Erythropoietin accelerates tumor growth through increase of erythropoietin receptor (EpoR) as well as by the stimulation of angiogenesis in DLD-1 and Ht-29 xenografts.

Anemia is a relatively common symptom coexisting with colorectal carcinoma. Besides having a positive impact on hematological parameters, erythropoietin (Epo) has the serious adverse effect of promoting the neoplastic process. The role of Epo in colon cancer has not been clearly shown. The aim of this study was to assess the effects of Epo therapy on colorectal carcinoma cells both in in vitro and in animal models. Human colon adenocarcinoma cells DLD-1 and Ht-29 were cultured in medium with Epo beta in normoxia. Cell proliferation was measured with an automated cell counter. Expression of erythropoietin receptor (EpoR) mRNA, Akt mRNA, and their proteins were assessed by RT-PCR and confocal microscopy, respectively. Nude mice were inoculated with adenocarcinoma cells and treated with a therapeutic dose of Epo. Expression of EpoR, VEGF, Flt-1 and CD31 was evaluated in xenograft tumors. We identified that Epo through EpoR activates Akt, which promotes colon cancer cell growth and proliferation. Epo, and high levels of phosphorylated EpoR, directly accelerates tumor growth through its proliferative and proangiogenic effects. This study demonstrated that Epo had enhanced carcinogenesis through increase of EpoR and Flt-1 expression, and thereby contributed to tumor development. These results suggest that both EpoR-positive and EpoR-negative cancer cells could be regulated by exogenous Epo. However, an increased response to erythropoietin was observed in the EpoR-positive cells. Thus, erythropoietin increases the risk of tumor progression in colon cancer and should not be used to treat anemia in this type of cancer.

Norovirus infections in children under 5 years of age hospitalized due to the acute viral gastroenteritis in northeastern Poland.

The primary aim of this study was to evaluate the frequency and seasonality of norovirus infection in hospitalized Polish children under 5 years of age, and a secondary aim was to compare the clinical severity of norovirus and rotavirus disease. The prospective surveillance study was carried out from July 2009 through June 2010. Stool samples from 242 children hospitalized due to acute viral gastroenteritis were tested for rotavirus group A and adenovirus with commercial immunochromatographic test and for norovirus with EIA assay. Single norovirus infection was found in 35/242 (14.5%) patients and in a further 5 (2.1%) children as co-infection with rotavirus. Overall, norovirus was detected in 16.5% of stool specimens. Norovirus infections tended to peak from October to November and again from February to March. In autumn months and in February, the proportion of norovirus gastroenteritis cases was equal or even surpassed those of rotavirus origin. Both norovirus and rotavirus infections most commonly affected children between 12 and 23 months of age. The low-grade or no fever was significantly more common in children infected with norovirus (94.3%) compared to rotavirus cases (52.9%). Overall, norovirus gastroenteritis was less severe than rotavirus disease with regard to 20-point severity scale (p < 0.05). Noroviruses have emerged as a relevant cause of acute gastroenteritis in Polish children. There is a great need for introducing routine norovirus testing of hospitalized children with gastroenteritis.

Norovirus and Rotavirus--two major causative agents of sporadic viral gastroenteritis in hospitalized Polish children.

PURPOSE: The aim of the study was to establish the main etiologic agents of acute viral gastroenteritis and to asses the severity of illness associated with the different viral agents of gastroenteritis in children hospitalized during spring/summer season 2008. MATERIAL AND METHODS: 181 stool specimens were collected from children under 5 years of age, hospitalized with acute viral diarrhea from April to September 2008. Commercial enzyme immunoassay kits were used to detect noroviruses. The immunochromatographic tests for combined detection of rotaviruses and adenoviruses were performed routinely in our department in all in-patients suspected for viral gastroenteritis. RESULTS: A viral etiologic agents were detected in 108 of 181 (59.7%) samples tested. Dual viral pathogens (rotavirus and norovirus) were found in 3 of 181 (1.7%) samples. Rotavirus was the most common viral pathogen found in the study group (86/181; 47.5%), followed by NV (19/181; 10.5%) and adenoviruses (3/181; 1.7%). Approximately, 60% of acute gastroenteritis episodes occurring in children less than 5 years of age were accounted for by infection due to rotavirus and/or norovirus. Norovirus cases were clinically indistinguishable from those of rotavirus origin in children aged less than 2 years whereas they were slightly milder in older group of patients. CONCLUSIONS: Rotavirus infections are leading cause of children's hospitalization in spring months whereas Norovirus infections during spring/summer time. There is a great need to apply molecular diagnostic tools to determine the actual and monitoring the changing etiology of acute enteritis in Polish population.

