Relationship between aortic wall oxidative stress/proteolytic enzyme expression and intraluminal thrombus thickness indicates a novel pathomechanism in the progression of human abdominal aortic aneurysm.

The possibility that oxidative stress promotes degradation of the extracellular matrix and a relationship between intraluminal thrombus (ILT) thickness and proteolytic activity within the abdominal aortic aneurysm (AAA) wall has been suggested. In the present study, the hypothesis that thin ILT is correlated with an increase in oxidative stress-related enzymes and matrix metalloproteinase-9 (MMP-9) expression within the human AAA wall was investigated. We also studied the antioxidant activity of superoxide dismutases, catalase, glutathione peroxidase, glutathione reductase, and thioredoxin within the full-thickness AAA wall and through fluoroimmunohistochemical staining of catalase and MMP-9 expression within the inner and outer media, in relation to ILT thickness. Reactive oxygen species control the degradation and remodeling of the extracellular matrix by up-regulating proteolytic enzymes, such as MMPs. Results showed that oxidative stress and proteolytic enzyme expression were simultaneously, significantly higher within thin thrombus (≤10 mm)-covered aneurysm wall when compared with the wall covered by thick thrombus (≥25 mm). These findings provide the first demonstration, to our knowledge, of a causative link between oxidative stress instigating proteolytic enzyme expression at the tissue level and human AAA development. Presence of a thin circumferential thrombus should always be considered as a risk factor for the greatest increase in aneurysm growth rate and rupture, giving an indication for surgery timing.-Wiernicki, I., Parafiniuk, M., Kolasa-Wolosiuk, A., Gutowska, I., Kazimierczak, A., Clark, J., Baranowska-Bosiacka, I., Szumilowicz, P., Gutowski, P. Relationship between aortic wall oxidative stress/proteolytic enzyme expression and intraluminal thrombus thickness indicates a novel pathomechanism in the progression of human abdominal aortic aneurysm.

Spirometry results (FEV1 and FVC) in young Bantu men from Tanzania vs environmental and family characteristics.

OBJECTIVES: The aim of this paper was to examine the extent to which socioeconomic factors, anthropological data and somatic indices influenced the results of spirometric measurements (FEV1 and FVC) in Tanzanian youth. MATERIALS AND METHODS: The population studied were young black Bantu men aged 12.8-24.0 years. Analysis was performed for the whole data set (n = 255), as well as separately for two age groups: under 17.5 years (n = 168) and 17.5 + (n = 87). A backward stepwise multiple regression analysis was performed for FEV1 and FVC as dependent variables on socioeconomic and anthropometric data. RESULTS: Multiple regression analysis for the whole group revealed that the socioeconomic and anthropometric data under analysis accounted for 38% of the variation in FEV1. In addition the analysis demonstrated that 34% of the variation in FVC could be accounted for by the variables used in the regression. A significant impact in explaining the variability of FVC was exhibited by the thorax mobility, financial situation of the participants and Pignet-Verwaecka Index. CONCLUSION: Analysis of the data indicates the significant role of selected socio-economic factors on the development of the biological specimens investigated. There were no perceptible pathologies, and the results can be treated as a credible interpretation of the influence exerted by the environment in which the teenagers under study grew up.

Hemorrhagic stroke caused by xylometazoline poisoning.

An increase in the use of over-the-counter medications has been observed in recent years. This also concerns xylometazoline, approved for the treatment of allergic rhinitis or upper respiratory tract infections. We present the fatal case of a 40 year-old-woman with a massive hemorrhagic stroke. Initial toxicology tests of biological material collected during autopsy revealed the presence of xylometazoline. No other significant toxicology findings were noted. LC-MS/MS method has been developed to determine xylometazoline concentration, which was 18.6 ng/mL in blood and 498.9 ng/mL in urine. The macroscopically detected hemorrhagic focus was confirmed by histopathological which confirmed hemorrhagic infarcts in the brain tissue, especially in the subarachnoid area. No other pathological changes were found. Based on findings from autopsy and toxicological analyses, the direct cause of death was concluded to be hemorrhagic stroke resulting from xylometazoline intoxication. Although xylometazoline products are regarded as relatively safe and are available over the counter, the risk of adverse effects, in particular stroke leading to death, should be considered. If adverse effects are observed, it is reasonable to measure the concentration of the drug in blood and urine. With such data, it will be possible to assess the actual exposure to this xenobiotic and draw firmer conclusions.

