Effect of Ag modification on TiO2 and melem/g-C3N4 composite on photocatalytic performances

Here, the comparison of two different semiconductor materials is demonstrated, TiO₂ and melem/g-C₃N₄ composites-modified with balls of approximately 5 nm Ag nanoparticles (NPs) as photocatalysts for the degradation of the model dye acid orange 7 (AO7). The melem molecule synthesized here is one of a series of organic compounds consisting of triazine ring compounds with a structure similar to that of melam and melamine. The photodegradation process of AO7 was carried out to examine all powder materials as a potential photocatalyst. Additionally, two different lamps of wavelengths 368 nm (UV light) and 420 nm (VIS light) were applied to compare the photodegradation tests. A new synthesis route for the acquisition of Ag NPs (Ag content 0.5, 1.0 and 2.5 wt%), based on a wet and low temperature method without the use of reducing reagents was proposed. The best photocatalytic performances under UV and VIS light were obtained for both, TiO₂ and melem/g-C₃N₄ materials (new synthesis route) modified with a very low Ag content-0.5 wt%. The photodegradation activities using UV lamp (3 h, 368 nm irradiation) for samples with 0.5 wt% of Ag: TiO₂ and melem/g-C₃N₄, in excess of 95 and 94%, respectively, were achieved. The highest photoactive materials melem/g-C₃N₄ with 0.5 and 1 wt% Ag revealed 98% of activity under the VIS lamp after 3 h long irradiation. Our work demonstrates a novel, environmentally acceptable, and cost-effective chemical strategy for preparation of photocatalysts suitable for degradation of organic contaminants in wastewater treatment.

FRI0089 COMPARATIVE EFFICACY (ACR 20) OF TOCILIZUMAB TO OTHER TARGETED IMMUNE MODULATORS (TIM) FOR RHEUMATOID ARTHRITIS: A NETWORK META-ANALYSIS (NMA)

Background:

Clinical trial and real-world evidence have both firmly established efficacy and safety of intravenous (IV) and subcutaneous (SC) tocilizumab, both as monotherapy or in combination with a conventional disease modifying antirheumatic drug (cDMARD). However, tocilizumab’s relative efficacy to the new Janus kinase (JAK) inhibitor class of therapies is less certain, given the lack of head-to-head trials.

Objectives:

To evaluate the relative efficacy of: 1) combination tocilizumab plus cDMARD to other TIMs plus a cDMARD in TIM-naïve or mixed (<20% TIM-experienced) adults with moderate to severe RA; 2) tocilizumab monotherapy to other TIM monotherapies in TIM-naïve or mixed adults with moderate to severe RA. Efficacy was defined as achievement of an ACR20 response or better at 24 weeks.

Methods:

Randomized controlled trials (RCTs) were selected from a recent systematic literature review conducted by the Institute for Clinical and Economic Review (ICER), as well as from a trial for upadacitinib (SELECT-COMPARE,NCT02629159), which was not included in the ICER 2017 report. Treatments included JAK inhibitors (upadacitinib, baricitinib, and tofacitinib), tumor necrosis factor alpha inhibitors (TNFi; adalimumab, certolizumab pegol, etanercept, golimumab, and infliximab), and other non-TNFis (rituximab, sarilumab, tocilizumab, and abatacept). A Bayesian NMA was performed in OpenBUGS and R to evaluate comparative efficacy using a random effects model for combination therapy and fixed effects model for monotherapy. Model selection was based on deviance information criterion. Forest plots of relative risks (RR) are presented.

Results:

In combination therapy analysis, a total of 35 studies were included with a pooled study population of 17,508 patients. Study populations were predominantly female (mean 79%, range 39-95%), and had a baseline mean age of 52 years (range 47-58), mean disease duration of 8 years (range 2-12), and mean DAS28 score of 6 (range 5-7). When compared to cDMARD, all TIMs were 1.69 to 2.22 times more likely to achieve an ACR20 response or better at 24 Weeks (statistically significant) (Figure 1). In pair-wise comparison, tocilizumab IV and SC did not differ from all other TIMs, including JAK inhibitors (no statistically significant difference).

