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1.
J Gastrointest Surg ; 27(1): 7-16, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36138310

RESUMO

BACKGROUND: The American Joint Committee on Cancer (AJCC) staging system has limited accuracy in predicting survival of gastric cancer patients with inadequate counts of evaluated lymph nodes (LNs). We therefore aimed to develop a prognostic nomogram suitable for clinical applications in such cases. METHODS: A total of 1511 noncardia gastric cancer patients treated between 1990 and 2010 in the academic surgical center were reviewed to compare the 7th and 8th editions of the AJCC staging system. A nomogram was developed for the prediction of 5-year survival in patients with less than 16 LNs evaluated (n = 546). External validation was performed using datasets derived from the Polish Gastric Cancer Study Group (n = 668) and the SEER database (n = 11,225). RESULTS: The 8th edition of AJCC staging showed better overall discriminatory power compared to the previous version, but no improvement was found for patients with < 16 evaluated LNs. The developed nomogram had better concordance index (0.695) than the former (0.682) or latest (0.680) staging editions, including patients subject to neoadjuvant treatment, and calibration curves showed excellent agreement between the nomogram-predicted and actual survival. High discriminatory power was also demonstrated for both validation cohorts. Subsequently, the nomogram showed the best accuracy for the prediction of 5-year survival through the time-dependent ROC curve analysis in the training and validation cohorts. CONCLUSIONS: A clinically relevant nomogram was built for the prediction of 5-year survival in patients with inadequate numbers of LNs evaluated in surgical specimens. The predictive accuracy of the nomogram was validated in two Western populations.


Assuntos
Nomogramas , Neoplasias Gástricas , Humanos , Prognóstico , Estadiamento de Neoplasias , Neoplasias Gástricas/patologia , Linfonodos/patologia
2.
Sci Rep ; 12(1): 14100, 2022 08 18.
Artigo em Inglês | MEDLINE | ID: mdl-35982071

RESUMO

To report the visual and refractive outcomes of new aspheric hydrophobic acrylic monofocal intraocular lens (IOL). Retrospective case series. This study included eyes of patients who underwent routine cataract surgery for uncomplicated age-related cataract with implantation of a Aktis SP (NS-60YG; Nidek Co. Ltd., Japan) IOL and attended regular follow ups at 1 week, 1 month, 3 months, and 12 months. At each post-operative visit, ophthalmological evaluation included measurement Uncorrected (UCVA) and Best corrected visual acuity (BCVA), contrast sensitivity, posterior capsular opacification (PCO), optical aberrations, analysis of point spread function (PSF) and modulation transfer function (MTF). The study included 2102 eyes of 1358 patients aged 45 to 75 years (mean age 62.6 years ± 5.6 SD). The mean preoperative BCVA was 0.56 ± 0.26 logMAR. At 1 year follow up, the mean postoperative UCVA and BCVA were 0.11 ± 0.09 and 0.02 ± 0.03 logMAR, respectively. At the end of 6 months, around 1487 (93%) eyes had BCVA of 20/20 and better than 20/30 in 100% of the eyes. Mild posterior capsule opacification (PCO) was observed in 56 patients, but none required Nd YAG laser capsulotomy. There was reduction in ocular spherical aberration and Higher order aberrations (HOAs) as compared to pre operative. This explains better contrast sensitivity obtained by MTF and PSF values. The study shows that the Aktis SP IOL is safe, effective, and stable lens that could be inserted through 2.2 mm incision with satisfactory visual and refractive outcomes, even in late post-operative period.


Assuntos
Opacificação da Cápsula , Catarata , Lentes Intraoculares , Facoemulsificação , Opacificação da Cápsula/etiologia , Opacificação da Cápsula/cirurgia , Catarata/etiologia , Humanos , Implante de Lente Intraocular/efeitos adversos , Pessoa de Meia-Idade , Facoemulsificação/efeitos adversos , Complicações Pós-Operatórias/etiologia , Desenho de Prótese , Estudos Retrospectivos , Acuidade Visual
3.
J Physiol Pharmacol ; 70(1)2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31172973

