Giant breast tumour in a 13-year-old girl.

This study describes a rare case of a giant phyllodes tumor in a 13-year-old girl. The authors have conducted an analysis of the diagnostic process and have shown the results of operative treatment of the tumor. Moreover, organisational aspects of the diagnostics concerning breast diseases in patients from smaller towns in Poland have been discussed. It has been indicated that the availability of suitable diagnostics and treatment of breast diseases in children and teenagers from rural areas and smaller towns is limited.

[Symbolizm of medical institutions]. / Symboliczny wymiar wizerunku placówki medycznej.

Marketing in health service has become an indispensable tool for creating and maintaining a positive image of medical institutions which to a great extent determines their success on the market. This process entails not only providing professional, reliable and up-to-date patient care but also establishing good reputation among those who already use it and its potential customers. It should be recognizable also for deliverers, investors, competitors, media and particularly for society and local authorities. The key to success is professionalism of personnel and their identification with the mission of the institution and the direction of changes being implemented there. For a complete success and recognition is essential health care facilities, which affects virtually matched the name and symbol, and communication of people responsible for contact with the media.

[Marketing in health service--a necessity or a temporary whim?]. / Marketing w sluzbie zdrowia--koniecznosc czy chwilowa zachcianka?

Permanent changes occurring in economy and politics, open borders, a greater number of people with higher education as well as growing social awareness concerning taking care of health are followed by changes in healthcare sector. In response to an increased social demand, new medical institutions are being founded. They offer their patients a vast array of services ranging from therapeutic to preventive and highly specialized procedures improving their standard of living. In order to attract regular patients, and therefore receive regular income, it is necessary to stabilize such institutions on services market. It can be achieved by numerous marketing tools which, when applied appropriately, enable to create a positive image of a medical institution.

[Epidemiology of occupational diseases in Tarnow and Tarnow District in years 1994-2003]. / Epidemiologia chorób zawodowych w Tarnowie i powiecie tarnowskim w latach 1994-2003.

An occurance and analysis of occupational diseases found in years 1994-2003 by State District Sanitary Inspector in Tarnow among workers of working places from Tarnow and Tarnow district were presented. In the discussed decade the following occupational diseases were dominate: bilateral permanent noise - induced hearing loss of cochlear type, chronic diseases of vocal organ related to excessive vocal effort and infections and parasitic diseases or their sequels. A diversification of the occupational diseases occurance among women and men was showed. Noxious agents being the reason for occupational diseases were presented.

Effect of selected alcohol dehydrogenase inhibitors on human hepatic lactate dehydrogenase activity - an in vitro study.

Metabolic acidosis severely complicates methanol and ethylene glycol intoxications. Acidosis is caused by acid metabolites and can be intensified by lactate elevation. Lactate concentration depends on the NADH(2)/NAD ratio. Lactate dehydrogenase (LDH, E.C.1.1.1.27.) supplies more lactate when the level of NADH(2) is elevated. The aim of the study was to evaluate the effect of alcohol dehydrogenase (ADH) inhibitors and substrates: cimetidine, EDTA, 4-methylpyrazole (4-MP), Ukrain and ethanol on LDH activity. The activity of LDH was determined spectrophotometrically in human liver homogenates incubated with cimetidine, EDTA, 4-MP and Ukrain at concentrations of 2 x 10(-6), 10(-5) and 5 x 10(-5) m as well as ethanol at concentrations of 12.50, 25.00, 50.00 mm. The LDH activity was significantly increased by 10(-5) and 5 x 10(-5) m concentrations of cimetidine and 4-MP, and by all concentrations of ethanol. The most effective change of LDH activity of about 26% (P<0.01) was observed at the highest concentration of ethanol. Ukrain inhibited LDH activity at both concentrations, i.e. 10(-5) and 5 x 10(-5) m (P<0.05). However, EDTA did not significantly influence LDH activity. The data showed that ethanol and 4-MP, the main antidotes in methanol or ethylene glycol poisoning, may increase liver LDH activity - an undesirable effect during the therapy of patients intoxicated with these alcohols. On the other hand, the decrease of LDH activity in the presence of Ukrain is a promising finding but definitely requires further investigation.

Gastrointestinal and hepatic toxicity of selective and non-selective cyclooxygenase-2 inhibitors in pregnant and non-pregnant rats.

