Heparanase link between vasculogenesis and angiogenesis as well as a predictive factor of a shorter survival rate.

Heparanase concentration is low in normal epithelia cells but its overexpression is reported in many carcinomas, including sarcomas and haematological malignancies. The purpose of this study was to investigate the association with selected angiogenic parameters as well as in the number of circulating endothelial progenitors (EPCs) in respect to low, moderate and high concentrations of heparanase. Also, we estimated the diagnostic usefulness of the heparanase concentration for disease recurrence prediction in breast cancer cases. Eighty-six patients with IA-IIB stage invasive breast carcinoma who passed a comprehensive clinicopathologic evaluation were included in the study. The median tumour diameter was 1.5 cm. Twenty cases showed lymph node metastasis (N1). Follow-up was completed in all patients a median follow-up was 33.5 months with a 11.6% recurrence rate. An immunoassay of selected angiogenic parameters, heparanase, as well as an immunohistochemistry of oestrogen and progesterone receptors, human epidermal growth factor receptor 2 (HER2), Ki67 and E-cadherin was performed in all cases. Circulating EPCs were determined by flow cytometry. Higher levels of heparanase in oestrogen and progesterone receptor negative cancers than in positive ones were noted. A higher concentration of heparanase was observed in T2 cases than T1 subjects. Significant positive associations between circulating EPCs, soluble forms of VEGF receptors and increasing plasma levels of heparanase were obtained. Follow-up revealed a significantly higher incidence of disease relapse in breast cancer patients with high baseline concentrations of heparanase. Heparanase was the most accurate biomarker with an AUCROC = 0.72. The cut-off value of 213.74 pg/mL was identified in order to discriminate between disease recurrence patients and those without disease relapse. We suggest, that a high concentration of heparanase next to tumour size and oestrogen and progesterone receptor expression may serve as an indicator of a more an aggressive character of tumour cells and a shorter survival rate.

Elevated plasma levels of tissue factor as a valuable diagnostic biomarker with relevant efficacy for prediction of breast cancer morbidity.

The aim of this study was to evaluate the concentrations of tissue factor (TF) and its inhibitor (TFPI), vascular endothelial growth factor A (VEGF-A), soluble forms of VEGF receptors type 1 and 2 (sVEGFR1 and aVEGFR2) in patients diagnosed with luminal A breast cancer (BrC) and in healthy individuals and to find associations of analyzed factors with demographic, clinical and pathological characteristics in a homogeneous breast cancer group. Study group consisted of 60 women aged 40 - 69 years, diagnosed with luminal-A subtype of BrC, without distant metastases (M0). Control group comprised 40 healthy women aged 45 - 63 years. Blood samples were collected from each patient in order to determine plasma levels of TF, TFPI, VEGF-A and sVEGFR1 and sVEGFR2. The examined parameters were measured by enzyme-linked immunosorbent assay (ELISA). The capacity of angiogenic and hemostatic parameters in predicting neoplasm disease was analyzed using receiver operating characteristic (ROC) curve analysis. According to ROC curve analysis, the optimum cut-off point for TF was 304.58 pg/ml, with 100% sensitivity and 100% specificity, which was calculated to discriminate between controls and malignancy patients. In luminal A BrC patients there were significantly higher concentrations of VEGF-A and TF than in controls. On the contrast the levels of sVEGF receptors type 1 and 2 as well as TFPI in luminal-A BrC cases were significantly lower in respect to healthy volunteers. Levels of examined factors in the study group varied depending on age, menopausal status, lymph node involvement and histological type. We concluded that altered levels of examined factors in patients diagnosed with luminal-A breast cancer indicate increased activation of angiogenesis and hemostasis. The results obtained may be indicative of a mutual connection between angiogenesis and hemostasis processes in tumor development and progression. Clinical and pathological parameters may possibly affect levels of angiogenic and coagulation factors.

Increased number of endothelial progenitors in peripheral blood as a possible early marker of tumour growth in post-menopausal breast cancer patients.

