Esophageal varices during pregnancy in the course of cirrhosis.

Esophageal variceal bleeding is one of the most severe complications that may occur during pregnancy in patients with liver cirrhosis. It may result in death of the mother and the fetus. Therefore, screening endoscopy should be performed both before the conception and in the second trimester. Endoscopic band ligation is a method of choice in case of variceal bleeding. Close cooperation of hepatologist, obstetrician-gynecologist and endoscopist is recommended in order to provide maximum care and increase the chances of successful delivery. We present a case of 28-years-old primigravida, at 27 weeks pregnant with esophageal varices and liver cirrhosis.

Two unusual cases: vulvar lipoma - description of the largest case in literature. Developing myoma with the longest pedicle.

The authors present two cases of benign tumors one located on the outer surface of the vulva, and the second extending beyond the vagina. The first, originating from the right pudendal lip, a lipoma measuring 23 cm in greatest diameter, weighing 6.6 kg, and the second a pedunculated, uterine smooth muscle myoma with a pedicle of 6.5 cm, maximum diameter 18 cm, weight 700 grams, which caused significant metroptosis. Operative procedures in each case were free of complications.

Genetic analysis of poliovirus strains isolated from sewage in Poland.

The study describes genetic characterization of poliovirus (PV) strains isolated from sewage samples in Poland. The analyses were performed for the detection of any putative polio revertants and recombinants in three genomic regions by sequencing analysis. Thirty-six strains were analyzed. The analyzed strains were identified by neutralization assay as 7 strains of serotype P1, 10 strains of serotype P2, and 19 strains of serotype P3. Sewage isolates were sequenced in 5'UTR, VP1, and 3D genomic regions. All detected PVs were classified as vaccine strains on the basis of VP1 sequence. Mutational differences in the VP1 sequences of isolated viruses ranged from 0.0% to 0.4%, indicating a limited replication period. The genetic analysis of the 3D region showed that some strains have recombinant genomes. Nine strains were found as dipartite recombinants (seven strains--S3/S2, one strain--S2/S1, one strain--S3/S1), while one strain was found as tripartite recombinant (S3/S2/S1). No recombinants with non-PV enteroviruses were identified. None of wild-type PVs or vaccine-derived polioviruses (VDPVs) were detected. This study showed the absence of wild or VDPV circulation in the country and demonstrated the usefulness of environmental surveillance in addition to acute flaccid paralysis (AFP) surveillance in support of polio eradication initiatives.

The maintenance of pulp health 17 years after root fracture in a maxillary incisor illustrating the diagnostic benefits of cone bean computed tomography.

AIM: To demonstrate the maintenance of pulp health in a tooth with a fractured root without any complications or endodontic treatment and the advantage of cone bean computed tomography (CBCT) compared with traditional radiographs in the diagnosis of root fractures. SUMMARY: The horizontal fracture of a maxillary central incisor is described that was an incidental finding on a routine radiographic examination 17 years after trauma. The tooth was asymptomatic. Intra-oral radiography revealed a complicated multiple root fracture with separation of the root fragments, which was not confirmed by CBCT. This case report illustrates spontaneous healing of root fracture and the reparative potential in the area of root fracture including preservation of pulp health and also demonstrates that CBCT is a more reliable imaging technique than conventional radiographs regarding root fracture diagnosis. KEY LEARNING POINTS: The dental pulp is characterized by the ability to heal spontaneously in cases of root fracture. CBCT has advantages in diagnosing root fractures over intra-oral radiographs. CBCT should be employed with caution due to its increased radiation dose compared with periapical radiography.

[Use of painkillers by Polish secondary school students and the influence of TV commercials]. / Die Einnahme von schmerzstillenden Mitteln durch polnische Oberstufenschüler und der Einfluss der Werbung.