RESUMO

Obesity is characterised by imbalance in lipid metabolism manifested by high concentrations of circulating triacylglycerols and total cholesterol as well as low high-density lipoprotein (HDL) levels. Abnormalities related to these lipids lead to metabolic complications such as type 2 diabetes, arterial hypertension and cardiovascular disease. Despite extensive research, it is still unclear why a subset of obese subjects develop metabolic syndrome, while others do not. The aim of our work was to assess total and plasma membrane expressions of cholesterol transport proteins: adipocyte ATP-binding cassette A1 (ABCA1), adipocyte ATP-binding cassette G1 (ABCG1), class B scavenger receptor (SR-BI) in visceral and subcutaneous adipose tissue of obese subjects with and without metabolic syndrome. To keep our preliminary study group uniform, we focused on women, who constitute the majority of bariatric patients. The study was performed on 34 patients: 24 morbidly obese women subjected to bariatric surgery, half of whom had metabolic syndrome; and 10 lean subjects undergoing elective laparoscopic cholecystectomy. Total and plasma membrane expressions of cholesterol transport proteins (SR-BI, ABCA1 and ABCG1) were assessed in samples of both visceral and subcutaneous adipose and analysed in relation to other clinical and laboratory parameters. We demonstrated lower plasma membrane expressions of ABCG1 in visceral adipose tissue of obese patients with metabolic syndrome as compared to lean ones. In addition, total ABCG1 expressions in both types of adipose tissue were lower in morbidly obese patients with metabolic syndrome compared to those without metabolic syndrome. Plasma membrane ABCA1 expressions in visceral adipose tissue were lower in the group of morbidly obese patients without metabolic syndrome, compared to lean patients. We did not find any significant differences in SR-BI expressions. Because of ABCG1 is responsible for cholesterol efflux to HDL, reduced plasma membrane expression of ABCG1 in VAT of morbidly obese women with metabolic syndrome may leads to a significantly decreased concentration of HDL in serum. This may be also confirmed by high positive correlation between both parameters.


Assuntos
Transportador 1 de Cassete de Ligação de ATP/metabolismo , Membro 1 da Subfamília G de Transportadores de Cassetes de Ligação de ATP/metabolismo , Tecido Adiposo/metabolismo , Síndrome Metabólica/metabolismo , Obesidade Mórbida/metabolismo , Adulto , Idoso , Colesterol/sangue , Diabetes Mellitus Tipo 2/metabolismo , Feminino , Humanos , Hipertensão/metabolismo , Pessoa de Meia-Idade , Receptores Depuradores Classe B/metabolismo , Adulto Jovem
4.
J Physiol Pharmacol ; 69(4)2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30552304

RESUMO

Chronic inflammation is a critical feature of obesity in the development of myocardial dysfunction. The observations that interleukin-6 (IL-6) is implicated in lipid and glucose homeostasis as well as its connection with the pathogenesis of insulin resistance might suggest the involvement of this cytokine in metabolic disorders of the failing heart. In the present study we aimed to assess the effects of IL-6 ablation in mice fed with normal and high fat diet on the myocardial expression of glucose and fatty acid transporting proteins, and to evaluate the paralleled alterations in lipid content. We demonstrated that mice devoid of IL-6 exert reduced glucose transporter type 4 (GLUT-4) expression (-26%) and plasma membrane abundance (-43%), with no effect on glucose transporter type 1 (GLUT-1) content. Although there were no significant alterations in fatty acid translocase (FAT/CD36) and plasma membrane-associated fatty acid-binding protein (FABPpm) levels, we revealed a substantial decline in intramyocardial triacylglycerol level (-49%). Challenging of IL-6 knockout (KO) mice with high fat diet evoked an increase in FAT/CD36 expression (+19%) concomitantly with a trend for its reduced amount in plasma and mitochondrial membranes. Additionally, an increase in triacylglycerol level (+56%) was noticed, simultaneously with elevated content of saturated (+62%), monounsaturated (+69%) and polyunsaturated (+38%) fatty acids in this lipid fraction. The presented data reflect different roles of IL-6 in cardiomyocytes under selected conditions (i.e., normal and excessive lipid supply).


Assuntos
Dieta Hiperlipídica , Proteínas de Transporte de Ácido Graxo/metabolismo , Interleucina-6/genética , Metabolismo dos Lipídeos , Miocárdio/metabolismo , Animais , Membrana Celular/metabolismo , Masculino , Camundongos Endogâmicos C57BL , Camundongos Knockout , Mitocôndrias Cardíacas/metabolismo
5.
Adv Med Sci ; 58(2): 376-81, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24421217

