The expression profile of genes encoding tumor necrosis factor-alpha, interleukin-6 and their receptor in benign adrenal tumors.

In the process of neoplasia, during which benign adrenal tumors are formed, stimulators of new blood vessel growth as well as growth of tumor cells are cytokines, especially tumor necrosis factor-alpha (TNF-α) and interleukin 6 (IL-6). We analyzed the expression profile of genes coding: TNF-α, tumor necrosis factor receptor 1 (TNF-R1), TNF-R2, IL-6, interleukin 6 receptor (IL-6R) in sections of adrenocortical tumor tissue, rated on the Weiss point scale, in patients with clinically diagnosed Conn's and Cushing's syndrome, and the usefulness of determining the examined genes as markers differentiating individual clinical units. There was no correlation between the expression of the examined genes and clinical parameters such as age, BMI or blood pressure, both in the entire study group and in individual subgroups. Elevated expression of the genes coding TNF-α, TNF-R2 and IL-6R was observed, whereas genes encoding TNF-R1 and IL-6 showed relatively low expression. The highest statistically significant differences in the expression of the examined genes were observed between IL-6 and IL-6R. High positive correlation was found in the subgroup of patients with Conn's clinical syndrome, between genes encoding both types of receptors for TNF-α, IL-6 and TNF-R2, TNF-α and IL-6 receptor, and between TNF-R2 and IL6-R receptors, which may suggest the mutual influence of these cytokines and their receptors on their own expression.

Omentin, vaspin and irisin in chronic liver diseases.

Omentin and vaspin are adipokines potentially considered in the development of liver pathology. Irisin is new myokin potentially participating in energy processes in the organisms. The aim of this study was to evaluate the plasma concentration of these cytokines and the relationships of them with selected parameters of laboratory tests and of histopathological changes in selected chronic liver diseases: non-alcoholic fatty liver diseases (NAFLD), primary biliary cholangitis (PBC) and alcoholic cirrhosis (AC). The plasma concentration of omentin was the highest in AC group and the lowest in control group (CG). Irisin plasma concentration was the highest in CG and the lowest in AC. Mean vaspin concentrations did not differ significantly between groups. Among many laboratory parameters, only in the AC group positive relationships were found between omentin concentration and bilirubin, as well as glucose, and negative between omentin level and the number of platelets and erythrocytes; there was a positive relationship between the concentration of vaspin and bilirubin, as well as negative between vaspin level and the number of erythrocytes or hematocrit value in this group. INR value had positive correlation with vaspin concentration and negative with irisin level in NAFLD group. No significant dependences between the concentrations of explored cytokines and laboratory tests were found in PBC group. It was found the positive correlation between the plasma concentration of irisin and fibrosis as well as inflammation in PBC group. The negative correlation between irisin level and inflammation in NAFLD was also showed. Omentin can be considered as an indicator for predicting inflammation, steatosis and balloon degeneration in NAFLD and PBC. Summarizing, it is unclear but possible that explored cytokines have some relationships with certain features of liver damage and development of chronic diseases of this organ.

Fibroblast growth factor-21 and omentin-1 hepatic mRNA expression and serum levels in morbidly obese women with non-alcoholic fatty liver disease.