Increase in adhesion molecules in cerebrospinal fluid of children with mumps and mumps meningitis.

Adhesion molecules play a key role in leucocyte migration into the central nervous system (CNS). Concentrations of endothelial-derived soluble intercellular adhesion molecule-1 (sICAM-1) and leucocyte-originated soluble L-selectin (sL-selectin) in cerebrospinal fluid (CSF) of children with mumps meningitis (mononuclear pleocytosis, n = 33) and mumps (absence of pleocytosis, n = 9) were compared with values from age-matched control group (n = 19). In 14 patients from the meningitis group, adhesion molecule levels together with albumin concentration were estimated in paired CSF/serum samples to calculate concentration quotients and determine molecule intrathecal release. Both sICAM-1 (median 3.44 versus 0.86 ng/ml; P < 0.0001) and sL-selectin (median 29.91 versus 8.52 ng/ml; P < 0.0001) concentrations in CSF were increased in mumps meningitis patients compared with controls. Increased levels of the selected adhesion molecules were also observed in mumps patients without CNS involvement when compared with controls (median sICAM-1: 1.14 versus 0.86 ng/ml, sL-selectin: 13.54 versus 8.52 ng/ml; P < 0.01). Additionally, the concentration of adhesion molecules was found to correlate with CSF leucocyte count. Considerable correlation of sICAM-1 and sL-selectin quotients and corresponding albumin quotients suggests that a majority of the soluble adhesion molecules originated from the bloodstream. Analysis of adhesion molecule levels demonstrated indirect evidence of brain-derived fractions. Our results suggest the involvement of adhesion molecules during the early phase of mumps meningitis.

Occurrence rate of oral Candida albicans in denture wearer patients.

PURPOSE: The aim was to determine the fungi occurrence rate in the oral cavity of denture wearer patients in comparison to those without dentures. MATERIAL AND METHODS: The examinations were conducted in patients treated in two clinical departments of the University Hospital. Demographic data and those connected with basic diseases were collected and the evaluation concerning dentition and oral hygiene was performed. Samples for mycological examinations from the tongue dorsa, palatal mucosa, and mucosal surfaces of dentures were collected from patients with dentures while tongue and palate swabs were taken from those without dentures. For culture and identify of fungi standard methods were used. RESULTS: Dental and mycological examinations were performed in 95 patients, out of which 57 (60.0%) used complete or partial dentures and 38 (40.0%) had their own dentition (without dentures). Oral cavity revealed only growth of Candida albicans species, more frequently in patients with dentures (38/57; 66.7%) than in those without dentures (11/ 38; 28.9%) (p = 0.0003). C. albicans statistically significantly more frequently was isolated in denture wearer patients with diabetes mellitus (p = 0.0207) and without diabetes (p = 0.0376) comparing to such groups of patients but without dentures. Among 32 patients with diabetes mellitus, 14 (43.8%) revealed C. albicans; this rate was comparable with 9/23 (39.1%) patients without diabetes (p > 0.05). A similar analysis, conducted in 25 surgical patients with abdominal cancer and 15--without--cancers, did not show statistically significant differences in the incidence rate of C. albicans; it also concerned denture wearers (14/16; 87.5%) and non-wearing dentures (5/9; 55.6%) (p > 0.05) with cancer. In 37 (64.9%) wearer patients denture stomatitis was observed, associated mainly with C. albicans infections (29/37; 78.4%). CONCLUSIONS: 1) Mycological findings from the present study do not indicate that diabetes mellitus or advanced cancer has a significant effect on oral colonisation by Candida albicans or other species of Candida genus. 2) The occurrence rate of oral Candida albicans in patients with dentures (diabetic and non-diabetic, cancer and non-cancer patients) was higher than in patients without dentures (p < 0.05).