In monotherapy analysis, a total of 5 studies were included with a pooled study population of 1,189 patients. Study populations were predominantly female (mean 82%, range 75-90%), had a baseline mean age of 53 years (range 51-54), mean disease duration of 6 years (range 2-9), and mean DAS28 score of 6 (range 5-7). When compared to cDMARD, all TIMs were 1.65 to 1.84 times more likely to achieve ACR20 response or better (statistically significant) (Figure 2). In pair-wise comparison, tocilizumab IV was associated with a greater likelihood of achieving an ACR20 response or better compared to adalimumab (RR=1.10, 95% credible interval (Crl) = 1.03,1.29).

Conclusion:

Results of this NMA demonstrate similar efficacy (ACR20 at week 24) between tocilizumab (IV and SC) and other TIMs, including new JAK inhibitors, when used in combination with a cDMARD among TIM-naïve/mixed patient populations. Tocilizumab IV monotherapy had more favorable efficacy than adalimumab monotherapy. Patients unable to tolerate cDMARDs may experience additional value from tocilizumab compared to adalimumab.

Acknowledgments:

This study was sponsored and funded by Genentech, Inc.

Disclosure of Interests:

Joseph Dang Shareholder of: Genentech, Inc., Employee of: Genentech, Inc., Jennifer Uyei: None declared, Yilin Jiang: None declared, Rajpal Singh: None declared, Pinar Bilir: None declared, Andreas Karabis: None declared, Julie Munakata: None declared, Margaret Michalska Shareholder of: Genentech, Inc., Employee of: Genentech, Inc., Jennie H. Best Shareholder of: Genentech, Inc., Employee of: Genentech, Inc.

SAT0125 ASSOCIATION BETWEEN CHANGE IN HEALTH ASSESSMENT QUESTIONNAIRE DISABILITY INDEX AND TREATMENT RESPONSE IN PATIENTS WITH RHEUMATOID ARTHRITIS IN TOCILIZUMAB CLINICAL TRIALS

Background:

The efficacy and safety of intravenous (IV) and subcutaneous (SC) tocilizumab (TCZ) in combination with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) and as monotherapy in patients with rheumatoid arthritis (RA) has been demonstrated in large clinical trials and real-world data studies. The Health Assessment Questionnaire Disability Index (HAQ-DI) is commonly used to assess physical function in patients with RA. While HAQ-DI outcomes at Week 24 in TCZ clinical trials have been reported, outcomes at Week 12 and results stratified by treatment response categories at Weeks 12 and 24 have not been previously described.

Objectives:

To report the association between change in HAQ-DI from baseline to Weeks 12 and 24 and Disease Activity Score in 28 joints (DAS28) response categories in patients who received TCZ or comparators in TCZ clinical trials.

Methods:

Data from patients with active RA who received TCZ or a comparator from 6 Phase III or IV TCZ-IV studies (OPTION [NCT00106548], RADIATE [NCT00106522], TOWARD [NCT00106574] LITHE [NCT00109408], ACT-RAY [NCT00810199] and ADACTA [NCT01119859]) and 1 Phase III TCZ-SC study (BREVACTA [NCT01232569]) were analyzed. Mean change in HAQ-DI score at Weeks 12 and 24 was assessed in patients stratified by DAS28 disease activity level (DAS28 < 2.6 [remission], DAS28 ≥ 2.6 to ≤ 3.2 [low disease activity; LDA], DAS28 > 3.2 to ≤ 5.1 [moderate disease activity; MDA], DAS28 > 5.1 [high disease activity; HDA] at Weeks 12 and 24. The adjusted least squares mean (LSM) change from baseline was estimated using a mixed model with repeated measures, including region (North America vs non-North America), RA duration (> 2 years vs ≤ 2 years), baseline HAQ-DI and DAS28, treatment, visit, visit by treatment and visit by baseline HAQ-DI.

Results:

Data from 5051 patients were included. Across all studies, the mean duration of RA ranged from 6.3 to 12.6 years. At baseline, patients had severe RA with a mean DAS28 ≥ 6.3; baseline HAQ-DI was ≥ 1.5. At Week 12, patients who achieved remission or LDA had greater improvements in HAQ-DI than those in MDA or HDA (Figure 1). Results were similar at Week 24 (Figure 2). Among patients who received TCZ and achieved remission or LDA, mean improvement in HAQ-DI was ≥ 0.65 and ≥ 0.44, respectively, at Week 12 (Figure 1) and ≥ 0.48 and ≥ 0.43 at Week 24 (Figure 2). Mean changes in HAQ-DI were similar between patients who received TCZ-IV in combination with MTX or as monotherapy (ACT-RAY) and in those who received TCZ-IV or ADA as monotherapy (ADACTA).

