Exercise capacity and cardiac hemodynamic response in female ApoE/LDLR(-/-) mice: a paradox of preserved V'O2max and exercise capacity despite coronary atherosclerosis.

We assessed exercise performance, coronary blood flow and cardiac reserve of female ApoE/LDLR(-/-) mice with advanced atherosclerosis compared with age-matched, wild-type C57BL6/J mice. Exercise capacity was assessed as whole body maximal oxygen consumption (V'O2max), maximum running velocity (vmax) and maximum distance (DISTmax) during treadmill exercise. Cardiac systolic and diastolic function in basal conditions and in response to dobutamine (mimicking exercise-induced cardiac stress) were assessed by Magnetic Resonance Imaging (MRI) in vivo. Function of coronary circulation was assessed in isolated perfused hearts. In female ApoE/LDLR(-/-) mice V'O2max, vmax and DISTmax were not impaired as compared with C57BL6/J mice. Cardiac function at rest and systolic and diastolic cardiac reserve were also preserved in female ApoE/LDLR(-/-) mice as evidenced by preserved fractional area change and similar fall in systolic and end diastolic area after dobutamine. Moreover, endothelium-dependent responses of coronary circulation induced by bradykinin (Bk) and acetylcholine (ACh) were preserved, while endothelium-independent responses induced by NO-donors were augmented in female ApoE/LDLR(-/-) mice. Basal COX-2-dependent production of 6-keto-PGF1α was increased. Concluding, we suggest that robust compensatory mechanisms in coronary circulation involving PGI2- and NO-pathways may efficiently counterbalance coronary atherosclerosis-induced impairment in V'O2max and exercise capacity.

Barium concentration in cast roe deer antlers related to air pollution caused by burning of barium-enriched coals in southern Poland.

Concentrations of Ba, Zn, Pb, Fe, and Mn were determined by atomic absorption spectroscopy in freshly cast antlers from male roe deer of different ages (2 to 4 years old and older than 4 years) collected in Balin near Chrzanów and in the vicinity of Zywiec, S Poland. Barium content ranged from 124 to 196 ppm (mean 165 ppm) in the Balin 12 samples and from 207 to 351 ppm (mean 287 ppm) in 3 antlers from Zywiec. The concentration of Ba was comparable to that of Zn (134-275 ppm, mean 169 ppm). Elevated concentrations of Ba in antlers most probably originated from direct uptake of airborne barite nanocrystals through the respiratory system and/or by digestion of barite-rich dust particles deposited on plants. Burning of Ba-enriched coals is regarded as the principal source of Ba in the investigated areas inhabited by roe deer. Increased concentrations of Ba in antlers from the Zywiec area compared to Balin reflect particularly high air pollution caused by coal-burning mostly for domestic purposes combined with an unfavorable topography that impedes efficient air circulation.

Characterization of Porcine Granulosa Cell Line AVG-16.

Commercially available, but not yet characterized, the AVG-16 granulosa cell line was established from granulosa cells of medium porcine follicles. To examine the suitability of the AVG-16 cell line for studying the molecular mechanism of action of various environmental oestrogens, we investigated: 1/ cell morphology (by standard haematoxylin and eosin (HE) staining); 2/ basal and follicle-stimulating hormone (FSH) or luteinizing hormone (LH)-stimulated steroid hormone (progesterone; P4 and 17ß-oestradiol; E2) secretion (by radioimmunoassay) and 3/ expression of receptors involved in the regulation of granulosa cell function: FSH receptor (FSHR), LH receptor (LHR), oestrogen receptor α (ERα), oestrogen receptor ß (ERß) and aryl hydrocarbon receptor (AhR). mRNA and protein expression was determined by RT-PCR and fluorescence immunocytochemistry, respectively. The secretion of P4 and E2 by AVG-16 cells was in the range of steroid hormone secretion by porcine cultured primary granulosa cells. Neither FSH (100 ng/ml) nor LH (100 ng/ml) affected P4 and E2 secretion by AVG-16 cells. The presence of FSHR and LHR at both mRNA and protein level was not demonstrated in the cells. However, AVG-16 cells were found to express mRNA and protein of ERα, ERß and AhR. The results of our study showed that AVG-16 cells possess the capability of steroid hormone production, and both oestrogen receptors and AhR are present in these cells. Therefore, AVG-16 cells may serve as an unlimited source of homogenous porcine granulosa cells useful for studying the effects of environmental oestrogens on ovarian physiology.

