Neck duplex Doppler ultrasound evaluation for assessing chronic cerebrospinal venous insufficiency in multiple sclerosis patients.

INTRODUCTION: Recent clinical studies have suggested a relationship between multiple sclerosis (MS) and the occurrence of pathological changes in the jugular, vertebral and azygous veins that result in abnormal blood outflow from the brain and the spinal cord. Together, these pathological changes have been designated chronic cerebrospinal venous insufficiency (CCSVI). The aim of the present study was to evaluate the usefulness of duplex Doppler ultrasound in the evaluation of central nervous system venous outflow disturbances in patients suffering from MS. METHODS: We examined 181 patients with MS, diagnosed on the basis of the McDonald criteria, and 50 healthy volunteer controls. All patients underwent Doppler ultrasound examination of the internal jugular veins (IJV) and vertebral veins (VVs). The presence of outflow disturbances and morphological abnormalities were evaluated. RESULTS: Pathological changes in the extracranial jugular veins were diagnosed in 148/181 MS patients (82%) and 7/50 control group volunteers (14%). The following abnormalities in the MS group were revealed: the presence of a reflux in the IJVs and/or VVs (54%), narrowing (54%), a complete block in the flow through the IJV (10%) and an abnormal postural control of the cerebral outflow route (25%). These particular pathologies were of statistical significance in the MS group compared with the control group. This study also revealed a correlation between the occurrence of inverted flow in patients in a sitting position and chronic progressive MS (P = 0.0033). CONCLUSIONS: The examinations undertaken indicate a possible connection between MS and CCSVI. The widely accessible and highly sensitive and specific Doppler ultrasound test may be useful for revealing, and preliminary analysis of, CCSVI pathologies.

Smooth muscle cell apoptosis in primary varicose veins.

OBJECTIVES: One of the important factors responsible for vessel wall remodelling is programmed cell death. In the paper the role of smooth muscle cell (SMC) apoptosis in primary varicose veins (PVV) is investigated. MATERIAL AND METHODS: Vein specimens were obtained from 40 patients with PVV. In each case proximal and distal (upper crural) great saphenous veins (GSV) were harvested. Morphometric computer assessed quantitative evaluation of SMCs, collagen and elastin content was carried out. Apoptotic cells were detected by TUNEL assay. The levels of p53, BAX, BCLl-2 and p21 mRNA expression were assessed by real time RT-QPCR and the presence of respective proteins in the vessel wall was confirmed by immunohistochemistry. RESULTS: In the proximal GSV segments a significant increase of p53, p21 and BCL-2 mRNA levels was found in PVV patients. In the distal segments BAX and BCL-2 expression levels were higher. Taking into account the patient age, elevated p53 mRNA expression level was noticed in the distal incompetent GSVs of young PVV patients. In this group a statistically significant increase in the apoptotic index (APIx) within the vein media was found which correlated positively with p53 mRNA expression level. There was no increase of the apoptotic activity in elderly patients that led to the structural changes increase. In proximal GSV segments, despite SMC amount reduction or presence of structural changes in perivalvular wall region, no increase of the APIx with was noticed. CONCLUSIONS: P53-related apoptosis is one of the regulatory mechanisms of vein wall homeostasis maintenance. During varicose vein development its activation is related to the early stages of the disease. In the further course, the down-regulation of the SMC apoptosis within the vein media leads to the structural changes increase. The reduction of the SMC population corresponding to an increase of p21 expression in proximal saphenous vein segments suggests that the cell cycle disturbances may lead to the 'weakness' of the proximal GSV wall. Valve injury is not the only factor leading to the varicose veins occurrence.

Fractal analysis of placenta mature villi in healthy, smoking and non-smoking women.

