood donation (withdrawal of 450 ml of blood) on the plasma volume and concentration of morphologic elements of blood. Thirteen subjects (mean +/- SD), age 23 +/- 3 years; body mass 75 +/- 10 kg; BMI 23.4 +/- 2 kg x m(-2); VO2max 2903 +/- 334 ml x min(-1), volunteered for this study. The exercise test started at the power output of 20 W with an increase by 20 W every 3 minutes--until exhaustion. This test was performed once in the control study (7-12 days before blood donation) and repeated 24 hrs after blood donation. The blood samples were taken from the antecubital vein, in a sitting position (1) at rest, (2) at the stage of 100 W power output, (3) at the end of the test (the stage of exhaustion) and (4) at 2 hours after the end of the test. The changes in plasma volume were evaluated according to changes in hemoglobin and hematocrit concentrations. The significance of differences in the studied variables were tested using Wilcoxon test. At the end of the exercise test a significant (p<0.05) decrease in plasma volume was found in both study. It amounted to--11.1 +/- 2.9% in the control study, and to--13.0 +/- 3.9% after blood donation. Within 2 hours after the end of the exercise test plasma volume returned to the pre-exercise value in the control study and exceeded the pre-exercise value by 3.9 +/- 6.7% (p<0.05) in the study performed after blood donation. The MCV, MCH, and MCHC values were not affected by the exercise performed before and after blood donation. In the control study, at the end of the incremental exercise test a significant increase in the leukocyte, lymphocyte and thrombocyte count was found. At 2 hours after exercise thrombocytes count returned to the pre-exercise level, whereas the exercise-induced leucocytosis remained at the end-exercise level. The lymphocyte count decreased to lymphopenic level. During the incremental exercise test performed after blood donation the changes in the concentration of the studied morphologic elements of blood were similar as in the control study. The only difference was noticed in the changes of lymphocyte count which returned to the pre-exercise level within 2 hours after exhaustion. Taking into consideration the changes in plasma volume it was found that during the incremental exercise tests (both in the control study and after blood donation) there was a significant (p<0.05) extra vascular escape of erythrocytes and thrombocytes. This was accompanied by a significant accumulation of neutrophils and lymphocytes in circulating blood. At 2 hours after the end of exercise, neutrophils count increases and lymphocytes migrate into peripheral lymphoid tissues, causing lymphopenia.

[Resection of the renal vein leiomyosarcoma with preservation of the kidney]. / Wyciecie miesaka gladkokomórkowego zyly nerkowej z zaoszcz dzeniem nerki.

We present a case of 75 years old woman who successfully underwent resection of the right renal vein leiomyosarcoma (LMS-VR) with preservation of the kidney. It is the first reported case in Polish and fifth in world literature. The patient is alive without recurrence 24 months after operation. The surgical resection of LMS-VR with the preservation of the kidney should always be considered when the tumour does not infiltrate the renal hilus.

Prognostic significance of epidermal growth factor receptor in surgically treated squamous cell lung cancer patients.

Epidermal growth factor receptor (EGFR) is one of signalling pathways activated during premalignant proliferative changes in the airway epithelium. However there is no agreement about prognostic significance of EGFR expression in non-small cell lung cancer (NSCLC). Facts mentioned above prompted us to study EGFR expression in the group of 78 surgically treated squamous cell lung cancer (SqCLC) patients. The EGFR expression was visualized in formalin-fixed, paraffin-embedded sections, using immunohistochemistry. Three methods of assessment of EGFR expression were applied: percentage of cells with membranous EGFR expression--EGFR labellig index (EGFR LI), percentage of fields with membranous EGFR staining (PS%) and staining intensity (absent, weak or strong) in the whole specimen (SI). Mean EGFR LI and PS% values were 30.4 +/- 3.5% and 51.6 +/- 3.9%, respectively. Patients with higher EGFR expression (EGFR LI, PS%, SI) were significantly younger than those with low EGFR expression. EGFR LI was higher in pT3 tumours than in pT1+pT2 tumours, moreover, EGFR expression (EGFR LI, PS%, SI) was significantly higher in G1+G2 tumours than in G3 tumours. There were significant correlations between parameters used for assessment of EGFR expression. PS% < or = 50 indicated shorter disease-specific survival than PS% > 50. However, patients with tumours with both very low and very high EGFR LI (13% > or = EGFR LI > 80%) showed significantly shorter survival than those with medium EGFR LI (13% < GFR LI < or = 80%). Additionally, pTNM and pN significantly influenced patients' survival. In multivariate analysis, EGFR LI and pTNM were independent prognostic parameters influencing disease-specific survival of patients.

