Effects of Long-Term High-Fat Diet and Its Reversal on Lipids and Lipoproteins Composition in Thoracic Duct Lymph in Pigs.

BACKGROUND This study was carried out to evaluate the effects of a long-term high-fat diet on lipids and lipoproteins composition in thoracic duct lymph in pigs. MATERIAL AND METHODS We examined lymph taken from the thoracic duct from 24 female white sharp-ear pigs, divided into 3 experimental groups fed different diets for 12 months: (a) the control group, fed the standard balanced diet; (b) the HFD group, fed an unbalanced, high-fat diet, and (c) the reversal diet group (RD), fed an unbalanced, high-fat diet for 9 months and then a standard balanced diet for 3 months. RESULTS Lymph analysis after 12 months of fixed diets revealed significantly higher concentration of proteins in the HFD group in comparison to the control and RD groups. Examination of lymph lipoproteins fractions showed that the high-fat diet in the HFD group in comparison to control group caused an increase in cholesterol, phospholipids, and proteins content within HDL and chylomicrons. There were also more proteins within HDL in the HFD group in comparison to the RD group and more triglycerides within chylomicrons in the HFD group in comparison to the control group. CONCLUSIONS A long-term high-fat diet resulted in changed structure of HDL and chylomicrons in the thoracic duct lymph. Alterations in HDL composition suggest that a high-fat diet enhances reverses cholesterol transport. Changes in chylomicrons structure show the adaptation to more intense transport of dietary fat from the intestine to the liver under the influence of a high-fat diet. Reversal to a standard balanced diet had the opposite effects.

Assessment of nutritional status on the basis of the mini nutritional assessment (MNA) questionnaire in patients on the internal medicine ward

Background: The inadequate nutritional status of hospitalized patients leading to the malnutrition is one of the crucial clinical problems. Objective: The aim of the study was to assess nutritional status of patients on the basis of the mini nutritional assessment (MNA) questionnaire. Material and Methods: The study group included 120 patients staying on the internal medicine ward. The average age for female and male was 65±9.7 and 63±8.4 years, respectively. To assess malnutrition the anthropometric measurements and the MNA questionnaire was conducted. Results: The average MIS (Malnutrition Indicator Score) value in female and male was 25.0 ± 3.0. Among 29% of women and 18.2% of men the risk of malnutrition occurrence was noted. The incorrect values of BMI (body mass index) were observed more frequently in male compared to female (84.0% vs. 67.0%). Incorrect values of the MAC (mid arm circumference) and CC (calf circumference) were found respectively in 6.6 % and 10.5% of female and in 2.3% of male. 55.3% of women and 75% of men declared taking more than 3 prescription drugs a day. In women were observed a significantly higher deficiency of dairy products, meat, fish, or poultry as well as meals containing legume plants or eggs per week compared to men (21.0% vs. 4.5%). An insufficient daily intake of vegetables was declared by 20.4% of men and 15.8% of women. Conclusions: The occurrence of malnutrition or its risk was observed in about a quarter of studied hospitalized patients. The malnutrition was worsened by a reported loss of appetite, a significant number of drugs being taken, and inadequate nutrition among the patients.

The influence of different diets on metabolism and atherosclerosis processes-A porcine model: Blood serum, urine and tissues 1H NMR metabolomics targeted analysis.

The global epidemic of cardiovascular diseases leads to increased morbidity and mortality caused mainly by myocardial infarction and stroke. Atherosclerosis is the major pathological process behind this epidemic. We designed a novel model of atherosclerosis in swine. Briefly, the first group (11 pigs) received normal pig feed (balanced diet group-BDG) for 12 months, the second group (9 pigs) was fed a Western high-calorie diet (unbalanced diet group-UDG) for 12 months, the third group (8 pigs) received a Western type high-calorie diet for 9 months later replaced by a normal diet for 3 months (regression group-RG). Clinical measurements included zoometric data, arterial blood pressure, heart rate and ultrasonographic evaluation of femoral arteries. Then, the animals were sacrificed and the blood serum, urine and skeletal muscle tissue were collected and 1H NMR based metabolomics studies with the application of fingerprinting PLS-DA and univariate analysis were done. Our results have shown that the molecular disturbances might overlap with other diseases such as onset of diabetes, sleep apnea and other obesity accompanied diseases. Moreover, we revealed that once initiated, molecular changes did not return to homeostatic equilibrium, at least for the duration of this experiment.

