Effect on peripheral blood natural killer cytotoxic cell activity in rats after intraperitoneal implantation of double veloured polyester (Dacron) prosthesis

INTRODUCTION: The aim of this study was to assess the changes affecting natural killer cytotoxic cell (NKCC) activity following intraperitoneal implantation of a double veloured polyester prosthesis in a rat model. MATERIAL/METHODS: Blood samples were taken by cardiac puncture 1 h before (base line) and 14, 28, 100 and 180 days post-implantation. Peripheral blood mononuclear cells were separated from heparinized blood by density centrifugation. A standard, 4 h (51)Cr-release assay against YAC-1 target cells at effector to target ratios of 12:1; 25:1 and 50:1 was performed and the number of total leukocytes, lymphocytes, granulocytes, monocytes, and large granular lymphocytes (LGLs), as well as serum corticosterone levels (radioimmunoassay method) were determined. RESULTS: Comparative analysis of the results obtained from animals with implants, baseline samples, and a control group (laparotomy only) revealed lower NKCC, LGL, leukocyte and lymphocyte counts and elevated plasma corticosterone levels in animals receiving the implant on the 14th day post-implantation. CONCLUSIONS: Our findings indicate that the polyester implant can transiently modulate immune system activities. Since NK cells are important in the control of viral infection and carcinogenesis in humans, it is possible that the stress generated by polyester prostheses can exacerbate the surgical stress and put patients at a higher risk for viral infection and/or metastases.     

Use of the Hasson technique for creating pneumoperitoneum in laparoscopic surgery

OBJECTIVE: The aim of this study was to estimate safety and efficacy of Hasson technique in laparoscopic surgery. MATERIAL AND METHOD: In those patients where adhesions are suspected pneumoperitoneum was achieved by open Hasson technique. The time of this procedure, changes of hemoglobin concentration, duration of hospitalization and postoperative pain was compared with those cases where pneumoperitoneum was performed by blind insertion of the Veress needle. RESULTS AND CONCLUSIONS: Hasson technique is more time consuming procedure but its safety and efficacy is significantly higher in those patients where adhesions are suspected.     

Metabolic activity of peripheral blood neutrophils in women with ovarian tumours

OBJECTIVES AND DESIGN: Neutrophils play important role in first line defence an they release soluble growth and chemotactic factors and guide the recruitment of non-specific immune effector cells. We estimated the activity and ability to reduce of nitroblue tetrazolium (NBT) by peripheral blood neutrophils in women with benign or malignant ovarian tumours. MATERIALS AND METHODS: The study was performed on 43 women between the ages of 19 and 72 with ovarian tumours. Cystadenoma serosum was diagnosed in 19 women, Cystadenocarcinoma serosum in 9, and teratoma adultum in 15 women. Venous blood samples were obtained prior to the operation. The control group consisted of 30 women their age range was from 22 to 60 years. In peripheral blood samples from both groups; there leukocyte counts and total neutrophils were determined. Metabolic activity was investigated by nitroblue tetrazolium reduction spontaneous (NBTsp) test, and stimulation by latexs (NBTst) test. RESULTS: In women with ovarian tumours, the index of spontaneous NBT reduction turned out to be significantly higher than that in the control group (p<0.0001). In the group studied, the index of latex-stimulated NBT reduction was significantly lower than that in the control group (p<0.0001). CONCLUSIONS: Intensity oxidation-reduction changes of neutrophils in reduction NBT in women with ovarian tumours were observed.     

Doppler examination of fetal cerebral circulation in pregnancies complicated with idiopathic oligohydramnios

OBJECTIVE: The aim of this study was to investigate the cerebral circulation in pregnancy complicated with oligohydramnios. MATERIALS AND METHODS: Comparative clinical studies evaluated Doppler curve middle cerebral artery separately in proximal (basal, MCA-P) segment and distal (cortical, MCA-D) anatomical segment. Doppler velocity waveforms analysis was performed on the base of systolic (Vs), mean (Vm) and end-diastolic (Ved) velocity of the blood wave, systolic/diastolic ratio (S/D), resistance index (RI) and pulsatile index (PI). Results were compared in the group with oligohydramnios (15 pregnancies) and the group with normohydramnios (15 pregnancies). RESULTS: We found statistically significant correlation between S/D MCA-P, S/D MCA-D, RI MCA-P. Other parameters did not show statistically significant differences. Especially we did not find statistically significant differences of parameters of the fetal cerebral circulations between pregnancies with oligohydramnios and with normohydramnios. CONCLUSIONS: On the basis of this correlation, the following conclusions were drawn: 1/ pregnancies complicated with oligohydramnios do not change fetal cerebral circulation, 2/ idiopathic oligohydramnios does not qualify for group of high risk pregnancy.     