[Ventilatory efficiency during incremental exercise in relation to various types of myosin heavy chain content in vastus lateralis m. quadricipitis femoris in healthy young men]. / Efektywnosc wentyiacji pluc w wysilku fizycznym a zawartosc róznych typów ciwzkich lancuchów miozyny w miesniu czworoglowym uda u mlodych zdrowych mezczyzn.

The main aim of this study was to determine whether ventilatory efficiency during incremental exercise is related to various types of myosin heavy chain (MyHC) content in vastus lateralis in. quadricipitis femoris in young healthy men. The respiratory efficiency was expressed by VE/VCO2 slope, determined during sublactate threshold power outputs of the incremental exercise. A significant negative correlation between V(E)/VCO2 and P(ET)CO2 (amounting to: at rest r = -0.43 p < 0.05; at the LT r = -0.87 p < 0.01; at the VO2 max r = -0.95 p < 0.01) was observed. Moreover, the level of PETCO2 at rest and during exercise was not related to the MyHC content of the vastus lateralis muscle. No relationship between the content of various types of MyHC and respiratory efficiency was found.

Synchronous anal and penile cancers.

Malignancies of the anogenital region have similar etiology, including viral infections, sexual habits, social and educational factors. Condylomata acuminata represent precancerous lesions. In the available literature, we found no cases of synchronous cancers of anus and penis reported. We report a case of synchronous cancer of the penile foreskin and cancer of the anus in a 36 year-old man. The microscopic diagnosis of the anal lesion was squamous cell cancer, basaloid type. The penile lesion was squamous cell cancer, keratinizing type. Both cancers presented with the in situ component. Immunohistochemical staining (MIB-1) and histological features (koilocytosis, acanthosis and dyskeratosis) indirectly confirmed the past viral infection. Numerous etiological similarities in anogenital cancers entail careful clinical inspection in patients with a malignant lesion in this region and suggest searching for possible other concomitant cancers or precancerous lesions.

[Early results of esophagectomy and total or proximal gastrectomy without perioperative administration of total parenteral nutrition]. / Wczesne powiklania i zgony po wycieciu przelyku oraz blizszym lub calkowitym wycieciu zoladka u chorych leczonych bez stosowania calkowitego zywienia pozajelitowego.

UNLABELLED: The aim of the study was to analyse complications after radical oesophagectomy or gastrectomy in cancer patients without administration of total parental nutrition (TPN). PATIENTS AND METHODS: 45 consecutive patients underwent oesophagectomy (8 patients), proximal subtotal gastrectomy (10 patients) and total gastrectomy (27 patients). Stapler sutures were used to create anastomoses between oesophagus and stomach or oesophagus and jejunum. None patient received TPN. In all patients antropometrical and biochemical characteristics were assessed. Preoperative risk factors and type of complications were estimated. Patients with surgical complications were compared with patients without surgical complications using anthropometric and biochemical values. RESULTS: Surgical complications occurred in 10(22%) patients. The most common complication was postoperative wound infection (6 patients). Anastomotic dehiscence occurred in 4 patients and resulted in 2 deaths. Complications and deaths were observed more frequently in severely malnourished patients (BMI < 18). CONCLUSIONS: There is no justification for routine perioperative use of TPN in patients without severe malnutrition undergoing oesophageal or gastric surgery for cancer.

[Effect of blood withdrawal on changes in plasma volume and protein concentration during incremental cycling exercise in men]. / Wplyw upustu krwi na zmiany objetosci osocza i stezenie bialek w surowicy u mlodych dawców krwi podczas intensywnego wysilku fizycznego.