RESUMO

PURPOSE: The most important index of renal function is estimated glomerular filtration rate (eGFR) which can be calculated from creatinine or cystatin C concentration in serum. There is uncertainty, which formula is best suited to assess renal function in morbidly obese patients. The aim of this study was to evaluate eGFR in patients with morbid obesity using formulas: Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), Grubb, Le Bricon, Hoek, Larsson, and to compare the obtained results. MATERIAL AND METHODS: In 40 morbidly obese patients, serum concentration of cystatin C and creatinine were assayed. Values of eGFR were calculated using the above-mentioned formulas. RESULTS: The mean value of eGFR ranged from 85.9 to 111.1 ml/min/1.73 m², depending on the formula. The biggest difference between the obtained values was 29% (Grubb vs. Hoek p<0.01). After calculation of eGFR from creatinine concentration (MDRD), 7 patients were qualified to the 2nd and 3rd stage of chronic renal disease, while application of Hoek's formula, based on cystatin C concentration, allotted 27 patients to 2nd and 3rd stage of chronic renal disease. Le Bricon formula gave eGFR values, that correlated best with albuminuria. CONCLUSION: eGFR calculated using Le Bricon formula based on the cystatin C concentration was significantly lower than eGFR calculated from creatinine concentration and was more closely associated with albuminuria. Relying only on creatinine concentration to estimate glomerular filtration rate can lead to underestimation of renal malfunction in obese patients.


Assuntos
Creatinina/sangue , Cistatina C/sangue , Testes de Função Renal/métodos , Modelos Biológicos , Obesidade Mórbida/metabolismo , Insuficiência Renal Crônica/metabolismo , Adulto , Ensaio de Imunoadsorção Enzimática/métodos , Feminino , Taxa de Filtração Glomerular , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/epidemiologia , Insuficiência Renal Crônica/epidemiologia , Fatores de Risco
6.
Adv Med Sci ; 57(1): 58-64, 2012 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-22440938

RESUMO

PURPOSE: Obesity is a widespread health issue caused by chronic impaired balance between energy supply and its expenditure. It leads to gathering of excessive fat tissue and numerous co-morbidities.The aim of this study is to present the influence of laparoscopic adjustable gastric banding (LAGB) on plasma ghrelin, insulin, glucose, triglycerides, total, HDL- and LDL-cholesterol concentration as well as on alanine and aspartate aminotransferase in obese patients and influence on co-morbidities such as type 2 diabetes mellitus, dislipidemy, hypertension and sleep apnea. MATERIALS AND METHODS: 100 obese patients underwent LAGB: 34 men - average age 39.18 ± 12.17 years old and 66 women - average age 37.0 ± 12.6 years old. During 6 months follow-up, particular measurements have been conducted in different time points. Evaluation of body mass loss (%EWL, %EBL) and the homeostatic model assessment insulin resistance (HOMA IR) was conducted. In the same time ghrelin, insulin, glucose, triglycerides, total cholesterol, HDL- and LDL-cholesterol concentration was determined after 7 days, 1, 3 and 6 months after the surgery. RESULTS: Significant decrease in BMI and HOMA IR was observed as well as in insulin and glucose concentration. Increase in ghrelin concentration in comparison to preoperative values was also stated. CONCLUSIONS: LAGB leads to significant body mass loss, improvement in patients' general health state and to normalization of metabolic parameters. Improvement or total resolution of type 2 diabetes (T2DM), hypertension and sleep apnea was also noticed.


Assuntos
Gastroplastia , Grelina/sangue , Insulina/sangue , Obesidade/sangue , Obesidade/cirurgia , Adulto , Glicemia/metabolismo , Índice de Massa Corporal , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Triglicerídeos/sangue
8.
Horm Metab Res ; 43(4): 236-40, 2011 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21332025

RESUMO

Interleukin-6 has been shown to cause imbalance between bone resorption and formation in thyrotoxicosis. The aim of the present study was an attempt to estimate the influence of estrogens on thyrotoxicosis-related disturbances in bone turnover in relation to RANKL-RANK/osteoprotegerin system in IL-6 deficient mice. The study was performed on 56, 12-13 weeks old, female mice: C57BL/6J (wild-type; WT) and C57BL/6J (IL6-/-Kopf) (IL-6 knock-out; IL6KO). The mice were randomly divided into 8 groups with 7 mice in each one: 1. WT controls, 2. IL6KO controls, 3. WT mice with thyrotoxicosis, 4. IL6KO mice with thyrotoxicosis, 5. WT ovariectomized, 6. IL6KO ovariectomized, 7. WT ovariectomized mice with thyrotoxicosis, and 8. IL6KO ovariectomized mice with thyrotoxicosis. Experimental model of menopause was evoked by bilateral ovariectomy carried out in 8-9 weeks old mice. Thyrotoxicosis was induced by intraperitoneal injection of levothyroxine at a dose of 1 µg/g daily over 21 days. The serum levels of TRACP5b, osteocalcin, OPG, and RANKL were determined by ELISA. RANKL serum concentrations were elevated significantly in all groups of ovariectomized mice as compared to respective controls, however, in a minor degree in IL6KO thyrotoxic mice as compared to wild-type animals. Osteoprotegerin serum levels were significantly increased in all thyrotoxic groups of mice except ovariectomized IL6KO animals. To sum up, the results of the present study suggest that IL-6 plays a key role in stimulation of RANKL-RANK/OPG system and this effect is strongly enhanced in conditions of accelerated bone turnover such as thyrotoxicosis and/or estrogen depletion.


