Evaluation of Parameters Affecting the Occurrence of Systemic Inflammatory Response Syndrome in Patients Operated on Due to Kidney Tumors.

The application and prognostic nature of systemic inflammatory reaction syndrome (SIRS) is still being researched, as using SIRS parameters to predict patient status is cheap, efficient, fast, and easy. The study aimed to determine SIRS markers and postoperative complications occurrence in patients undergoing kidney tumor surgery, and to verify if SIRS occurrence depends on age, sex, BMI (body mass index), comorbidities, patients' general condition before the surgery, type of surgery, intraoperative blood loss, or intraoperative ischemia time. Body temperature, heart rate, respiratory rate, and leukocyte count were measured in patients (n = 285) operated on due to a kidney tumor on the first (T0) and third (T3) postoperative day. Univariable and multivariable logistic regression were used to analyze the factors affecting postoperative SIRS and complications occurrence. T0: SIRS developed in patients with higher BMI, >2 ASA points, and more substantial intraoperative blood loss. T3: SIRS developed in obese or overweight patients, with >2 ASA points, significantly higher relative HR change, lower relative body temperature change, respiratory rate, and leukocyte count. BMI values, preoperative general health status, and the amount of intraoperative blood loss in patients undergoing surgery due to a kidney tumor can contribute to SIRS occurrence. Patient's sex, age, tumor size, type of surgery, operated side, and time of intraoperative ischemia do not affect SIRS occurrence.

Personalised Approach to Diagnosing and Managing Ischemic Stroke with a Plasma-Soluble Urokinase-Type Plasminogen Activator Receptor.

BACKGROUND: The increasing incidence of ischemic stroke has led to the search for a novel biomarker to predict the course of disease and the risk of mortality. Recently, the role of the soluble urokinase plasminogen activator receptor (suPAR) as a biomarker and indicator of immune system activation has been widely examined. Therefore, the aim of the current study was to assess the dynamics of changes in serum levels of suPAR in ischemic stroke and to evaluate the prognostic value of suPAR in determining mortality risk. METHODS: Eighty patients from the Department of Neurology, diagnosed with ischemic stroke, were enrolled in the study. Residual blood was obtained from all the patients on the first, third and seventh days after their ischemic stroke and the concentrations of suPAR and C-reactive protein (CRP), as well as the number of leukocytes and National Institute of Health's Stroke Scale (NIHSS) scores, were evaluated. RESULTS: On the first day of ischemic stroke, the average suPAR concentration was 6.55 ng/mL; on the third day, it was 8.29 ng/mL; on the seventh day, it was 9.16 ng/mL. The average CRP concentration on the first day of ischemic stroke was 4.96 mg/L; on the third day, it was 11.76 mg/L; on the seventh day, it was 17.17 mg/L. The number of leukocytes on the first day of ischemic stroke was 7.32 × 103/mm3; on the third day, it was 9.27 × 103/mm3; on the seventh day, it was 10.41 × 103/mm3. Neurological condition, which was assessed via the NIHSS, on the first day of ischemic stroke, was scored at 10.71 points; on the third day, it was scored at 12.34 points; on the seventh day, it was scored at 13.75 points. An increase in the values of all the evaluated parameters on the first, third and seventh days of hospitalisation was observed. The patients with hypertension, ischemic heart disease and type 2 diabetes showed higher suPAR and CRP concentrations at the baseline as well as on subsequent days of hospitalisation. The greatest sensitivity and specificity were characterised by suPAR-3, where a value above 10.5 ng/mL resulted in a significant increase in mortality risk. Moreover, an NIHSS-1 score above 12 points and a CRP-3 concentration above 15.6 mg/L significantly increased the risk of death in the course of the disease. CONCLUSIONS: The plasma suPAR concentration after ischemic stroke is strongly related to the patient's clinical status, with a higher concentration on the first and third days of stroke resulting in a poorer prognosis at a later stage of treatment. Therefore, assessing the concentration of this parameter has important prognostic value.

Evaluation of serum human epididymis protein 4 in patients with relapsing-remitting multiple sclerosis.

