Ageing-related changes in the levels of ß-catenin, CacyBP/SIP, galectin-3 and immunoproteasome subunit LMP7 in the heart of men.

Aging is a major risk factor for morbidity and mortality from cardiovascular causes in men. To better understand the cellular processes related to age-related cardiac complications, we undertook research aimed at comparative evaluation of genes expression and distribution of ß-catenin, CacyBP/SIP, galectin-3 and LMP7 in the heart of healthy men in different age groups. The study was conducted on the hearts of 12 men (organ donors) without a history of cardiovascular disease, who were divided into two age groups: men under and men over 45 years of age. On paraffin sections, immunohistochemical reactions were performed to detect ß-catenin, CacyBP/SIP, galectin-3 and immunoproteasome subunit LMP7. The expression of genes coding ß-catenin, CacyBP/SIP, galectin-3 and LMP7 was also evaluated by real-time PCR method. In the heart of men over 45 years old, both gene expression and immunoreactivity of ß-catenin, CacyBP/SIP, galectin-3 and LMP7 were stronger compared to younger individuals. The results of the presented studies suggest that ß-catenin, CacyBP/SIP, galectin-3 and immunoproteasomes might be involved in the internal regulation of heart homeostasis during ageing.

Differences in leptin biosynthesis in the stomach and in serum leptin level between men and women.

BACKGROUND AND AIM: Although the stomach has been identified as an important source of leptin, the detailed biosynthesis sites of leptin in human gastrointestinal tract have not been fully elucidated. The study objective was to compare leptin distribution and expression in the stomach and its serum level between healthy men and women. METHODS: Nineteen subjects (organ donors; 10 men and 9 women) with normal gastric mucosa histology were recruited. Research material contained gastric samples from the cardia, fundus, and pyloric regions. Gastric mucosa leptin content and leptin gene expression were determined by immunohistochemistry and real-time polymerase chain reaction method. Plasma leptin level was measured using ELISA method. RESULTS: In the stomach of healthy adult subjects, leptin-immunoreactive cells were mainly found in the fundus, and the number of immunoreactive cells was higher in women than in men. Leptin-containing cells were less numerous in the cardia and pylorus mucosa. Similarly, leptin gene expression was the highest in the fundus and higher in women than in men. Serum leptin level was higher in women than in men and was found to correlate positively with body mass index and weight in both sexes. A negative correlation between leptin level and age was noted in women, but not in men. CONCLUSIONS: The current study is the first to provide evidence for the presence of leptin-containing cells in all segments of the human stomach. The differences in gastric leptin biosynthesis and serum leptin levels between men and women suggest that leptin secretion can be controlled by sex hormones or other unknown factors.

Sex differences in distribution of cannabinoid receptors (CB1 and CB2), S100A6 and CacyBP/SIP in human ageing hearts.

BACKGROUND: Women live about 4 years longer due to lower prevalence of cardiovascular complication with ageing. However, the mechanisms involved in the preservation of heart functionality in women have not been fully elucidated. The endocannabinoid system fulfils a significant role in the regulation of cardiovascular system functioning. Cannabinoids, acting through specific receptors (CB1 and CB2), influence on blood pressure, heart rate and myocardial contractility. The function of cardiac muscle cells is strictly dependent on calcium ions. Calcium homeostasis in cardiomyocytes is subjected to complex regulation via calcium-binding proteins. Among them, increasing attention has been paid to the recently discovered S100A6 and CacyBP/SIP. In order to better understand sex differences in the regulation of cardiomyocyte function during ageing, we undertook the present research aimed at immunohistochemical identification and comparative evaluation of cannabinoid receptors, S100A6 and CacyBP/SIP, in the myocardium of ageing men and women. METHODS: The study was conducted on the hearts of 12 men and 10 women (organ donors) without a history of cardiovascular disease. The subjects were divided into two age groups: subjects older than 50 years and subjects under 50 years old. Paraffin heart sections were processed by immunohistochemistry for detection of cannabinoids receptors, S100A6 and CacyBP/SIP. In the heart samples from each study, participant's expression of genes coding for CB1, CB2, S100A6 and CacyBP/SIP using real-time PCR method was measured. RESULTS: CB1 and CB2 immunoreactivity in the cytoplasm of cardiomyocytes in the heart of subjects over 50 was weaker than in younger individuals. In the heart of younger men, CB1-immunoreactivity was weaker and CB2-immunoreaction was stronger compared to women. In the hearts of older men, the CB1-immunostaining was more intense and CB2-immunoreactivity was weaker than in women. Immunodetection of CB1 shoved the presence of receptor in the intercalated discs, but only in the hearts of individuals over the 50 years old. In the hearts of older individuals, stronger immunolabelling was observed for S100A6 and CacyBP/SIP. Male hearts had greater S100A6-immunoreactivity (both age groups) but less CacyBP/SIP immunostaining (individuals over 50 years) compared to the age-matched women. The expression of genes coding CB1, CB2, S100A6 and CacyBP/SIP in the human heart was sex and age-dependent. Observed changes between men and women as well as between subject under and over 50 years were consistent with immunohistochemically stated changes in peptide content. CONCLUSION: Together, the data presented here indicate a close interaction between ageing and sex on the distribution and levels of cannabinoid receptors (CB1, CB2), S100A6 and CacyBP/SIP in the human heart.