Two cases of the bronchial carcinoid tumors successfully treated with the parenchymal-sparing bronchoplastic resections.

Carcinoid tumors account for 2% of primary lung tumors. We report two cases of the relatively young patients with typical and atypical carcinoid (AC) tumors that were managed successfully with a parenchymal-sparing bronchoplastic procedure.

Frequency of the use of biological treatment of patients with rheumatoid arthritis and ankylosing spondylitis in Lower Silesia.

BACKGROUND: Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) are chronic connective tissue diseases. Inadequate treatment of RA and AS results in health failure, disability and premature death. In recent years, development of immunology and genetic engineering techniques has started a new generation of drugs in the treatment of RA and AS, called biologic response modifiers or biologics. It is a very effective therapy of serious RA and AS. In many cases, they represent the only way to improve the quality of life, slowing or even arresting the development of these diseases. According to national statistics, the percentage of patients with rheumatic diseases treated with biologic treatment in Poland is less than 1.5%, and it is much lower than in Western European countries (20%). PURPOSE: The aim of the study was to evaluate the use of biological treatment in Lower Silesia in patients with RA and AS in the years 2006-2015, based on data obtained from the Lower Silesian Branch of the Polish National Health Fund. RESULTS AND CONCLUSIONS: In the last 10 years the frequency of biological treatment of RA or AS in Lower Silesia was estimated as 2.06% of patients (in 2011) to 6.03% of patients (during the first 8 months of 2015). Biological treatment is more often used in Lower Silesia in comparison to national statistics and ranks at a similar level as in other countries of Central and Eastern Europe.

Primary cardiac lymphoma (PCL) - diagnostic difficulties.

Primary cardiac lymphoma (PCL) is the very rare disease that is associated with a high mortality rate. A prompt and proper diagnosis may affect the prognosis, and proper treatment may improve life expectancy. This report documents the case of a 74-year-old female with primary cardiac lymphoma. Unfortunately, the patient died from heart failure on her 23(rd) day in hospital.

Arterial wall lymphangiogenesis is increased in the human iliac atherosclerotic arteries: involvement of CCR7 receptor.

Twenty-six iliac artery segments were divided in two groups: atherosclerotic (A) and nonatherosclerotic (NA). Expression of LYVE-1, VEGF-C, VEGF-D, and CCR7 receptor were studied with immunohistochemistry (IHC) and Western blot (WB). IHC was performed on 26 samples of iliac arteries obtained from deceased 19 organ donors. The samples were divided into an atherosclerotic group (A) [subjects with history of cardiovascular disease (hypertension, ischemic heart disease) or/and diabetes] (n=16), and a nonatherosclerotic group (NA) [subjects without any known cardiovascular diseases or cardiovascular risk factors] (n=10). WB was performed on 19 iliac artery segments obtained from two groups, based on clinical data: an atherosclerotic group (A) [patients with atherosclerosis, who underwent surgery for lower limb ischemia] (n=10), and a nonatherosclerotic group (NA) [deceased organ donors without cardiovascular diseases/risk factors (n=9)]. Expression of LYVE-1, VEGF-C, VEGF-D, and CCR-7 was increased in atherosclerotic arteries. Positive correlations between LYVE-1 and VEGF-C expression in the intima-media complex assessed by IHC: (r=0.54; p=0.005) and WB: (r=0.47; p=0.005) were found. Positive correlations between expression of CCR-7 and other markers were observed. Lymphangiogenesis is enhanced within the atherosclerotic arterial wall. Our results confirm lymphatic system activation with increased lymphangiogenesis and lymphocyte/macrophage trafficking in atherosclerosis.

Nogo-B expression, in arterial intima, is impeded in the early stages of atherosclerosis in humans.

