Verapamil - L type voltage gated calcium channel inhibitor diminishes aggressive behavior in male Siamese fighting fish.

Verapamil is a L-type voltage gated calcium channels inhibitor (VGCCI), which is a highly prescribed drug used in the treatment of hypertension, angina pectoris, cardiac arrhythmia and cluster headaches. Its common use caused its appearance in water environment. VGCC inhibit epinephrine release and cause many neuro-hormonal changes influencing also fish behavior. Siamese fighting fish was chosen to study the influence of verapamil given to the water on the beginning of experiment in 3 different concentrations of 0 (control), 8 and 160 µg · L-1, on aggressive behavior in these fish. The experimental fish were placed in individual glass containers for 3 weeks and the mirror test was used. The highest concentration led to a significant modulation of fish behavior after 1 week and the lower dose caused statistically significant behavioral changes after 2 weeks of verapamil treatment. Siamese fighting fish males exposed to verapamil had longer latencies to the first chase - 12.6 s (8 µg · L-1 of verapamil) and 18.8 s (160 µg · L-1 of verapamil) compared to 5.6 s in the control group, decreased attack frequency and shorter duration of these attacks. The number of attacks within 10 min was decreased from 38.3 in the control group to 27.1 and 16.1, respectively. Also the total duration of these attacks decreased from 354.8 (control) to 326.4 (decrease statistically insignificant) and to 194.8 s in verapamil treated groups. It was shown, that even relatively low concentrations of verapamil in water may have adverse effects on fish and probably other living organisms.

Assessment of cerebral perfusion in post-traumatic brain injury patients with the use of ICG-bolus tracking method.

The aim of this study was to verify the usefulness of the time-resolved optical method utilizing diffusely reflected photons and fluorescence signals combined with intravenous injection of indocyanine green (ICG) in the assessment of brain perfusion in post-traumatic brain injury patients. The distributions of times of flight (DTOFs) of diffusely reflected photons were acquired together with the distributions of times of arrival (DTAs) of fluorescence photons. The data analysis methodology was based on the observation of delays between the signals of statistical moments (number of photons, mean time of flight and variance) of DTOFs and DTAs related to the inflow of ICG to the extra- and intracerebral tissue compartments. Eleven patients with brain hematoma, 15 patients with brain edema and a group of 9 healthy subjects were included in this study. Statistically significant differences between parameters obtained in healthy subjects and patients with brain hematoma and brain edema were observed. The best optical parameter to differentiate patients and control group was variance of the DTOFs or DTAs. Results of the study suggest that time-resolved optical monitoring of inflow of the ICG seems to be a promising tool for detecting cerebral perfusion insufficiencies in critically ill patients.

Norovirus and Rotavirus--two major causative agents of sporadic viral gastroenteritis in hospitalized Polish children.

PURPOSE: The aim of the study was to establish the main etiologic agents of acute viral gastroenteritis and to asses the severity of illness associated with the different viral agents of gastroenteritis in children hospitalized during spring/summer season 2008. MATERIAL AND METHODS: 181 stool specimens were collected from children under 5 years of age, hospitalized with acute viral diarrhea from April to September 2008. Commercial enzyme immunoassay kits were used to detect noroviruses. The immunochromatographic tests for combined detection of rotaviruses and adenoviruses were performed routinely in our department in all in-patients suspected for viral gastroenteritis. RESULTS: A viral etiologic agents were detected in 108 of 181 (59.7%) samples tested. Dual viral pathogens (rotavirus and norovirus) were found in 3 of 181 (1.7%) samples. Rotavirus was the most common viral pathogen found in the study group (86/181; 47.5%), followed by NV (19/181; 10.5%) and adenoviruses (3/181; 1.7%). Approximately, 60% of acute gastroenteritis episodes occurring in children less than 5 years of age were accounted for by infection due to rotavirus and/or norovirus. Norovirus cases were clinically indistinguishable from those of rotavirus origin in children aged less than 2 years whereas they were slightly milder in older group of patients. CONCLUSIONS: Rotavirus infections are leading cause of children's hospitalization in spring months whereas Norovirus infections during spring/summer time. There is a great need to apply molecular diagnostic tools to determine the actual and monitoring the changing etiology of acute enteritis in Polish population.

