Experimental rat models for Hashimoto's thyroiditis

PURPOSE

Hashimoto's thyroiditis (HT) is an autoimmune thyroid disease characterized by T lymphocyte-mediated destruction of thyroid follicles. To study the pathogenesis of HT and the efficacy of new substances for its treatment, an easily obtained and adequate to the human disease experimental model is needed. The aim of our study was to find out whether it is possible to induce experimental autoimmune thyroiditis (EAT) similar to Hashimoto's thyroiditis by injecting with thyroglobulin (Tg) without using agents that enhance its thyroiditogenicity and without taking into account the genetic sensitivity of animals.

METHODS

Wistar rats were immunized with freshly isolated rat Tg or porcine Tg. In 8 weeks, histological studies of the thyroid and parathyroid glands were performed. Thyroid function and total serum calcium level were also evaluated.

RESULTS

Immunization with both rat and porcine freshly isolated Tg caused T lymphocytic infiltration of the thyroid gland, thyroid follicle atrophy and degradation in Wistar rats. EAT caused by porcine Tg was characterized by greater severity than EAT induced with rat Tg. In 55% of rats with porcine Tg-induced EAT, oxyphilic metaplasia was detected in the parathyroid glands. In addition, low total serum calcium was observed in these rats.

CONCLUSION

Two rat models of autoimmune thyroiditis were obtained. EAT caused in Wistar rats by immunization with rat Tg is similar to Hashimoto's thyroiditis. EAT induced with porcine Tg was accompanied by oxyphil cell metaplasia in the parathyroids and hypocalcemia.

Absolute emission intensities of the gamma rays from the decay of 224Ra and 212Pb progenies and the half-life of the 212 Pb decay

Absolute gamma-ray emission intensities for 36 characteristic gamma rays from the decay of 224Ra, 212Pb, and their progeny were determined by measuring sources calibrated for activity by means of primary methods based on well-defined high-purity germanium (HPGe) detectors at both NIST and NPL. Results from the two laboratories agree with recent data evaluations, except for gamma rays with low emission intensities. The decay schemes have been re-balanced based on the new results. In addition, the half-life for 212Pb was measured using several HPGe detectors, ionization chambers, and a well-type NaI(Tl) detector.

Determination of the Terbium-152 half-life from mass-separated samples from CERN-ISOLDE and assessment of the radionuclide purity

Terbium-152 is one of four terbium radioisotopes that together form a potential theranostic toolbox for the personalised treatment of tumours. As 152 Tb decay by positron emission it can be utilised for diagnostics by positron emission tomography. For use in radiopharmaceuticals and for activity measurements by an activity calibrator a high radionuclide purity of the material and an accurate and precise knowledge of the half-life is required. Mass-separation and radiochemical purification provide a production route of high purity 152Tb. In the current work, two mass-separated samples from the CERN-ISOLDE facility have been assayed at the National Physical Laboratory to investigate the radionuclide purity. These samples have been used to perform four measurements of the half-life by three independent techniques: high-purity germanium gamma-ray spectrometry, ionisation chamber measurements and liquid scintillation counting. From the four measurement campaigns a half-life of 17.8784(95) h has been determined. The reported half-life shows a significant difference to the currently evaluated half-life (ζ-score = 3.77), with a relative difference of 2.2 % and an order of magnitude improvement in the precision. This work also shows that under controlled conditions the combination of mass-separation and radiochemical separation can provide high-purity 152Tb.

On the structures and luminescent properties of Eu3+ doped Li2 CaGeO4 , Ca2 GeO4 and Ca5 Ge3 O11 compounds