The severity of depressive symptoms vs. serum Mg and Zn levels in postmenopausal women.

The aim of this study was to assess the severity of depressive symptoms in postmenopausal women, depending on serum Mg and Zn levels. The study involved 171 postmenopausal women from Poland, who were not using menopausal hormone therapy (MHT). The intensity of depressive symptoms was evaluated using a standard research technique, the Beck Depression Inventory (BDI). The plasma Mg and Zn concentrations were measured. Depressive symptoms of different severity levels were diagnosed in 36.8 % of the women. The mean serum Mg level was 1.53 ± 0.28 mg/dL, and Zn level was 72 ±14 µg/dL. The women with higher serum Mg and Zn levels had less depressive symptoms, and this observation is a precious information which can be used when planning depressive disorder prevention programmes.

PM(2.5) in the central part of Upper Silesia, Poland: concentrations, elemental composition, and mobility of components.

The paper discusses ambient concentrations of PM(2.5) (ambient fine particles) and of 29 PM(2.5)-related elements in Zabrze and Katowice, Poland, in 2007. The elemental composition of PM(2.5) was determined using energy dispersive X-ray fluorescence (EDXRF). The mobility (cumulative percentage of the water-soluble and exchangeable fractions of an element in its total concentration) of 18 PM(2.5)-related elements in Zabrze and Katowice was computed by using sequential extraction and EDXRF combined into a simple method. The samples were extracted twice: in deionized water and in ammonium acetate. In general, the mobility and the concentrations of the majority of the elements were the same in both cities. S, Cl, K, Ca, Zn, Br, Ba, and Pb in both cities, Ti and Se in Katowice, and Sr in Zabrze had the mobility greater than 70%. Mobility of typical crustal elements, Al, Si, and Ti, because of high proportion of their exchangeable fractions in PM, was from 40 to 66%. Mobility of Fe and Cu was lower than 30%. Probable sources of PM(2.5) were determined by applying principal component analysis and multiple regression analysis and computing enrichment factors. Great part of PM(2.5) (78% in Katowice and 36% in Zabrze) originated from combustion of fuels in domestic furnaces (fossil fuels, biomass and wastes, etc.) and liquid fuels in car engines. Other identified sources were: power plants, soil, and roads in Zabrze and in Katowice an industrial source, probably a non-ferrous smelter or/and a steelwork, and power plants.

[Protective mechanism of the gastric mucosa]. / Ochranné mechanizmy zaludecní sliznice.

The gastric mucosa represents a masterpiece in the functional design. As the tissue lining the stomach, it secretes aggressive combination of digestive fluids, powerful enough to digest any tissue. Nonetheless, the gastric mucosa remains undamaged by the effect of its inherent protective mechanisms. The possibility of development of gastric erosions and ulcers remains vivid evidence that the gastric mucosa is not always resistant to injury.

[Indication for the treatment of Helicobacter pylori infection]. / Indikace k eradikaci a lécbe infekce Helicobacter pylori.

Helicobacter pylori is a microorganism that is thought to play a role in the etiopathogenesis of peptic ulcer disease. Eradication of this microorganism is valuable clinical cure of infected patients. Efficacious regimens generally include an antisecretory agent combined with two antimicrobials. The main determinant of overall cost of treatment is the rate of eradication of the microorganism. Resistance can occur to the commonly used antibiotics but can usually be overcome with an altered regimen. It is important for care physicians to clearly understand indication and how to select appropriate therapy against Helicobacter pylori infection.

[Helicobacter pylori infection and diseases of the stomach and duodenum]. / Problematika infekce Helicobacter pylori u chorob zaludku a duodena.