Aerobic and anaerobic bacteria in subgingival and supragingival plaques of adult patients with periodontal disease.

PURPOSE: Clinical, epidemiological and microbiological examinations of adult patients with periodontal disease. MATERIAL AND METHODS: The study of population consisted of 21 subjects (13 female and 8 male) aged 38-58 years, treated in the Outpatient Department of Periodontology. Dental examinations were performed at an artificial light and using a WHO periodontometer, a mirror and a probe. Periodontal status was assessed by determination of the probing pocket depth (CPI), gingival state (GSBI according to Mühlemann and Son), and oral hygiene index (according to Silness and Löe). Material for microbiological examination was collected from subgingival and supragingival plaques of each patient. Additionally, pus was obtained from 8 patients and periodontal pocket fluid from 2 patients. The samples were examined for the presence of aerobic and anaerobic bacteria and Candida yeasts. Standard procedures were used for culture and identification of bacteria and fungi. RESULTS: Candida yeasts were not isolated from adults with periodontal disease. In 19/21 patients, cultures of both aerobic and anaerobic bacteria from subgingival and supragingival plaque samples were positive. A total of 42 bacterial strains were isolated from subgingival plaques, of which 24 (57.1%) belonged to 7 anaerobic species and 18 (42.9%) to 12 aerobic species (p > 0.05). There were more aerobic (33/53; 62.3%) than anaerobic bacteria (20/53; 37.7%) (p < 0.05) in supragingival plaques. Anaerobes were isolated more frequently than aerobes from the abscess (p < 0.05). CONCLUSIONS: 1) In adult patients with periodontal disease, Gram-positive anaerobes, including Peptostreptococcus, were the predominant bacteria in the subgingival plaque. 2) While in the supragingival plaque, Gram-positive aerobic cocci (Streptococcus and Staphylococcus) were predominant.

Aerobic bacteria in the oral cavity of patients with removable dentures.

PURPOSE: Determination of bacterial composition in the oral cavity of patients with removable dentures and with own dentition (without dentures). MATERIAL AND METHODS: Bacteriological investigations were performed in 55 patients from the department of internal medicine (32 diabetic patients) and 40 patients treated in surgical department (25 patients with malignancy). Palate mucosa and tongue dorsa swabs were collected from two groups of patients, and additionally swabs from mucosal part of denture surfaces in prosthetic patients. Cultures in oxygenic and microaerophilic (5% CO2) conditions were conducted on solid non-selective and selective media as well as media enriched with 5% sheep blood. Standard procedures of bacterial culture and identification were applied. RESULTS: Among 95 of examined patients, 57 (60.0%) with removable dentures and 38 (40.0%) had their own dentition. As far as prosthetic patients were concerned, the rate of bacterial isolations from palate, tongue dorsa and denture plaque swabs were generally comparable (p > 0.05); in number and species compositions. Statistically significant differences were observed in the bacterial composition of denture plaques, palate and tongue dorsa in patients with and without abdominal cancers. Patients without cancer did not reveal staphylococci and enteric bacteria in the samples from a various sites of their oral cavities. These bacteria were most common in cancer patients. Similar (in number and species) composition of bacteria occurred in palate and tongue swabs in patients without dentures (p > 0.05). The incidence rate of aerobic bacteria in denture plaques and palatal mucosa of patients with (37/57; 64.9%) and without (20/57; 35.1%) denture associated stomatitis were comparable (except for Neisseria spp.). CONCLUSIONS: 1) Generally, there were no statistically significant differences in species composition of bacteria isolated from the hard palate and tongue dorsa in patients with and without removable dentures. 2) Staphylococcus spp. and Gram-negative enteric bacilli were isolated more often from denture plaque, palate and tongue dorsa of cancer patients than from patients without cancer (p < 0.05). 3) Staphylococcus spp. was isolated more frequently from denture plaques of diabetic patients compared with non-diabetic patients (p < 0.05). 4) No significant differences observed in isolation frequencies (%) of aerobic bacteria in denture plaques and palatal mucosa of patients with and without denture associated stomatitis.