Analysis of the genetic variants of glucose-6-phosphate dehydrogenase in inhabitants of the 4th Nile cataract region in Sudan.

Malaria is one of the most common diseases in the African population. Genetic variance in glucose dehydrogenase 6-phosphate (G6PD) in humans determines the response to malaria exposure. In this study, we aimed to analyze the frequency of two single-nucleotide polymorphisms (G202A and A376G) present in two local tribes of Sudanese Arabs from the region of the 4th Nile cataract in Sudan, the Shagia and Manasir. The polymorphisms in G6PD were analyzed in 217 individuals (126 representatives of the Shagia tribe and 91 of the Manasir tribe). Real-time PCR and RFLP-PCR were utilized to analyze significant differences in the prevalence of alleles and genotypes. The 202A G6P allele frequency was 0.7%, whereas the G202 variant was found in 93.3% of cases. The AA, GA, and GG genotype frequencies for the A376G G6PD codon among the Shagia were 88, 11.1, and 0.9%, respectively; this is similar to the distribution among Manasir tribe representatives (94.5, 3.3, and 2.2%, respectively; OR 3.44 [0.85-16.17], p=0.6). Notably, in north-eastern Sudan the G6PD B (202G/376A) compound genotype frequency was 90.3%, whereas the G6PD A variant (202G/376G) was found in 1.4% of that population. Identification of the G6PD A- variant (202A/376G) in the isolated Shagia tribe provides important information regarding the tribal ancestry. Taken together, the data presented in this study suggest that the Shagia tribe was still nomadic between 4000 and 12,000 years ago. Moreover, the lack of G6PD A- genotype among ethnically diverse Monasir tribesmen indicates a separation of the Shagia from the other tribes in the region of the 4th Nile cataract in Sudan.

Molecular Diagnosis of COVID-19 Sudden and Unexplained Deaths: The Insidious Face of the Pandemic.

The COVID-19 epidemic has led to a significant increase in the number of deaths. This has resulted in forensic autopsies focusing on additional diagnostic possibilities. The following article is a summary of 23 autopsies of sudden and unexplained deaths. Particularly noteworthy are the described cases of children whose deaths were originally classified as SIDS (sudden infant death syndrome). All tests were performed at the Department of Forensic Medicine and Forensic Genetics, Pomeranian Medical University in Szczecin. Autopsy analyses were extended to include diagnostics of the SARS-CoV-2 virus using molecular methods and a detailed histopathological analysis of lung tissue. The material for molecular tests consisted of a nasopharyngeal swab taken postmortem and a lung tissue homogenate. In both cases, the RT-PCR method with CT cut-off point analysis was used for diagnosis. In all analyzed cases, the lungs showed massive congestion and increased fragility and cohesion. The tested material showed the presence of the SARS-CoV-2 virus, which indicated various stages of infection. It was observed that the higher the virus expression in the lungs, the lower or undetectable it was in the nasopharyngeal swab. This may explain false negative results during life in swabs. An interesting finding is that child deaths classified as SIDS also showed the presence of the virus. This may constitute a new direction of research.

Skeletal evidence of the ethnic cleansing actions in the Free City of Danzig (1939-1942) based on the KL Stutthof victims analysis.

In the early days of World War II, many of the prominent and influential people of Polish nationality from the Free City of Danzig were arrested by the Germans and sent to the nearby concentration camp KL Stutthof. Nearly a hundred of them died within the next seven months upon their arrival, and were buried in a clandestine mass grave in a nearby forest. However, the exact nature of their death is unknown, as it is unclear what the attitude of the aggressors was toward the victims. We do not know whether there was only one executioner or there were several assassins, nor if the killing methodology was consistent with the other state-regulated executions. The studied material represents the commingled remains of a minimum thirty-four people, possibly all male, aged from under eighteen to over sixty at the time of death. Perimortem traumatic lesions are shown mainly on the skull bones. We asked whether the perimortem trauma lesions visible on the victims' skeletons could be informative on the cause and manner of their death. Our results show the prevalence of the perimortem trauma inflicted by a blunt object are on the parietal bones above the Hat Brim Line (HBL), which is commonly associated with a violent attack. The gunshot trauma was usually localized on the occipital bone or posterior parietal, which could indicate a shot to the back of the head, and this was commonly encountered during executions. No signs of defensive injuries can be explained either by restraining of the hands or by a surprise attack. The abundance and variability of the trauma type can be evident of multiple assailants. Moreover, the multiple impact points detected on several crania prove unnecessary overkill and brutality, which reflects the personal attitudes of the executioners towards the victims.

