Assessment of connective tissue metabolism in patients with head and neck malignancies treated with radiotherapy.

<br><b>Introduction:</b> Despite the use of highly specialized irradiation techniques in the treatment of head and neck tumors, it is still impossible to selectively destroy cancer cells without damaging normal structures, including connective tissue cells.</br> <br><b>Aim:</b> The aim of the study was to analyze the concentration of degradation markers such as collagen type I (carboxyterminal telopeptide of type I collagen; ICTP) and elastin (elastin-derived peptides; EDPs) as well as selected metalloproteinases (MMP-1, MMP-2, MMP-9) in patients with head and neck malignancies undergoing radiotherapy.</br> <br><b>Material and methods:</b> The test group consisted of 56 men, who underwent radical or palliative radiotherapy. The concentrations of ICTP, EDPs, MMP-1, MMP-2, MMP-9 were determined in three blood samples collected from patients prior to radiotherapy, immediately after its completion and 3 months after the therapy.</br> <br><b>Results</b>: Both radical and palliative radiotherapy contribute to a significant increase in the concentration of EDPs. At the time of healing of post-irradiation lesions, the level of EDPs was reduced in both groups. The ICTP concentration was not affected by radiotherapy. No significant differences were observed in the concentration of MMP-1 and MMP-2 before and after radiotherapy. Radical radiotherapy caused a statistically significant late reduction in the concentration of MMP-9. The lowest concentrations of MMP-1, MMP-2, MMP-9 in the serum of patients qualified for palliative radiotherapy were recorded in a samples collected three months post-irradiation.</br> <br><b>Conclusions:</b> The degradation markers of key extracellular matrix structural proteins may be helpful tools in the objective assessment of radiation-induced injuries to the connective tissue.</br>.

Seasonal Activity of Urban Bats Populations in Temperate Climate Zone-A Case Study from Southern Poland.

Municipal greenery can mitigate the negative impact of urbanization on biodiversity, including bats, by providing a migration corridor, food base and roosts. Our study aimed to evaluate the species composition and diversity, test the differences in activity between seasons, and identify the atmospheric conditions influencing the bats' activity in the Planty Park (Cracow). Fieldworks were conducted in 2016 and 2017. We recorded 10 species, two new for this part of Poland: the Kuhl's pipistrelle (Pipistrellus kuhlii) and the Savi's pipistrelle (Hypsugo savii). Taxa were divided into three ecological guilds. Myotis group's activity was insufficient to perform statistical analyses. The activity of Nyctalus, Eptesicus and Vespertilio group peaked in late summer. A similar insignificant trend was observed for Pipistrellus and Hypsugo. Temperature enhanced the activity of Nyctalus, Eptesicus and Vespertilio group in spring and early summer, while cloud cover suppressed their activity in autumn. Temperature also enhanced Pipistrellus and Hypsugo group activity in spring and autumn, but it suppressed their summer activity. Our study is one of the first to investigate temperate urban bats' phenology and may serve as a preface for further research to introduce detailed urban landscape planning recommendations.

Collagen Type III Metabolism Evaluation in Patients with Malignant Head and Neck Cancer Treated with Radiotherapy.

Ionizing radiation affects the metabolism of key proteins of extracellular matrix including type III collagen, an important component of human skin. The aim of the work is an analysis of the impact of radical and palliative radiotherapy on collagen type III synthesis in patients with head and neck cancer. The test group consisted of 56 males with histopathologically confirmed head and neck cancer, for whom radiotherapy was applied as a form of radical or palliative treatment. The level of procollagen III aminoterminal propeptide (PIIINP), which is a marker of collagen type III synthesis, was determined in blood serum before radiotherapy, immediately following radiotherapy, and 3 months after it was finished. As a result of radical radiotherapy a statistically significant decrease of PIIINP levels in serum (p < 0.0001) was observed, both immediately after the radiotherapy and 3 months after the end of the treatment. Also the palliative radiotherapy caused a significant decrease of PIIINP right after the treatment (p = 0.0052), as well as during the examination performed 3 months later (p = 0.0004). The achieved results suggest that PIIINP can be used as a marker helpful in assessing radiation damage to connective tissue.