The last twenty years have been the witness of the major revolution in the medical science and practice. Pathogenesis of gastric ulcer disease has probably undergone the most serious change both in the conception and in practice. Though the number of information concerning Helicobacter pylori (Hp) is rising explosively, our understanding of the specific and detailed role of Hp infection in the pathogenesis of various Hp related diseases remains modest.

Genetic factors in the development of gastric precancerous lesions--a role of Helicobacter pylori ?

UNLABELLED: Helicobacter pylori is believed to predispose to gastric cancer by inducing gastric precancerous alterations. There is a well known predisposition to gastric cancer and the risk of developing it is greater in relatives of patients with familial cases of this malignancy. The aim of this study was to determine the prevalence of gastric precancerous lesions (atrophy and intestinal metaplasia) and their association with Hp infection in first-degree relatives in patients with noncardia gastric cancer. METHODS: Hp status and gastric histology assessed by upper gastrointestinal endoscopy, biopsies from the antral and body region, the rapid urease test and staining for Hp, inflammation, activity, atrophy and intestinal metaplasia (prevalence and grading) were studied in 108 first-degree relatives of patients with noncardia gastric cancer and compared with 73 controls with mild non-ulcer dyspepsia who had no cancer relatives and were examined in the same way. RESULTS: subjects with and without cancer relatives had a similar prevalence of Hp infection (49 vs. 47%). Endoscopy revealed a few asymptomatic duodenal ulcers and small hiatus hernias in Hp positive subjects of both groups. Hp positive relatives of gastric cancer had a markedly higher prevalence of atrophy than those with Hp negativity without cancer relatives (29 vs. 9%) and those with Hp negativity and cancer relatives (29 vs. 3%. Prevalence of intestinal metaplasia was also higher in those with Hp positivity and cancer relatives than in those without cancer relatives (15 vs. 5% and was not present in Hp negative subjects with cancer relatives. Inflammation and activity showed similar scores in subjects with and without cancer relatives with higher scores in both Hp positive groups. The prevalence of precancerous lesions in the relatives of gastric cancer was nearly always confined to those with Hp positivity. One year after eradication the prevalence of atrophy in cancer relatives decreased from 29 to 14%; prevalence of intestinal metaplasia remained without substantial changes. Scores for inflammation and activity were also lower after eradication. CONCLUSIONS: First-degree relatives of patients with gastric cancer have an increased prevalence of gastric precancerous abnormalities which are strongly confined to those with Hp infection. Eradication of Hp in these subjects with cancer relatives reduces the prevalence of precancerous lesions (atrophy) and grades of inflammation and activity. In view of these results, eradication of Hp should be offered to such subjects.

[The results of treatment of laryngeal cancer in 30-year material of General Hospital in Zielona Góra]. / Wyniki leczenia raka krtani w 30-letnim materiale Oddzialu Laryngologii Szpitala Wojewódzkiego w Zielonej Górze.

The authors present the material of 520 patients with cancer of the larynx operated during 1969-1998. Most of them (60%) have had III-th and IV-th degree advanced cancer. 399 (77%) patients have had the combined treatment--laryngectomy and X-ray or Co-therapy. The 5 years survival rate of 341 patients treated during 1969-93 is presented. 5-year cures after surgery occurred in 188 patients (55%).

The role of the host versus the environment in duodenal ulcer disease.

Gastric functions can be understood only in the context of a network including the brain gut axis, neuro-endocrine and paracrine mechanisms and growth factors. These host factors including parietal cell sensitivity (PCS) may well interact with an important environmental factor, Helicobacter pylori (Hp), and help to explain its actions. The aim of this study was to investigate PCS related to Hp status and duodenal ulcer (DU). PCS was assessed by constructing dose-response curves after pentagastrin and calculating the D50. Five groups of patients were studied: I) active DU, Hp pos. (8); II) history of DU, Hp pos. (8); III) asymptomatic Hp pos. (8); IV) asymptomatic Hp neg. (10); V) DU on maintenance H2 blocker therapy, Hp pos. (20). PCS was repeated after Hp eradication. PCS was lowest in group IV, and in Hp pos. groups, was significantly higher, with insignificant differences among them, irrespective of DU. PCS declined significantly after Hp eradication. Group V showed an insignificant decline in PCS during treatment, not preventing recurrence. A higher PCS in Hp infection irrespective of DU, declining after eradication, suggests that this may be a reversible epiphenomena related to Hp infection. This may offer an explanation as to why DU develops only in some subjects with Hp, suggesting the importance of the host in the pathogenesis of DU.

