[Splenic artery aneurysms in pregnancy as a life threatening disorder]

Splenic artery aneurysms (SAA) is very rare and uncommon condition what makes it difficult in diagnosis and treatment. We report a rare case of 27-year old patient in 24th week of pregnancy with rupture of SAA. This article reviews the etiology, clinical features, diagnosis of this potentially lethal condition. Although there is prompt treatment, rupture during pregnancy is associated with a very high maternal and fetal mortality rate. The aim of the report is to draw attention of early diagnosis of this condition to achieve good materno-fetal outcome.

Metalloproteinases MMP-9, MMP-2 and their tissue inhibitors TIMP-1, TIMP-2 in peripheral transbronchial lung biopsies of patients with sarcoidosis

INTRODUCTION

The imbalance between metalloproteinases (MMPs) and their tissue inhibitors TIMPs) may be involved in the pathogenesis of lung sarcoidosis, a granulomatous inflammatory disease which may lead to lung fibrosis.

OBJECTIVES

The aim of the study was to verify whether the expression of MMP-9, MMP-2, TIMP-1, and TIMP-2 in peripheral lung biopsies of patients with sarcoidosis correlate with lung function tests, radiological pattern, and bronchoalveolar lavage (BAL) cells. We compared the expression of MMPs and TIMPs between patients with sarcoid-positive vs. - negative biopsy and fibrosing vs. non-fibrosing high-resolution computed tomography (HRCT)pattern.

PATIENTS AND METHODS

We examined patients with histologically proven stage II and III sarcoidosis (n = 17). Immunohistochemistry with antibodies against the studied molecules was performed in the lung and bronchial tissue specimens obtained from transbronchial lung biopsies. The radiological pattern was evaluated based on HRCT. The total cell number and percentage of cells were calculated in the BAL samples.

RESULTS

MMPs and TIMPs were present in the cells of sarcoid granuloma, and were more prevalent in the parenchyma than in the bronchi. We found no correlation between MMP-9, MMP-2, TIMP-1, TIMP-2 and HRCT pattern or BAL cells. There were inverse associations between MMP-9 and FEV1 (% predicted), and also between MMP-2 and maximal expiratory flow 25-75% (L and % predicted) in patients with sarcoidosis diagnosed by transbronchial lung biopsy. There were no differences in the measured parameters between patients with and without fibrotic changes and between those with negative vs. positive lung biopsy results.

CONCLUSIONS

Our study provides an indirect evidence for a potential involvement of MMPs/TIMPs in the sarcoid inflammation of the distal airways.

The evaluation of selected indices of apoptosis in placentas from pregnancies complicated by fetal growth restriction

BACKGROUND

Fetal growth restriction is related to a high rate of prematurity and mortality. In cases of unknown origin utero-placental circulation changes are the main factor which is due to the changes in blood vessels. The understanding of the mechanism may help in further prevention of FGR.

MATERIAL AND METHODS

The expression of bcl-2 and bax in normal pregnancies and complicated by FGR were compared. The study was conducted in 2005-2006 at The Medical University of Lodz--HRP Unit and The Kopernik Hospital--Lodz. Bcl-2 and bax were estimated using an immunohistochemical method. Bcl-2 was estimated in trophoblast, bax in decidua and trophoblast.

RESULTS

In a study group the mean value of bcl-2 in trophoblast was 37.04 +/- 10.51, in a control group the mean value was 65.74 +/- 6.97. The estimation of bax was done in trophoblast and decidua separately. In the group of FGR mean value of bax expression in trophoblast was 45.35 +/- 10.5. In decidua the mean bax expression value was 24.11 +/- 7.3. In controls in trophoblast the mean value was 12.53 +/- 7.54, in decidua the mean expression of bax was 6.63 +/- 2.24.

CONCLUSION

1. Apoptosis in trophoblast is lower in normal pregnancy than in FGR. 2. Increased expression of pro-apoptotic proteins in placenta might be one of the reason for FGR development.

Immunohistochemical expression of progesterone and estrogen receptors in meningiomas

In this study we present results of investigations of progesterone and estrogen receptors in most frequent, WHO grade I histological types of meningiomas (meningothelial, fibrous, and transitional) and in atypical--WHO grade II variant of these tumors. Samples from 64 tumors were examined. The cohort consisted of 46 WHO grade I (21 transitional, 13 fibrous and 12 meningothelial histologic variants) and of 18 atypical meningiomas. Apart from immunohistochemical examination of progesterone and estrogen receptors, MIB 1 labeling index was estimated. Positive immunoreaction for progesterone receptors was found in 100% meningothelial, 95% transitional, 46% fibrous and 78% atypical variant of meningiomas. Intensity of immunoreaction was stronger in grade I than in grade II tumors. Immunoexpression of estrogen receptors was found in 48% of the investigated meningiomas. No correlation was stated between WHO grade I and grade II tumors, and between meningothelial, transitional and fibrous variants of the neoplasms.

Complement factors C1q and C3b in brains with Creutzfeldt-Jakob disease

Neuronal loss in Creutzfeldt-Jakob disease (CJD) is due to apoptosis and autophagy, however the apoptotic cell death may be related to the influence of cytokines. The role of complement system in induction of this process was recently postulated. In our study we examined the immunoreactivity for "early activation" complement factors C1q and C3b in the brains of the patients with CJD. We showed the positive immunoreactivity for C1q and C3b in neurons mainly in areas of spongiform change, in Purkinje cells, molecular layer and granular layer of cerebellum, and in prion protein positive plaques. The evident positive reactivity of two complement factors may suggest the role of complement system in neurodegeneration in CJD.