Powder samples of Li₂ CaGeO₄ , Ca₂ GeO₄ and Ca₅ Ge₃ O₁₁ doped by 0.5, 1, 2, 3, 4 and 5 at% Eu³⁺ relative to the Ca²⁺ , were prepared by conventional solid state synthesis technique. XRD analyses confirm obtaining of the pure phases at all dopant concentrations. In parallel, single crystals of the three compounds with the experimentally found optimal Eu³⁺ concentration were grown using the flux method. Structural investigation on the single crystals are done with a special attention on the form of Ca-O polyhedron, the mean Ca-O distance, the Ca-Ca distance in the structure, the distortion degree of the polyhedron as well as the of Eu-Ca substitution site. The main spectral characteristics are analyzed and several relations between the structural and spectra features were found. The optimal dopant concentration is 3 at% for Ca₂ GeO₄ and 4at% for Ca₅ Ge₃ O₁₁ and Li₂ CaGeO₄ . CIE coordinates of the samples show emission colors in the red region close to the standard red coordinates and slightly influenced by the active ion concentration. The obtained results show that europium doped Li₂ CaGeO₄ , Ca₂ GeO₄ and Ca₅ Ge₃ O₁₁ could be used as red phosphors.

Acute Ekbom’s syndrome in a patient with acute urethritis

Introduction

Delirium of parasitosis was first described by Karl Ekbom in Sweden in 1938. It is a hallucinatory monothematic delirium characterized by the unwavering conviction of having the skin infested with insects or parasites. Multiple etiologist has been described such as psychiatric and neurological disorders, substance intoxication or other medical conditions. We present a case of debut of Ekbom’s syndrome in an individual recently diagnosed with acute urethritis on antibiotic treatment.

Objectives

To report a case of a patient with a debut of Ekbom’s syndrome and acute urethritis.

Methods

A 40-year-old man with no previous psychiatric history is admitted psychiatric emergency room accompanied by his wife for intense anxiety and isolation at home. During the examination, the patient explains a lot of fear of a series of bugs such as bees and small parasites that invade him. The onset of symptomatology coincides with a diagnosis of chlamydia urethritis and the initiation of treatment with ceftriaxone 500mg IM + Azithromycin 1g VO. Complete physical examination is performed without alterations. Toxicological, biochemistry, hormonal and vitamin study did not show any alterations.

Results

Antipsychotic treatment was started with Olanzapine up to 10mg/day and supportive treatment with benzodiazepines. The patient showed rapid improvement. At discharge, he is asymptomatic from the urological and psychopathological point of view.

Conclusions

Ekbom’s syndrome is a multifactorial disorder. The patient was diagnosed of an acute psychotic disorder due to another medical condition and/or treatment with antibiotics.

Disclosure

No significant relationships.

Angular momentum generation in nuclear fission

When a heavy atomic nucleus splits (fission), the resulting fragments are observed to emerge spinning¹; this phenomenon has been a mystery in nuclear physics for over 40 years^2,3. The internal generation of typically six or seven units of angular momentum in each fragment is particularly puzzling for systems that start with zero, or almost zero, spin. There are currently no experimental observations that enable decisive discrimination between the many competing theories for the mechanism that generates the angular momentum^4-12. Nevertheless, the consensus is that excitation of collective vibrational modes generates the intrinsic spin before the nucleus splits (pre-scission). Here we show that there is no significant correlation between the spins of the fragment partners, which leads us to conclude that angular momentum in fission is actually generated after the nucleus splits (post-scission). We present comprehensive data showing that the average spin is strongly mass-dependent, varying in saw-tooth distributions. We observe no notable dependence of fragment spin on the mass or charge of the partner nucleus, confirming the uncorrelated post-scission nature of the spin mechanism. To explain these observations, we propose that the collective motion of nucleons in the ruptured neck of the fissioning system generates two independent torques, analogous to the snapping of an elastic band. A parameterization based on occupation of angular momentum states according to statistical theory describes the full range of experimental data well. This insight into the role of spin in nuclear fission is not only important for the fundamental understanding and theoretical description of fission, but also has consequences for the γ-ray heating problem in nuclear reactors^13,14, for the study of the structure of neutron-rich isotopes^15,16, and for the synthesis and stability of super-heavy elements^17,18.

An analysis of missed cases with surgical emergencies admitted in non-surgical departments. Case series and а review of the literature

INTRODUCTION

The delayed diagnosis in emergency surgery can be associated with significant morbidity and mortality and often lead to litigations. The aim of the present work is to analyse the outcome in cases with non-trauma surgical emergencies wrongly admitted in non-surgical departments.