Fibroblast growth factor-21 (FGF21) and omentin-1 have been recognized as potent antidiabetic agents with potential hepatoprotective activity. The aim of this study was to evaluate hepatic FGF21 and omentin-1 mRNA expression as well as their serum levels as predictive markers of liver injury and insulin resistance in morbidly obese women with non-alcoholic fatty liver disease (NAFLD). This study included 56 severely obese women who underwent intraoperative wedge liver biopsy during the bariatric surgery. Hepatic FGF21 and omentin-1 mRNA were assessed by quantitative real-time PCR, while their serum concentrations were measured with commercially available enzyme-linked immunosorbent assays. The FGF21 serum level was significantly higher in patients with a greater extent of steatosis (grade 2 and 3) compared to those without or with mild steatosis (grade 0 and 1) (P = 0.049). Receiver Operating Characteristic analysis, however, showed poor discriminant power for the FGF21 serum levels in differentiating between more and less extensive steatosis with an AUC = 0.666. There was a tendency towards higher levels of hepatic FGF21 mRNA in patients with lobular inflammation and fibrosis and towards lower levels in the case of hepatocyte ballooning and steatosis. There was a positive mutual correlation between hepatic FGF21 and omentin-1 mRNA levels (r = 0.78; P < 0.001). Fibrosis stage was associated with serum glucose and homeostatic model assessment for insulin resistance (HOMA-IR) (P = 0.03 and P = 0.02, respectively). Serum omentin-1 was not associated with histopathological features. The hepatic omentin-1 mRNA levels showed a tendency to be lower in patients with advanced steatosis and hepatocyte ballooning. In conclusion, our study, which focused on hepatic FGF21 and omentin-1 mRNA expression, confirmed marked expression of both molecules in the liver of morbidly obese patients with NAFLD. More extensive steatosis was associated with evident changes in the serum FGF21 concentration in morbidly obese women with NAFLD, but the difference did not reach statistical significance. The vast amount of fat, both visceral and subcutaneous, in severely obese patients may be the additional source and influence the FGF21 and omentin-1 serum levels.

The role of the tissue plasminogen activator as a prognostic and differentiation factor in patients with pancreatic cancer and chronic pancreatitis.

Unsatisfactory pancreatic cancer treatment outcomes have prompted multiple avenues of research focused on identifying not only biomarkers of pancreatic adenocarcinoma progression but also potential prognostic survival factors in patients with pancreatic adenocarcinoma. Study consisted of 75 patients who underwent pancreatic resections between 2006 and 2011: 35 patients with pancreatic ductal adenocarcinoma (PC), 30 patients with chronic pancreatitis (CP), and a non-malignant control group (NMCG) of 10 patients who underwent surgery due to benign tumors. Tissue plasminogen activator (t-PA) concentrations in tissue homogenates and sera were evaluated. The mean t-PA concentration in PC tissue homogenates was 12.3 ± 2 (7.5, 15) ng/mg. Compared with the t-PA concentration in the PC group, lower concentrations of t-PA (3.3 ± 0.7 (2.2, 4.7) ng/mg and 5.9 ± 0.8 (4.6, 7.3) ng/mg (P < 0.01)) were observed in tissue homogenates of the CP and the NMCG patients, respectively. Although serum concentrations of t-PA did not differ between patient groups, in PC patients, the t-PA concentrations were higher in sera than in tissue homogenates. In contrast, the CP and NMCG patient groups had lower t-PA concentrations in sera compared with tissue homogenates. Increasing tissue homogenate t-PA concentrations were associated with blood vessels infiltration. Tissue homogenate and serum t-PA concentrations were not related to the survival rate of patients with PC. The t-PA concentration above 7.45 ng/ml in tissue homogenates was indicative of PC. We concluded that higher concentrations of t-PA were observed in pancreatic cancer tissue compared to chronic pancreatitis, suggesting its potential role in the development and progression of pancreatic cancer. In contrast, the lack of significant differences in the serum t-PA concentrations between treatment groups suggests that serum t-PA concentrations may not be suitable as a biomarker for the diagnosis of pancreatic cancer.

Limited usefulness of histopathological features in identification of a clinically aggressive solid-pseudopapillary neoplasm of the pancreas.

Solid-pseudopapillary neoplasms (SPN) are rare tumours of the pancreas. Distant metastases and/or local recurrence following surgical resection occur in 10% to 15% of patients with SPN. In the present study, we aimed to systematically examine the usefulness of virtually all histopathological features of SPN which were previously considered potential risk factors of clinically aggressive behaviour of SPN following surgical resection. Seventeen SPN were included. None of the cases had an undifferentiated component. Follow-up data were available for 14 patients (median 52 months). One patient developed liver metastasis 17 months after resection of the primary tumour and fulfilled the criteria of a clinically aggressive disease. None of the histopathological features allowed identification of that case with an adequate diagnostic yield. At present, histopathological examination cannot identify patients who may develop tumour recurrence following resection of the primary lesion. A close follow-up should be offered to all patients treated for SPN.

Multifocal type of pilomatrixoma.

