Search

Spontaneous osteonecrosis of the knee (SONK) is said to be a relatively common disease which may lead to an end-stage osteoarthritis of the knee. The aim of this paper was to review the literature on this field published until now, discuss the results of both conservative and surgical treatment options, as well as to introduce new methods of treatment, which may be applicable in SONK treatment. We searched the PubMed and Cochrane databases until November 2019 and presented the most recent findings in this work. The exact aetiology of SONK still remains unclear; however, recent studies suggested that early stage of SONK is rather a result of the subchondral fracture than primary osteonecrosis. So far described conservative treatment includes non-weight bearing or protected weight bearing with a knee brace, nonsteroidal anti-inflammatory drugs, analgesics, and bisphosphonates. Surgical management includes arthroscopic debridement, core decompression, osteochondral autograft, high tibial osteotomy, and unicompartmental knee arthroplasty or total knee arthroplasty. Although the aetiology of SONK remains unknown, there are many treatment options, and the choice of the most suitable one is challenging. We think that subchondroplasty may be one of the effective methods.

The notion of ‘civilization diseases’ is used to describe certain ailments whose aetiology is difficult to explain based on the knowledge about the functioning of the body and its metabolism. Only studies at the cellular level, on biochemical changes shed light on the causes of some diseases described as civilization diseases (cancers, cardiovascular and respiratory diseases, obesity, psychomotor disorders in children and an increase in the frequency of malformations). The factors whose incontestable influence on the increase in the frequency of occurrence of various ‘civilization diseases’ has been proved are persistent organic pollutants, among others belonging to the group of organohalogen compounds. Among organohalogen pollutants one needs to distinguish organochlorine compounds, which have been used as pesticides, and pollution emitted by various industries such as dioxins and furans, polychlorinated biphenyls, and polybrominated organic compounds used as flame retardants and perfluoroalkylated substances, which are characterized by high chemical and thermal stability as well as high surface activity due to which they may be widely used as oleophobic and hydrophobic factors.

Objective: Decompensated chronic hyperglycemia often leads to late microvascular complications such as retinopathy, diabetic foot syndrome, and diabetic kidney disease. The aim of this study was to determine the concentration of vascular endothelial growth factor A (VEGF-A) and its receptors in patients with well-controlled diabetes. Methods: The study was conducted on 31 patients with well-controlled type 2 diabetes without micro- or macroangiopathy. Thirty healthy volunteers were enrolled in a control group. Serum concentrations of VEGF-A, VEGF receptors 1 and 2 (VEGFR1 and VEGFR2), fasting glucose, and lipid profiles were measured, and the plasma concentration of glycated hemoglobin (HbA1c) was determined. Results: No significant differences were observed between the concentration of VEGF-A, VEGFR1 or VEGFR2 in the subject group and that in the control group. Positive correlations were noted between the levels of VEGF-A, VEGFR2, and triglyceride, and there was a negative correlation between the levels of VEGFR2 and high-density lipoprotein (HDL)-cholesterol in the study group. Conclusions: The concentrations of VEGF-A and its receptors 1 and 2 in patients with well-controlled diabetes are comparable to those of healthy individuals, which may indicate that appropriate control of glucose levels delays the occurrence of vascular complications. A negative correlation between VEGFR2 and HDL-cholesterol levels, and positive correlations between VEGF-A, VEGFR2, and triglyceride levels, suggest that lipid abnormalities occurring in diabetes may be involved in the modulation of angiogenesis.

Aim The aim of the study was to assess the blood concentration of orexin and its association with other clinical factors in patients with alcohol dependence. Methods Thirty-two males hospitalized on an addiction treatment ward due to alcohol dependence and 23 healthy men as a control group were enrolled in the study. The measurement of orexin in the blood was made at the beginning of the treatment (after withdrawal symptoms had stopped) and again after 4 weeks of observation. Results At the beginning of the observation, the alcohol-dependent patients had significantly greater orexin blood concentration than the control group. After 4 weeks of treatment for relapse prevention, the blood orexin level decreased significantly to a value similar to that in the control group. At the beginning of the study, more severely alcohol-dependent patients (Short Alcohol Dependence Data [SADD] score range: 20–45) had significantly greater orexin blood concentration than individuals with moderate addiction severity (SADD score range: 10–19). However, after 4 weeks of abstinence, the peptide blood concentration was similar in both groups of alcoholic patients. Conclusions Orexin or its receptor is a potential target for relapse prevention treatment, but further study with long-term observation is needed to verify the usefulness of blood orexin determination as a marker of alcohol relapse risk.

Objective: Diabetes, including type 1 and type 2, is associated with the hypercoagulable state. The aim of this study is to evaluate the concentration of selected hemostatic parameters and vascular endothelial growth factor-A (VEGF-A) in diabetic subjects. Methods: The study was conducted in 62 patients with diabetes. Group I consisted of 27 patients having uncontrolled diabetes with microalbuminuria and Group II included 35 well-controlled diabetic patients. The control group was made up of 25 healthy volunteers. In the citrate plasma, the concentrations of tissue factor (TF), tissue factor pathway inhibitor (TFPI), thrombin-antithrombin (TAT) complexes, and D-dimer were assayed. Serum concentrations of VEGF-A, lipid profile, creatinine, and plasma fasting glucose were measured and in the versene plasma the concentration of HbA1c was determined. Results: In the patients with uncontrolled diabetes, higher concentrations of TF, TFPI, and VEGF-A were observed, as compared with the well-controlled diabetics group and the control group. A significantly lower activity of antiplasmin was reported in patients from Group I as compared with the control group. In Group I, using the multivariate regression analysis, the glomerular filtration rate was independently associated with VEGF-A and dependently associated with total cholesterol. Conclusions: The study showed higher concentrations of TF and TFPI in the patients with uncontrolled diabetes with microalbuminuria, which is associated with rapid neutralization of the thrombin formation, since TFPI inhibits the complex of TF/VIIa/Ca2+. The manifestation of the above suggestions is the correct TAT complexes and D-dimer, which indicates a low grade of prothrombotic risk in this group of patients, but a higher risk of vascular complications.

Objective: The aim of this study was to evaluate the concentrations of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and the degree of homeostasis model assessment-insulin resistance (HOMA-IR) in patients with morbid obesity exposed to a three-week low-calorie diet and balneotherapy. Methods: The study included 33 patients (25 females and 8 males; mean age 46 years) with body mass index (BMI) values of >40 kg/m2. Evaluations of CRP, IL-6, TNF-α, lipid profile, HOMA-IR, and fasting glucose were carried out before (baseline data) and three weeks after the treatment. The control group consisted of 20 healthy volunteers (15 females and 5 males) with a mean age of 39 years and BMI values of ≤24.9 kg/m2. Results: In the blood of patients with morbid obesity we found significantly elevated levels of CRP, TNF-α, triglycerides, HOMA-IR and fasting glucose, but a decreased level of high density lipoprotein (HDL)-cholesterol, compared with the healthy individuals. The treatment resulted in about a 9.4% reduction in body weight from 122.5 to 111.0 kg and a significant decrease in the concentration of CRP, but no change in TNF-α or IL-6. HOMA-IR was significantly reduced. Conclusions: The decrease in CRP level without changes in TNF-α or IL-6 concentrations after the low-calorie diet and balneological treatment, suggests that an essential amount of adipose tissue must be removed before proper adipocyte function is restored. The decrease in HOMA-IR indicates an improvement in insulin sensitivity, which is beneficial in obese patients.

