Immunomodulation inhibits the development of endometriosis in rats.

Endometriosis, the presence of ectopic endometrium, has an unclear etiology and is commonly associated with endocrine, genetic, and immunological imbalance. This study determined whether immunomodulation by the RESAN vaccine could alter the potentially pathogenic gene expression profiles in the cells of the eutopic endometrium in an animal model of endometriosis. Preventing these changes could inhibit the early development of the illness and support the success of surgical treatment. Wistar rats were divided into three groups: prophylaxis (vaccinated before ectopic endometrium implantation, n = 23), therapeutic (vaccinated at the time of the ectopic excision, n = 23) and control (n = 10). During the first laparotomy, autotransplantation of the endometrium to the peritoneum was performed in the prophylaxis and therapeutic groups. The second laparotomy was carried out three months later in all groups to examine endometriotic foci and adhesions. Suspected endometriosis foci were removed. Three months later, the third laparotomy was performed in all animals, followed by suspected foci excision. Fragments of the eutopic endometrium were collected from all animals during the first and third laparotomies. All samples were analysed by real-time PCR to assess the expression of Bcl2, Bax, Bax/Bcl2 ratio, Mki67, and Tert genes. Endometrial foci were found in abdominal peritoneum at the second laparotomy in 1 animal in the prophylaxis group, compared to 16 animals in the therapeutic group. The prophylaxis group showed a high expression of Bax while the therapeutic group showed high expression of Bax, Tert and Mki67 genes. Additional analysis revealed that throughout the six months of the experiment, the expression of the Bax, Tert, and Mki67 genes decreased significantly in the prophylaxis group, Mki67 gene expression decreased in the therapeutic group, and Tert, Mki67, and Bcl2 gene expression decreased in the control group. The results indicate that immunomodulation affects the balance between apoptosis and proliferation in the eutopic endometrium and may prevent the onset and recurrence of endometriosis.

The impact of the age range of young healthy reference population on the cut-off points for low muscle mass necessary for the diagnosis of sarcopenia.

OBJECTIVE: According to the consensus report published by the European Working Group on Sarcopenia in Older People (EWGSOP), sarcopenia researchers should determine sex-specific cut-off points (COPs) for low muscle mass (LMM) in their respective countries. To this end, it is necessary to investigate young healthy adults' group (YHAG). As the EWGSOP hasn't specified any inclusion criteria for this group, there is a significant divergence in literature regarding the age range characterizing YHAG. Therefore, the primary aim of our study was to assess the impact of different YHAG age ranges on the calculated values of COPs for LMM. The secondary aims were to use the calculated COPs for evaluating the prevalence of sarcopenia among the older people from Poland. MATERIALS AND METHODS: 1512 young healthy individuals were divided into six age subgroups: 20-30, 18-40, 18-39, 20-39, 20-40, and 20-35 years. The sex-specific COPs for LMM were calculated using the Appendicular Lean Mass index. The prevalence of sarcopenia was assessed in 468 older adults from Poland. RESULTS: In the six age subgroups, six different COPs were obtained in the group of young women (ranging from 5.51 kg/m2 to 5.60 kg/m2), and three different COPs were found in the group of young men (ranging from 7.35 kg/m2 to 7.40 kg/m2). After applying the determined COPs, the overall prevalence of sarcopenia was found to range between 4.5% and 5.1%. CONCLUSIONS: Since there are no guidelines establishing the YHAG age range, if multiple sex-specific COPs are obtained, the highest values should be applied in the diagnostic of sarcopenia to avoid the misclassification of patients with this disease.

Surgical site infections in liver recipients in the early posttransplantation period: etiological agents and susceptibility profiles.