The aim of the study was to evaluate the number of circulating endothelial progenitor cells (circulating EPCs) in the blood of patients diagnosed with breast cancer and to make an attempt at finding associations with the number of circulating EPCs and selected clinic-pathological factors; TNM and histological grading, molecular subtype of breast cancer, hormonal status, the expression of Ki-67 and the size of tumour. The study involved 96 Caucasian ethnicity post-menopausal women. Sixty-six women aged 48 - 63 (mean age 55) with breast cancer diagnosis without distant metastases (M0). The median value of the tumour diameter was 1.51 cm. The control group consisted of 30 healthy, non-smoking, post-menopausal women, mean age 49, range 44 - 54 years of age. The exclusion criteria for all the participants were hypertension, hyperlipidaemia, and hyperglycaemia, acute and chronic infection. With regard to the fresh blood samples the number of circulating endothelial progenitors was determined using flow cytometry. The fluorescence of 100,000 cells was measured during the analysis. Circulating EPCs were identified with the immune-phenotype CD45-, CD34+, CD133+, CD31+. A significantly higher number of circulating EPCs in the study group, as compared to the controls (P = 0.0001) and a significantly higher number of circulating EPCs in women over 60 with breast cancer than in the younger women (P = 0.0029) were reported. A positive correlation was noted between circulating EPCs and age as well as between circulating EPCs and HER-2 (P = 0.0231, P = 0.0414, respectively), and a negative correlation between circulating EPCs and histological grading of breast cancer (P = 0.0272). The study has shown a higher number of circulating EPCs in breast cancer patients, which indicates stimulation of neovascularization. Additionally, since bone morrow-derived circulating EPCs are more intensively mobilised in older and overweight breast cancer patients, we can speculate that more aggressive neo-angiogenesis can occur in those patients.

Association of adiponectin and leptin-to-adiponectin ratio with the function of platelets in morbidly obese patients.

Adipokines regulate glucose homeostasis, insulin sensitivity, lipids metabolism, reproduction, as well as endothelial and platelets function. The study compares the plasma and adipose tissue concentrations of total adiponectin, leptin, leptin receptor and leptin-to-adiponectin ratio (LAR) in morbidly obese patients. Additionally it evaluates selected adipokines (leptin, adiponectin), endothelial markers and LAR depending on the gender in morbidly obese and non-obese subjects. The study involved 51 patients (31 women aged 21 - 60 (mean age of 39) and 20 men aged 24 to 60 (mean age of 41)). The eligibility criterion included the BMI ≥ 40 kg/m2. The non-obese group consisted of 30 healthy volunteers with the BMI < 24.9 kg/m2; nineteen women, aged 24 - 53 (mean age of 41), and 11 men aged 21 - 52 (mean age of 38). In the plasma and adipose tissue, the concentrations of total adiponectin, leptin, leptin receptor and plasma soluble forms of E-selectin, P-selectin, thrombomodulin were measured applying immunoassay techniques. There were noted significantly higher plasma leptin and sE-selectin concentrations, leptin-to-adiponectin ratio, additionally lower concentrations of plasma leptin receptor and sP-selectin in obese subjects regardless of the gender. Significantly higher concentrations of total adiponectin, leptin, leptin receptor expressed per 1 mg of total protein in adipose tissue, as compared to plasma in morbidly obese patients, were observed. Significant positive correlations between the BMI and the concentration of leptin and between total adiponectin and sP-selectin were reported in the subject group. Similarly there were noted significant negative correlations between leptin receptor and the BMI and between leptin-to-adiponectin ratio and sP-selectin in obese patients. The study has shown that adiponectin has a positive impact on platelets through a possible reduction in sP-selectin, and thus on platelets activation. On the other hand an elevated sE-selectin reveals perspective about the endothelium stimulation and a higher risk of endothelial damage in morbidly obese patients. Also in morbidly obese the higher leptin level and leptin-to-adiponectin ratio and simultaneously lower concentration of leptin receptor are associated with leptin resistance, additionally in possible future risk of insulin resistance and diabetes type 2.

Selected angiogenic factors in plasma of patients with lower limb symptomatic peripheral arterial disease: preliminary report.

