Biomedical subjects
Publications and source records attributed to M Nowak.
Polypoid lesions composed of gastric mucosa in the jejunum are rare. The vast majority of cases of ectopic gastric tissue occur in the duodenum. In this article, we present a case of heterotopic gastric mucosa forming a giant polyp in the mid jejunum. A review of the literature is presented, and the clinical and pathologic features of this unusual lesion are discussed.
We report the case of a cavernous hemangioma with a recently developed hematoma of the umbilical cord. Because of a threatening intrauterine asphyxia an operative vaginal delivery was performed followed by pulmonary disturbance of adaptation and anemia with transfusion. Possible complications are discussed both in terms of the case-history and literature.
UNLABELLED: The purpose of our study was to analyze the efficacy of serum C-reactive protein (CRP), white blood cell count (WBC) and erythrocyte sedimentation rate (ESR) serial evaluations in the prediction of chorioamnionitis in cases of premature rupture of membranes (PROM). MATERIALS AND METHODS: A group of 80 patients with PROM before 35 weeks' gestation were evaluated prospectively and managed expectantly. We applied the expectant management with the permanent use of tocolysis, antibiotics, steroids, amnioinfusions of artificial amniotic fluid and intravaginal chemotherapeutics. Patients were monitored with frequent vital signs, fetal heart rate evaluation and everyday blood tests as follows: CRP, WBC and ESR. All afterbirths were examined to establish the presence of histologic chorioamnionitis (gold standard of intrauterine infection). RESULTS: 59 (73.7%) patients had significant chorioamnionitis on histopathology and only 15 of them had clinical chorioamnionitis. Serum CRP serial determinations (definition of abnormal tests: 1) > 1.2 mg/dl; 2) > 2.0 mg/dl; 3) > 1.2 mg/dl and increasing in two consecutive days) were found the most reliable with a sensitivity 1) 91.5%; 2) 85%; 3) 88%, specificity 57%; 76%; 86%, positive predictive value 86%; 90%; 94.5%, negative predictive value 70.5%; 64%; 72% and accuracy 82.5%; 82.5%; 87.5% respectively. The efficacy of WBC (abnormal tests: > 12500/mm3; > 15000/mm3; > 12500/mm3 and increasing in two consecutive days) and ESR (abnormal tests: > 60 mm/h; > 60 mm/h and increasing in two consecutive days) serial evaluations was significantly lower. Moreover, in cases of chorioamnionitis CRP increased above the upper limit of normal 3 days earlier than WBC or ESR. CONCLUSIONS: CRP was found the most reliable indicator of histologic chorioamnionitis and indicated the presence of intrauterine infection earlier than WBC or ESR.
UNLABELLED: The purpose of this study was to evaluate the influence of dexamethasone administration on selected markers of infection during the expectant management of premature rupture of membranes (PROM). MATERIALS AND METHODS: A group of 80 patients with PROM before 35 weeks' gestation were evaluated prospectively and managed expectantly. All patients were managed in the hospital. All pregnancies had ultrasonographic evaluations to confirm gestational age, rule out lethal anomalies, and document oligohydramnios. We applied the expectant management with the permanent use of tocolysis, antibiotics, steroids (4 mg of dexamethasone every 8 hr for 2 days, every week), amnioinfusions of artificial amniotic fluid and intravaginal chemotherapeutics. Patients were monitored with frequent vital signs, fetal heart rate evaluation and everyday blood tests as follows: C-reactive protein (CRP), white blood cell count (WBC) and erythrocyte sedimentation rate (ESR). After completing 25 weeks antenatal fetal surveillance included a nonstress test at least once a day. All afterbirths were examined to establish the presence of histologic chorioamnionitis. In order to eliminate the influence of intrauterine infection we analyzed only the results obtained of patients without histologic chorioamnionitis (n = 24). RESULTS: WBC raised significantly in the first day of steroidotherapy (mean: 14,895/mm3), was elevated in the second day (15,716/mm3) and the day after (15,100/mm3), and decreased to the normal limit in the second day after steroids (12,316/mm3); p < 0.001. There were no statistically significant differences in the results of CRP and ESR connected with the administration of dexamethasone. CONCLUSIONS: Dexamethasone administration caused the independent of infection and temporary elevation of WBC. We did not observe such influence on the results of CRP and ESR.
