SLEEP-GOAL: A multicenter success criteria outcome study on 302 obstructive sleep apnoea (OSA) patients.

OBJECTIVE: To demonstrate SLEEP-GOAL as a more holistic and comprehensive success criterion for Obstructive Sleep Apnoea (OSA) treatment. METHODS: A prospective 7-country clinical trial of 302 OSA patients, who met the selection criteria, and underwent nose, palate and/or tongue surgery. Pre- and post-operative data were recorded and analysed based on both the Sher criteria (apnoea hypopnea index, AHI reduction 50% and <20) and the SLEEP-GOAL. RESULTS: There were 229 males and 73 females, mean age of 42.4±17.3 years, mean BMI 27.9±4.2. The mean VAS score improved from 7.7±1.4 to 2.5±1.7 (p<0.05), mean Epworth score (ESS) improved from 12.2±4.6 to 4.9±2.8 (p<0.05), mean body mass index (BMI) decreased from 27.9±4.2 to 26.1±3.7 (p>0.05), gross weight decreased from 81.9±14.3kg to 76.6±13.3kg. The mean AHI decreased 33.4±18.9 to 14.6±11.0 (p<0.05), mean lowest oxygen saturation (LSAT) improved 79.4±9.2% to 86.9±5.9% (p<0.05), and mean duration of oxygen <90% decreased from 32.6±8.9 minutes to 7.3±2.1 minutes (p<0.05). The overall success rate (302 patients) based on the Sher criteria was 66.2%. Crosstabulation of respective major/minor criteria fulfilment, based on fulfilment of two major and two minor or better, the success rate (based on SLEEP-GOAL) was 69.8%. Based solely on the Sher criteria, 63 patients who had significant blood pressure reduction, 29 patients who had BMI reduction and 66 patients who had clinically significant decrease in duration of oxygen <90% would have been misclassified as "failures". CONCLUSION: AHI as a single parameter is unreliable. Assessing true success outcomes of OSA treatment, requires comprehensive and holistic parameters, reflecting true end-organ injury/function; the SLEEP-GOAL meets these requirements.

Cell viability of normal human skin fibroblast and fibroblasts derived from granulation tissue: effects of nutraceuticals.

The effects of lycopene, genistein, and epigallocatechin-3-gallate (EGCG) on cell viability were tested in vitro using a normal human skin fibroblast (NHSF) cell line (CRL-1474) and granulation tissue fibroblasts (GTFs) obtained from a patient with middle ear cholesteatoma. Cell cultures were added with lycopene (1, 5, and 10 microM), genistein (1, 5, 10, 25, and 50 microM), and EGCG (1, 5, 10, 25, and 50 microM) and their respective control cultures were established by adding 5 mL/L tetrahydrofuran (THF), 5 mL/L dimethyl sulfoxide (DMSO), and 5 mL/L DMSO. A colorimetric assay was employed for determining cell viability using thiazolyl blue tetrazolium bromide. Cell viability was expressed as a percentage of the control. Data were analyzed using two-way analysis of variance separately for each compound. Lycopene addition decreased viability of NHSFs and GTFs compared with THF addition (64.1%, 60.5%, and 100%, respectively, P < .0001). Genistein addition also increased viability of both NHSFs and GTFs compared with DMSO addition (P < .02). Increasing EGCG concentration tended to cause a linear increase in viability of NHSFs but did not alter viability of GTFs (P < .10). Our data suggest that genistein and EGCG but not lycopene could help maintaining or improving skin health through enhancing viability of skin fibroblasts.

Comparative cytokeratin distribution patterns in cholesteatoma epithelium.

Cytokeratins (CKs) are known as the intermediate filament proteins of epithelial origin. Their distribution in human epithelia is different according to the type of epithelium, state of growth and differentiation. We used monoclonal mouse antibodies against cytokeratins to study CK expression in the following human tissues: cholesteatoma, middle ear mucosa, glandular epithelium, and meatal ear canal epithelium. Immunohistochemical processing was performed using the labeled steptavidin peroxidase method to demonstrate the presence of CKs in cells of human epidermis. Positive reaction was obtained for CK4, CK34betaE12, CK10, CK14 in skin and cholesteatoma epithelium. However, a more extensive positive reaction with those CKs was observed in cholesteatoma epithelium. Positive immunoreactivity was seen with anti- CK19 in the glandular epithelium. Middle ear mucosa specimens revealed positive immunoreactivity with the antibodies against CK4. The expression of CK4 was definitely positive within the basal layers of the epidermis. The glandular epithelium showed no positive reaction with anti- CK4, anti- CK34betaE12, anti- CK14 and anti-CK10. Immunohistochemistry for CK18 showed no reaction in all examined tissues. Cholesteatoma is known as a proliferative disease in the middle ear which pathogenesis is not completely understood. Keratinocytes express hyperproliferation- associated CKs and after reaching the suprabasal layers they finally undergo apoptosis creating keratinous debris. Cytokeratin expression observed in the epithelium explains proliferative behavior of cholesteatoma which is associated with increased keratinocyte migration. Cytokeratins can be used as potential proliferative markers. It can also allow for searching the usefulness of inhibiting regulators in the treatment of hyperproliferative diseases.