[Accidental poisoning with silo gas]. / Przypadkowe zatrucie gazem silosowym.

Eight cases of poisoning in workers cleaning silo are presented. Silo gas, produced during fermentation of vegetable material, contains very toxic nitrogen oxides. In this group three workers died within silo, four patients were hospitalized (one of them with acute toxic pulmonary oedema, two with sings of pneumonia, one had only transient decrease of consciousness) and recovered without detectable sequelae. One patient, in general good condition, refused hospitalization and recovered.

[Viruses and primary hepatocellular carcinoma]. / Viry a primární hepatocelulární karcinom.

The etiological association between primary hepatocellular carcinoma (PHCC) and chronic viral hepatitis has been proved by now beyond doubt in the hepatitis B virus (HBV) and C virus (HCV). PHCC develops most frequently in cirrhotic livers, sometimes also in the absence of cirrhosis. Extensive epidemiological studies provided convincing evidence of this etiological relationship which is also supported by observations and animal experiments. An important factor in hepatocarcinogenesis due to the influence of HBV is integration of the viral genoma into the liver cell genoma. In the tumourous part of the liver integrated HBV sequences are more frequent than in the non-tumourous part. The integration can produce changes in the genome of the liver cell which may sometimes lead to malignant transformation. The mechanisms of this process are not quite clear so far. Their outcome--the development of carcinoma--can be summarized as the peak effect of factors leading to the disorganization of DNA with participation of chromosomal changes, the action of transactivation of HBs protein, transformation growth factors and the important influence of mutations of the suppressor gene p 53 on the 17th chromosome which is probably the target of HBV. HCV produces chronic live: disease developing into cirrhosis and PHCC, even more frequent than HBV; however its integration into the liver cell does not take place. The genetic variability of this gene is great. Its transformating action is probably implemented rather as a co-carcinogen on the background of cirrhosis of the liver which alone regardless of its cause is an increased risk for the development of PHCC. In clinical practice these findings imply the necessity of optimal prevention of chronic viral hepatic infection (vaccination, so far available for HBV, transfusions) and the necessity to assess the virological status in patients with chronic liver disease and early detection of small tumourous liver lesions where nowadays due to modern therapeutic approaches the prognosis has improved greatly.

Healing of gastric body ulcer with gastroprotective versus antisecretory treatment.

The aim of this study was to compare the healing effect of a gastroprotective agent and antisecretory drugs in gastric body ulcer where failure of the mucosal defense might be an important factor. Eighty-five patients with benign gastric ulcer were divided into four groups: treated with antacids (I), cimetidine (II), ranitidine (III), and colloidal bismuth subcitrate (De-Nol) (IV). Endoscopically confirmed complete healing was achieved in 57, 61, and 63% in groups I, II, and III, respectively, and in 88% in group IV (P < 0.05). Gastric secretion did not change significantly. Relapses during the next three years occurred several times more frequently in groups I, II, and III than in group IV. Helicobacter pylori was positive in about half the relapsing patients in groups I, II, and III but negative in those of group IV. It is concluded that De-Nol treatment of gastric body ulcer was more efficient than antisecretory drugs both initially and in reducing relapses.

Clinical implications of recognition of the hereditary non-polyposis colon cancer syndrome (HNPCC) for the early detection of colorectal cancer.

