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Background: Changes in the structure and functioning of the body occur with age. Also nutrition is continually modified. Eating habits may affect favorably or unfavorably on the process of aging and the functioning of various tissues, organs and the whole body., Objectives: The purpose of the study was to evaluate dietary habits and food preferences of patients in different age groups. In the studied groups also body mass index (BMI) and body fat content were analyzed., Material and Method: 237 people (133 women and 104 men, age 18-79 years) were examined. The participants completed questionnaires of the frequency of food consumption and food preferences. The height, weight, body mass index (BMI), the percentage of body fat (BIA) were also measured. For statistical analysis the assessment of correlation Spearman's rank order and nonparametric ANOVA rank Kruskal-Wallis were used., Results: With age, the frequency of milk (p < 0,05) and cheese (p < 0,05) consumption decreased whereas consumption of cottage cheese increased (p < 0,05). Increased consumption of offal (p < 0,05), salt (p < 0,05) and coffee (p< 0, 05) was also noted. With age, the respondents preferred animal fats (p < 0.05) and vegetable fats (p < 0.05). The frequency of butter consumption decreased (p < 0.05) and consumption of vegetable fats increased (p < 0,05). The consumption of brown rice (p < 0,05), whole wheat pasta (p < 0,05) and cereals (p < 0,05) was reduced whereas the consumption of groats (p < 0,05) potatos (p < 0,05) and fruits (p < 0,05) increased. The decreased desire (p < 0,05) and frequency of nuts / almonds consumption (p < 0,05) were noted. With age, the BMI and percentage of body fat were increasing (p < 0,05, R = 0,39, p < 0,05, R = 0,31, respectively)., Conclusions: Taste preferences and dietary habits vary depending on age and may be one of the elements affecting the increase in BMI, body fat content, bone mass loss and increased risk of metabolic disorders. The observed changes in dietary habits can contribute to the development of dyslipidemia, glucose dysmetabolism and arterial hypertension, especially in the presence of overweight and obesity.

Introduction: In spite of intensive research the pathogenesis of type 1 diabetes mellitus is not thoroughly understood. One of the ideas which currently has a great number of supporters is the theory of the participation of T regulatory cells in the mechanism of insufficient suppression of the immune response against pancreatic self -antigens. According to some authors, the infusion of T regulatory cells in autoimmune diseases could lead to long -term remission or even a complete cure., Aim of the Study: The aim of our present study was to achieve T regulatory cells from conventional T lymphocytes isolated from a small amount of peripheral blood in children with type 1 diabetes mellitus and their comparison to the Tregs generated from the blood of control children. Additionally, we assessed the changes in the expression of selected genes essential for the function of these cells during Tregs generation., Material and Methods: The examined group consisted of 20 children with type 1 diabetes mellitus, the control group consisted of 20 non -diabetic children. From the peripheral blood CD4+CD25 - cells were separated and cultured with T -reg expander and interleukin (IL) 2. Before and after the culture the cells were analysed according to the expression of transcription factor FoxP3 and other molecules/cytokines: OX40, 4 -1BB, GITR, ICOS -1, CTLA -4 and IFN -γ, IL -10 and TGF -β., Results: We observed a significantly higher percentage of T regulatory cells after the culture (with no difference between diabetic and control children). Moreover, we observed a lower expression of mRNA for GITR molecule and a higher IL -10 expression in the cultures of diabetic children compared to the control ones. The cells cultured from the blood of control children were characterised by a higher increase in the expression of mRNA for ICOS -1 and a lower expression of mRNA for TGF -β in comparison to the cultures from diabetic children., Conclusions: The results of our investigations confirm the possibility of generating T regulatory cells from conventional T lymphocytes from peripheral blood of children with newly recognised type 1 diabetes mellitus.

The management of thyroid disorders during pregnancy is one of the most frequently disputed problems in modern endocrinology. It is widely known that thyroid dysfunction may result in subfertility, and, if inadequately treated during pregnancy, may cause obstetrical complications and influence fetal development. The 2007 Endocrine Society Practice Guideline endorsed with the participation of the Latino America Thyroid Association, the American Thyroid Association, the Asia and Oceania Thyroid Association and the European Thyroid Association, greatly contributed towards uniformity of the management of thyroid disorders during pregnancy and postpartum. Despite the tremendous progress in knowledge on the mutual influence of pregnancy and thyroid in health and disease, there are still important areas of uncertainty. There have been at least a few important studies published in the last 3 years, which influenced the thyroidal care of the expecting mother. It should also be remembered that guidelines may not always be universally applied in all populations with different ethnical, socio-economical, nutritional (including iodine intake) background or exposed to different iodine prophylaxis models. The Task Force for development of guidelines for thyroid dysfunction management in pregnant women was established in 2008. The expert group has recognized the following tasks: development of the coherent model of the management of thyroid dysfunction in pregnant women, identification of the group of women at risk of thyroid dysfunction, who may require endocrine care in the preconception period, during pregnancy and postpartum - that is in other words, the development of Polish recommendations for targeted thyroid disorder case finding during pregnancy, and the development of Polish trimester-specific reference values of thyroid hormones. Comprehensive Polish guidelines developed by the Task Force are to systematize the management of the thyroid disorders in pregnant women in Poland.