Comparative evaluation of cannabinoid receptors, apelin and S100A6 protein in the heart of women of different age groups.

BACKGROUND: Recent studies have shown a significant role of the endocannabinoid system, apelin and S100A6 protein in the regulation of cardiovascular system functioning. The aim of the study was to compare and evaluate the distribution of cannabinoid receptors (CB1 and CB2), apelin and S100A6 protein in the heart of healthy women in different age groups. METHODS: The study was conducted on the hearts of 10 women (organ donors) without a history of cardiovascular disease, who were divided into two age groups: women older than 50 years and women under 50 years of age. Paraffin heart sections were processed by immunohistochemistry for detection of cannabinoids receptors (CB1 and CB2), apelin and S100A6 protein. RESULTS: CB1 and CB2 immunoreactivity in the cytoplasm of cardiomyocytes in the heart of women over 50 was weaker than in younger individuals. There was also strong immunoreactivity of CB1 in intercalated discs (ICDs) of the heart, only in women over 50. The presence of this receptor in this location was not found in women under 50. Apelin- and S100A6-immunoreactivity in the cardiomyocytes was stronger in older women compared to women under 50.The CB1, apelin and S100A6 immunostaining in the endothelium of myocardial vessels was weaker in women over 50 than in younger women, while intensity of CB2- immunoreaction in coronary endothelium was similar in both groups of women. The results of the study indicate the important role of endocannabinoids, apelin, and S100A6 protein in cardiac muscle function. CONCLUSION: This report might contribute to a better understanding of the role of endocannabinoid system, apelin and S100 proteins in heart function as well as shed new light on processes involved in age-related cardiomyopathy.

Vertebroplasty of cervical vertebra.

BACKGROUND: The first vertebroplasty was performed by Harve Deramond in France in 1984 due to a hemangioma of cervical vertebral body. Procedure technique consisted of inserting a needle through the bony palate of the oral cavity. Bone cement injected under pressure not only fills the areas of bone loss. The heat released in the process of crystallization causes denaturation of pathological tissue proteins (metastasis) and disrupts blood supply (hemangiomas). The aim of this study was to evaluate the method of treatment from anterolateral access. MATERIAL/METHODS: In the years 2007-2012 the procedure was performed in 6 men and 9 women aged from 42 to 71 years (mean age: 56.3 years). In 10 cases the reason for vertebroplasty was the vertebral hemangioma, in another 4 - pathological vertebral fractures due to metastases, and in one case - multiple myeloma. Procedures were performed from anterolateral access, under local anesthesia, under x-ray guidance (fluoroscopy). Bone needle was inserted into the vertebral body, followed by injection of PMMA cement. RESULTS: In 100% cases pain relief was observed immediately after the procedure and beneficial therapeutic effect was obtained. No life-threatening complications and clinical symptoms were observed. Average length hospital stay amounted to 2.9 days. CONCLUSIONS: Cervical spine vertebroplasty from anterolateral access seems to be a safe, effective and beneficial method of treatment. It reduces the risk of infection in comparison to the transoral method.