This article refers to the results of research conducted in 2008 with financial support (as a grant) of UMCS vice-chancellor. The topic was: Environmental and personal circumstances of taking painkillers available without prescription by secondary school students. 276 high school pupils in Lublin (equivalent of higher grammar-school level in Germany) were examined with a copyright questionnaire to check, among other things, how TV commercials affect taking painkillers. 40.6% of participants take analgesics very often, almost half of them (47.1%) reach for drugs which they know from commercials. 75% of students can indicate at least four examples of specific commercials advertising painkillers. In their depiction of these analgesics by metaphors a great number of analogies with TV advertisements can be found. Those who claim frequent intake of painkillers describe them as 'necessary, essential' (31.3%) or as 'convenient (giving comfort)' (19.6%). At the same time the majority of students (94.6%) is convinced that reaching for painkillers is socially accepted. Such attitude is probably reinforced by ubiquitous advertising of those drugs in Polish media.

Transcriptional activity of telomerase complex in CD34- stem cells of cord blood in dependence of preparation time.

The aim of the study was to determine whether the expression of telomerase subunits encoding genes changes during the process of cord blood preparation. It should establish if the commonly accepted 24 hours time interval in stem cells kriopreservation procedure significantly influences their immortalization and so decreases the "quality" of cord blood stem cells. Investigation includes 69 women. Spontaneous labour was the inclusion condition. The material was collected at birth after clamping of umbilical cord by direct vasopuncture. CD34- cells were extracted from cord blood (MACS, Miltenyi Biotec; Bisley, Surrey, UK). The expression profile of telomerase activators and inhibitors encoding genes was determined using HG_U133A oligonucleotide microarray (Affymetrix). We used a real-time quantitative RT-PCR assay to quantify the telomerase TERT, hTR and TP1 subunits mRNA copy numbers in CD34- cells in 0, 6, 12 and 24 hours after cord blood collection. We observed significant decrease of numbers of copies of TERTA+B mRNA within the successive hours of observation. Significant decrease of numbers of TERTA mRNA copies was confirmed after 24 hours. However, we observed significant increase of numbers of copies of TERTB mRNA after 6 hours of observation. Similar level was maintained during another 6h. The significantly lower number of copies of TERTB mRNA was observed after 24h. We also observed significant increase of number of copies of TERT mRNA after 6 hours. Number of copies of TERT mRNA significantly decreased after another 6h, remaining, however, on a higher then initial one. The significant lower number of copies of TERT mRNA was observed 24h after delivery. The possible explanation of those results is discussed in the paper.

Human telomerase RNA as endogenous control in endometrial tissue.

Telomerase is a reverse transcriptase that adds repetitive telomere sequences to the end of chromosomes, which is thought to be essential for cellular immortality and oncogenesis. The enzyme consists of three subunits: human telomerase reverse transcriptase (hTERT), human telomerase RNA (hTR), and telomerase protein 1 (TP1). The hTERT subunit determines the activity of telomerase as an enzyme and is detected in most human tumors and regenerative cells. But many studies have revealed that hTR and TP1 are expressed constitutively. This results suggest that the hTR and TP1 subunits may be potentially good markers of endogenous RNA control. Endometrial dating was determined from the pathomorphology of the endometrium and classified into normal proliferative endometrium, endometrial hyperplasia (simple, complex, and atypical), and endometrial adenocarcinoma. The analysis of the expression of the hTERT, TP1, and hTR telomerase subunits was performed by a quantitative polymerase chain reaction method, based on fluorescent TaqMan methodology (ABI Prism 7,700 Sequence Detection System) capable of measuring fluorescence in real time. The aim of the study was an analysis of the expression profiles of genes encoding hTR and TP1 telomerase subunits in normal endometrium, endometrial hyperplasia, and adenocarcinoma for the estimation of the possibility of once application in endogenous RNA control of gene analysis in the endometrium. The nonparametric Mann-Whitney U test and analysis of variance Friedman test were used to evaluate the variation in telomerase subunit mRNA level between normal endometrium, and endometrial hyperplasia and adenocarcinoma. The results confirm the hTR subunit expression as a good marker of endogenous control in quantitative analysis of gene transcription in endometrial tissue. TP1 subunit transcriptions have not been detected constitutively in our study.

CHEK2 is a multiorgan cancer susceptibility gene.

