Red blood cells deformability and oxidative stress in acute pancreatitis

The aim of this study was to evaluate the RBC deformability and oxidative stress parameters during acute pancreatitis. Healthy volunteers and patients with mild or severe acute pancreatitis were evaluated. There were no changes in erythrocyte's deformability in patients with mild acute pancreatitis. In severe acute pancreatitis loss of deformability of erythrocytes was observed. Serum lipofuscin level increased both in mild and severe form of the disease. The superoxide dismutase (SOD) activity was increased in erythrocytes from mild and severe form without systemic complications and was positively correlated with erythrocyte's deformability in a severe form of acute pancreatitis. Significant positive correlation between serum total antioxidant status and deformability of erythrocytes in healthy humans and negative correlation in mild pancreatitis were found.

Influence of temporary ischemia on energetic functions of rat liver in early and late reperfusion period

Energetic function impairment is one of the main reasons of liver ischemia-reperfusion injury. The aim of the study was to estimate the influence of temporary rat liver ischemia on energetic functions of the organ in the early and late reperfusion period and to answer the question whether the reduction of destructive factors release in sinusoids in the early phase of reperfusion can prevent liver energetic function impairment. To perform the experiment 55 Wistar rats divided into 5 experimental groups were used. 60 min. partial ischemia of the liver was applied, with 30 min, 72 h and 5 days reperfusion period. Suppression of KC was performed by intravenous administration of GdCl3. In the group of animals subjected to liver ischemia a considerable decrease of reaction to SDH and LDH activity was observed in the reperfusion period. In animals with KC suppression the loss of reaction to SDH intensity in zones I of acini was insignificant and the decrease of reaction to LDH was more orderly and proceeded in a more regular manner. The value of AKBR fell significantly after 30 min. of reperfusion in both groups of animals subjected to ischemia, while the serum level of AspAT and LDH increased rapidly. Temporary ischemia of the rat liver induces a decrease of the organ energetic functions in the early and the reperfusion period. The elimination of Kupffer cell activity in the early reperfusion phase does not prevent liver energetic functions impairment, but reduces the time in which they return to initial values in remote observation.

[The value of lipofuscin determination in blood at the pathophysiologic clinic--literature review]

Lipofuscin is a conjugated Schiff base delivered from reaction of malonylodialdehyde with proteins, amino acids and phosphatidylethanolamines. It emits yellow-green autofluorescence in ultraviolet light. It is believed to be one of the parameters of oxidation stress in vivo. Increased amount of lipofuscin in the blood has been found in uremia, diabetes, aging process, adult respiratory distress syndrome and multiple organ failure.

[Influence of some infusion fluids on red blood cells deformity in vitro]

The aim of this study was in vitro investigation of the influence of following infusion liquids: 20% human albumin, 5% dextran 40,000, 10% hydroxyethylstarch, 0.9% NaCl and Ringer lactate solution on red cell blood corpuscles deformability (elongation index). Examinations were compared with erythrocytes suspended in autologous plasma. Infusion liquids were added to red blood cells suspension and incubated during 30 minutes at 37 degrees C. The erythrocyte deformability was measured by shear stress defractometer Rheodyn SSD. We observed the slight increase of erythrocyte deformability under the influence of hydroxyethylstarch and lactate buffered Ringer solution.

[Sepsis in surgery: pathogenesis, new therapeutic approaches]

Sepsis and septic shock are phenomena with a characteristic clinical picture and etiologically related to injury. Chains of events from injury (e.g., infection) through activation of immunological system to multiple organ failure are responsible for sepsis. Neutralization of endotoxins, TNF, interleukins and so on, can improve the treatment of sepsis in the future.

[Biotransformation ability of the liver in ischemic reperfusion injury]

The aim of the study was to estimate the activity of enzymes connected with xenobiotics biotransformation in early reperfusion period after 90 minutes ischemia of rat liver and to state the correlation of obtained results with values of standard liver tests. Full, global liver ischemia was performed using Isozaka model with temporary portocaval anastomosis. The activity of alanin and aspargine aminotransferase and lactate dehydrogenase in blood serum, and P-450 and b5 cytochromes with related to them reductases in microsomal fractions of liver homogenates were estimated in 24th hour of reperfusion. Considerable decrease of the activity of mixed function oxidase system, not correlating with the results of standard liver tests was observed.

