Influence of Vitamin D on the Incidence of Metabolic Syndrome and Hormonal Balance in Patients with Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) is a heterogeneous endocrine disorder that affects 8-13% of women of reproductive age. It is one of the most common causes of infertility and is associated with hyperandrogenism in the form of hirsutism and acne, non-ovulatory cycles, and characteristic ovarian morphology. The available research on serum vitamin D deficiency in patients with PCOS and the appropriateness of vitamin D supplementation in this group of women is inconclusive, so we decided to investigate the influence of vitamin D on the incidence of metabolic syndrome and hormonal balance in patients with polycystic ovary syndrome. The study comprised 120 women aged between 18 and 42 years, who were divided into two groups: a group with diagnosed polycystic ovary syndrome (PCOS) and a group of regularly menstruating women without features of androgenisation, in whom polycystic ovary syndrome was excluded. Each patient underwent a history and physical examination, including a gynecological examination, anthropometric measurements were taken, including height, weight, waist, and hip circumference, and blood pressure was measured using the Korotkow method. In the female patients, the following parameters were also determined from the blood: follicle-stimulating hormone (FSH), luteinizing hormone (LH), oestradiol, TSH, ft4, prolactin (PRL), total testosterone, DHEASO4, 17-hydroxyprogesterone (17-OHP), sex-hormone-binding globulin (SHBG), androstendione, 25(OH) vitamin D3 metabolite. The majority of the patients with polycystic ovary syndrome were found to have deficient or suboptimal serum vitamin D levels, and the effects of vitamin D on the SHBG levels and free-androgen indices in these patients was examined. The effects of vitamin D on the incidence of metabolic syndrome and BMI, waist-to-hip ratio, waist circumference, and blood pressure in patients with polycystic ovary syndrome were also found.

Comparison of Visual Field Measurement with Heidelberg Edge Perimeter and Humphrey Visual Field Analyzer in Patients with Ocular Hypertension

BACKGROUND

Glaucoma is a group of eye diseases which result in damage to the optic nerve and vision loss. The most important examination in glaucoma patients is visual field assessment. One of the newer perimeters is Heidelberg Edge Perimeter (HEP).

OBJECTIVES

The aim of the study was to compare visual field measurements made with Humphrey II 740 Visual Field (Carl Zeiss Meditec) and Heidelberg Edge Perimeter (HEP) (Heidelberg Engineering). FDF stimulus (flicker defined form) in HEP stimulates magnocellular retinal cells, which are the first to be damaged in the early stage of glaucoma. Even a small loss of magnocellular cells may influence HEP visual field.

MATERIAL AND METHODS

The observed group consisted of 45 patients (82 eyes), age 60 ± 9.8 years, glaucoma suspects, not treated pharmacologically or surgically before, with intraocular pressure ≥ 22 mm Hg. Visual field values were measured with two different devices: Humphrey II 740 Visual Field (Carl Zeiss Meditec, Jena, Germany) and Heidelberg Edge Perimeter (Heidelberg Engineering, Heidelberg, Germany). The patients were divided into two groups: Group 1 - tested with SITA Standard program on Humphrey perimeter and ASTA Standard HEP, and Group 2 - tested with SITA Fast program on Humphrey perimeter and ASTA Standard on HEP.

RESULTS

Few positive ΔMD results (ΔMD = MD HEP - MD HUM) were obtained in Groups 1 and 2, which means that the deviation value on the HEP perimeter was only slightly higher than the mean deviation value on Humphrey. Therefore, one can conclude that HEP perimeter may detect visual field defects with greater precision. The visual field measurements between ASTA Standard on HEP and SITA Standard on Humphrey as well as ASTA Standard on HEP and SITA Fast on Humphrey are not equal: MD values on HEP perimeter are lower than MD on Humphrey, which can mean that HEP perimeter provides more precise results and shows even early visual field lesions.

CONCLUSIONS

HEP perimeter measures visual field defects with greater precision so it should be taken into consideration for earlier glaucoma detection in routine ophthalmological diagnosis.