METHODS

A retrospective trial in two independent University hospitals was conducted. The first group encompassed the patients worked-up in the Surgical unit of Emergency department (2014-2018). The second one included all cases visited Emergency department (2018). Only cases with acute abdomen and delayed diagnosis and operation were included. The analysis included the proportion of the delayed diagnosis, time between admission and operation, intraoperative diagnosis, complications and mortality rate.

RESULTS

In the first group there were 30 194 visits in the surgical unit with 15 836 hospitalizations (52.4%). Twenty patients of the last (0.13%) were admitted in the Clinic of Infectious disease and subsequently operated. The mean delay between hospitalization and operation was 3 days (1-10). Seventeen patients (85%) were operated with mortality of 10%. In the second group, there were a total of 22 760 visits with 11 562 discharged cases. Of the last, 1.7% (n=192) were re-admitted in a surgical ward, 25 of which underwent urgent surgery (0.2%).

CONCLUSIONS

The missed surgical cases represent only a small proportion of the patients in emergency department. The causes for wrong initial admissions in our series were misinterpretation of the symptoms, insufficient clinical examination and underuse of US and CT. The careful clinical assessment, point-of care US and CT may decrease the rate of the delayed diagnosis.

The impact of high-energy tailing in high-purity germanium gamma-ray spectrometry on the activity determination of 224Ra using the 241.0 keV emission

High-energy tailing is an often-overlooked component in high-purity germanium gamma-ray spectrometry when performing the non-linear least squares fit of a full-energy peak. This component comes from the incomplete restoration of the baseline prior to the next pulse being processed and therefore is an issue of increased count rates. In the current work, the impact of this oversight is shown through the dynamics and decay characteristics of ²²⁴Ra and its radioactive decay progeny. Multiple measurements of two samples, separated from the decay progeny and at differing activities, have been made. The results of full-energy peak fitting of the convoluted 238.6 keV and 241.0 keV full-energy peaks with and without the high energy tailing component are presented. Trends in the observed activity that approximate the ingrowth of ²¹²Pb have been observed where no high-energy tailing component is used, with maximum relative differences of 2% and 5% determined.

Alpha-particle emission probabilities of 231Pa derived from first semiconductor spectrometric measurements

The nuclide ²³¹Pa is a member of the ²³⁵U decay chain. It is a complex alpha emitter with 25 identified alpha emissions. Formerly published alpha-particle emission probabilities were derived from measurements taken with magnetic spectrometers. This work presents the first measurements made with semiconductor detectors. High-resolution alpha-particle spectrometry was carried out at CIEMAT and JRC using ion-implanted planar silicon detectors. Alpha-particle emission probabilities of 23 transitions were derived from deconvolutions of the spectra. For the major lines, uncertainties are lower than 1%, a significant improvement to existing data. The new data set will allow a more accurate evaluation of the decay scheme of ²³¹Pa.

The potential radio-immunotherapeutic α-emitter 227Th - part I: Standardisation via primary liquid scintillation techniques and decay progeny ingrowth measurements

Thorium-227 is a potential therapeutic radionuclide for applications in targeted α-radioimmunotherapy for the treatment of various types of cancer. To provide nuclear medicine departments involved in Phase I clinical trials traceability to the SI unit of radioactivity (Bq), a standardisation of a radiochemically pure ²²⁷Th aqueous solution has been performed at the National Physical Laboratory. This was achieved via two primary liquid scintillation (LS) techniques -4π(LS)-γ digital coincidence counting (DCC) and 4π LS counting. These absolute techniques were supported by the indirect determination of the ²²⁷Th activity via the measurement of the ingrowth and decay rate of the decay progeny by both ionisations chambers and high purity germanium (HPGe) gamma-ray spectrometry. The results of the primary techniques were found to be consistent, both with each other (zeta score = 1.1) and to the decay progeny ingrowth measurements. An activity per unit mass of 20.726 (51) kBq g^-1 was determined for the solution. A procedure has been developed that provided an effective separation of the ²²⁷Th from its decay progeny, which was shown by the effective time zero of the ²²⁷Th-²²³Ra nuclear chronometer measured by HPGe gamma-ray spectrometry.