The aim of the study was to evaluate the toxicity of non-selective (tolmetin, ibuprofen and piroxicam) and selective (DFU) cyclooxygenase-2 inhibitors on pregnant and non-pregnant rats. The drugs were administered orally once (DFU, piroxicam) or three times (tolmetin, ibuprofen) a day from days 8 through 21 of gestation experiment in three doses. The initial dose was similar to the human antiinflammatory one and set as 8.5 mg/kg (tolmetin, ibuprofen), 0.3 mg/kg (piroxicam) and 0.2 mg/kg (DFU). The middle dose was increased 10 times and the highest one 100 times the initial dose. The highest dose for ibuprofen was set at 200mg/kg due to high mortality. On gestation/experimental day 21 animals were sacrificed, blood was collected and abdominal organs were taken for pathological examination. Activity of alanine and asparate aminotransferases and levels of total protein and urea were determined. Stomach, small and large intestines, and liver were grossly and histologically examined. Dose-dependent mortality, signs of gastrointestinal toxicity, and significant changes of biochemical parameters were found in groups exposed to non-selective COX inhibitors in both pregnant and non-pregnant rats. Mild regressive structural hepatic changes were observed. Significant decrease of protein level in non-pregnant rats treated with high DFU dose, and occasionally observed gastrointestinal changes were the only changes noted in groups exposed to the selective COX-2 inhibitor. Tolerability of non-selective COX inhibitors was lower in both pregnant and non-pregnant groups when compared with DFU. Insignificant mortality and histological changes were noted between pregnant and non-pregnant groups.

Effect of selected alcohol dehydrogenase inhibitors on the human heart lactate dehydrogenase activity--an in vitro study.

Metabolic acidosis complicates methanol, ethylene glycol and other alcohol intoxications. It is caused firstly by acid metabolites and secondly by the lactate elevation. The aim of the study was to evaluate the effect of alcohol dehydrogenase (ADH; EC 1.1.1.1) inhibitors and substrates: 4-methylpyrazole (4-MP), cimetidine, EDTA, ethanol and methanol on lactate dehydrogenase (LDH; EC 1.1.1.27) activity. The activity of LDH was determined spectrophotometrically in in vitro human heart homogenates with the mentioned compounds at 0.01, 0.1, 1.0 mM concentrations of 4-MP, cimetidine, EDTA, and 12.5, 25.0, 50.0 mM of ethanol and methanol. The LDH activity was significantly inhibited by 0.1 mM (p<0.05) and 1.0 mM (p<0.01) 4-MP and 1.00 mM EDTA (p<0.05). Higher LDH activity vs. control was observed in the samples incubated with all studied ethanol and methanol concentrations but these differences were not statistically significant. Thus, 4-MP was found to be the most effective inhibitor of LDH of all compounds tested. Therefore, such effect of 4-MP seems to be an additional advantage in methanol and ethylene glycol intoxications.

[Human erythrocyte lactate dehydrogenase activity changes in the presence of some alcohol dehydrogenase inhibitors]. / Aktywnosc dehydrogenazy mleczanowej ludzkich erytrocytów w obecnosci wybranych inhibitorów dehydrogenazy alkoholowej.

The aim of the study was to evaluate the effect of alcohol dehydrogenase (ADH; E.C. 1.1.1.1) inhibitors and substrates: cimetidine, 4-methylpyrazole (4MP), EDTA, ethanol and methanol on lactate dehydrogenase (LDH; E.C. 1.1.1.27) activity. The activity of LDH was spectrophotometrically determined in in-vitro prepared diluted hemolysates obtained from human erythrocytes with mentioned compounds at the concentrations 0.01, 0.1, 1.0 mM of cimetidine, EDTA, 4MP and 12.5, 25.0, 50.0 mM of ethanol and methanol. The reaction was conducted at 37 degrees C in pH 7.5 and changes of optical density was measured at lambda = 340nm. LDH activity was significantly inhibited by 0.10 mM (p < 0.05) and 1.0 mM (p < 0.01) of cimetidine and EDTA. There were no observed any significant changes vs. control in LDH activity when 4MP, ethanol or methanol was added to environment of reaction.

A developmental anomaly of the mammary glands - gigantomastia. A case report.