BACKGROUND: So far, little is known about the properties of human epididymis protein 4 (HE4) in multiple sclerosis (MS). This type 4 glycoprotein belongs to a family of genes encoding proteins whose expression is associated with the process of spermatogenesis in the epididymis. The biological function of HE4 is not fully understood. Overexpression of HE4 has been found in several malignant tumors, particularly in ovarian cancer, as well as in mesothelioma, lung, endometrial, breast, and kidney cancers. OBJECTIVES: To evaluate serum HE4 in patients with relapsing-remitting multiple sclerosis (RRMS) as compared to healthy controls. MATERIAL AND METHODS: Fifty patients with RRMS undergoing first-line immunomodulatory treatment were enrolled in the prospective study. We analyzed correlations between serum HE4 levels and gender, age, disease duration, the Expanded Disability Status Scale (EDSS), annualized relapse rate (ARR), and magnetic resonance imaging (MRI) lesions. RESULTS: The patients from the study group had higher concentrations of HE4 than the subjects from the control group. Patients with EDSS > 2 had significantly higher concentrations of HE4. Positive correlations were found between HE4 concentrations and age as well as between HE4 concentrations and disease duration. No significant correlations were found between HE4 concentrations and EDSS or between HE4 concentrations and ARR. CONCLUSIONS: The results of the study indicate a novel aspect of the HE4 protein in the pathomechanisms of MS.

The Association between Serum Levels of 25[OH]D, Body Weight Changes and Body Composition Indices in Patients with Heart Failure.

We try to determine the association between weight changes (WC), both loss or gain, body composition indices (BCI) and serum levels of 25[OH]D during heart failure (HF). WC was determined in 412 patients (14.3% female, aged: 53.6 ± 10.0 years, NYHA class: 2.5 ± 0.8). Body fat, fat percentage and fat-free mass determined by dual energy X-rays absorptiometry (DEXA) and serum levels of 25[OH]D were analyzed. Logistic regression was used to calculate odds ratios for 25[OH]D insufficiency (<30 ng/mL) or deficiency (<20 ng/mL) by quintiles of WC, in comparison to weight-stable subgroup. The serum 25[OH]D was lower in weight loosing than weight stable subgroup. In fully adjusted models the risk of either insufficient or deficient 25[OH]D levels was independent of BCI and HF severity markers. The risk was elevated in higher weight loss subgroups but also in weight gain subgroup. In full adjustment, the odds for 25[OH]D deficiency in the top weight loss and weight gain subgroups were 3.30; 95%CI: 1.37-7.93, p = 0.008 and 2.41; 95%CI: 0.91-6.38, p = 0.08, respectively. The risk of 25[OH]D deficiency/insufficiency was also independently associated with potential UVB exposure, but not with nutritional status and BCI. Metabolic instability in HF was reflected by edema-free WC, but not nutritional status. BCI is independently associated with deficiency/insufficiency of serum 25[OH]D.

Utility of serum concentration of protein S100 at admission to the medical intensive care unit in prediction of permanent neurological injury.

INTRODUCTION: Admission to the intensive care unit (ICU) may be preceded by dramatic events leading to permanent neurological injury. Plasma S100 protein levels are proved to be clinically useful in predicting neurological outcome following cardiac arrest. It is unclear, however, whether this may be extrapolated to a broader population of ICU patients. AIM: To assess the utility of plasma S100 protein in predicting death, permanent neurological damage, or unfavourable outcome at admission to the intensive care unit. MATERIAL AND METHODS: The concentration of plasma S100 protein was established in 102 patients on admission to the ICU, regardless of their neurological status and the reason for admission. The majority of patients were admitted with various cardiac diseases, excluding trauma patients. The patients were classified into three groups with the following binary outcomes: permanent neurological deficit or restoration of consciousness; unfavourable outcome (death or survival with permanent neurological deficit) or favourable outcome; and death or survival. RESULTS: Plasma S100 protein levels at admission facilitated the identification of patients who later developed a permanent neurological deficit or regained consciousness (p < 0.0001). All patients with plasma S100 protein over 0.532 µg/l at ICU admission either developed a permanent neurological deficit or had an unfavourable outcome (death or survival with permanent neurological deficit). However, sensitivity for this cut-off value was only 48% and 40%, respectively. CONCLUSIONS: Plasma S100 protein levels over 0.532 µg/l are specific but not sensitive for both permanent neurological deficit and unfavourable outcome when assessed in a heterogeneous population at admission to the ICU.