Analysis for genotyping Duffy blood group in inhabitants of Sudan, the fourth cataract of the Nile.

BACKGROUND: Genetic polymophisms of the Duffy antigen receptor for the chemokines (DARC) gene successfully protected against blood stage infection by Plasmodium vivax infection. The Fy (a-, b-) phenotype is predominant among African populations, particularly those originating from West Africa, and it is rare among non-African populations. The aim of this study was to analyse the frequency of four Duffy blood groups based on SNPs (T-33C, G125A, G298A and C5411T) in two local tribes of Sudanese Arabs, the Shagia and Manasir, which are both from the region of the Fourth Nile cataract in Sudan. METHODS: An analysis of polymorphisms was performed on 217 individuals (126 representatives of the Shagia tribe and 91 of the Manasir). Real-time PCR and TaqMan Genotyping Assays were used to study the prevalence of alleles and genotypes. RESULTS: The analysis of allelic and genotype frequency in the T-33C polymorphisms demonstrated a significant dominance of the C allele and CC genotype (OR = 0.53 [0.32-0.88]; p = 0.02) in both tribes. The G125A polymorphism is associated with phenotype Fy(a-, b-) and was identified in 83% of Shagia and 77% of Manasir. With regard to G298A polymorphisms, the genotype frequencies were different between the tribes (p = 0,002) and no single AA homozygote was found. Based on four SNPs examined, 20 combinations of genotypes for the Shagia and Manasir tribes were determined. The genotype CC/AA/GG/CT occurred most often in Shagia tribe (45.9%) but was rare in the Manasir tribe (6.6%) (p < 0.001 Shagia versus Manasir). The FY*AES allele was identified in both analysed tribes. The presence of individuals with the FY*A/FY*A genotype was demonstrated only in the Shagia tribe. CONCLUSION: This is probably the first report showing genotypically Duffy-negative people who carry both FY*BES and FY*AES. The identification of the FY*AES allele in both tribes may be due to admixture of the non-African genetic background. Taken as a whole, allele and genotype frequencies between the Shagia and the Manasir were statistically different. However, the presence of individuals with the FY*A/FY*A genotype was demonstrated only in the Shagia tribe.

Lack of association between CAG repeat polymorphism in the androgen receptor gene and the outcome of rheumatoid arthritis treatment with leflunomide.

PURPOSE: Leflunomide (LEF) is a disease-modifying antirheumatic drug used for treating rheumatoid arthritis (RA) and the action of which may be modified by sex hormones. The aim of this study was to examine the association between CAG repeat polymorphism in the androgen receptor (AR) gene and the response to treatment with LEF in women with RA. METHODS: We studied 114 women diagnosed with RA and treated with LEF (20 mg daily). Follow-up was 12 months. CAG repeat polymorphism was determined using polymerase chain reaction (PCR) and subsequent fragment analysis by capillary electrophoresis. RESULTS: Analysis revealed no statistically significant associations between CAG repeat polymorphism in the AR gene and improvement of disease activity parameters: erythrocyte sedimentation rate, serum C-reactive protein, patient's global assessment of disease activity on a visual analog scale (VAS), disease activity score of 28 joints (DAS28), and swollen and tender joint count. CONCLUSION: Our results suggest no correlation between CAG repeat polymorphism in the AR gene and response to treatment with LEF in women with RA.

Hyaluronic Acid and Radiofrequency in Patients with Urogenital Atrophy and Vaginal Laxity.

