[Technical assist devices : Perspectives and new developments]. / Technische Hilfssysteme : Perspektiven und neue Entwicklungen.

The development of technical assist devices in the context of cardiopulmonary resuscitation (CPR) reaches back to the early roots of modern resuscitation research. This article covers the subjects of extracorporeal CPR (ECPR), including extracorporeal life support (ECLS), emergency ECLS (EECLS) and mechanical resuscitation devices. Specifically, the potential use of active compression-decompression CPR (ACD-CPR), impedance threshold devices (ITD) and capnography as additional measures during resuscitation are described in detail. Furthermore, the article presents a compact preview of the potential future developments of technical aids in the field of life support and postresuscitation care.

Bioactive phenols in algae: the application of pressurized-liquid and solid-phase extraction techniques.

A new extraction technique based on the off-line combination of pressurized-liquid with solid-phase extraction (PLE-SPE) is described. The method was used for the extraction of bioactive phenolic acids (protocatechuic, p-hydroxybenzoic, 2,3-dihydroxybenzoic, chlorogenic, vanillic, caffeic, p-coumaric, salicylic acid), cinnamic acid and hydroxybenzaldehydes (p-hydroxybenzaldehyde, 3,4-dihydroxybenzaldehyde, vanillin) from in vitro culture of two freshwater algae (Anabaena doliolum and Spongiochloris spongiosa) and from food products of marine macroalgae Porphyra tenera (nori) and Undaria pinnatifida (wakame). For the identification and quantification of the compounds the molecular ions [M-H](-) and specific fragments were analyzed by quadrupole mass spectrometry analyzer connected on-line with a reversed-phase HPLC system. Our analysis showed that the freshwater algae and marine algal products contained submicrogram or microgram level of above-mentioned phenols per gram of lyophilized sample. In addition, the total phenol content (Folin-Ciocalteu assay) and antioxidant activity (TEAC assay, Trolox equivalent antioxidant capacity assay) of the PLE-SPE extracts were determined and discussed.

Determination of phenolic compounds and their antioxidant activity in fruits and cereals.

Three methods, FCM (with Folin-Ciocalteu reagent), PBM (Price and Butler) and AAPM (with 4-aminoantipyrine) for assessment of phenolic compounds and three commonly used methods, TEAC (Trolox equivalent antioxidant capacity), DPPH (with diphenyl-picrylhydrazyl radical), and FRAP (ferric reducing antioxidant power) for evaluation of antioxidant capacity, were modified to a semimicroscale (total volume 1ml) with minimum consumption (to 100mul) of a sample and thereby applicable for fast screening. Appropriate standards and extracts of 17 kinds of fruit and six kinds of cereal were assessed for total content of phenolic compounds and total antioxidant capacity by each of these methods. The results of analyses of commonly used standards (gallic, caffeic and ferulic acids, (+)-catechin, Trolox, fenol and FeSO(4)) for these methods and identical plant extract showed different reactivity of principal reagent of the methods with individual standards and therefore with phenolic substances of extracts as well. However, the trends of the measured values of extracts could be compared, though their absolute values differ proportionally. At assessments of phenolic compounds it is important to determine content of ascorbic acid at roughly the same time and correct the obtained values according to its contribution to the increase in absorbance calculated on the basis of absorbance equations, especially for samples with a higher content. The same is true for reducing saccharides; they can significantly "elevate" values of contents of phenolic compounds and antioxidant activities (by even more than 50%), especially in samples of sweeter fruits. The saccharides should therefore be removed or a correction applied reflecting their concentration.

Biochemical analysis of breast cyst fluid as a possible predictor of breast carcinoma development.

The occurrence of breast cancer in patients with gross cystic disease is 2-5 times higher as compared to control group of women. During 3 years, 183 cyst fluid samples were analyzed in 129 females, in 30 patients of them the samples were analysed repeatedly. The distribution of the Na+/K+ ratio, considered as the measure of cancer risk, was found to be bimodal. In repeated analyses the type I cyst fluid markedly predominated (Na+/K+ < or = 4.0). A direct dependence on this ratio was found in the concentration of glucose, albumin, carcinoembryonic antigen (CEA), tissue polypeptide antigen (TPA) and its specific form, TPS; an indirect dependence was found for the level of uric acid, phosphates, alkaline phosphatase (ALP) and alpha-amylase (AMS). The predominance of apocrine metaplasia cells released into the cyst fluid is characteristic of type I cysts. A definitive assessment of significance of these parameters will be enabled by a long-term follow-up of the disease in the respective patients.