Assuntos
Osso e Ossos/fisiologia , Estrogênios/metabolismo , Interleucina-6/metabolismo , Ligante RANK/metabolismo , Receptor Ativador de Fator Nuclear kappa-B/metabolismo , Tireotoxicose/metabolismo , Animais , Densidade Óssea , Modelos Animais de Doenças , Feminino , Humanos , Interleucina-6/genética , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Tireotoxicose/genética
9.
Langenbecks Arch Surg ; 396(3): 407-13, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-20694733

RESUMO

PURPOSES: Necrotizing fasciitis is an aggressively progressing complication of the skin and soft tissue infections. It has dramatic course and often leads to patient's death. METHODS: In our research, we present the casuistic case concerning double suicide attempt with petroleum oil injection, complicated by the necrotizing fasciitis, patient was with deliberately withheld mental disorders. RESULTS: During the first suicide attempt, the oil substance was injected into the left cubital fossa and left toes areas, what lead to amputation of the upper left limb above the cubitial fossa and the left toes. Afterward, patient gradually recovered and survived. Two years later, another suicide attempt took place with the same substance: a 27-year-old man injected the petroleum oil into the right supraclavicular area. That affected a necrosis penetrating into the mediastinum and the patient died. CONCLUSIONS: To our knowledge, such case of the necrotizing fasciitis has not been previously reported. The mechanism of derivatives of oil influence on tissues is not investigated yet; therefore, treatment method is uncertain and sometimes ineffective.


Assuntos
Fasciite Necrosante/induzido quimicamente , Fasciite Necrosante/cirurgia , Petróleo/intoxicação , Infecções dos Tecidos Moles/induzido quimicamente , Infecções dos Tecidos Moles/cirurgia , Tentativa de Suicídio/estatística & dados numéricos , Adulto , Progressão da Doença , Fasciite Necrosante/patologia , Evolução Fatal , Humanos , Injeções Intramusculares , Extremidade Inferior , Masculino , Índice de Gravidade de Doença , Infecções dos Tecidos Moles/microbiologia , Extremidade Superior
10.
Folia Histochem Cytobiol ; 48(2): 178-84, 2010 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-20675271

RESUMO

The aim of this study was to estimate sodium iodide symporter (NIS) and thyroid peroxidase (TPO) expression in thyrocytes from patients with GD and no-toxic multinodular goitre (NTMG) in relationship with apoptotic (TIAR and TIA-1) markers. The investigation was performed on thyroid cells isolated from postoperation thyroid tissues from 15 patients aged 12-21 years old with GD and 15 cases aged 13-21 years old with NTMG. Detection of NIS and TPO was performed by immunohistochemistry. Analysis of apoptotic markers in thyroid tissues was performed using antibodies to TIAR and TIA-1 by Western Blot and immunohistochemistry. Identification of proapoptotic TIAR and TIA-1 molecules in the thyroid tissues revealed a higher expression of both proteins in patients with Graves' disease (+++; +, respectively) in comparison to patients with NTNG (+; 0). In addition, TIAR expression was detected in three bands [p50, p42, p38 (kDa)] and TIA-1 in two bands [p22, p17 (kDa)]. using Western Blot test in patients with thyroid autoimmune diseases. In patients with NTNG expression of both apoptotic proteins was lower and identified in single bands: 42 (kDa) for TIAR and 17 (kDa) for TIA-1. The analysis of expression of NIS and TPO in thyroid follicular cells was higher in patients with Graves' disease in compared to their detection in patients with NTMG. In addition, degree of thyroid antigen expression positive correlated with amount of proapoptotic markers (TIAR, p<0.001; TIA-1, p<0.025 for NIS; TIAR, p<0.012 for TPO). We conclude that elevated expression of NIS and TPO in Graves' disease is associated with higher stimulation and activation of apoptosis in thyroid follicular cells during autoimmune process.