Conclusion:

Patients with long-standing, severe RA who received IV or SC TCZ as monotherapy or in combination with csDMARDs had improvement in physical function and disease activity at Week 12 that was maintained at Week 24. Overall, across all the trials, response to treatment was associated with improvement in physical function.

Acknowledgments :

This study was sponsored by Genentech, Inc. Support for third-party writing assistance, furnished by Health Interactions, Inc, was provided by Genentech, Inc.

Disclosure of Interests: :

Sebastian Unizony Grant/research support from: Genentech, Inc., Joseph Dang Shareholder of: Genentech, Inc., Employee of: Genentech, Inc., Jian Han Shareholder of: Genentech, Inc., Employee of: Genentech, Inc., Margaret Michalska Shareholder of: Genentech, Inc., Employee of: Genentech, Inc., Jennie H. Best Shareholder of: Genentech, Inc., Employee of: Genentech, Inc.

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.

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)-β. 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-β 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-β secretion.

A single nucleotide polymorphism in the 5' untranslated region of RAD51 and ovarian cancer risk in Polish women

BACKGROUND

DNA repair gene polymorphisms are known to influence cancer risk. The RAD51 gene encodes proteins essential for maintaining genomic stability by playing a central role in holmology-dependent recombinational repair of the DNA double-strand breaks. Aims. We investigated the association of polymorphisms in the DNA repair genes RAD51-135G > C and 172G >T with ovarian cancer risk.

METHODS

120 Polish ovarian cancer patients and 120 healthy controls were genotyped for RAD51 (135G > C and 172G > T) by PCR-RFLP.

RESULTS

In the present work no association was detected between ovarian cancer risk and 172G > T polymorphism of the RAD51 gene. The 135G > C polymorphism was associated with ovarian cancer risk. We found evidence of an increased ovarian cancer risk in CC homozygotes (OR 12.97 [95% confidence interval {CI} (5.73-29.36)]) but not in heterozygotes (OR 0.55 [95% CI 0.23-1.29]). We demonstrated a significant positive association between the RAD51 variant 135C allele and ovarian carcinoma, with an adjusted odds ratio (OR) of 6.24 (p < .0001).

CONCLUSION

The results indicated that the polymorphism 135G > C of RAD51 may be positively associated with ovarian carcinoma in the Polish population. Further studies on the role of the RAD51 gene on ovarian cancer are warranted.

Chromosomal localization of two novel repetitive sequences isolated from the Chenopodium quinoa Willd. genome

The chromosomal organization of two novel repetitive DNA sequences isolated from the Chenopodium quinoa Willd. genome was analyzed across the genomes of selected Chenopodium species. Fluorescence in situ hybridization (FISH) analysis with the repetitive DNA clone 18-24J in the closely related allotetraploids C. quinoa and Chenopodium berlandieri Moq. (2n = 4x = 36) evidenced hybridization signals that were mainly present on 18 chromosomes; however, in the allohexaploid Chenopodium album L. (2n = 6x = 54), cross-hybridization was observed on all of the chromosomes. In situ hybridization with rRNA gene probes indicated that during the evolution of polyploidy, the chenopods lost some of their rDNA loci. Reprobing with rDNA indicated that in the subgenome labeled with 18-24J, one 35S rRNA locus and at least half of the 5S rDNA loci were present. A second analyzed sequence, 12-13P, localized exclusively in pericentromeric regions of each chromosome of C. quinoa and related species. The intensity of the FISH signals differed considerably among chromosomes. The pattern observed on C. quinoa chromosomes after FISH with 12-13P was very similar to GISH results, suggesting that the 12-13P sequence constitutes a major part of the repetitive DNA of C. quinoa.