Vaginal laxity (VL) and genitourinary syndrome of menopause (GSM), as well as aesthetic changes in the vulvar skin, often occur together and cause physical, psychological, and functional problems for women and their partners. The current study evaluated the efficacy of a nonsurgical radiofrequency device (RF) procedure combined with hyaluronic acid (HA) injection into the skin of the labia majora on clinical, histological, and aesthetic levels. Twenty women with GSM and VL, aged between 36 and 72 (mean age 53.4), were treated with bipolar RF SECTUM, vaginal and vulvar application, as well as with a hyaluronic acid (HA) injection into the skin of the labia majora. The Vaginal Laxity Questionnaire (VLQ), Vaginal Health Index (VHI), and Female Sexual Function Index (FSFI) were used to examine the clinical effects of the operations. The Global Aesthetic Improvement Scale was utilized to measure patient satisfaction. On a histochemical level, the concentrations of elastin and collagen in the vaginal wall and vulvar skin were examined. Results: There was significantly higher patient satisfaction and a considerable clinical improvement across all areas of analysis. On the histochemical level, elastin and collagen fiber concentration increased after the treatment protocol both in the vulvar skin and in the vaginal wall: elastin in the vaginal wall, 11.4%, and in the vulvar skin, 61%; collagen in the vaginal wall, 26%, and in the vulvar skin, 27%. The current study demonstrated the efficacy and safety of this nonsurgical RF procedure combined with a hyaluronic acid (HA) injection into the skin of the labia majora on clinical, histochemical, and aesthetic levels.

[Y-STR Poland--a database for evaluation of evidence value in forensic genetics]. / Y-STR Polska--baza danych do oceny wartosci dowodowej w genetyce sadowej.

The "Y-STR Poland" is a multicenter project, the aim of which is the construction of a widely available database of Y chromosome haplotypes determined in the Polish population in a range of sixteen loci in AmpFISTR Y-filer system. The database will be regularly updated and it will be used in assessment of evidence value in forensic genetics. The starting base "Y-STR Poland" contains 1600 Y-STR haplotypes and encompasses data collected in Lodz (two independent centers), Warsaw and Szczecin regions. The present report contains as an attachment the data in an Excel-type file, which serves as a tool in frequency determination of a given Y haplotype in the Polish population. The file will be updated on a regular basis along with updating the database, and will be freely available from www.genetyka-sadowa.pl.

Thermography in clinical ophthalmic oncology.

PURPOSE: The aim of this study was to present our own experience with the use of thermography as a complementary method for the initial diagnosis and differentiation of intraocular tumors, as well as for the evaluation of the efficacy of treatment of intraocular melanomas. METHODS: The study group comprised 37 patients with intraocular tumors, including 9 with uveal melanoma, 8 with uveal melanoma after I125 brachytherapy, 12 with a focal metastasis to the uvea, and 8 with retinal capillary hemangioblastoma. A FLIR T640 camera was used to capture images in the central point of the cornea, eye area, and orbital cavity area. RESULTS: Eyes with uveal melanoma had higher temperature compared with the fellow normal eye of the patient in the range of all measured parameters in the regions of interest. In the group of patients with melanoma after unsuccessful brachytherapy, higher temperature was observed at the central point of the cornea. In patients with tumor regression, all measured parameters were lower in the affected eye. We observed lower tempe-ratures in the range of all tested parameters and areas in eyes with choroidal metastases. Eyes with diagnosed intraocular hemangioblastoma were characterized by higher parameters for the regions of interest versus eyes without this pathology. CONCLUSIONS: A thermographic examination of the eye can be used as an additional first-line diagnostic tool for the differentiation of intraocular tumors. Thermography can be a helpful tool in monitoring the treatment outcome in patients with intraocular melanoma.

Infrared thermography for the analysis of ocular surface temperature after phacoemulsification.