OBJECTIVE: This study evaluated the frequency of microbial isolates and their susceptibility profiles from cultures at the surgical site of 83 liver recipients in the early posttransplantation period. PATIENTS AND METHODS: We prospectively collected microbiologic culture data on 83 adult patients undergoing orthotopic liver transplantation (OLT) using standard procedures and commercially available tests. Susceptibility of the strains to antibacterial agents was performed by the Clinical and Laboratory Standards Institute (CLSI) guidelines. RESULTS: All patients were followed prospectively for the first 4 weeks after surgery. Among 284 microbial isolates from clinical surgical site samples in 80 liver recipients, cultures were positive in 110 samples. The most commonly isolated species were: Gram-positive cocci (n = 222 isolates, 78%) with dominance of methicillin-resistant coagulase-negative staphylococci (MRCNS; 42%) and high-level aminoglycoside-resistant enterococci (HLAR strains; 24.3%). Gram-negative bacteria were identified in 21.5% of positive cultures, including 30 strains (24%) from the Enterobacteriaceae family, with 13.3% of extended spectrum beta-lactamase producers [ESBL(+)]. Significant differences (P = .0012) were observed during the analysis of changes in the occurrence of Gram-positive bacteria isolated from the surgical site in the first week versus the second to the end of the fourth week. CONCLUSION: Gram-positive bacteria predominated as 78% of isolates.

Bacteria isolated from bile samples of liver recipients in the early period after transplantation: epidemiology and susceptibility of the bacterial strains.

OBJECTIVE: We estimated the frequency and susceptibility to antibacterial agents of bacterial isolates from bile samples obtained from 83 liver recipients in the early period after transplantation. PATIENTS AND METHODS: We prospectively collected data on 83 adult patients undergoing orthotopic liver transplantation (OLT), including bile samples taken during the first 30 days after OLT from adult liver recipients suspected to have bile infections. The isolation/identification of cultured bacteria was performed according to standard microbiological procedures and commercially available tests. Susceptibility of the strains to antibacterial agents was determined according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. RESULTS: Among 210 bile samples obtained from 79 liver recipients, bacterial cultures were positive in 110 samples from 59 (75%) recipients yielding 156 bacterial strains. The most commonly isolated species were as follows: gram-positive cocci (109 isolates) with dominance of coagulase-negative staphylococci (52%) and enterococci (36%); and gram-negative bacteria, 21 strains from the Enterobacteriaceae family and 14 of non-fermenting rods. We identified some multidrug-resistant (MDR) bacterial strains. In the first week after OLT, we investigated samples from 59 patients, yielding 36 bacterial strains. From the second to the end of the fourth week after OLT, 120 bacterial strains were isolated from 65 recipients. CONCLUSION: Gram-positive bacteria comprised 68.5%. The dominance of MDR gram-positive bacteria may be related to selection by perioperative antibiotic prophylaxis.

Detection of Clostridium difficile in stool samples from patients in the early period after liver transplantation.

OBJECTIVE: We examined the frequency of detection of Clostridium difficile (CD) toxins compared with the recovery of C. difficile in stool specimen cultures among orthotopic liver transplant (OLT) patients with nosocomial diarrhea in the early period. MATERIALS AND METHODS: The study included stool samples obtained during the first 30 days after OLT in adults who were suspected of CD-associated diseases. The identification of cultured CD strains was performed by standard microbiological methods. The presence of CD toxins was assayed using a commercial immunoassay. RESULTS: All patients were followed prospectively for CD infections from the date of OLT for the first 4 weeks after surgery. Among 54 samples, 16.7% were culture-positive for CD. CD toxins were tested on 54 samples, yielding 63% toxin-positive samples and 30% toxin- and culture-negative results. In the first week after OLT, samples from 19 patients were subjected to CD investigation. Among 19 samples positive for toxin, 52.6% of all samples were culture-negative. We analyzed 35 samples from the second to the fourth week after OLT in 31 recipients. Among 35 samples, 68.6% and 25.7% were positive for CD toxin and for culture, while 20% of samples were negative for toxin and culture. CONCLUSION: In our study, 63% of samples were toxin-positive with 16.7% yielding growth of CD and 30% being negative for toxins and cultures.

Etiological agents of bacteremia in the early period after liver transplantation.