UNLABELLED: Hereditary non-polyposis colon cancer (HNPCC), also known as the Lynch syndrome or, previously, as the cancer family syndrome (CFS) is a recently defined autosomal cancer syndrome which is different from familial adenomatous polyposis and accounts for a considerable proportion of colorectal cancer (CRC). The main features of HNPCC include familial aggregation of CRC (either solely or combined with other, particularly gynaecological cancer sites- Lynch I or II, resp.), very frequent localization of the cancer in the right colon, a considerably lower age at the time of occurrence and a high risk of synchronous and metachronous tumours. Recognition of the syndrome through family history offers an important chance to detect CRC at a presymptomatic stage with a positive effect on the prognosis. In 1981/82 we started a prospective follow-up of symptom-free subjects conforming with the criteria of HNPCC. Up to 1994 we found 364 subjects of this type coming from 38 families. After initial colonoscopy these subjects entered a system of colonoscopic surveillance built up according to the individual degree of risk. Initial colonoscopy revealed cancer in 61 and adenomas in 122 subjects, both in more than 70% in the right colon. The mean age at this time was 47.5 in cancer and 45.3 in adenomas. More cancers and adenomas were found on repeated colonoscopies during surveillance. All the cancers were well resectable, a 5 year survival in all. During this course in a group of 239 non-screened symptomatic cases of the HNPCC syndrome, detected only at the time of colonoscopy, cancer was found in 146 and adenomas in 71 patients. Five year survival was 65% in this group. The cancers in the screened group were Dukes A and B (mostly A) in 82% and C in 18%, in the symptomatic group Dukes A or B (mostly B) in 67%, C in 18 and D in 15%. - CONCLUSIONS: The results show more favourable colonoscopic findings and better prognosis in symptom-free, colonoscopally screened cases of HNPCC than in symptomatic ones and fully justify an active approach based on colonoscopic surveillance of HNPCC subjects prior to diagnosis.

[Risk of development of colorectal carcinoma in patients with ulcerative colitis]. / Riziko vzniku kolorektálního karcinomu u nemocných s ulcerózní kolitidou.

In patients with ulcerative colitis of prolonged duration and major extent there is according to the majority of investigations an increased risk of development of colorectal carcinoma; the magnitude of the risk which is of major importance for clinical practice, however, differs according to different authors. The present study comprises 189 patients with ulcerative colitis, 103 men and 86 women, perspectively followed up for a period of 12.5 years (8.0-24.5). In 60 patients the distal form was present, in 68 left-sided colitis and in 61 pancolitis. The patients were monitored systematically--clinically colonoscopically and endoscopically. The intervals between these check-ups were gradually shorter when the disease persisted for 10 or 12 years, i.e. the patients were checked once to twice a year. The endoscopic findings were focused in particular on evidence of dysplasia. The follow-up system was modified with regard to individual conditions. In the course of the follow-up colorectal carcinoma was detected in 9 patients (4.8%) with a persistence of the disease for 9-25 years (in one patient after 9 years, in 5 after 10-20 years and in 3 after longer periods). In three instances the left-sided form was involved, in 6 pancolitis. Dysplastic changes were mostly medium grade and were found at least once in all patients. The preoperative diagnosis of carcinoma was established for certain in three patients, there was major suspicion in four patients. In two patients the carcinoma was detected only on operation (in active forms of the disease). All carcinomas were resectable, 4 times DUKES A, 4 times B, once C. As to the remaining 180 patients, 32 were operated on account of colitis; in 28 at least once dysplasia was proved, with a rising trend as the disease had a prolonged duration. These results confirm the increased risk of carcinoma in ulcerative colitis with a long duration and with a major extent and justify systematic colonoscopic and endobioptic follow-up of these patients.

[Early diagnosis of colorectal carcinoma in the familial carcinoma syndrome (Lynch I and II)]. / Casná diagnóza kolorektálního karcinomu v syndromu karcinomové rodiny (Lynch I a II).

