Lipidomic and metabolomic analysis reveals changes in biochemical pathways for non-small cell lung cancer tissues.

Lung cancer represents one of the leading worldwide causes of cancer death, but the pathobiochemistry of this disease is still not fully understood. Here we characterize the lipidomic and metabolomic profiles of the tumor and surrounding normal tissues for 23 patients with non-small cell lung cancer. In total, 500 molecular species were identified and quantified by a combination of the lipidomic shotgun tandem mass spectrometry (MS/MS) analysis and the targeted metabolomic approach using liquid chromatography (LC) - MS/MS. The statistical evaluation includes multivariate and univariate methods with the emphasis on paired statistical approaches. Our research revealed significant changes in several biochemical pathways related to the central carbon metabolism, acylcarnitines, dipeptides as well as the disruption in the lipid metabolism observed mainly for glycerophospholipids, sphingolipids, and cholesteryl esters.

Surgical treatment of gastric and small bowel gastrointestinal stromal tumours.

AIM: This study aimed to evaluate a set of gastrointestinal stromal tumours (GIST) of the stomach and the small bowel managed with a laparoscopic technique. MATERIAL AND METHODS: The study covers a period from January 1, 2007 until June 1, 2010 during which 13 patients underwent the laparoscopic removal of stomach tumours and 2 patients underwent the removal of a small bowel GIST in the General Hospital in Pardubice. In all cases tumours were removed in a laparoscopic way, including the healthy border of the stomach tissue. RESULTS: No death was observed in our study. Two patients suffered from wound infection (secondary healing), one of them requiring repeat surgery owing to the excessive narrowing of the distal part of the stomach. Dehiscence of laparoscopic sutures or other intra-abdominal complications were not observed. During monitoring all patients were free of signs of local recurrence, but tumour progression into the liver was observed in 1 patient. Gastrointestinal stromal tumours are very rare tumours but their incidence is increasing. At this time the consensus about the necessity of preoperative unambiguous differentiation between malignant or less malignant variants is not available. Strict differentiation is very difficult and the decision whether to choose a more radical surgical approach for more malignant variants is not clear-cut. CONCLUSIONS: In cases of gastric and small bowel GISTs the local removal of a tumour with the healthy border of the stomach tissue may be chosen as an adequate approach. Our results support this local surgical approach.

Effect of S-adenosylmethionine on liver regeneration induced by partial hepatectomy.

S-adenosylmethionine (SAMe) is a key metabolite regulating growth, differentiation and death of hepatocytes. Experimentally, exogenous SAMe has been documented to attenuate hepatocarcinogenesis. The aim of our study was to evaluate the effect of SAMe on proliferation of hepatocytes that are not cancerously transformed. Partial 2/3 hepatectomy (PH) was performed in rats, control animals underwent laparotomy. SAMe was injected immediately after the surgery and then at 24 h intervals for two days at 10 or 40 mg/kg. The animals were sacrificed 24, 48 and 72 h after operation and the intensity of liver regeneration was evaluated. SAMe treatment at 10 mg/kg was associated with decrease in the synthesis of liver DNA 48 h after PH, however, it was not reflected in DNA content. SAMe treatment at 40 mg/kg led to the reduction of DNA synthesis 72 h after PH followed by the diminution of DNA content. The results have documented the inhibition of the liver regeneration by SAMe that may be mediated by the suppression of liver fat accumulation. Cell GSH level correlating with the growth rate was not affected by SAMe. Prevention from the decrease in the intracellular content of SAMe, as a factor attenuating regeneration remains to be verified.

Systemic inflammatory response syndrome (SIRS) in serious chest injuries: is a pharmacological blockade effective?

PURPOSE: There has been an ongoing increase in the frequency and severity of blunt chest injuries. Their rather high lethality is caused by the injury alone as well as by the following systemic inflammatory response. The aim of the study is to verify the efficacy of the pharmacological blockade of the systemic inflammatory response syndrome (SIRS) in serious blunt chest injuries, and to identify whether the administration of indomethacin as a cyclooxygenase inhibitor could prevent a multiorgan dysfunction (MODS) and a multiorgan failure (MOF). METHODS: Patients were divided into 4 Groups according to trauma severity--injury severity score (ISS) and into two subgroups--an indomethacin subgroup where patients received indomethacin together with standard therapy, and a non-indomethacin subgroup. RESULTS: Eighty-four patients were included in the study and 33 patients were given indomethacin. In Groups III and IV there was a later increase in inflammatory markers in patients treated with indomethacin. The elevation of inflammatory markers and the period of mechanical ventilation support in patients treated with indomethacin were shorter in Groups II and III. Seven (8.3%) patients died. Six of the seven dead patients were from the non-indomethacin subgroup. MOF was the cause of death in two patients in the non-indomethacin subgroup and in one patient in the indomethacin subgroup. CONCLUSION: The results obtained during the first 20 months of the study imply that a certain number of patients with serious blunt chest trauma could benefit from indomethacin administration.

[Diagnosis and surgical treatment of bronchial carcinoid]. / Diagnostika a chirurgická lécba bronchiálního karcinoidu.

The purpose of this study was to look at the clinical behaviour of bronchial carcinoids and clarify a surgical approach. Over 30 years 61 patients with a final histological diagnosis of carcinoid tumours were assessed for surgery. All patients were retrospectively reviewed for clinicopathological variables, surgical management and outcome. Tumours were considered typical and atypical based on histological features. The mean age at presentation was 46 years (range 11-69). Overall survival in the group of typical carcinoids was 96%, and 67% in the group of atypical carcinoids.