Introduction Left ventricular (LV) function and prognosis in patients after myocardial infarction are associated with some angiographic parameters. Objectives The aim of the study was to assess the associations between the TIMI score in the infarct-related artery (IRA) before percutaneous coronary intervention (PCI), myocardial blush grade (MBG) following effective PCI, and the extent of collaterals measured using the Rentrop scale and plasma levels of vascular endothelial growth factor (VEGF) and angiogenin, number of CD34⁺ cells, as well as LV ejection fraction (LVEF) and wall motion score index (WMSI). Patients and methods In 62 patients with the first ST-segment elevation myocardial infarction (STEMI) treated with PCI and bare metal stent implantation, plasma VEGF and angiogenin levels as well as the number of CD34⁺ cells were assessed before PCI, 24 hours after PCI, at discharge, and at 30 days following STEMI. LVEF and WMSI were evaluated by echocardiography at discharge and at 1 and 6 months after STEMI. Results Patients with TIMI 0-1 flow in the IRA before PCI (64.6% of the patients) had significantly higher troponin I and VEGF levels as well as a higher number of CD34⁺ cells than patients with TIMI 3 flow. Patients with TIMI 0-1 flow also had worse LV systolic function at 1 and 6 months following STEMI. Neither the MBG grade nor the Rentrop score showed associations with the mobilization of CD34⁺ cells, VEGF and angiogenin levels, and parameters of L V systolic function. Conclusions Early patency of the IRA and lower myocardial necrosis seem to be more important for LV function assessed in patients 6 months after STEMI than mobilization of CD34⁺ cells and levels of angiogenic factors.

Background In patients with intracranial tumors, hypercoagulability is observed due to brain tissue and tumor cells being the source of tissue factor. Objectives The aim of the study was to assess tissue factor (TF), tissue factor pathway inhibitor (TFPI) and protein C in the plasma and tumor tissue homogenate in patients with intracranial tumors. Material and methods The study included 77 patients; 24 patients were diagnosed with glioma, 20 patients with meningioma and 33 patients with metastatic tumors; mean age - 54 years. The material for the study was the plasma and tumor tissue homogenate sampled during surgery. The control group consisted of 30 controls; mean age - 51 years. In the plasma of all the participants and in tumor tissue homogenate, the concentrations of TF-Ag, TFPI-Ag and protein C activity, and the concentration of total protein were measured. The results were converted per mg of protein. Results In patients with intracranial tumors, elevated concentrations of TF-Ag, TFPI-Ag and protein C activity were noted, also after the conversion per mg of protein. A 100-fold higher concentration of TF per 1 mg of protein was found in tumor tissue compared to the patients' plasma. In tumor tissue homogenate, a lower TFPI concentration and a lower protein C activity were recorded. Conclusions The study confirmed the essential prothrombotic properties in patients with intracranial tumors, expressed with an elevated TF level, as well as a tremendous amount of TF in tumor tissue homogenate derived from tumors. The elevated concentration of TFPI and protein C activity converted per mg of total protein should be analyzed in terms of their pleiotropic function, along with the participation in hemostasis control. It seems that the reduced protein C activity and low TFPI level are associated with the enormous TF value in tumor tissue homogenates.

The aim of the study was to investigate whether treatment with non-vitamin K antagonist oral anticoagulants (NOACs) is effective and well tolerated in real-life patients following venous thromboembolism (VTE) associated with severe inherited thrombophilia. We evaluated 33 consecutive patients with severe inherited thrombophilia, defined as the presence of deficiencies in protein C, protein S, or anti-thrombin, homozygous factor V Leiden and prothrombin G20210A mutations, or combined defects. The patients were recruited from March 2010 to December 2015 and followed till July 2016. Rivaroxaban was used in 23 patients (70%), whereas dabigatran and apixaban were used in 4 patients each. During a median 21 (range 8-34) months' follow-up, three recurrent VTE episodes (9%) were observed. Deep vein thrombosis recurred after 6 months on rivaroxaban in a protein S-deficient 32-year-old woman who had heavy menstrual bleeding resulting in interruptions of therapy. A long journey preceded deep vein thrombosis recurrence after 12 months of rivaroxaban use in a 59-year-old obese man homozygous for prothrombin 20210A mutation. The third recurrent VTE following anticoagulation withdrawal prior to surgery and during hospitalization was observed in a 56-year-old woman with protein S deficiency and heterozygous factor V Leiden. The three patients continued use of NOACs, apixaban, dabigatran, and rivaroxaban, respectively. This largest real-life series of patients with severe thrombophilia receiving NOACs indicates that such patients could be safely and effectively treated with NOACs. Lower efficacy was observed in protein S deficiency. Recurrent VTE was mostly related with nonadherence, which highlights an important role of regular intake of NOACs in high-risk patients.

Activated protein C resistance (APC-R) is assessed as part of thrombophilia screening, preferably in patients not taking oral anticoagulants. Rivaroxaban is known to alter some APC-R assays. To our knowledge, there have been no reports on the effect of rivaroxaban on the Russell viper venom time (RVVT)-based APC-R assay in real-life patients. In 168 consecutive outpatients suspected of having venous thromboembolism because of thrombophilia, APC-R was determined using the RVVT-based ProC Ac R assay (Siemens, Marburg, Germany). Patients receiving rivaroxaban or vitamin K antagonists were eligible. We measured rivaroxaban concentrations using the anti-Xa Biophen DiXal assay (Hyphen Biomed, Neuville-Sur-Oise, France) and factor V Leiden using the real-time PCR. APC-R was detected in 23 (28%) patients on rivaroxaban (n = 81) administrated 2-48 h since the blood draw, 15 (28%) patients on vitamin K antagonists (n = 54), and in four (12%) patients off anticoagulation (n = 33). Compared with nonanticoagulated patients, APC-R ratios were similar in patients on rivaroxaban, without any correlation with rivaroxaban concentrations (from 0 to 303 μg/l). None of the patients on rivaroxaban were found to have false-negative or false-positive APC-R ratios. Rivaroxaban concentrations up to 300 μg/l do not affect results of the ProC Ac R RVVT-based assay, which could be recommended in patients referred to a clinic for thrombophilia screening in whom the time since the last dose of rivaroxaban is uncertain.

Objective: Uncontrolled diabetes has become a major cause of mortality and morbidity by reason of vascular angiopathy. The aim of this study was to evaluate the concentrations of soluble forms of vascular adhesion molecule-1 (sVCAM-1), intercellular adhesion molecule-1 (sICAM-1), E-selectin, and thrombomodulin in patients with well-controlled and uncontrolled diabetes type 2. Methods: The study was conducted on 62 patients with diabetes. Group I consisted of 35 patients with well-controlled diabetes. The second group included 27 patients with uncontrolled diabetes with micro-albuminuria. A control group was made up of 25 healthy volunteers. The concentrations of sVCAM-1, sICAM-1, sE-selectin, and soluble thrombomodulin were assayed in plasma. Serum concentration of creatinine was measured and the plasma concentrations of fasting glucose and glycated hemoglobin (HbA1c) determined. Results: Lower concentrations of ICAM-1 were found in the group of uncontrolled diabetes patients compared with those with well-controlled disease. In patients with uncontrolled diabetes, VCAM-1 levels were significantly higher compared with the group with well-controlled diabetes. In patients with uncontrolled diabetes a positive correlation was obtained between glomerular filtration rate and sE-selectin and a negative correlation between the levels of creatinine and ICAM-1, although there was a positive correlation between (HbA1c) and ICAM-1. Conclusions: The study confirmed the participation of the inflammatory process associated with impaired vascular endothelial function in the pathogenesis of type 2 diabetes. The opposite effect of uncontrolled hyperglycemia on adhesion molecules suggests different functions of VCAM-1 and ICAM-1 in complications of diabetes.

BACKGROUND The most common cause of death among people with obesity are cardiovascular complications as a result of a hypercoagulability state. OBJECTIVES The purpose of the study was to assess the potential of coagulation system activation depending on the tissue factor and to analyze of the influence of a 3-week low-calorie diet and balneological treatment on selected coagulation parameters in morbidly obese patients. MATERIAL AND METHODS The study included 36 patients (28 females and 8 males; mean age 46) with the value of BMI > 40 kg/m2. The study was designed in two stages: baseline and after 21-days. The evaluation of tissue factor (TF), tissue factor pathway inhibitor (TFPI), von Willebrand factor (vWF), fibrinogen, D-dimer, thrombin-antithrombin complexes (TAT), and the activity of antithrombin (AT) was performed in patients before and after the treatment. The control group consisted of 24 healthy volunteers (16 females and 8 males) at a mean age of 39 with BMI . 24.9 kg/m2. RESULTS There were significantly higher levels of TF, TFPI, fibrinogen, TAT complexes and D-dimer in the study group as compared to the controls. Moreover, there were no significant changes in the parameters studied before and after the treatment. In the group of obese patients, there were significant positive correlations between the concentrations of vWF and BMI and BMI changes and a significant negative correlation between the WHR changes and TFPI concentration. CONCLUSIONS The study confirmed that morbidly obese patients represent a high risk of hypercoagulability state, despite no clinical evidence, which could be due to the great inhibitory potential of TFPI in suppressing the extrinsic pathway of the coagulation system. However, the lack of effect of the 3-week exposure to the LCD and balneological treatment in morbidly obese subjects indicates that substantial fat mass must be reduced before adequate hemostasis is re-established.