The hereditary form of colorectal cancer (Lynch syndrome, cancer family syndrome "nonpolyposis hereditary colorectal cancer"), which is different from familial adenomatous polyposis, represents probably 5-8% of the development of this malignancy. The main characteristics of the syndrome include an autosomal dominant hereditary type, frequent familial occurrence of colorectal cancer (either solely at this site--Lynch variant I--or in combination with other, particularly gynecological sites of cancer-Lynch variant II), younger age at the time of diagnosis, more frequent localization in the right colon and more frequent occurrence of synchronic and metachronic cancer. During the years 1982-1992, we found 339 asymptomatic members of families meeting the criteria of the syndrome. After initial colonoscopy these individuals entered a long-term surveillance system with repeated colonoscopies; intervals between them where organized according to the individual degree of risk and to at the initial finding. Results of initial colonoscopy showed colorectal cancer in 16.2% and adenomas in 32.1% of the whole group. The right colon was affected in 74.5% of the cancers and in 64% of the adenomas; the mean age of the probands with these findings was 46.4% years. The Lynch variant I was found in 34%, the variant II in 66%. Cancer in relatives of the variant II was mostly in the colorectal, followed by the gynecological region. The highest number of cancers detected on initial colonoscopy was found in probands with the highest degree of genetic risk-with 3 or more than 3 direct relatives. On repeated colonoscopies a new cancer was found in 7 further probands. All the cancers were well resectable, mostly DUKES A and B.(ABSTRACT TRUNCATED AT 250 WORDS)

[Significance of the detection of the familial carcinoma syndrome (Lynch I and II) in the early diagnosis of colorectal carcinoma]. / Význam detekce syndromu karcinomové rodiny (Lynch I a II) pro casnou diagnózu kolorektální rakoviny.

In 1982-1991 at the Fourth Medical Clinic 309 asymptomatic family members meeting the criteria of the hereditary form of colorectal carcinoma (Lynch syndrome--syndrome of familial cancer, also "non-polypous" hereditary colorectal carcinoma) which differs from familial polyposis (adenomatosis) of the colon. The syndrome is characterized by autosomal dominant heredity and by familial incidence of colorectal carcinoma (Lynch I) or colorectal carcinoma and carcinoma of other, in particular gynaecological areas (Lynch II) and a younger age of the affected subjects, a more frequent localization in the right colon, synchronous and metachronous neoplasia. In the authors group 34% were type I, the remainder type II. Initial total coloscopy revealed carcinoma in 51 subjects (78% in the right colon), adenomatous polyps in 99 (73% in the right colon). The mean age of the patients with carcinoma was 47.5 years, of those with adenoma 46.5 years. The majority of cases were recorded in subjects with three or more than three direct relatives with carcinoma (highest risk grade). During subsequent coloscopic check-up examinations at intervals depending on individual risk, colorectal carcinoma was detected in another six subjects. In 30 patients it was carcinoma Dukes A, in 12 B and in 3 Dukes C. These results indicate that identification of asymptomatic cases of Lynch syndromes via the family-history and coloscopic follow-up contributes to the early diagnosis of colorectal carcinoma.

Resistance to medical ulcer therapy--possible reasons and management.

UNLABELLED: In 112 patients with duodenal ulcer (males, mean age 29, range 18-35) with a history of at least 3 years, and never being treated with H2-antagonists, maintenance therapy with Tagamet was started. All of them had ulcer recurrence when entering the study. The first two months a full dose was applied, after this bedtime doses up to 24 months. Endoscopy was performed at the beginning, after the first and second months and then every two-month period. Gastric secretion was measured every 2-3 months. A resistant ulcer was defined as one 1/not healing within the two initial months, 2/recurring on maintenance treatment. RESULTS: in 78% the ulcer was healed within one month, in 96% within two months, in the rest within the following 3-4 weeks. Relapses occurred in 21 patients, altogether 27 times. Factors likely to contribute to recurrence included a large ulcer size, longer duration, an inflamed mucosa and--most frequently--heavy smoking. Patients with relapses had higher initial secretory values and smaller decrease during maintenance treatment. Helicobacter pylori (examined in a subgroup) was not clearly associated with ulcer recurrence.