Developmental anomalies of the breast are frequently observed in women. The most serious pathology is gigantomastia. This type of breast hypertrophy may be caused by hypersensitivity of the breast oestrogen and progesterone receptors, by disturbances of the normal balance of oestrogen and androgen hormones, by hyperthyroidism or by hormonal activity of the neoplasm. In most cases gigantomastia produces pathological changes in the vertebral column which become manifest as discopathia, scoliosis or scoliokyphosis. A case of gigantomastia treated with surgery is presented and the effect of plastic operation is demonstrated. Surgery may be recommended as an excellent therapeutic treatment of gigantomastia.

Mammary gland anatomy and the role of mammography and ultrasonography in the early diagnostics of breast cancer. A case report.

Progress in imaging techniques has brought a solution to the problem of the early diagnosis of breast cancer. An interesting case of breast cancer is presented here, pictures of the malignant tumour are demonstrated and the usefulness of new diagnostic methods analysed. The presentation of this case may contribute to greater effectiveness in early breast cancer detection.

Axillary lymph node and early breast cancer diagnostics. A case report.

Understanding of the anatomy of the axillary lymph nodes is important in diagnostic and treatment procedures for breast cancer. An interesting case is presented here of breast cancer without a breast tumour. The first symptom of the disease was lymphadenopathy of the axillary region. This kind of case is extremely rare in clinical practise (one case per 1-5 years) and constitutes a great problem for specialists, since in many cases the primary neoplasm source is unknown. The anatomical and clinical implications of such a situation are discussed.

Activity of cathepsin B, D and L in rat cerebrum after cimetidine and famotidine administration.

Cathepsins are lysosomal enzymes that are used a sensitive markers in various toxicological investigations. The purpose of this study was to evaluate and compare the influence of cimetidine and famotidine on the cerebral cortex, particularly on the activity of cortical cathepsin B, D and L in the frontal lobe of rat brain. The drugs were administered intraperitoneally, twice a day, for six weeks to male Wistar rats in two doses. The initial dose was 2.85 mg/kg for cimetidine and 0.285 mg/kg for famotidine. The second dose was 10 times higher. Control animals were injected with 0.9% NaCl. Half of the animals from each of the drug-treated and control groups were sacrificed on the 42nd day of the experiment. The remaining animals were raised for another 6 weeks without any xenobiotics, and sacrificed on the 84th day. The frontal lobe of the right cerebral hemisphere was taken for biochemical investigation. The activities of free and bound fractions of cathepsin B, D and L were evaluated spectrophotometrically in cortical homogenates. The activity of bound fraction of cathepsin D and L decreased significantly in animals exposed to the higher dose of cimetidine and sacrificed on the 42nd day. Also significant elevation of the free fraction of cathepsin L was noted in the same group of rats. Cathepsin activities were normalized during the next six weeks. No behavioural changes were noted among the observed animals. Unlike cimetidine, famotidine did not change profiles of the cerebral cathepsins.

Hepatic lysosomal enzymes activity and liver morphology after short-time omeprazole administration.

The aim of the study was to establish the influence of short-time omeprazole administration on liver function and morphology. Omeprazole was administered intraperitoneally, twice daily, for 3 days to male Wistar rats in two doses: 0.571 mg/kg and 5.71 mg/kg. Control animals were treated with physiological saline. Half of the animals were sacrificed 12 hours after the last injection. The remaining rats were raised for another 6 weeks, without any xenobiotics, and sacrificed on the 47th day of the experiment. The activity of free and bound fractions of hepatic acid phosphatase, beta-galactosidase, beta-N-acetyl-glucosaminidase, cathepsin B, D and L, lipase, and sulphatase were determined spectrophotometrically in homogenates of the liver. The liver sections were examined by light microscopy with hematoxylin-eosin, azan, and periodic acid-Schiff stains. Marginally significant (p < 0.1) differences in activity of free sulphatase fraction, and free and bound fractions of beta-galactosidase were found in animals exposed to the higher dose of omeprazole and sacrificed 12 hours after the last injection. Enzymatic profiles were normalised during the next 6 weeks. Histological evaluation revealed small degenerative and adaptive changes in all examined groups. It could be concluded that observed differences of hepatic lysosomal enzyme activities were the result of accompanied chemical-induced peritonitis as previously reported, and not a direct drug-toxic effect.