Effect of nitrosative stress on extracellular nucleotide metabolism in endothelial cells.

Mechanisms of free radical injury involve chemical modification of proteins, lipid derivatives and nucleic acids and consequent loss of its function. However, specific targets and exact sequence of events has not been fully clarified. We determined whether extracellular enzymes that are involved in adenosine formation such as ecto-5'nucleotidase (e5N) and removal such as extracellular form of adenosine deaminase (eADA) could be affected by peroxynitrite. We used intact cell assay system that involves exposure of cultured HMEC-1 cells to substrates followed by HPLC analysis of conversion of substrates into products. We found that e5N and ADA activities decreased by 20-40% after incubation for 20 or 60 minutes with 30 µM peroxynitrite. Decrease of cellular ATP and NAD was also observed. We conclude that besides other cytotoxic effects modification of extracellular enzymes of nucleotide metabolism could be important target for free radical injury.

Elastography of the uterine cervix: implications for success of induction of labor.

OBJECTIVES: To perform a preliminary investigation into the use of elastography for cervical assessment, in order to determine the effectiveness of this method for the evaluation of cervical consistency. METHODS: Elastography of the uterine cervix was performed in 29 patients before induction of labor, with tissue surrounding the internal os described using a numeric scale called the elastography index (EI). A color map from purple to red was produced with the hardest tissues displayed as purple and assigned a score of 0 points and progressively softer tissues displayed as blue (1 point), green (2 points), yellow (3 points) and red (4 points). The EI of tissue around the internal os, in the middle part of the cervical canal and around the external os were analyzed in relation to the success of induction of labor using the t-test. RESULTS: The mean EI of the internal os in the group of patients with successful induction of labor was 1.23, while in the group with failed induction of labor it was 0.39 (Student's t-test, P=0.024). No difference was found for the EI of the middle part of the cervical canal or for the EI of the external os in relation to the success of induction of labor (P>0.05). CONCLUSION: Elastography of the uterine cervix may be an objective method for assessment of softening of tissue in the region of the internal os before induction of labor. Standardization of the cervical properties observed on elastography during pregnancy may help to guide the use of prostaglandins or oxytocin for induction of labor.

Successful pregnancy in a patient with medullary cystic disease and severe renal impairment.

We present a successful pregnancy in a 37-year-old women with severe renal impairment due to medullary cystic disease. She presented five years earlier with hypertension and chronic renal failure with creatinine was 2.1 mg/dl (Ccr 35 ml/min). She had had two successful pregnancies in the past, nine and seven years earlier. Diagnosis of medullary cystic disease (MCD) was made based on typical ultrasound appearance, sodium wasting and acidosis out of the proportion to the degree of renal failure. Over the next 5 years, a slow progression of chronic renal failure was observed with creatinine reaching 5.1 mg/dl (Ccr 15,4 ml/min), shortly before she became pregnant in December 2001. Her hypertension remained well-controlled and serum creatinine decreased at the beginning of the second trimester to 3.7 mg/dl with subsequent increase toward the end of the pregnancy. She required increasing doses of erythropoietin and intravenous iron supplementation to maintain hemoglobin levels. The polyhydramnios developed necessitating five procedures of amnio reduction. She was not treated by dialysis. A boy weighing 1,600 g was delivered by cesarean section in the 35th week of gestation. The mother's creatinine rose to 5.2 mg/dl (Ccr 15 ml/min) post partum and her renal function declined only slightly over the next 20 months. Our report illustrates that successful fetal and maternal outcome can be achieved even in cases of advanced renal failure preceding gestation. It appears that the type of renal disease influences the pregnancy course and outcome and thus should be considered in patient counseling and therapeutic decisions.

[Application of pcr in paternity determination in pregnancy preceded by rape]. / Zastosowanie reakcji lancuchowej polimerazy (PCR) we wczesnej ciazy w badaniu spornego ojcostwa zwiazanego z gwaltem.