Introduction Antiphospholipid syndrome (APS) is a common acquired thrombophilia associated with a high thrombotic risk, in which vitamin K antagonists (VKA) represent the mainstay of therapy. Case series involving up to 35 patients with APS suggested limited efficacy and safety of direct oral anticoagulants (DOACs). Material and methods In the prospective case series we followed 56 consecutive patients with APS (44 women and 12 men, aged from 22 to 64 years), including 33 (60%) associated with systemic lupus erythematosus (SLE) and 16 (28.6%) with triple APS who were treated with DOACs due to their preferences or unstable anticoagulation with VKA. DOACs were started at least 3 months since the thromboembolic event in patients with D-dimer below 500 ng/ml. Results Forty-nine (87.5%) patients were treated with rivaroxaban, 4 (7.3%) with dabigatran and 3 (5.4%) with apixaban. During follow-up of 2 to 43 (mean 22) months, 6 (10.7%, 5.8 per 100 patient-years) patients (4 women and 2 men, 4 with triple positive APS) experienced recurrent thrombosis, including deep vein thrombosis (n = 4, including 2 episodes preceded by nonadherence), superficial vein thrombosis (n = 1) and non-ST elevation myocardial infarction (n = 1). The recurrence rate of VTE on DOACs was 5.8 per 100 patient-years. Two patients (3.6%) experienced severe bleeding. Conclusions This case-series suggests that DOACs are safe in patients with APS. These findings need to be confirmed in larger studies.

Obesity is a multifactorial, progressing and life-long illness that consists in an exaggerated collection of fatty tissue. In 1997 WHO acknowledged that overweight and obesity had the character of an epidemic in developed countries. Studies show that in Poland morbid obesity was diagnosed in 2.2% of women and in 0.6% of men. Thromboembolic incidents occur very often in people with obesity, especially with morbid obesity. In hypercoagulability, fibrinolysis process decides about the scale of clinical symptoms of disorders of the hemostasis.The aim of this study was to assess the chosen parameters of the fibrinolysis process in patients with BMI crossing 40, classified for surgical treatment of obesity.The study was conducted in 50 patients with BMI40, including 30 women and 20 men. The mean age of the patients was 38.5 years. The control group was made up of 20 healthy volunteers, with a mean age of 38 years. In the blood of both groups the following examinations were performed: concentration of tissue plasminogen activator antigen (t-PA:Ag), antigen of the plasminogen activator inhibitor type-1 (PAI-1:Ag), D-dimers, fibrinogen and plasminogen, activity of the α2-antiplasmin (α2-AP).The conducted study showed that in patients with morbid obesity there was a higher concentration of tPA:Ag, PAI-1:Ag, D-dimers and a higher activity of α2-AP.The conducted study demonstrates that the activation of the fibrinolysis process appeared after the coagulation process, indicated by an increase in the t-PA:Ag concentration and D-dimers concentration in patients with morbid obesity. The essential growth of PAI-1:Ag level and α2-AP level shows strong inhibition of fibrinolysis in patients.

The present study's purpose has been to examine the development of the human suprarenal glands (SGs) during the prenatal period. Special attention was paid to sexual dimorphism and the differences between the parameters of the right and left SGs. Specimens were obtained from 187 human fetuses spontaneously aborted between the 4th and 7th months of gestation. The SGs were dissected from the fetuses after an immersion and preservation period of 3-24 months in 9% formalin solution. The mass and linear dimensions of each isolated SG were obtained, and these data revealed a progressive two-fold increase between the 4th and 7th months of gestation. There was a gradual reduction in the ratio of the SG mass to the overall mass of the fetus with a marked decrease evident between the 4th and 5th months. Statistical analysis of both SGs showed significant differences between sexes in the mass and in the thickness of the left SG during the 5th and 6th months of gestation. Differences in the mass and linear dimensions of the left and right SGs were recorded from the 5th month of gestation to the 7th month. The mass and volume of the left SGs were higher than those on the right side. This allometric analysis provides data from a large sample of human fetuses and will later aid in microscopic and ultrasonographic studies.

Persistent organic pollutants (POPs), such as PCBs (polychlorinated biphenyls) and DDT [1,1,1-trichloro-2,2-bis(4-chlorophenyl)ethane], are environmental contaminants with potential endocrine disrupting activity. DNA methylation levels in peripheral blood lymphocytes have been associated with serum concentrations of POPs in Greenland Inuit and Korean populations. Greenland Inuits are characterized by the highest worldwide POP levels. In this cross-sectional study we evaluated the relationship between serum POP concentrations and DNA methylation levels in sperm of non-occupationally exposed fertile men from Greenland, Warsaw (Poland), and Kharkiv (Ukraine). Serum levels of PCB-153 [1,2,4-trichloro-5-(2,4,5-trichlorophenyl)benzene], as a proxy of the total PCBs body burden, and of p,p'-DDE [1,1-dichloro-2,2-bis(4-chlorophenyl)ethylene], the main metabolite of DDT were measured. Sperm DNA methylation level was assessed globally by flow cytometric (FCM) immunodetection of 5-methyl-cytosines and at specific repetitive DNA sequences (Alu, LINE-1, Satα) by PCR-pyrosequencing after bisulfite conversion. Multivariate linear regression analysis was applied to investigate correlations between serum POP concentrations and DNA methylation. No consistent associations between exposure to POPs and sperm DNA methylation at repetitive DNA sequences were detected. A statistically significant global decrease in methylation was associated with exposure to either POP by FCM analysis. This is the first study to investigate environmental exposure to POPs and DNA methylation levels considering sperm as the target cells. Although POP exposure appears to have a limited negative impact on sperm DNA methylation levels in adult males, the global hypomethylation detected by one of the methods applied suggests that further investigation is warranted.

The goal of this paper is to determine concentrations of seven selected perfluoroalkylated substances (PFASs): perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorohexane sulfonic acid (PFHxS), perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), perfluoroundecanoic acid (PFUnDA), perfluorododecanoic acid (PFDoDA) in the blood serum of men and women of reproductive age from the central region of Poland. The relation between sex of tested subjects and the levels of compounds in blood serum of humans will also be considered and analysed as an element of the risk assessment. The study was made on the blood serum samples collected from 253 women and 176 men of reproductive age between 20 and 44 years from Warsaw and surrounding areas. Higher concentrations of five (PFOS, PFOA, PFNA, PFDA, PFUnDA) from among seven selected PFASs were observed in men in comparison to women from the same populations. Only the concentrations of PFHxS and PFDoDA were slightly higher in women than in men. These differences were statistically significant in all cases, except for PFUnDA. The hypothesis that the concentrations of said compounds increase with age of the test subjects, regardless of gender has not been confirmed.

Organohalogen compounds constitute one of the important groups of persistent organic pollutants (POPs). Among them, due to their long-term health effects, one should pay attention on organochlorine pesticides, polychlorinated biphenyls (PCBs) and perfluoroalkylated substances (PFASs). This paper is an attempt to answer the question about relation between the fact of cohabitation by couples expecting a child and the level of the organohalogen compounds in the blood serum of both parents. The study was done on a population of parent couples from Greenland, Poland and Ukraine, from whom blood samples were collected in order to establish the levels of marker organohalogen compounds. We selected, as the representative of these compounds, the most persistent metabolite of DDT, i.e. p,p'-DDE, the most frequently detected PCB congener - CB-153, and PFOS and PFOA as the representatives of PFASs. The results show that in case of all compounds under study the highest concentrations were present always in men in relation to the levels detected in the blood serum of their female partners, regardless of the country of origin of the couple. A positive correlation was noted between the concentrations of the studied compounds in the blood serum of men and women in parenting couples. In some cases these correlations were statistically significant, e.g. for concentrations of p,p'-DDE in pairs from Greenland and Ukraine, of CB-153 in pairs from Poland and Ukraine, and of PFOS for parents from Greenland and Poland, while for PFOA - only for couples from Greenland. The concentrations of the compounds included in the study were similar to the levels found in general population in other countries. Our results show that the exposure to POPs resulting from cohabitation plays a role in the general exposure to these compounds.