Higher serum phosphorus is associated with catabolic/anabolic imbalance in heart failure.

BACKGROUND: A higher serum phosphate level is associated with worse outcome. Energy-demanding intracellular transport of phosphate is needed to secure anion bioavailability. In heart failure (HF), energy starvation may modify intracellular and serum levels of phosphate. We analysed determinants of serum phosphates in HF and assessed if catabolic/anabolic balance (CAB) was associated with elevation of serum phosphate. METHODS: We retrospectively reviewed data from 1029 stable patients with HF and have calculated negative (loss) and positive (gain) components of weight change from the onset of HF till index date. The algebraic sum of these components was taken as CAB. The univariate and multivariable predictors of serum phosphorus were calculated. In quintiles of CAB, we have estimated odds ratios for serum phosphorus above levels previously identified to increase risk of mortality. As a reference, we have selected a CAB quintile with similar loss and gain. RESULTS: Apart from sex, age, and kidney function, we identified serum sodium, N-terminal fragment of pro-brain-type natriuretic peptide, and CAB as independent predictors of serum phosphorus. The odds for serum phosphorus above thresholds found in literature to increase risk were highest in more catabolic patients. In most catabolic quintile relative to neutral balance, the odds across selected phosphorus thresholds rose, gradually peaking at 1.30 mmol/L with a value of 3.29 (95% confidence interval: 2.00-5.40, P < 0.0001) in an unadjusted analysis and 2.55 (95% confidence interval: 1.38-2.72, P = 0.002) in a fully adjusted model. CONCLUSIONS: Metabolic status is an independent determinant of serum phosphorus in HF. Higher catabolism is associated with serum phosphorus above mortality risk-increasing thresholds.

Serum phosphorus level is related to degree of clinical response to up-titration of heart failure pharmacotherapy.

Serum phosphorus abnormalities may pose a risk on the cardiovascular system. In heart failure (HF) phosphorus homeostatic mechanisms are altered and may be modified by modern HF therapy. The impact of therapy optimization on phosphorus abnormalities and related outcome remains unknown. In 722 patients with HF subjected to treatment up-titration we analyzed the prevalence of serum phosphorus abnormalities and their relation to HF severity on top of optimal treatment, and we assessed adjusted risk of phosphorus abnormalities at different stages of HF. We analyzed predictors of hypo- and hyperphosphatemia and relation to prognosis. Hypophosphatemia was associated with better response to therapy, was more prevalent in milder HF, and the association was independent of age, sex, BMI, etiology of HF, kidney function and the use of diuretics. Hypophosphatemic patients lost more phosphorus into urine. They had also less catabolic profile. Patients with hyperphosphatemia on top of optimal therapy responded worse to treatment. Hyperphosphatemia was more prevalent in advanced HF, but the effect was attenuated after adjustment for potential confounders. Clinical and biochemical profiles of hyperphosphatemics suggested domination of catabolism. Neither hypophosphatemia nor hyperphosphatemia modifies the outcome Serum phosphorus abnormalities are related to HF severity on top of optimal therapy. Hypophosphatemia occurring on HF up-titration therapy likely has a multifactorial pathophysiology comprising of urinary phosphorus wasting and refeeding effects. Hyperphosphatemia is linked to the catabolic profile but the effect of renal impairment can't be ruled out. The prognostic impact of serum phosphorus abnormalities remain to be established.

Evaluation of usefulness of hs-CRP and ferritin assays in patients with nasal polyps.