[Liver injury as a result of temporary occlusion of the hepatoduodenal ligament in the rat]

The aim of the study was to state consequence of 90 minutes occlusion of hepatoduodenal ligament and 24 hours reperfusion. Full liver ischemia was performed by a Pringle manoeuvre above temporary, internal portocaval anastomosis. Changes of the liver were analysed at the level of light microscope, and the activity of many enzymes participating in processes of energy production and distribution was measured using histochemical methods. It was stated, that hepatocytes included in zone I of the liver cluster possess the biggest regenerative opportunities.

[Adrenal gland diseases--results of surgical treatment]

The aim of the study is presentation of own remarks, related to surgical treatment of 183 patients with adrenal glands pathology in the years 1976-1996. The diagnosis was based on typical clinical symptoms and hormonal studies. The localisation of lesion was determined initially by X-ray examinations, mostly arteriography, later by ultra-sound and computer tomography, recently also by nuclear magnetic resonance and scintigraphy. The paper discusses methods of preparing the patients for surgery, tactics of surgical treatment, intra- and postoperative complications (8.2%), problem of incidentalomas.

[Atypical recipient and longterm results of kidney transplantation]

In their study authors compared the results of renal transplantations in a group of 51 patients with relative contraindications to a remaining group of 413 patients. Congenital anomalies or previously performed operations of urinary tract, previous renal transplantations, laparotomies, peritoneal dialysis, extreme atherosclerosis of the aorta and iliac arteries were regarded as relative contraindications. Results of the treatment do not differ considerably in both groups of patients what confirms the necessity of renal transplantations in difficult recipients.

[Rectal cancer in clinical material. Effect of advanced clinical staging, tumor location and type of surgical treatment on long term results]

The aim of the research is presentation of patients' material, operated on in The Clinic in the years 1965-1993 because of rectal cancer. The material makes 1363 patients, where group of 214 patients was separated from, treated in the years 1989-1993, basing on modern system of medical examinations qualifying for the surgical intervention and included by intensive prospecting monitoring. At investigative periods 1965-1989 and 1989-1993 the transition of rectal Dukes' stages on A and B interest was noticed, this admitted to increase the whole number of local excision et anterior rectum resection and improve distant treatment results, five years' survival measured. Percentage of patients with inoperable clinical staging, at periods: 1965-1989 and 1989-1993, is similar, in spite of considerable development of diagnostic methods.

[Inflammatory tumors of the colon--diagnostic and therapeutic problem in clinical materials]

38 patients with inflammatory tumours of the large bowel (ITLB) were studied, it is 2.4% of all patients operated in our department for the large bowel tumours. 28 patients (73.7%) underwent elective surgery, 10 (26.3%) had emergency operations. One-stage operations were performed in 26 cases (68.4%) and two-stages operations in 12 (31.6%). Permanent colostomies were performed in 4 patients (10.5%). Histological examination indicated chronic colitis in 19 cases (50.0%), mostly on divercular disease basis, Crohn's disease in 7 (18.4%), profound ulcerative colitis in 5 (13.1%), actinomycosis in 3 (7.9%) and typhlitis in 2 (5.3%).

[Primary retroperitoneal tumors--course, diagnosis and treatment results]

36 patients with primary retroperitoneal tumors (PRT) were studied. In 15 cases (41.7%) tumours were found incidentally. Ultrasound examination seems to be the golden standard for finding asymptomatic retroperitoneal neoplasms. High percentage of malignancy (72.2%-26 cases), mesenchymal texture of tumors and late detection of the disease caused by its occult clinical course are the frequent reasons of inoperability (11 patients-30.5%).

[The role of intracellular activation of enzymes in pathogenesis of acute pancreatitis--literature review]

Pathophysiology of acute pancreatitis (AP) is not full clear to present-day. Current review shows an importance of experimental models of AP with observations of intracellular changes during early stages of disease. One of the actual opinion suggest that abnormality in intracellular transport, secretion with intracellular activation of enzyme protein plays an important role in evolution of AP. These events further start cascade reactions and lead to autodigestion of pancreas.