Selective sorption of uranium from aqueous solution by graphene oxide-modified materials

The effect of competing ions on the sorption behaviour of uranium onto carboxyl-functionalised graphene oxide (COOH-GO) were studied in batch experiments in comparison to graphene oxide (GO) and graphite. The effect of increasing the abundance of select chemical functional groups, such as carboxyl groups, on the selectivity of U sorption was investigated. In the course of the study, COOH-GO demonstrated superior performance as a sorbent material for the selective removal of uranyl ions from aqueous solution with a distribution coefficient of 3.72 ± 0.19 × 10³ mL g⁻¹ in comparison to 3.97 ± 0.5 × 10² and 2.68 ± 0.2 × 10² mL g⁻¹ for GO and graphite, respectively.

Development of an optimised method for analysis of 90Sr in decommissioning wastes by triple quadrupole inductively coupled plasma mass spectrometry

The ongoing development of an optimised procedure for the measurement of ⁹⁰Sr in decommissioning samples using the latest generation triple quadrupole inductively coupled plasma mass spectrometry (ICP-QQQ-MS) is presented. The procedure incorporates digestion, and separation from interferences using a combination of wet chemical and instrument-based separation using the ICP-QQQ-MS reaction cell. The key factors under study are the procedural time and limits of detection achievable compared to existing radiometric techniques.

Optimisation of photonic crystal coupling through waveguide design

This paper considers multiple structural designs for photonic crystal surface emitting lasers operating at key wavelengths. Initially a structure from Williams et al. is modelled, the structure is modified to include an additional GaAs waveguide layer (termed ballast layer) and to include an additional PC layer (termed double decker). These structures are modelled by a combination of coupling calculation and waveguide modelling and are compared to the original structure. We show that both of these schemes give an increase in coupling, but present fabrication challenges. Next, we model standard laser structures operating at key wavelengths (400 nm, 1.3 and 10 µm) where a photonic crystal is located above the active region and explore the effect of increasing thickness of photonic crystal. We find that increasing the thickness increases the coupling coefficient but not true for the full range of thicknesses considered. This study allows a more universal comparison of the use of all-semiconductor, or void containing PCSELs to be conducted and we find that the realisation of all semiconductor PCSELs covering a wide range of material and wavelengths are possible.

Development of the NPL gamma-ray spectrometer NANA for traceable nuclear decay and structure studies

We present a brief report on the progress towards the construction of the National Nuclear Array (NANA), a gamma-ray coincidence spectrometer for discrete-line nuclear structure and decay measurements. The proposed spectrometer will combine a gamma-ray energy resolution of approximately 3% at 1MeV with sub-nanosecond timing discrimination between successive gamma rays in mutually coincident decay cascades. We also review a number of recent measurements using coincidence fast-timing gamma-ray spectroscopy for nuclear structure studies, which have helped to inform the design criteria for the NANA spectrometer.

[FETAL LOSSES DURING THE MATURATION OF THE PLACENTA AND THE RELATIONSHIP WITH SOME PROCOAGULANT CONDITIONS.]

Among the major causes and risk factors for fetal loss are chromosomal abnormalities, genetic syndromes, placental abnormalities, thrombophilia (FVL, Fil G20210A, C677T MTHFR, PAl-1 4G /-5G), infection and inflammation (IL-3, IL-4, IL-17, IL-10), antiphospholipid syndrome, maternal diseases such as hypertension, diabetes and obesity. Pregnancy is a prothrombotic state as a result of specific physiological changes with multifactorial ethio-pathogenesis, leading to increased procoagulant factors and structural changes turned a sTasis, inflammatory component and contribution of individual genetic and acquired thrombophilic risk factors. Understanding of the molecular mechanisms of control over the process of embryogenesis, placentation and fetal development and impact of the factors of hemodtasis, inflammation and apoptosis, contributes to the application- of appropriate therapy and increase the chance of successful completion of pregnancy.

Electronic control of coherence in a two-dimensional array of photonic crystal surface emitting lasers

We demonstrate a semiconductor PCSEL array that uniquely combines an in-plane waveguide structure with nano-scale patterned PCSEL elements. This novel geometry allows two-dimensional electronically controllable coherent coupling of remote vertically emitting lasers. Mutual coherence of the PCSEL elements is verified through the demonstration of a two-dimensional Young’s Slits experiment. In addition to allowing the all-electronic control of the interference pattern, this type of device offers new routes to power and brightness scaling in semiconductor lasers, and opportunities for all-electronic beam steering.