AIM: The number of people suffering from atherosclerosis-related complications such as peripheral arterial disease (PAD) ­ including lower limbs PAD increases. Hypoxia and ischemia stimulate angiogenesis ­ a postnatal multistage process in which new blood vessels form and the Vascular Endothelial Growth Factor (VEGF-A) is the key proangiogenic factor whereas its soluble receptors type 1 and type 2 (sVEGFR-1, sVEGFR-2) are regarded as inhibitory factors. The aim of this study was to assess the concentrations of VEGF-A, sVEGFR-1 and sVEGFR-2 in plasma of patients with symptomatic lower extremity PAD compared with selected clinical parameters (Ankle-Brachial Index, distance in walking test) and severity of PAD (according to the Fontaine classification). METHODS: The study group included 46 patients suffering from symptomatic PAD with Fontaine class IIa-IV without any history of neoplastic disease. The control group consisted of 30 healthy non-smoking volunteers. The following parameters were determined: plasma concentrations of VEGF-A, its soluble receptors (sVEGFR-1, sVEGFR-2) using the ELISA method also VEGF-A and sVEGFR-1 quotient was calculated on the basis of mean concentrations in homogenous units (pg/mL). RESULTS: The study group revealed a statistically significant higher level of VEGF-A concentration when compared with the control group and statistically significant lower concentration of sVEGFR-2 in the study group. In the study group a statistically significant negative correlation between VEGF-A concentrations and the length of irrelative distance in walking test was observed. In the group of PAD a significantly higher VEGF-A/sVEGFR-1 ratio in comparison with the control group was obtained. Within the group of patient suffering from PAD there was noticed an increasing VEGF-A/sVEGFR-1 ratio in subsequent subgroups according to the Fontaine classification. CONCLUSION: The plasma concentrations of VEGF-A correlated with increased clinical symptoms of PAD in the walking test. The plasma VEGF-A/sVEGFR-1 ratio may be used as a useful ischemic marker in patients with PAD which should be tested and finally verified in large group of patients.

Phototherapy with low-level laser influences the proliferation of endothelial cells and vascular endothelial growth factor and transforming growth factor-beta secretion.

The healing process and the angiogenesis associated with it, is a very important but currently poorly understood area. Low level laser therapy (LLLT) has been reported to modulate the process of tissue repair by stimulation of cellular reaction such as migration, proliferation, apoptosis and cellular differentiation. The aim of this work was to evaluate the influence of laser radiation in the range of visible and infrared light on the proliferation of vascular endothelial cells in vitro and the secretion of angiogenic factors: vascular endothelial growth factor (VEGF)-A and transforming growth factor (TGF)-ß. Vascular human endothelial cells (Ecs) were exposed to radiation with laser beam of the wavelengths: 635 nm (1.875 mW/cm²) and 830 nm (3.75 mW/cm²). Depending on the radiation energy density, the experiment was conducted in four groups : I) the control group (no radiation, 0 J/cm²); II) 635 nm - the energy density was 2 J/cm²; III) 635 nm - 4 J/cm²; IV635 nm - 8 J/cm², II) 830 nm - the energy density was 2 J/cm²; III) 830 nm - 4 J/cm²; IV) 830 nm - 8 J/cm². The proliferation and concentration of VEGF-A and TGF-ß were examined. LLLT with wavelength 635 nm increases endothelial cell proliferation. Significant increase in endothelial cell proliferation and corresponding decrease in VEGF concentration may suggest the role for VEGF in this process. The wavelength of 830 nm was associated with a decrease in TGF-ß secretion.

The effect of cause of cadaveric kidney donors death on fibrinolysis and blood coagulation processes.