Bacteremia is one of the major infections in orthotopic liver transplantation (OLT). The study of 83 adults who underwent OLT from 2001 to 2004, included patients followed prospectively from the day of transplantation to 4 weeks after the procedure by bacteriological cultures. The microorganisms were investigated according to standard National Committee for Clinical Laboratory Standards (NCCLS) procedures. Blood samples were examined in 59 recipients (71.1%) before and in 76 patients (91.6%) during the month after transplantation. Among 249 investigated samples, 96 were positive, as cultured from 19 recipients before OLT and 48 patients afterward. The most common were Gram-positive cocci (n = 71) and coagulase-negative staphylococci (n = 52), including methicillin-resistant coagulase-negative staphylococci (MRCNS). Enterococcus spp. occurred in 9 isolates (high-level aminoglycoside-resistant enterococci [HLAR] strains were cultured). We cultured the Enterobacteriaceae family (n = 16 isolates) and (n = 15 isolates), Gram-negative nonfermenting rods some of which were extended spectrum beta-lactamase producing [ESBL(+)] strains. The predominance of Gram-positive cocci was caused by CNS, and the use of prophylaxis to reduce Gram-negative bacteria. The increased rate of isolation of bacteria with multidrug resistance (MDR) to antimicrobial agents may be due to their frequent use for prophylaxis of bacterial infections in OLT. These MDR bacterial strains caused severe BSI after OLT.

Results of surgical treatment of non-small cell lung cancer: validation of the new postoperative pathologic TNM classification.

OBJECTIVE: Prognostic relevance of the current TNM stage grouping for lung cancer is still a matter of debate. METHODS: To validate the new pathologic TNM classification for non-small cell lung cancer, we analyzed the survival data of 586 patients who underwent complete pulmonary resection and pathologic staging at one institution. RESULTS: The current TNM stage grouping well reflected the long-term prognostic hierarchy. There was a good distinction between new substages IA and IB (5-year survivals of 66% and 53%, respectively). The subdivision of stage II led to an under-representation of stage IIA (6 patients [1.0%]), and therefore the appropriateness of this modification could not be verified. Five-year survival in the T3 N0 category (30%) was significantly better than that found in the new stage IIIA (15%). No difference was found between T3 N0 and T2 N1, the categories constituting new stage IIB. Within stage IIIA there was a significant survival difference between T3 N2 (6%) and the remaining T and N designations (18%). Moreover, the 5-year survival in the T3 N1 category (35%) was similar to that found in the new stage IIB (27%) and better than in any T N2 tumors (12%). CONCLUSION: Most of our findings confirmed prognostic relevance of the current pTNM stage grouping in patients with resectable non-small cell lung cancer. However, despite recent modifications, there is still a significant heterogeneity that flaws stage IIIA.

[Evaluation of drug sensitivity and biochemical properties of coagulase-negative S. aureus strains isolated from clinical specimens]. / Ocena wrazliwosci na leki i cech biochemicznych u koagulazo-ujemnych szczepów S. aureus izolowanych z materialów klinicznych.

20-25% of strains isolated in our hospital in 1991 from clinical specimens and identified as S. aureus were coagulase-negative. These strains were characterized in respect of biochemical properties and resistance to antibacterial drugs. It was shown that the investigated group of strains displayed high drug resistance and particularly high percent of strains were resistant to methicillin (60%). 100% strains were resistant to penicillin and tetracyclines and most of them were resistant to aminocyclitol antibiotics. Coagulase-negative strains, in comparison with coagulase-positive, less frequently produced hemolysins and more frequently staphylokinase.

[Production of staphylokinase and hemolysin by coagulase-negative staphylococcus]. / Wytwarzanie stafylokinazy i hemolizyn przez gronkowce koagulazo-ujemne.