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In addition to their regular meal service, most of the major domestic and international airlines offer special meals. It should be noted that regular meal services on international flights often give a choice of meals, even in economy class, and often include a salad and or fruit dish, which could be consumed by most people. More airlines also seem to be moving towards having at least one more culturally appropriate meal on the menu, particularly for relevant flight sectors. However, these meals may be inappropriate for some passengers, and there is a need for this special meals service. Meals services on airlines have improved greatly in recent years, particularly with the employment of consultant dietitians to the catering staff of airlines and advances in chef training. Special meal services are designed to cater to the most common variations of meals required by most passengers for medical, religious, or other reasons. The special requirements for these meals are described elsewhere.1 It is important to realize that the meals are designed and the ingredients interpreted by that airline, and may not necessarily reflect what the traveler might eat at home. So it is important to advise travelers not to have high expectations of this special meal service. This paper aims to provide some basic practical advice for selection of special diets for airline travelers.
Dynamic exercise increases the transcranial Doppler determined mean blood velocity in basal cerebral arteries corresponding to the cortical representation of the active limb(s) and independent of the concomitant rise in the mean arterial pressure. In 12 rowers we evaluated the middle cerebral artery blood velocity response to ergometer rowing when regulation of the cerebral perfusion is challenged by stroke synchronous fluctuation in arterial pressure. Rowing increased mean cerebral blood velocity (57 +/- 3 to 67 +/- 5 cm s-1; mean +/- SE) and mean arterial (86 +/- 6 to 97 +/- 6 mmHg) and central venous pressures (0 +/- 2 to 8 +/- 2 mmHg; P < 0.05). The force on the oar triggered an averaging procedure that demonstrated stroke synchronous sinusoidal oscillations in the cerebral velocity with a 12 +/- 2% amplitude upon the average exercise value. During the catch phase of the stroke, the mean velocity increased to a peak of 88 +/- 7 cm s-1 and it was in phase with the highest mean arterial pressure (125 +/- 14 mmHg), while the central venous pressure was highest after the stroke (20 +/- 3 mmHg). The results suggest that during rowing cerebral perfusion is influenced significantly by the rapid fluctuations in the perfusion pressure.
The subcutaneous injection of 5'-bromo-2' deoxyuridine (BrdU) was found to raise the plasma concentrations of ACTH, aldosterone and corticosterone in rats. The aldosterone response was observed at a lower dose of BrdU and lasted for a longer period than those of ACTH and corticosterone (1.25 versus 2.50 mg/100 g body weight; 48 versus 24 h). Corticosterone response to BrdU was partially reversed by the ACTH-receptor antagonist corticotropin-inhibiting peptide (CIP), and aldosterone response by the arginine vasopressin (AVP) V1-receptor antagonist [amino-Pen1, Val4,D-Arg8]-vasopressin (AVP-A). The angiotensin-II (ANG-II)-receptor antagonist [Sar1, Val5, Ala8]-ANG-II (SAR) was ineffective. CIP, AVP-A and SAR, when administered alone, did not alter basal levels of ACTH, aldosterone and corticosterone. In light of these findings the following conclusions can be drawn: (i) BrdU stimulates the hypothalamo-pituitary-adrenal axis in rats, and this effect may influence the results of cell-kinetics studies carried out with the BrdU-labelling technique, especially in those tissue that are highly responsive to glucocorticoids (e.g. pituitary, adrenal and lymphatic tissues); and (ii) different mechanisms underlie the aldosterone and corticosterone secretagogue effects of BrdU, the former being at least in part dependent on the stimulation of AVP release and the latter on the rise in ACTH secretion.