BACKGROUND: Organ donors can be generally divided into two groups according to the cause of their death. The first group is composed of those who died because of physical injuries, especially road traffic injury, and the second group, those who died from central nervous system (CNS) stroke or bleeding. The aim of our work was to examine hemostatic processes among kidney donors. MATERIALS AND METHODS: The 38 deceased kidney donors (KD) included 11 women and 27 men of overall average age of 37±12 years. The donor group of according to the cause of death, included 14 injured donors (ID) (41%) and 24 noninjured donors (ND) donors (59%). The control group consisted of 25 healthy volunteers matched for sex and age. We determined the following concentrations: antithrombin (AT), thrombin/antithrombin complexes (TAT), and prothrombin F1+2 fragments. The fibrinolytic parameter concentrations were: plasminogen (PL), plasmin/antiplasmin complexes (PAP), and D-dimers. RESULTS: Deceased kidney donors showed an increased plasma concentrations of TAT complexes (P<.000001) and prothrombin fragments F1+2 (P<.0000001); however, the protein C concentration was decreased (P<.000001). The antithrombin activity was similar to the control group. The concentrations of PAP complexes and d-dimers were higher (both P<.000001), but the level of PL lower among KD compared with controls (P<.0000001). The higher of TAT, PAP complexes, d-dimers, and F1+2 concentrations as well and as lower plasminogen and PC concentrations were evidence for increased activation of blood coagulation and fibrinolysis in cadaveric KD. However, analysis compairing ID versus ND donors revealed increased concentrations of PAP complexes (P<.05) and decreased amounts of TAT complexes (P<.01) among ID subgroup. The positive predictive value (PPV) and negative (NPV) for PAP complexes were 75% and 68% and for TAT, 71% and 57%, respectively. On the basis of these observations, we concluded that an intensive activation of fibrinolytic process occurs among the ID. In contrast, ND show intensive activation of blood coagulation.

The outcomes of treatment and the etiology of lymphoceles with a focus on hemostasis in kidney recipients: a preliminary report.

BACKGROUND: The etiopathogenesis of lymphoceles remains incompletely understood. The aim of our work was to analyze the perturbations of blood coagulation process for their possible impact on the etiology of lymphoceles. Additionally we performed an evaluation of the incidence and effectiveness of treatment methods for lymphoceles. MATERIALS AND METHODS: During 2004 to 2010, we performed 242 kidney transplantations in 92 female and 150 male patients. The hemostatic parameters included concentrations of: antithrombin, plasminogen, thrombin/antithrombin complexes (TAT), prothrombin products F1+2 (F1+2), d-dimers, and plasmin/antiplasmin complexes. RESULTS: At 7 years follow-up 27 (11%) recipients had developed symptomatic lymphoceles, namely abdominal discomfort, a palpable mess in the lower abdomen, arterial hypertension, infection of the operative site with fever, lymphorrhoea with surgical wound dehiscence, decreased diurnal urine output with an elevated plasma creatinine, voiding problems of urgency and vesical tenesmus, and/or symptoms of deep vein thrombosis. We applied the following methods of treatment aspiration alone, percutaneous drainage, laparoscopic fenestration or open surgery. In two only patients did perform open surgery. Since 2008 we have not performed an aspiration alone because of high rate of recurrence (almost 100%) and abandoned open surgery in favor of a laparoscopic approach. Our minimally invasive surgery includes percutaneous drainage guided by ultrasound and a laparoscopic procedure with 100% effectiveness. The examined hemostatic parameters revealed decreased concentrations of TAT complexes and F1+2 in subjects with lymphocele showing positive predictive values of 33% and 41% respectively. The negative predictive values for TAT complexes and F1+2 were 14% and 10%, respectively, suggesting decreased blood coagulation activity among effected recipients. Altered blood coagulation processes may explain some aspects of the disturbances of postoperative obliteration of damaged lymphatic vessels and formation of pathological lymph collection afterward. CONCLUSIONS: Perturbations of blood coagulation may be one cause for a lymphocele.

Minimally invasive methods for the treatment of lymphocele after kidney transplantation.