The reversible phosphorylation of structural and regulatory proteins in eucaryotic cells is one of the most important regulatory mechanisms. Protein tyrosine phosphatases (PTP) regulate a wide range of signal transduction pathways that control many cellular processes such as cell proliferation, differentiation and growth. Disorder in PTP gene expression is implicated in the development of cancer, autoimmune and neurodegenerative diseases. The active sites of these enzymes are characterized by the consensus sequence containing cysteine which is essential for enzyme activity and highly susceptible to oxidation. Reversible oxidation of the catalytic cysteine is becoming recognized as a general mechanism for regulation of PTP enzymatic activity. These findings suggest that protein tyrosine phosphatases may be considered as very sensitive markers of oxidative stress. Many studies have demonstrated that the production of reactive oxygen species during oxidative stress can inactivate protein tyrosine phosphatases.

Introduction: The natural history of type 1 diabetes is concerned with the appearance of autoantibodies against antigens of pancreatic beta cells. The last decade revealed some evidence of the participation of T regulatory lymphocytes - cells which suppress immune response - in the pathogenesis of type 1 diabetes and prediabetes., Aim of the Study: was the assessment of T regulatory cells in the blood of children at risk for developing type 1 the diabetes mellitus., Material and Methods: 85 subjects, siblings of children with type 1 diabetes, were enrolled into the study. The presence of anti-GAD65 antibodies was assessed. With the use of flow cytometry the following cell subpopulations were noted: CD4+, CD4+CD25high and CD4+CD25highCD127low with the coexpression of: CD28, CD45RO, CD54, CD62L and CD134 molecules., Results: We did not observe any differences in white blood cell count, lymphocyte (including CD4+) count and the percentage between the examined and control groups. We noted higher percentages of T regulatory cells: CD4+CD25high, CD4+CD127low and CD4+CD25highCD127low in children with the presence of anti-GAD65 antibodies as compared to the control children., Conclusion: Higher percentages of T regulatory cells in the blood of children with the presence of anti-GAD65 antibodies may suggest an intensive regulatory response present in patients at risk for developing type 1 diabetes.

Introduction: People with a high risk of development of type 1 diabetes, like first degree relatives, have characteristics for diabetes immunological/ or metabolic/or genetic markers. Presence of these markers in the blood increase the risk of development of clinically symptoms of the disease. The aim of the study was to evaluate the fasting level of the C-peptide, depending on immunological markers presence (anti-GAD, IAA and anti-IA2 antibodies) and usefulness of this parameter in the risk assessment of development of type 1 diabetes in the first degree relatives of autoimmunological diabetic patients., Material and Methods: The study was carried out in the group of 90 relatives in age from 13 to 65 (an average of age 33.1 +/- 15.48 years old) and an average BMI 24.6 +/- 4.95 kg/m(2) (17-38 kg/m(2)). The fasting level of C-peptide was marked by ELISA method, anti-GAD, IAA, anti-IA2 antibodies titres by RIA method., Results: Lowered level of the C-peptide secretion was not observed in our study. In 22 persons (24.44%) increased of the fasting C-peptide secretion was assessed (> 2.9 ng/ml). Within this group, 7 relatives (31.8%) was positive titre of at least one of antibodies. We observed the positive correlation between C-peptide secretion and IAA (r = 0.282; p < 0.002). Until present moment no clinical symptoms of diabetes were observed in none of the persons., Conclusions: The increase of fasting level of C-peptide can indicate compensatory increase of beta cell secretion. It can indirectly prove the presence of insulin resistance in this group of people. The presence of higher level of C-peptide and positive IAA titre with no clinical symptoms of type 1 diabetes, seems to be the prognostic factor to retard of clinical symptoms of diabetes.

Obesity is recently considered as the twentieth first century epidemy. An excessive accumulation of adipocytes that constitute metabolically active tissue, plays an important role in lipid and carbohydrate metabolism. In the morbidly obese population dyslipidemia is common., Aim of Our Study: To determine the content of total cholesterol (TC), HDL-cholesterol (HDL), LDL-cholesterol (LDL) and triacylglicerol (TG) in obese subjects treated with the Bioenterics Intragastric Balloon (BIB)., Material and Methods: BIB was placement for 6 months in 21 obese patients, mean age 40 (21-60), with BMI 473 +/- 5.7 kg/m2. The control group consisted of 15 morbidly obese patients treated conservatively. Plasma lipid concentration were assessed by the enzymatic methods., Results: No major complications have been noted in patients with BIB. However, nearly all patients complained of discomfort, nausea and vomiting for the first few days. Over a 6-month-period, a reduction in body mass in the BIB group was 17.1 +/- 8.0 kg as compared to 3.2 +/- 6.4 kg in the control group (p = 0.00003). The biggest reduction in body mass was observed during first month. After one month, total cholesterol (TC) decreased by 17.6% (p < 0.001), triacylglycerol (TG) decreased by 25.5% (p = 0.01), low-density lipoprotein cholesterol (LDL) decreased by 27.5% (p < 0.001). In the control group, the corresponding levels of TC, TG and LDL remained unchanged. The level of HDL increased in both group., Conclusions: In patients with morbid obesity treated with BIB, weight loss is accompanied by a decrease in concentration TC, LDL and TG and increase in plasma HDL. The reduction of lipid concentration in blood serum may cut down cholesterol-lowering therapy and diminish the risk for development of coronary heart disease.