[Profile of adults suffering from COPD in Poland].

INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is one of the most common chronic diseases in adults. It is estimated, that in Poland around two million people suffer from COPD. THE AIM: The aim of this study, was to characterize population of patients with COPD in Poland. MATERIAL AND METHODS: The study, established and coordinated by the Polish Respiratory Society, included a representative sample of 500 GPs where were asked to fill questionnaires on diagnosis and treatment of their COPD patients. The questions dealt with disease history and clinical presentation, COPD severity stage, diagnostic and therapeutic procedures. RESULTS: Altogether 298 physicians (59.6% of invited) provided information about 2756 COPD patients aged 61.6 ± 11.1 years (36.3% were women). According to GOLD recommendations 16.6% of patients had mild, 57.0% moderate, 18.6% severe and 2.1% very severe COPD. Smoking history was declared by 97.8% of respondents. 51.4% of COPD patients had continued smoking. Over the last year Ambulance Service intervened in 19.7% of patients and 29.1% of respondents required hospital treatment of COPD. Among more than 80% of patients, doctor diagnosed limitation in exercise tolerance, and shortness of breath at rest, and in approximately 60% of the respondents were presented productive cough, weakened vesicular murmur and prolonged phase of exhalation. CONCLUSIONS: Despite the diagnosis, more than half of men and women had continued smoking. The number of hospitalizations and emergency intervention positively correlated with the severity of the disease. The survey results emphasize the urgent need for health education in patients with COPD.

[Exacerbations in perimenstrual asthma. Clinical significance of peripheral blood eosinophilia and BMI]. / Zaostrzenia w astmie okolomiesiaczkowej. Znaczenie kliniczne eozynofilii w krwi obwodowej i BMI.

INTRODUCTION: Asthma is a heterogeneous disease characterized by lower airways' obstruction, caused by various factors. There are many asthma phenotypes. Lately, perimenstrual asthma (PMA) with a pattern of exacerbations before and during menstruation as well as obesity associated asthma have been a subject of particular scientific and clinical interest. MATERIAL AND METHODS: 30 women were qualified for this three-arm case-control study(women with a pattern of asthma exacerbations in the perimenstrual period, women with asthma but no perimenstrual exacerbations, healthy control group). All patients performed spirometry and assessed disease control using specific questionnaires. Peripheral blood counts with smear were also performed. RESULTS: PMA patients differ in a statistically significant way in respect of anthropometric measurements such as BMI: in PMA group 25.8±1.8; in non-PMA asthmatics 23.9 ±2.2; healthy control 23.1±1.5; p=0.018) and spirometry results (FEV1 [%]: 85.1 (36.3-113.0); in PMA asthmatics, 93.1 (81,6-109,7), in nonPMA group, p<0.05; 105.4 (108,3-119,0) in healthy control and Tiffeneau index [%]: 70.1 (41.2-98.1); in PMA vs 83.5 (59.6-94.4); in non-PMA asthmatics 93.1(81,8-97,5) in healthy control p<0.05; ). PMA asthmatics also complain of poorer disease control than non-PMA asthmatics. There were no differences in peripheral blood eosinophilia or CRP between studied groups, p>0.05). CONCLUSIONS: Asthma exacerbations are not associated with the effect of peripheral blood eosinophilia. Women with greater BMI are more predisposed to perimenstrual asthma.

Comparison of efficacy of products containing azelaic acid in melasma treatment.