BACKGROUND: One common complication after kidney transplantation is a lymphocele. The aim of our work was an analysis of incidence of lymphocele and the effectiveness of minimal invasive methods in the management of this complication. MATERIALS AND METHODS: The examined group was consisted of 158 patients (68 female and 90 male) with end-stage renal disease who underwent kidney transplantation. RESULTS: Twenty-one patients (13%) developed symptoms of lymphocele after transplantation procedure within an average time of 34 weeks. The clinical symptoms included a decrease in 24-hour urine collection, an increase in plasma creatinine concentration, abdominal discomfort, lymphorrhea with a surgical wound dehiscence, voiding problems of urgency or vesical tenesmus, febrile states, or symptoms of deep vein thrombosis. The following methods were applied with variable efficacy: aspiration with recurrence 75%; percutaneous drainage with 55%, effectiveness; laparoscopic fenestration with 72% satisfactory outcomes (1 patient presented an excessive bleeding after the procedure), and classic surgery with favorable results. CONCLUSION: Percutaneous drainage guided by ultrasonic imaging should be recommended as the first attempt to cure a lymphocele. Laparoscopy is a feasible, safe technique that should be used after unsuccessful percutaneous drainage. A larger series of patients is required to confirm the superiority of minimal invasive methods to the classical approach.

Lymphocele after kidney transplantation.

BACKGROUND: One of the most often occurring complications after a kidney transplantation is a lymphocele. MATERIALS: The examined group consisted of 118 patients (70 males and 48 females) with end-stage renal disease (ESRD). RESULTS: Fourteen patients (12%) developed symptoms of lymphocele within an average time of 34 weeks. The clinical symptoms included the following: decreased 24-hour urine collection and increased creatinine level, abdominal discomfort, lymphorrhoea with surgical wound dehiscence, urgency, vesical tenesmus, and/or fever. Increased appearance of lymphocele was noticed in patients with diabetic nephropathy, congenital malformations of the urinary tract, and inflammatory diseases, including glomerulopathy and extraglomerular ones, after high-voltage radiotherapy and after removal of the renal graft. The methods of treatment and their efficacy were as follows: percutaneous aspiration with the ratio of recurrence 100%; ultrasound guided percutaneous drainage 50%; laparoscopic intraabdominal marsupialization 75%; and surgical intervention with favorable results. CONCLUSIONS: Ultrasound-guided percutaneous drainage with a success rate greater than 50% should be recommended as the first line of treatment. As a minimal invasive surgery this kind of treatment does not interfere with subsequent internal drainage through an open or a laparoscopic surgery. Laparoscopy, a feasible, safe technique with a success rate of more than 80%, should be used routinely after unsuccessful percutaneous drainage.

[Von Willebrand factor in hemodialysed patients with chronic renal failure]. / Czynnik von Willebranda u chorych hemodializowanych z powodu przewleklej niewydolnosci nerek.

The aim of the work was to evaluate the von Willebrand factor antigen (vWF Ag) concentration in the blood plasma of hemodialysed patients with chronic renal failure. The study was performed in the group of 43 patients (means aged 42.8 years) with chronic renal failure dialysed means 4 hours 3 times a week. The blood was obtained before and after hemodialyze and in 11 patients additionally after 1 year of systematic hemodialyze. The control group consisted of 51 healthy volunteers means aged 35.6 years. In the citric blood plasma concentration of vWF Ag was determined using immunosorbed enzyme-linked assay (ELISA). In the blood plasma of patients with chronic renal failure significantly higher concentration of vWF Ag than in controls was observed. 4-hours and 1-year dialyze did not influence the level of vWF Ag in patients with chronic renal failure.

[Von Willebrand factor in patients with subarachnoid hemorrhage]. / Czynnik von Willebranda u chorych z krwotokiem podpajeczynówkowym.

UNLABELLED: Von Willebrand factor (vWF) plays an important role in the coagulation system. It affects platelet aggregation in the place of vessel endothelium damage. The importance of vWF in cerebrovascular disease is not clear. The aim of this presentation was to evaluate the vWF level in the plasma and cerebrospinal fluid of patients after subarachnoid hemorrhage including cases with cerebral vasospasm and cerebral infarct. We investigated 66 patients (38 persons graded I-III H&H and 28 persons graded IV H&H). The control group consists of 8 subjects. VWF was measured by ELISA method using standard kit Asserachrom (Boehringer). The vWF level in the plasma reached 288.81 +/- 99.66% (in the control group, 98.84 +/- 14.53%) without significant differences regarding clinical condition of patients. In the cerebrospinal fluid the vWF level was significantly different in I-III H&H patients and in IV H&H patients (1.21 +/- 0.52% and 9.18 +/- 7.58%, respectively, p < 0.001) and in the control group (0.13 +/- 0.33%). Our data indicate that there is correlation (Pearson, p < 0.01) between the level of vWF and neurological condition (GCS) of patients. There is also correlation (p < 0.01) between the level of VWF and the presence of clinical disorders (cerebral vasospasm, delayed neurological deficit (DIND) and cerebral infarct). Based on multivariate analysis, we confirmed that vWF is an independent prognostic factor of cerebral vasospasm (p < 0.01) and ischemic complications (p < 0.02). CONCLUSIONS: vWF is elevated in the plasma of patients after subarachnoid hemorrhage in early stage of the disease. VWF is present in the cerebrospinal fluid of patients with SAH and its level is higher in patients with poor neurological condition. The VWF elevation in csf is correlated with clinical condition of patients and also the presence of cerebral vasospasm and cerebral infarct. VWF can be used as an independent prognostic factor of cerebral vasospasm and ischemic complications.

