Immunohistochemical markers of proliferation and vascularisation in preneoplastic bronchial lesions and invasive non-small cell lung cancer.

Autofluorescence bronchoscopy (AFB) has been shown to be sensitive to detect preneoplastic lesions in central lung airways system. In early stages of carcinogenesis, up-regulation of cyclooxygenase (COX)-2, Ki67 and/or increased angiogenesis may play a role by promoting the proliferation of tumoral cells and their resistance to apoptosis, as well as angiogenesis, tumor cell invasion and setting up of the metastatic process. The present study compared the expression of proliferative (COX-2, Ki67 and PCNA) and angiogenic markers (CD34 and NG2) between preneoplastic bronchial squamous dysplasia lesions and invasive squamous cell carcinoma. Biopsies obtained during AFB [preneoplastic lesions: low-grade (lesions up to moderate dysplasia), n=13; high-grade lesions (severe dysplasia), n=12] and surgical specimens (resections of bronchogenic carcinoma, n=11) were stained with COX-2, Ki67, PCNA, CD34 and NG2 monoclonal antibodies. Microvessel density (MVD) was analysed based on anti-CD34 immunostaining. Lesions were positive for COX-2 in 12 out of 25 preneoplastic lesions, and in 10 out of 11 invasive carcinomas (p=0.025). In preneoplastic lesions, the mean percentage of Ki67 positive cells was lower compared to invasive carcinomas (37.4+/-5.8 versus 58.6+/-8.4%, p=0.043). In addition, significant differences in MVD were observed between preneoplastic and NSCLC specimen [35.3 (25.9, 61.9) versus 22.1 (20.1, 32.6), p=0.016]. No differences were observed in the mean percentage of PCNA or NG2 positive cells between preneoplastic lesions and invasive carcinomas. Findings of the present study indicate that increases in COX-2 and Ki67 expression may be associated with the development of bronchogenic carcinomas and possibly with acquisition of an invasive phenotype. In contrast, increased CD34 expression in preneoplastic lesions suggests that increased MVD may represent an early marker of lung carcinogenesis.

[Actinomycosis of the lungs mimicking a Pancoast tumor]. / Aktinomykóza pl'úc predstierajúca pancoastoidný rakovinný nádor.

The authors present a case-review of a patient with a thoracic form of actinomycosis, simulating a "pancoastoid" lung tumor clinical picture- furthermore, confirmed by a false-positive cytological examination. The disorder was managed by enlarged lobectomy from the right lung, followed by postoperative antibiotic therapy, lege artis. The long-term outcome is very good.

[Postintubation stenosis of the trachea--case reviews]. / Postintubacná stenóza trachey--nase skúsenosti.

Stenoses of the respiratory tract are life threatening conditions of various origins. The authors give referrence on 21 patients operated for postintubation stenoses of their trachea at the IInd Surgical Clinic of the UPJS Medical Faculty, the Faculty Hospital of L. Pasteur in Kosice, from 01. 01. 1999 to 30. 06. 2005. All patients had a tracheobronchoscopic examination and a CT examination completed prior to the procedure. Within 24 hours of their admission, 9 patients were operated, 7 underwent resection procedures and 2 patients had Montgomery's T-cannula introduced. 12 patients had their procedures planned, and were operated later than 24 hours after their admission. 10 patients underwent resections of the trachea, 2 had Montgomery's T-cannula implanted. The postoperative course following the resection of the trachea was without complications in 14 patients, 1 patient experienced transitional oedema in the anastomosis and 2 patients suffered restenoses. In this patient group, no fatal case was recorded. The authors stress up multidisciplinary approach in the diagnostics and treatment of the postintubation stenoses of trachea. In cases of postintubation stenoses of trachea, resection of the trachea with primary anastomosis represents the most advantageous treatment approach for the patient.

Bacteremia due to Pseudomonas aeruginosa: results from a 3-year national study in the Slovak Republic.

Risk factors, mortality and antimicrobial susceptibility of Pseudomonas aeruginosa bacteremias isolated from 148 patients from all University Hospitals in Slovakia were analyzed. Only 1.2% of 169 strains of P. aeruginosa were resistant to meropenem, 4.1% to piperacillin/tazobactam, 7.7% to ceftazidime as well as cefepime and 12% to amikacin. More than 30% of P. aeruginosa were resistant to ciprofloxacin. Our analysis of risk factors for antimicrobial resistance to the particular antimicrobials, indicated no difference in risk factors and outcome in cases infected with P. aeruginosa bacteremias resistant to amikacin, piperacillin/tazobactam or ceftazidime in comparison to episodes caused by P. aeruginosa due to susceptible isolates. When comparing risk factors for P. aeruginosa bacteremia in children vs. adults, cancer vs. non-cancer patients, several differences in risk factors were observed. Neither antimicrobial resistance to amikacin, ceftazidime or piperacillin/tazobactam, nor appropriateness of therapy according to two separate analyses were associated with better outcome.

Prospective study of antibacterial susceptibility, risk factors and outcome of 157 episodes of Acinetobacter baumannii bacteremia in 1999 in Slovakia.