Authors present a case of PCR (Polymerase Chain Reaction) technique application for the paternity determination in pregnancy preceded by the rape. Diagnostic material was obtained in the 10th week of pregnancy by the use of transabdominal Chorionic Villous Sampling under the echo-guidance and its DNA feature was compared against the DNA material obtained from the vagina after the rape and the material from mother and her husband. The PCR technique revealed in chorionic villi the presence of allele that were present in material deriving from mother and her husband as well as no even single allele from the material of violator. Exclusion of violator as a father of the foetus effected in decision of continuing the pregnancy.

[Appendiceal mucinous carcinoma]. / Rak sluzowy wyrostka robaczkowego.

Appendiceal carcinoma is very rare. Preoperative diagnosis of this kind of neoplasm is difficult. Even at operation in under half of cases this diagnosis is considered. We present a case of a woman admitted to the hospital with diagnosis of adnexal tumor of the right ovary. The diagnosis of adnexal mass was confirmed by ultrasound examination. Laparotomy was performed and tumor of appendix was found. There was also a small tumor (2 cm) in small bowel and some increased lymphatic nodules. Uterus with adnexis, tumor of appendix, part of small bowel and colon were resected. Because of infiltration of the neoplasm a part of the bladder was resected as well. There were no complications after operation. She received chemotherapy with 5-FU. After 9 months computed tomography revealed no changes in abdomen. Diagnosis of pelvic masses when they do not origin of adnexis is usually very difficult. In many cases proper diagnosis is made only during laparotomy.

[Primary malignant schwannoma in peritoneum of pelvis minoris: a case report]. / Zlosliwy nowotwór wychodzacy z komórek Schwanna zlokalizowany w miednicy malej -- opis przypadku.

There are reports of rare cases of malignant schwannoma of the small bowel, ovary or urinary bladder. We report a case of malignant schwannoma found in peritoneum without any other localisation in 66-year-old woman. The first diagnosis was tumor of right ovary. Laparotomy was performed and a big, solid tumor of urinary bladder involving the small bowel was found. There were some small tumors in peritoneum and parametrium. All the tumors were removed. The histological changes of the small lesions were described as malignant schwannoma. The mass in urinary bladder and small bowel was found to be of an inflammatory origin. The cases described by other authors suggest, that the diagnosis of malignant schwannoma in pelvis minoris is very difficult. Surgery is an adequate way of final diagnosis and management.

[A case of cystic adenomatoid lung malformation treated by thoracocentesis]. / Przypadek wrodzonego torbielowatego gruczolakowatego zwyrodnienia pluc u plodu leczony drenazem plodowo-owodniowym.

A case of Cystic Adenomatoid Lung Malformation (CALM) treated by serial thoracocenteses followed by implantation of the feto-amniotic shunt is presented. The idea was to prevent prolonged lung compression leading to lung growth retardation and maturation restriction. Postnatally the baby presented good respiratory condition. She underwent lung lobectomy in the 2nd day of life. The histological assessment confirmed the ultrasound diagnosis of CALM. The postoperative period was not complicated. The method of feto-amniotic shunting is presented as promising in the treatment of CALM prenatally.

[Neurofibroma plexiforme of the small pelvis: a case report]. / Neurofibroma plexiforme miednicy mniejszej--opis przypadku.

There are reports of rare cases of nerve tissue tumors of the small bowel, ovary, urinary bladder or retroperitoneal space. We report a case of neurofibroma plexiforme of pelvis minoris in 42-year-old woman. The first diagnosis was adnexal tumor. Laparotomy was performed and a big, solid tumor of left parametrium was found. The histology of the tumor was described as neurofibroma plexiforme. There was also an inflammatory tumor of appendix involving right Fallopian tube. The described by other authors cases suggest, that diagnosis of nerve tissue tumors in pelvis minoris is very difficult. Surgery is an adequate way of final diagnosis and management.