Introduction: Epidemiologic data for the last decade reveal increasing incidence of female breast cancer in Poland. One of the serious therapeutic consequences in breast cancer is secondary lymphedema of the upper extremity which significantly affects the quality of life. The aim of this study was to assess the incidence and to identify risk factors of lymphedema after breast cancer surgery., Material and Methods: Lymphedema and its severity were studied on the basis of anamnesis, clinical examination, and optoelectronic measurement of limb volume. The study group consisted of 246 women after breast cancer surgery., Conclusions: Lymphedema was observed in 40.6% of women. The most important risk factors for lymphedema include previous infections, radiotherapy, and obesity.

Introduction: The aim of this study was to examine usefulness of oral glucose tolerance test (OGTT) in clinical evaluation of different glucose metabolism disturbances in subjects with at least one risk factor of type 2 diabetes. We compared the effectiveness of non-pharmacological and pharmacological prevention and treatment regiments on metabolic control in these individuals., Material and Methods: The study involved 130 patients, with the following characteristics: age between 18 to 76 years, mean body mass index (BMI) - 31.82 +/- 7.24 kg/m(2), and presence of at least one of the risk factor of type 2 diabetes. Glucose metabolism disturbances were diagnosed according to World Health Organization (WHO) criteria. Non-pharmacological regiments were applied for 3 months for patients with impaired glucose tolerance (IGT) and type 2 diabetes. Patients, whose still met criteria for type 2 diabetes during OGTT after non-pharmacological treatment were scheduled for pharmacological interventions. These patients were assigned at random to two groups, that were treated with either metformin or acarbose. The measurements of total cholesterol (TC), HDL-cholesterol , LDL-cholesterol, trigliceryde (TG), glucose, HbA(1c) and/or OGGT were performed during each visit. We also assessed risk factors for type 2 diabetes in these subjects., Results: The prevalence of abnormal glucose tolerance in subjects with at least one of the risk factor of diabetes type 2 was near 40%. OGTT in these subjects increased the possibility of diagnosis diabetes type 2 and IGT. Hypertension (81%), hypercholesterolemia (71.4%), hypertriglicerydemia (71.4%) and obesity (66.7%) were the most frequent risk factors observed. There were no differences in biochemical measurements between these groups of patients., Conclusions: Individuals with at least one risk factor of type 2 diabetes should have screening test to diagnose glucose intolerance. Both non-pharmacological and pharmacological intervention was effective in normalization of glucose OGTT in patients with diabetes type 2 and IGT in newly diagnosed with disease patients.

Introduction: Apoptosis plays a pivotal role in the regulation of immune mechanisms in the pathogenesis of autoimmune thyroid diseases (AITD). The prevalence of AITD increases with age. Purpose to compare soluble Fas, FasL and Bcl-2 in Graves disease (GD) and Hashimoto thyroiditis (HT) in relation to the age of the studied patients., Material and Methods: 3 groups of subjects: 1/25 patients with GD in euthyreosis on methimazol 2/27 patients with ChH in euthyreosis on levothyroxine. 3/12 healthy volunteers age and sex-matched to group 1-2. The serum levels of Fas, FasL and Bcl-2 were determined by the ELISA kit., Results: We found positive correlations between sFas and age in GD patients (r = 0.35; p < 0.05). In GD patients we found a negative correlation between sFasL and age in all studied patients with AITD (r = -0.34; p < 0.01). We also found a negative correlation between sBcl-2 and age in HT patients (r = -0.42; p < 0.05)., Conclusions: Fas/FasL and Bcl-2 signaling pathways seem to be age-related and may explain, at least in part, milder course of Graves disease in elderly patients and increased prevalence of Hashimoto disease in this group of subjects.

Introduction: Therapeutic approach to incidentaloma, in spite of existing algorithms, is not always obvious due to diagnostic difficulties. The aim of the study was to assess the validity of the initial diagnoses of incidentaloma which determined the qualification for the operation., Material and Methods: 125 patients hospitalised in the Endocrinology Dept. of the Medical University of Bialystok in the years 2003-2005 and in the Endocrinology dept. of Voivodeship Hospital of Bialystok. The patients were clinically and hormonally examined (metanephrines in daily urine collection, daily cortisol rhythm, short dexamethasone test, aldosterone, and renin plasma activity, Na, K levels in the serum) as well as computer tomography of the adrenal glands were performed., Results: 42 patients were qualified for adrenalectomy. Adenoma was confirmed in 25 patients (in 7 subclinical Cushing syndrome was diagnosed, in 2 Conn disease, in 16 inactive changes), phaeochromocytoma in 6 patients, cysts in 3, lipoma in 2, carcinoma in one, in 4 patients metastases (in 2 of kidney carcinoma, in 1 of malignant melanoma and in 1 of planocellular carcinoma) and in one oncocytoma. Metanephrines urine measurements showed 33% of false positive results., Conclusions: Qualification for adrenalectomy requires an assessment of tumor's enlargement, its tissue density, morphology and growth dynamics. To reduce the percentage of false positive results of metanephrine measurement there is to eliminate an influence of some drugs, victuals, beverages and nicotine and eventually to carry out additional tests. The decision as to proceeding with adrenal incidentaloma should be individualized based on clinical symptoms, hormonal tests and tumor morphology.

