Healing effect of warfarin in the course of cerulein-induced acute pancreatitis in rats.

Acute pancreatitis (AP) is the most common gastrointestinal disease leading to hospitalizations and unexpected deaths. The development of AP leads to damage of the pancreatic microcirculation with a cascade of subsequent events resulting, among others, in coagulopathy. Previous research showed that anticoagulants can be important therapeutic agents. Heparin and acenocoumarol can alleviate the course of AP, as well as accelerate healing and post-inflammatory regeneration of the pancreas. The aim of this study was to determine whether warfarin, a drug with more stable effects than acenocoumarol, affects the healing and regeneration of the pancreas in the cerulein-induced AP. AP was evoked in Wistar male rats by intraperitoneal administration of cerulein. The first dose of warfarin (45, 90 or 180 µg/kg) was administered 24 hours after the first dose of cerulein and the doses of warfarin were repeated once a day in subsequent 10 days. The severity of AP was assessed immediately after the last dose of cerulein, as well as at days 1, 2, 3, 5, and 10 after AP induction. Treatment with warfarin dose-dependently increased international normalized ratio (INR) and attenuated the severity of pancreatitis in histological examination and accelerated pancreatic recovery. These effects were accompanied with a faster reduction in the AP-evoked increase in serum activity of amylase and lipase, the serum concentration of pro-inflammatory interleukin-1ß, and the plasma level of D-Dimer. In addition, treatment with warfarin decreased pancreatic weight (an index of pancreatic edema) and improved pancreatic blood flow in rats with AP. The therapeutic effect was particularly pronounced after the administration of warfarin at a dose of 90 µg/kg. We conclude that treatment with warfarin accelerated regeneration of the pancreas and recovery in the course of cerulein-induced mild-edematous acute pancreatitis.

Administration of warfarin accelerates the recovery in ischemia/reperfusion-induced acute pancreatitis.

Acute pancreatitis is associated with activation of coagulation and there is a close relationship between coagulation and the severity of this disease. Administration of anticoagulants such as heparin or acenocoumarol has shown to reduce the severity of acute pancreatitis and accelerate the recovery. The aim of the current study was to determine the impact of warfarin administration on the course of ischemia/reperfusion-induced acute pancreatitis. Acute pancreatitis was induced in rats by pancreatic ischemia followed by reperfusion. Vehicle (1 ml/dose) or warfarin (45, 90 or 180 µg/kg/dose in 1 ml of vehicle) were administered intragastrically once a day. The first dose of warfarin was given 24 h after the start of pancreatic reperfusion. The severity of acute pancreatitis was assessed 2, 5, 9 and 14 days after the beginning of pancreatic reperfusion. Treatment with warfarin reduces pancreatic damage and accelerates recovery in histological examination and this effect is accompanied by a faster reduction in serum activity of pancreatic digestive enzymes, lipase and amylase. In addition, warfarin led to an earlier decrease in serum concentration of pro-inflammatory interleukin-1ß and plasma level of D-dimer. These effects were associated with an improvement of pancreatic blood flow. We conclude that warfarin exhibits a therapeutic effect in acute pancreatitis evoked by pancreatic ischemia followed by reperfusion.

The influence of pretreatment with ghrelin on the development of acetic-acid-induced colitis in rats.

Ghrelin has been primarily shown to exhibit protective and therapeutic effect in the gut. Pretreatment with ghrelin inhibits the development of acute pancreatitis and accelerates pancreatic recovery in the course of this disease. In the stomach, ghrelin reduces gastric mucosal damage induced by ethanol, stress or alendronate, as well as accelerates the healing of acetic acid-induced gastric and duodenal ulcer. The aim of present studies was to investigate the effect of pretreatment with ghrelin on the development of acetic acid-induced colitis. Studies have been performed on male Wistar rats. Animals were treated intraperitoneally with saline (control) or ghrelin (4, 8 or 16 nmol/kg/dose). Saline or ghrelin was given twice: 8 and 1 h before induction of colitis. Colitis was induced by a rectal enema with 1 ml of 4% solution of acetic acid and the severity of colitis was assessed 1 or 24 hours after induction of inflammation. Rectal administration of acetic acid induced colitis in all animals. Damage of colonic wall was seen at the macroscopic and microscopic level. This effect was accompanied by a reduction in colonic blood flow and mucosal DNA synthesis. Moreover, induction of colitis significantly increased mucosal concentration of pro-inflammatory interleukin-1ß (IL-1ß), activity of myeloperoxidase and concentration of malondialdehyde (MDA). Mucosal activity of superoxide dismutase (SOD) was reduced. Pretreatment with ghrelin reduced the area and grade of mucosal damage. This effect was accompanied by an improvement of blood flow, DNA synthesis and SOD activity in colonic mucosa. Moreover, ghrelin administration reduced mucosal concentration of IL-1ß and MDA, as well as decreased mucosal activity of myeloperoxidase. Administration of ghrelin protects the large bowel against the development of the acetic acid-induced colitis and this effect seems to be related to the ghrelin-evoked anti-inflammatory and anti-oxidative effects.