Endothelins (ETs) and their receptor subtypes A and B (ETA and ETB) are expressed in the various components of the mammalian hypothalamo-pituitary-adrenal (HPA) axis, but their involvement in the functional regulation of HPA is controversial. To gain insight into this topic, we have investigated the effects of ET-1 and/or the specific antagonists of ETA and ETB receptors (BQ-123 and BQ-788, respectively) on the plasma concentrations of ACTH, corticosterone and aldosterone of non-stressed (control) and ether- or cold-stressed rats. The study of the effects of the administration of the two ET-receptor antagonists alone could provide informations about the possible action of endogenous ETs on the HPA axis. Exogenous ET-1 increased ACTH, corticosterone and aldosterone blood levels in control rats, as well as evoked a sizable enhancement of the HPA axis response to ether stress and a marked depression of the response to cold stress. BQ-123 and BQ-788 did not prevent the stimulatory effect of exogenous ET-1 in control rats, but when administered alone, raised the plasma concentrations of ACTH, corticosterone and aldosterone. Both ET-receptor antagonists magnified the HPA axis response to ether and cold stresses, but their effect was not counteracted by exogenous ET-1. Although very difficult to interpret, our present findings allow us to conclude that endogenous ETs play a role in the maintenance of the basal activity of rat HPA axis acting through ETA and ETB receptor subtypes, which are partially insensitive to BQ-123 and BQ-788. Conversely, the involvement of ETs in the modulation of the HPA axis responses to various stresses is very doubtful.
After more than a decade of intensive research, the precise role of human immunodeficiency virus (HIV)-specific cytotoxic T lymphocytes (CTL) in determining the course of the infection remains open to argument. It is established that HIV-specific CTL appear early in the infection and are temporally associated with the clearance of culturable virus from the blood; that CTL are generally detectable at very high levels throughout the asymptomatic phase and decline at the time of progression to AIDS; and that CTL-mediated killing is sufficiently fast to prevent production of new virions by HIV-infected cells. However, viral turnover is high throughout the course of the infection, and infected individuals progress inexorably to disease in spite of the CTL response. In order to address the question of whether CTL play an active part in influencing the course of HIV infection, one approach has been to seek evidence for CTL-mediated selection pressure on the virus. Several clear examples of CTL epitope-specific mutations selected to fixation are described. We argue that CTL escape is a common event which occurs at all stages of the infection. Detailed longitudinal studies are required to detect CTL escape and to understand the complexities contributed by factors such as a polyvalent CTL response and the presence of epitope variants which antagonise the CTL response. In conclusion, there is strong evidence of a dynamic process in which CTL impose important selection constraints upon HIV from which the virus attempts to escape; ultimately, at the time of disease progression, the tenuous control of CTL over the virus is lost.
Serum cathepsin B-like activity was determined in 75 patients with ovarian carcinomas and in control groups. Ovarian cancers were of FIGO stages I-IV. Control groups consisted of 15 healthy women, 20 patients with myomas of the uterus, and 17 with benign ovarian cysts. Preoperative results showed elevated cathepsin B-like activity in 100% of the patients with ovarian cancers in relation to healthy subjects and patients with myomas, and in 78% in relation to benign ovarian cysts. Cathepsin B activity increased progressively with the FIGO stage of the disease, but the differences among particular stages were not statistically significant. In serous tumours cathepsin activity was significantly higher only in comparison to endometrioid ones (p < 0.001). Antipapain capacity of cystatins in the sera was also determined. No significant correlation between cathepsin B-like, and antipapain activity of cystatins was found. Serum cathepsin B-like activity may be helpful in the preoperative differential diagnosis between ovarian carcinomas and benign ovarian or uterine tumours.
PURPOSE: To evaluate the plasma concentration of P I CP and P III NP as markers of the connective tissue metabolism in human with and without POAG. The mechanical properties of the collagen could be one of the common factors involved in the pathogenesis of chronic open angle glaucoma. MATERIAL AND METHODS: P I CP and P III NP were studied in serum in 20 patients with POAG and in 10 healthy subjects using RIA method. RESULTS: The concentration of P III NP in the blood serum was markedly increased (3.99 +/- 1.5 micrograms/l) compared with control group (2.84 +/- 0.77 micrograms/l), p < 0.05. There was not significant difference in concentration of P I CP in both groups.
Inflammation plays the main role in the pathogenesis of asthma. Glucocorticosteroids (GS), as the most effective anti-inflammatory drugs are widely used in asthma treatment. So far the mechanism of action, both molecular and on the level of tissues and organs has not been entirely explained. In this work molecular mechanism of glucocorticosteroids action is discussed especially in aspect of therapy. The influence of GS on adrenocortical function is also presented.
