Functional polymorphisms of the receptor for the advanced glycation end product promoter gene in inflammatory bowel disease: a case-control study.

The receptor for the advanced glycation end products (RAGE) is a multiligand transmembrane receptor involved in chronic inflammation whose specific polymorphisms of the promoter gene were found to increase its transcriptional activity. We investigated the association of both allelic and genotypic -374T/A and -429T/C polymorphisms with inflammatory bowel disease. The STREGA guidelines were applied for planning and reporting. We enrolled 133 patients with Crohn's disease (CD), 149 with ulcerative colitis (UC), and 128 blood donors. Genomic DNA was extracted from peripheral blood leukocytes collected from each patient and control. RAGE polymorphisms were analyzed by PCR-restriction fragment length polymorphism assay. The Hardy-Weinberg equilibrium was first assessed, and then, the Kruskal-Wallis test and the Fisher exact test were used for etiologic group comparisons. Distribution of patients' characteristics across genotypes was evaluated by the Fisher exact test, while that across alleles was analyzed with a probit model. A 2-sided value of p < 0.05 was considered significant. Following the evidence of the Hardy-Weinberg equilibrium, we found a higher prevalence of the allele A of the -374T/A haplotype in UC (p = 0.043), and of the allele C of the -429T/C haplotype in CD (p < 0.001) with respect to the other groups. Moreover, the homozygous AA genotype of the -374T/A polymorphism resulted associated with late onset of CD, while its TT genotype with early onset (p = 0.049). The allele C of the 429T/C haplotype was associated with early onset of UC (p = 0.03), while a higher frequency of the heterozygous TC haplotype was found in those with pancolitis (p = 0.026). The differing distribution of these polymorphisms in healthy donors and CD/UC patients suggests a role in the development and outcome of these pathological conditions.

Electrochemically deposited silver detection substrate for surface-enhanced Raman spectroscopy cancer diagnostics.

Surface-enhanced Raman spectroscopy (SERS) of blood plasma on an electrochemically prepared silver surface has been studied as a label-free, noninvasive diagnostic test for colorectal cancer. Indium tin oxide glass substrates were modified with 0.01 mol dm - 3 silver nitrate using the pulsed double-potentiostatic method. The prepared silver substrates were tested with Rhodamine 6G as a model analyte and the surface with the highest signal enhancement was selected. This silver dendritic surface was used as a diagnostic substrate for SERS measurements of human blood plasma. A group of oncological patients with declared colorectal carcinoma (n = 15) and the control group of healthy volunteers (n = 15) were compared. The biomolecular changes in chemical composition in the cancer samples were detected by statistical processing of the resulting SERS spectra. About 94% specificity and 100% sensitivity were achieved for the analysis by the ratio of the SERS peak intensity at 725 cm - 1 for adenine to the peak intensity at 638 cm - 1 for tyrosine and 100% specificity and sensitivity by using principal component analysis. This method of SERS diagnostics of colorectal cancer, which does not require the nanoparticle preparation, mixing, and incubation of plasma with a colloidal solution as in conventional tests, is a rapid, inexpensive method, which could be introduced as a primary diagnostic test.

Effect of equal daily doses achieved by different power densities of low-level laser therapy at 635 nm on open skin wound healing in normal and diabetic rats.

BACKGROUND AND OBJECTIVE: Despite the fact that the molecular mechanism of low-level laser therapy (LLLT) is not yet known, the exploitation of phototherapy in clinical medicine and surgery is of great interest. The present study investigates the effects of LLLT on open skin wound healing in normal and diabetic rats. MATERIALS AND METHODS: Four round full-thickness skin wounds on dorsum were performed in male adult nondiabetic (n = 24) and diabetic (n = 24) Sprague-Dawley rats. AlGaInP (635 nm, wavelength; 5 J/cm(2), daily dose) was used to deliver power densities of 1, 5, and 15 mW/cm(2) three times daily until euthanasia. RESULTS: PMNL infiltration was lower in the irradiated groups (15 mW/cm(2)). The synthesis and organisation of collagen fibres were consecutively enhanced in the 5 mW/cm(2) and 15 mW/cm(2) groups compared to the others in nondiabetic rats. In the diabetic group the only significant difference was recorded in the ratio PMNL/Ma at 15 mW/cm(2). A significant difference in the number of newly formed capillaries in the irradiated group (5, 15 mW/cm(2)) was recorded on day six after injury compared to the control group. CONCLUSION: LLLT confers a protective effect against excessive inflammatory tissue response; it stimulates neovascularization and the early formation of collagen fibres.

Trehalase as a possible marker of intestinal ischemia--reperfusion injury.

BACKGROUND: Different pathological affections of the small intestine cause corresponding morphological and functional changes. The present study was aimed to assess intestinal trehalase activities during ischemia and following reperfusion, correlate them with the pathological changes and determine whether trehalase could be used as a biochemical marker of the intestinal ischemia, ischemia - reperfusion injury. MATERIAL AND METHODS: Wistar rats, randomly divided into 5 experimental groups (IR) (each n=15), were subjected to one hour mesenteric ischemia followed by 0, 1, 4, 12 and 24 hours of reperfusion. As a control group sham operated animals were used (n=15). The activity of trehalase was determined using an adapted Dahlqwist method. The range of intestinal injury was determined using histological (histopathological injury index and goblet cell quantification) and immunohistochemical (Ki67, InSitu TUNEL) methods. RESULTS: The highest activities of trehalase were recorded in the control group (C=4.42 ± 0.373 µmol/mg/h). The most altered intestinal histology detected in group IR1 was accompanied by the lowest trehalase activity (IR1=0.97 ± 0.209 µmol/mg/h; p < 0.001 C vs. IR1). Improved histological structure in the remaining reperfusion periods correlated with increase in trehalase activity. Almost normal mucosal histological architecture and 72% of the enzymatic activity were restored after 24 hours of reperfusion (IR24=3.20 ± 0.266 µmol/mg/h; p < 0.01 IR1 vs. IR24). CONCLUSION: The correlation between intestinal histology and trehalase activities during intestinal injury has been shown. Trehalase activity is closely associated with the status of the histological architecture of the small intestine.