BACKGROUND: Chronic nature of the nasal polyps, tendency to recurrence, and lack of satisfying treatment need the diagnostic's parameters which show early inflammatory state as ferritin and hs-CRP. The Aim of Study. Assessment of hs-CRP and ferritin blood levels in nasal polyps patients in evaluation of treatment efficacy. METHODS: All 38 patients were divided into 2 groups. Group I included 19 patients with anti-inflammatory therapy 2 weeks after surgery. Group II included 19 patients without anti-inflammatory therapy 2 weeks after surgery. The levels of hs-CRP and ferritin have been assessed before and 2 and 6 weeks after surgical treatment. RESULTS: Research showed statistically significant difference of ferritin's concentration between examined groups 6 weeks after surgery (P < 0.05) and statistically significant difference of hs-CRP concentration 2 and 6 weeks after surgery (P < 0.05). CONCLUSION: (1) The analysis of serum ferritin and hs-CRP concentrations can be useful in early postoperative detection of inflammatory state in patients with nasal polyps and for the effectiveness of therapy. (2) Lack of correlation between mean ferritin and hs-CRP serum levels, at each diagnostic and monitoring stage, shows that they are independent and cannot be determined interchangeably.

Antibodies against Hsp60 and Hsp65 in the sera of women with ovarian cancer.

BACKGROUND: The aim of this study was to evaluate the concentrations of IgG antibodies against Hsp60 and Hsp65 in sera of patients with ovarian cancer at various stages of clinical progress and for different histopathological types of disease. METHODS: Serum samples from 149 patients with ovarian carcinoma and 80 healthy women were investigated. The concentrations of anti-Hsp60 and anti-Hsp65 antibodies were determined using the enzyme-linked immunosorbent assay technique. RESULTS: The mean concentrations of anti-Hsp60 and anti-Hsp65 antibodies in the patients with ovarian cancer did not differ significantly from the mean levels in healthy women. Analysis in relation to the clinical progression stage showed that the concentrations of these antibodies were higher when the neoplastic process was less advanced and at early stages significantly higher than in control group. Mean concentrations of both antibodies were not significantly different in relation to the histological type of the ovarian cancer. The use of chemotherapy as a primary anticancer treatment did not cause a significant change in the concentration of anti-Hsp60 antibodies, but the mean level of anti-Hsp65 after this treatment was significantly higher than in control group. CONCLUSIONS: The immunological response to Hsp60/65 is increased in early clinical stages of ovarian cancer and the level of anti-hsp60/65 antibodies may be then a helpful diagnostic marker. Even antibodies against highly homologous Hsps may be cross-reactive only partially and differ by some functional properties.

[The usefulness of evaluation of: ferritin, ultrasensitive CRP and tissue specific polypeptide 18th (TPS) in assessment of therapy efficacy in patients with nasal polyps]. / Wartosc oznaczen wybranych parametrów diagnostycznych: ferrytyny, ultraczulego CRP i rozpuszczalnych fragmentów cytokeratyny 18. (TPS) w ocenie skutecznosci terapii chorych z polipami nosa.

BACKGROUND: Chronic rhinosinusitis with nasal polyps is social, clinical and cost-effective problem, by reason of bothersome symptoms, chronic nature of the disease, tendency to recur and lack of satisfying treatment. AIM: The aim of this study is assessment of suitability of hsCRP, ferritin and blood levels in nasal polyps patients in evaluation of treatment efficacy. METHODS: The study enrolled 38 patients between 20 and 68 years of age. Patients were divided into 2 groups. Levels of ultrasensitive CRP ferritin and TPS have been measured in all patients. The ultrasensitive CRP levels have been measured by chemiluminescence method. Ferritin levels have been measured by MEIA method. The TPS levels have been measured by chemiluminescence method. RESULTS: Comparison of mean ferritin levels in both study groups in each stage of observation shows the significant difference of mean values in only 6 weeks after surgery. Mean ferritin level is significantly lower in group I than in group II (p<0.05). Mean hsCRP levels vary from one corresponding to ferritin levels. Statistically significant difference between study groups in 2nd and 6th week after surgery has been ascertained (p<0.05). Similarly, like in ferritin levels, the TPS levels are significantly different in 6th week after surgery. CONCLUSIONS: Analysis of ferritin, hsCRP and TPS serum levels indicates that these may be useful in assessment of treatment efficacy in patients with nasal polyps. Rise of the chosen inflammatory state parameter level in the postoperative monitoring and anti-inflammatory treatment introduction in nasal polyps patients may inhibit the recurrence of the disease.