Pilomatrixoma is a benign skin neoplasm that arises from hair follicle matrix cells. The skin lesion occurs usually as a solitary tumor and the multifocal types are very rare. Skin changes can be described as a firm to hard, non-painful, oval-shaped tumor that is covered by normal skin. It commonly occurs on a scalp, face, neck and rarely back and extremities. Complete surgical excision with the proper margin is the treatment of choice, what guaranteed the radical therapy of pilomatrixoma. In this paper case of 16-years-old male patient with many solid tumors in subcutaneous tissue on both arms will be reported. The first skin lesion appeared on the left arm 6 years ago. Clinically the disturbance was diagnosed as an atheroma, and it was excised. One year after surgical procedure the patient observed the appearance of new nodules on both arms. In the therapy surgical excision was performed with histopathological examination of the tissues. Histopathological test has proved the clinical diagnosis of pilomatrixoma. The case of multifocal pilomatrixoma, which is rarely diagnosed and described in professional literature, will be presented.

[Recurrent disseminated intravascular coagulation in the course of gastrointestinal stromal tumor (GIST)]. / Nawracajacy zespól rozsianego wykrzepiania wewnatrznaczyniowego w przebiegu gastrointestinal stromal tumor (GIST).

The objective of this paper was the description of a case of 68-year old male patient with epithelioid gastrointestinal stromal tumor (GIST). Disseminated intravascular coagulation syndrome (DIC) as the first and predominant revealed symptom of disease was observed. The final diagnosis was performed using the specific immunohistochemic and ultrastructural assays. The diagnostic and therapeutic difficulties were presented in discussion.

[Morphological picture of alimentary tract in the process of food allergy in children]. / Obraz morfologiczny przewodu pokarmowego w przebiegu alergii pokarmowej u dzieci.

Morphological and histopathological changes in the mucosa of the stomach, duodenum and small and large intestine have been evaluated in 83 children aged between 12 months and 15 years with diagnosed food allergy. The examined patients were analysed depending on clinical symptoms. Among 23 children aged 7-15 years, in whose clinical picture abdomen pains dominated, endoscopic examination of upper part of alimentary tract was performed. In 22 children (66.6%) macroscopic changes in stomach mucosa were observed. Histopathological examination of excisions from optically changed places showed variations in 13 children (39.3%). In 43 children aged 12 months--8 years with dominating symptoms of protracted diarrhoea and/or body mass deficiency, biopsy of small intestine mucosa was examined. In 13 children (30.2%) subtotal villus atrophy was observed, in 14 children (32.5%)--partial and in 16 children (37.3%) no small intestine mucosa atrophy was noticed. In all patients lymphocytic infiltrations occurred in small intestine mucosa lamina propria. Large intestine inflammation was observed in food allergy process in 7 children. In the cases of food allergy in children the inflammation changes in mucosa can be seen in all of its sections. Over 2/3 of examined children with food allergy showed inflammation and inflammation-atrophical changes in alimentary tract mucosa.

[A rare case of multiple neoplasms of parotid gland: adenolymphoma and squamous cell carcinoma]. / Rzadki przypadek pierwotnego mnogiego nowotworu slinianki przyusznej: gruczolakotorbielaka limfatycznego i raka plaskonablonkowego.

The authors have presented a very rare case of multiple primary neoplasms of parotid gland: adenolymphoma and squamous cell carcinoma. Primary multiple neoplasms and multifocal neoplasms are a very complex problem and therefore have been a topic of many articles. The authors describe mechanism of origin, frequency of occurrence, possibilities of diagnostics. The main reason of these neoplasms origin are simultaneously exposure of the tissue to damaging factors and special tissue sensitivity.

[Histological and clinical analysis of mesenchymal malignant neoplasms (soft tissue sarcomas) of head and neck region in the data of I ENT Department of Silesian Medical Academy]. / Analiza histokliniczna nowotworów zlosliwych pochodzenia mezenchymalnego (miesaków tkanek miekkich) regionu glowy i szyi na podstawie materialu operacyjnego I Katedry i Kliniki Laryngologii Slaskiej Akademii Medycznej w Katowicach.