Estrogenicity of food-associated estrogenic compounds in the fetuses of female transgenic mice upon oral and IP maternal exposure.

The present study investigated to what extent seven food-associated in vitro estrogenic compounds can induce estrogenic effects in the fetuses of pregnant female mice with an estrogen receptor (ER)-mediated luciferase (luc) reporter gene system. The luc-induction was determined either 8h after maternal dosing with a single intraperitoneal (IP) dose or 24h after the last of a series of 8 daily oral dosages. Three known estrogens, 17beta-estradiol (E(2)), 17 alpha-ethynylestradiol (EE) and 17beta-estradiol 3,17-dipropionate (EP) were used as positive controls at 1mg/kgbw and DMSO as solvent control. The food-associated estrogenic compounds tested were: bisphenol A (BPA), nonylphenol (NP) both at 50mg/kgbw, dichlorodiphenyldichloroethylene (p,p'-DDE) at 50mg/kgbw, quercetin at 16.6 mg/kgbw, and di-isoheptyl phthalate (DIHP), di-(2-ethylhexyl) phthalate (DEHP) and di-(2-ethylhexyl) adipate (DEHA) all at 100mg/kgbw. Exposure to E(2), EE and EP resulted in significant luc inductions upon both oral and/or IP dosing in a variety of tissues including liver, tibia and femurs, and upon IP dosing also in fetuses. BPA, NP, DEHA, DEHP, DIHP, DDE and quercetin were unable to significantly induce luc activity in fetuses. However, after maternal oral exposure during gestation to NP, BPA and DIHP placental luc activity was significantly lowered. The results indicate that at the current levels of exposure to food-associated estrogenic compounds, estrogenic effects to the fetus are not expected. The significant luc reduction in the placenta, should be further studied for its significance for fetal development and relevance for the human situation.

Food-associated estrogenic compounds induce estrogen receptor-mediated luciferase gene expression in transgenic male mice.

The present paper aims at clarifying to what extent seven food-associated compounds, shown before to be estrogenic in vitro, can induce estrogenic effects in male mice with an estrogen receptor (ER)-mediated luciferase (luc) reporter gene system. The luc induction was determined in different tissues 8h after dosing the ER-luc male mice intraperitoneally (IP) or 14h after oral dosing. Estradiol-propionate (EP) was used as a positive control at 0.3 and 1mg/kg bodyweight (bw), DMSO as solvent control. The food-associated estrogenic compounds tested at non-toxic doses were bisphenol A (BPA) and nonylphenol (NP) (both at 10 and 50mg/kgbw), dichlorodiphenyldichloroethylene (p,p'-DDE; at 5 and 25mg/kgbw), quercetin (at 1.66 and 16.6mg/kgbw), di-isoheptyl phthalate (DIHP), di-(2-ethylhexyl) phthalate (DEHP) and di-(2-ethylhexyl) adipate (DEHA) all at 30 and 100mg/kgbw. In general IP dosing resulted in higher luc inductions than oral dosing. EP induced luc activity in the liver in a statistically significant dose-related way with the highest induction of all compounds tested which was 20,000 times higher than the induction by the DMSO-control. NP, DDE, DEHA and DIHP did not induce luc activity in any of the tissues tested. BPA induced luc in the liver up to 420 times via both exposure routes. BPA, DEHP and quercetin induced luc activity in the liver after oral exposure. BPA (50mg/kgbw IP) also induced luc activity in the testis, kidneys and tibia. The current study reveals that biomarker-responses in ER-luc male mice occur after a single oral exposure to food-associated estrogenic model compounds at exposure levels 10 to 10(4) times higher than the established TDI's for some of these compounds. Given the facts that (i) the present study did not include chronic exposure and that (ii) simultaneous exposure to multiple estrogenic compounds may be a realistic exposure scenario, it remains to be seen whether this margin is sufficiently high.