The aim of this study was to evaluate the effect of blood withdrawal on the plasma volume and serum proteins concentration during incremental cycling exercise test performed 24 hours after blood donation (withdrawal of 450 ml of blood). Thirteen subjects (mean +/- SD), age 23 +/- 3 years; body mass 75 +/- 10 kg; BMI 23.4 +/- 2 kg.m-2; VO2max 2903 +/- 334 ml.min-1, performed an incremental cycling exercise test, starting at the power output of 20 W with an increase by 20 W every 3 minutes--until exhaustion. This test was performed twice: once in the control study (7-12 days before blood donation) and repeated 24 h after blood donation. The blood for this study was taken from the antecubital vein, in a sitting position at rest (6 minutes before the exercise test, at the end of the test (the stage of exhaustion) and 2 hours after the end of the test. The changes in plasma volume were evaluated on the basis of changes in hemoglobin and haematocrit concentrations. Significances of differences in the studied variables were tested using Wilcoxon test. At the end of the exercise test a significant (p < 0.05) decrease in plasma volume was found in both study. It amounted to -11.1 +/- 2.9% in the control study, and to -13.0 +/- 3.9% after blood donation. The difference in the changes in plasma volume in both tests was not significant. In the control study plasma volume return to the pre-exercise value within 2 hours after the end of the exercise test. In the study performed after blood donation the values of plasma volume exceeded the control value by 3.9 +/- 6.7% (p < 0.05) within 2 hours after finishing the exercise test. Taking into consideration the changes in plasma volume it was found that during incremental exercise there is a significant (p < 0.05) extra vascular escape of the serum proteins both in the control study, in case of total serum protein amounting to 4.05 +/- 2.97 g.l-1 as well as during exercise performed after blood donation, amounting to 5.49 +/- 3.98 g.l-1. Moreover, it was found that in the control study all the measured serum proteins concentrations (albumin, alpha 1-, alpha 2-, beta-, and gamma-globulins) return to the pre-exercise level within 2 hours after the end of exercise, but in the study performed after blood donation a continuous extra vascular escape of some serum proteins (alpha 1-, alpha 2- and gamma-globulins) was observed.

Carcinoembryonic antigen, squamous cell carcinoma antigen, CYFRA 21-1, and neuron-specific enolase in squamous cell lung cancer patients.

BACKGROUND: Carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCC-Ag), and CYFRA 21-1 are the most useful markers for non-small cell lung cancer (NSCLC), but neuron-specific enolase (NSE) is a tumor maker of choice for SCLC. The determination of NSE in NSCLC could allow selection of patients with neuroendocrine features. NSCLC patients whose tumors have neuroendocrine properties may be more responsive to chemotherapy; however, these tumors have been reported to be more aggressive. Tumor markers are not suitable for diagnosis; their principal applications are in monitoring of therapy and prognosis. METHODS: Tumor markers were measured in 200 untreated patients with squamous cell lung cancer (SQC) and a reference group (n = 220; 124 healthy persons and 96 patients with nonmalignant lung disease). CEA and SCC-Ag were measured by microparticle enzyme immunoassays on Abbott AxSYM and IMx analyzers. CYFRA 21-1 and NSE were measured by electrochemiluminescence immunoassays on the Roche Elecsys 2010. RESULTS: CEA, SCC-Ag, CYFRA 21-1, and NSE were increased above the cutoffs in 26%, 32%, 67%, and 28% of tested patients, respectively. The area under the ROC curve for CYFRA 21-1 was higher than those for CEA, SCC-Ag, and NSE (SQC vs controls). CYFRA 21-1 and CEA were significantly higher in advanced SQC than in early stages of disease (P <0.0001 and P <0.0004, respectively). In multivariate analysis of survival, CYFRA 21-1 was an independent but nonspecific prognostic factor in the operable group of SQC patients, whereas NSE was an independent prognostic factor in the advanced stages of disease. CONCLUSION: CYFRA 21-1 is an independent prognostic factor in earlier stages and NSE in the advanced stages of SQC.