Distribution of lymphomas in Poland according to World Health Organization classification: analysis of 11718 cases from National Histopathological Lymphoma Register project - the Polish Lymphoma Research Group study.

Most national lymphoma registers rely on broad classifications which include Hodgkin and non-Hodgkin lymphomas (NHL), multiple myeloma and leukaemia. In Poland the National Histopathological Lymphoma Register project (NHLR) was implemented by hematopathologists in accordance with the 2008 WHO classification into haematopoietic and lymphoid tissues. We present the NHLR data and compare lymphoma distribution in Poland, Europe, as well as in North Central and South America. Records of 11718 patients diagnosed in 24 pathology departments from all over the country were retrieved and reclassified into indolent and aggressive lymphomas according to the 2008 revised WHO classification system. DLBCL (32.9%; 2587), CLL/SLL (31.84%; 2504) and MCL (9.04%; 711) were the three most frequent NHL. The ratio of indolent to aggressive NHL was 1.72; 63.25% (4809) to 36.25% (2794) of cases respectively. Multiple myeloma was less frequent as compared to the data from population-based national cancer register (13.32% vs. 28.94%). Major differences between NHLR and European and American data on NHL subtypes concered: higher incidence of aggressive B-cell lymphomas including DLBCL, lower FL and MALT incidence rate. The percentage of unclassified lymphomas in the study was minimal due to participation of hematopathologists.

History and current status of Polish gastroenterological pathology.

The present paper summarizes the contribution of Polish investigators to the development of gastroenterology, and especially pathology of the gastrointestinal tract. We called to mind meritorious scientists among the 19(th)-century and modern pathologists. Especially interesting are discoveries of Browicz, being the first, who described typhus bacilli and shortly after Kupffer - fagocytozing cells in the liver. Noteworthy are detailed description of tumorous lesions being the contribution to oncological pathology of the gastrointestinal tract as well as the reports on congenital malformations (i.e. esophageal fistulas). Moreover we remind the investigators dealing with pathology of gastric ulcer disease, its pathogenesis and mechanisms of healing. Of great importance was also the discovery of regeneration existing also outside the mucosal surfaces. In the paper, besides the above-mentioned Tadeusz Browicz investigations of professors: Lesniowski, Ciechanowski, Kowalczykowa, Stachura, Konturek are called to mind.

Evaluation of the proliferative activity as an adjuvant helpful tool in the diagnosis of primary gastric lymphoma in gastrobiopsy.

Gastrobiopsy specimens obtained from 15 patients, in whom gastroscopy examination pointed to gastric cancer and primary gastric lymphoma was later diagnosed in surgical material after gastrectomy, were immunostained using the anti MIB-1 antibody to assess the proliferative index. A control study was carried out on representative surgical specimens from these patients and on 10 gastrobiopsy specimens from patients in whom histopathology revealed moderate/severe gastritis. The proliferative activity was assessed with respect to the type of lymphoma (primary gastric marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue MALT type vs. diffuse large B-cell lymphoma) and stage of the lymphoma, and we compared the proliferative indices between inflammatory infiltrate and lymphoma cells. There were significant differences in the proliferative indices between inflammatory infiltrate and lymphoma cells, with immunohistochemical reactivity for MIB-1 antigen being visible even in the case of markedly mechanically damaged (crushed) gastrobiopsy material and accompanying necrosis. There were also differences in the proliferative indices between the groups of lymphomas varying in stage, although without statistical significance. There were no statistical differences in the rate of proliferation between lymphomas varying in "malignancy". The present results argue for the auxiliary role of the assessment of proliferative activity in gastrobiopsy material facilitating differentiation between inflammatory infiltrate and neoplastic infiltrate, especially in cases where mechanical damage or necrosis do not allow for precise histopathological evaluation.