Influence of antibiotic therapy on the level of selected angiogenic factors in patients with benign gynecologic tumors--preliminary report

An increased fibrin level enhances the activity of proangiogenic factors and may contribute to tumor formation. Formation of new blood vessels during angiogenesis leads to neoplasm development through interaction with factors such as basic fibroblast growth factor (bFGF), vascular endothelial growth factor (VEGF) and interleukins. The aim of this study was to investigate the influence of perioperative antibiotic therapy in women with benign gynecological tumors with regard to basic fibroblast growth factor level, fibrinogen concentration and fibrin viscosity. The influence of clindamycin plus metronidazole therapy (group I) and cephazolin therapy (group II) on fibrinogen concentration, level of bFGF and fibrin viscosity was studied in women diagnosed with nonmalignant myomas and cysts. In patients with benign gynecologic tumors, higher bFGF levels (51.40 +/- 13.72 pg/ml), fibrinogen concentration (348.26 +/- 164.74 mg/dl) and fibrin viscosity (2.63 +/- 0.36 mPa) were observed, as compared with healthy women. There were strong indications that antiangiogenic activity occurred with both clindamycin plus metronidazole and cephazolin, although the response to these particular antibiotic therapies was different. The use of various drug therapies in groups I and II resulted in faster and delayed antiangiogenic effects, respectively. Further research is essential to provide more detailed information about the mechanisms of the induction of antiangiogenic activity by perioperative adjuvant antibiotic treatment.

Efficiency of postoperative pain management after gynecologic oncological surgeries with the use of morphine + acetaminophen + ketoprofen versus morphine + metamizol + ketoprofen

Surgical treatment used in gynecological oncology involves acute postoperative pain which requires efficient treatment. This study covered a group of 128 patients who were randomly divided into two groups. In the postoperative period patients in group I were administered morphine subcutaneously, acetaminophen intravenously and naproxen per rectum. The pain intensity level was checked by means of the pain intensity numeric rating scale (NRS). In the instances of pain rated at 5 or more, patients were additionally administered ketoprofen intravenously. Patients in group II were administered morphine, naproxen, and metamizole instead of acetaminophen and ketoprofen additionally. In group I after the administration of morphine and acetaminophen 22 patients (34.37%) needed additional doses of ketoprofen. In group II 33 women (51.56%) required ketoprofen after the administration of morphine and metamizole (N1 = 22 vs N2 = 33, p < 0.05). The use of metamizol with morphine (without ketoprofen) gave worse analgesic results than acetaminophen with morphine, but the combination of morphine, acetaminophen and ketoprofen or morphine, metamizol and ketoprofen gave satisfactory analgesic results.

Release kinetics of basic fibroblast growth factor (bFGF) from certain biopolymers in the presence of ketoprofen

The aim of the present study was the evaluation of basic fibroblast growth factor (bFGF, FGF-2) release in vitro from four types of polymer bases (carriers), fibrin, microcrystalline chitosan (MCCh), fibrin and MCCh, as well as MCCh and methylcellulose (MC) in the presence or absence of ketoprofen (KTA). Amount of released basic fibroblast growth factor was measured immunoenzymatically using Elisa (R&D System). Ketoprofen concentration was determined spectrophoto-metrically at 255 nm, using an appropriate absorbance factor, alpha 1 cm (1%) = 662. The most significant influence of ketoprofen on bFGF release was seen in the case of microcrystalline chitosan carrier elution. Parameters of the equation which describe the amount of bFGF released from chitosan carrier with and without KTA are y = 6.842 +/- 1.637 In(t) + 14.935 +/- 2.378, determination coefficient, R2 = 0.9332 and y = 4.070 +/- 0.622 In(t) + 10.589 +/- 1.011, determination coefficient, R2 = 0.9606. The time after which 20% of bFGF was released (t 20%) in the presence of ketoprofen was 2.1 h whereas it was significantly longer without ketoprofen (10.1 h). The amount of bFGF released from fibrin carrier was lower in the presence of ketoprofen. The time taken for 20% of bFGF to be released (t 20%) was very long (41.7h) in the presence of KTA and 16.3 h. without KTA. The other carriers (fibrin + MCCh and MCCh + MC) in the presence of ketoprofen appear to have an insignificant influence on the kinetics of basic fibroblast growth factor release. For the chitosan carrier (p = 0.05, and also p = 0.01, when t(theoret) = 2.921), there is a statistically significant difference between the coefficients (a1 and a2) of the regression equation describing the process of basic fibroblast growth factor release from the base with and without ketoprofen. It was also found that the amount of ketoprofen released varied considerably according to the carrier. All results clearly indicate that the type of carrier not only has an impact on the amount of bFGF released, but also on the kinetics of ketoprofen release.