Bacterial composition in the supragingival plaques of children with and without dental caries.

PURPOSE: The purpose of the present investigation was to determine if the supragingival bacterial composition plaques in children with caries would differ from those found in caries-free controls. MATERIAL AND METHODS: Pooled supragingival plaque samples from the smooth surfaces of teeth were collected from 75 children with caries and 131 children without caries. The plaque samples were analysed for bacterial content by cultures on a series of non-selective and selective media for aerobic, microaerophilic and anaerobic bacteria. Additionally, the specimens of dentine carious lesions were examined. The standard culture procedures and identifications of bacteria were used. RESULTS: Among 131 children without dental caries, 41 (31.3%) were at preschool age with deciduous teeth and 90 (68.7%) at school age with permanent teeth. Dental plaques of caries-free children revealed 452 strains, out of which 326 (72.1%) were from permanent teeth, 126 (27.9%)--from deciduous teeth (p = 0.0001). Among 75 children with dental caries, 61 (81.3%) were at preschool age and 14 (18.7%)--at school age. There were 239 strains isolated from supragingival plaques in children with dental caries, 187 (78.2%) --in preschool children, and 52 (21.8%)--in school children (p < 0.05). From dentine carious lesions in these children, 209 strains were isolated; 164 from preschool children and 45--from school children (p < 0.05). Gram-positive bacteria were isolated more frequently than Gram-negative ones (p = 0.0001) from supragingival plaques both in children with and without dental caries. Streptococcus genus bacteria were isolated more often (p = 0.0002) from the plaques in school children without dental caries. The proportion (%) of aerobic and anaerobic bacteria was comparable (p > 0.05) in dental plaques in children with and without dental caries, except for Veillonella spp., which were isolated more frequently from dental plaques in school children with dental caries (p = 0.01). CONCLUSIONS: 1) Generally, there was no statistically significant difference of bacterial species composition isolated from supragingival plaques in children with deciduous and permanent dental caries and caries-free children. 2) There was no difference between bacterial composition in dentine carious lesions of deciduous teeth and permanent teeth as compared to supragingival plaques in these children (except for Neisseria spp., Peptostreptococcus spp.).

Oral Candida albicans carriage in healthy preschool and school children.

PURPOSE: The purpose of the present study was to detect Candida albicans carriage in the oral cavity of healthy preschool and school children. The second aim was the determination of correlation between C. albicans occurrence and dental caries in children population. MATERIAL AND METHODS: The samples for mycological examinations were collected from the pharynx and supragingival plaque, and carious lesions in 102 children, aged 4-7 years (preschool children) and 104 children and adolescents, aged 12 and 18 (school children). All samples were cultured directly on Sabouraud agar medium. Isolated yeasts were identified based on API 20C AUX (bioMérieux). RESULTS: A total of 123 C. albicans strains were isolated, in which 61 (49.6%) derived from supragingival plaque, 48 (39%)--from carious lesions, and 14 (11.4%)--from pharyngeal swabs. C. albicans was isolated from the samples of single material in 61 children (35--school children, 26 --preschool children) while from the rest of 29 children, C. albicans was isolated from two (25x) or three materials (4x). C. albicans was detected in 48/75 (64%) children with dental caries; the rate was statistically significantly higher as compared to the overall number of children with C. albicans carriage (90/206; 43.7%) (p = 0.0026). Similar results was obtained in preschool children (38/61; 62.3% and 47/102; 46.1%, respectively) (p = 0.0449), as in school children (10/14; 71.4% and 43/104; 41.3%, respectively) (p = 0.0336). CONCLUSIONS: 1) Candida albicans was observed in the oral cavity of healthy children with high (approximately 40%)--comparable rate in school and preschool children (p > 0.05). 2) C. albicans was isolated with high comparable rate from carious lesions in preschool and school children. The statistically significant differences between the rate of C. albicans in carious lesions in preschool children (62.3%) and school children (71.4%) and the overall number of children with C. albicans carriage in the oral cavity of children in both age groups (p < 0.05) were showed.

