Risk and protective factors for development of colorectal polyps and cancer (Bulgarian experience).

BACKGROUND/AIMS: Colorectal cancer takes third place among all malignancies in the Varna region. The present study aims to determine the typical and distinguishing risk and protective factors for colorectal polyps and cancer formation. METHODOLOGY: 166 patients with large bowel polyps and 107 patients with colorectal cancer were questioned, examined endoscopically and histologically. Logistic regression analysis was used to find a possible correlation between alimentary habits, way of life, and risk for colorectal polyps and cancer formation. The latter have been used to define a strategy for their prevention. RESULTS: Our results showed that fried, preserved, and grilled meat, consumption of animal fats, sugar, and being overweight are positively associated with colorectal polyps. In contrast, consumption of fruit, vegetables, rye- and brown bread, green tea, vegetable food, yoghourt, vegetarian food, fish, lamb, hare, garlic, boiled food, and mineral water, have strong protective effect against large bowel polyps. We have confirmed the role of the well-known risk factors for colorectal cancer, and discovered an association between H. pylori infection, age, villous component in the adenomatous polyps, and family history for any neoplasia and large bowel carcinoma. CONCLUSIONS: We suggest the following protective factors for CRC: vegetarian food, plant oil, rural life, aspirin intake, legumes, fish, fruit and vegetable consumption. We observe a similarity between the risk factors for colorectal polyps and cancer formation. They act simultaneously and depend on genetic predisposition. A combination of endoscopic treatment and correction of the alimentary factors could be used as a means of cancer prevention.

[Successful treatment of locally invasive, nonmetastatic choriocarcinoma after ectopic pregnancy by monochemotherapy].

A case of choriocarcinoma in 33-year old woman after ectopic pregnancy has been reported. CT-scan established an invasion of the vagina, posterior wall of the bladder and rectum. The patient's leading symptoms were: severe genital bleeding,haematuria, acute postbleeding anaemia, haemorrhagical shock. After treatment with Metothrexate and symptomatic therapy the patient achieved complete clinical remission and she is free of disease 18 months after the onset of the therapy.

[The effect of the beta adrenomimetic trimethoquinol and its rigid tetrahydroberberine conformer on histamine liberation induced by compound 48/80 in mast cells]. / Einfluss des beta-Adrenomimetikums Trimethoquinol und seines rigiden Tetrahydroprotoberberin-Konformers auf die durch Substanz 48/80 induzierte Histaminfreisetzung aus Mastzellen.

The effects of the beta 2-adrenomimetic trimethoquinol (TMQ) and one of its rigid tetrahydroprotoberberin conformer - compound Is-35 - on the histamine content and the compound 48/80 induced histamine release have been studied. The histamine content in skin parts of ears and in the whole heart of male rats has been determined spectro-photofluorometrically. TMQ and Is-35 were injected in doses of 3 mumol/kg and compound 48/80 in increasing doses (1, 2 and 3 mg/kg) during 3 successive days. It has been found that the antagonizing effect of TMQ on the mast cell histamine release is tissue-dependent: it prevents the release of 20% of the compound 48/80-releasable histamine in ears and of 40% in heart. Is-35 has not effect on the compound 48/80 induced histamine release in ears and prevents the release of only 12% of the compound 48/80-releasable histamine in heart. The morphological studies show quantitative and qualitative changes in the heart mast cell population which are in good agreement with the biochemical data obtained. The fixation of the flexible part of the TMQ molecule in a tetrahydroprotoberberin configuration results in a reduction of the antagonistic activity towards the compound 48/80 induced histamine release. On the basis of this finding it could be suggested that an aporphin-like conformation of the TMQ molecule is responsible for its activity established.

[A case of leiomyosarcoma of the stomach in which diagnosis echotomographic study made a contribution]. / Vurkhu edin sluchai ot leiomiosarkom na stomakh, za diagnosti-tsiraneto na koito doprinese mnogo i ekhotomografskoto izsledvane.

The authors describe a case of leiomyosarcoma of the stomach, progressing clinically with manifested pains in almost all joints, febrile-septic state and repeated enterorrhagias - hematemesis and melena. The case was diagnosed prior to the operation, with the ehcotomographic study of the stomach contributing greatly.