PURPOSE: In this study, we present our observations on changes in the surface temperature of the cornea, eye, and orbital cavity after cataract surgery. METHODS: A total of 39 patients who underwent cataract surgery based on phacoemulsification were enrolled. Temperature was measured at the center of the cornea, on the eye surface, and in orbital cavities using the FLIR T640 thermal imaging camera at days 1, 14, and 28 after cataract phacoemulsification and compared with preoperative baseline values. RESULTS: The mean value of ocular surface temperature of the orbital cavity 14 days after cataract surgery was significantly different compared with the preoperative temperature (p£0.05). Temperature of the investigated areas showed a reduction, with the greatest decrease on day 14 after surgery, followed by an increase on day 28 after surgery, which was comparable to the temperature measured prior to surgery. CONCLUSIONS: The reduction in ocular surface temperature toward the end of post-cataract surgery follow-up may be associated with increased instability of the tear film after phacoemulsification. Therefore, patient awareness regarding the possibility of clinical symptoms of dry eye syndrome during the first month after surgery should be part of clinical management of cataract surgery. Ocular surface temperature did not increase after cataract surgery, suggesting the absence of significant inflammation, and the temperature about 1 month after cataract surgery was comparable to that before surgery. Nevertheless, the negative correlation between age and ocular surface temperature should be of concern in the elderly.

[Identification of the site of skeletal remains from World War II]. / Identyfikacja stanowiska szkieletowego z okresu II wojny swiatowej.

The objective of the present article is to show the model of processing in case of discovering a WW II grave with skeletal remains and to discuss the possibilities of personal identification of the victims. In many similar cases, it is impossible to employ genetic methods because of lack of samples for comparison. The shown procedure proved to be efficient in spite of the fact that more than 60 years passed since the date of death.

Surgical instrument left inside abdomen.

Leaving surgical instruments in the patient's body is one of the most difficult situations in the professional career of an operator and it can also have severe consequences for the patient. Contrary to world literature, there are no reports of such incidents in Polish publications. Lack of such reports creates an illusion that leaving surgical instruments in the patient's body does not happen in Poland, which is an unsubstantiated thesis. This paper presents two cases of leaving hemostats in the abdominal cavity. According to the authors, similar publications may facilitate critical assessment of the existing rules for inspecting instruments and surgical material by surgical teams. Importantly, confirming the compliance of instruments and material by surgical nurses is not the only criterion of assessment in this matter for the operator.

Ultrasonographic and histological analysis of atheromatous plaques in carotid arteries and apoplectic complications.

BACKGROUND: The aim of the study was to compare a computer assessment of carotid plaques with the quantity and distribution of inflammatory cells in the plaques and to find correlation with the incidence of cerebral stroke. MATERIAL/METHODS: The material consisted of 20 carotid plaques causing stenoses of internal carotid arteries ranging from 70 to 99%. USG images of the plaques were assessed by a computer-assisted program for image analysis. For each plaque a histogram was obtained for which the gray scale median (GSM), a measure of plaque echogenicity, was determined. Then the quantity and distribution of inflammatory cells in plaques taken during endarterectomy were assessed and these data were compared with the GSM and the incidence of stroke. Moreover, grouping of cases according to histometric variables was analyzed. RESULTS: Statistical analysis showed a considerable correlation between low GSM and the incidence of stroke. At the same time, a correlation between the presence of inflammatory cells on the edges of plaque with a low GSM was found and the analysis of clusters demonstrated a significant increase in the number of patients with strokes. CONCLUSIONS: The use of computer analysis of USG images allows determining the echogenicity of any carotid plaque and can be applied in clinical studies in which the aim is to find characteristic parameters for an unstable plaque.

Genetic variation of 15 autosomal STRs in a population sample of Bedouins residing in the area of the Fourth Nile Cataract, Sudan.

ABSTRACT: The purpose of the paper was to report allelic frequencies of 15 autosomal STR markers (AmpFlSTR NGM PCR Amplification Kit) for Bedouin inhabitants in the area of the Fourth Nile Cataract in Sudan, and compute commonly used population and forensic biostatistical parameters. Buccal swabs were collected from 117 unrelated individuals. DNA was extracted using DNA QIAamp® DNA Mini Kit, and quantitated with Quantifiler Human Quantification Kit in a 7500 Real-Time PCR System. Amplification of 15 AmpFlSTR NGM PCR Kit loci was performed in PCR System 9700. Electrophoresis and typing were performed in 3130 Genetic Analyzer. Arlequin v3.5 software and PowerStats v1.2 spreadsheet were used for statistical calculations. The STR frequency distributions showed no deviations from HWE. The combined values of Matching Probability and Power of Exclusion are 1.77 × 10-18 and 0.9999996, respectively. The average observed heterozygosity over 15 loci is 0.8069. Five different allelic microvariants were found. A significant linkage disequilibrium was observed in five pairs of loci. A 15 STR population database has been established for Sudanese Bedouins. The systems studied have been shown to be useful tool for personal identification in this population.