Purpose: Pregnancy is considered an important risk factor of the development and progression of diabetic retinopathy (DR). The aim of the study was to assess whether retinal changes tend to progress during pregnancy in women with type 1 diabetes., Material and Methods: 136 women with type 1 diabetes were enrolled to this 3 years prospective study. The patients were divided according to White's scale into the following classes: B (n=76), C (n=34), D (n=24), R (n=2). Before conception and during pregnancy the patients were treated with intensive insulin therapy to achieve optimal metabolic control. Ophthalmic examination was performed before planned conception, in each trimester of the pregnancy and after delivery., Results: No pathologies were discovered with fundoscopy in all the women belonging to class B, in 22 women from class C and in 4 women from class D. No progression of diabetic retinopathy was observed during the entire period of observation in 12 women from class C and in 20 from class D with nonproliferative DR in the first examination. In 3 women from class C progression of DR were observed in the second trimester with partial improvement after delivery. Visual acuity in these patients also deteriorated. Proliferative DR diagnosed in 2 patients from class R at the beginning of the observation, progressed during the pregnancy to diminish after delivery., Conclusions: Pregnancy does not influence significantly the progression of pre-existing diabetic retinopathy, provided that proper metabolic control is achieved and patients are subject to systematic ophthalmological control.

Objectives: Recent studies suggest the essential role of different cytokines realised from adipose tissue in pathogenesis of gestational diabetes. The aim of the study was evaluation of adiponectin (diabetes development protective factor) and TNFalpha (one of the most important insulin resistance mediator) genes expression in maternal visceral and subcutaneous adipose tissue as well as placental tissue., Material and Methods: The study group consists of patients with gestational diabetes, healthy pregnant glucose tolerant women represented the control group. Tissue samples--placental tissue, visceral and subcutaneous adipose tissue--were obtained from patients who were undergoing ceasarean section. RT-PCR technique was performed for evaluation of adoponectin and TNF alpha genes expression., Results: Our study showed decreased adiponectin gene expression and increased TNFalpha gene expression in visceral adipose tissue in pregnant women with gestational diabetes. An expression of adiponectin gene in diabetic placental tissue was not observed. We also noticed slight increase of TNF alpha gene expressionin placenta of diabetic cases., Conclusions: Decreased adiponectin and increased TNFalpha genes expression in adipose tissue of pregnant women with gestational diabetes seems to play a significant role in insulin resistance appearance and can lead to development of diabetes in pregnancy.

Unlabelled: Experimental and clinical reports suggest the role of antiphospholipid antibodies (aPL) in the pathogenesis of atherosclerosis and arterial thrombosis. The aim of our study was to evaluate IgM and IgG anti-beta2-glycoprotein I (anti-beta2-GPI), as well as IgG antiphosphatydylserine (aPS) antibodies in 80 consecutive patients (mean age 58.6+/-8.3 years) referred for coronary angiography, dependent on the extent of atherosclerotic lesions in coronary vessels and the disturbances of glucose tolerance. Antiphospholipid antibodies were measured by ELISA. The mean values of aPS and anti-beta2-GPI did not differ significantly between patients with 1- (n = 17), 2- (n = 15) or 3-vessel disease (n = 14) and subjects without significant changes in coronary arteries (n = 34), as well as between patients with unstable (n = 12) and effort angina (n = 68). Significantly higher levels of IgG anti-beta2-GPI were found in the subgroup with type 2 diabetes in comparison with the subjects with impaired glucose tolerance (median 3,8 (1.9 -9.3) U/ml vs 2,8 (1.5-5.0) U/ml, p = 0.027). Current smokers (n = 11) had significantly higher values of aPS than non smokers (55.8 +/- 30.7 - 64.7) U/ml vs 38.7 (5.7 +/- 82.6) U/ml, p = 0.017). Abnormal aPS values were found in 34 subjects (42,5%): 16 (6 diabetics) with normal angiograms (47.0%), 9 (26.5%) with 1-vessel disease, 3 (8,8%) with 2-vessel disease and 6 (17,6%) with 3- vessel disease. Increased IgG anti- (2-GPI levels were found in 8 (10%), and IgM anti-beta2-GPI - in 4 patients (5%). All subjects with high IgM anti-beta2-GPI values, as well as 5 persons with high IgG anti-beta2-GPI levels (62.5%) had significant coronary artery lesions. Multiple regression analysis revealed that factors independently influencing the levels of aPS were: patient's age (Beta = -0.8417, p = 0.0003) and glycaemia 120 min. after glucose load (Beta = 0.6453, p = 0.025)., Conclusions: our results do not confirm an association between aPS or/and anti-beta2-GPI antibodies and the extent of atherosclerotic lesions in coronary vessels, although they suggest an increased membrane phospholipids immunogenicity in relatively young patients with elevated postload glycaemia, as well as cigarette smokers.

Background and Purpose: Progress in neurooncology suggests a need to combine information from anatomical-morphological and functional imaging in diagnosis and management. It is not always possible to establish a correct diagnosis using MRI imaging techniques alone, especially in the case of recurrent brain tumors. It is suggested that the results of different imaging techniques should be combined especially in these circumstances. The aim of this study was to evaluate the usefulness of fused post gadolinium MRI and single photon emission tomography (SPECT) images for planning 1H MRS., Materials and Methods: 19 patients with a histopathological diagnosis of glial brain neoplasms were examined. SPECT was performed after i.v. administration of iodine-alpha-methyltyrozine (IMT). Fused SPECT and post Gd MR images were obtained on a peripheral console (Linux, PC), using a self developed technique. 1H MRS was performed on a 1.5 T scanner with the single voxel (SVS) technique using STEAM (TE 20 ms, TR 2000 ms) and (PRESS TE 136 TR 2000 ms) sequences., Results: 1H MRS with a volume of interest positioned in the most metabolically active areas on fused images, gave a more accurate diagnosis of tumor type and grade that was clinically relevant in 3 patients., Conclusions: The authors conclude that planning 1H MRS with the use of fused MRI and SPECT images improves the diagnosis.