Targeting of nucleoprotein to chemokine receptors by DNA vaccination results in increased CD8(+)-mediated cross protection against influenza

Vaccination is at present the most efficient way of preventing influenza infections. Currently used inactivated influenza vaccines can induce virus-neutralizing antibodies that are protective against a particular influenza strain, but hamper the induction of cross-protective T-cell responses to later infections. Thus, influenza vaccines need to be updated annually in order to confer protection against circulating influenza strains. This study aims at developing an efficient vaccine that can induce broader protection against influenza. For this purpose, we have used the highly conserved nucleoprotein (NP) from an influenza A virus subtype H7N7 strain, and inserted it into a vaccine format that targets an antigen directly to relevant antigen presenting cells (APCs). The vaccine format consists of bivalent antigenic and targeting units, linked via an Ig-based dimerization unit. In this study, NP was linked to MIP-1α, a chemokine that targets the linked antigen to chemokine receptors 1, 3 and 5 expressed on various APCs. The vaccine protein was indirectly delivered by DNA. Mice were vaccinated intradermally with plasmids, in combination with electroporation to enhance cellular uptake of DNA. We found that a single DNA vaccination was sufficient for induction of both antibody and T cell responses in BALB/c mice. Targeting of nucleoprotein to chemokine receptors enhanced T cell responses but not antibody responses. Moreover, a single dose of MIP1α-NP conferred protection in BALB/c mice against a lethal challenge with an H1N1 influenza virus. The observed cross-protection was mediated by CD8(+) T cells.

The MRN protein complex genes: MRE11 and RAD50 and susceptibility to head and neck cancers

BACKGROUND

The members of MRE11/RAD50/NBN (MRN) protein complex participates in DNA double-strand break repair and DNA-damage checkpoint activation. We have previously shown that the p.I171V NBN gene mutation may contribute to the development of laryngeal cancer. This study tested the hypothesis that variants of the MRE11 and RAD50 genes, previously described as cancer risk factors, predispose to increased susceptibility to head and neck cancer.

FINDINGS

In this study we analyzed the RAD50 and MRE11 genes in 358 patients: 175 with a single laryngeal cancer (LC), 115 with multiple primary tumors but one malignancy (primary or second) localized in the larynx (MPT-LC), 68 patients with multiple primary tumors localized in the head or neck (MPT) and 506 controls. No carriers of previously reported mutation in the MRE11 or RAD50 gene (particularly the pathogenic c.687delT) were detected in the present study. We identified the p.V127I variant (2/175 LC, 2/506 controls; OR=2.91; 95% CI 0.41-20.85) and p.V315L variant (2/115 MPT-LC, 1/506 controls; OR=8.96; 95% CI 0.81-99.68) of the RAD50 gene.

CONCLUSIONS

Our data indicated that previously described common genetic variations in the MRE11 and RAD50 genes do not contribute to an increased risk of laryngeal cancer and second primary tumors localized in the head and neck. Prospective studies with larger groups of patients may reveal the possible impact of these genes in tumor occurrence.

The composition of house dust mite is critical for mucosal barrier dysfunction and allergic sensitisation

BACKGROUND

House dust mite (HDM) allergens have been reported to increase airway epithelial permeability, thereby facilitating access of allergens and allergic sensitisation.

OBJECTIVES

The authors aimed to understand which biochemical properties of HDM are critical for epithelial immune and barrier responses as well as T helper 2-driven experimental asthma in vivo.

METHODS

Three commercially available HDM extracts were analysed for endotoxin levels, protease and chitinase activities and effects on transepithelial resistance, junctional proteins and pro-inflammatory cytokine release in the bronchial epithelial cell line 16HBE and normal human bronchial cells. Furthermore, the effects on epithelial remodelling and airway inflammation were investigated in a mouse model.

RESULTS

The different HDM extracts varied extensively in their biochemical properties and induced divergent responses in vitro and in vivo. Importantly, the Greer extract, with the lowest serine protease activity, induced the most pronounced effects on epithelial barrier function and CCL20 release in vitro. In vivo, this extract induced the most profound epithelial E-cadherin delocalisation and increase in CCL20, CCL17 and interleukin 5 levels, accompanied by the most pronounced induction of HDM-specific IgE, goblet cell hyperplasia, eosinophilic inflammation and airway hyper-reactivity.

CONCLUSIONS

This study shows the ability of HDM extracts to alter epithelial immune and barrier responses is related to allergic sensitisation but independent of serine/cysteine protease activity.