[Clinico-morphologic changes in the small intestine mucosa in duodenal ulcer]. / Kliniko-morfologichni promeni v tunkochrevnata ligavitsa pri iazva na duodenuma.

The morphological-functional state of small-intestinal mucosa was studied in patients with duodenal ulcer. The authors established that the functional disorders developed mainly in the intestines, manifested with enhanced resorption and considerable increase of mucus production by mucosa, with highly increased content of glucosamine-glicans in the mucus. Those processes have compensatory-adaptive and protective character associated with the high acidity of the gastric juice in case of duodenal ulcer.

[Changes in the small intestine mucosa in liver cirrhosis]. / Promeni v tunkochrevnata ligavitsa pri bolni s chernodrobna tsiroza.

A morphological examination was carried out of 33 patients with cirrhosis of liver and 10 clinically healthy subjects. Chronic jejunitis, with the prevalence of its atrophic forms (in 59.1%) was established to develop in 86.4 per cent of the patients. The morphological characteristics of the changes observed (prevalence of dystrophic-destructive processes with marked lesions of the specialized structures, presence of hypore-generative and moderately manifested inflammatory reaction) allow that they be considered as endogenously conditioned forms of chronic jejunitis.

[Dynamics of the restorative processes in the liver in chronic poisoning with zolon]. / Dinamika na vuzstanovitelnite protsesi v cherniia drob pri khronichna intoksikatsiia s preparata zolon.

The authors examined the dynamics of the repairing processes in liver of rats after 2 and 4-month intoxication, caused by the phosphor-organic preparation ZOLON. They found that the changes in liver were reversible at this length of intoxication. Glycogen and RNA storage recovered almost to their initial values. Kupffer's cells were hyperplastic and the number of two-nuclear liver cells was increased diffusely in the lobule. The changes in the vascular walls of the periportal areas persisted. The degree of the repairing processes in liver depended on the dose used and the duration of the action. The obtained data could be taken into consideration in preparing hygienic and prophylactic measures for the individuals working with this preparation.

[Changes in the parietal cells of the gastric mucosa in liver cirrhosis]. / Promeni v pristennite kletki na stimashnata ligavitsa pri bolni s chernodrobna tsiroza.

The delomorphus cells of gastric mucosa in patients with liver cirrhosis and healthy subjects were investigated. They were counted according to Card and Marks method, their number being determined in 0,005 mm2 mucosa. In the patients with liver cirrhosis, corresponding to the stage of gastric mucosa alterations, a considerable decrease of the delomorphus cell number was established as compared with the healthy subjects. Succindehydrogenase activity in them is also decreased. Those data correlate with the hypo- and anacidity in patients with liver cirrhosis, observed and described at the clinic and come to confirm the correlation between the functional and structural state of gastric mucosa.

[Enzymatic changes in the mucous membrane of the small intestine in tetrachlormethane-induced experimental liver cirrhosis]. / Enzimni promeni v ligavitsata na tunkoto chervo v usloviiata na eksperimentalno predizvikana s tetrakhlormetan chermodrobna tsiroza

The author examined the enzymatic activity in the intestinal mucosa under the conditions of rat liver cirrhosis, experimentaly induced by carbon tetrachloride. There was a correlative connection between liver damage and the functional activity of the intestines, manifested by the inhibition of the activity of the membrane enzymes-alkaline phosphatase and aminopetidase as well as the activity of acid phosphatase and succinic dehydrogenase.

[Morphological changes in the gastric and duodenal mucosa in duodenal ulcer in young persons]. / Morfologichni izmeneniia v ligavitsata na stomakha i duodenuma pri iazva na dvanadesetoprustnika u mladi individi

Histological investigations were carried out upon the state of the gastric and duodena mucosa in 27 young patients with duodenal ulcer, seven out of them being in the state of exaverbation of the ulcer and 20-in remission. While the duodenal mucosa in the majority of the cases (88.9%) was established to be affected, in 85.2 percent of the patients the gastric mucosa remained intact. The chronic duodenitis observe n 24 of the cases have no atrophic character. The changes in the mucous secretion of duodenal mucosa are in direct correlation with the state of exacerbation or remission of the ulcer process. Similar correlation was not established in gastric mucosa.