Background Prior studies on the association between prenatal exposure to polychlorinated biphenyls (PCBs) and dichlorodiphenyldichloroethylene (DDE) and child motor development have found contradicting results. Using data collected in the INUENDO cohort in Kharkiv (Ukraine), Warsaw (Poland) and Greenland (N = 1,103) between the years 2002 and 2012, we examined relations of prenatal exposure to 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene (p,p′-DDE) and 2,2′,4,4′,5,5′-hexachlorobiphenyl (CB-153) on motor development and developmental milestones; crawling, standing-up and walking. Methods CB-153 and p,p′-DDE were measured in maternal blood in second or third trimester of pregnancy. Motor development was measured in terms of the parentally assessed screening tool Developmental Coordination Disorder Questionnaire 2007 and developmental milestones were assessed via retrospective parental reports of child age at the first time of crawling, standing-up and walking. Results We saw no associations between tertiles of CB-153 and p,p′-DDE or log-transformed exposures and retrospective reports of the developmental milestones crawling, standing-up and walking in infancy or the motor skills measured as developmental coordination disorder at young school age. Conclusions In utero exposure to CB-153 and p,p′-DDE was not associated with parentally retrospectively assessed developmental milestones in infancy or parentally assessed motor skills at young school age. The use of a more sensitive outcome measure may be warranted if subtle effects should be identified. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-1465-3) contains supplementary material, which is available to authorized users.

Introduction Data about angiogenic factors in diabetic foot syndrome (DFS) are insufficient. Therefore, in the present study we focus on circulating endothelial progenitor cells (EPCs) and two major angiogenic factors: vascular endothelial growth factor (VEGF-A) and fibroblast growth factor (FGF-2) in patients with DFS. Materials and methods We included 75 subjects: 45 patients with type 2 diabetes and 30 controls. The study group was divided into 2 subgroups: 23 patients with diabetic foot and 22 patients without diabetic complications. The concentration of VEGF-A, soluble VEGF receptor 2 (sVEGF-R2) and FGF-2 were measured in plasma samples. The number of circulating EPCs was determined in peripheral venous blood. The number of endothelial progenitor cells was measured with FACSCalibur flow cytometer using monoclonal antibodies directed against antigens specific for EPCs. Results In our study we observed significant higher levels of VEGF-A and FGF-2 and lower sVEGF-R2 concentration in patients with T2DM compared to healthy subjects. The conducted analysis showed decreased levels of VEGF-A and elevated levels of FGF-2 in patients with DM complicated DFS compared to diabetic patients without DFS. Increased circulating EPCs number was reported in patients with DFS, and the difference was almost statistically significant. Conclusions The high concentration of VEGF-A and FGF-2, and a positive correlation between them indicate their participation in the process of angiogenesis in T2DM. Decreased sVEGF-R2 may result from inactivation of VEGF-A during complexes formation.

In patients with diabetic foot syndrome (DFS), an inadequate angiogenic response is observed. The aim of this study was to evaluate the concentrations of VEGF-A, PDGF-BB, sVEGF-R2 and sVEGF-R1 in patients with diabetes-complicated diabetic foot syndrome and analyse them using selected clinical data.Forty seven diabetic patients, 25 women mean age 63 and 20 men mean age 60.5, with diabetic foot syndrome (DFS) were enrolled in the experimental group. To evaluate angiogenesis factors depending on Wagner grade, the subjects were divided into three subgroups: I - patients with 0 Wagner grade (n = 14); II - patients with 1,2,3 Wagner grades (n = 15); and III - patients with 4,5 Wagner grades (n = 18). The control group consisted of 20 healthy volunteers. The material for research was blood.Significantly higher levels of VEGF-A and PDGF-BB in the DFS cases compared to controls were observed (VEGF-A p = 0.000001; PDGF-BB p = 0.000051). Analysis of angiogenic parameters according to the stage of diabetic foot syndrome advancement showed higher VEGF-A level (I: p = 0.000867; II: p = 0.001827; III: p = 0.000024) and PDGF-BB (respectively p = 0.004113, p = 0.004224, p = 0.002480) in all the subgroups. Decreased sVEGF-R2 concentrations were observed in the I (p = 0.054) subgroup and the III (p = 0.03524) subgroup. In this study, a strong positive correlation between VEGF-A and PDGF-BB was observed (R = 0.66; p = 0.000001).Our study revealed that proangiogenic factor levels were increased in DFS. This is associated with lower limb ischaemia and hypoxic conditions. The stage of diabetic foot syndrome advancement influenced VEGF-A and PDGF-BB concentrations.

Persistent organic pollutants (POPs) may affect male reproductive function. Many dioxin-like POPs exert their effects by activation of the aryl hydrocarbon receptor (AHR) signalling pathway. We analysed whether gene-environment interactions between polymorphisms in AHR (R554K) and AHR repressor (AHRR P185A) and serum levels of markers of POP exposure 1,1-bis-(4-chlorophenyl)-2,2-dichloroethene (p,p'-DDE) and 2,2',4,4',5,5'-hexachlorobiphenyl (CB-153) are associated with 21 parameters of male reproductive function in 581 proven-fertile European and Greenlandic men. In Greenlandic men, AHR variants significantly modified the association between serum levels of both p,p'-DDE and CB-153 and inhibin B levels, sperm chromatin integrity, and seminal zinc levels. In the total cohort, interactions between AHRR variants and serum levels of CB-153 were associated with sperm chromatin integrity and the expression of the pro-apoptotic marker protein Fas. The data indicate that susceptibility to adverse effects of POP exposure on male reproductive function is dependent on polymorphisms in genes involved in AHR signalling. © 2014 Elsevier Inc.

Recently, it has been reported that nonstenotic bicuspid aortic valve (BAV) with dilated proximal aorta is linked with increased matrix metalloproteinase-2 (MMP-2) and endothelial dysfunction.We wondered whether asymmetric dimethylarginine (ADMA), a nitric oxide synthase inhibitor, might be altered and associated with MMP-2 in BAV patients. We assessed the relation between ADMA levels and aortic diameters and hypothesized that elevated ADMA might be an independent predictor of progressive aortic dilatation in BAV patients.We studied 20 patients with nonstenotic BAV (17 men and 3 women, median age 27, range 24-33 years). Twenty age-matched patients with tricuspid aortic valves served as controls. Plasma levels of ADMA, symmetric dimethylarginine (SDMA), L-arginine, serum MMP-2, MMP-9, and plasma total homocysteine (tHcy), together with parameters of aortic elasticity, were measured.ADMA and MMP-2 levels were higher in the BAV group compared with controls (medians, 0.55 vs. 0.43 μmol/l, P0.001 and 1.25 vs. 1.00 μmol/l, P0.001, respectively). The BAV patients also had higher SDMA and tHcy levels than controls (0.39 vs. 0.35 μmol/l, P0.001 and 11.5 vs. 9.7 μmol/l, P = 0.006). ADMA levels in BAV patients correlated with aortic annulus (r = 0.4, P = 0.043), peak aortic velocity (r = 0.6, P = 0.001), aortic distensibility (r = 0.6, P = 0.004), aortic stiffness index (r = 0.7, P0.001), and aortic strain (r = 0.7, P0.001) as well as with MMP-2 (r = 0.6, P = 0.002) and tHcy (r = 0.4, P = 0.042).This study is the first to show that circulating ADMA together with MMP-2 is a marker of proximal ascending aortic dilatation and impaired aortic elastic properties in nonstenotic BAV patients. It might be speculated that plasma ADMA could be helpful in identifying BAV patients at a higher risk of aortic aneurysm.