Assuntos
Apoptose/fisiologia , Doenças Autoimunes/metabolismo , Biomarcadores/metabolismo , Proteínas de Ligação a Poli(A)/metabolismo , Proteínas de Ligação a RNA/metabolismo , Doenças da Glândula Tireoide/metabolismo , Glândula Tireoide/metabolismo , Adolescente , Autoanticorpos/sangue , Doenças Autoimunes/patologia , Criança , Feminino , Humanos , Imuno-Histoquímica , Iodeto Peroxidase/metabolismo , Masculino , Simportadores/metabolismo , Antígeno-1 Intracelular de Células T , Doenças da Glândula Tireoide/patologia , Glândula Tireoide/citologia , Glândula Tireoide/patologia
11.
Eur J Surg Oncol ; 36(10): 969-76, 2010 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-20727706

RESUMO

AIMS: The purpose of this study was to evaluate the effects of overweight on surgical and long-term outcomes in a Western population of patients with gastric cancer (GC). METHODS: An electronic database of all patients with resectable GC treated between 1986 and 1998 at seven university surgical centres cooperating in the Polish Gastric Cancer Study Group was reviewed. Overweight was defined as a body mass index (BMI) of 25 kg/m(2) or higher. RESULTS: Four hundred and ninety-two of 1992 (25%) patients were overweight. Postoperatively, higher BMI was associated with higher rates of cardiopulmonary complications (16% vs 12%, P = 0.001) and intra-abdominal abscess (6.9% vs 2.9%, P < 0.001). However, other complications and mortality rates were unaffected. The median disease-specific survival of overweight patients was significantly higher (36.7 months, 95% confidence interval (CI) 29.0-44.4) than those with BMI<25 kg/m(2) (25.7 months, 95%CI 23.2-28.1; P = 0.003). These differences were due to the lower frequencies of patients with T3 and T4 tumours, metastatic lymph nodes, distant metastases, and non-curative resections. A Cox proportional hazards model identified age, depth of infiltration, lymph node metastases, distant metastases, and residual tumour category as the independent prognostic factors. CONCLUSIONS: Overweight is not the independent prognostic factor for long-term survival in a Western-type population of GC.


Assuntos
Índice de Massa Corporal , Sobrepeso/mortalidade , Neoplasias Gástricas/mortalidade , Neoplasias Gástricas/cirurgia , Estudos de Coortes , Comorbidade , Feminino , Seguimentos , Gastrectomia/métodos , Gastrectomia/mortalidade , História Medieval , Humanos , Estimativa de Kaplan-Meier , Masculino , Análise Multivariada , Estadiamento de Neoplasias , Obesidade/mortalidade , Polônia , Complicações Pós-Operatórias/mortalidade , Complicações Pós-Operatórias/fisiopatologia , Modelos de Riscos Proporcionais , Sistema de Registros , Estudos Retrospectivos , Medição de Risco , Estatísticas não Paramétricas , Neoplasias Gástricas/patologia , Resultado do Tratamento
12.
Oncology ; 78(1): 54-61, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20215786

RESUMO

OBJECTIVE: The aim of this study was to evaluate the efficacy of adjuvant chemotherapy with etoposide, Adriamycin and cisplatin (EAP) after potentially curative resections for gastric cancer. METHODS: After surgery, patients were randomly assigned to the EAP or control arm. Chemotherapy included 3 courses, administered every 28 days. Each cycle consisted of doxorubicin (20 mg/m(2)) on days 1 and 7, cisplatin (40 mg/m(2)) on days 2 and 8, and etoposide (120 mg/m(2)) on days 4, 5, and 6. RESULTS: Of 309 eligible patients, 141 were allocated to chemotherapy and 154 to the supportive care group. Four (2.8%) treatment-related deaths were recorded, including 3 due to septic complications of myelosuppression and 1 due to cardiocirculatory failure. Grade 3 or 4 toxicities were found in 17 (22%) patients. According to the intention-to-treat analysis, the median survival was 41.3 months (95% confidence interval, 24.5-58.2) and 35.9 months (95% confidence interval, 25.5-46.3) in the chemotherapy and control group, respectively (p = 0.398). Subgroup analysis revealed survival benefit from chemotherapy in patients with tumors infiltrating the serosa and in those with 7-15 metastatic lymph nodes. CONCLUSION: Three cycles of EAP regimen postoperatively offer no survival advantage in gastric cancer patients.