Nogo-B (Reticulon 4B) is considered to be a novel vascular marker, which may have a protective role in injury-induced neointima formation and atherosclerosis. Nogo A/B is found to be crucial for monocyte/macrophage recruitment in acute inflammation and it is expressed in CD68 + macrophages. We hypothesize that macrophage infiltration in atherosclerosis is not dependent on Nogo-B expression in arterial wall. We have assessed Nogo-B expression and macrophage accumulation in the iliac arteries of healthy organ donors and organ donors with cardiovascular risk factors. Paraffin sections of 66 iliac arteries, from 44 deceased organ donors (17 women and 27 men), were studied. The healthy and cardiovascular risk (CVR) subgroups were created. With regard to staging of the atherosclerotic process, the thickness of arterial intima was measured in digitalized images of H+E stained tissue sections. Immunohistochemical reactions (Nogo-B and CD68) were carried out in all arteries (66 samples). Western blotting (WB-19 samples) and real-time PCR (27 samples) were performed on selected arteries. Significantly higher Nogo-B expression was demonstrated in the intima of the healthy subjects' subgroup, using immunohistochemistry. WB and real-time PCR revealed a trend toward lower Nogo-B expression in the adventitia of the CVR subgroup. Furthermore, the thickness of the intima was found to negatively correlate with the expression of Nogo-B in the intima and media (r = -0.32; p < 0.05; r = -0.32; p < 0.05). Macrophage infiltrates were more prominent in intima of CVR subjects (0.65 vs 3.52 a.u.; p < 0.01). Macrophage density in intima increased with atherosclerosis progression (r = 0.37; p < 0.01). CD68 macrophages density in adventitia was lower in CVR arteries than in healthy arteries. The expression of Nogo-B, in arterial intima, is impeded in the early stages of atherosclerosis. Accumulation of arterial intimal CD68 macrophages has been shown to progress; however, the overall macrophage density in the adventitia is reduced in arteries shown to have intimal thickening. Macrophage infiltration is not accompanied by Nogo-B expression in atherosclerotic arteries.

LAM cells biology and lymphangioleiomyomatosis.

Progressive lung tissue destruction in lymphangioleiomyomatosis (LAM) occurs as a result of excessive proliferation of LAM cells caused by a mutation in one of the tuberous sclerosis complex suppressor genes, TSC1 or TSC2. These cells show constitutive activation of the mammalian target of rapamycin (mTOR) pathway and many of the mTOR-related kinases such as Akt, Erk, S6K1 and S6. Phenotype of LAM cells differs considerably depending on their microenvironment. LAM cells show differences in morphology, size and expression of various factors depending on their location in the tumor or body fluids. The presence of LAM cells in blood, urine, bronchoalveolar lavage fluid (BALF), and chyle proves their ability to metastasis. Antigens of smooth muscle cells are expressed in most LAM cells. Some of these cells are immunoreactive with HMB-45 antibody, which is used for the immunohistochemical diagnosis of LAM. Receptors for estrogen and progesterone may also be expressed in these cells, which probably is associated with the fact that LAM occurs almost exclusively in women of childbearing age. LAM cells via increased production of metalloproteinases are involved in the destruction of the extracellular matrix, as well as the remodeling and damage of lung tissue. Sporadic LAM occurs extremely rarely. Therefore a good experimental model of this disease is necessary. To date, several animal and human cell lines, which both genetically and phenotypically resemble LAM cells, have been obtained. These cell lines, derived from LAM nodule or an angiomyolipoma, are usually characterized by a mutation of the TSC2 gene, expression of smooth muscle cell antigens such as a-smooth muscle actin (aSMA) or S6K1 and S6 protein hyperphosphorylation. Presently, there is no commercially available cell line representing a good model of LAM. A better understanding of LAM cell biology is necessary for creating a useful model in vitro for further exploration of both LAM pathomechanisms and more general mechanisms of carcinogenesis.

Cavernous haemangioma of the oviduct.

Haemangiomas represent benign tumours of vascular origin. Cavernous haemangiomas are formed by cavernally widened irregular vascular spaces, lined with endothelia with no signs of atypia. In the fallopian tube haemangiomas are rare. In the available literature, only six cases were noted. We present a clinical and morphological case of a 69-year-old woman with cavernous haemangioma of the oviduct.

Differentiated expression of estrogen receptors (ER) and progesterone receptors (PgR) in ductal breast cancers.

Contents of estrogen receptors (ER) and progesterone receptors (PgR) in cells of breast cancers represent strong predictive factors. The higher is the contents of ER and PgR in breast cancer, the higher is a probability of obtaining a response to hormonal therapy and prognosis for the patient is better. In a routine manner, all tumours of mammary gland are subjected to evaluation of ER and PgR expression using immunohistochemistry. Forty ductal breast cancers (pT2N0) were subjected to an immunohistochemical evaluation (IHC) aimed at detection of ER and PgR expression. From every tumour three samples were taken for immunohistochemical studies: the lateral one from the side of axilla (ER-1; PgR-1); the median one (ER-2; PgR-2) and the medial one from the side of sternum (ER-3; PgR-3). The levels of both ER and PgR expression proved to be highly differentiated between the medial zone of the tumour and its periphery. The distinct expression of ER and PgR in ductal breast cancers, dependent on evaluated zone of the tumour, confirms its heterogeneous character and exerts an effect on the type of applied treatment.