Background: Left ventricular (LV) systolic function is a significant prognostic factor in patients after myocardial infarction (MI). Multiple angiogenic and inflammatory factors are involved in postinfarction LV remodelling process. In addition, CD34+progenitor cells mobilised from bone marrow and tissue niches participate in regeneration of the infarcted myocardium. Aim: To examine relationships between LV ejection fraction (LVEF) and wall motion score index (WMSI) and the number ofCD34+ cells and plasma levels of vascular endothelial growth factor (VEGF), angiogenin and such inflammatory factors asinterleukin 6 (IL-6), interleukin 8 (IL-8), and high-sensitivity C-reactive protein (hsCRP) in patients with ST-elevation MI (STEMI). Methods: The study group included 61 patients with STEMI treated with primary percutaneous coronary intervention (PCI)involving bare metal stent implantation. Plasma levels of the evaluated angiogenic and inflammatory factors were measured byflow cytometry at 4 time points (just before PCI, 24 h later, at hospital discharge, and 30 days after STEMI). LVEF and WMSIwere measured by echocardiography at hospital discharge, 1 month later, and 6 months later. We compared angiogenic andinflammatory factor levels in patients with no improvement of the LV systolic function during the follow-up (group 1, n = 22)vs. those with improved LV systolic function (group 2, n = 39). Results: No differences in the levels of VEGF, angiogenin, IL-6, IL-8, and hsCRP, and the number of CD34+ cells wereobserved between the two groups. Despite this, we found significant negative correlations between hsCRP level and LVEF,and positive correlations between hsCRP level and WMSI in both patient groups, but these correlations were much strongerin group 1. We also found a significant negative correlation between WMSI at 6 months and the number of CD34+ cellsmeasured 24 h after PCI. Conclusions: 1. Evaluation of plasma VEGF, angiogenin, IL-6, IL-8, and hsCRP levels and the number of CD34+ cells at differenttime points in patients with STEMI did not allow predicting the direction of changes in LVEF and WMSI. 2. Observedsignificant correlations between hsCRP level and LVEF and WMSI may suggest a harmful effect of inflammation on postinfarctionmyocardial remodelling. 3. A significant negative correlation between the number of CD34+ and WMSI suggests thatincreased mobilisation of these cells might have a beneficial effect on systolic function after MI.

Asymmetric dimethylarginine (ADMA) has been recognized as a marker of cardiovascular risk. We sought to investigate whether consumption of tea, coffee, fruit or vegetables is associated with ADMA. In 148 consecutive apparently healthy subjects (104 men and 44 women aged 40 to 70), daily tea, coffee, fruit and vegetable consumption was ascertained by questionnaire. Plasma ADMA, symmetric dimethylarginine (SDMA), and l-arginine levels were measured by high-performance liquid chromatography. Median tea and coffee consumption was 2 cups/d, while vegetable and fruit intake was 152 (120-179)g/d and 120 (108-134)g/d, respectively. Median plasma ADMA, SDMA and arginine were 0.47 (0.43-0.53)μmol/L, 0.59 (0.54-0.66)μmol/L and 86 (68-101)μmol/L, respectively. ADMA correlated inversely with tea (r = -0.70, P < .0001) and vegetable consumption (r = -0.50, P < .0001) even after adjustment for age, sex, body mass index, smoking status, and potential dietary and biochemical parameters. No association between ADMA and fruit consumption was found. ADMA correlated positively with coffee intake (r = 0.37, P < .0001), although these associations were less potent after adjustment for dietary factors. Higher tea and vegetable intake is associated with lower plasma ADMA levels in healthy middle-aged subjects.

SummaryIt has been demonstrated that formation of compact plasma fibrin clots resistant to plasmin-mediated lysis characterises patients following instent thrombosis (IST). The relationship between defective fibrinolysis, reflected as prolonged clot lysis time (CLT) and IST is unclear. We sought to investigate whether patients with acute and subacute IST have impaired fibrinolytic capacity. We studied 41 definite IST patients, including 15 with acute and 26 with subacute IST experienced 2–73 months prior to enrollment, versus 41 controls matched for demographics, cardiovascular risk factors, concomitant treatment and angiographic/stent parameters. CLT, reflecting lysis of a tissue factor-induced plasma clot by exogenous tissue plasminogen activator, together with plasminogen activator inhibitor-1 (PAI-1) antigen and activity, thrombin-activatable fibrinolysis inhibitor (TAFI) antigen and activity, thrombomodulin (TM), plasminogen and α2-antiplasmin (α2AP) were measured. There were no inter-group differences in angiographic parameters, indication to the first PCI, culprit vessel or a type of stent. Patients with IST had 11% longer CLT (p=0.005) and 13% higher PAI-1 antigen (p=0.04) compared to controls. There were positive correlations in both groups between CLT and PAI-1 antigen and TAFI activity (all p

Phthalates are widely used as a plasticizers in manufacture of synthetic materials and as solvents in sanitary products, cosmetics and pharmaceutical products. Dibutylphthalate (DBP) is used as a plasticizers and as a textile lubricating agent and as solvent in printing ink. The study aimed the evaluation of the magnitude of DNA damage in liver and bone marrow cells and estimation of dibutyl phthalate (DBP) concentration in peripheral blood following prolonged exposure to DBP. Experiments were conducted an the Pzh:Sfis male mice. Animals were exposed 8 weeks, 3 days per week per os to DBP suspension in oil in doses of 500 mg/kg bw (1/16 LD50) and 2000 mg/kg bw (1/4 LD50). Following groups of mice were sacrificed 4 and 8 weeks after the start of exposure and 4 weeks after the end of exposure. Decreased body weight of mice and statistically significant decreased liver and relative liver weights were observed following 8-weeks exposure to 2000 mg/kg bw DBP. In the same time higher however not statistically significant level of DNA damage measured by Comet assay in liver cells were noted. DBP did not induce enhanced frequency of DNA damage in bone marrow cells. Following 8-weeks exposure to the dose of 2000 mg/kg bw DBP the increased level of DBP in peripheral blood was observed. Enhanced levels of DBP were still noted 4 weeks after the termination of exposure. Results confirmed that DBP acts as a weak mutagen for DNA of somatic cells. However, following prolonged exposure this compound seems to undergo slower metabolism and was reaching temporarily higher levels in peripheral blood.

Phthalate are found in the environmental samples due to their wide use in the industry as plasticizers. Di-n-butylphthalate (DBP) is mainly used in nitrocellulose and polyvinyl acetate products as well as in personal-care products. This study was performed to investigate the influence of exposure to DBP on the quantity and quality (motility, morphology) and DNA damage (induction of micronuclei and DNA strand breaks) of male mice gametes. The estimation of DBP residues was also done. Eight weeks exposure to DBP (500 mg/kg bw and 2000 mg/kg bw) did not significantly affect testes and epididymes weights as well as sperm count. DBP clearly diminished sperm motility, enhanced frequency of abnormal sperm heads and not significantly increased DNA strand breaks in germ cells as well as frequency of micronuclei in spermatids. There were no bioacumulation of DBP in mice. Results suggest that DBP may affect the male mice germ cells.

Background Epidemiological studies on the association between maternal exposure to persistent organic pollutants (POPs) and fetal growth alteration report inconsistent findings which weights in favor of additional studies. Methods Blood samples were collected from interviewed pregnant women in Greenland (572), Kharkiv (611) and Warsaw (258) and were analyzed for CB-153 and p,p'-DDE by gas chromatography-mass spectrometry. Data on birth weight, gestational age and preterm birth were obtained for 1322 singleton live births. We examined the association between natural log-transformed serum POPs concentration and birth weight and gestational age using multiple linear regression and the association with prematurity using logistic regression controlling for potential confounding factors. Results The median serum concentrations of CB-153 and p,p'-DDE were for Inuit mothers 105.6 and 298.9, for Kharkiv mothers 27.0 and 645.4 and for Warsaw mothers 10.7 and 365.2 ng/g lipids, respectively. Increase in CB-153 concentration by one unit on the log scale in Inuit mothers serum was associated with significant decrease in infant birth weight of -59 g and gestational age by -0.2 week. Decreases observed in the cohorts in Kharkiv (-10 g and -0.1 week) and in Warsaw (-49 g and -0.2 week) were not statistically significant. Increase in p,p'-DDE concentration by one unit on the log scale was associated with a statistically significant decrease in infant birth weight of -39.4 g and -104.3 g and shortening of gestational age of -0.2 week and -0.6 week in the Inuit and Warsaw cohorts, respectively. In the Kharkiv cohort decrease in birth weight (-30.5 g) was not significant, however a shortening of gestational age of -0.2 week per increase in p,p'-DDE concentration by one unit on the log scale was of the borderline significance. There was no significant association between CB-153 and p,p'-DDE concentrations and risk of preterm birth however, in all cohorts the odds ratio was above 1. Conclusions In utero exposure to POPs may reduce birth weight and gestational age of newborns however, new insights as to why results vary across studies were not apparent.

