Presence and content of kynurenic acid in animal feed.

Kynurenic acid (KYNA) was found to be an antagonist of iontropic glutamate receptors and alpha7 nicotinic acetylcholine receptors. Furthermore, it was documented that KYNA is an agonist of G-protein coupled GPR35 receptors which are mainly present in the gastrointestinal tract. It was also found that KYNA is present in the gastrointestinal tract and that its concentration gradually increases along it. The origin of KYNA in the gastrointestinal tract is not known. Both might be synthesized from tryptophan in it or absorbed from food and other dietary products. Therefore, the aim of the study was to investigate the concentration of KYNA in animal feed. The results indicate that the highest concentration of KYNA was found in animal feeds intended for livestock. The lower amount of KYNA was detected in animal feeds for fish. Interestingly, the lowest amount of KYNA was found in dog and cat feeds. Furthermore, an analysis of KYNA content in animal food ingredients was conducted. The concentration of KYNA found in one of the ingredients ­ rapeseed meal ­ was several times higher in comparison to animal feeds studied. The content of KYNA in the remaining feed ingredients tested was significantly lower. This is the first report on the concentration of KYNA in animal feeds. There is a need for further detailed analysis leading to establishing a set of guidelines for animal feeding.

Cardiovascular disease in psoriatic post-menopausal women.

BACKGROUND: It is generally accepted that the risk of cardiovascular disease (CVD) in women is significantly increased after the menopause. Hormonal changes associated with the menopausal transition may also alter the course of autoimmune diseases. It has been reported that menopause may exacerbate the symptoms of rheumatoid arthritis, systemic sclerosis and giant cell arteritis, but attenuate the course of systemic lupus erythemathosus. There is a growing body of literature indicating that the course of psoriasis may be altered by menopausal hormone changes. Considering the fact that both psoriasis and menopause are independent risk factors for CVD, and that menopause may exacerbate the course of psoriasis, a possible additive effect between these two conditions may be crucial for proper monitoring and treatment of peri- and post-menopausal psoriatic patients. OBJECTIVE: The aim of this study is to analyse potential relationship between psoriasis, menopausal status and risk of CVD. MATERIALS AND METHODS: A retrospective analysis of the Clalit Health Services database was performed in an attempt to provide new data and the available literature concerning these issues was reviewed. Data on cardiovascular events in 10 872 female psoriatic patients and 19 471 controls were extracted and compared. RESULTS: In both psoriatic and control patients the association of CVD increased with age. The association of CVD was significantly greater in psoriatic patients, but no significant differences were found between any of age groups. CONCLUSIONS: The association of psoriasis and CVD in women increases with age but there is insufficient evidence to confirm that menopause increases the risk of psoriasis. Further studies directly addressing this issue are needed.

Septic course of chronic pancreatitis caused by infected visceral pseudoaneurysm content.

Visceral pseudoaneurysms occur in approximately 4-10% of all patients with chronic pancreatitis and in untreated cases the mortality rate can reach 90% of cases. The septic course of visceral pseudoaneurysm formation adds major problems to the complex treatment of these patients: Namely the removal of infected material and the occlusion of the ruptured visceral artery significantly complicate treatment strategy. The aim of this report is to present the case of a patient with severe sepsis due to chronic pancreatitis complicated by pseudoaneurysm formation of the gastroduodenal artery in the head of the pancreas. A 32-year-old man underwent semi-urgent surgery after initial haemodynamic stabilization and urgent diagnostic processing including color-coded abdominal duplex sonography, angio-CT, angiography and endoscopic retrograde cholangio-pancreaticography. The removal of infected pseudoaneurysm content was performed and preceded by the extra-pancreatic ligatures of the gastroduodenal and right-sided gastro-epiploic arteries. Blood transfusions could be avoided and the postoperative outcome was uneventful. The rare septic course of visceral pseudoaneurysm complicating chronic pancreatitis may be treated successfully by open surgical technique, with consecutive elimination of the septic focus and the occlusion of ruptured and feeding arteries performed as a one-step procedure.

[Extended small bowel resection with right hemicolectomy after massive superior mesenteric artery embolism, management in early postoperative period]. / Rozlegla resekcja jelita cienkiego polaczona z prawostronnym wycieciem okreznicy w przebiegu zatoru tetnicy krezkowej górnej, postepowanie we wczesnym okresie pooperacyjnym.

Intensive care management in recent postoperative period in nine patients with superior mesenteric artery embolism was provided. In all patients during surgical treatment an extensive resection of small bowel and right colectomy were performed. On the basis of physiopathological mechanisms of occlusional bowel ischemia and septic shock development the appropriate therapeutic procedure during pre and postoperative period was submitted. The authors suggest usefulness of the antibiotic prophylaxis in patients with high risk of measenteric embolism in order to decrease the dynamics of septic complications in the cases with bowel necrosis.

[Single stab wounds causing multiple trauma]. / Pojedyncze przenikajace rany klute jako przyczyna obrazen wielonarzadowych.