Morphological and Functional Evaluation of Meibomian Gland Dysfunction in Rosacea Patients.

PURPOSE: Skin rosacea is a chronic inflammatory disease affecting up to 10% of the population in some European countries. Although considered a skin disease, acne rosacea may involve the eyes, causing eyelid and ocular surface inflammation. This study investigated the relationship between skin rosacea and various signs of ocular involvement and evaluated severity of meibomian gland dysfunction in rosacea patients. METHODS: The ocular surface and meibomian gland parameters were evaluated in 41 patients with diagnosed skin rosacea and 44 age-matched healthy controls. We analyzed meibomian gland function (meibum quality and meibum expressibility) and morphology (meibography) and lid margin alterations. We correlated our findings with self-reported ocular symptoms and tear film abnormalities (tear film breakup time, Schirmer test). RESULTS: The prevalence of ocular erythema and lid margin alterations was significantly higher in rosacea patients compared with controls. We found that rosacea is accompanied with significant loss of meibomian gland tissue defined as reduced meibomian gland area and decreased meibomian gland density. A positive correlation between margin abnormality score and the extent of meibomian gland loss in rosacea group was observed (rs = +0.30, p = 0.005), suggesting that ocular rosacea is accompanied by meibomian gland dropout. CONCLUSION: Skin rosacea is associated with ocular erythema and lid margin abnormalities. Our results suggest that ocular signs of rosacea may influence meibomian gland morphology, causing meibomian gland loss.

Clinical and Histological Evaluation of Direct Pulp Capping on Human Pulp Tissue Using a Dentin Adhesive System.

Objective. This study presents a clinical and histological evaluation of human pulp tissue responses after direct capping using a new dentin adhesive system. Methods. Twenty-eight caries-free third molar teeth scheduled for extraction were evaluated. The pulps of 22 teeth were mechanically exposed and randomly assigned to 1 of 2 groups: Single Bond Universal or calcium hydroxide. Another group of 6 teeth acted as the intact control group. The periapical response was assayed, and a clinical examination was performed. The teeth were extracted after 6 weeks, and a histological analysis was performed. The pulp status was assessed, and the thickness of the dentin bridge was measured and categorized using a histological scoring system. Results. The clinical phase was asymptomatic for Single Bond Universal patients. Patients in the calcium hydroxide group reported mild symptoms of pain, although the histological examination revealed that dentin bridges with or without limited pulpitis had begun forming in each tooth. The universal adhesive system exhibited nonsignificantly increased histological signs of pulpitis (P > 0.05) and a significantly weaker thin mineralized tissue layer (P < 0.001) compared with the calcium hydroxide group. Conclusion. The results suggest that Single Bond Universal is inappropriate for human pulp capping; however, further long-term studies are needed to determine the biocompatibility of this agent.

[Artefacts in the anthropologic (craniologic) material at the archives of ZMS PAM--possible diagnostic difficulties]. / Artefakty w materiale antropologicznym (kraniologicznym) ZMS PAM--mozliwe trudnosci diagnostyczne.

In the study we presented some of the more interesting forms of artefacts which had been documented during last 7 years of the anthropological laboratory of the Forensic Med. Department of the Pomeranian Med. Univ. We also present the outgoing conclusions concerning the possible diagnostic difficulties. The descriptions of archaeological as well as autopsy-derived material were included. The anthropological analysis was made using data contained in the classic works of literature, which included cranioscopy. The longitudinal and transversal intersections of skulls were used for the analysis of their deformations.

Consent for Surgery in View of an Ambigious Court Decision - Case Report.

Guardianship courts seem to issue decisions in case of the need to obtain consent for surgery, amongst other things, when the patient is unable to consciously express written consent, and at the same time does not have a legal representative or a statutory representative does exist, but settlement with him is impossible. The presented study case demonstrated the abnormalities of applying court procedures, as well as the responsibilities and dilemmas posed in front of a surgeon. A specialist surgeon wanted to help the patient and he was able to accomplish his mission.