A comparison of the clinical usefulness of CA 19-9 and CA 50 in the diagnosis and monitoring of gastrointestinal cancers

We compared serum levels of CA 19-9 and CA 50 in 108 patients with malignant neoplasms of the stomach, pancreas, liver, and colon with the serum levels in 60 patients with benign gastrointestinal diseases, and 10 healthy subjects. Increased serum levels of CA 19-9 and CA 50 were found in 51.8 and 62% of the cancer patients, respectively. The results of CA 19-9 and CA 50 assays in the nonneoplastic group showed less specificity. False positive results were noted in 11.7% of CA 19-9 tests and in 31.6% of CA 50 tests. We concluded that in gastrointestinal cancer, the CA 19-9 test should be performed initially. CA 50 determination can be useful, but the lower specificity of the test should be taken into consideration. CA 50 should be recommended only for postoperative monitoring, especially in patients with normal CA 19-9 serum levels.

[Usefulness of determining tumor markers CEA, CA125 and CA72-4 in blood serum of patients with ovarian carcinoma]

Serum levels of 3 markers: CEA, CA125 and CA72-4 have been determined in 58 patients aged from 15-60 years with histologically diagnosed ovarian cancer. Serum CEA was determined by radioimmunoassay using kits POLATOM (Poland), CA72-4 was determined using kits CIS BIOINTERNATIONAL (France) and CA125 was determined by enzyme immunoassay using kits Hoffmann-la-Roche (Wien-Austria). We have observed the growth of sensitivity and specificity of serum levels: CA125 and CA72-4 if we have referred to the simultaneous elevation of CA125 and CA72-4 markers. We have observed that CA125 and CA72-4 elevated levels were proceeded clinical recurrent of the disease from 2 to 6 months.

[Abdominal resection of rectal cancer]

Preservation of anal sphincters in the surgical treatment of rectal cancer is often controversial as far as an extent of surgery, incidence of complications and an increase in mortality rate in perioperative period are concerned. The study was aimed at results of the retrospective analysis of patients, who undergone abdominal excision of the rectum for malignant tumours. Totally 136 patients were operated. Perioperative mortality rate was 5.14%. Totally 26.4% of patients survived for at least 5 years, including 80% of patients operated in A stage of cancer, according to Duke, and 43.3% of patients with tumour in B stage. An emphasis is on the necessity to leave a 2-centimeter margin of healthy tissues around the tumour, provided, that the result of intraoperative histological examination was negative. Such a margin is sufficient for anastomosis. Low anastomoses do not produce early complications and recurrences.

Endocrine function of the pancreas and gastrin secretion in patients with a kidney transplant

In 24 patients with a kidney transplant and in 10 healthy subjects the test meal response of immunoreactive insulin (IRI), glucagon (IR-G), pancreatic polypeptide (IR-PP) and gastrin (IR-Ga) was studied. Patients with a kidney transplant showed significantly elevated basal plasma glucagon levels but normal levels of plasma IRI, IR-PP and IR-Ga. After administration of a test meal a significantly suppressed response of IRI, IR-PP and IR-Ga secretion was observed both in the patients treated with azathioprine as well as those treated with ciclosporin. In patients of the ciclosporin group the compromised response of IR-Ga and IRI secretion was significantly more marked than in subjects in the azathioprine group. From the results obtained in this paper it follows that the type of immunosuppressive drugs (azathioprine or ciclosporin) seems to be of minor importance in the pathogenesis of the described endocrine abnormalities.

Influence of type of immunosuppressive therapy on secretion of somatotropin and function of the pituitary-adrenal and pituitary-gonadal axis in patients with a kidney transplant

In 24 patients with a functioning kidney transplant, hypoglycemia-induced somatotropin (STH), adreno-corticotropin and cortisol secretion was studied. In a further 24 transplanted patients, secretion of lutropin, follitropin and testosterone after the intravenous administration of luliberin was assessed. Data obtained in this paper suggest the presence of abnormal function of the pituitary-adrenal and pituitary-gonadal axis and abnormal STH secretion in patients with a functioning transplant. Type and duration of immunosuppressive therapy seem to influence the intensity of the above-mentioned endocrine abnormalities.