A single founder allele of the CHEK2 gene has been associated with predisposition to breast and prostate cancer in North America and Europe. The CHEK2 protein participates in the DNA damage response in many cell types and is therefore a good candidate for a multisite cancer susceptibility gene. Three founder alleles are present in Poland. Two of these result in a truncated CHEK2 protein, and the other is a missense substitution of an isoleucine for a threonine. We ascertained the prevalence of each of these alleles in 4,008 cancer cases and 4,000 controls, all from Poland. The majority of the common cancer sites were represented. Positive associations with protein-truncating alleles were seen for cancers of the thyroid (odds ratio [OR] 4.9; P=.0006), breast (OR 2.2; P=.02), and prostate (OR 2.2; P=.04). The missense variant I157T was associated with an increased risk of breast cancer (OR 1.4; P=.02), colon cancer (OR 2.0; P=.001), kidney cancer (OR 2.1; P=.0006), prostate cancer (OR 1.7; P=.002), and thyroid cancer (OR 1.9; P=.04). The range of cancers associated with mutations of the CHEK2 gene may be much greater than previously thought.

Pituitary tumor in a woman with a 47,XXX karyotype--case report.

BACKGROUND: The 47,XXX karyotype is a rare sex chromosome anomaly. This karyotype is usually not associated with a characteristic physical phenotype. CASE REPORT: In presented case a 47 triple X women with pituitary tumor and premature ovarian failure is identified. Diagnosis of a 47,XXX individual remains difficult because specific clinical criteria used to identify this condition are not available. CONCLUSIONS: The case described should attract attention to how difficult it is to diagnose properly a genetic disease in young women with correct phenotype.

Differentiation strategies of alternative splicing variants mRNA estrogen receptor-alpha.

From the clinical point of view recognizing the concentrations and type profile of isoforms could be of significant practical importance. The aim of the study is designed QRT-PCR reaction to assess profile of mRNA ER-alpha and their isoforms. Theoretical part of the study was made according to computer program and available Genbank database. To detect a isoform one of the primer was designed to hybridize within exon-border linked in alternative splicing. The study presents the differentiation strategies in isoforms coming about as the alternative splicing result. Designed oligonucleotide probes and primers allow to distinguish mRNA isoforms of ER-alpha and their quantification in assessed tissues.

Quantitative analysis of estrogen receptor mRNA in human endometrium throughout the menstrual cycle using a real-time reverse transcription-polymerase chain reaction assay.

We conducted a quantitative analysis of ERalpha and ERbeta mRNA expression in normal human endometrium throughout the menstrual cycle in regular menstruating premenopausal women, taking advantage of this real-time PCR assay. Endometrial dating was determined from the histology of the endometrium and classified into: proliferative endometrium and secretory endometrium. Both ERalpha and ERbeta mRNA expression were detected in all endometrial samples at both proliferative and secretion phase. However ERalpha mRNA expression level was higher than that of ERbeta specially during proliferative phase. These results suggest that estrogenic effects occur predominantly through ERalpha than ERbeta.

Quantitative analysis of estrogen receptor-alpha and -beta and exon 5 splicing variant mRNA in endometrial hyperplasia in perimenopausal women.

We used real-time reverse transcription-polymerase chain reaction (QRT-PCR) to detect wild-type ERalpha and ERbeta and their isoforms as well as exon 5 splicing variant mRNA ERalpha in various types of endometrial hyperplasia in perimenopausal women. Our data suggest that the exon 2 and 7 deletion ERalpha mRNA isoforms are present in endometrial tissue undergoing various hyperplastic states. Wild type ERbeta mRNA and their isoforms 2, 4, 5, 6 were observed in each type of assessed endometrial specimens, and ERalpha/delta5 was found only in hyperplasia complex group.

Expression of telomerase genes as potential marker of neoplastic changes.

We conducted a quantitative analysis of TERT, TP1 and hTR mRNA expression in various types of endometrial hyperplasia in perimenopausal women, taking advantage of the real-time PCR assay. All women underwent hysterectomy for gynecological reasons. Endometrial dating was determined from the patomorphology of the endometrium and classified into endometrial hyperplasia: simplex, complex and atypica. Our data suggest that only hTR was observed in each normal and hyperplastic endometrium specimens, suggesting that this factor constitutively expressed in endometrium. The results obtained indicate that the expression activity of the TERT subunit changes but not significantly, depending on the stage of development of the hyperplasia.