The maturation rate of girls living in rich and poor rural regions of Poland before and after the transformation of 1989.

The aim of this study was to find out whether the political and economic system transformation in Poland in 1989 had an influence on the rate of maturation of girls from various categories of the rural population in two regions, differing in wealth. The stratification of the villagers was based on the source of the family income (farmers, farmer-workers and non-farmers), on parents' education, and on the number of children per family. The age at menarche (AM) was used as biological indicator of living conditions. Rural girls aged 9.5-18.5 years were studied in 1987 in Leszno (L), a rich region (n = 2049), and in 1989 in Suwalki (S), a poor region (n = 2077). The study was repeated in 2001 in the same villages, the numbers of subjects amounting to 2440 and 2122, respectively. In the 1980s, AM in regions L and S amounted to 13.18 and 13.88 years, respectively, and was strongly related to social stratification. The earliest AM was found in daughters of non-farmers and the latest in the girls from farmers' families. In 2001, the acceleration in AM amounted to 0.14 years in the rich region and to 0.46 years in the poor region. The percentage of families owning a car, freezer, colour TV and automatic washing machine markedly increased and the education of parents improved. Such results are indicative of an improvement in the living standard of the groups investigated, but the villagers regard themselves as the losers as a result of the system transformation in Poland. Since the Polish population is considered as ethnically homogenous, the great differences in AM within the rural population, as well as the differences between the inhabitants of villages and large cities should be regarded as biological effects of social inequalities. Such differences indicate that Polish rural girls are far below the genetic potential for menarcheal age.

[The assessment of the modified radical neck dissection in the treatment of laryngeal cancer]. / Ocena wyników zmodyfikowanej operacji radykalnej wezlów chlonnych szyi w leczeniu raka krtani.

The retrospective analysis of 238 patients treated because of laryngeal cancer was performed to examine the results of modified radical neck dissection. Authors estimated the presence of nodal metastases in clinically negative and clinically positive neck. Evaluation of the metastatic node levels was performed.

Somatic DNA variability in human breast carcinoma.

Bkm-related probe 2[8], consisting mainly of GATA repeats, detects a hypervariable pattern of restriction fragment length polymorphisms in human DNA which is normally developmentally stable. However, specific somatic DNA variability was found in 53% (7/13) of human breast carcinomas, but not in eight cases of bladder carcinoma, when compared with leukocyte DNAs from the same patient under the same conditions. Certain of the restriction fragments detected carry both GATA-related sequences and sequences related to the M13 vector. Comparison of BstN1 digests of tumour and cognate leukocyte DNA revealed a further variable ethidium-stained restriction fragment class, not recognised by the probe, in 93% of breast and in 63% of bladder carcinomas.

The effect of certain anions on muscle resting potential in Tenebrio molitor.

Experiments were carried out on longitudinal ventral muscles of the mealworm larva (Tenebrio molitor) using conventional microelectrode methods. Both sodium nitrate and sodium sulphate depolarized the fibres markedly, whereas sodium propionate exerted an hyperpolarizing influence. It is concluded that the differences in the mode of action are due to different permeabilities of the membrane to the applied anions. The results obtained confirm also the concept of a multi-ionic electrode with respect to insect muscle fibres.

Mitochondrial chromatin in Paramecium aurelia.

Chromatin-like structures have been observed in material extracted from the mitochondria of Paramecium aurelia and evidence is presented which establishes that these structures do not originate from nuclear contamination of mitochondrial preparations but are exclusively of mitochondrial origin. Extraction of these chromatin-like structures with dilute acid followed by gel electrophoresis of the extract shows the presence of five major basic proteins which are of similar electrophoretic mobility to histones. Digestion of mitochondrial extracts with endogenous nuclease, followed by electrophoresis of the extracted DNA, demonstrated that the mitochondrial genome is protected from nuclease digestion by regular repeating units very similar to those observed in the nuclease digestion of chromatin.

Further studies on the influence of ions on the muscle fibre resting potential in the cricket Acheta domesticus.

Experiments were carried out on tergosternal muscle fibres of the house cricket Acheta domesticus. Conventional microelectrode methods were used. All the investigated fibres depolarized with time (0, 60, 120 min) in statistically significant manner. Replacing CL- in the physiological solution by carbonate prevents this depolarization. Citrate anions added to the bath depolarize the fibers. Acetate does not change the resting potential. Increasing osmolarity by adding 100 or 200 mM saccharose exerts no significant influence on the level of the resting potential. Lowering the level of sodium ions leads to a slight but significant depolarization. The present work confirmed the opinion that skeletal muscle fibers of Acheta domesticus are at rest multiionic electrodes.

The effect of some ions on the muscle fibre resting potential in the cricket Acheta domesticus.

Experiments were carried out on the skeletal muscle fibres of the cricket Acheta domesticus using conventional microelectrode methods. Both potassium and ammonium ions depolarized the fibres but with a considerable divergance from the slope of 58 mV. Calcium ions hyperpolarized the fibres. High concentrations of magnesium ions or dramatic increase in the osmotic pressure of the bathing medium exerted no influence on the resting potential. It seems likely that skeletal muscle fibres of Acheta domesticus at rest are multionic electrodes, but the role played by various ions needs further studies.