Evaluation of vestibulo-ocular reflex in patients with damage to the central nervous system (GCS score 5-3).

PURPOSE: The aim of our study was to evaluate the vestibulo-ocular reflex (VOR) in patients with severe damage to the central nervous system (CNS) in the diagnosis of brain death and survival prognosis. MATERIAL AND METHODS: The study was conducted in 20 patients with extensive primary central nervous system damage against spontaneous intracranial haemorrhage or craniocerebral trauma and secondary central nervous system damage as a result of cardiac arrest with Glasgow Coma Scale (GCS) score from 3 to 5 treated in the Intensive Care Unit, University Hospital in Bialystok. For labyrinth stimulation we used water at 30°C, recording the reactions with ENG appliance. Records were analyzed in Nathanson-Bergman four-level scale. The first assessment was performed on the second day after the trauma and subsequently the assessments were repeated at 2-day intervals. RESULTS: Of the 20 patients studied, the reflex was recorded in nine, which accounted for 45%. In the remaining 11 (55%) patients the reflex was not reported in any test and all of them died. Among patients with recorded VOR, five died and four survived. CONCLUSIONS: The results of our study show the usefulness of performing the vestibulo-ocular test in patients with severe brain injury to predict their survival.

Vasculitis and stroke due to Lyme neuroborreliosis - a review.

Abstract Lyme neuroborreliosis (LNB) is a rare cause of vasculitis and stroke. It may manifest as subarachnoid hemorrhage, intracerebral hemorrhage, and most often ischemic stroke due to cerebral vasculitis. The vast majority of reported cases have been described by European authors. A high index of suspicion is required in patients who live or have traveled to areas with high prevalence of tick-borne diseases, and in the case of stroke-like symptoms of unknown cause in patients without cardiovascular risk factors. In this review, we also present four illustrative cases of vasculitis and stroke-like manifestations of LNB.

Infectious spondylodiscitis - a case series analysis.

PURPOSE: We aimed to describe the clinical and laboratory features as well as diagnostic difficulties in the case series of spondylodiscitis. MATERIALS/METHODS: We retrospectively reviewed 11 cases of spondylodiscitis. The diagnosis of spondylodiscitis was based on clinical, radiological and microbiological evidence and by the response to antimicrobial therapy. RESULTS: There were 7 men and 4 women, and the age ranged from 21 to 74 years. Risk factors of spondylodiscitis were observed in 7 patients. The approximate time from onset of symptoms to diagnosis was from 2 to 7 months (median 45 days). Back pain was the most common symptom. The most frequent location of spondylodiscitis was lumbar spine. Pathogens were isolated in 6 cases and were as follows: Staphylococcus aureus (4 cases), Staphylococcus warneri (1 case) and Escherichia coli (1 case). After therapy, all patients had rapid regression of symptoms and no permanent neurological impairments and recurrence of infection were observed. CONCLUSIONS: Diagnosis of spondylodiscitis is frequently delayed. This disease should be taken into consideration in differential diagnosis in patients with root syndromes accompanied by back pain and usually fever as well as increased values of CRP and ESR.

Extraordinary level of hormone and number of ghrelin cells in the stomach and duodenum of an obese woman.

Obesity is a major metabolic disorder, in which ghrelin plays a significant role. The objective of this study was to characterize the morphology of ghrelin cells in the stomach and duodenum and the levels of ghrelin and leptin in the serum of a 52-year-old obese woman. Material for the study was obtained from the stomachs and duodenum, of obese and control women. Each subject had been treated at the Intensive Care Unit of the Clinical University Hospital in Bialystok, due to brain damage, due to primary cardiac arrest. After brain death was diagnosed and individual death was confirmed by doctors, stomach and duodenum samples were collected from each body. Paraffin sections were stained with hematoxylin and eosin and processed for immunolocalization of ghrelin. The density of ghrelin cells in each part of the gastrointestinal tract was estimated under a light microscope with a digital camera. Ghrelin-IR cells were also analyzed in terms of morphometric features such as length, width and area. The ghrelin and leptin concentrations in each blood sample were measured by ELISA. Immunohistochemical studies revealed a small number of ghrelin cells in the stomach and duodenum which did not reflect the high level of hormone. The obese woman had lower number of ghrelin cells in the stomach and duodenum and elevated ghrelin and leptin levels in serum. It can therefore be assumed that additional source of ghrelin and probably changes in activity of ghrelin o-acylotransferase, are responsible for the high concentration of ghrelin in the obese woman.