A cannabinoid receptor, sensitive to O-1918, is involved in the delayed hypotension induced by anandamide in anaesthetized rats

BACKGROUND AND PURPOSE

Intravenous injection of the endocannabinoid anandamide induces complex cardiovascular changes via cannabinoid CB(1), CB(2) and vanilloid TRPV1 receptors. Recently, evidence has been accumulating that in vitro, but not in vivo, anandamide relaxes blood vessels, via an as yet unidentified, non-CB(1) vascular cannabinoid receptor, sensitive to O-1918 (1,3-dimethoxy-5-2-[(1R,6R)-3-methyl-6-(1-methylethenyl)-2-cyclohexen-1-yl]-benzene). We here examined whether the anandamide-induced hypotension in urethane-anaesthetized rats was also mediated via a non-CB(1) vascular cannabinoid receptor.

EXPERIMENTAL APPROACH

Effects of two antagonists (O-1918 and cannabidiol) of the non-CB(1) vascular cannabinoid receptor on anandamide-induced changes in mean, systolic and diastolic blood pressure (MBP, SBP, DBP), mesenteric (MBF) and renal (RBF) blood flow and heart rate (HR) in urethane-anaesthetized rats was examined.

KEY RESULTS

In anaesthetized rats, anandamide (1.5-3 micromol.kg(-1)) and its stable analogue methanandamide (0.5 micromol.kg(-1)) caused a delayed and prolonged decrease in MBP, SBP, DBP, MBF and RBF by about 10-30% of the respective basal values without changing HR. In pithed rats, anandamide (3 micromol.kg(-1)) decreased blood pressure by about 15-20% of the basal value without affecting HR, MBF and RBF. All vascular changes were reduced by about 30-70% by cannabidiol and O-1918 (3 micromol.kg(-1), each).

CONCLUSIONS AND IMPLICATIONS

Non-CB(1) cannabinoid vascular receptors, sensitive to O-1918, contribute to the hypotensive effect of anandamide in anaesthetized rats. Activation of these receptors may be therapeutically important as the endocannabinoid system could be activated as a compensatory mechanism in various forms of hypertension.

Four close bupranolol analogues are antagonists at the low-affinity state of beta1-adrenoceptors

Bupranolol is an antagonist at the cardiostimulatory low-affinity state of b(1)-adrenoceptors and we were interested whether this effect is shared by its fluorine (GD-6), methyl (DZ-51) and isopropyl analogue (DZ-13) and by the analogue hydroxylated at the tertiary butyl moiety (DZ-52). (-)-Bupranolol and compounds (-)-GD-6, (+)-GD-6, (-)-DZ-13, (+)-DZ-13, DZ-51 and DZ-52 antagonized the CGP 12177-induced tachycardia in pithed rats with "apparent pA(2) values" of 6.1, 6.1, 4.6, 5.5, 4.6, 5.1 and 5.3, respectively. For comparison, their potencies and affinities at the high-affinity state of b(1)-adrenoceptors were determined, using the xamoterol-induced tachycardia in pithed rats and [(3)H]CGP 12177 binding to rat cerebrocortical membranes. The respective "apparent pA(2) values" in the functional experiments were 7.9, 8.1, 5.4, 8.4, 5.7, 7.3 and 6.8 and the pK(i) values in the binding experiments were 8.8, 8.4, 6.9, 8.5, 6.7, 8.4 and 8.2. In conclusion, (-)-bupranolol and its fluorine analogue (-)-GD-6 are equipotent at the low-affinity state of beta(1)-adrenoceptors. The stereoselectivity of GD-6 and DZ-13 suggests that the low-affinity state is indeed a receptor.

Virodhamine relaxes the human pulmonary artery through the endothelial cannabinoid receptor and indirectly through a COX product

BACKGROUND AND PURPOSE

The endocannabinoid virodhamine is a partial agonist at the cannabinoid CB(1) receptor and a full agonist at the CB(2) receptor, and relaxes rat mesenteric arteries through endothelial cannabinoid receptors. Its concentration in the periphery exceeds that of the endocannabinoid anandamide. Here, we examined the influence of virodhamine on the human pulmonary artery.

EXPERIMENTAL APPROACH

Isolated human pulmonary arteries were obtained during resections for lung carcinoma. Vasorelaxant effects of virodhamine were examined on endothelium-intact vessels precontracted with 5-HT or KCl.