The ability to staphylokinase production by the representative of the six of fifteen investigated species of staphylococci was detected: S. epidermidis, S. lentus, S. sciuri, S. lugdunensis, S. xylosus and S. hominis. The frequency of occurrence of this feature was different among the investigated species. Relatively, the least frequently this feature was observed with S. epidermis (2.3%) and S. xylosus (8.3%) strains. This property most frequently occurred among S. lentus--all the examined strains of this species produced staphylokinase. The hemolysins synthesis was shown among 13 of 15 investigated coagulase-negative species of staphylococci. The only two species of the examined representatives did not produce any hemolysin: S. hyicus and S. schleiferi. Complete correlation between staphylokinase synthesis and the absence of beta-hemolysin production was observed among strains: S. lugdunensis and S. lentus as with the lysogenic S. aureus strains with the double converting phages.

[Use of PCR for evaluating detection of coa and nuc genes in methicillin-resistant, coagulase-negative strains of Staphylococcus aureus (MRSA-CN)]. / Zastosowanie PCR do oceny wystepowania genów coa i nuc u metycylino-opornych, koagulazo-ujemnych szczepów Staphylococcus aureus (MRSA-CN).

Strains showing a negative reaction in tube test for coagulase constitute 10 to 20% of all Staphylococcus aureus isolated from patients of Hospital of Infant Jesus in Warsaw. Most of them are MRSA. In 42 MRSA strains showing negative reaction for coagulase, the presence of coagulase (coa) and nuclease (nucA) genes was checked. Determination of whole cell DNA with PCR reaction was performed. The obtained results revealed that all 42 strains possessed gene nucA, but only 39 strains possessed the coa gene.

An influence of immunomodulation on Th1 and Th2 immune response in endometriosis in an animal model.

AIM: To assess the role of the Th1 and Th2 cellular response in the etiology of endometriosis observed in a rat model, with the use of the RESAN immunomodulator. MATERIALS AND METHODS: A comparative analysis of cytokines in blood serum typical of Th1 (TNF-α and INF-γ ) and Th2 (IL-4, IL-6, IL-10) cell response in groups of rats, in which RESAN preparation was used as prophylaxis (Gr. I) or treatment (Gr. II) of endometriosis. RESULTS: The results indicated an increase in the level of cytokines in blood serum typical of Th2 cell response by comparing the second and third stages of the experiment in the second group of rats and a decrease in IL-4 and IL-10 between III and IV stages. There was a significant difference in cytokine levels during the third stage of the experiment by comparing I and II groups of rats. In the III group of rats, levels of IL-10 significantly increased between the II and III stages of the experiment. CONCLUSION: RESAN preparation shows Th2 cell response, inhibiting the development of endometriosis in a rat model. Due to successful prophylactic action, one may speculate that RESAN vaccine may be effective as a complementary treatment after surgical excision.

Heavy metals in three lakes in West Poland.

Concentrations of heavy metals (Ni, Cr, Co, Zn, Mn, Pb, Cd, Cu, Hg, Fe) as well as macronutrients (P, Ca, Mg) were measured in water, bottom sediments, and plants of three lakes in West Poland (southwest of Poznan). The plants collected were Nymphaea alba, Nuphar luteum, Ceratophyllum demersum, Phragmites communis, Typha latifolia, and Schoenoplectus lacustris. These plants contained elevated levels of Co, Zn, Pb, Cd, Cr, and Hg. Analyses of water and bottom sediments indicated that the lakes were polluted with Zn, Cd, Cu, and Pb and partly with Ni and Hg. Strong positive correlations were found between concentrations of Cd in water and in plants, between concentrations of Cd in bottom sediments and in plants, between concentrations of Cr in water and in plants, between concentrations of Cr in bottom sediments and in plants, and between concentrations of Fe in water and in plants, indicating the potential of plants for pollution monitoring for these metals. A negative correlation was found between biomass production and Pb and Mn content in water and Pb and Mn content in bottom sediments. Cr and Cd accumulated in plants at a higher rate from bottom sediments than from water. The accumulation rate of Fe in plant tissues was higher with an increase in Fe in water than with an increase in Fe in bottom sediments.