[Histone H3 gene expression level as markers of hyperplasia simplex of endometrium]. / Ekspresja mRNA histonu H3 jako marker aktywnosci proliferacyjnej komórek w rozroscie prostym endometrium.

SUBJECT: The excessive proliferative activity of endometrial cells drives to hyperplasia, via states: simplex hyperplasia, complex and atypical hyperplasia, and finally preneoplastic state may arise. New molecular markers and their ability to differentiate physiological and pathological states are described. DESIGN: The aim of this study was to evaluate the usefulness of histone H3 gene expression level as a marker of hyperplasia of endometrium. MATERIAL AND METHODS: The level of H3 mRNA was estimated using RT-QPCR method in proliferative phase (n = 5) and endometrial hyperplasia simplex (n = 8). Differences in expression level of H3, were evaluated by Student's t-test (t-test for independent samples). RESULTS: In our experiments the average mRNA H3 expression was significantly higher(p < 0.05, p = 0.03) in case of hyperplasia simplex in comparison to H3 expression in proliferative state of endometrium. CONCLUSION: The results confirm advantage of estimation of H3 mRNA level as a marker of cell proliferation in endometrium.

[Quantitative (RT-QPCR) analysis of telomerase subunit in normal endometrial tissues]. / Ilosciowa ocena ekspresji genów telomerazy TERT, hTP-1 i TR w prawidlowym endometrium.

Telomerase is a specialized ribonucleoprotein polymerase that elongates telomeres. To clarify the molecular mechanisms through which telomerase is activated in normal endometrium, we examined the expression profiles of each telomerase subunit in this tissues. A total of 22 normal human endometrium in various menstrual phases were examined for the expression of each telomerase subunit (hTERT, hTR, TP-1) using RT-QPCR. The hTERT as well as TP-1 subunit had higher expression levels in proliferative than secretory phase endometrium. Expression levels of hTR did not change during menstrual cycle. Our data showed the strong correlation between the level of expression of telomerase in human endometrium and phase of menstrual cycle.

[Expression of VEGF, KDR, p53, E6 HPV16 and HPV18 in vulvar and cervix cancer]. / Ekspresja genów angiogenezy--VEGF i jego receptora KDR, genu supresorowego P53 oraz E6 HPV16 i HPV18 w raku sromu i szyjki macicy.

The aim of the study was a comparison of expression of angiogenesis genes: vascular endothelial growth factor (VEGF), KDR, suppressor gene p53, E6-HPV16 and HPV18, in tissue samples of normal, dystrophic, lymph nodes and malignant cancers of vulva and uterine cervix. The results demonstrate that molecular diagnostics of cancers using gene expression profiling indicates the definitive difference in expression profiles of aforementioned genes in tissues of the same malignancy.

[Profiles of expression of genes coding kininogen and kinin receptors as a marker of tissue pathology in cervical cancer coexisting with HPV infection]. / Ekspresja genów receptorów dla kinin i kininogenu w raku szyjki macicy wspólistniejacym z infekcja HPV.

Kinins are peptides involved in inflammatory processes, vascular permeability, proliferation and mitogenesis of tumor cells. The majority of kinins actions are mediated through an interaction with cell surface bradykinin receptors BR1 and BR2. Kinins precursor is kininogen (kng). The changes in proteins are initiated by changes in the expression of genes coding these proteins, thus can be a valuable diagnostic markers of malignant processes including cervical carcinoma. The paper presents an analysis of kininogen-kinins receptor genes expression in women treated surgically because of a carcinoma of uterine cervix. Among the studied women in 5 cases previously brachyHDR therapy was applied. In all studied cases HPV 18 infection and in 2 cases a co-infection HPV 16/18 by use of Consensus Primers MY09, MY 11 and type specific primers for HPV 16, 18 was ascertained. In RNA extracts the number of the mRNA copies for kiningen, BR1 and BR2 was assessed using QRT-PCR Taq Man. The higher expression of BR1 than BR2 was marked in the tissue with cancer cells. In the patients after brachytherapy higher expression of BR2 than BR1 mRNA was found. The higher BR1 expression was also shown in iliac lymph nodes in patients with active neoplastic process, opposite to the patients after brachytherapy in whom higher BR2 expression was ascertained. The lack of expression of kng mRNA was found only in 3 specimens. The high expression of kinin receptors especially BR1 in infiltrating carcinoma margin can be a marker of pathology intensity: proliferative potential of neoplasms cells or chronic inflammatory state in the presence of invasive carcinoma.