[ACTIVATION OF PERIPHERAL NATURAL KILLER CELLS IN WOMEN WITH REPEATED EARLY PREGNANCY LOSS]

The increased number of peripheral blood NK (pNK) cells has been discussed as a factor for embryo implantation failure and early pregnancy loss. However, the assessment of activated pNK cells with increased cytotoxic activity could be a distinct marker for immune dysregulation leading to pregnancy complications. CD69 membrane receptor expression has been measured by flow cytometry in different subtypes of pNK cells in 55 women with two or more pregnancy loss between six and twelve week of gestation with absence of any hormonal, anatomical or inherited cause for pregnancy loss and in 43 healthy women with at least one delivery at term and no history for reproductive failure. Increased expression of CD69 in CD56 positive pNK cells was found in the study group compared to controls (12.2% versus 6.5%, p<0.005). In addition, the subpopulation of CD56dim and CD56brightpNK cells in women with recurrent pregnancy loss showed increased percent of CD69 activation marker expression compared to controls (respectively 13.2% versus 7.2 p<0.005; and 4.6% versus 3.1% p=0.04). CD56brightCD16negative pNK cells (identical with those in uterine endometrium) in the investigated group has been found with higher CD69 expression compared to controls (3.3% versus 1.7%, p=0.03). Primary dysregulation in NK cells activity could be supposed in women with repeated early pregnancy loss without another underlined pathology. Investigation of active status of NK cells but not only NK cell count could be evaluation marker of impaired immunology regulation in early pregnancy development.

[SEX HORMONE INFLUENCE ON PERIPHERAL NATURAL KILLER CELLS COUNT]

Proper evaluation of immunological factors connected with pregnancy establishment increased the possibility for exact treatment in high risk gestation cases. Hormonal changes during an ovarian cycle may affect immune response, which is crucial for the embryonic implantation. Peripheral Natural killer (pNK) cells are key components of immune systems and their activities could be regulated by sex hormones. In the present study we investigated the effects of estrogen fluctuation on the number of NK cells in vivo during the early follicular and middle luteal phase of menstrual cycle. In 63 healthy women with at least one full term pregnancy and regular menstrual cycle with duration between 24 and 32 days, blood samples have been collected twice for investigation of CD3/CD16/CD56 positive lymphocytes. The mean pNK count in follicular phase was 11.6% with 4.7% variation. The median was 10.6%. The mean pNK count in luteal phase was 12.1% with 5.1% variation, respectively median for cell number 11.8%. The two-tailed t-test comparison did not find any statistical difference despite the slight elevation of pNK cells count in luteal phase. The insignificant variation in pNK cells count objected the suggestion to evaluate immunological status in women with adverse pregnancy outcome in specific phase of menstrual cycle.

The production of Neptunium-236g

Radiochemical analysis of (237)Np is important in a number of fields, such as nuclear forensics, environmental analysis and measurements throughout the nuclear fuel cycle. However analysis is complicated by the lack of a stable isotope of neptunium. Although various tracers have been used, including (235)Np, (239)Np and even (236)Pu, none are entirely satisfactory. However, (236g)Np would be a better candidate for a neptunium yield tracer, as its long half-life means that it is useable as both a radiometric and mass spectrometric measurements. This radionuclide is notoriously difficult to prepare, and limited in scope. In this paper, we examine the options for the production of (236g)Np, based on work carried out at NPL since 2011. However, this work was primarily aimed at the production of (236)Pu, and not (236g)Np and therefore the rate of production are based on the levels of (236)Pu generated in the irradiation of (i) (238)U with protons, (ii) (235)U with deuterons, (iii) (236)U with protons and (iv) (236)U with deuterons. The derivation of a well-defined cross section is complicated by the relevant paucity of information on the variation of the (236m)Np:(236g)Np production ratio with incident particle energy. Furthermore, information on the purity of (236g)Np so produced is similarly sparse. Accordingly, the existing data is assessed and a plan for future work is presented.