Five-year survival of patients with chronic systolic heart failure of ischemic and non-ischemic etiology: analysis of prognostic factors.

INTRODUCTION: Despite advances in pharmacotherapy, electrotherapy and interventional treatment, chronic heart failure (HF) is still associated with poor long-term outcome. AIM OF THE STUDY: To determine the death rate and risk factors in patients with HF of ischemic and non-ischemic etiology in five-year follow-up. MATERIAL AND METHODS: Consecutive patients with chronic systolic HF hospitalized in the period 2006-2008 were analyzed retrospectively. Study exclusion criteria were: infections (< 3 months before hospitalization), hemodynamically significant valve disease, advanced chronic kidney disease, liver cirrhosis and neoplastic diseases (< 5 years before hospitalization). RESULTS: The analysis encompassed 266 patients divided into two groups: Group A, with HF of ischemic etiology (n = 157), and Group B, with HF of non-ischemic etiology (n = 109). Mortality was significantly higher in Group A than in Group B (49% vs. 28.4%, p = 0.001). The independent risk factors for death in Group A were: New York Heart Association (NYHA) class (HR = 1.81; p < 0.001); concentrations of high-sensitivity C-reactive protein (hs-CRP) (HR = 1.01; p < 0.05), fibrinogen (HR = 1.04; p < 0.001) and N-terminal prohormone brain natriuretic peptide (NT-proBNP) (HR = 1.02; p < 0.001); and right ventricular end-diastolic diameter (RVEDd) (HR = 1.07; p < 0.01). In Group B they were age (HR = 1.07; p < 0.05) and NT-proBNP concentration (HR = 1.03; p < 0.001). CONCLUSIONS: Mortality was significantly lower in Group B than in Group A. The independent risk factors for death in Group B were age and NT-proBNP serum concentration, whilst in Group A they were NYHA class, serum concentrations of hs-CRP, NT-proBNP and fibrinogen, and RVEDd.

Depression is the strongest predictor of long-term outcome in patients with chronic nonischemic heart failure.

INTRODUCTION: Despite advances in medicine, chronic heart failure (CHF) still remains a significant clinical problem associated with poor outcome. AIM OF THE STUDY: To determine risk factors for major adverse cardiac events (MACE) in three-year follow-up in patients with CHF of nonischemic etiology. MATERIAL AND METHODS: The prospective study included consecutive hospitalized patients with stable CHF (LVEDD > 57 mm; LVEF < 40%) and symptom duration > 6 months. Study exclusion criteria were: serious neurological and/or psychiatric diseases, stenoses in epicardial coronary arteries in coronarography, active myocarditis confirmed by myocardial biopsy, diseases of the respiratory system with pulmonary hypertension, presence of heart defects, neoplastic or connective tissue disease, documented infectious diseases at least three months before inclusion in the study, diabetes, liver cirrhosis, chronic kidney disease (eGFR < 30 ml/min/1.73 m(2)), alcoholism, planned heart transplantation. Depression severity was assessed with the Beck and the Hamilton Scales. Depression was diagnosed based on the ICD-10 criteria. Clinical follow-up began on admission and lasted three years. RESULTS: The analysis encompassed 199 patients aged 49 (41-54), who met the inclusion/exclusion criteria. Depression was diagnosed in 30% of the patients. Independent factors increasing the risk of MACE (death, transplantation, ventricular assist device, hospitalization) were: depression (HR: 2.26; p < 0.001), E/A index (HR: 1.31; p < 0.01), right ventricular dimension (HR: 1.06; p < 0.01), hsCRP level (HR: 1.06; p < 0.01) and alkaline phosphatase activity in blood serum (HR: 1.01; p < 0.05). CONCLUSIONS: Factors affecting 3-year outcome are: depression, right ventricular dimension, the E/A index, alkaline phosphatase activity and the level of high-sensitivity C-reactive protein (hs-CRP).