Incidence rate of Candida species in the oral cavity of middle-aged and elderly subjects.

PURPOSE: The aim of this study was to determine the incidence rate of oral Candida species in middle-aged and elderly subjects. MATERIAL AND METHODS: The study carried out in 103 adults aged 35-92 years, in which 32 (31.1%) used complet or partial acrylic dentures. Mycological tests were performed by using culture (Sabouraud agar) and API 20C AUX (bioMérieux) for identification of the species level. Material for analysis included swabs taken from the palate mucosa and mucosal part of denture surfaces in denture wearers, as well as, from tooth surface and/or dentine carious lesions. The dental caries status of each patients was evaluated using DMF index (WHO 1986 criteria). RESULTS: Yeasts of Candida genus were isolated in 65/103 (63.1%) adults. The incidence rate of Candida spp. was higher in adults without dentures (46/71; 64.8%) compared to denture wearers (19/32; 59.4%); however, the differences were not statistically significant (p = 0.59 > p = 0.05). Candida albicans were the most frequently isolated species, and with a comparable rate (p = 0.06), both in adults with and without dentures (17/32; 53.1% and 38/71; 53.5%, respectively). In 3 individuals without dentures, two other species were found apart from C. albicans, namely C. glabrata (2x) and C. krusei (1x). In a total of 11/49 (22.5%) strains belonging to 5 non-C. albicans species were detected in adults without dentures, while in denture wearers only 2/19 (10.5%) other species were found (C. krusei and C. oralis) (p = 0.26 > p = 0.05). Strains of C. glabrata species were isolated only from the elderly. No significant differences were noted in the incidence of Candida spp. between middle-aged subjects (35-44 years) (35/52; 67.3%) and the elderly (> 55 years) (30/51; 58.8%) (p > 0.05), both in denture wearers and non-denture wearing subjects. However, the frequency of oral Candida spp. strains was increased in advanced age subgroup 71-92 years (74.2%) compared with 56-70 years (35.0%) of elderly subjects (p < 0.05), only in denture wearers (30.0% vs 5.0%) (p < 0.05). The sex and DMF index distribution of both subject groups had no significant influence on the numbers of Candida spp. detected. CONCLUSIONS: Yeasts of the genus Candida were isolated at a comparable rate (p > 0.05) from the oral cavity of adults with and without dentures, as well as in middle-aged (35-44 years) and elderly subjects (56-92 years). However, a significant difference was observed only between elderly subgroups aged 56-70 (35%) and advanced age subgroup 71-92 years (74%).

Prevalence rate and antibiotic susceptibility of oral viridans group streptococci (VGS) in healthy children population.

PURPOSE: The aim of this study was to evaluated the prevalence rate of oral viridans group streptococci (VGS) and their susceptibilities to some antibiotics in healthy children. MATERIAL AND METHODS: Samples of pharyngeal swabs and supragingival dental plaques for microbiological studies were collected from 206 healthy children, aged 4-18 years. Additionally, 75 samples of carious lesions from children with dental caries were included. The streptococci were isolated and identified using standard methods and commercial identification kits. For performance of antibacterial susceptibility testing of VGS strains disk diffusion and/or breakpoints procedures were used according to NCCLS standards and criteria. A total of 425 VGS strains were tested against penicillin, ampicillin, erythromycin, clindamycin, tetracycline, doxycycline, ciprofloxacin and vancomycin. RESULTS: A total of 239 VGS strains belonging to 8 species from pharyngeal swabs of 192 (93.2%) children were isolated. VGS strains from supragingival plaques were isolated in 149 (72.3%) healthy children (p < 0.05), and from carious lesions in 37 (49.3%) children with dental caries. VGS strains of S. mitis species were isolated most frequently from 4-5 year old as compared to 12 and 18 year old children (p < 0.05), while S. vestibularis strains isolated most often in 12 year old ones (p < 0.05). Among 425 VGS strains, high level of penicillin resistance (MIC > or = 2.0 mg/L) was shown in 71 (16.7%) strains, 33 (46.5%) of them belonged to S. mitis species. VGS strains were also resistant to erythromycin (23.5%), clindamycin (23.1%), tetracyclines (T-52%, DOX-16%), gentamycin (25.9%) and ciprofloxacin (55.2%). All VGS strains were vancomycin - susceptible. CONCLUSIONS: 1. In the oral cavities of healthy children, approximately 98% of streptococci belonged to two VGS groups, i.e. mitis and salivarius groups. Streptococci of mutans and anginosus groups were isolated sporadically (2%). 2. We observed difference in susceptibility to penicillin and other antibiotics between the various species of viridans groups streptococci. Mitis group strains (except S. pneumoniae) were more frequently penicillin-resistant (23%) in comparison to salivarius group of VGS strains (9%) (p = 0.0001).