Introduction: There are many factors causing endothelial dysfunction. The aim was to observe chosen markers of endothelial function in patients with subclinical and overt hyperthyroidism., Material and Methods: We studied 97 patients with hyperthyroidism: 51 with subclinical (44 F/7 M; mean age 49.3 +/- 15.9 y) and 46 patients with overt (39 F/7 M, mean age 50.4 +/- 13.2 y). The control comprised of 39 healthy volunteers (26 F/13 M, mean age 47.5 +/- 11.8 y). Concentration of TSH, FT3, FT4 were measured by MEIA, TPO Ab, TG Ab, E-selectin, interleukin 6, VCAM-1, ICAM-1 by ELISA., Results: The goiter was found in 71 persons 63F/8M, mean age 49.9 +/- 15.3 y, (42-subclinical, 29-overt). Morbus Graves-Basedow was diagnosed in 26 persons, 20 F/6 M, mean age 49.5 +/- 12.8 y (9-subclinical, 17-overt). There were no significant differences serum concentration of E-selectin, IL-6, ICAM-1 in patients with subclinical and overt hyperthyroidism compared to the control. Statistically significant differences were shown between concentration of IL-6 in patients with Graves-Basedow compared with the control (p < 0.05). Significance of VCAM-1 values were found in the patients with subclinical and overt hyperthyroidism compared to the control (p < 0.001; p < 0.001, respectively)., Conclusions: Among persons with overt and subclinical hyperthyroidism occurs endothelial dysfunction which doesn't depends on exciting cause of thyrotoxicosis but on degree of hyperthyroidism. Elevated concentrations of endothelial markers may confirm that persons with thyroid disorders are extremely exposed to the occurrence of the cardiovascular diseases.

We describe a 37 year-old woman case of latent autoimmune diabetes in adults (LADA). She was presented with unfounded weight loss. The diagnosis of diabetes mellitus was established on twice plasma glucose measurements above 200 mg/dl. In other routine biochemical examinations we did not observe dehydratation, electrolyte depletion, acidosis. However plasma level of C peptide basal and after stimulation with glucagon was reduced. Initially, the patient responded well to sulphonylurea treatment. To test immunological pathogenesis we examine autoimmune markers of diabetes type 1. Autoimmune antibodies (GAD, IAA) were found in patients and her parents, which were until now diabetic type 2. We report this case because incidence of latent autoimmune diabetes in adults is underestimate and rarely diagnosed in clinical practice.

Introduction: It has been reported that hyperthyroidism is associated with an altered endothelial function and increased risk of arterial thromboembolism. The aim of our study was to estimate chosen markers of endothelial dysfunction in iodine-induced thyrotoxicosis (IIT)., Materials and Methods: The groups studied consisted of 41 hyperthyroid subjects, who had been treated with amiodarone (n = 6) or vitamin preparations supplemented with iodine (n = 35) and 40 persons with normal thyroid function. The following parameters were measured: thyroglobulin antibodies (TG Ab), thyroid peroxidase antibodies (TPO Ab), THS receptor antibodies (TR Ab), soluble adhesion molecules: sVCAM-1 and sICAM-1, von Willebrand factor (vWF), plasminogen activator inhibitor-1 (PAI-1), C-reactive protein (CRP), fibrinogen and urine iodine concentration., Results: Patients with IIT had significantly higher levels of sVCAM-1 (p < 0.01), IL-6 (p < 0.005), fibrinogen (p < 0.005) and CRP (p < 0.05) in comparison to healthy subjects, whereas sICAM-1, PAI-1 and vWF concentrations did not differ between the groups studied. The highest sVCAM-1 levels were observed in patients with amiodarone induced thyrotoxicosis, and fibrinogen and CRP--in subjects receiving vitamin preparations. There were significant correlations between sVCAM-1 concentration and the levels of sICAM-1 (r = 0.341; p = 0.029) and PAI-1 (r = 0.347; p = 0.026), as well as with urine iodine concentration (r = 0.448; p = 0.004). IL-6 concentration correlated with vWF (r = 0.456; p = 0.003), TPO Ab (r = 0.328; p = 0.036) and PAI-1 level (r = 0.319; p = 0.042)., Conclusion: Iodine induced thyrotoxicosis is associated with an increase of sVCAM-1 and IL-6 levels, possibly reflecting inflammatory and destructive processes in the thyroid gland. However, increased procoagulant activity was not found in patients with IIT.

Introduction: Differentiated thyroid carcinoma (DTC) in children presents different biological behavior in comparison to adults. Authors presents preliminary results of multicenter analysis concerning incidence, diagnostics and treatment of DTC in children., Material and Methods: The study is a retrospective analysis of 107 pediatric patients from 14 academic centers based on the data from 2000 to 2005 obtained by questionnaire in hospitals involved in the treatment of DTC in children., Results: Papillary thyroid cancer was diagnosed in 83 children, follicular thyroid cancer in 10 children and medullary thyroid cancer in 14 children. Incidence of DTC in children was estimated between 18 and 23 cases per year. The biggest group of patients consisted of children between 11 and 15 years of age, with girls to boys ratio 3.3 : 1. Clinically DTC in children presented most often as solitary thyroid nodule. Cervical lymphadenopathy was observed in 42% of patients. Intraoperative verification indicated metastatic nodes in 50% of children. Low stage DTC predominated (T1 in 36% and T2 in 26% of children). One step surgery was performed in 65% of children with DTC, two step surgery in 25% of patients. I131 therapy was undertaken in 80% of children. Lung metastases were indicated in post therapeutic studies in 14% of children with DTC. Prophylactic thyroidectomies were performed in 79% of children in the group of patients with MTC and RET gene mutations., Conclusions: The necessity of introduction of unified therapeutic standard in children with DTC in Poland is underlined.