Assuntos
Adenocarcinoma/tratamento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Neoplasias Gástricas/tratamento farmacológico , Adenocarcinoma/cirurgia , Idoso , Quimioterapia Adjuvante , Cisplatino/administração & dosagem , Doxorrubicina/administração & dosagem , Etoposídeo/administração & dosagem , Feminino , Gastrectomia , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Gástricas/cirurgia , Análise de Sobrevida
13.
Horm Res ; 70(3): 155-64, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18663316

RESUMO

The Bcl-2 family proteins that control homeostasis of cells play an important role in apoptosis. This group consists of antiapoptotic (Bcl-2, Bcl-XL) and proapoptotic (Bcl-2 associated protein X, Bax; B-cell homologous antagonist/killer, Bak) molecules. In the thyroid, abnormal apoptotic activity may be involved in a variety of diseases such as autoimmune thyroid diseases. The aim of the current study was to estimate the expression of pro- and antiapoptotic proteins in thyroid tissues from young patients with Graves' disease (GD), nontoxic nodular goiter and toxic nodular goiter using Western Blot and immunohistochemistry. Identification of the antiapoptotic Bcl-2 and Bcl-XL molecules in the thyrocytes revealed higher expression of both proteins in patients with GD (assessed as +++/++ and ++/+, respectively). In adolescents with toxic and nontoxic nodular goiter, this expression was lower (Bcl-2 ++/+ , ++/+; Bcl-XL +, +). The tissue material was additionally subjected to Western Blot analysis, which in GD patients showed the presence of Bcl-2 and Bcl-XL in one band p26 kDa. In patients with toxic and nontoxic nodular goiter, the intensity of expression for these two antiapoptotic proteins was lower (referred to band 26 kDa for Bcl-2 and Bcl-XL). Identification of the proapoptotic proteins Bax and Bak revealed their predominance in thyrocytes of GD patients (+, ++/+, respectively) as compared to patients with toxic and nontoxic nodular goiter (0/+, 0/+ for Bax and 0/+, 0/+ for Bak). In GD patients, Western Blot analysis showed Bax expression in one band 21 kDa and Bak in two bands p50, p24 kDa. In patients with nodular goiter, the degree of expression of both proapoptotic proteins was lower and referred to band 21 kDa for Bax (toxic and nontoxic goiter) and 24 kDa for Bak (toxic goiter only). Patients with GD showed a statistically significant correlation between Bcl-2 expression and antibodies against receptor for thyroid stimulating hormone (R = 0.47, p < 0.03); however, such a correlation was not observed in patients with nodular goiter. In conclusion, our findings suggest that the changes in the expression of regulatory proteins of the Bcl-2 family in the thyroid follicular cells indicate the involvement of apoptosis in the pathogenesis of GD.


Assuntos
Bócio Nodular/metabolismo , Doença de Graves/metabolismo , Proteínas Proto-Oncogênicas c-bcl-2/biossíntese , Adolescente , Adulto , Antitireóideos/uso terapêutico , Apoptose/fisiologia , Western Blotting , Criança , Feminino , Bócio Nodular/sangue , Bócio Nodular/tratamento farmacológico , Bócio Nodular/patologia , Doença de Graves/sangue , Doença de Graves/tratamento farmacológico , Doença de Graves/patologia , Humanos , Imuno-Histoquímica , Masculino , Metimazol/uso terapêutico , Tireotropina/sangue , Tiroxina/sangue , Tri-Iodotironina/sangue
14.
Autoimmunity ; 41(2): 163-73, 2008 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-18324486

RESUMO

Apoptosis, i.e. natural programmed cell death, is a physiological phenomenon indispensable for normal functioning of the organism. The signal to apoptosis can be started practically in any cell. Disturbances in the apoptosis regulation determine the essential link of the pathogenesis of many diseases, including autoimmune thyroid disorders. The aim of the study was to assess the expression of Fas/FasL and caspase eight in the tissues of the thyroid gland in patients with Graves' disease (GD), non-toxic nodular goiter (NTNG) and Hashimoto's thyroiditis (HT). The analysis of Fas/FasL expression was performed by western blot and immunohistochemical investigation with DAB-visualization and Mayer's hematoxylin staining. Caspase-8 expression in thyroid follicular cells was assayed by western blot method. Identification of the proapoptotic proteins FasL and Fas exhibited their pronounced expression in the thyroid tissue in GD patients (++; ++) and HT (+++; +++) as compared to the NTNG group (0/+; 0/+). Among the study groups, the expression of caspase-8 was revealed in band 55 kDa from patients with autoimmune thyroid diseases. In GD patients, the percentage of thyrocytes with FasL expression correlated positively with TRAb (R = 0.58, p < 0.02). However, no such correlations were noted in HT or non-toxic multinodular goiter. There were no significant correlations between thyroid hormones and the percentage of thyrocytes with Fas and FasL expression. In conclusion, our findings suggest that the changes in the expression of apoptotic molecules on the surface of T lymphocytes and thyroid follicular cells in patients with autoimmune thyroid disorders reflect their substantial involvement in the pathogenesis of GD and HT. In addition, analysis of Fas/FasL and caspase-8 expression in thyroid tissue may indicate the disease activity and immunological phenotype.