Microorganisms in root carious lesions in adults.

PURPOSE: Root caries is emerging as a significant problem in the middle aged and elderly subjects because of the improving general health conditions, and medical and technological advances. The purpose of this investigation was to assess the prevalence of aerobic and anaerobic bacteria as well as yeasts of Candida genus in root carious lesions in middle-aged and older adults. MATERIAL AND METHODS: Specimens of root carious lesions were collected from 78 adults for bacteriological and mycological studies. Standard procedures of culture, isolation, and identification of aerobic and anaerobic bacteria, and fungi were used in the study. RESULTS: The analysis of results was performed independently in two age groups of adults, i.e. 52 subjects aged 35-44 years (middle age) and 26-aged 55-72 years (older age). There were 120 bacterial strains isolated from root carious lesions in middle-aged subjects, 63 (52.5%) strains belonged to 5 genera of aerobic bacteria and 57 (47.5%)--to 7 genera of anaerobic bacteria (p > 0.05). While in the second group, 85 strains were isolated, 54 (63.5%)--6 genera of aerobic bacteria and 31 (36.5%)--4 genera of anaerobic bacteria (p = 0.0004). There were no differences between the isolation rate of a various species in both examined groups, except for Streptococcus spp., S. oralis, Micrococcus spp., Neisseria spp. and Veillonella spp., which statistically significantly most frequent occurred in elderly (p < 0.05). The yeasts of Candida genus of 4 species (C. albicans, C. lusitaniae, C. pelliculosa, and C. pulcherrima) were isolated from middle-aged subjects (32.7%) with the comparable rate to older adults (30.8%; only C. albicans) (p > 0.05). Among all isolated microorganisms, Candida spp., were comprised about 10% in both examined groups (p > 0.05). CONCLUSIONS: Aerobic Gram-positive cocci (Staphylococcus spp. and Streptococcus spp.) as well as anaerobic ones (Peptostreptococcus spp.), and Candida albicans were occurred most frequently in root carious lesions in middle-aged and older adults.

[Frequency of giardiasis in children with chronic abdominal pain coming from North-East Poland]. / Rozpowszechnienie zarazenia pier wotniakiem Giardia lamblia u dzieci z przewleklymi bólami brzucha w pólnocno-wschodniej Polsce.

Chronic or recurrent abdominal pain constitutes a serious diagnostic and therapeutic problem in childhood. The gastrointestinal, biliary tract or renal lesions often produce the chronic abdominal pain in children. Among causative factors of the chronic abdominal pain the infection with Giardia lamblia is more and more often taken into account. The sample of 112 patients hospitalized during the period from 1992 to 1993 in two departments of the University School of Medicine in Bialystok and in three pediatric wards of the Municipal Hospital in Bialystok, was assessed. In all children the duodenal aspiration was performed. The following questions were evaluated: 1. What is the frequency of giardiasis in children coming from north-east Poland and presenting chronic abdominal pain? 2. Is there any specific spectrum of symptoms of giardiasis in children? Based on the results of the duodenal fluid examination, the infection with G. lamblia was diagnosed in 77 (67.75%) children. The analysis of the clinical symptoms indicated that only failure to thrive and recurrent episodes of the loose stools were significantly more frequent in infected children compared with uninfected. The frequency of the other symptoms like nausea, headache, vomiting, constipation, fever or allergic skin lesions was similar in both study groups.