Unlabelled: Autoimmune thyroid diseases (AITD) constitute a group of the most common disorders caused by autoaggression of the immune system, comprising up to 1.5% of the human population. That is why optimalisation of diagnostics of Hashimoto thyroiditis (ChH) and Graves' disease (ChG) is an important issue. Aim of the study was to assess usefulness of humoral markers estimation: antithyroperoxidase antibodies (anty-TPO), antithyreoglobulin antibodies (anty-TG) and antithyroropin receptor antibodies (anty-TSHR)., Material and Methods: The study was carried out in 5 groups of subjects: 1/14 patients with GD in euthyreosis on methimazol (Geu) 2/20 patients with hyperthyroid GD (Ghiper) 3/15 patients with ChH in euthyreosis on levothyroxine (Heu) 4/16 patients with hypothyroid ChH (Hhipo) 5/12 healthy volunteers age and sex-matched to group 1-4. The serum levels of anty-TPO and anty-TG were determined by the ELISA kit. Anty-TSHR were measured by the RIA method., Results: The highest level of anty-TPO were observed in Hhipo group: 2.81 IU/I (1.79-3.22) (p<0.001 vs controls, p<0.05 vs ChH in euthyreosis). Among ChG patients higher values of anty-TPO were found in Ghiper group: 1.87 IU/I (0.68-2.88) (p<0.01 vs controls, p<0.05 vs ChG in euthyreosis). In ChH patients a positive correlation was observed between serum TSH and anty-TPO (R=0.47, p<0.01). In studied groups it was found a positive correlation between anty-TPO and anty-TG. Levels of anty-TG were increased in all studied patients as compared to controls, however there were no significant differences in anty-TG values between the groups. The highest concentration of anty-TSHR were found in Ghiper group: 6.71 (3.92-11.32) (p<0.001 vs controls, p<0.001 vs ChG in euthyreosis). There was a significant difference in anty-TSHR concentration between ChH groups: Hhipo i Heu (p<0.05). There was a negative correlation between serum TSH and anty-TSHR level in ChG patients (R=-0.05, p<0.001)., Conclusions: In diagnostics of humoral markers in patients with AITD the most valuable in clinical practice is estimation of antithyroperoxidase antibodies serum level in Hashimoto thyroiditis and antithyroropin receptor antibodies serum concentration in Graves' disease.

Unlabelled: Latent autoimmune diabetes in adults (LADA) is subtype of diabetes type 1. It is well know, that 50% patients with new diagnosed diabetes type 2 present late complications. As far we don't know how many patients with new diagnosed diabetes have late complications according to presence of antibodies against islet antigens. The aim of the study was to compare late complications of diabetes: microangiopathy and macroangiopathy in newly diagnosed adult diabetic patients in relation to presence of humoral autoimmune markers., Material and Methods: We evaluated the presence of late complications in group of 41, hospitalized patients base on clinical examination and medical history. Glutaminic acid decarboxylase antibodies (anti-GAD), protein tyrosine phosphatase antibodies (anti-IA-2) and anti-insulin antibodies (IAA) titers were measured by RIA. The C peptide basal and stimulated, HbA1c, glucose, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, urea, creatinine levels and microalbuminuria were evaluated., Results: The presence of islet cell specific antibodies were shown in 25 subjects. We observed late complications in 13/25 (52%) in group with positive antibodies titers, and in 10/16 (62.5%) in group without antibodies. We diagnosed the nephropathy (16% vs 6.25%), retinopathy (12% vs 0%), polyneuropathy (20% vs 12.5%), hypertension (32% vs 50%), chronic heart disease (8% vs 25%), overweight (32% vs 50%) and hyperlipidemia (12% vs 25%) respectively in subjects with and without antibodies. The concentrations of total cholesterol (185 +/- 47.8 vs 218 +/- 38.7, p < 0.05) and creatinine level (0.8 +/- 0.15 vs 0.95 +/- 24, p < 0.05) were higher in group without antibodies, but fasting glycemia (181 +/- 69.1 vs 132 +/- 32.8, p < 0.05) was higher in the group presenting with autoantibodies. We did not observed the difference between level of glycosylated hemoglobin in the investigated groups., Results: There is the tendency to higher incidence of microangiopathy in group of patients positive to islet cell antibodies. Conversely the macroangiopathy appears frequently in patients without antibodies.

Asthma is one of the most common chronic diseases among children. The prevalence of asthma among adult and children has systematically increased for the last thirty years. It was hypothesized that atopy was a strong background predisposing to asthma. The aim of the study was to assess the occurrence of atopy in children suffering from asthma. Two groups of children were examined. The study group consisted of 24 children aged 3-7 suffering from asthma and 26 children with bronchitis. Data about each patient's personal and family allergic history were collected. Each child had skin prick tests with common allergens made, total and specific IgE level was measured and blood eosinophil count and spirometry were performed. The result showed that asthma in 88% of the children had an atopic background. Above 70% of the children had allergic diseases other than asthma--the most common was allergic rhinitis (54%) and atopic dermatitis (37.5%). Skin tests revealed that the examined children were mostly sensitized to the allergens of house dust (85.7%), house dust mite (66.6%), and grass pollen (33.3%). Atopic features were also found in children suffering from recurrent bronchitis.