The authors presented their two-year experience regarding diagnosis and treatment of 6 patients with single stab wounds causing polytrauma. In 4 cases the thoracoabdominal penetrating wounds were diagnosed. Emergency x-ray of the chest and ultrasonographic examination of abdomen were diagnostic in 1 case (17%). Five patients (83%) were operated in first three hours after trauma with good results. In 1 case (17%) delayed operation was complicated by left pyothorax. The results of this study indicated that patients with stab wounds causing polytrauma should be operated urgently in order to avoid complications and improve prognosis.

[Antibacterial treatment in patients after extended bowel resection with ileo-cecal valve removal--personal experience]. / Leczenie przeciwbakteryjne chorych po rozleglych resekcjach jelita cienkiego polaczonych z usunieciem mechanizmu zastawkowego kretniczo-katniczego--doswiadczenia wlasne.

Small bowel infection in patients that underwent extensional bowel resection is one of causal mechanisms of massive diarrhoea in postoperative period. The aim of this study was to investigate clinical importance of ciprofloxacin efficacy in treatment of massive diarrhoea in patients after extensional bowel resection with removing of ileo-coecal valve (EBR + ICVR). From group of 21 patients that underwent EBR + ICVR the postoperative period survived only 11. In 9 cases massive diarrhoea and sepsis was observed. Routinely applied three-drugs antibacterial therapy based on penicillin or first-generation cephalosporin, aminoglycoside and metronidazole was efficient in 18% of patients only. The ciprofloxacin was used as a second-shot therapy in patients which did not realt on routine three-drugs antibacterial management. In all cases the clinical efficacy was observed as recessing of diarrhoea and septic symptoms. On the basis of our experience we suggest that in patients with massive diarrhea due to ascending contamination of small bowel after extensive resection with removal of ileo-coecal valve, ciprofloxacine is the treatment of choice.

[P21-ras protein in tumors of the large intestine]. / Bialko p21-ras w rakach jelita grubego.

We carried out a prospective analysis of cytoplasmatic accumulation of p21ras protein-a Ki-ras gene product. The study was completed on the group of 80 patients with sporadic colorectal cancer. p21ras protein was detected immunohistochemically with use of NCC-001 antibody. In 64/80 cases (80%) we found p21ras protein accumulation in the tumor. We found that the protein accumulation is present more often in poorly differentiated cancers 91.3% (42/46) than in well and intermediate differentiated 64.7% (22/34) and in the right side of the colon 100% (14/14) than in left side colon 53.3% (14/24). The differences were statistically significant (p < 0.05). We found no statistically significant differences in survival time after surgery in correlation with p21ras accumulation in tumor. Our result suggest that p21ras accumulation is not a solitary prognostic factor in sporadic colorectal cancer.

[The role of nm23 protein in progression of sporadic adenocarcinoma of the large intestine]. / Udzial bialka nm23 w rozwoju sporadycznych gruczolakoraków jelita grubego.

We analysed the nm23 protein expression in the selected group of 80 patients with sporadic colorectal cancer. nm23 protein was detected in cytoplasm with use of monoclonal anti nm23 antibody. Decreased expression of nm23 protein was found in 58/80 (72.5%) colorectal cancer samples. Positive reaction was found more often in the group A and B according to Dukes, than in the C and D. The difference was statistically significant at p < 0.05, and the occurrence was 75% vs. 15.63% respectively. We also found statistically significant difference in nm23 protein expression in well differentiated (G1) and poorly (G3) and intermediate (G2) differentiated. The positive reaction was observed in 85.71% in G1 group and 12.92% in G2 and G3 together. On the base of our study we suggest a usefulness of histochemical identification of nm23 protein expression in evaluation of metastatic potential of colorectal cancer.

[P53 protein in adenocarcinoma of the large intestine]. / Bialko p53 w gruczolakorakach jelita grubego.

P53 gen mutations play significant role in neoplastic transformation of colorectal mucosa. We investigated p53 immunostaining in 80 cases of spontaneous human colorectal adenocarcinomas (with monoclonal DO7 antibody and LSAB+ kit). We found positive, nuclear p53 immunostaining in 64% of nonmucinous adenocarcinoma tissues and in 19% of mucinous adenocarcinomas tissues. P53 protein deposits were most often found in colorectal adenocarcinomas localised in rectum (66.67%) and in advanced (Dukes C, D) colorectal adenocarcinomas (59.38%) as well. There was no statistical significance between the p53 positive immunostaining and the histological differentiation of the colorectal adenocarcinomas. The overall survival of patients with tumours positive for p53 protein was significantly shorter than that of patients with colorectal cancers negative for p53 protein. We conclude that p53 immunohistochemical analysis may be treated as a supplementary prognostic marker for patients with colorectal adenocarcinoma, especially it may be useful for adjuvant therapy selection.

[Ileocolic intussusception]. / Wglobienie jelita kretego spowodowane guzem zapalnym zastawki kretniczo-katniczej.

A case of ileocolic intussusception in a 22-year female patient with ileocecal valve inflammatory process in presented. An absence of the acute gastrointestinal obstruction symptoms has been due to the inflammatory infiltration to the front of intussusception. Diagnostic problems in case of the intestinal intussusceptions in adults caused by non-characteristic clinical course have been emphasized.