[Plasminogen activators (t-PA and u-PA) and other fibrinolysis parameters in patients with atherosclerosis obliterans and diabetic macroangiopathy]. / Aktywatory plazminogenu (t-PA i u-PA) oraz inne parametry ukladu fibrynolizy u chorych z miazdzyca zarostowa i makroangiopatia cukrzycowa konczyn dolnych.

UNLABELLED: The aim of the study was to evaluate plasminogen activators in compare fibrinolysis parameters in patients with atherosclerosis obliterans (AO) and diabetic macroangiopathy (DM) of lover extremities. The study group consist of 40 patients with AO (mean age 59 years) and 40 with DM (mean age 61 years). All the patients were diagnosed as the II stage in Fontaine scale. Ischemia lover extremities were: aorta-hip, femoral-popliteal and peripheral dependent closure. The control group consist of 30 healthy volunteers (mean age 51 years). Concentration of: tissue plasminogen activator antigen (t-PA:Ag), urokinase plasminogen activator antigen (u-PA:Ag), plasminogen activator inhibitor type 1 antigen (PAI-1:Ag) (ELISA), PAI-1 activity (PAI-1 act.), euglobulin lysis time (ELT) (Kowarzyk-Buluk method), fibrinogen, fibrin degradation products (FDP) (Merskey method) in blood plasma were evaluated. The results shows statistically higher concentrations of: t-PA:Ag, PAI-1:Ag, fibrinogen, and lower concentrations of u-PA:Ag and elongated ELT in blood plasma patients with AO and DM in compare with healthy volunteers. Comparing analysed parameters between patient groups shows higher concentration FDP in patients with AO than patients with DM. CONCLUSIONS: 1) Although elongated ELT in both groups it was shown evidence of the fibrinolysis activation in the shape of elevated FDP concentration. It was probably compensation for hypercoagulability. 2) Elevated t-PA:Ag concentration in patients with AO and DM is an evidence of the higher releasing of the endothelium in AO and DM.

[Fibrinolytic system in bronchial asthma after prednisone treatment]. / Uklad fibrynolizy u chorych na astme oskrzelowa po leczeniu prednizonem.

Forty one patients with recently recognised bronchial asthma were studied. Activity of plasminogen activator inhibitor (PAI-1), platelet adhesion and aggregation, antigens of tissue and urokinase plasminogen activators (respectively, t-PA Ag and u-PA Ag), euglobulin lysis time (ELT), complexes of plasmin-antiplasmin (PAP) and fibrin degradation products (FDP) were tested before and after fourteen days administration of 20-30 mg/d prednisone. Statistical significant increase of PAI-1 activity, on the average about 75%, was found (8.35 +/- 9.38 U/ml before, and 14.6 +/- 13.3 U/ml after treatment; p < 0.02). In 31 asthmatic patients (75.6%), after prednisone treatment, increased of PAI-1 activity together with platelet adhesion and aggregation were observed. Among other studied fibrinolysis factors no statistical significant differences before and after treatment were found. These results suggest that in asthmatic patients after prednisone treatment raises PAI-1 activity, probability because of releasing of the increased amount of PAI-1 from activated platelet.

Fibrinolysis system in patients with bronchial asthma.

