Chordoid Meningioma. Case Report and Review of the Literature.

Chordoid meningioma is an uncommon histopathological type of meningioma, frequently associated with Castleman's syndrome. Histologically, chordoid meningiomas are similar to chordomas. Because of their high proliferative index, they present aggressive biological behavior and high risk of postoperative recurrence. We report a case of chordoid meningioma in an adult patient without Castleman's syndrome manifestation. As its chordoid feature is related with a rapid recurrence after incomplete removal, meticulous histopathological examination is crucial for the adequate postoperative treatment plan.

The development of cerebral amyloid angiopathy in cerebral vessels. A review with illustrations based upon own investigated post mortem cases.

The process of ß-amyloid accumulation in cerebral vessels is presented. Cerebral amyloid angiopathy (CAA) was confirmed during an autopsy. It was diagnosed according to the Boston criteria. Cerebral amyloid angiopathy can involve all kinds of cerebral vessels (cortical and leptomeningeal arterioles, capillaries and veins). The development of CAA is a progressive process. ß-amyloid appears first in the tunica media, surrounding smooth muscle cells, and in the adventitia. ß-amyloid is progressively accumulated, causing a gradual loss of smooth muscle cells in the vessel wall and finally replacing them. Then, the detachment and delamination of the outer part of the tunica media results in the "double barrel" appearance, fibrinoid necrosis, and microaneurysm formation. Microbleeding with perivascular deposition of erythrocytes and blood breakdown products can also occur. ß-amyloid can also be deposited in the surrounding of the affected vessels of the brain parenchyma, known as "dysphoric CAA". Ultrastructurally, when deposits of amyloid fibers were localized in or outside the arteriolar wall, the degenerating vascular smooth muscle cells were observed. In the Institute of Psychiatry and Neurology the study was carried out in a group of 48 patients who died due to intracerebral hemorrhage caused by sporadic CAA.

Osteopontin and endostatin concentrations in peripheral blood of patients with adrenal tumors undergoing unilateral adrenalectomy.

Peripheral blood osteopontin (OPN) and endostatin (END) levels were studied in 35 patients with adrenal cortex tumors and 10 patients with pheochromocytoma before unilateral adrenalectomy, as well as in 10 healthy subjects (controls). Thirty days after surgery, OPN and END were evaluated again in 16 patients with adrenal cortex tumors and 4 female patients with pheochromocytoma. Before surgery, OPN blood concentrations increased in the group of patients with adrenal cortex carcinomas as compared to controls (p < 0.001) and the group with Conn syndrome (p < 0.05); they did not change after surgery. Before adrenalectomy, OPN blood levels in pheochromocytoma patients were also lower than in Conn syndrome subjects (p < 0.05). After adrenalectomy, the normal concentrations of END decreased only in the group of patients with hormonally inactive cortical adenomas (p < 0.05). We were unable to demonstrate any relationships between removed tumor volumes and OPN or END blood levels.

Effect of the growth hormone-releasing hormone [GHRH(1-44)NH2] on IL-6 and IL-8 secretion from human peripheral blood mononuclear cells in vitro.

OBJECTIVE: Bidirectional communication between the neuroendocrine and immune systems is now a subject of an intensive investigation. Growth hormone-releasing hormone (GHRH) is synthesized by the hypothalamus, but is present also in the immune cells. Some recent data indicate also an immunomodulatory role of the neuropeptide. The aim of the study was to examine the influence of GHRH(1-44)NH2 on interleukin-6 and interleukin-8 secretion from human peripheral blood mononuclear cells cultured in vitro. METHODS: Peripheral blood mononuclear cells (PBMC) were isolated by centrifugation using Böyum technique and cultured in a humidified atmosphere of 5 % CO2 and 95 % O2 at 37 degrees C for 24 hours in the presence of lipopolysaccharide (LPS) at the concentration of 2 microg/ml and GHRH(1-44)NH2 (the final neuropeptide concentrations to be tested were 10(-12) to 10(-6) M). ELISA methods were used to measure IL-6 and IL-8 concentrations in the supernatants of cultured cells RESULTS: GHRH(1-44)NH2 influenced IL-6 secretion from cultured cells, but significant inhibition of IL-6 release was observed at 10-6 M (p < 0.001). The negative correlation between the GHRH concentration studied and the IL-6 level in the supernatants was found (r = -0.759; p < 0.001). GHRH had no influence on the secretion of IL-8 from activated PBMC. CONCLUSIONS: Our results demonstrate that GHRH in vitro modulates IL-6 secretion from the human peripheral blood mononuclear cells, without any significant effect on IL-8 secretion.