Low health-related quality of life is a predictor of major adverse cardiovascular events in patients with chronic nonischemic heart failure.

INTRODUCTION: The need to indentify patients with chronic heart failure (CHF) at a higher risk of major adverse cardiovascular events (MACEs) has become increasingly important; therefore, new parameters, such as health-related quality of life (HRQoL), are gaining ground. THE AIM OF THIS STUDY: The aim of this study was to determine the risk factors for MACEs, with a special emphasis on HRQoL in chronic non-ischemic heart failure (NIHF) patients. MATERIAL AND METHODS: This prospective study enrolled 271 hospitalized patients with heart failure symptoms (NYHA II and III), without neoplastic disease, diabetes, hepatic cirrhosis or chronic kidney disease, who had been receiving optimal medical treatment. In all the patients, laboratory examinations, electrocardiography, echocardiography, a 6-minute walking test, invasive right heart pressure measurements and coronary angiography were performed. HRQoL assessment was conducted with the Short-Form Health Survey (SF-36). Clinical observation commenced on admission to the hospital and lasted 3 years. Data concerning MACE incidence (death, transplantation, circulatory support, hospitalization) were obtained during outpatient visits. RESULTS: The final analysis enrolled 202 patients, while 17 patients were lost to follow up. The MACE incidence was 42.1%. Major adverse cardiovascular events risk factors in multiple factor analysis were: alkaline phosphatase (hazard ratio [HR] = 1.01; p < 0.05); right ventricular end-diastolic diameter (HR = 1.08; p < 0.001); hsCRP (HR = 1.04; p < 0.05); and the following HRQoL indices: Bodily Pain (HR = 0.98; p < 0.05) and Mental Health (HR = 0.97; p < 0.01). CONCLUSIONS: Low values for HRQoL parameters (Bodily Pain and Mental Health), right ventricular end-diastolic diameter, serum concentration of hsCRP and alkaline phosphatase are prognostic factors in NIHF patients.

Plasma insulin, leptin, adiponectin, resistin, ghrelin, and melatonin in nonalcoholic steatohepatitis patients treated with melatonin.

Insulin resistance, oxidative stress, and an abnormal production of adipokines and cytokines are implicated in the pathogenesis of nonalcoholic steatohepatitis (NASH). Recently, we reported a significant improvement in plasma liver enzymes among patients with NASH treated with melatonin. In this study, we investigated the effect of melatonin, administered at a dose of 10 mg/day for 28 days to 16 patients with histologically proven NASH on insulin resistance (HOMA-IR), on the plasma levels of adiponectin, leptin, ghrelin, and resistin. Additionally, plasma levels of aminotransferases and gamma glutamyltranspeptidase as well as plasma concentrations of melatonin were evaluated. Median baseline values of HOMA-IR, leptin (ng/mL), and resistin (pg/mL) in patients with NASH were significantly higher in comparison with controls: 4.90 versus 1.60, 10.70 versus 4.30, and 152 versus 91, respectively. Median adiponectin level (µg/mL) was decreased in patients compared to controls: 6.40 versus 16.25; no significant difference in ghrelin levels between patients and controls was found. After melatonin treatment, the median value of HOMA-IR was significantly reduced by 60% as compared to baseline values, whereas adiponectin, leptin, and ghrelin plasma levels rose significantly by 119%, 33%, and 20%, respectively; the difference between pre-/posttreatment in plasma resistin levels was not significant. These findings make melatonin a suitable candidate for testing in patients with NASH in the large controlled clinical trials.

Three­year survival of patients with chronic systolic heart failure due to hypertension: analysis of prognostic factors.