[Acute multiple organ failure after endoscopic polypectomy]. / Akútne multiorgánové zlyhanie po kolonoskopii s polypektómiou.

BACKGROUND: Serious intraabdominal infections belong among life treating diseases. They are based on spreading infections from focal sources of inflammation in abdomen or damaged intestinal wall. METHODS AND RESULTS: Treatment strategies are surgical intervention, antimicrobial therapy, distributional shock treatment and accurate nutritional support (1). Glutamine and selenium supplementation may improve intestinal functions and restore antioxidant defence (2). Septic shock with multiple organ failure accompanied by serious catabolism and decrease of albumin had developed in a patient after endoscopic polypectomy. Infection source was not discovered by medical imaging examinations non surgical laparotomy. After distributive shock treatment, wide spectral antibiotics and enteral and parenteral nutrition the patients health improved. As adjuvant therapy intravenous supplementation was administered: glutamine in daily dose 2g and sodium selenite in continual infusion in daily dose 750 µg over 6 days. During intensive therapy, inflammatory markers decreased: C-reactive protein, procalcitonin, leukocyte count and neutrophils. Albumin levels increased. CONCLUSIONS: The paper describes therapeutic options during septic shock treatment and reversion possibilities in the catabolic phase of disease.Key words: colonoscopy, septic shock, multiorgan failure, enteral nutrition, parenteral nutrition.

Obturator artery injury after hip fracture surgery.

We present the case of a 55-year-old woman who sustained a left femoral neck fracture which was managed by insertion of a dynamic hip screw. Six hours after surgery, distension appeared in the left lower quadrant of her abdomen associated with a decline in haemoglobin concentration and clinical signs of ongoing bleeding. Computed tomography showed a left retroperitoneal mass without concomitant extravasation of contrast material. Exploratory laparotomy revealed a damaged left obturator artery with a large haematoma in its vicinity. After arterial ligation and retroperitoneal space decompression her postoperative course was uneventful. Reviewing intraoperative C arm images a 0.8 cm protrusion of the threaded guide wire was identified as the cause of obturator artery damage.

Low-level laser therapy for protection against skeletal muscle damage after ischemia-reperfusion injury in rat hindlimbs.

BACKGROUND AND OBJECTIVE: Despite numerous hypotheses regarding the action of laser light, the use of low-level laser therapy (LLLT) in ischemic reperfusion (I/R) injury is still being verified. The present study investigates the effects of low-level laser irradiation (LLLI) on I/R injury of the musculus gracilis in rats. MATERIALS AND METHODS: I/R injury of the musculus gracilis flap was induced in male adult Sprague-Dawley rats (n = 84). Rats were subdivided depending on treatment into four subgroups: (1) healthy group, (2) I/R injury without irradiation, (3) R group irradiated only during reperfusion after injury, and (4) IR group irradiated during ischemia and reperfusion injury. LLLT (AlGaInP; λ = 670 nm; 4 J/cm²; 40 mW/cm²) was applied to the injured muscle four times daily until euthanasia. RESULTS: Lactate dehydrogenase (LD) levels were significantly lower (P<0.05) in the irradiated groups during the first 12-120 hours, while the lower creatine kinase (CK) level reached statistical significance only at 24 hours in the irradiated group when compared to the control group. The number of polymorphonuclear leukocytes in the gracilis muscle was significantly lower in the treated group only on the second day (P<0.0001). The lowered percentage of necrosis in the muscle tissue was statistically significant after 6 and 10 days of treatment (P<0.0001), while lower atrophy and higher neovascularization were observed at 6-14 days of irradiation (P<0.05). There was no statistically significant difference between the group irradiated only during reperfusion and that irradiated during ischemia and reperfusion. CONCLUSION: LLLT confers a protective effect against early inflammatory tissue response, further atrophy, and necrosis of the muscle and it stimulates neovascularization after I/R injury.

[Have changes in the management of treatment of the patients with acute pancreatitis brought the expected result?]. / Priniesla zmena manazmentu u chorých s t'azkou akútnou pankreatitídou ocakávaný výsledok?

BACKGROUND: Mortality from severe acute pancreatitis (AP) has remarkably decreased (10-20%) during the last decades. However, many questions on the treatment of this disease remained opened. To extend the most recent professional literature which discuses the abovementioned problem, experience from the treatment of patients at the department where the authors work is presented. METHODS: Influenced by the new methods published in professional literature and under the circumstances at own workplace, the decision to change the management of the treatment of AP has been made. The management referred to the enteral nutrition, epidural analgesy, antibiotic prophylaxis, pushing the surgical operation to the later period in the case of infected necrosis. Comparing of two groups of patients--A (2003-2005 years) and B (2006-2008 years) the authors came to interesting results. RESULTS: Applying the new protocol we observed: increased percentage of patients with sterile necrosis from 46% to 58%, decreased number of surgical re-operations from 43% to 33% and decreased mortality from 53,8% to 18%. CONCLUSIONS: Applying changes in the management of treatment of the patients with the complicated form of acute pancreatitis, the authors achieved remarkable results. Nevertheless, these results have to be evaluated very cautiously, because the group of patients who have been treated by the novel approach has not been very large.