Thrombin markers in pregnant women: measurements of prothrombin fragments F 1+2 and thrombin-antithrombin III complexes (TAT) in the cord blood, the mother's blood and in amniotic fluid

OBJECTIVES: Hypercoagulability is a well known feature of pregnancy, while hypocoagulability is attributed to newborns. The level of thrombin markers in the blood reflects the relations in coagulation system. We have measured two markers of thrombin generation, e.i prothrombin fragments F 1+2 and thrombin-antithrombin III complexes (TAT), in the cord blood and the mother's blood, as well as in amniotic fluid. MATERIAL AND METHODS: The study group consisted of 33 parturient women, 24.2 +/- 3.6 years old, 20 primiparas and 13 multiparas with normal course of pregnancy. The level of F 1+2 and the level of TAT were estimated by ELISA method. RESULTS: The highest level of F 1+2 and TAT was in amniotic fluid, e.i. 29.99 (9.15 - 50.75) nmol/l vs. 519.62 +/- 270.51 microg/l. In the blood cord the level of F 1+2 was 7.15 (5.05 - 22.05) nmol/l, and the level of TAT was 151.57 +/- 134.17 microg/l. In the mother's blood plasma the levels of F 1+2 and TAT were significantly lower than in cord blood (5.15, range 3.50 - 6.05 nmol/l vs. 36.30 +/- 18.65 microg/l respectively, p < 0.001). CONCLUSION: Increased generation of thrombin in foetal blood which is reflected in increased levels of F 1+2 and TAT, is one of the features of "foetal phenomenon" concerning foetal coagulation system. High concentration of F 1+2 and TAT in amniotic fluid can be consider to be a result of increased thrombin generation or the lowered metabolism of F 1+2 and TAT.     

IL-1beta and PGE2 production in whole blood and gingival fluid in women with periodontitis and preterm low birth weight

DESIGN: The aim of the investigation was to evaluate of IL-1beta and PGE2 concentrations in gingival fluid, whole blood as well as IL-1beta, PGE2 production after Escherichia coli lipopolysaccharide stimulation in whole blood in women with preterm low birth weight (PLBW), as compared to the control group. MATERIAL AND METHODS: A case-control study of 88 postpartum women aged 17 to 39 was performed. The case group consisted of 52 women with PLBW and the control group consisted of 36 women giving birth in time. Concentration of inflammatory mediators in gingival fluid, blood serum and IL-1beta, PGE2 production in whole blood after bacterial lipopolysaccharide stimulation were determined by means of immunoenzymatic method. RESULTS AND CONCLUSIONS: The levels of IL-1beta and PGE2 in gingival fluid were significantly higher in all PLBW mothers (also PLBW primiparous) than in the control group. In addition in the primiparous with PLBW group significantly higher PGE2 concentration in blood serum was found compared to the primiparous controls. There were no significant differences between women with PLBW and the controls together with a significantly higher production of IL-1beta and PGE2 in whole blood after LPS stimulation in women with periodontitis and gingivitis compared to subjects with healthy periodontium. Such findings suggest that inflammatory mediator synthesis is mainly result of specific cells exposition to bacterial products. Therefore it seems that more frequent occurrence of the phenotype of hyperactive cells that synthesise these mediators is not responsible for PLBW.     

Clinical analysis of pregnancy complicated by hypertension in the material of the Department of Obstetrics and Perinatology of the Pomeranian Academy of Medicine

OBJECTIVES: The aim of this study was retrospective analysis of arterial hypertension during pregnancy in the Department of Obstetrics and Perinatology of Pomeranian Academy of Medicine in Szczecin, and severe PIH intensive obstetrical care optimization. DESIGN: The retrospective analysis of 81 pregnancies complicated by arterial hypertension in the years 1995-2000 was performed. MATERIAL AND METHODS: The retrospective analysis of 81 pregnancies was performed. Patients were divided into two groups. In the first pregnancy was ended by caesarean section (n = 43), in the second by vaginal delivery. The mean gestational age, the way of delivery, accompanying diseases, uric acid levels, short term variability, Dawes - Reedman's criteria, presence of decelerations in CTG, Doppler PI, S/D, RI parameters in umbilical artery and cerebral arteries, presence of AEDVF and REDVF in umbilical artery were analyzed. RESULTS: Caesarean section was performed in 53.1% of all cases, in 46.9% vaginal delivery took place. Absolute range of short-term variability was more often less than 6 ms in caesarean section group (41.9%). Uric acid level was also higher in caesarean section group (p = 0.000194) CONCLUSIONS: 1. The caesarean rate in pregnancies complicated by arterial hypertension is over 50% and during severe PIH is approximately 100%. 2. Caesarean section takes place before estimated delivery date and indications to it are in most cases connected with a main disease 3. Short-term variability is lower among patients from caesarean section group. 4. Uric acid level is a relevant parameter of a degree of arterial hypertension, and the level is higher in first group. 5. Doppler velocimetry of umbilical artery and middle cerebral artery are valid part of obstetrical care among patients with PIH.     

Laparoscopic identification of sentinel lymph node in treatment of invasive cervical cancer

The fundamental prognostic factor in treatment of early cervical cancer is the state of regional lymph nodes. If the first lymphatic node is involved by cancer, the other ones may be affected; otherwise if the first one is free of metastatic cells, the others should not be involved by cancer either. Detection and removal of the lymphatic node called the sentinel lymph node permit to avoid radical lymphadenectomy which is connected with many severe complications. We reported a technique of identification of the sentinel lymph node during laparoscopic radical hysterectomy with pelvic lymphadenectomy in treatment of early invasive cervical cancer with presentation of case history. Identification of sentinel node with its histopathology examination may be essential in women with cervical cancer and potentially identifies women in whom lymph node dissection can be avoided. Laparoscopic lymphadenectomy seems to be equally effective and less invasive in comparison to traditional technique.