Vaginal hysterectomy aided with surgery by the abdominal approach as a method of hysterectomy with salpingo-oophorectomy due to endometrial carcinoma in a woman with morbid obesity. Case report

The most important risk factors of endometrial carcinoma are fat consumption, obesity (BMI > or = 25 kg/m2) and use of unbalanced estrogen therapy. Other factors include lack of physical activity, a high-calorie diet, arterial blood pressure above 140/90 mmHg and high concentrations of glucose in the blood. The basic treatment in cases of endometrial carcinoma is surgery including hysterectomy with salpingo-oophorectomy and complete interoperational assessment of the development degree of the disease. Basic operational treatment is difficult as far as obese women are concerned (BMI > or = 50 kg/m2). This is linked with poor access to operated tissues and limited visibility, mainly in the area of the bottom of the pelvis minor. Our 69-year-old patient was admitted to and operated on at the Gynecological Department due to endometrial carcinoma. Because of her giant obesity, BMI - 51.30 kg/m2, surgery by the abdominal approach was very difficult to perform, so vaginal hysterectomy with salpingo-oophorectomy was carried out.

Evaluation of preoperative diagnosis with results of histopathological examinations of ovarian tumors in women of reproductive age

Ovarian tumors are the most frequent lesions encountered by gynecologists. Ovarian carcinoma most often develops asymptomatically and until now no sufficient screening diagnostic methods have been developed, which is why various diagnostic methods are being tried concurrently to increase diagnostic sensitivity. The aim of this paper was to evaluate the compliance of the preoperative diagnoses with the results of histopathological examinations of ovarian tumors and to determine the usefulness of simultaneous application of gynecological, ultrasonographic, and Doppler examinations together with determination of CA-125 antigen in the diagnostic process of ovarian tumors. The study comprised a group of 250 women in reproductive age who were operated on for tumors of the ovary. Results of histopathological examinations were compared with the preoperative diagnosis based on the above-mentioned examinations and prognostic indicators: sensitivity, specificity, negative and positive prediction value as well as accuracy were determined. The results showed that combining the four diagnostic methods is a useful research panel in the preoperative diagnostic process of ovarian tumors and makes selecting the appropriate procedure and surgical treatment viable.

Difficulties in the diagnosis of ovarian carcinoma: case report of squamous cell ovarian carcinoma in a 26-year-old woman

A 26-year-old woman who was admitted to the Gynecology Department with abdominal pain was later diagnosed with a multi-chamber tumor in the left ovary. Neoplastic markers were within normal limits. It was proposed that the patient should be operated on in order to remove the tumor, and a left salpingo-oophorectomy was performed. During the intraoperative histopathological examination, the tumor was described as being benign. However, in the final histopathological examination, a malignant neoplasm, a squamous cell carcinoma (G-2) of the ovary (pT1a), was found. It was decided that a hysterectomy and a right salpingo-oophorectomy should be performed. No other neoplastic foci were found in the postoperational material. The patient is currently undergoing periodic control examinations.

Posttransplantation diabetus mellitus under calcineurin inhibitor

BACKGROUND

The development of postransplantation diabetes mellitus (PTDM) is a serious complication of kidney transplantation. PTDM has a major impact on quality of life decreasing rates of patient and graft survival. It is well known that some currently used immunosuppressants are diabetogenic. Greater diabetogenicity of FK-506 has been reported in multicenter trials. We initiated a study of conversion from tacrolimus (FK-506) to cyclosporine (CsA) among kidney allograft recipients presenting with PTDM to evaluate whether this maneuver would ameliorate a diabetic state.

METHODS

This analysis of 20 adult, renal allograft recipients presenting with PTDM assumed the need for insulin therapy or oral hypoglycemics before and after conversion of the immunosuppressive regimen. The criteria for evaluating the outcome were as follows: dose reduction of insulin or oral hypoglycemic agents, adequacy of glucose control, C-peptide levels, and insulin concentration.

RESULTS

During the follow-up, we observed an improvement in the control of blood glucose in the converted group. In 13 patients, satisfactory glucose control was obtained without insulin or any other agent. In 3 patients a significant dose reduction of required insulin was possible. In another 2 patients who were insulin-dependent, the switch to oral hypoglycemic treatment was clinically possible after conversion. After conversion we observed significantly lowered fasting blood glucose levels and increased C-peptide levels.

CONCLUSIONS

The conversion from a tacrolimus to a CsA-based immunosuppressive regimen resulted in better glucose metabolism. We demonstrated a positive effect of conversion on the diabetic state of patients with PTDM.