[Implication of PAI-1 4G/5G polymorphism in recurrent implantation failure after IVF]

During implantation, an accurate balance of coagulation, fibrin deposition and fibrinolysis is mandatory for trophoblastic invasion. Inhibition of fibrinolysis after increased activity of plasminogen activator inhibitors such as PAI-1 could impair properdeep trophoblastic invasion. This study investigated correlation between increased PAI-1 levels due to gene polymorphism (PL) 4G/5G and recurrent implantation failure after IVF procedure. Sixty one women with two or more unsuccessful IVF procedure after good quality embryo transfer and 97 health women with at least one normal delivery were investigated for carrier status for PL 4G/5G (genotype 4G/4G) and serum levels of anti-cardiolipin (ACA) and anti-beta2-glycoprotein antibody level (IgG and IgM type). The prevalence of genotype 4G/4G in women with RIF was about two times higher compared to controls although the difference did not rich significance (respectively 41% and 26.8%, OR 1.9, 95%CI 0.91-3.96, p=0.09). The prevalence of polymorphism was similar after exclusion of for women with elevated levels of ACA (respectively 42.1% and 26.8%, OR 1.99, 95%CI 0.94-4.21, p=0.075). PL 4G/5G could be possible risk factor forimpaired embryo implantation. The causative hypofibrinolysis due to increased PAI-1 levels should be interpreted in context of multifactor complexity of recurrent implantation failure development. A discussion remains for fraction heparin application and endometrial receptivity modulation in very early pregnancy wastage.

[Reproductive problems in women with PCOS, the impact of PAL-1 CARRIERS OF 4G PAI -1 polymorphism and BMI]

Approximately 7-12% of women in reproductive age are affected by PCOS[2] and 40 to 70 percent of them are overweight contributing to the clinical picture of PCOS and increased reproductive and metabolic disorder. In order to investigate the role of PAl-1 as a possible risk factor for the development of PCOS a group of 67 women with polycystic ovarian disease and 70 healthy controls were investigated for levels of PAI-1 and carriage of the promoter polymorphism 675 4G/5G in gene of PAl-1. The results of the DNA analysis showed a high carriage of polymorphism 675 4G/4G in promoter of PAI-1 gene in women with PCOS but not as significant (OR = 1.6645, p = 0.141). Serum levels of PAI-1 were significantly higher in total group of patients compared to controls. The levels of PAI-1 is correlated with carriage of 675 4G/5G polymorphism in the gene for PAI-1 (R = 0.534, p = 0.03) as well as wih BMI, like correlation coefficients were higher in the group with PCOS (0.572, p = 0.04). Data from the disease history showed a higher percentage of women with reproductive problems: 61.5% (early pregnancy loss and infertility) significantly higher in the group with PCOS (70.1% compared to 54.1%). The carriers of polymorphism 4G are at greater risk for early pregnancy loss than those with 5G (61.45% as compared to 36.8%), which confirms that carriage of the polymorphism 4G/5G 675 gene PAI-1 has a specific in multifactorial pathogenesis and expression of PCOS.

[Preplacentation pregnancy loss in cases of angiotensin-converting enzyme insertion/deletion polymorphism]

The balance between coagulation and fibrinolysis processes is critical for establishment and development of early pregnancy. Angiotensin-converting enzyme (ACE) is related with plasminogen activator inhibitor-1 activity which is a key regulator in embryo implantation. Therefor polymorphisms in ACE gene and variation in ACE activity could be associated with an early pregnancy wastage risk. This study investigated carrier status for insertion/deletion (I/D) polymorphism in introne 16 of ACE gene in 71 women with two or more pregnancy loss in preplacentation period (between 10 and 14 weeks of gestation) and 75 women without pregnancy complications. DD genotype for I/D polymorphism was found respectively in 31% and 24% in patients and controls. Heterozygosity of D allele was found correspondingly in 47.9% and 54.7%. The dominant genetic model was used for allele prevalence comparison. D allele in DD genotype was not significantly prevalent in women with early pregnancy wastage compared with the control subjects, OR = 1.42, 95% CI (0.64-3.15). The study found a weak association between I/D polymorphism and preplacentation pregnancy loss. The additive effect over the pregnancy loss risk of I/D polymorphism could be supposed in a presence of other inherited or acquired factors connected with endometrial receptivity and implantation process.