The aim of this study was to evaluate whether the type of heart vasculature is in any way related to the length of the main stem of the left coronary artery. The study was inspired by publications describing a shorter main stem of the left coronary artery in adults with left coronary artery predominance, also associated with a worse clinical outcome. Such relationships have not been been examined in a fetus. A short main stem of the left coronary artery is thought to convey faster progression of atheromatosis in coronary arteries.This investigation was performed on 187 fetuses of both sexes at the Nicolaus Copernicus University Department of Histology and Embryology. Vasculature types were determined in line with criteria set by Adachi. All fetuses had been delivered naturally. None of them had any signs of malformations or developmental abnormalities. Prior to examination, all fetuses had been conserved for a 3-month period in 9% formaldehyde solution. Statistical analysis was carried out using Statistica software for Windows.The length of the left main stem was found to be related to the type of vasculature, though this relationship did not achieve statistical significance. There were no differences in relation to gender or type of vasculature or between analyzed sub-groups.There was no relationship between the length of the main stem and dominance of the coronary artery in this study.

Transformed cells of solid tumors often contain activators of fibrinolytic system allowing to create new metastatic centers. There are a few data of fibrinolytic potential of neoplastic cells of hematopoietic system. The aim was the evaluation of t-PA (tissue plasminogen activator) and PAI-1 (inhibitor of plasminogen activator type 1) in lymphocytes datained from patients with chronic lymphoid leukemia.The study was performed in 35 patients with chronic lymphoid leukemia and in control group containing 20 healthy persons. From venous blood lymphocytes were isolated, calculated and homogenized using ultrasound disintegrator. In homogenates of cells and in the blood plasma concentrations of t-PA antigen (t-PA:Ag) and antigen of PAI-1 (PAI-1:Ag) were determined.In lymphocytes obtained from healthy persons more t-PA and PAI-1 was detected than in lymphocytes from patients with chronic lymphoid leukemia. In lymphocytes from patients PAI-1: Ag concentration was 14 fold higher than t-PA:Ag.The lymphocytes of patients suffering from chronic lymphoid leukemia are different from healthy person in respect of t-PA:Ag and PAI-1:Ag concentration.

A normal coronary angiogram is found in about 20% of patients who undergo coronary angiography due to chest pain. In some of them syndrome X is diagnosed. Endothelial dysfunction is one possible cause of this pathology.To compare the endothelial function estimated by two different methods in patients with typical or atypical anginal pain and with no chest pain.Fifty-three patients who underwent coronary angiography due to suspected coronary artery disease and who had a normal coronary angiogram were included in the study: 34 patients had typical anginal pain (group 1) and 19 patients had atypical chest pain (group 2). The control group consisted with 20 subjects without chest pain. The plasma concentration of such endothelial markers as von Willebrand factor (vWF), thrombomodulin (TM), endothelin 1 (ET-1), tissue plasminogen activator (tPA), plasminogen activator inhibitor type 1 (PAI-1) and C-reactive protein were measured. We also determined endothelial-dependent brachial arterial dilatation (flow-mediated dilation, FMD).The groups of patients were different with regard to the factors of known effects on endothelial function but endothelial markers were not different in all groups with two exceptions. The concentration of tPA was the highest in patients with typical chest pain and the concentration of PAI-1 was the highest in patients without chest pain. The FMD values were low in all patients and there were no significant differences in the FMD values between the three analysed groups. We did not find any correlation between the concentration of examined endothelial markers and FMD. A non-significant relationship between the presence of classical risk factors and decreased FMP was observed. We have found a significant relationship between the number of risk factors and FMD, tPA, PAI-1 and hsCRP.The assessment of endothelial function using FMD or estimation of endothelial markers is not useful to differentiate chest pain.

Literature search referring to the role of haemostasis disturbances in pathogenesis of ulcerative colitis in children revealed considerable discrepancies in the obtained findings and some controversies in their interpretation. The aim of the study was the assessment of urokinase plasminogen activator (u-PA) and urokinase type plasminogen activator receptor (u-PAR) in children with ulcerative colitis.22 children with ulcerative colitis were included in our investigation, there were 7 girls and 15 boys whose mean age was 15.55 (+/-3.0) years. The reference group was made up of 22 children of similar age and sex suffering from celiac disease during the period of full compensation. Blood was drawn in the morning from the cubital vein with minimal stasis into a tube containing 3.2% sodium citrate at the ratio of 1:10. The levels of u-PA and u-PAR (of the American Diagnostical Company) were measured with ELISA.The children with ulcerative colitis did not reveal any essential difference in concentration of u-PA and u-PAR with regard to the reference group. In the group of patients over the remission period, concentrations of u-PA and u-PAR were similar to the group of children in the acute period. In the course of ulcerative colitis no increased concentrations of u-PA:Ag and u-PAR in the blood of sick children were confirmed.It seems probable that the inflammatory process in colon mucosa at the time of the study did not cause any neoplastic change in mucosal cells in these children in the period of aggravation.

Since artherosclerosis processes were proved to have their origins as early as in one's childhood, attempts have been made to find the risk factors in the population of the developmental age.The aim of this work was the analysis of lipidogram parameters and the parameters of coagulation and fibrynolysis systems in overweight and obese children and adolescents.101 children and adolescents aged 4-19 were examined, including 30 overweight and 34 obese ones, with the control group comprising 37 patients with normal body weight.No significant differences in the studied groups were noticed in the total cholesterol level, LDL, fibrinogen and in alpha2-antiplasmin activity. The HDL cholesterol level was actually lower in the group with obese patients, while the PAI-1 level was actually higher.Overweight and obese children and adolescents comprise a group threatened by premature development of atherosclerosis and need to be monitored for risk factors.

Perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA) blood levels are commonly used as biomarkers of human environmental exposure to these compounds. Many biomonitoring studies indicate 100% detection for PFOS and PFOA thus justifying a concern of possible risk for the most exposed individuals.This study addresses the predictive value of hazard quotients (HQs) calculated on the basis of serum PFOS and PFOA in male and female populations of reproductive age in Greenland, Poland and Ukraine.Overall, 2026 results of PFOS and PFOA serum concentrations (589 males, 1437 females) were obtained from the INUENDO database. HQs were calculated from the actual biomonitoring results and literature-based animal data linking toxicological outcomes and critical PFOS/PFOA serum levels. HQs for serum PFOS were calculated based on Points of Departure (PoD) at 13 μg mL−1 (cynomolgus monkeys, 183 days, changes in THS and T3) and for PFOA at 7.1 μg mL−1 serum (male rats, 90 days, hepatocellular necrosis, increased liver weight). Uncertainty factors were applied to reflect interspecies differences and human variability. Serum HQs were expressed as a ratio relative to the point of departure for each PFOS and PFOA. Only in the three cases of males in Greenland were there serum PFOS levels showing HQ values exceeding 1, so indicating that such serum levels may be of concern. The mean serum concentration of PFOS was significantly higher in male than in female populations. Despite significant differences between HQ profiles for PFOS and PFOA in donors from Greenland, Poland and Ukraine, the concentrations of these perfluoroalkylated compounds do not indicate a cause for concern, except for the three aforementioned cases from Greenland.This study demonstrates that the HQ approach can help to interpret human biomonitoring data and thus serve as a valuable tool in further risk assessment priority settings and may also be used as a basis for taking decisions in risk management. Keywords: Perfluorooctane sulfonate, Perfluorooctanoic acid, Hazard quotients, Serum levels, Risk assessment, Environmental contaminants