Uptake of radiolabelled alpha-fetoprotein by experimental mammary adenocarcinoma and adenoma: in vivo and in vitro studies

The biodistribution of iodine-labelled alpha-fetoprotein ( I-AFP) in experimental mammary tumours was studied. C3H mice with subcutaneously transplanted mammary adenocarcinoma and Sprague-Dawley rats treated with -methyl- -nitrosourea for mammary adenoma induction were used as animal models. The accumulation of labelled I-AFP in mouse mammary adenocarcinoma was significantly higher than that in rat mammary adenoma. The tumour/muscle radioactivity ratios increased with time and, 48 h after intravenous injection, were estimated as 23.4 and 6.7, respectively. For experiments, extracts from both mammary tumours were prepared. The extracts were subjected to sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE), transferred to polyvinylidene difluoride (PVDF) membranes and incubated with I-AFP. A single major AFP-binding protein with a molecular weight of about 30 kDa was detected in both extracts. The amount of AFP-binding protein was clearly higher for adenocarcinoma than for adenoma. In the presence of cross-linking reagent, I-AFP formed a complex (about 100 kDa) with adenocarcinoma proteins.

[Character of the big-city municipal waste water bacterial contamination and assessment of its elimination degree as a result of biological treatment process]

The highest possible effectiveness of sewage treatment is of particular significance when the sewage is discharged into surface waters used for recreational purposes. The Gulf of Gdańsk, with its much frequented beaches along the shore, is the disposal reservoir for the wastewater from two large biological treatment plants collecting the sewage from Gdańsk and Gdynia. The purpose of this work was to perform bacteriological examination of the communal sewage from these two large agglomerations before and after their biological treatment. On that basis the degree of reduction of bacteriological contamination of sewage as a result of biological treatment was determined. The examination included determining of coliform and faecal coliform bacteria MPN (Most Probably Number), faecal streptococci index as well as Salmonella sp. and coagulase positive staphylococci. An extremely high level of bacterial contamination of raw sewage was found amounting from 9.3 x 10(18) (Gdańsk) to 1.8 x 10(20) (Gdynia) faecal coliform bacteria in 100 cm3 of sewage and respectively from 5.6 x 10(5) to 1.8 x 10(6) faecal streptococci in 100 cm3 of sewage on average. It was also observed that the effectiveness of the sewage treatment plants is so high that it assures the level of reduction of bacterial contamination within the limits of 92% for staphylococci and streptococci to 99.999% for coliform bacteria. It was also pointed out that despite a very effective work of sewage treatment stations the level of contamination of treated sewage discharged into the surface waters is often high. Hence the necessity of verification of data concerning level of sewage contamination which are usually assumed in the project documentation.

Systemic lupus erythematosus. Measures to keep this unpredictable disease under control

SLE is a chronic autoimmune disease with an unpredictable history and course. It can occur in men or women at any age, but it is most prevalent in women of childbearing age. SLE displays a variety of clinical and laboratory manifestations that vary from vague constitutional symptoms to findings of end-organ dysfunction. Early recognition can lead to better treatment and preventive care, thereby avoiding the more aggressive renal, cardiovascular, and septic manifestations. Recognition and management of lupus flares and of medication side effects can markedly reduce morbidity and mortality, allowing patients to live more functional lives.

Malignant melanoma of the vulva: 2 case reports

It was described two cases of vulvar melanoma malignum. Both women after primary radical treatment, unfortunately died. It was discussed the classification of melanoma malignum, the efficiency of treatment nowadays and the problems in diagnosis. General results of treatment are poor. It is due to tendency for spreading in early stage of this neoplasm.

Subcutaneous administration of CAMPATH-1H: clinical and biological outcomes

OBJECTIVE

A 24 week study of subcutaneous (sq) dosing with titration of CAMPATH-1H (C1H) dose against the circulating CD4+ T cell count in patients with rheumatoid arthritis (RA) was undertaken to examine the safety, biologic activity, and clinical efficacy of this approach.

METHODS

All patients met American Rheumatism Association (ARA) criteria for active RA. Patients received either 0.5 or 1.0 mg of C1H subcutaneously twice per week; dosing could be doubled after the first 8 weeks of treatment and subsequently following 4 week dose intervals for lack of clinical efficacy, but was discontinued any time the CD4+ T cell count fell below 400/mm3. Patients were evaluated weekly for 2 weeks and then biweekly for clinical and laboratory variables of safety, biological activity, and disease activity.