KEY RESULTS

Virodhamine, unlike WIN 55,212-2, relaxed 5-HT-precontracted vessels concentration dependently. The effect of virodhamine was reduced by endothelium denudation, two antagonists of the endothelial cannabinoid receptor, cannabidiol and O-1918, and a high concentration of the CB(1) receptor antagonist rimonabant (5 muM), but only slightly attenuated by the NOS inhibitor L-NAME and not affected by a lower concentration of rimonabant (100 nM) or by the CB(2) and vanilloid receptor antagonists SR 144528 and capsazepine, respectively. The COX inhibitor indomethacin and the fatty acid amide hydrolase inhibitor URB597 and combined administration of selective blockers of small (apamin) and intermediate and large (charybdotoxin) conductance Ca(2+)-activated K(+) channels attenuated virodhamine-induced relaxation. The vasorelaxant potency of virodhamine was lower in KCl- than in 5-HT-precontracted preparations.

CONCLUSIONS AND IMPLICATIONS

Virodhamine relaxes the human pulmonary artery through the putative endothelial cannabinoid receptor and indirectly through a COX-derived vasorelaxant prostanoid formed from the virodhamine metabolite, arachidonic acid. One or both of these mechanisms may stimulate vasorelaxant Ca(2+)-activated K(+) channels.

[Potassium channels in blood vessels: their role in health and disease]

Endothelial cells and vascular smooth muscle cells express four different classes of potassium ion channels: 1) voltage-gated potassium channels (K(V)); 2) Ca2+-activated potassium channels (KCa), including large - (BK(Ca)), intermediate - (IKCa), and small-conductance (SK(Ca)) Ca2+-activated potassium channels; 3) ATP-sensitive potassium channels (K(ATP)); and 4) inwardly rectifying potassium channels (K(IR)). The activation of potassium channels is the main determinant of the cell membrane potential. Therefore, potassium channels participate in the regulation of vascular tone. Endothelium-dependent vasodilators, i.e. nitric oxide (NO), prostacyclin (PGI2), and endothelium-derived hyperpolarizing factor (EDHF), may activate (open) K+ channels in the cell membrane, which allows K+ efflux out of the cell, causing a decrease in membrane potential and hyperpolarization and, as a consequence, closing voltage-gated calcium channels in the cell membrane and vascular muscle relaxation (vasodilatation). Conversely, inhibition (closing) of vascular K+ channels by vasoconstrictors decreases K+ efflux and opens calcium channels, thereby increasing membrane potential, leading to depolarization and vasoconstriction. Dysfunction of the potassium channels is related to the pathogenesis and/or pathomechanism of some cardiovascular diseases, such as hypertension, atherosclerosis (disorders of all types of potassium channels), diabetes (mainly impairment of K(ATP)), and septic shock (hyperactivity of K(ATP)). On the other hand, abnormal vasoconstriction or vasodilatation is likely to be the consequence of defective potassium channel activity. However, increased or decreased function may also constitute a compensatory mechanism for inappropriate vascular tone. Nowadays modulators of potassium channels are used as therapeutic agents in some health disorders. A multitude of outgoing investigations aims at expanding the novel activators and inhibitors of potassium channels, which may provide a unique therapeutic benefit in vascular therapy.

[Endothelium-derived hyperpolarizing factor (EDHF): potential involvement in the physiology and pathology of blood vessels]

Vascular endothelium plays an important role in maintaining vascular homeostasis by synthesizing and releasing some vasodilating factors, such as prostacyclin (PGI2), nitric oxide (NO), and a yet unidentified endothelium-derived hyperpolarizing factor (EDHF). Although the nature of EDHF is still controversial, this additional endothelial pathway, endothelium-dependent hyperpolarization, has been demonstrated in many blood vessels of different species, including humans. Despite tissue- and species-specific site differences, endothelium-dependent hyperpolarization plays an important role in the regulation of resistance of vessels and microcirculation. The most probable candidates for EDHF include epoxyeicosatrienoic acids, endothelium-derived potassium ions (K+), and hydrogen peroxide (H2O2). Endothelium-dependent hyperpolarization also probably involves the activation of two populations of endothelial potassium channels, i.e. the small- and intermediate-conductance calcium-activated potassium channels (SKCa and IKCa). Electrical communication between endothelial and smooth muscle cells through gap junctions has also been suggested to be involved in endothelium-dependent hyperpolarization. EDHF-mediated responses are clearly sex-dependent and altered in aging and various pathological conditions, such as hypoxia, hypertension, atherosclerosis, and diabetes, which are mainly related to endothelial dysfunction. Suitable therapeutic treatment can restore these impaired vascular responses. Activating endothelial potassium channels or improving myo-endothelial communication could become interesting therapeutic targets.