Distribution pattern of CART-containing neurons and cells in the human pancreas.

Cocaine- and amphetamine-regulated transcript (CART) has been shown to play a critical role in appetite suppression, cell survival, thermoregulation, glucose sensing, stimulation of hormone secretion, as well as for the regulatory function of the islets of Langerhans. Although the principal site of CART synthesis has already been reported, our knowledge of the subject is mainly based on and limited to research conducted on animals owing to difficulties in obtaining human samples. Therefore, the primary goal of the reported study was an attempt to identify and localize CART in healthy human pancreas. Nineteen deceased subjects (donors of organs) with normal pancreas and alimentary tract were used in the study. After determination of brain death and confirmation of death by the relevant doctors committee, pancreas samples, about 1cm long, were collected from each corpse (the same part of the pancreas) after the organs were harvested for transplantation. Paraffin sections were made and stained with hematoxylin and eosin and then subjected to CART immunohistochemistry. In the normal pancreas of human adults, CART is mainly present in both nerve fibers and in nerve cell bodies in pancreatic ganglia. In addition to pancreatic neurons, immunoreactivity to CART was also seen in islet endocrine cells. This is the first report on the presence of CART-IR structures in the normal human pancreas. CART should be now added to the numerous regulatory peptides that are involved in the complex regulation of pancreatic endocrine and exocrine processes.

Proton MR spectroscopy in mild traumatic brain injury.

BACKGROUND: To assess the role of 1H MRS in the detection of changes in cerebral metabolite levels in pyramidal tracts after mild traumatic brain injury (MTBI) and to compare metabolite alterations to the clinical status (Glasgow Coma Scale). MATERIAL/METHODS: Study group consisted of 25 patients after mild traumatic brain injury, with a score of 11 to 15 in GCS. The MR studies were performed with a 1.5 T scanner. The results of spectra approximation (presented as metabolite ratios: NAA/Cr, NAA/Cho, Cho/Cr, lac/Cr, lip/Cr, Glx/Cr) were subjected to statistical analysis. MR spectra were recorded from a normal-appearing brain region: internal capsules and cerebral peduncles. Spectra from traumatic patients were compared with a control group including 34 healthy volunteers recorded with the same techniques. RESULTS: The statistical analysis revealed significant differences between the data obtained from various brain regions of the same patients after an MTBI and between the study and the control group. Proton MR spectroscopy detects changes in cerebral metabolite levels in apparently normal regions. In pyramidal tracts (internal capsules, cerebral peduncles), we noticed a significant reduction of NAA /Cho, lip/Cr, lac/Cr and Glx/Cr. CONCLUSIONS: In patients with mild brain injury, we can detect some metabolite abnormalities in normal-appearing brain structures. Proton MRS is a very useful tool for evaluation of major changes in metabolite levels in pyramidal tracts after mild traumatic brain injury.

[Neuroradiologic imaging results suggestive of parasitic cysts in central nervous system in course of neoplastic disorders--cases report]. / Obraz neuroradiologiczny imitujacy torbiele pasozytnicze osrodkowego ukladu nerwowego w przebiegu chorób nowotworowych--opisy przypadków.

Cystic changes within CNS, revealed by computed tomography or magnetic resonance imaging, pose difficult diagnostic and therapeutic problem. We present two patients with primary diagnosis of parasitic cysts of CNS, in whom neoplastic etiology was finally confirmed. Differential diagnosis of cystic foci should from the beginning include not only parasitic infections, but also neoplastic diseases, which are much more frequent in Poland at present and in which prolonged diagnostic process and delayed treatment is highly unfavorable.