[Reproductive problems in women with PCOS, the impact of PAI-1 carriers of 4G PAI-1 polymorphism and BMI]

Approximately 7-12% of women in reproductive age are affected by PCOS[2] and 40 to 70 percent of them are overweight contributing to the clinical picture of PCOS and increased reproductive and metabolic disorder. In order to investigate the role of PAl-1 as a possible risk factor for the development of PCOS a group of 67 women with polycystic ovarian disease and 70 healthy controls were investigated for levels of PAl-1 and carriage of the promoter polymorphism 675 4G/5G in gene of PAI-1. The correlation with BMI was checked. The results of the DNA analysis showed a high carriage of polymorphism 675 4G/4G in promoter of PAl-1 gene in women with PCOS but not significant (OR = 1.655; p = 0.141), as well in the total group of the patient (OR =1.474; p>0.05). Serum levels of PAI-1 were significantly higher in total group of patients compared to controls. The levels of PAI-1 is correlated with carriage of 675 4G/5G polymorphism in the gene for PAI-1 (r=0.534; p=0.03) as well as with BMI, like correlation coefficients were higherin the group with PCOS (0.572; p=0.04). Data from the disease history showed a higher percentage of women with reproductive problems: early pregnancy loss 48.5% and infertility 23.2%, significantly higher in the group with PCOS (58.1% compared to 32.4%). The carriers of polymorphism 4G are at greater risk for early pregnancy loss than those with 5G (61.45% as compared to 36.8%), which confirms that carriage of the polymorphism 4G/5G 675 gene PAl-1 has a specific in multifactorial pathogenesis and expression of PCOS.

[A weak association of 677 C>T polymorphism in MTHFR with recurrent embryonic loss]

Early (embryonic) pregnancy loss before 10 week of gestation (wg) could also be related with endometrial receptivity as well as with gene expression regulation in developed embryo. Methylation of genome is a key process in the gene expression. Because the methylenetetrahydrofolate reductase (MTHFR) have had significant role in methionine metabolism polymorphisms into the gene could be related with early embryonic development. This study evaluated relationship between T allele in 677 C>T polymorphism in MTHFR and recurrent embryonic loss development. One hundred six women with tree or more pregnancy loss before 10 wg and 165 women without reproductive failure have been evaluated for 677 C>T carrier status. Sixteen (15.1%) of women with pregnancy loss have had TT genotype and 54 (50.9%) are heterozygous carriers for T allele. T allele frequency was higher but not significant differ from carrier status in control group (13.9% for TT genotype and 43.9% for CT OR and 95% CI respectively 1.1, 0.52-2.3 u 1.34, 0.8-2.26, p > 0.05). T allele (in homozygous and heterozygous carriers) was in higher but not significant prevalence in patients compared with controls (66% and 57.6% respectively, OR 1.43, 95% CI 0.84-2.46, p > 0.05), This study found a weak association between T allele carrier status (both in homozygous and heterozygous state) and recurrent embryonic loss development. T allele in 677 C>T polymorphism could be considered like an agent for early pregnancy wastage only in a constellation with other risk factors influencing embryonic development.

[Factor V Leiden in women with repeated IVF failures]

A plenty of factors have been connected with embryo implantation and further fetus development. Recurrent implantation failure (RIF) after assisted reproductive technology (ART) forces seeking the causes of decreased endometrial receptivity. A non-haemostatic function of thrombophilic mutations such as Factor V Leiden (FVL) was considered a factor related with endometrial receptivity. One hundred eighty eight women with two or more RIF after in vitro fertilization procedures investigated for carrier status for FVL was compared with carrier status of 97 women without reproductive failure who give a birth of at least one health child. There was no significant difference in carrier status for FVL in patients and controls (5.9% and 7.2% respectively, OR 0.80, 95% CI (0.26-2.73, p>0.05). Negligible higher prevalence of FVL was fond in health subjects compared with women with RIF A slightly positive relationship was found between FVL and embryo implantation. A preliminary determination of thrombophilic status in RIF women could specify needing or rejection of anticoagulant therapy during implantation period.