[Estrogen receptor: superfamily of thyroid hormone receptors]. / Receptor estrogenowy--nadrodzina steroidowo-tarczycowego receptora hormonalnego.

Estrogen signal transduction plays an important role in mammary tissue. The principal mechanism by which the effects of estrogen are mediated by target tissues is via an initial interaction with the estrogen receptor (ER), a member of the steroid/thyroid/retinoid receptor gene superfamily. The ER can be isolated from the cytosol of target cell extracts as a large nontransformed 7-8S oligomeric complex, which contains hsp 90 and hsp 70. Like other steroid receptors, ER has six regions, A-F. The DNA-binding (region c) and the ligand binding (region) domains of ER alpha and beta show 96% and 55% amino acid sequence homology, respectively. The other regions (the hypervariable A/b domain, the hinge region D, and the C-terminal F-domain) are less conserved. The heat-shock proteins function help fold the ER protein properly and to protect the hydrophobic hormone binding domain from inappropriate interactions. Recently, a novel ER, referred to as ER-beta was cloned and characterized rat prostate.

[Novel estrogen receptor: a chance for more specific and safe endocrinological treatment?]. / Nowy receptor estrogenowy--szansa na bardziej swoiste i bezpieczne leczenie w endokrynologii ginekologicznej?

In 1996 Kuiper et al. have cloned a novel member of the nuclear receptor superfamily. The cDNA of clone 29 was isolated from a rat prostate cDNA library. The new receptor was highly homologus to the rat estrogen receptor protein, particularly in the DNA-binding domain. New protein consists of 485 amino acid residues and its molecular weight is 54.2 kDa. Like other steroid receptors, ER beta has six regions, A-F. A novel receptor is expressed in the secretory epithelial cells of the prostate and also in the granulosa cells of the ovary. Differences in the ligand-binding properties and transactivation function on target genes may exist. The tissue distribution and relative level of ER alpha and beta expression seems to be quite different, i.e. moderate to high expression in uterus, testis, pituitary, ovary, kidney, and adrenal for ER alpha and prostate, ovary, lung, bladder, brain, uterus and testis for ER beta. The differences between the receptors subtypes in relative ligand binding affinity and tissue distribution could contribute to the selective action of ER aginists and antagonists in different tissues. These new findings bring up many questions. The most intriguing is how has this second ER eluded investigators for so many years? Perhaps a limited number of estrogen target tissues were screened. The biological significance of the existence of two different ERs is at this moment unclear. Perhaps the existence of two ERs subtypes provides an explanation for the selective actions of estrogens in different target tissues.

N-acetylcysteine or trolox derivative mitigate the toxic effects of methanol on the antioxidant system of rat brain.

The effect of two compounds: N-acetylcysteine (NAC) and trolox derivative (U-83836E) on the methanol induced impairment of the antioxidant system of the rat brain was studied in male Wistar rats (approx. 250 g body weight). The animals were divided into six main groups: control group (0.5 ml of physiological saline intragastrically), NAC group (150 mg/kg intraperitoneally-i.p), U-83836E group (10 mg/kg i.p.), methanol group (3 g/kg intragastrically), NAC+methanol and U-83836E+methanol groups. In these particular groups the changes in antioxidant parameters were observed for 6,12,24,48 h and 5 and 7 days. The results proved that the use of methanol and N-acetylcysteine increased the activities of Cu,Zn-superoxide dismutase, glutathione peroxidase and glutathione reductase by about 15,15 and 41%, respectively, in comparison to the group of rats receiving methanol alone. Similarly, the level of GSH increased by about 17%, the concentration of ascorbate by 20%, while the thiobarbituric acid-reactive substances (TBA-rs) diminished to the values as in control group. The use of new antioxidant U8383E and methanol showed less beneficial effect in the measured parameters however, it serves as a better protector for the methanol induced decrease in GSH-content. These data suggest that NAC and U-83836E mitigate the toxic effects of methanol on the antioxidant system of the rat brain.