BACKGROUND: Melasma is one of the most frequently diagnosed hyperpigmentation changes on the skin of women's faces. Nearly 30% of women using oral estrogen therapy struggle with this problem. A common way of reducing melasma is the application of azelaic acid products. AIM: Comparison of efficacy of three dermocosmetic products, containing azelaic acid, in the reduction in melasma for women aged 35-55. MATERIAL AND METHODS: A group of 60 women diagnosed with melasma were divided into three even, twenty-person subgroups. Each subgroup was assigned one dermocosmetic product containing azelaic acid. For 24 weeks, the patients applied the assigned product twice a day. The level of the colorant within the hyperpigmentation was marked before the treatment, after 1 month, after 3 months, and after 6 months of therapy. The pigmentation was measured using Mexameter(®) (Courage + Khazaka electronic, Germany). In addition, during each inspection, the patients' level of hydration, elasticity, and intensity of erythema was checked using Corneometer(®) , Reviscometer(®) . RESULTS: All dermocosmetics containing azelaic acid that were applied significantly contributed to the reduction in pigment in the pigmentary lesion. The largest decrease in the amount of pigment was observed in the first 3 months of use of the products. A combination containing 20% azelaic acid and mandelic acid, phytic acid, 4N-butyl resorcinol, and ferulic acid proved to be the most effective dermocosmetic III (Sesderma, Valencia, Spain). CONCLUSIONS: Dermocosmetics containing azelaic acid significantly contribute to the clearing of melasma. The effect depends on the treatment time, the acid concentration, and addition of other components.

[Oral health in multiple sclerosis patients]. / Choroby jamy ustnej u chorych na stwardnienie rozsiane.

Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system occuring in young adults, mainly female. MS dominates in Caucasians living in regions far away from the equator. The coexistence of genetic and environmental factors is considered in its etiopathogenesis. MS mostly occurs in the form of relapses and remissions, leading to the physical disability and cognitive decline. The diagnosis is based on MRI images and cerebrospinal fluid testing. The current guidelines for therapy recommend immunosuppression (steroids during relapses) and immunomodulation. Symptomatic treatment of pain or muscle rigidity is used additionally. The epidemiological data draw attention to the geographical distribution of indicators related to the increased prevalence of MS and dental caries. The role of D3 vitamin is discussed in the development of both diseases, but the role of amalgam filling in the development of MS is rejected. The demyelinating process in MS and applied treatment predispose to the neurological pain in the facial area or the temporomandibular joints. The increasing disability and used treatment enhance the susceptibility to mucosal inflammation and xerostomia, and activate viral and fungal infections. Patients with MS require regular dental control often in conditions arranged for disable people.

Volumetric techniques: three-dimensional midface modeling.

Aging is a complex process caused by many factors. The most important factors include exposure to UV radiation, smoking, facial muscle movement, gravity, loss and displacement of fat and bone resorption. As a symptom of aging, face loses elasticity, volume and cheerful look. While changing face proportions, the dominant part of a face is its bottom instead of the mid part. The use of three-dimensional face modelling techniques, particularly the mid-face - tear through and cheeks, restores the skin firmness, volume and healthy look. For this purpose the hyaluronic acid is used, calcium hydroxyapatite, and L-polylactic acid fillers. Volumetric techniques require precision and proper selection of the filling agent to give a sense of satisfaction to both the patient and the doctor.

Hepatic tissue changes in rats due to chronic invasion of Babesia microti.

The etiological agents of babesiosis are intraerythrocytic parasites of the genus Babesia, which are transmitted by ticks. The course of disease is characterized by variable severity. The risk of a complicated course of babesiosis occurs in premature infants, the elderly, splenectomized patients and other immunocompromised patients. Severe cases of this disease can lead to multiple organ dysfunction. The study focuses on the impact assessment of chronic Babesia microti invasion on the morphology and ultrastructure of rat liver. The analyzed material was comprised of liver samples collected from Wistar rats infected with a reference strain of B. microti (ATCC 30221). None of the livers collected from rats with babesiosis was enlarged. The histopathological analyses showed signs of intensive inflammatory processes, especially in the perivascular areas. The hepatic mononuclear phagocyte system was characterized by increased activity. The ultrastructral analyses confirmed disintegration of hepatocytes with vacuolization in the perivascular areas. In addition, the perisinusoidal space (space of Disse) had irregular structure. In some areas, the space of Disse was enlarged or compressed. The morphological and ultrastructural analyses of rat liver with chronic babesiosis caused by B. microti showed significant pathological changes in perivascular areas which may be the cause of hepatic dysfunction.

Influence of retinoids on skin fibroblasts metabolism in vitro.