Not all the objects created by nature can be described by means of the classical Euclidean geometry rules. New, quickly developing fractal theory can provide another instrument for describing irregular surfaces of e.g. geometric structures and objects whose development results from growth, differentiation and degeneration processes. In the present study we decided to perform fractal analysis of mature, terminal villi of placenta taken from smoking and non-smoking women, during the third trimester of pregnancy. The aim of this study was to find another morphometric parameter, independent of subjective factors, which would provide new information about the studied structure. Placentas were taken from healthy women, untreated primiparas, who did not undergo any hormonal treatment, aged 18 to 27. The material was divided into: control group--placentas from non-smoking women, and two experimental groups--placentas from non-smoking up to 30 cigarettes daily and placentas from women smoking up to 30 cigarettes daily and placentas from women smoking over 30 cigarettes daily. Fractal dimension was determined by three methods: box counting, dilation and mass scaling method. Taking under consideration the results obtained in the present study it seems that fractal dimension, objectively and independently of many factors, allows to perform mathematical estimation of the parameter which is the terminal villi occurrence density within placenta. Among the applied fractal analysis methods, used for placenta terminal villi density grade estimation, the most useful seems to be the box counting method, whereas for estimating villi surface complication--the ratio--mass scaling method. Comparing obtained fractal dimension results, we have found that they increase together with the amount of cigarettes smoked during pregnancy.

The circadian rhythm in activity of the periodic acid Schiff reaction and of the Mg and Ca content in rat liver in relation to age and season of the year.

The experiments were carried out on male Wistar rats aged 6, 12 and 24 months, over the four seasons of the year. Analysis of the results obtained in all age groups disclosed that changes in activity of the p.a.S (periodic acid Schiff) reaction and in concentrations of Mg and Ca in the liver showed rhythmic oscillations with a period of 12 hours. The maximal p.a.S reaction activity and of Ca and Mg levels were generally found to coincide throughout all seasons and in all age groups. The rhythms of change in these parameters in 12- and 24-month-old rats showed a phase shift as compared to the 6-month-old animals.

Oral solid dosage forms that should not be crushed: 1994 revision.

This revision and update of an article published previously in Hospital Pharmacy (1992; 27:690-699) alerts healthcare practitioners about medications that should not be crushed. This list serves those who dispense and administer medications so that potential problems associated with disruption of special pharmaceutical formulations may be prevented. Products are identified that should not be crushed and for which a similar liquid form is available.

Changes in liver and kidney concentration of copper, manganese, cobalt and iron in rats exposed to static and low-frequency (50 Hz) magnetic fields.

The concentration of copper, manganese, cobalt, and iron in the liver and kidneys of fertilized and not-fertilized rats exposed to static and low-frequency magnetic fields has been analysed. Using atomic absorption spectrophotometry, no change in concentration has been observed in pregnant rats after exposure to static field. However, significant changes have been observed in fertilized animal exposed 2 hours daily to low-frequency magnetic fields. Changes in concentration of the above-mentioned metals have also been observed in the kidneys of non-fertilized female rats. It seems possible that alternating magnetic fields may have an influence on biological substances which contain metals and on the metabolism of such substances as well.

Photochemical and enzymatic redox transformations of reduced forms of coenzyme NADP+.

The two reduced forms of NADP+, NADPH and its dimer (NADP)2, on irradiation in aqueous medium at 365 nm, are converted to enzymatically active NADP+, with accompanying formation of H2O2. The rate photooxidation of NADPH is strongly dependent on the presence of oxygen, but that of (NADP)2 is similar under aerobic and anaerobic conditions. In the presence of oxygen, but not in its absence, O2-. is an intermediate in the reaction. Generation of H2O2 under anaerobic conditions, confirmed by the fact that presence of peroxidase in irradiated solutions of (NADP)2 enhances photooxidation of the latter, is ascribed to attack on water of the excited dimer. Under anaerobic conditions at pH 9.5, Fe(EDTA)2+ and Fe(CN)4-(6) increase the rate of photooxidation of NADP dimer two-fold. gamma-Irradiation of (NADP)2 at pH 9.5 in the presence of N2O results in 80% conversion to enzymatically active NADP+. A mechanism for photooxidation of (NADP)2 under anaerobic conditions is suggested, and some relevant biological implications are presented.

Electrochemical study of the reduction of toyocamycin and sangivamycin in aqueous media.

The redox behaviour of two antibiotics, toyocamycin and sangivamycin, structurally related pyrrolopyrimidine nucleosides, and their reduction products in buffered aqueous media, have been examined by direct current polarography and cyclic voltammetry. Both compounds exhibit one 3-electron polarographic wave in the pH range 1-6. Macroscale electrolysis at the crest of the polarographic wave was followed electrochemically and by UV spectroscopy. The photochemical transformation of the reduction products on UV irradiation has been examined. It was found that the reduction of both compounds occurs in the pyrimidine ring, leading to two reduction products. One of these (lambda max = 306 nm) is photochemically reversible to the parent compound.