Laparoscopic vs open resection for rectal carcinoma--a prospective analysis

In the recent years, laparoscopic surgery has established itself worldwide as a method of treatment for colorectal cancer. Several prospective randomized trials comparing laparoscopic with open resection of the colon, showing the advantages of laparoscopic surgery in terms of a shorter hospital stay, faster recovery of intestinal transit and physical activity in equivalent survival and recurrence rate. However, in many of the studies the data on laparoscopic resection for rectal cancer are scarce and it is still controversial.

AIM

In this report, we aimed to make a comparative analysis of the clinical and oncological outcomes after laparoscopic and open rectal resection in patients with a rectal cancer.

MATERIAL AND METHODS

We compare and analyze prospectively data from two groups of patients with rectal cancer--66 undergoing laparoscopic and 47 undergoing open rectal resection respectively. Both groups were selected with comparable demographic characteristics (gender, age, body mass index), ASA class (American Society of Anesthesiologists), tumor stage, type of neoadjuvant radiochemotherapy and operations. The data were statistically processed.

RESULTS

The mean age was 61, body mass index ranged from 18 to 42. The frequency of conversion was 6.06%. Postoperative complications were similar in both groups, except for wound infection was lower for the laparoscopic group (p = 0.02). The laparoscopic group had a shorter hospital stay (7 and 5 days respectively p < 0.01), faster recovery of intestinal motility (3 and 4.5 days respectively, p < 0.001) compared with the open group. Three-year survival rate and the rate of local and late recurrences were identical in both groups.

CONCLUSIONS

Laparoscopic surgery is applicable in the treatment of rectal cancer with similar oncologic outcomes compared with conventional surgery and has all the advantages of miniinvasive methods. There is a need for further randomized studies to refine the applicability of laparoscopic rectal resection for cancer.

Analysis of sleep fragmentation and sleep structure in patients with sleep apnea and normal volunteers

Sleep disorders have a high prevalence. Sleep disorders are recognized first by the complaint of nonrestorative sleep. A quantification of the disorder is done by the investigation in a sleep laboratory. The investigation in the sleep laboratory examines the EEG, EOG and EMG to derive sleep stages. This is a labor intensive sleep scoring after the polysomnography investigation. Usually the time course of the sleep stages is quantified in terms of percentages of stages related to total sleep time and the latencies for the individual stages. The additional feature of transitions between sleep stages and the disruption of sleep, which corresponds to periods of wakefulness during sleep are not evaluated systematically. We have evaluated these transitions using a statistical approach. We have detected systematic differences in the distributions o sleep stages and wake states during sleep. This differences were investigates in normal subjects and patients with sleep apnea. Then these differences were investigated in different species. The difference in the distributions can be explained only by fundamentally different regulation of sleep and wakefulness.

[Platelet intregrin beta3 A1/A2 polymorphism in women with stillbirth]

Maternal thrombophilia was recently discussed as possible cause for pregnancy complication, although the roles of some coagulation factors have not been clarified. Carrier status for platelet integrin beta3 polymorphism A1/A2 (PL A1/A2) was considered as possible risk factor for pregnancy complication. Seventy women with one or more stillbirth (intrauterine fetal death after 20 week of gestation) and 100 healthy control subjects were evaluated for PL A1/A2 to assess the impact of polymorphism for late pregnancy loss. The prevalence for PL A1/A2 in women with stillbirth was higher but not significantly differs from carrier status in control subjects (respectively 28.3% and 17%, OR = 1.93; 95% CI: 0.84 - 4.45). After adjustment for carrier status for Factor V Leiden (FVL) and Prothrombin (FII) gene mutation 20210 G > A the prevalence of PL 1/A2 remains a similar (28.2% O R = 1.92; 95% Il: 0.78 - 4.75). Combined carriers status for PL A1/ A2 with FVL or III 20210 G > A have had significantly higher prevalence in investigated group comparing with control subjects (respectively 20% and 2%, p < 0.0001). An independent impact of PL A1/A2 on risk of stillbirth development is not be yet established but additive role of the polymorphism in combination with other thrombophilic factors should be considered.