Trauma patients' desire for autonomy in medical decision making is impaired by smoking and hazardous alcohol consumption--a bi-national study.

This cross-sectional investigation studied the association between substance use and patients' desire for autonomy in medical decision making (MDM) in two trauma settings. A total of 102 patients (age 42.7 +/- 17.4 years, 70.6% male) admitted to an orthopaedic service in Warsaw, Poland, and 1009 injured patients (age 34.6 +/- 12.8 years, 62.3% male) treated in an emergency department in Berlin, Germany, were enrolled. Patients' desire for autonomy in MDM was evaluated with the Decision Making Preference Scale of the Autonomy Preference Index. Substance use (hazardous alcohol consumption and/or tobacco use) and educational level were measured. Linear regression techniques were used to determine the association between substance use and desire for autonomy in MDM. Substance use was found to be independently associated with a reduced desire by the patient for autonomy in medical decision making. No differences in patients' desire for autonomy were observed between the study sites. Empowerment strategies that encourage smokers or patients with hazardous alcohol consumption to participate in MDM may increase the effectiveness of health promotion and injury prevention efforts in this population.

Perioperative use of recombinant activated factor VII in liver transplantation.

Recombinant activated factor VII (rFVIIa, NovoSeven, Novo Nordisk A/S, Denmark) is a treatment used to prevent and arrest intra- and postoperative bleeds in patients with haemophilia A or B complicated by circulating anticoagulants (inhibitors of FVIII and FIX). Patients who qualify for liver transplantation may have varying degrees of coagulation impairment, which may adversely impact elective anaesthetic and surgical procedures and elevate the risk of intraoperative bleeds, which require massive blood transfusions and worsen prognosis. Recently, reports have been published on the use of rFVIIa prior to surgical procedures, which are likely to cause severe blood loss as well as for so-called emergency therapy of coagulation disorders during liver transplantation.

Application of recombinant activated factor VII for treatment of impaired haemostasis during liver transplantation in recipients with Wilson's disease--a report of two cases.

Recombinant activated factor VII (rFVIIa, NovoSeven, Novo Nordisk A/S, Denmark) is a treatment used to prevent and arrest intra- and postoperative bleeding in patients with haemophilia A or B complicated by circulating anticoagulants (inhibitors of FVIII and FIX) and in patients without haemophilia who spontaneously develop inhibitors of FVIII, i.e. in acquired haemophilia. Patients who qualify for liver transplantation due to liver dysfunction may have varying degrees of coagulation impairment and thus carry an elevated risk of massive bleeding and have worse prognosis. The authors administered recombinant activated factor VII to two patients with coagulation abnormalities in the course of Wilson's disease during liver transplantation.

[Atypical use of continuous spinal anesthesia sets]. / Nietypowe zastosowanie zestawu do znieczulenia podpajeczynówkowego ciaglego.

Continuous spinal anesthesia technique with portex sets was used for treatment of neuroinfection. The patients was 43 years old woman with meningitis caused by Cryptococcus sp. suffered from chronic kidney failure, after transplantation and graft removal because of it's rejection. Effectiveness of therapy confirmed high value of CSA not only for pain treatment, but for central nervous system diseases as well.

Some physico-chemical properties micelle--benzalkonium chloride (BAC) adduct on interface in selected eye drops.

In selected eye drops the value of surface tension coefficient delta 25 and critical micelle concentration (cmc) was determined. Calculation of the hydrophilic-lipophilic balance level (HLBcmc) and the solution of the surface state f.Am = K.T form of Gibbs equation enables the estimation of the type of action of micelle with lipid corneal epithelium. Particular attention has been paid to the forms of eye drops which contain benzalkonium chloride (BAC).

[The puzzle of spontaneous regression of pulmonary metastasis of renal carcinoma (after many years of observing the patient)]. / Zagadnienie samoistnej regresji przerzutów raka nerki do pluc (na podstawie wieloletniej obserwacji chorego).