RESULTS

Ten patients were treated, 6 in the 0.5 mg cohort and 4 in the 1.0 mg cohort. Four of ten patients had a 20% modified Paulus response (2 in each cohort) while taking drug; there were minimal side effects, primarily limited to local reaction at the injection site. All patients had a > 50% drop in circulating CD4+ T cells within the first 2 weeks of therapy, with no further significant reduction; only 1/6 patients in the 0.5 mg cohort had dose limiting CD4+ T cell depression vs 2/4 in the 1.0 mg cohort. All patients developed antibodies to C1H. Appearance of anti-C1H was temporarily associated with a halt in further reduction of CD4+ T cell count despite continued C1H administration.

CONCLUSION

Subcutaneous administration of C1H in low doses (0.5 mg biweekly) was well tolerated and did not result in dose limiting CD4+ T cell depletion in 5 of 6 patients. Clinical efficacy was observed in some patients but could not be maintained, possibly due to the production of anti-C1H antibodies.

Knee arthroscopy in the office

As the size of equipment has shrunk, the role of the procedure has expanded. Rheumatologists now capitalize on the procedure's capacity for direct visualization and biopsy to diagnose and treat inflammatory and noninflammatory disorders.

[Ectopic cervical pregnancy--conservative treatment with methotrexate]

Ectopic pregnancy regardless its localization always remains difficult diagnostic and therapeutical problem. Special attention is paid to cervical pregnancy because of its rare incidence and poor prognosis (even in this day and age maternal death rate is 40-45%). In this paper there has been reported the case of 38 years old patient, admitted to Dept of Gynecological Oncology with suspicion of alive cervical pregnancy. Diagnostic procedures have been described as well as positive results of conservative treatment with Methotrexate (under careful monitoring--ultrasound, beta hCG levels). Also there has been presented detailed description of endocervix curettage after fetal death confirmed ultrasonographically. Current conservative therapy methods for cervical pregnancy have been discussed.

The sea to air bacteria transfer from the coastal waters

Bacteria transfer from the water into the air may play an important role in bioaerosol cycle. Bubbles raising through the water column collect bacteria but also other suspended material and transport them towards water surface. When the bubble burst at the water surface collected material are skimmed off the bubble to become highly enriched in jet and film drops. After ejection airborne droplets can evaporate and as small droplets can be transported even to remote locations. Such a stream of aerosol droplets may carry stream of bacteria scavenged from the water column. The fate of bacteria in the air may possibly depend on the environmental conditions like intensity of sunlight or ambient air humidity. In addition the wind speed might be responsible for both wave/bubble mediated production of marine originated droplets and their transport in the atmosphere. The evidences that bacteria are transferred from the breaking waves, in particular in the coastal zone, were observed during several field experiments conducted in 1994 and 1995 over the Gulf of Gdansk and the Baltic Sea coast. Enhanced sea to air bacteria transfer were noticed over the polluted waters where in addition gas supersaturations in the water were recorded. Further laboratory investigations of bacteria scavenge via bubbles produced by single capillary and by plume of bubbles produced by ceramic stone indicated high enrichment within both mesophile and psychrophile bacteria categories.

[Usefulness of transvaginal ultrasound and hysteroscopy in diagnosing endometrial hyperplasia and endometrial carcinoma]

Modern methods enabling evaluation of endometrium in all phases of the menstrual cycle were presented. Transvaginal ultrasound does not give characteristic pictures. The most frequently observed sonographic features in endometrial hyperplasia and endometrial carcinoma were compared. Most frequently, in 29% we observed the thickening of the endometrium. The enlargement of the uterine body was detected in 27%. The dominant feature in endometrial carcinoma was distortion or lack of medium-focus echo-90%. Different echogenicity was observed in 69% of all cases. Application of hysteroscopy enables us to visualize changed endometrium and also to sample focal lesions for histopathological examination. Endometrial carcinoma was detected in all analyzed cases with application of hysteroscopy and ultrasound. Pathological endometrial hyperplasia was diagnosed by ultrasound only in 44% and with application of hysteroscopy in 84% of all material.

Effect of methylmercuric chloride (MMC) on fibrin polymerization

Methylmercuric chloride (MMC) in concentrations 0.1-10 microM reduces the amount of fibrinopeptides released from thrombin-activated human fibrinogen. However, the fibrin clot formation is not discriminated and the turbidity of the fibrin gel is even augmented. MMC does not cause such changes in the process of repolymerization of fibrin monomers. The addition of fibrinopeptides to the fibrin monomers results in a similar increase of turbidity of the repolymerizing sample in the presence of MMC as in the case of fibrinogen clotting. These experiments indicate that MMC modifies the structure of fibrin in the presence of fibrinopeptides.