Every inflammatory process, including that in the course of bronchial asthma may disturb the balance in blood coagulation and fibrinolysis system. The aim of the present study was to evaluate fibrinolysis in patients with bronchial asthma. The study group consisted of 41 patients with bronchial asthma, hitherto untreated (25 women, 16 men, at mean age 37.37 +/- 12.4 years) and 22 healthy adults (control group). In these subjects, the following parameters were established: euglobulin lysis time (ELT), the concentration of tissue plasminogen activator antigen (t-PA Ag), the concentration of urokinase plasminogen activator antigen (u-PA Ag), the activity of plasminogen activator inhibitor type 1 (PAI-1), the concentration of plasmin-antiplasmin complex (PAP) and fibrinogen/fibrin degradation products (FDP). It was found that patients with bronchial asthma had statistically significantly higher mean values of FDP (9.25 +/- 6.7 micrograms/ml vs. 5.0 +/- 5.9 micrograms/ml; p < 0.001), ELT (123.5 +/- 42.7 min vs. 97.4 +/- 27.1 min; p < 0.001), t-PA Ag (8.36 +/- 3.66 ng/ml vs. 5.5 +/- 3.71 ng/ml; p < 0.01) and PAP complexes (250.3 +/- 95.8 ng/ml vs. 193.4 +/- 60.7 ng/ml; p < 0.02). Mean u-PA Ag concentration in patients with bronchial asthma was significantly lower than in control group (0.24 +/- 0.16 ng/ml vs. 0.53 +/- 0.18 ng/ml; p < 0.01). No statistically significant differences were observed as to PAI-1 activity between patients with bronchial asthma and healthy subjects. The results of the present study suggest that increased concentrations of t-PA Ag, PAP and FDP complexes are the evidence for greater activity of fibrinolysis system in subjects with bronchial asthma.

Plasminogen activators (t-PA and u-PA) and plasminogen activators inhibitors (PAI-1 and PAI-2) in some myeloproliferative syndromes.

INTRODUCTION: Clinical observations and laboratory data indicate that patients with myeloproliferative syndrome (MPS) have hemostasis disorders that manifest with haemorrhagic diathesis or thrombotic disease. The role of fibrinolytic system is not clear in the pathomechanism of the disorders. In the study we aimed to evaluate fibrinolysis system in blood plasma of the patients with selected myeloproliferative syndromes on the basis of examinations of plasminogen activators (tissue--t-PA and urokinase-type--u-PA) and type 1 and type 2 plasminogen activator inhibitors (PAI-1 and PAI-2). MATERIAL AND METHODS: Forty-two patients (F/M 28/14) aged 36-78 years (average age--54 years) were enrolled into the study. Among the patients were 20 individuals with chronic myeloid leukaemia (CML), 17 with essential thrombocytemia (ET) and 5 with myelofibrosis (MF) treated in Provincial Haematological Outpatient Clinic in Bydgoszcz. Forty healthy volunteers (F/M 30/10) aged 24-65 (average 53) were included in control group. In citrate venous blood, the following parameters were determined: concentrations of antigen t-PA, u-PA, PAI-1, PAI-2, concentration of plasmin-alpha-2-antiplasmin complexes (PAP) determined with the use of ELISA technique, PAI-1 activity with amidolytic method, euglobulin lysis time (ELT) according to Kowarzyk-Buluk and fibrinogen/fibrin degradation products (FDP) concentration with the use of Merskey's method. RESULTS: Performed evaluations show that besides normal ELT elevated concentrations of FDP and PAP complexes occur in the blood of patients with myeloproliferative syndromes (MPS.). In studied myeloproliferative syndromes, high concentration of PAI-1 Ag and very low activity of PAI-1 were observed. In the patients with MPS intensified plasminogenesis and increased fibrin degradation were demonstrated. The role of granulocyte elastase is considered in activation of fibrinolysis system.

[The influence of ozone therapy on endothelial damage markers in patients with atherosclerosis of lower extremities]. / Wplyw ozonoterapii na wskazniki uszkodzenia sródblonka naczyniowego u chorych na miazdzyce zarostowa.