Potential involvement of a propranolol-insensitive atypical beta-adrenoceptor the vasodilator effect of cyanopindolol in the human pulmonary artery

The aim of our study was to examine whether non beta(1)-/beta(2)-adrenoceptors participate in the relaxation of the human pulmonary artery. For this purpose the vasodilatory effect of the non-conventional partial beta-adrenoceptor agonist cyanopindolol was examined. Cyanopindolol (1-300 microM), studied in the presence of the beta(1)-/beta(2)-adrenoceptor antagonist propranolol, relaxed the human pulmonary artery preconstricted with serotonin 1 microM in a concentration-dependent manner (maximally by about 80%). This effect was diminished by bupranolol 10 microM (an antagonist of beta(1)-beta(3)-adrenoceptors and the low affinity state of the beta(1)-adrenoceptor) and CGP 20712 10 microM (known to antagonize the low-affinity state of the beta(1)-adrenoceptor at high concentrations). In further experiments, the effect of beta-adrenoceptor ligands on the serotonin-induced vasoconstriction was examined. The concentration-response curve for serotonin was not affected by cyanopindolol 30 microM, bupranolol 10 microM and CGP 20712 10 microM but shifted to the right by cyanopindolol 100 and 300 microM; the serotonin 5-HT(2A) receptor antagonist ketanserin 0.3 microM abolished the maximum contraction elicited by serotonin. In conclusion, the present study reveals that the vasodilatory effect of cyanopindolol in the human pulmonary artery consists of two components, i.e. activation of a propranolol-insensitive atypical beta-adrenoceptor and antagonism against 5-HT(2A) receptors.

[Foreign body in the right frontal lobe of the brain as a result of right eyeball and right eye-socket trauma--case report]

We report a case of a 44 year old man, who was admitted to our hospital because of right eyeball and right eye-socket due to a piece of diamond circular saw. Right eyeball was sutured. CT--examination showed a metallic foreign body in the right frontal lobe of brain. Metallic foreign body, which damaged the right eyeball, caused upper restriction of right eye-socket ceiling and stuck in a frontal lobe of the brain was removed.

[Content of nitrates and nitrites in raw mild in different regions of the country]

The content of nitrates and nitrites in raw milk in different regions of the country was studied. The results obtained dependent both on the factory from which the samples origin and on the seasons of the year. In 37% of samples there was insignificant increase in the level of nitrates, and in 31.9 of nitrites.

[Etiology and clinical course of purulent meningitis and encephalitis in adults]

The authors, basing on the own experience in the treatment of 578 patients with purulent meningitis and encephalitis, discuss etiologic and clinical problems as an early diagnosis of the cause decides on the proper therapy and often on the patient's fate. The authors are convinced that the result of general CSF examination is a crucial diagnostic criterion in meningitis and encephalitis but does not permit identification of the disease causes. Problems with etiological verification is discussed. The authors have found that the infection with N. meningitidis and S. pneumoniae remains the most frequent cause of the disease in adults. However, the cause of the disease cannot be determined in over 50% of patients, and etiological verification of infections caused by H. influenzae and anaerobic organisms is quite unsatisfactory. The authors stress that over 20% of patients had skull injury and meningitis most frequently resulted from the infection with S. pneumoniae in these patients. It is suggested that purulent meningitis and encephalitis as a rule is endogenous disease produced by the activation of endogenous source of the infection.

[Methods and treatment results of purulent meningitis and encephalitis in adults--based on personal observations]

The authors present own methods and results of the treatment of 578 patients with suppurative meningitis and encephalitis. Etiologically most frequent infections due to N. meningitidis, S. pneumoniae, and H. influenzae were treated with penicillin and ampicillin; the authors recommend to replace the latter antibiotic with cefotaxime. If meningitis and encephalitis were due to aerobic gram-negative bacilli, a possibility of the simultaneous infection with anaerobic flora was considered, and the drugs active against both types of the organisms were administered. The same was the treatment in case of etiologically confirmed staphylococcal infection. In case of unknown etiology of meningitis and encephalitis therapy was based on clinical data, and laboratory findings.