Between the years 19890-1998 in I ENT Department of Silesian Medical Academy were treated surgically 15 patients suffering from soft tissue sarcomas of head and neck region. Patomorphological examination showed: fibrosarcoma (4 cases), haemangioendothelioma malignum (2 cases), rhabdomyosarcoma (2 cases), schwannoma malignum (2 cases), fibrohistiocytoma malignum (2 cases), tumor mixtus mesenchymalis (1 case), haemangiopericytoma malignum (1 case), extrasceletal osteosarcoma (1 case). Sarcomas were localised in paranasal sinuses (7 cases), orbita (5 cases), parapharyngeal space (1 case), parotid gland (1 case) and bucca (1 case). All those patients were treated surgically and most of them were irradiated postoperatively. The authors have presented the diagnostic and methods of treatment of soft tissue sarcomas. According to our experience and data of the literature the method of choice in treatment soft tissue sarcomas should consist of surgery and radiation therapy postoperatively.

Neurogenic tumors of the digestive tract: report of two cases.

We report two female patients with neurogenic tumors of the digestive tract. In the first patient, the tumor of 10 cm diameter originated in the stomach and at preoperative CT imitated a peripancreatic cyst. In the second patient, the tumor of 6 cm diameter originated in the duodenum. Despite large size, the tumors were clinically indolent and escaped detection at routine endoscopic evaluation. In both cases the neoplasm was removed and postoperative histopathology combined with immunohistochemistry was consistent with diagnosis of digestive Schwannoma.

[A case of laryngeal mucoepidermoid carcinoma]. / Przypadek raka sluzowo-naskórkowego w krtani.

The authors present a very rare case of laryngeal mucoepidermoid cancer. Well separated and encysted tumor was totaly removed with Kleinsasser method.

[A rare case of multiple primary malignant neoplasms of parotid gland: fibrosarcoma and squamous cell carcinoma]. / Rzadki przypadek pierwotnego mnogiego nowotworu zlosliwego slinianki przyusznej: wlókniako-miesaka i raka plaskonablonkowego.

Primary multiple malignant neoplasms and multifocal neoplasms are a very complex problem and therefore have been a topic of many articles. The mechanism of origin, frequency of occurrence, co-existence of neoplasms in functionally similar organs (uterus, mammary gland), heredity, a possibility of diagnostic and therapy are the most interesting aspects. Frequency of multiple primary malignant neoplasms occurrence is about 2-8% and still increases. Pathogenesis of multifocal and multiple neoplasms has rarely been a subject of articles. A simultaneous exposure of a tissue to damaging factors and special tissue sensitivity are the main reasons for neoplasms origin in this group. The authors present a rare case of parotid gland multiple neoplasm: fibrosarcoma and squamous cell carcinoma, as well as discuss the diagnostics, therapy, and prognosis of multiple neoplasms.

Morphological picture of the mucosa of small intestine in children with food allergy.

40 children aged from 1 to 8 years with failure to thrive, suspected of food allergy were examined. In the small intestine biopsy, normal mucosa or atrophy of intestinal villi of various intensity were found. Eosinophilic infiltration in the submucosa was present. In children over the 3rd year of life, "prick" skin test was performed, confirming polyallergy. Total IgE level was tested in all patients but only in 25% of children was it elevated.

[Primary adenoid carcinoma of the larynx and upper part of trachea]. / Pierwotne raki gruczolowato-torbielowate w krtani i w odcinku szyjnym tchawicy.

The aim of this study is presentation of two cases primary adenoid cystic carcinoma in subglottic part larynx and upper part trachea. Both were treated by surgical resection with following radiotherapy. Observation period in one case without any recurrent signs and neoplasmatic dissemination is 16 years.

[Focal nodular hyperplasia of the liver in doppler sonography--case report]. / Ogniskowy rozrost guzkowy watroby w ultrasonografii Dopplerowskiej. Opis przypadku.

Current diagnostic capabilities of Doppler sonography in solid focal lesions were presented. Diagnostic difficulties were discussed in the case of focal liver lesion, wherein the diagnosis was not reached by sonography backed up by pulsed and color Doppler. The patient was submitted to surgical treatment. A histological specimen disclosed focal nodular hyperplasia. The analysis of the case in question proved that sonography even combined with Doppler method cannot differentiate between hepatocellular carcinoma and focal nodular hyperplasia.