Assuntos
Apoptose , Caspase 8/metabolismo , Proteína Ligante Fas/metabolismo , Doença de Graves/fisiopatologia , Doença de Hashimoto/fisiopatologia , Glândula Tireoide/metabolismo , Receptor fas/metabolismo , Adolescente , Adulto , Criança , Feminino , Bócio Nodular/metabolismo , Doença de Graves/metabolismo , Doença de Hashimoto/metabolismo , Humanos , Masculino , Glândula Tireoide/citologia
15.
Adv Med Sci ; 52: 294-5, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-18217436

RESUMO

The extremely rare case of 83-year old woman with rupture of the gallbladder due to blunt abdominal trauma is presented. Patient's general condition was complicated because of coagulopathy caused by oral anticoagulant what has contributed to intra-abdominal haemorrhage. The rupture of the gallbladder and rupture of the liver were found during operation. The diagnosis of rupture of the gallbladder due to blunt abdominal trauma is difficult to establish before exploration and often coexists with injury to the liver. The treatment of choice in rupture of the gallbladder is cholecystectomy. In patients after abdominal trauma, beside damage of parenchymatous organs, the injury to other organs should be taken into consideration, even if they occur very rarely.


Assuntos
Traumatismos Abdominais/diagnóstico , Vesícula Biliar/lesões , Ferimentos não Penetrantes/diagnóstico , Abdome/patologia , Idoso de 80 Anos ou mais , Colecistectomia/métodos , Feminino , Vesícula Biliar/patologia , Humanos , Ruptura
16.
Autoimmunity ; 38(8): 605-11, 2005 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-16390813

RESUMO

Thyroid peroxidase (TPO) is the major thyroid autoantigen recognized by serum autoantibodies from patients with Graves' disease (GD) or Hashimoto's thyroiditis directed to two immunodominant conformational regions termed A and B. The epitopes of human TPO have been defined using a panel of mouse monoclonal antibodies (mAbs). The aim of this study was to estimate the expression of chosen surface antigen regions of TPO (1, 18, 30, 64 epitopes) on thyroid cells in 15 patients with non-toxic multinodular goiter (NTMG) and 15 patients with GD. The thyrocytes were identified by indirect method: in the first stage we added mouse monoclonal autoantibodies specific for TPO regions and in the second stage we conjugated this complex with rabbit anti-mouse antibodies IgG (Fab')(2) with FITC. All investigations were performed by flow cytometry using Coulter EPICS XL apparatus. The percentages of thyrocytes with expression of epitopes 1, 18, 30, 64 TPO were measured in relation to the respective anti-TPO concentrations: 50-1600 microg/ml. The analysis of epitopes located in immunodominant regions (IDR) of TPO revealed higher percentages of thyrocytes in cases with GD in comparison to NTNG. The most predominant difference was observed for mAb 64 epitope (48 vs 7%, p < 0.019; 39 vs 5%, p < 0.017) at the concentration of 100-200 microg/ml mAbs. The expression of 18 epitope on thyrocytes was also statistically higher in Graves' patients than in the NTMG (14 vs 6%, p < 0.025) at concentration of 400 microg/ml mAbs. However, this expression was much less pronounced. In all the cases, the percentages of thyrocytes with epitopes 1 and 30 were in low detection (8-15% of positive cells). In conclusion, our findings suggest that the elevated expression of TPO epitopes 18 and 64 in young patients with thyroid autoimmune diseases increase stimulation and activation of thyroid cells during inflammatory reaction within the thyroid gland. In addition, predominant expression of 64 TPO epitope that recognizes B domain in GD patients could be a useful marker of the immune process in the thyroid gland.


Assuntos
Anticorpos Monoclonais , Bócio Nodular/imunologia , Doença de Graves/imunologia , Epitopos Imunodominantes/metabolismo , Iodeto Peroxidase/imunologia , Linfócitos T/imunologia , Adolescente , Animais , Biomarcadores/análise , Feminino , Citometria de Fluxo , Bócio Nodular/enzimologia , Doença de Graves/enzimologia , Humanos , Epitopos Imunodominantes/imunologia , Iodeto Peroxidase/metabolismo , Masculino , Camundongos , Linfócitos T/enzimologia
17.
Rocz Akad Med Bialymst ; 49 Suppl 1: 132-4, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-15638398

RESUMO

In the thyroid gland of mammals, except the basic follicular (F) cells, parafollicular (C) cells are detected. They belong to disperse neuroendocrine cells of the APUD system. Co-localisation of F and C cells in the thyroid gland is not accidental. It seems possible that there is an interaction between them, mediated by the peptidergic hormones. Calcitonin (CT) is proposed as an essential indicator of C cells. The role of C cells in the function of the thyroid gland has been not clarified till now, especially in hyperthyroid state. There are only a few data which document the ultrastructure of C cells in the physiological and pathological state. In the present study, the ultrastructure of thyroid C cells in an experimental model of hyperthyroidism was evaluated. Our preliminary study may confirm the functional interaction between follicular and parafollicular cells in the thyroid gland.