[Reverse cholesterol transport processes and their role in artherosclerosis regression]. / Procesy transportu zwrotnego cholesterolu i ich rola w regresji miazdzycy.

Atherosclerosis represents dynamic process with periodic tendency to reverse. Although animal experiments and human studies have provided considerable evidence of atherosclerosis regression, our understanding of this phenomenon remains still incomplete. Atherosclerosis regression depends on removal of cholesterol deposits from atherosclerotic plague in the process of reverse cholesterol transport and possibly other mechanisms including migration of macrophages and foam cells, inhibition of inflammation and endothelial regeneration. Our paper reviews available data on the process of atherosclerosis regression with special attention to the reverse cholesterol transport.

[Risk of cardiovascular diseases in lead-exposed workers of crystal glassworks. Part II. Lead impact on the cardiovascular system based on ultrasound assessment of carotid arteries, electrocardiograms and ankle-brachial index]. / Ryzyko chorób ukladu krazenia u pracowników huty szkla krysztalowego narazonych na dzialanie olowiu. Czesc II. Wplyw olowiu na funkcje ukladu sercowo-naczyniowego na podstawie oceny przeplywów w tetnicach szyjnych wspólnych, badania elektrokardiograficznego i wskaznika kostka-ramie.

BACKGROUND: Cardiovascular diseases are one of the most common causes of the prevalence and mortality in the general population. Progressing pollution of the environment, as well as occupational exposure to heavy metals, including lead, may potentially accelerate the development of these disorders. Lead is a well known risk factor of arterial hypertension, and may be involved in atherogenesis. The aim of this study was to assess the influence of occupational lead exposure on the activity of cardiovascular system (CVS). MATERIAL AND METHODS: The study group comprised 153 potentially healthy volunteers, working in a crystal glass foundry. They were examined using ultrasound assessment of carotid arteries, electrocardiograms and ankle-brachial index (ABI). The toxicological assessment of the study group for occupational lead poisoning was performed. Correlations between the degree of intoxication and functional changes in CVS were analyzed. RESULTS: A negative linear correlation between blood lead level or fluorethylenepropylene (FEP) concentration and ABI values was shown, but only in a subgroup with normal lipid pattern. In the persons with higher blood lead levels, the higher values of arterial blood pressure and longer QT-space in electrocardiogram were evidenced. In addition, the right bundle branch block was more frequently observed (in 23% of workers). CONCLUSIONS: Lead may be an independent risk factor of cardiovascular diseases, especially in workers with normal lipid parameters. An increased arterial blood pressure and a decreased ankle-brachial index in the persons with normal cholesterol level can be regarded as a marker of this risk.

Adventitial lymphatics of internal carotid artery in healthy and atherosclerotic vessels.

OBJECTIVES: Presence of lymphatics in adventitia of major arteries remains controversial. Presence of lymphatics in adventitia of internal carotid artery was not documented and its relation to atherosclerosis was not studied. The aim of our study was to evaluate presence of lymphatic vessels in adventitia of internal carotid artery in healthy and atherosclerotic arteries. METHODS: Fragments of arterial wall of internal carotid artery were obtained during the surgical eversion endarterectomy in 15 patients with internal carotid artery stenosis and 2 healthy organ donors. 21 arteries were studied. Patients age ranged from 56 to 77 years. Fragments of arterial wall were embeded in paraffin. Lymphatics of arterial adventitia were visualized with immunohistochemistry using LYVE-1 and anty-podoplanin antibodies. RESULTS: The lymphatic vessels were visualized in adventitia of 20 carotid arteries. The serial sections have revealed that both LYVE-1 and podoplanin have identical specificity for lymphatic endothelium Number of lymphatics in adventitia significantly correlated with thickness of intima (p<0.046). CONCLUSIONS: Lymphatics are present in adventitia of internal carotid artery. Number of adventitial lymphatics increases with severity of atherosclerosis measured as intimal thickness.