Early diagnosis of breast cancer dissemination by tumor markers follow-up and method of prediction.

A mathematical model of prediction of progression was tested in patients with breast cancer employing long-term monitoring of tumor markers CEA, CA 15-3, MCA and TPA, erythrocyte sedimentation rate (FW), and the enzymes gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP) and lactate dehydrogenase (LD) in serum. At the same time, specificity, sensitivity, lead time and positive predictive value were evaluated along with false positivity for all these parameters and their combinations. A model was proposed for the follow-up of patients with breast cancer after the completion of basic therapy.

Carcinoembryonic antigen and alpha-lactalbumin in phylloid tumor tissues.

The concentration of carcinoembryonic antigen and alpha-lactalbumin in tumor tissue cytosol were analyzed in a group of 19 tumors of cystosarcoma phyllodes type. Both antigens were also localized in the tissue of identical tumors by means of immunohistochemical procedure. The cytosol levels of both proteins were found to be higher in the histologically defined malignant type of phylloid tumors. This group was also characterized by the simultaneous occurrence of both antigens. We did not manage to prove any relationship between the presence of alpha-lactalbumin and the steroid hormone receptor positivity in tumor tissue.

Complex biochemical analysis of human breast tumor tissue.

The quantitative biochemical analysis of tissue specimens from 76 human breast carcinomas consisted of examination for cytosolic estrogen receptors (cER), nuclear estrogen receptors (nER), progesterone receptors (PgR), 1,25-dihydroxycholecalciferol receptors (DR), carcinoembryonic antigen (CEA), alpha-lactalbumin (aLA), and gamma-glutamyl transferase (gGT). The highest incidence was found in CEA (76%), DR (70%), and aLA (62%). There was a high percentage of tumors containing only DR, in contrast to the tumors containing only cER or PgR. The simultaneous occurrence of DR and CEA was considerably high (61%). No statistically significant differences were observed in these biochemical parameters in relation to the grade of differentiation of the tumors. The values of aLA in tumors that invaded lymphatic or blood vessels were lower as compared to those tumors that invaded adipose or connective tissues. The level of statistical significance of this difference was close to 5%, the differences in other parameters were statistically insignificant. For prognosis assessed at the time of surgery, after a 2-3-year follow-up of 36 patients the level of gGT in the tumor seems to be the most promising prognostic factor. The values of gGT were significantly lower in those patients whose tumors were in progression during this time. The significance of nER and aLA was also taken into consideration.

Occurrence of carcinoembryonic antigen in tumor tissue and serum of breast cancer patients.

In 116 breast cancer patients, the levels of carcinoembryonic antigen (CEA) were determined before operation in the serum using RIA, and after operation in sections of breast tumor tissue using the immunohistological PAP technique. CEA circulating in the serum was found in 49 patients (42%). Elevated values (over 10 micrograms/l) were found in only 12 patients (10%). In histological specimens CEA positivity was found in 94 tumors (81%), however, in a majority of them the number of positive cells per section was low (1-10%). A comparison of positive and negative findings both in the serum and in the tumor specimens of individual patients showed that both serum and tumor sections were CEA positive in 40 patients (35%) and both localizations were CEA negative in 13 patients (12%). Although most patients had positive histological sections but negative sera (46%). Only 7% of patients had negative sections and positive sera. In 41 patients CEA could be examined both qualitatively (immunohistologically), and quantitatively in the cytosol of the same homogenized tumor. Of them, 30 patients (72%) had in the cytosol a CEA concentration exceeding 5 micrograms/g proteins, in 11 of the 41 patients (28%) no CEA was found. Immunohistological examination of CEA in this group gave positive results in 35 out of the 41 patients (85%), and only 6 tumors (15%) were completely negative. CEA was shown to be present in each histological type of the tumors studied, invasive ductal tumors being slightly more frequent and more positive than the lobular ones. No relation was observed to the structure of the tumors, nor to the degree of their differentiation. Thus, the examination of CEA levels can hardly contribute to the improvement of histological classification.

Clinical aspects of alpha 1-fetoprotein determination in human liver cancer and in humans and experimental animals at carcinogenic risk.