Assuntos
Hipertireoidismo/patologia , Glândula Tireoide/patologia , Animais , Modelos Animais de Doenças , Hipertireoidismo/induzido quimicamente , Masculino , Ratos , Ratos Wistar , Glândula Tireoide/efeitos dos fármacos , Tiroxina
18.
Rocz Akad Med Bialymst ; 49 Suppl 1: 135-7, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-15638399

RESUMO

The aim of this study was an evaluation of the activity of parafollicular (C) cells in a rat experimental model of hyperthyroidism, evoked by an intraperitoneal application of L-thyroxine (40 mg/kg daily) over 15 days. For that reason, immunohistochemical investigations and evaluation of calcitonin (CT) plasma concentrations were performed. Differences in the quantity and distribution, together with enhanced CT-immunoreactivity of C cells, were observed in hyperthyroid rats, in comparison to respective values in the control group, accompanied by a significant diminution of plasma TSH and CT levels. Our preliminary study may point to a functional interaction between follicular and parafollicular cells in the thyroid gland.


Assuntos
Hipertireoidismo/patologia , Glândula Tireoide/patologia , Animais , Modelos Animais de Doenças , Hipertireoidismo/induzido quimicamente , Imuno-Histoquímica , Masculino , Ratos , Ratos Wistar , Tiroxina
19.
Rocz Akad Med Bialymst ; 49 Suppl 1: 143-5, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-15638402

RESUMO

Mammalian tissues contain two types of cannabinoid receptors CB1 and CB2. The aim of our study was an evaluation of the influence of a single i.p. injection of a stable analogue of an endogenous cannabinoid anandamide--R-(+)-methanandamide (2.5 mg/kg) and CP 55,940 (0.25 mg/kg), which is an exogenous agonist of CB1 receptors, on the immunoreactivity of regulatory peptides, produced in rat thyroid C cells: calcitonin, CGRP, somatostatin and synaptophysin. This study indicates that a single injection of cannabinoids: R-(+)-methanandamide and CP 55,940 alters the immunoreactivity of regulatory peptides in thyroid parafollicular cells.


Assuntos
Ácidos Araquidônicos/farmacologia , Canabinoides/farmacologia , Glândula Tireoide/fisiologia , Animais , Peptídeo Relacionado com Gene de Calcitonina/metabolismo , Cicloexanóis/farmacologia , Endocanabinoides , Masculino , Alcamidas Poli-Insaturadas , Ratos , Ratos Wistar , Receptor CB1 de Canabinoide/efeitos dos fármacos , Receptor CB1 de Canabinoide/fisiologia , Receptor CB2 de Canabinoide/efeitos dos fármacos , Receptor CB2 de Canabinoide/fisiologia , Somatostatina/metabolismo , Sinaptofisina/metabolismo , Glândula Tireoide/efeitos dos fármacos
20.
Folia Histochem Cytobiol ; 40(2): 201-2, 2002.
Artigo em Inglês | MEDLINE | ID: mdl-12056645

RESUMO

Papillary structures of follicular cells are observed in nodular goiter, cysts, hyperplastic areas of follicular tumors, Graves' disease, thyroiditis and carcinomas. The distinction of papillary carcinomas from benign lesions has important implication for clinical management. The aim of the study was to test a marker of proliferation activity (MIB-1) in the diagnosis of benign and malignant thyroid papillary proliferation. The study was carried out in 98 women with papillary carcinoma, nodular goiter. intracystic proliferation. Graves' disease and hyperplastic areas of follicular benign tumors. The formalin fixed, paraffin-embedded specimens were microscopically examined using HE staining and immunostaining with MIB-1 antibody (DAKO). The proliferative index (PI) was significantly higher in malignant than in benign papillary hyperplasia. Our results may provide additional information for differential papillary proliferation diagnosis by FNAB.


Assuntos
Carcinoma Papilar/patologia , Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/patologia , Adulto , Biomarcadores Tumorais , Biópsia por Agulha , Carcinoma Papilar/cirurgia , Divisão Celular/fisiologia , Diagnóstico Diferencial , Feminino , Humanos , Hiperplasia , Imuno-Histoquímica , Antígeno Ki-67/biossíntese , Antígeno Ki-67/genética , Neoplasias da Glândula Tireoide/cirurgia
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