The most dangerous environmental factor for our skin condition is ultraviolet light radiation. Chronic exposition to ultraviolet light can induce epidermal atrophy, keratosis, depigmentation and dysplasia. In the dermis, UV light causes dramatic up-regulation of extracellular matrix-degrading enzymes. Matrix metalloproteinases (MMPs) are engaged in collagen, elastin and other extracellular matrix components degradation. In addition, to increase level of destructive enzymes, UV light has been shown to decrease collagen production. As a consequence of UV impact on skin, it shows signs of aging including loss of tone and elasticity, increased skin fragility, blood vessels weakness and wrinkles. The most dangerous effect of UV on skin is an increased risk of melanoma and other skin cancers. Retinoids are well known antiaging agents. For many years this vitamin has been used for the prevention and treatment of photoaging. Retinoids abolish cellular atypia, increase compacting of the stratum corneum and reduce skin hyperpigmentation caused by sun light. Recent evidence suggests that retinoids also play a role in the prevention of aging, because of its inhibitory effects on metalloproteinases expression. The aim of this study was to examine if all-trans-retinoic acid (ATRA) effects MMP-1, MMP-2, MMP-3 and MMP-14 gene expression in fibroblasts cultured in vitro.

[The use of retinoids in dermatology]. / Zastosowanie retinoidów w dermatologii.

Retinoids--new agents derived from vitamin A have initiated a new era in therapy of many skin diseases. They are highly effective medicines used in the treatment of severe forms of psoriasis. Also they are administered in many forms of acne, as alternative drugs do not exist. Moreover, retinoids show antineoplastic activity. They are also effective in the symptomatic treatment of the congenital keratinization disorder syndromes. The recent development of retinoids combined with the growth of expertise with regard to the biological function and mechanisms of retinoid receptors, are likely to improve the present therapeutic methods and to reveal new potentials regarding the use of retinoids in the therapy of many skin disorders.

[Cutaneous larva migrans--an unusual case]. / Larwa wedrujaca skórna--niecodzienny przypadek.

Cutaneous larva migrans is the result of human skin infestation by nematode larvae, which penetrate through the epidermis. The case of 21-year-old woman with serpiginous, erythematosus, and linear stripes was reported. The skin lesions lasted for five months. The diagnosis of cutaneous larva migrans was established based on the typical clinical picture of infestation. Thus, it is important for infestation to be recognized clinically, so that effective treatment may be instituted. Various therapeutic modalities, including cryotherapy, topical and systemic chemotherapy, can be used in the treatment of cutaneous larva migrans. It was demonstrated, that cryosurgery is a fast and effective method in the therapy of cutaneous larva migrans infestation.

[Present view on malignant melanoma treatment]. / Wspólczesne spojrzenie na leczenie czerniaka zlosliwego.

Malignant melanoma is a tumor arising from melanocytes. Epidemiological data indicate rapid and progressive increase of malignant melanoma cases in Poland and other countries. Early diagnosis in malignant melanoma is the most important for the prognosis. Therefore the best treatment is ultraviolet prevention--sunscreen prophylactic, educational campaigns. Early diagnosis of malignant melanoma is based on ABCDE rules, seven point check Glasgow scale, dermatoscopy (a modern method in the differential diagnostics) and the knowledge of predisposing factors. There are several methods of treatment of malignant melanoma (chemotherapy, radiotherapy, immunotherapy etc.) among them surgical procedure is still a treatment of choice.

[Pyoderma gangrenosum--positive effect of cyclosporin A therapy ]. / Piodermia zgorzelinowa--pozytywny efekt leczenia cyklosporyna A.

Although pyoderma gangrenosum is a disorder known since over 70 years, it still remains a diagnostic and therapeutic problem. We describe three subjects with pyoderma gangrenosum; two were females, one was male, one case was associated with colitis ulcerosa, two were without any related disorders. Histopathologic examinations supported the diagnosis in all cases. In spite of intensive topical and systemic treatment with corticosteroids, Dapsone, Clofazimine, no sufficient effects were achieved. Cyclosporin A introduced in the dose of 5 mg/kg/d resulted in dramatic response and complete remission. Serum CyA levels, biochemical parameters of liver and kidney function, blood pressure were monitored during the therapy. No adverse events due to Cyclosporin A were observed.