INTRODUCTION: Despite advances in medicine, chronic systolic heart failure (CHF) due to hypertension still constitutes a serious clinical challenge. OBJECTIVES: The aim of the study was to determine risk mortality factors in a 3-year follow-up of patients with CHF due to hypertension. PATIENTS AND METHODS: The study involved 140 consecutive stable inpatients with CHF (left ventricular end diastolic diameter >57 mm; left ventricular ejection fraction [LVEF] <40%), without epicardial artery stenosis (>30% vessel lumen), significant heart defect, diabetes, neoplastic, disease, or chronic kidney disease, with a minimum 5-year history of hypertension, and administration of angiotensin-converting enzyme inhibitors (or angiotensin II receptor antagonists), ß-adrenolytics, spironolactone and furosemide for 3 or more months. The follow-up began on admission to the hospital after laboratory tests, resting electrocardiogram and echocardiogram, six-minute walk test, coronarography, and endomyocardial biopsy. Late follow-up data was obtained from the follow-up visits or by telephone. RESULTS: The analysis involved 130 of 140 patients aged 47.8 ±7.9 years. The 3-year mortality rate was 18.5%. Independent risk factors for death were LVEF (hazard ratio [HR], 0.881; 95% confidence interval [CI], 0.797-0.975, P <0.05), serum glucose (HR, 1.266; 95% CI, 1.085-1.627; P <0.05), N-terminal pro-B-type natriuretic peptide (NT-proBNP; HR, 1.369; 95% CI, 1.166-1.671; P <0.001), and bilirubin levels (HR, 1.057; 95% CI, 1.021-1.094; P <0.01). CONCLUSIONS: Beside LVEF and serum NT-proBNP, other independent risk factors for death in patients with CHF due to hypertension are glucose and bilirubin levels.

VEGF and metalloproteinase 2 (MMP 2) expression in gastric cancer tissue.

BACKGROUND: Neoplasms are the second leading cause of death in Poland after vessel diseases, despite the huge progress in medical sciences in the last 20 years. Recently, gastric cancer morbidity has decreased, but mortality is still at a high level. MATERIAL/METHODS: Tissues from 24 patients with a histopathologically diagnosed mucosal and adenomucosal gastric cancer were tested. Patients were divided into 2 equal groups: patients without metastases (G1) and patients with metastases in the liver (G2). In all tested tissues of G1 and G2, the expression of VEGF (vascular endothelial growth factor) and metalloproteinase 2, respectively, were estimated. RESULTS: Results revealed a statistically significant increase in the VEGF expression for G1 and G2 in relation to the margin (p1<0.001; p2<0.001). The increase of gene expression for VEGF did not significantly differ statistically in G1 and G2. The obtained results revealed a statistically significant difference in the increase of gene expression for MMP-2 in G1 in relation to the margin (p<0.05) and a very high one in G2 in relation to the average margin value (p<0.001). A highly statistically significant correlation was obtained for VEGF and MMP-2 in the tissue of patients with metastases (p<0.001; r=0.714). The highly elevated expression of MMP-2 in the tissue of gastric cancer in patients with metastases confirms its participation in the invasiveness of the neoplasmatic process. CONCLUSIONS: The highly significant correlation between VEGF and MMP-2 suggests a connection between both mechanisms in the progression of gastric cancer.

Plasma homocysteine concentrations in mothers and term and preterm newborns.

AIM: To assess the correlation between homocysteine concentrations and gestational age, gender Apgar score, complications in pregnancy delivery modalities and levels of vitamin B12 and foliate. MATERIAL AND METHODS: Concentration of homocysteine, vitamins-B12, foliate were measured in cord blood and mother blood. There were 40 full-term babies and 38 preterm babies and their mothers. RESULT: The homocysteine concentration in newborns correlated with homocysteine level in mothers. There was no difference in homocysteine level regardless of newborns gender. There was no correlation in the homocysteine concentration of mothers blood and cord blood with the levels of vitamin 812 and foliate. In full-term newborns a significant increase in homocysteine levels in comparison with premature babies was observed (7.2 +/- 1.4 micromol/ vs. 6.4 +/- 1.3 micromo/l; p = 0.01). Additionally negative correlation between the mothers' age and homocysteine concentration (r = -0.23; p = 0.04) and positive correlation between homocysteine concentration in cord plasma and gestation age (r = 0.28; p = 0.01) were found. CONCLUSION: Homocysteine concentration depends on gestational age, Apgar score and mother's age. There is no correlation between homocysteine level and hypertension during pregnancy type of delivery levels of vitamin 812 and foliate. Determination of homocysteine level is therefore of no significant importance in newborns pathophysiology.