A case of spontaneous of pulmonary metastases of renal carcinoma RCC with 16-years follow-up was presented. Based on review of literature, current opinions on spontaneous regression of the pulmonary metastases in RCC after nephrectomy are discussed.

[Clinical evaluation of hydroxy-ethylated starch (preparation HAES)]. / Ocena kliniczna skrobi hydroksyetylowanej (preparatu HAES).

Hydroxy-ethylated starch (HAES-Fresenius) has been evaluated clinically at the Department of Anesthesiology and Intensive Care, Medical Academy in Warsaw. This plasma substitute is used in several countries as plasma substitute similar to dextran but of better properties. Results of our studies have shown, that HAES is worth its opinion. It is quite good plasma substitute of favourable effect on tissue perfusion. The above features together with a wide therapeutical margin and the lack of any effect on blood coagulation place HAES over dextran plasma substitutes. This preparation should have wider use in Poland.

[Effect of sulfinpyrazone on peritoneal and renal clearance in patients with chronic renal failure treated by intermittent peritoneal dialysis]. / Wplyw sulfinpyrazonu na oczyszczanie otrzewnowe i nerkowe u chorych z mocznica leczonych przerywana dializa otrzewnowa.

The paper was performed in order to evaluate the influence of sulfinpyrazone given orally in the doses of 400 mg to 16 uraemic patients during intermittent peritoneal dialysis on transperitoneal and renal transfer of different molecular weight substances. It was shown that sulfinpyrazone causes the increase in dialysate excretion of uric acid, sodium and protein but does not influence the transperitoneal transfer of water, potassium, creatinine, glucose, heparin and acetic acid. Renal function determined by diuresis volume as well as clearance of sodium, potassium, creatinine, uric acid and protein remained unchanged after the drug administration. Thus, when sulfinpyrazone is used during peritoneal dialysis a possibility of its action on the peritoneal membrane permeability should be taken into consideration.

Experimental porcine malignant hyperthermia: macromolecular characterization of muscle plasma membranes.

The purpose of this study was to examine muscle plasmalemma which is implicated as the site responsible for the appearance of malignant hyperthermia in human and susceptible strains of animals. In pigs with malignant hyperthermia (MH) the activity of Na+/K+, Mg2+-ATPase, p-nitrophenylphosphatase and Mg2+-ATPase fell significantly during anaesthesia. In the control group the contrary occurred. In both the groups tested there was a marginal rise in the levels of sialic acid. The levels of cholesterol and lysoderivatives were abnormal before the provoking agents were administered but they changed significantly after onset of the MH syndrome. Anaesthesia reduced the phospholipids level in both tested animal groups. Before and after the provoking agents an impoverishment in the polypeptide pattern in the range between 80,000 and 30,000 daltons of mol. wt. in MH susceptible animals occurred. It is postulated that in MH the macromolecular disorganization of the muscle plasma membranes means that defence mechanisms maintaining cell gradients do not work in the presence of provoking agents.

Experimental porcine malignant hyperthermia: the activity of certain transporting enzymes and myofibrillar calcium-binding protein content in the muscle fibre.

The activity of enzymes transporting calcium across the membrane of the muscle fibre and sarcoplasmic reticulum was studied. The activity of actomyosin Mg2+-ATPase and the composition of troponin were investigated also. In seven Pietrain pigs halothane alone or with suxamethonium induced the malignant hyperthermia syndrome. In the animals with malignant hyperthermia Ca2+-ATPase was not activated in the plasma membranes of the muscle fibres, when compared with control animals (n = 4). An increase of Ca2+-ATPase of the sarcoplasmic reticulum was observed in animals with malignant hyperthermia; the opposite was noted in the control group. No significant changes in the activity of Mg2+-ATPase of the sarcoplasmic reticulum and of Mg2+-ATPase of actomyosin were observed after exposure to halothane in control pigs and those with malignant hyperthermia. The amount of troponin C was significantly changed in the animals with malignant hyperthermia. The mechanism of the development of malignant hyperthermia syndrome is discussed.