Organochlorine pesticide levels were determined in Neotropical migrant passerines which have populations reported to be declining. Pesticide residues ranging from 0.385 to 27.4 ng/g were found in 19 of 21 birds, including both Hatch Year (HY) and After Hatch Year (AHY) age classes of nine different species. Eighteen of the 19 birds contained p,p'-DDE, while dieldrin was found in 16 birds and heptachlor epoxide was present in 10 birds. There were no significant differences in pesticide levels between HY and AHY birds, suggesting that HY birds are exposed to pesticides in their diet on the breeding ground or that pesticides are acquired from contaminated mothers, or both. Pesticide levels were not related to gender. Although the effects of these low residue levels on passerine fecundity are unknown, their presence has potential conservation implications for passerines and for the raptorial birds that feed upon them.
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Substance P (SP) did not change basal corticosterone (B) secretion of dispersed zona fasciculata-reticularis cells of the rat adrenal cortex. Conversely, spantide II (SPA), an antagonist of SP receptors, at a concentration 10(-7)/10(-6) M markedly raised it, and the effect was annulled by equimolar concentrations of SP. Both SP and SPA (10(-6) M) increased cytosolic free calcium concentration in our cell preparations; however, the response to SP was immediate, while that to SPA showed a lag-period of 4-5 min. SP concentration-dependently (from 10(-8) M to 10(-5) M) partially inhibited maximally ACTH (10(-8) M)-induced stimulation of B secretion of dispersed cells, and unexpectedly a similar effect was observed after SPA exposure. In light of these findings, the conclusion is drawn that SP, under basal conditions, does not exert a direct modulatory action of B secretion of rat adrenocortical cells. However, the possibility remains to be explored that SP may play a role in quenching, via a receptor-independent mechanism, the exceedingly high glucocorticoid responses to ACTH of rat adrenocortical cells.
DNA alkylating agents such as 1,2-dimethylhydrazine (SDMH) and azoxymethane (AOM) are potent carcinogens and are widely used to induce colon tumors in experimental animals. However, standard bacterial mutagenesis assays have failed to detect the mutagenic effects of these chemicals. Using derivatives of a set of Escherichia coli test strains developed by Cupples and Miller (Proc. Natl. Acad. Sci. USA, 86, 5345, 1989), we hve demonstrated that under two conditions, SDMH and AOM induced point mutations by several-fold in a dose-dependent manner: (i) of six possible base substitutions, they only induced GC-->AT transitions; and (ii) the cells must be deficient in O6-methylguanine (O6MeG) DNA methyltransferase (MTase) activity. SDMH and AOM up to 200 microg/ml were unable to induce His+ revertants in a Salmonella Ames test strain TA1535 (GC-->AT); however, in the absence of mammalian S9 extract, His+ revertants increased up to 55-fold upon treatment of an isogenic Salmonella strain deficient in MTase activity. These results indicate that SDMH and AOM are indeed bacterial mutagens and that lesions induced by them are the target of DNA repair MTases, which probably include mutagenic and carcinogenic lesions such as O6MeG. Furthermore, variable responses of bacterial species to SDMH- and AOM-induced mutagenicity suggests a difference either in the metabolism of potential mutagens or in the repair of specific lesions. Since O6MeG is not only a mutagenic lesion but also a lethal lesion if left unrepaired, we compared the mutagenicity and toxicity of SDMH and AOM with an SN-type methylating carcinogen. N-methyl-N'-nitro-N-nitrosoguanidine, and conclude that SDMH and AOM are weak bacterial mutagens.
OBJECTIVE: To describe the beliefs, attitudes and behaviours of North Queensland adolescents about weight, weight loss and body shape, and to examine the influence of gender. METHODOLOGY: A questionnaire was used to survey 791 year 8 adolescents from private schools in north Queensland. RESULTS: Only 41% of the girls and 54% of the boys were satisfied with their weight; 52% of the girls and 27% of the boys wanted to lose weight; 52% of the girls thought their thighs were too fat and 26% of the boys thought their stomachs were too fat. When surveyed, 35% of the girls and 22% of the boys were trying to lose weight. CONCLUSIONS: The weight loss drive, so prevalent in our culture, is already apparent among 12-14 year old schoolchildren. The challenge is to prevent obesity without encouraging an accompanying obsession with weight loss; however, good information, appropriately delivered, may be insufficient without a change in cultural expectations and assistance from the fashion and advertising industries.