This study prospectively investigated all 157 cases of Acinetobacter baumannii bacteremia occurring in major university hospitals or tertiary care institutions in Slovakia during 1999 in order to determine the antimicrobial susceptibility, risk factors and outcome. Resistance to meropenem was 7.4, gentamicin 35.6, amikacin 26.5, cefepime 20.4 and ciprofloxacin 32.7%, but was only 17.3% to cefoperazone/sulbactam or ampicillin/sulbactam. Antimicrobial susceptibility of A. baumanii was lowest among isolates from cancer patients (ceftazidime 58%, piperacillin/tazobactam 52% and azthreonam 48%; p < or = 0.01-0.001). In univariate analysis, several risk factors, such as wound infection (p < or = 0.01) and ventilatory support (p < or = 0.0001), were significantly related to A. baumannii bacteremia in surgical patients. Neutropenia (p < or = 0.0001), antineoplastic chemotherapy (p < or = 0.0001) and prior antibiotic therapy (p < or = 0.0006) were significant risk factors for A. baumannii bacteremia in cancer patients. In addition, ventilatory support and surgery (p < or = 0.0001) and prior antibiotic therapy (p < or = 0.01) were significantly related to A. baumannii bacteremia in children. Colonization at other body sites (p < or = 0.05), diabetes mellitus (p < or = 0.04) and decubital ulcers/burns (p < or = 0.002) as underlying disease were significantly related to death due to A. baumannii bacteremia. In a multiple logistic regression model, decubital ulcers/burns as underlying disease (p < or = 0.0006; relative risk 5.08) and nosocomial pneumonia (p < or = 0.045; relative risk 5.08) were independent predictors of mortality. Mortality was similar between cancer and surgical patients but significantly lower in children vs. adults (p < or = 0.009).

[Bleeding non-epithelial gastrointestinal neoplasms]. / Krovotochashchie neépitelialnye opukholi zheludochno-kishechnogo trakta.

Inefficiency of x-ray and endoscopic examinations of a bleeding hollow organ of the gastrointestinal tract may be explained by the effection of its wall with nonepithelial tumor (lipoma, neurinoma, leiomyoma). In some cases only laparotomy and examination of the abdominal cavity succeed in localization of the tumor. Intraoperative cytodiagnosis of nonepithelial benign tumors is a method conducive to sparing surgery (partial resection, dissection).

[Granular otitis externa]. / Granuliruiushchii naruzhnyi otit.

These authors examined 18 patients with granular external otitis. As other clinicians, the authors believe that the disease should be viewed as a separate nosological pathology. In the case of granular myringitis it is important to differentiate between this disease and chronic suppurative otitis media complicated with polyps or granulations. The granular tissue on the walls of the external acoustic meatus can develop due to inflammation of the skin alone without periosteum or bone involved. It may also occur as a result of suppurative osteoperiostitis of the external acoustic meatus. This pathology also requires differential diagnosis because different therapeutic approaches are to be applied.

[Potentiation of the antimicrobial action of antibiotics in combination with oxytocin]. / Usilenie antimikrobnogo deistviia antibiotikov v kombinatsii s oksitotsinom.

The antimicrobial effect of oxytocin in combination with 39 antibacterial drugs was studied in vitro with the use of 30 strains of different test cultures. It was shown that oxytocin had a capacity for potentiating the antibiotic effect on many microbial species. The potentiation ratio depended on the antibiotic and microbial species used and ranged from 2 to 24 times. The combined therapy with oxytocin and antibiotics was tested on animals with experimental staphylococcal sepsis. The survival rate of more than 50 per cent was observed only in the group of animals treated with the combinations of antibiotics and oxytocin, while in the other groups the death rate amounted to 100 per cent. The most favourable combinations of oxytocin and antibiotics were used in the treatment of 260 patients with pyoinflammatory affections of the soft tissues (mastitis, postinfection suppuration, paraproctitis, etc). In the majority of cases, the surgical treatment was replaced by the paracentetic treatment with local application of the combinations of oxytocin and antibiotics. This markedly decreased (by 3-4 times) the periods of temporary disability, provided better cosmetic results of the treatment and lowered consumption of the dressing material.

A Salmonella typhimurium mutant dependent upon carbamyl aspartate for resistance to 5-fluorouracil is specifically affected in ubiquinone biosynthesis.

The isolation and properties of a mutant dependent upon exogenous carbamyl aspartate for resistance to 5-fluorouracil are described. The mutant was deficient in the synthesis of ubiquinone and accumulated a quinone provisionally identified as the ubiquinone precursor 2-octaprenyl-3-methyl-6-methoxy-1,4-benzoquinone. The mutation resulted in an alteration in the regulation of synthesis of enzymes involved in de novo pyrimidine biosynthesis but did not establish a functional block in dihydroorotate dehydrogenase activity in vivo. Conditional resistance to 5-fluorouracil apparently occurred through an inhibition of the conversion of the analog to the nucleotide level.

A mutation in Salmonella typhimurium imparting conditional resistance to 5-fluorouracil and a bioenergetic defect: mapping of cad.

The position of the genetic locus allelic with the cad-2 mutation has been located between units 14 and 15 of the linkage map of S. typhimurium. Fine structure mapping established the gene order as cad flrB nag. The genetic evidence coupled with biochemical evidence indicates that this cad locus is homologous to the ubiF gene of Escherichia coli.

5-Fluoroorotate-resistant mutants of Salmonella typhimurium.

Spontaneously occurring mutants of Salmonella typhimurium resistant to 5-fluoroorotate (5-FOA) were isolated. One class of mutant showed marked derepression of pyrimidine biosynthetic enzymes and had the unusual property of being unable to grow on nutrient agar. However, when the osmotic strength of nutrient agar was increased, the mutants were able to grow. The genetic basis for the osmotic fragility and elevated pyr enzyme synthesis was the result of mutations affecting pyrH, encoding the enzyme uridine 5'-monophosphate kinase.