Unlabelled: The aim of the study was to examine the level of sICAM-1 in serum of patients suffering from allergic rhinitis treated with fexofenadine or fluticasone. The study was performed after two weeks' duration of the pollen season. Thirty -eight patients sensitized to grass pollen were participated in this study: 15 patients were treated for 10 days with oral fexofenadine (dose: 120 mg/d), 13 patients were treated with intranasal fluticasone (dose: 200 mcg/d), 10 patients were given oral placebo. Blood sample were collected both in the first and the last day of the treatment. The efficacy was evaluated with the use of symptom score. sICAM-1 level in serum was measured with ELISA method., The Results: Mean sICAM-1 level in serum was: in group treated with fexofenadine- 224,5 ng/ml before treatment, 228 ng/ml - after treatment; in group treated with fluticasone- 212 ng/ml before treatment, 214 ng/ml- after treatment; in placebo group- 226 ng/ml before treatment, 229 ng/ml- after treatment. There was no difference in statistical analysis between sICAM-1 values. (p > 0.05). In 7 patients treated with fexofenadine serum levels of sICAM-1 significantly decreased from 212 ng/ml to 185 ng/ml (p < 0.05), the same decrease was observed in 7 patients treated with fluticasone: from 233 ng/ml to 209 ng/ml (p < 0.01), and in 6 patients from placebo group: from 219 ng/ml to 205 ng/ml (p < 0.01). However in the rest of patient's level of sICAM-1 significantly increased after treatment. Patients treated with fexofenadine showed significant improvements of clinical symptoms (mean symptom score before treatment: 11, 3, after treatment-5, 3) and symptoms evaluated during laryngological examination (mean symptom score before treatment: 9, 5, after treatment- 5, 5). Significant improvement of clinical symptoms was also observed in patients treated with fluticasone (mean symptom score before treatment: 10, 7, after treatment 3, 6) and symptoms evaluated during laryngological examination (mean symptom score before treatment: 9, 2, after treatment- 5, 0). No changes were noticed in placebo group (mean clinical symptom score before treatment: 9, 0, after treatment 10, 3 and mean laryngological symptom score before treatment: 7, 5, after treatment 7, 7).

Right classification of diabetes is important clinical issue. The aim of present study was to compare clinical, biochemical and immunological features, to analyze their practical use and to establish new decision tree which make the distinction between diabetes type 1, LADA, diabetes type 2 and MODY. We studied 97 not obese (mean BMI 26.3 +/- 4.9 kg/m2) patients aged 14 to 70 years, mean age 43 +/- 11.7 years, 53 women, 44 men. Mean duration of diabetes--2.3 +/- 4.3 years. We measured basal and stimulated C-peptide (6 minutes after 1 mg i.v. glucagon) (ELISA) and antibodies titers to glutamic acid decarboxylase--antiGAD65, tyrosine phosphatase-like molecule--IA2 and insulin--IAA (RIA). Autoimmune diabetes (LADA, type 1) was diagnosed with presence of one or more islet antigen antibodies. The highest frequencies had anti-GAD antibodies 33/97 (34%). The most complicated was to sort out group of patients with LADA. Comparison between this group and patients with diabetes type 2 have shown that BMI, co-existence of autoimmune disease, autoimmune markers and basal and stimulated C-peptide level measured at entry for the classification were useful in differentiation. Moreover we observed significantly lower C-peptide basal, stimulated and over basal level in group with MODY diabetes in comparison to diabetes type 2 patients. In the studied group were 5 patients with diabetes type 2 and obesity, in relatively young age. At the end there was one case of ADM (atypical diabetes mellitus). Clinical criteria for the classification of diabetes not always correlated with diagnosis. Autoimmune markers, basal and stimulated C-peptide were useful specially in differentiation between LADA and diabetes type 2 or diabetes type 1. Autoimmune diabetes co-existe with autoimmune disease. Proposed diagnostic scheme take for consideration presence of autoantibodies as well as C-peptide criteria.

It is well known that classification of diabetes in the group of patients aged 25-55 years, particularly not obese, is a difficult clinical problem. The aim of the study was to estimate clinical status of the investigated group and evaluate biochemical features based on positive titers of humoral immunological markers in the development of diabetes mellitus. We studied 31 non obese, newly diagnosed patients (mean BMI < 26 kg/m2), mean age--41.6 +/- 11.1 years, mean duration of diabetes mellitus was 11.4 +/- 21.8 months. Nearly 50% of the patients aged 25-55 years showed presence of humoral immunological markers, which suggests high prevalence of autoimmunological diabetes. These patients have a lower reserve of endogen insulin secretion. The evaluation at both B-cell secretory capacity and markers of autoimmunity is recommended to provide a proper classification.