In June 2004, blood samples of fifteen volunteers were analyzed for presence of selected groups of chemical contaminants. The aim of this survey organized by WWF Poland (World Wildlife Fund) was highlighting the problem of man-made, persistent and bioaccumulative chemicals constantly present in surrounding environment and in our tissues. It was a part of European WWF "Detox" campaign supporting proposal of a new EU regulation that should lead to the identification and phasing out of the most harmful chemicals (known as REACH). Three laboratories in Czech Republic, Sweden and Belgium have analyzed blood samples for presence of the following groups of contaminants: organochlorine compounds (pesticides and polychlorinated pesticides), phthalates and perfluorinated aliphatic substances. The total number of single chemicals found in the blood samples was 25, that represents 64% of the 39 chemicals looked for. The average number of compounds found in the samples was 21 (from 19 to 22). Among organochlorine compounds analyzed, the predominant chemical found in the highest concentration was p,p'-DDE (range from 130 to 1310 ng/g of fat), which similarly like p,p'-DDT, beta-HCH, and HCB (concentrations ranging from 6,4 to 46 ng/g of fat) was present in every person's blood. Among analyzed polychlorinated biphenyls, in all samples the following congeners have been present: PCB-118, PCB-138, PCB-153, and PCB-180 (concentrations ranging from 3,7 to 61 ng/g of fat). The two predominant phtalates from total eight analyzed present in all samples were di(2-ethylhexyl)phthalate (DEHP) (concentration range from 49 to 293 ng/g of blood) and diisobutyl phthalate (DIBP) (concentration range from 10 to 63 ng/g of blood). Among fifteen perfluorinated aliphatic substances analyzed, six have been present in each single sample (perfluorohexanesulfonic acid - PFHxS, perfluorooctanoic acid - PFOA, perfluorooctane-sulfonic acid - PFOS, perfluorooctanesulfonylamide - PFOSA, perfluorononanoic acid - PFNA, and perfluorododecanoic acid - PFDA). The predominant compound in this class of contaminants was PFOS with the concentration ranging from 4,4 to 14 ng/ml of blood. The limited number of samples does not allow for making an analysis of potential impact of different factors on concentrations of particular contaminants in human blood. Results obtained in this survey confirm the ubiquitous contamination by a cocktail of hazardous chemicals of every person tested. Humans being a part of the environment are being contaminated with the same chemicals which are present in surrounding air, water, food, consumer articles, etc.

The analysis of bibliography referring to the role of haemostasis disturbances in pathogenesis of ulcerative colitis in children revealed considerable discrepancies in the obtained findings of the study and some controversies in their interpretation. The aim of the study was the assessment of tissue plasminogen activator (t-PA) and its inhibitor (PAI-1) in children with ulcerative colitis.The 22 children with ulcerative colitis were included in our investigation, there were 7 girls and 15 boys whose mean age was 15, 55 (+/- 3.0) years. The reference group was made up of 22 children suffering from celiac disease covering the period of full compensation in the range of similar age and sex. Blood was drawn from the cubital vein in the morning with minimal stasis into a tube containing 3.2% sodium citrate at the ratio of 1:10. The levels of t-PA and PAI-1 were measured with ELISA.In children with ulcerative colitis and in the control group we found out similar concentration of antigen tissue plasminogen activator (t-PA:Ag). In the group of children with ulcerative colitis under investigation a mean concentration of antigen inhibitor plasminogen activator (PAI-1:Ag) was statistically higher.Elevation of PAI-1:Ag concentration in plasma of the children suffering from ulcerative colitis may confirm the participation of PAI-1 in inflammatory reaction of disease- induced changes in colon mucosa.

Background The study is part of a collaborative project (Inuendo), aiming to assess the impact of dietary persistent organochlorine pollutants (POPs) on human fertility. The aims with the present study are to analyze inter-population variations in serum concentrations of 2,2',4,4',5,5'-hexachlorobiphenyl (CB-153) and 1,1-dichloro-2,2-bis (p-chlorophenyl)-ethylene (p,p'-DDE), to assess inter-population variations in biomarker correlations, and to evaluate the relative impact of different determinants for the inter-individual variations in POP-biomarkers. Method In study populations of 3161 adults, comprising Greenlandic Inuits, Swedish fishermen and their wives, and inhabitants from Warsaw, Poland and Kharkiv, Ukraine, serum concentrations of CB-153 and p,p'-DDE, were analysed by gas chromatography-mass spectrometry. Results The median serum concentrations of CB-153 were for male and female Inuits 200 and 110, for Swedish fishermen 190 and their wives 84, for Kharkiv men and women 44 and 27, and for Warsaw men and women 17 and 11 ng/g lipids, respectively. The median serum concentrations of p,p'-DDE were for Kharkiv men and women 930 and 650, for male and female Inuits 560 and 300, for Warsaw men and women 530 and 380, and for Swedish fishermen 240 and their wives 140 ng/g lipids, respectively. The correlation coefficients between CB-153 and p,p'-DDE varied between 0.19 and 0.92, with the highest correlation among Inuits and the lowest among men from Warsaw. Men had averagely higher serum concentrations of CB-153 and p,p'-DDE, and there were positive associations between age and the POP-biomarkers, whereas the associations with BMI and smoking were inconsistent. Dietary seafood was of importance only in the Inuit and Swedish populations. Conclusion CB-153 concentrations were much higher in Inuits and Swedish fishermen's populations than in the populations from Eastern Europe, whereas the pattern was different for p,p'-DDE showing highest concentrations in the Kharkiv population. The correlations between the POP-biomarkers varied considerably between the populations, underlining that exposure sources differ and that the choice of representative biomarkers of overall POP exposure has to be based on an analysis of the specific exposure situation for each population. Age and gender were consistent determinants of serum POPs; seafood was of importance only in the Inuit and Swedish populations.

Cavity in lung cancer patients is usually attributed to worse prognosis, which could be caused by diagnostic difficulties and late surgery. The aim of this study is to identify cavity as clinical subentity in squamous cell lung cancer (SqCLC) patients. 1094 patients with I0 - III0 of SqCLC underwent surgery with the purpose of radical lobectomy or pneumonectomy. The patients were divided into two groups: 100 patients with cavity (cSqCLC) and 994 with solid tumor (sSqCLC). The clinical, histological and prognostic features were compared for the both groups. The Cox multivariate analysis of the prognostic factors was performed. The survival curves for both groups were compared. cSqCLC patients showed lower body mass and more frequent hemoptoe. They had larger tumors, located peripherically, rarer nodal involvement and atelectasis. Despite the similar cancer stage and the exploratory thoracotomies ratio, cSqCLC patients lived shorter. The survival curves for both groups were different: in all population, for patients after radical surgery and even after exploratory thoracotomy. We conclude that the cavitation in SqCLC patients can be regarded as a separate subentity related to worse prognosis.

To evaluate clinical, physiochemical and biochemical changes in rabbit vitreous body caused by local injection of sulphur hexafluoride gas.The volume of fluid vitreous fraction was measured with Na+, K+, Mg2+, Ca2+ levels and full proteins concentration in both vitreous fractions in 24 New Zealand rabbits at 2, 7 and 14 day after SF6 injection. The activity of superoxide dismutase, catalase and malonyl dialdehyde were used to evaluate the activity of antioxidative enzymatic system. Control group consisting of 6 New Zealand rabbits had no experimental procedures.In the investigated group, the fluid vitreous fraction volume was increased while gelatous one was diminished from 0.08 ml in control group to 0.32 ml in the study group (on day 14). The level of Na+, K+, Mg2+, Ca2+ in the fluid fraction was unchanged. On day 7, we noticed statistically significant increase in protein concentration in comparison with the control group and the study group on 14 day. The activity of superoxide dismutase and catalase as well as the level of malonyl dialdehyde were increased in the fluid vitreous fraction compared to the gelatous one in the control group. After the SF6 injection we did not observe any changes of superoxide dismutase and catalase activities in the gelatous part of vitreous body while in the fluid one there was statistically significant decrease in the enzymatic activity and the MDA level in the whole observation time.The injected sulphur hexafluoride gas caused the damage of the gelatous vitreous fraction with the increase in the fluid one. The oxygen free radicals might trigger these pathological processes.

Ninety-three patients with pulmonary metastases (PM) were operated on between 1983 and 1997. Surgical complications occurred in 8 (9%) of patients. Two (3%) of patients died in hospital, 7 were operated on again due to further PM. An average survival after lung metastasis surgery was 40 months, median 22 months. 44% and 35% of patients survived respectively 3 and 5 years. Thanks to lung metastasis surgery the overall survival was longer; an average overall survival was 87 months (median 58 months). 58% and 38% of patients survived respectively 5 and 10 years. Time between treatment of primary tumour (PT) and lung metastasis surgery (disease free interval DFI) was on average 4 years, median 41 months. The patients who showed DFI-longer than 2 years had tendency to live longer (p = 0.086). Patients with PM are recommended to be operated on, even if further PM occur.