Gastroduodenoscopy: a routine examination of 2,800 patients before laparoscopic cholecystectomy.

BACKGROUND: Unrecognized gastric and duodenal peptic ulcer is a common cause of epigastric pains for patients with cholelithiasis qualified for laparoscopic cholecystectomy. Undiagnosed gastric or duodenal ulcer may be the cause of persistent pains after cholecystectomy. The purpose of the study was to assess the value of a routine preoperative panendoscopy for qualifying patients to undergo laparoscopic cholecystectomy. METHODS: The study enrolled 2,800 patients treated for cholelithiasis from May 1993 to December 2002. Endoscopic examination was performed for all treated patients 1 to 4 days before their operations. RESULTS: Preoperative endoscopy showed pathologic changes in the stomach or duodenum in 1,187 (42%) of 2,800 patients qualified for laparoscopic cholecystectomy. Gastric ulcer was found in 179 patients (6.4%) duodenal ulcer in 127 patients (4.5%), gastritis in 735 patients (26.3%), polyps in 143 patients (5.1%), and cancer in 3 patients (0.1%). The surgery was postponed for patients with ulcer, and antiulcer treatment was started. In 16 patients, the symptoms associated with cholelithiasis subsided after healing of the ulcer. Cholelithiasis in these patients was asymptomatic, and a cholecystectomy was not performed. CONCLUSIONS: Panendoscopy should be a routine examination performed for each patient qualified to undergo laparoscopic cholecystectomy. For some patients with asymptomatic cholelithiasis, pain in fact is caused by peptic ulcer.

P53 concentration and soluble FasL (sFasL) serum level as indicators of apoptosis in patients with benign and malignant thyroid tumors.

During embryonal development and morphogenesis, apoptosis may be induced by two pathways. The first is an external protein signal originating from other cell--also named as "death signal". The another one is a specific cell reaction to external stress factors. Plasma concentration of proteins regulating both apoptosis pathways may be useful in early diagnosis and staging of thyroid tumors. The aim of the study was to evaluate p53 and sFasL plasma concentration in patients with benign and malignant thyroid tumors. The study population was composed of 33 patients with thyroid carcinoma and 10 patients with follicular carcinoma (tumor types were verified by fine-needle biopsy). All patients underwent surgical procedures. p53 and sFasL levels were evaluated before surgery. Control group consists of 10 adult healthy volunteers. The results revealed high p53 and sFasL plasma concentration in patients with benign and malignant thyroid tumors. Such results confirm a significant role of p53 and sFasL in apoptosis in thyroid tumors. Expression of both proteins may be an indicator of an increased apoptosis and useful in preoperative diagnosis in thyroid tumors (Tab. 1, Ref. 31).

Effect of growth hormone-releasing hormone (GHRH) and GHRH antagonist (MZ-4-71) on interferon-gamma secretion from human peripheral blood mononuclear cells in vitro.

Numerous reports indicate close interactions between the neuroendocrine and the immune systems. Hypothalamic neuropeptide, growth hormone-releasing hormone (GHRH) stimulates growth hormone (GH) secretion from the anterior pituitary gland, but recently some immunomodulatory properties of this peptide have also been demonstrated. In the present studies we evaluated the effect of human synthetic GHRH(1-44)NH(2) and GHRH antagonist (MZ-4-71) on interferon (IFN)-gamma secretion from human peripheral blood mononuclear cells (PBMC). GHRH(1-44)NH(2) at 10(-10), 10(-8) and 10(-6) M concentrations significantly (p < 0.05) increased the IFN-gamma level in supernatants of cultured cells, as compared with the controls. GHRH antagonist (MZ-4-71) at 10(-10), 10(-8) and 10(-6) M concentrations diminished the IFN-gamma level in supernatants in a dose-dependent manner, but statistically significant differences were observed only at 10(-8) M and 10(-6) M (p < 0.05 vs controls). Our results demonstrate that GHRH and GHRH antagonist MZ-4-71 can modulate IFN-gamma secretion in vitro by human peripheral blood mononuclear cells.

GH-RH antagonist (MZ-4-71) inhibits VEGF secretion and proliferation of murine endothelial cells.