The radiological symptoms of lumbar disc herniation and degenerative changes of the lumbar intervertebral discs.

BACKGROUND: The x-ray examination is one of the fundamental diagnostic modalities in patients with low-back-pain. The aim of study was to establish relation between radiological findings and herniation type and its localization. As well, we looked for relation between radiological findings and progression of disc degeneration. MATERIAL/METHODS: The study enrolled 187 individuals operated due to lumbar disc herniation. In each case the x-ray examination of lumbar spine was performed. Herniation was classified as protrusion, prolapse or disc sequestration. According to localization, herniation was defined as central, lateral or intermediate. Removed discs were histologically evaluated to determine degeneration symptoms. The radiological picture was related to the degeneration of the intervertebral discs. RESULTS: The statistical analysis revealed the only one relation -between traction osteophytes and herniation classified as disc prolapse (p<0.05). We found no relations between other radiological findings (narrow intervertebral space, diminished lordosis, scoliosis) and herniation and its localization within the spinal canal. Also there is no relation between disc degeneration and radiological findings. CONCLUSIONS: Classic x-ray examination presents low value in diagnostics of lumbar disc degeneration and its herniation. There is no relation between radiological picture and intensity of degenerative changes within the lumbar discs.

[Vascular proliferation within the herniated lumbar intervertebral discs in surgically treated patients]. / Proliferacja naczyniowa w zmienionych przepuklinowo ledzwiowych krazkach miedzykregowych, bedacych przyczyna leczenia chirurgicznego.

Blood vessels are observed in intervertebral discs of children, and after individuals skeletal maturity the intervertebral discs become avascular structures. According to some opinions, new vessels in the annulus fibrosus can appear in adults as a result of regeneration processes. The lumbar intervertebral discs resected during surgery due to low-back-pain and during autopsies (control group) were evaluated histologically. The vascular proliferation was observed in 35% of surgical specimens in all types of herniation (protrusio, prolapse, and free sequesters). The statistical analysis revealed that proliferation take place mainly in young individuals.

[Autopsy evaluation of the extent of degeneration of the lumbar intervertebral discs]. / Autopsyjna ocena stopnia degeneracji ledzwiowych krazków miedzykregowych.

The aim of study was to evaluate the degree of lumbar intervertebral disc degeneration during post-mortem studies, and its relation to the age and gender of cadavers. The changes of intervertebral disc were classified according to Nachemson [13]. The study included 308 lumbar intervertebral discs taken during autopsy from 57 females (mean age 41.83) and 79 males (mean age 42.06). Two hundred and forty discs showed degenerative changes. The statistic analysis revealed that the degeneration is more pronounced with age (ANOVA p < 0.05). The study demonstrated that in males degeneration occurs a decade earlier than in females, and could be observed in the second decade of life. Similarly, the degeneration of 3rd or 4th grade could be observed a decade earlier in men than in women. The statistical analysis revealed the differences (p < 0.05) in degeneration between upper (levels L2 and L3), and lower (levels L4 and L5) lumbar spine. Analysing the discs as single levels, no statistical differences in degeneration were observed.

[Ageing and degeneration of human lumbar intervertebral discs]. / Starzenie sie i degeneracja ledzwiowych krazków miedzykregowych u czlowieka.

Intervertebral discs undergo serious age-related changes. It is generally accepted that degeneration of discs begins during the second decade of life, and it is well known that other structures of spine do not change as fast as the intervertebral discs. The most extensive degenerative changes occur in the nucleus pulposus, including degradation of proteoglycans aggregates with its fragmentation, dehydration, and loss of viable cells. Data available in literature, suggests that the most critical factor contributing to the degeneration, is increasing volume of the disc due to its growth, resulting in longer nutritional pathways and insufficient nutrition.

[Lumbar intervertebral herniation. The composition of free sequesters--a morphologic study]. / Przepuklina ledzwiowego krazka miedzykregowego--morfologiczna ocena wolnych sekwestrów.