Factors associated with progression of primary gastric marginal zone B-cell lymphomas of mucosa-associated lymphoid tissue (MALT type).

Sixty cases of primary MALT type lymphomas were subjected to a retrospective analysis, which assessed the proliferative (PI) and apoptotic (AI) indices. The MIB-1 antibody was used for the Ki-67 proliferative antigen epitope, as well as the Apoptag In Situ Apoptosis Detection Kit (Oncor). The group included 32 low-grade and 28 high-grade lymphomas. In addition, the high-grade lymphomas group was divided into subgroups, depending on the presence or absence of a low-grade component. Significant differences were demonstrated in proliferative and apoptotic indices for cases differing with respect to their histological grade and stage. In low-grade lymphomas, the increase of AI value was associated with the increase of blast cells in the neoplastic infiltrate. It was necessary to exclude from this group cases of intensified plasmocytic differentiation, as such intensified differentiation alone was associated with increased AI values also. Considerable variations were noted in AI and PI values, even in groups with the same histological grade. The results suggest a potential clinical importance of AI and PI evaluations, stressing the necessity of treating each case of primary MALT type lymphoma individually. It appears that histological grade and stage evaluation alone may be insufficient when planning the management and prognosticating the response to therapy.

Epithelial-myoepithelial carcinoma of the bronchus.

The authors describe an extremely rare case of epithelial-myoepithelial carcinoma of bronchial mucous glands involving lower lobe of the right lung, which was detected on a routine radiological examination in a 34-year-old woman, and then surgically resected.

Primary localized cutaneous amyloidosis--lichen amyloidosus. A case report.

We report a case of primary localized cutaneous amyloidosis-lichen amyloidosus in a 55-year-old man. Immunohistochemistry using antibodies against cytokeratin and AL immunoglobulins revealed the presence of both components in amyloid foci located subepidermally, mainly in dermal papillae. The results of histochemical reactions confirm the keratin-derived nature of amyloid in primary cutaneous amyloidosis.

[Invasive pulmonary aspergillosis in the course of allergic pulmonary alveolitis]. / Inwazy jna grzybica kropidlakowa pluc w przebiegu alergicznego zapalenia pecherzyków plucnych.

20 years old man with history of acute allergic alveolitis 7 years ago, was admitted to hospital because of dyspnea, fever and cough after massive exposition to organic dust. Corticosteroids were introduced. During 3-weeks treatment respiratory failure progressed. Chest x-ray showed massive bilateral nodular opacities. Antibiotic therapy was not effective. The autopsy revealed invasive pulmonary aspergillosis. Presence of precipitins to aspergillus fumigatus was confirmed postmortem. Diagnostic difficulties are discussed.

Synchronous carcinoma and primary MALT-lymphoma of the stomach. A report of two cases.

A synchronous presentation of an adenocarcinoma and a primary low grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) in the stomach is reported in a 73-year-old woman and a 55-year-old man. The diagnosis was based on microscopic examination of surgical specimens with immunohistochemistry. A possible etiology of the simultaneous presence of these two neoplasms in the stomach is discussed on the basis of our own material and review of the literature.

Gastric fundic gland polyps (Elster's polyps) and Helicobacter pylori-induced gastritis.

In a series of 555 gastric polyps characteristic Elster's polyps were identified in 31 cases. Spiral bacteria (Helicobacter pylori) in these polyps were sporadic, much less frequent (9.7%) than in hyperplastic polyps (35%) in the present series and in relation to the bacteria frequency found in our randomly chosen gastric biopsy specimens (43%). The present results indicate that Elster's polyps are not readily colonized by Helicobacter pylori and accordingly, they do not show the signs of active gastritis. The reasons for this are unknown. One of the mechanisms preventing from bacterial colonization may be a different from normal gastric mucosa and other polyps character of mucus produced by glandular neck cells, which was found in our series of gastric fundic gland polyps.