Angiogenesis plays a key role in solid tumor formation, invasiveness and metastasis. Vascular endothelial growth factor (VEGF) is an endothelial cell-specific mitogen that is necessary in the process of neovascularisation. Antagonists of growth hormone-releasing hormone (GH-RH) have been shown to suppress both in vivo and in vitro growth and metastasis of many human cancer cell lines. The mechanisms that mediate the antitumorigenic actions of these antagonists involve direct and indirect pathways, but are not completely elucidated. We have examined the effect of GH-RH antagonist MZ-4-71 on proliferation activity and VEGF release from cultured murine endothelial cells HECa10 in vitro. MZ-4-71 at 10(-8) to 10(-6) M concentrations inhibited the proliferative activity of cultured cells and suppressed the release of VEGF into supernatants of 72 h endothelial cell cultures. To our knowledge this is the first study reporting antiangiogenic properties of GH-RH antagonists.

Angiogenesis of endocrine gland tumours--new molecular targets in diagnostics and therapy.

Angiogenesis is one of the key stages in the development of neoplastic tumours, in which a small group of mutated cells transforms into a large malignant tumour metastasising to the neighbouring tissues and organs. The studies on the significance of neoangiogenesis in the progression of endocrine gland neoplasms have recently become one of the most rapidly evolving branches of molecular endocrinology. The induction of angiogenesis has been demonstrated to result from the imbalance between positive and negative factors which control this process. Our paper presents the results of current studies on the role of factors such as molecular markers of angiogenesis (e.g. vascular endothelial growth factor and basic fibroblast growth factor), metalloproteinases (which regulate the decomposition of the extracellular matrix) and their inhibitors, and adhesive molecules (e.g. soluble vascular cellular adhesion molecule-1 and soluble intracellular adhesion molecule-1) in the pathogenesis and diagnostics of endocrine gland tumours in humans. Also, we discuss new therapeutic strategies for inhibiting the growth of neoplasms by blocking the formation of blood vessels using angiogenesis antagonists, which inhibit various stages of angiogenesis. More and more data are being accumulated suggesting that these preparations could, in the near future, be used in the pharmacotherapy of some endocrine gland neoplasms.

[Diagnostic pitfalls in stereotactic biopsy]. / Trudnosci diagnostyczne w ocenie materialu z biopsji stereotaktycznej.

Between October 1998-August 2000, 65 patients were diagnosed, and underwent stereotactic biopsy of brain lesions. Procedures were performed with the Riechert-Mundinger stereotactic device. The diagnosis was made intra-operatively, by examination of cytological smears. The initial diagnosis was confirmed after H&E, and selective stains, as well as immunohistochemical examinations of paraffin specimens. The method applied makes possible to obtain a reliable, and precise morphological diagnosis in the majority of cases, so that a proper treatment method could be introduced.

[Assessment of cerebral blood flow velocity changes by transcranial Doppler examination in patients with closed craniocerebral trauma]. / Ocena zmian predkosci przeplywu krwi w naczyniach mózgowych metoda TCD u chorych po zamknietych urazach czaszkowo-mózgowych.

24 patients after minor or moderate, closed isolated head injuries and 10 patients of control group were included to this study. Right after admission blood flow velocities of both middle cerebral arteries (MCAs) by using transcranial Doppler method (TCD) and blood flow velocities of both extracranial parts of internal carotid arteries (ICAs) by "duplex-scan method" were examined. Changes in mean flow velocities (MFVs) in MCAs and ICAs, VMCA/VICA ratio were analysed. 40% of patients who had minor or moderate head injury demonstrated increase of MCA velocity homolateral to the trauma or bilateral. We observed cerebral hyperemia in 16.7% of patients and posttraumatic vasospasm (TVSP) in 25% of patients. There is a high risk of occurring TVSP in patients with CT shows evidence of subdural or intracerebral hematoma.

[Free fatty acid levels in the blood serum and aqueous humor of patients with cataract]. / Poziom wolnych kwasów tluszczowych w surowicy krwi i cieczy wodnistej u pacjentów z zacmq.

The authors present the results of determination of the level of free fatty acids in the serum and aqueous in patients with a senile cataract (23 persons), with cataract and glaucoma (9 persons), complicated post-uveitis cataract (10 persons) and diabetic cataract (10 persons). The level of the free fatty acids in senile cataract was significantly lower in the aqueous in comparison with the serum. Their content in senile cataract was significantly lower in comparison with cataract and glaucoma and with complicated cataract.