Since 1934 when surgery for lumbar disc herniation was first performed various forms of disc herniation have been described. It is generally accepted that disc herniations can be classified as follows: disc protrusion, disc prolapse, and free sequestration. Histological evaluations of protruded and prolapsed disc have been presented in literature, revealing degenerative changes. No special attention was given to free sequestered disc elements. The aim of this paper was to analyse the frequency of freely sequestered intervertebral disc fragments and to investigate the morphologic nature of sequestered discs. The free sequesters were observed in 15.5% of all operated cases (N = 187). In 16 (55.2%) of these cases the sequester was composed of nucleus pulposus material, in 12 (41.4%) cases end-plate elements were noted and in one case (3.4%) anulus fibrosus elements were found.

[Presence and intensity of the Lasegue sign in relation to the site of lumbar intervertebral disc herniation]. / Obecnosc i nasilenie objawu Lasegue'a a umiejscowienie i wielkosc przepukliny ledzwiowego krazka miedzykregowego.

The manouevre of stretching the sciatic nerve known as the Lasegue test is very useful in the clinical evaluation of patients with suspicion of lumbar disc herniation and has been in use for over 100 years. The relationship between the intensity of the Lasegue test and intraoperative localization of disc herniation is presented. The material comprised 87 cases (54 males and 33 females) aged 47 (+/- 9) years. Duration of symptoms was on average 9 months (+/- 7.5 months). The Lasegue sign was positive in 84 patients and negative in 3 patients (absent in 1 case, and more than 70 degrees in 2 cases). In the investigated group the Lasegue sign was positive at 39 degrees (+/- 22 degrees) on average. The obtained results indicate a strong relation between a positive Lasegue sign and disc herniation leading to direct spinal nerve or nerve sheath compression.

Degenerated lumbar intervertebral disc. A morphological study.

According to many investigators, lumbar disc herniation is formed by the nucleus pulposus displaced to the vertebral canal through the cracks in the annulus fibrosus as a final result of disc degeneration. Specimens obtained during 187 disc surgeries were studied to identify the morphological nature of various forms of disc herniation, especially protrusion and prolapse. In 29% of cases the herniated part was annulus fibrosus and in 21.5% cases the annulus fibrosus was seriously involved. Simultaneously 308 autopsy specimens were studied. On gross examination the signs of degeneration were advanced in 82, and strongly pronounced in 42. In 15 specimens, aged 40 years or older, fibre bundles were reversed to normal convex orientation producing annulus fibrosus bulge. Microscopic examination showed pronounced myxomatous degeneration within the annulus fibrosus. In these circumstances, we believe that general opinion must be verified, because in some herniations the nuclei pulposus are not involved and herniations are solely prolapses of annulus fibrosus. So, the lumbar intervertebral disc herniation should be classified on the basis of histological examinations as a herniation of nucleus pulposus, herniation of annulus fibrosus or as a mixed type herniation where both disc elements are involved.

[The efficacy of intraventricularly administered vancomycin in the case of central nervous system infection caused by enterococcus faecalis]. / Skutecznosc wankomycyny stosowanej dokomorowo w zakazeniu osrodkowego ukladu nerwowego wywolanego przez Enterococcus faecalis.

The case of 40 years old man with subarachnoid hemorrhage with intraventricular bleeding and with consecutive cerebro-meningitis is presented. The bacterial pathogen was Enterococcus faecalis sensitive only to glycopeptide antibiotics. The standard therapy with intravenously administered Vancomycin and Teicoplanin was not effective. Because of the worsening of patient's clinical status and clinical symptoms of sepsis the intraventricular Vancomycin (20 mg/day) was introduced. At the second day of the therapy the gradual patient's recovery was observed. The symptoms typical for meningitis diminished as well as cerebro-spinal fluid (CSF) parameters normalized. There was no bacterial growth in the blood serum and in CSF. As we can observe the intraventricular administration of Vancomycin is efficient method of cerebro-meningitis treatment. In our opinion the blood-brain barrier, even pathologically changed by infection, do not allow antibiotics to penetrate CSF, even in the maximal intravenous doses. In the cases of cerebro-meningitis caused by bacteria sensitive only to glycopeptide antibiotics, the intraventricular administration of the drug might be an alternative way of therapy especially when the doses of intravenous antibiotics need to be reduced.