The review summarizes recent progress in the study of the cardiac actions of second--generation antihistamines. Terfenadine and astemizole, two antihistamines of the second generation, are in vitro potent blockers of potassium channels (K+). It has been considered to be responsible for QT prolongation of the electrocardiogram and life--treating ventricular tachycardias called torsades de pointes. Loratadine and descarboethoxyloratadine, the major metabolite of loratadine were studied on a human cardiac K+ channel (hKv 1.5) cloned from human ventricle. Parent compound and its metabolite in high concentration blocked hKv1.5 channels. However, loratadine (10 mumol/L) failed to inhibit HERG potassium channel and HERG K+. Ebastine also inhibit potassium channels, cloned human Kv 1.5. Cetirizine was completely devoid of any inhibitory action on HERG K+ channels in concentration up to 30 mumd/L. On the other hand terfenadine and astemizole effectively blocked HERG K+ channels with nanomolar affinities (330 and 480 nmol/L, respectively), whereas loratadine was about 300-fold less potent. Fexofenadine--the major metabolite of terfenadine, does not block either HERG or Kv1.5. The quinea pig model (in vitro) revealed that only terfenadine, astemizole and ebastine produced significant QT interval prolongation and arrhythmogenic effects. The other nonsedating antihistamines including cetirizine, loratadine and the major metabolite of ebastine (carabastine), terfenadine (feksofenadine) and astemizole (norastemizole) were devoid of QT interval prolongation and other adverse ECG effects.

The aim of this study was an evaluation of the mucociliary clearance of airways with saccharine test in children with juvenile chronic arthritis. In tested group the displacement time of saccharine was significantly longer than in healthy children. In control group the displacement time of saccharine was longer in children older 13 years, but in tested group the quality of mucociliary clearance was independent of age and of arthritis duration. The mucociliary clearance impairment wasn't dependent of increasing incidence of infections of respiratory system.

The study included 65 patients--42 males and 23 females aged 67 +/- 17 with the diabetic foot syndrome. They were divided into 2 groups: those who underwent amputation (25 patients) and 40 who were treated conservatively. Amputations were preceded most frequently by ulceration (17 cases), phlegmona (5 cases) or dry necrosis (3 cases). The high percentage of amputations in the studied patients could be explained, at least in part, by poor general condition and advanced local changes. In the group of patients, who underwent amputation--in relation to those treated conservatively a decrease in filtration function was found (46.0 +/- 24.3 vs 89.5 +/- 26.2) and a higher percentage in the prevalence of microalbuminuria or proteinuria (80% vs 45%) as well as a higher percentage of cigarettes smokers in this group (72% vs 40%). The majority of the studied patients was characterized by poor education, lack of self-control of glycaemia, no efficient metabolic control of diabetes, measured by glycated haemoglobin and the presence of neuropathy and retinopathy. In addition, in 4 patients among the whole studied group (including 1 patient who underwent amputation), diabetes was newly diagnosed. These results indicate the necessity of improving education, early diagnosis of insulin independent diabetes, more frequent foot examinations and the elimination of amputation risk factors. Prophylaxis of diabetes foot associated with the proper treatment of diabetes is a necessary condition for decreasing of the amputation rate according to St. Vincent Declaration.

A case is presented of a 30-year old man with long-term history of painful muscle cramps, episodes of tetany, general malaise and persistent hypokaliemia. On the ground of clinical appearance and biochemical data the Bartter's syndrome in Gitelman's variant was diagnosed. In differential diagnosis we considered renal tubular acidosis, other tubular defects (Liddle's syndrome), primary and secondary hyperaldosteronism. Other possible causes of hypokaliemia were excluded such as surreptitious diuretic and lexative abuse, persistent vomiting and diarrhea. Good therapeutic effect were achieve using spironolacton, indomethacin, propranolol and potassium supplementation.

The purpose of the presented study was the assessment of diagnostic and therapeutic efficacy of percutaneous drainage of pancreatic pseudocysts and abscesses, guided by ultrasound (US). The study population comprised 65 patients, aged 21-79 years: in 18 of them pancreatic abscess and in remaining 47--pancreatic pseudocyst were diagnosed. Causes of the fluid accumulation were: acute pancreatitis--in 57, trauma--in 3 and in 5 the specific etiological factor was not found. Ultrasound was performed with Aloka Hellige SSD 280-LS scanner and Braun Melsungen Nephrofix and Cystofix kits were used for drainage. Enzymatic, bacteriologic and cytologic examination of aspirate was performed. Duration of catheter drainage in pseudocysts was 10-40 days (mean 18) and from abscesses--21-56 days (mean 32). A variety of organisms was cultured from pancreatic fluid, Escherichia coli being most prevalent, also Proteus, Staphylococcus, aureus etc were found. Definite cure was obtained in 54 (83%) patients, among them in 40 (85.1%) with pseudocysts and in 14 (77.7%) with abscesses, which was confirmed in control imaging examinations (US and/or CT) after 4-6 months after catheter was removed. In 10 (15.38%) cases surgical intervention appeared necessary--in 7 patients during unsuccessful drainage and in 3--because of late recurrence. One patient died after relaparotomy. Percutaneous drainage is effective in the treatment of pancreatic fluid collections, allowing in most cases avoiding surgical intervention and providing additional diagnostic data.

In 110 diabetics type I and type II and in 30 control subjects the total serum activity of NAG as well as of its isoenzymatic forms A and B was determined. In cases with diabetic nephropathy the GFR and serum creatinine was also analysed. It was found that NAG activity is correlated to the degree of clinical symptoms of diabetic vascular changes. Therefore it could be suggested that NAG plays a role in development of microangiopathy. NAG determination may also serve as an index differentiating the diabetic microangiopathy from other forms of microvessels.

Presence of alfa-fetoprotein was found in serum of patient in whom primary hepatoma was suspected. The post-mortem microscopical examination did not confirm the clinical diagnosis ut showed changes typical for Hodgkin's disease.