Aims:To evaluate the efficacy of pulmonary metastasectomy in 93 patients with lung metastases (LM) operated on from 1983 to 1997.Methods:We assessed: location and histological diagnosis of the primary tumour (PT); the extent of pulmonary resection; and disease-free interval (DFI). Survival analysis was undertaken using the Kaplan–Meier method.Results:Surgical complications occurred in eight (9%) patients; two (3%) died in hospital; seven (8%) were operated again because of further LM. In the whole patient group the average survival after metastasectomy was 40 months (median 22 months). The actuarial survival was 44% at 3 years and 35% at 5 years. With metastasectomy we achieved an overall survival after treatment of PT of 87 months (median 58 months). The actuarial survival was 58% at 5 years and 38% at 10 years. The average time between the treatment of PT and metastasectomy DFI was 4 years (median 41 months). Patients with a DFI of more than 2 years tended to live longer (P=0.086). There were 23 patients with non-epithelial and 70 patients with epithelial tumours. Their DFIs were similar (mean 47, median 34 months for non-epithelial and mean 51, median 29 months for epithelial tumours). Of patients with non-epithelial tumours, 38% survived for 5 years and their survival curves were similar. In the group of tumours with the most frequent location, the results of metastasectomy did not differ considerably: 5 year survival rates of 20% for patients with kidney tumours, 28% for colorectal cancer, 30% for soft-tissue sarcoma, 28% for skin melanoma and 18% for breast cancer.Conclusions:Lung metastasectomy seems to be a safe and efficient method of treatment even for patients who show further metastases. According to our study it seems that, except for LM of breast carcinoma (which has a slightly worse prognosis), the results of surgical resection are not dependent on either the location or the histological pattern of the PT. For this reason patients indicated for operation can be selected according to similar criteria.

Lacrimal fluid plays a very significant role in maintaining proper functions of conjuctivas, cornea and eyelids. The fluid is secreted by the main lacrimal gland and additional glands. It produces the so called preocular lacrimal film. A number of clinical tests, such as Chirmer's tests I and II, break-up-time (BUT), lysozyme, and flow tests are used in quantitative and qualitative analyses, as well as in the determination of the lacrimal film stability. The aim of work was to utilize these in assessing the lacrimal secretion and the lacrimal film stability in workers chronically exposed to petroleum derivatives. Fifty three workers from departments of acetobenzene, benzene and butadiene, phenol and acetone, sewage waters, asphalt oxidas, polyethylene and polypropylene, were eligible for the study (group I). During previous examinations, acquired disorders in colour perception were diagnosed in all the subjects by means of the Mansuella-Fansworth 100-Hue test. The age range was 25 to 56 years, with a mediane of 44.1 years +/- 6.5. Mean duration of employment was 22 years (SD +/- 8.25). The control group (group II) was composed of 28 men aged between 24 and 60 years with a median of 42.7 years +/- 6.3, never employed under conditions of exposure to toxic chemicals. On the right eye of each subject Schirmer's test was performed after instilling into the conjunctival sac 1-2 drops of Alcain solution according to Whitcher. Five min following anesthesia of the conjunctival sac, a standardised belt of blotting-paper with colour dampness markers Vidisic (Dr Mann Pharma GMBH, Germany) was placed in the vicinity of the external angle of the eye. After 5 min the degree of the belt dampness was measured in millimetres. After 30 min the break-up-time test was performed on the left eye. Fluorescein was released to conjunctival sac from a sterile belt of blotting-paper (Haag-Strait Co.). A slit lamp with cobalt filter was used to calculate time (in sec) that elapsed between opening of the lid slit and the first symptom of breaking-up the lacrimal film. The results obtained were presented in the form of arithmetic means and standard deviation values +/- SD. Schirmer's test was 13.40 +/- 7.43 mm in group 1, and 22.54 +/- 8.25 mm in the control group, mean values differed significantly, p0.01. Lacrimal film break-up-time was 16.30 +/- 6.19 sec in group 1, and 31.48 +/- 7.96 sec in the control group, mean values differed significantly, p0.01. In persons chronically exposed to petroleum derivatives, statistically significant decrease in lacrimal secretion, as well as shortening of lacrimal film break-up-time were found when compared with the control group.

The aim of the study was to analyse the clinical course and frequency of complications depending on type of retinal vein occlusion. The material included 70 patients (27 men, 43 women) aged 60.3 +/- 10.5 years. Follow-up period was 3 to 36 months from the occurrence of first clinical symptoms. Case history included occurrence of common diseases predisposing to occlusion formation, use of drugs and type of predromal symptoms. Full ophthalmologic examination was performed at the start and the end of follow-up. Visual field was measured with TOPCON statistic perimeter SPB 2020. Fluorescein angiography was done in 45 patients.8 patients appeared to have congestive retinography, 27-ischaemic retinal vein occlusion and 35-central retinal vein branch occlusion. Prodromal symptoms were mainly short-term (few minutes) eye blindness. Both the evaluation of sight organ function and ophthalmoscopy indicated more severe course of ischaemic occlusion in comparison with congestive occlusion. Absence of retinal capillary perfusion was observed only in cases of ischaemic occlusion.

Most of the persistent organochlorine (OC) pesticides, excluding lindane, were banned in Poland in 1975/76. The first restrictions concerning the use and marketing of lindane (gamma-HCH) became effective in 1980 and were gradually extended until it's agricultural use was ultimately banned in 1989. Unfortunately, there are no detailed data on the use and release of PCBs to the environment in Poland. The former studies showed that in the late seventies the concentrations of OC pesticides and their metabolites in men reached considerable high levels. Despite of the restrictions or bans of these pesticides in most of the countries of the temperate climate, they still circulate in various food chains and eventually concentrate in man. Many authors claim an uneven distribution of the OC compounds in the population and report different levels in men and women and also some relations between OC compounds levels in fat tissues and age. Environmental contamination also plays an important role in the magnitude of OC compounds levels in man. The aim of this paper is to present the actual concentrations of HCB, p,p[prime]-DDT, p,p[prime]-DDE, isomers of HCH (alpha, beta, gamma), and PCBs in human adipose tissues particularly regarding age and sex as possible factors influencingmore » the levels of these compounds and to contribute to the general discussion on the distribution patterns of the organochlorine compounds in the population. 12 refs., 3 tabs.« less

The results of radical and partial surgical treatment of 146 patients with mediastinal tumors have been assessed. All patients were operated at the Specialistic Hospital in Zakopane from the 1st January, 1967 to the 31st December, 1989. Hundred twenty one patients (82.9%) suffered from malignancy and 25 (17.1%) from non-malignant mediastinal tumors. Mortality rate was 2.0%. Late results have been expressed in terms of survival period, and they have been as follows: 44.4% of patients survived 20 years after surgery, 36.5% of patients survived 15 years, 42.9% of patients--10 years, and 56.1% of patients survived 5 years. More than 50% of operated patients resumed their previous work.

The internal carotid artery occlusion causing an insufficiency of the cerebral circulation manifests itself--besides the neurological symptoms--by disorders of the visual organ. One can distinguish among them early, functional symptoms in the form of transient unilateral hemianopia on the side opposite to the occluded carotid artery and the attacks of transient amblyopia. Signs of fixed ischaemia of the eye ball appear afterwards in the form of oculomotor and pupillary disturbances, neovascularization of the iris, disturbances of the IOP, central retinal artery occlusion, ischaemic optic atrophy. The authors emphasize the value of Doppler's diagnostic ultrasonography, a fast and non-invasive method of direct evaluation of the blood flow in the internal carotid artery system.

Photocoagulation of the iris surface in the course of rubeosis iridis was performed in 11 patients (12 eyes) with secondary absolute glaucoma. The intraocular pressure was lowered down to 30-35 mm Hg in 8 eyes, in the remaining 4 eyes it oscillated between 45 and 50 mm Hg. The pain receded in all the cases. One considers the possibility that in the disappearance of pain--besides the lowering of the IOP--a substantial factor was the lesion of the innervation of the iris.