The aim of study was to evaluate the influence of the treatment with oxygen-ozone mixture on the blood plasma antigen concentration of tissue plasminogen activator (t-PA) and von Willebrand factor (vWF) in patients suffering from atherosclerotic disease of lower extremities. The study was performed in the group of 28 (M/F 22/6) patients means aged 64.1 years with atherosclerotic diseases of lower extremities, in whom 2 weeks therapy with oxygen-ozone mixture was used. The control group consisted of 30 healthy volunteers in mean age 51.0 years. In the blood plasma obtained from the patients before and after treatment with oxygen-ozone mixture and from the control group determinations of t-PA and vWF antigen using ELISA were done. Both parameters were significantly increased in the patients before the treatment in comparison to the healthy controls. The treatment with oxygen-ozone therapy caused in patients slight statistically not significant raise of t-PA and vWF antigen showing the endothelial stimulation but not the destruction of vascular endothelium.

[Markers of endothelial stimulation in hyperthyroidism]. / Wskazniki pobudzenia sródblonka naczyniowego w nadczynnosci tarczycy.

The aim of the study was to evaluate function of endothelial cells in the patients with hyperthyrosis before thyrostatic treatment on the base of known markers of endothelial disturbances: von Willebrand factor and tissue plasminogen activator. The study was performed in the 36 patients aged 20-60 (means 36.7) years suffering from Graves disease and in 17 patients with hyperthyrotic goitre aged 30-59 (means 45.8). The control group consisted of 40 healthy volunteers. In the blood plasma concentration of tissue plasminogen activator (t-PA) and von Willebrand factor (vWF) antigen were determined with enzyme-linked immunoassay (ELISA). In patients with hyperthyroidism significantly increased antigen concentration of both studied parameters were observed. It seems that increased concentration of t-PA and vWF antigen in the blood of hyperthyrotic patients was the result of the release of them from injured thyroid gland by disease or of stimulating effect of thyroid hormones on the t-PA and vWF synthesis in the endothelial cells.

[Changes in platelet function, activated partial thromboplastin time and plasminogen activator inhibitor in patients with bronchial asthma after prednisone treatment]. / Zmiany funkcji plytek krwi, czasu czesciowej generacji tromboplastyny i inhibitora aktywatora plazminogenu u chorych na astme oskrzelowa po leczeniu prednizonem.

Twenty patients with recently recognised bronchial asthma and 22 age and sex-matched healthy control subjects were studied. In both groups the activated partial thromboplastin time (APTT), prothrombin ratio (INR), fibrinogen, euglobulin lysis time (ELT), platelet number and platelet adhesion and aggregation, tissue plasminogen activator antigen (t-PA Ag) and activity of plasminogen activator inhibitor (PAI-1) were tested and compared. Statistically significant differences between asthmatic and control groups concerning adhesion, aggregation, APTT and ELT were found. In asthmatic group after 14 days of prednisone administration in a dose of 20 mg/d statistically significant (p < 0.05) shortening of APTT, and a significant increase of adhesion, aggregation and PAI-1 activity were found. These results suggest that in asthmatic patients after prednisone treatment platelet activity appeared in a form of intensification of adhesion and of aggregation degree, also the activity of PAI-1 probably of the platelet origin increased.

[The influence of some surgical procedures on the activity of protein C]. / Wplyw niektórych zabiegów chirurgicznych na aktywnosc bialka C.

Protein C is the important regulating factor of coagulation and fibrinolytic system. It is known that surgery causes disturbances of haemostasis. The aim of work was to study the influence of different kind of surgery on the protein C activity. The study contained 102 operated patients in whom vascular operation (20), operation of prostate because of carcinoma (20) and hypertrophy (40), cholecystectomy (12) and operation of hernia (10) were performed. Protein C activity was measured using Kabi Diagnostika test applying chromogenic substrate. In the most of patients surgery caused on the 0 and 1st postoperative day the decrease of protein C activity and the return to the preoperative values in the next few days. The exception was the hernia operation which did not diminish protein C activity. It seems that the decrease of protein C after surgery was the effect of consumption of it in the extremely activated coagulation and fibrinolytic system during operation.