High frequency ultrasonography: a complementary diagnostic method in evaluation of primary cutaneous melanoma.

AIM: The aim of our study was to assess the usefulness of high frequency ultrasonography in the diagnosis of melanoma. METHODS: We examined 84 patients with suspicious melanocytic skin lesions, including 19 cases of melanoma. In vivo high-resolution ultrasonography (30 MHz) was performed prior to excision. RESULTS: In ultrasound scans early melanomas presented as flat oval or fusiform shaped structures and were clearly demarcated, while advanced melanomas were characterized by a roundish shape with less distinct borders. The ultrasonographic thickness of in situ melanomas ranged from 0.02 to 0.85 mm. In the case of invasive tumors, the mean thickness evaluated by high frequency ultrasonography was 10.7% higher compared to the Breslow Score (1.44±0.8 mm and 1.3±0.88 mm, respectively). In all melanomas of Breslow Score of 1 mm or more ultrasound also indicated a Breslow Score of 1 mm or more. CONCLUSION: High frequency ultrasound examination has limited value in differential diagnosis of melanoma, but it gives a clear picture of the size and depth of the tumor. The method should be used as a complementary method (after dermoscopy and, where applicable, reflectance confocal microscopy) in preoperative evaluation of the tumor. In some cases of locally advanced melanoma, ultrasound examination may allow to reduce the number of surgical procedures and favor the decision of a one-time surgical treatment (removal of primary tumor and sentinel lymph node biopsy at the same time).

[The influence of heparin on histamine level in plasma during the early reaction phase of asthma]. / Wplyw heparyny na poziom histaminy w osoczu we wczesnej fazie reakcji astmatycznej.

Heparin, well known anticoagulant, can also modulate inflammatory and immunologic processes. Some investigators suggest that heparin inhibits mast cell degranulation. Mast cells play very important role in early phase of asthmatic reaction, releasing many proinflammatory mediators including histamine. The purpose of study was to determine the effect of heparin on early asthmatic response and on histamine level in plasma after allergen challenge. Eleven patients with mild and moderate asthma were studied in a double blind placebo controlled manner. Sodium heparin or placebo were taken via nebulizer, and 15 minutes later allergen challenge (Dpt./grass pollen) was performed. FEV1 was measured at 5, 15, 30 and 60 minutes after challenge and PC20 for allergen was calculated. Peripheral blood was collected before and 30 minutes after challenge to assess histamine concentration in plasma by an immunoenzymatic assay. We observed that heparin significantly decreased early asthmatic response in all patients. After challenge with the same concentration of allergen FEV1 fell 36% for placebo and 8% for heparin. Heparin also prevented rise in histamine level in plasma after allergen challenge. The concentration of histamine before and after challenge were respectively 9.55 +/- 4.08 and 13.06 +/- 3.86 nM for placebo (p < 0.05) and 8.88 +/- 1.50 and 11.18 +/- 1.84 nM for heparin (p > 0.05). There was no correlation between FEV1 and histamine level before and after challenge. Our results suggest that heparin diminishes allergen induced early phase of asthmatic recreation by inhibition of mast cells degranulation.

[The effect of heparin on release of histamine from basophils under the influence of MCAF/MCP-I in patients with bronchial asthma]. / Wplyw heparyny na uwalnianie histaminy z bazofilów pod wplywem MCAF/MCP-I u chorych na astme oskrzelowa.

The clinical studies show that heparin, well known as an anticoagulant, inhibits early asthmatic response (EAR) and bronchial hyperactivity after allergen challenge in allergic patients. We have previously shown that heparin attenuates also the late phase of allergic reaction (LAR) Recently it has been shown that heparin modulates mastocyte mediator release. This could explain the beneficial role of heparin in EAR. The goal of this study was to explore the protective mechanism of heparin on LAR. Basophils are important cells in the development of LAR. We studied the effect of heparin on histamine release from basophils induced by anti-IgE and monocyte chemotactic-activating factor/monocyte chemotactic protein (MCAF/MCP-I). MCAF belongs to the chemokine family and is the most potent histamine releasing factor. Basophils were isolated from peripheral blood of 12 asthmatic patients. The cells were incubated with heparin in various concentrations: 10, 25, 50 and 100 U. Histamine was measured by spectrophotofluorometric method. We observed that incubation of basophils with heparin inhibits histamine release as shown in the table: [table: see text] Preincubation of anti-IgE or MCAF/MCP-I with heparin did not induce any changes in histamine release. The suggest that action of heparin depends on interaction with the cells but not with the agonists.

[The effect of heparin on eosinophil chemotaxis induced by Rantes and FMLP]. / Wplyw heparyny na chemotaksje eozynofilów wywolana chemokina Rantes i FMLP.

Eosinophils are important cells of inflammatory infiltration in respiratory tract of asthmatics patients. Rantes is a potent chemotactic agent for eosinophils. It belongs to the chemokine family. Heparin has been reported to diminish size of allergen skin tests and decrease response to allergen bronchoprovocation in allergic asthma. We have found that heparin diminished late phase of allergic reaction and inhibits allergen induced increase in specific and nonspecific bronchial hyperresponsiveness. In order to explore the mechanism involved in these protective effects we studied the influence of heparin on eosinophil chemotaxis induced by Rantes and FMLP. Eosinophils were isolated from peripheral blood of 12 asthmatic donors. Chemotaxis was evaluated using polycarbonate filters in 48-well chemotactic chamber. The table shows the results (*) p < 0.05. [table: see text] Ten minutes exposure of eosinophils to heparin was sufficient for inhibition. Removal to heparin by washing the cells ablated observed effects. Preincubation of Rantes or FMLP with heparin did not induce any significant changes in eosinophil chemotaxis. Heparin alone did not posess any chemotactic activity for eosinophils. Our results suggest that heparin ameliorate allergic inflammation by inhibition of eosinophil flux and this inhibition is a surface phenomenon.