Recent findings concerning the significance of alpha 1-fetoprotein (AFP) as a tool for clinical diagnosis and monitoring of tumor diseases are reviewed briefly. The applicability of this protein marker to the early diagnosis of patients at carcinogenic risk is discussed. In addition, experimental data obtained with a model of chemical hepatocarcinogenesis are reported. The increase of proliferative activity in precancerous liver tissue preceded AFP production under experimental conditions with azodyes and aflatoxin B1 as carcinogens. Immunohistochemical analysis of the relation of AFP to changes of cell populations and to liver tissue rearrangement led to the conclusion that AFP-producing cells cannot be precursors of malignant hepatocytes; however, AFP appeared to be linked to dividing hepatocytes at a certain step of cell differentiation regardless of the stages of precancerous development. A decrease in the rate of nuclear RNA synthesis was observed in both precancerous and tumor tissues. A possible analogy between the early phase of AFP production in animal carcinogenesis and that in human carcinogenesis is considered.

Relationship between alpha-fetoprotein positive cells and precancerous lesions in rat liver during 3'-methyl-4-dimethylaminoazobenzene carcinogenesis.

Localization of characteristic precancerous lesions was compared with that of alpha-fetoprotein (alpha-FP) positive cells during hepatocarcinogenesis in Wistar rats fed 0.06% 3'-methyl-4-dimethylaminoazobenzene in basal diet. Proliferative activity of liver cells was simultaneously followed by deoxycytidylate deaminase. The first alpha-FP positive hepatocytes were found after 3 weeks of carcinogenesis in certain parts of the capsule 0.1--0.2 mm thick. In the seventh week of carcinogenesis their number increased and they were present in groups also subcapsularly. At this stage, hyperplastic islets began to be formed in the liver parenchyma. After 14 weeks of carcinogenesis, alpha-FP positive cell clusters and islets were also found in the deeper layers of liver parenchyma in regions with proliferation of transitory cells. Hyperplastic basophilic foci and islets occurred regularly, however, these were not identical with alpha-FP positive sites and their incidence was more frequent.

Localization of alpha-fetoprotein by immunofluorescent method during induction of rat liver tumors by 3'-methyl-4-dimethylaminoazobenzene.

Localization of alpha-fetoprotein (alpha-FP) has been followed in hepatal tissue and tumors during induction of primary hepatomas with the aid of 0.12% 3'-Me-DAB (3'-methyl-4-dimethylammoazobenzene) in Wistar rats. The indirect immunofluorescence method was used for the localization of alpha-FP positive cells. During the course of carcinogenesis, alpha-FP in serum was detected by means of the crossing over immunoelectrophoresis. This study has yielded the following results: Alpha FP positive cells resembling small hepatocytes occurred dispersed and in groups beginning with the 5th week of a carcinogenic diet until the appearance of tumors. No alpha-FP positive oval cells have been found. Alpha-FP positive cells were always found in rats with alpha-FP positive serum, but they were rarely present in rats with alpha-FP negative serum. From the 10th week, tumors of the cholangiohepatoma type began to be formed in which variously scattered alpha-FP positive cells of the type of small hepatocytes were present, with the serum being negative. Between week 14 and 21 hepatoma nodules began to be formed. At week 21 frequent alpha-FP positive cells close to normal hepatocytes were observed both singly and in groups. These are considered to be the sites of developing tumor nodules. In all the hepatoma nodules, the number of positive tumorous cells and the intensity of fluorescence proved to be directly proportional to alpha-FP concentration in serum.

Localization of alpha-fetoprotein in liver tissue of rats during postnatal development: comparison of the immunofluorescent and autoradiographic methods.

Localization of alpha-fetoprotein has been followed in the liver of rats of the Wistar strain from birth up to 37th day of life, and its presence was detected by means of the immunofluorescent and the autoradiographic methods. The former has shown alpha-fetoprotein to be localized in hepatocytes and the number of positive hepatocytes to decline proportionally with that of alpha-fetoprotein concentration in the serum. In newborn rats almost all the hepatocytes were found to be positive. During the course of the subsequent development of the liver tissue the number of positive hepatocytes decreases and at the time of the formation of the lobular structure only certain groups of lobes remain positive. The number of positive cells, gradually diminishes from the periphery towards the vena centralis. The autoradiographic method revealed only small groups of individual cells to be alpha-fetoprotein positive, without any specific localization.