[Usefulness of evaluation of soluble fragment cytokeratin 18, carcinoembryonic antigen and gastrointestinal carcinoma-associated antigen in diagnostic of patients with colorectal cancer]. / Przydatnosc oznaczen rozpuszczalnego fragmentu cytokeratyny 18., antygenu karcynoembrionalnego oraz mucynopochodnego antygenu (CA 19-9) w diagnostyce chorych na raka okreznicy i odbytnicy.

Colorectal cancer is one of the most frequent malignant neoplasms which affects humans. Last year studies indicate a constantly increasing inception rate. Multidisciplinary teams direct all their efforts towards detection of cancer in it's asymptomatic phase. In parallel with development of diagnostic imaging is development of clinical immunodiagnostics. The last allows for quantitative determination of active neoplasmic process markers. In the following article authors show the most frequent markers used in immunodiagnostic. Colorectal cancer known as "tumor burden markers CEA, CA 19-9 as well as the "new one" tissue polypeptide specific antigen proliferation marker--TPS.

The diagnostic utility of S-100B protein and TPA in patients with ischemic stroke.

OBJECTIVE: The aim of the study is to asses blood plasma concentrations of S-100B protein and Tissue Polypeptide Antigen (TPA) in patients with confirmed ischemic stroke and to correlate these concentrations with stroke severity. METHODS: S-100B protein and TPA blood plasma concentrations were determined in 47 patients with acute ischemic infarction and in the control population. S-100B protein was assessed on the 1th day, TPA on the 1th, 7th and 14th day. The clinical status was documented using Scandinavian Stroke Scale. The functional deficit after the stroke was scored by Barthel Index. RESULTS: The analysis of the entire examined group in relation to the control population showed elevated concentrations of S-100B protein (0.47 ng/ml vs. 0.19 g/ml). The highest concentrations were in the severe stroke group (0.89 ng/ml). The assessment of TPA blood plasma concentrations showed higher ones in the examined group of patients: 225.7 U/l on the 1st day; 96.1 U/l on the 7th day; 125.64 U/l on the 14th day after the stroke in relation to the control population. CONCLUSION: The analysis of obtained results showed significant increase of S-100B protein blood plasma concentrations in patients with severe stroke and TPA in patients with mild stroke. S-100 protein blood plasma concentration assessed on the 1st day after the ischemic stroke is the parameter presenting the highest diagnostic utility and its value above 0.6 ng/ml was obtained only in patients with severe stroke.

Is serum protein electrophoresis useful in separating the "high risk group" in patients with colonic polyps?

BACKGROUND: Adenomas have the highest potential or clinical value from among colonic polyps of developing into adenocarcinoma. The aims of this paper are: to establish criteria to identify the high risk group of patients in a group of patients with colonic polyps, to work out a simple scheme for follow-up care after endoscopic polypectomy, and to establish indications for surgery. The usefulness of determination of electrophoresis of serum proteins has been specially analysed to detect early development of malignant growths in patients with colonic polyps regarding alfa-1/alfa-2 and alfa/beta. 67 cases - 21 women, 46 men were tested. Follow-up endoscopy with the electrophoresis was performed after 6 weeks, 6 and 12 months after polypectomy. 97 polyps were resected with endoscopy in 67 patients. 38 patients (39.17%), those constituting the high risk group, were selected. Included were all polyps with grade II and III of cellular differentiation. CONCLUSIONS: 1) alfa-1/alfa-2 and alfa/beta is a helpful test in identifying the high risk group among patients with colonic polyps and it can be used as a screening test, 2) the determination of beta-2-macroglobuline is not useful in the diagnosis of this group of patients, 3) the electrophoresis of proteins should be the first test to perform on patients with colonic polyps. The relation of electrophoresis to endoscopic polypectomy aids evaluations of patients specially predisposed to malignant.