Blood coagulation changes in rats poisoned with methylmercuric chloride (MeHg)

The effects of methylmercuric chloride on the coagulability of blood were studied in rats. The administration of a single dose (17.9 mg Hg/kg) and a repeated dose (5 X 8 mg Hg/kg/day) of this compound resulted in hypercoagulation. The reduction of the clotting time, the increase of fibrinogen level in plasma and changes characteristic of hypercoagulation in the thromboelastographic parameters were observed. Simultaneously, signs of impaired activity of blood platelets: decreased aggregation velocity and clot retraction as well as prolongation of the bleeding time were noticed.

Coagulation and fibrinolysis in rats poisoned with mercuric chloride

The effect of mercuric chloride on blood coagulation and fibrinolysis in rats was studied. The mercurial was administered to the animals intragastrically in a single dose of 17.9 mg Hg/kg and the effects were tested on the 1st, 3rd and 7th day. The symptoms of hypercoagulability accompanied by decreased fibrinolytic activity of the plasma were observed in the poisoned rats. The main reason of the lowered fibrinolytic activity seemed to be the inhibition of plasma plasminogen activator or the inhibition of plasminogen activation reaction catalyzed by this enzyme.

Cross-linked polymers in the red cell membranes of a patient with Hb-Koln disease

Membranes isolated from the red cells of a Hb-Koln patient were shown to contain appreciable amounts of N epsilon-(gamma-glutamyl)lysine, the characteristic product of the post-translational cross-linking of proteins by transglutaminase. Such an apparently irreversible fusion of membrane proteins may contribute to the membrane defect in Hb-Koln disease.

Inhibition of protein cross-linking in Ca2+-enriched human erythrocytes and activated platelets

Treatment of human erythrocytes with Ca2+, in the presence of ionophore A23187, causes the formation of high molecular weight (greater than 10(6)) membrane protein polymers. This phenomenon, known to involve cross-linking of essentially all of the band 4.1 and 2.1 (ankyrin) proteins, as well as some spectrin, band 3, and hemoglobin molecules, could be prevented by preincubating the cells with a noncompetitive inhibitor of intrinsic transglutaminase, 2-[3-(diallylamino)propionyl]benzothiophene, at concentrations of about (3-6) X 10(-4) M. The compound also eliminated the proteolytic breakdown of the two major transmembrane proteins band 3 and glycophorin, which would otherwise occur during the Ca2+ loading of fresh human red cells. In addition, the inhibitor effectively blocked the formation of a cross-linked protein polymer in thrombin-activated human platelets.

Altered response of stored red cells to Ca2+ stress

Short-term Ca2+ loading of erythrocytes was used as a test for probing membrane protein susceptibilities toward intrinsic enzymes in cells from fresh and from stored blood. The proteolytic response, affecting mainly glycophorin and band 3, could be elicited only in fresh cells, whereas the transglutaminase-mediated cross-linking reaction was evident both in fresh and stored cells. Loss of the proteolytic response might be an important sign of erythrocyte damage from blood bank storage.

Plasma and platelet fibrin-stabilizing factor activity in rats intoxicated with phenylmercuric acetate

Effect of phenylmercuric acetate on the activity of rat plasma and platelet fibrin-stabilizing factor (FSF) was studied. The mercurial was administered to the animals intragastrically in a single dose of 17.9 mg Hg/kg or in repeated doses of 1.79 mg Hg/kg, twice a week for 152 days. The activities of the investigated fibrin-stabilizing factors were significantly increased in the case of intoxicated rats. Such an effect was observed in both types of the exposure.

Interaction of fibrinogen with mercury

The interaction of bovine fibrinogen with mercuric chloride was studied. Gel filtration on Sephadex G-25 revealed that fibrinogen bound twice the amount of mercury such as fibrin or fibrin monomers (8.8, 4.5, and 3.4 micrograms Hg2+ ions/mg protein, respectively). Fibrinogen complexed with mercury or in the presence of Hg2+ ions at concentration above 10-6 M was clotted by thrombin more effectively than in the control system which was devoid of this metal. Reaggregation of the purified fibrin monomers was not affected by mercury.