Diagnostic methods in torsion of the spleen

Torsion of a spleen is a frequent complication of a rare entity--a wandering spleen. A wandering spleen is revealed occasionally, with physical and/or sonographic exam. However, it is often overseen. It has very unspecific simptoms, and can present a diagnostic problem. Splenic torsion manifets itself like an acute abdomen. We have presented a rare case of splenic torsion with unusual clinical findings, followed by a splenic infarction. Due to their promptness, sensitivity, uniqueness and availability, two diagnostic methods have definitive primacy in visualisation of splenic torsion: Color-Doppler sonography and CT with intravenous application of contrast medium.     

Superoxide and its interaction with nitric oxide modulates renal function in prehypertensive Ren-2 transgenic rats

OBJECTIVE: The present study was performed to examine the role of superoxide (O2*) and its interaction with nitric oxide (NO) in the regulation of renal function in prehypertensive heterozygous Ren-2 transgenic rats (TGR). METHODS: Renal responses to the O2* scavenger, tempol (150 microg/min per 100 g), and/or the NO synthase inhibitor, nitro-L-arginine methylester (L-NAME; 5 microg/min per 100 g), infused alone or in combination directly into the renal artery were evaluated in anesthetized heterozygous male TGR and aged-matched Hanover Sprague-Dawley rats (HanSD). RESULTS: There were no differences in arterial pressure (122 +/- 3 versus 115 +/- 2 mmHg), renal plasma flow (RPF; 2.09 +/- 0.1 versus 2.07 +/- 0.1 ml/min per g), glomerular filtration rate (GFR; 0.73 +/- 0.1 versus 0.74 +/- 0.1 ml/min per g) or sodium excretion (0.63 +/- 0.13 versus 0.67 +/- 0.16 micromol/min per g) between TGR and HanSD. Tempol alone caused significant increases in RPF and GFR (10 +/- 4% and 12 +/- 2%, respectively) in TGR but not in HanSD. Tempol also caused greater sodium excretory responses in TGR compared to HanSD (112 +/- 16% versus 43 +/- 7%; P < 0.05). 8-Isoprostane excretion was significantly higher in TGR than in HanSD (10.2 +/- 0.8 versus 6.5 +/- 0.7 pg/min per g), which was attenuated by tempol. L-NAME caused greater decreases in RPF and GFR in TGR (-34 +/- 4% and -22 +/- 4%, respectively) than in HanSD (-19 +/- 3% and -10 +/- 4%, respectively). Co-infusion of tempol partially attenuated the renal hemodynamic and excretory responses to L-NAME in TGR. CONCLUSIONS: These data suggest that the enhanced O2* activity and its interaction with NO during the prehypertensive phase in TGR modulates renal hemodynamic and excretory function, which may contribute to the development of hypertension in this transgenic rat model.     

Thyroid autoimmunity occurs more frequently in women with breast cancer compared to women with colorectal cancer and controls but it has no impact on relapse-free and overall survival

The aim of the study was to compare the prevalence of autoimmune thyroid diseases (AITD) in patients with breast and colorectal cancer and controls and to evaluate the impact of AITD on the outcome of patients with breast cancer. Serum levels of TSH (thyroid-stimulating hormone), FT4 (free thyroxine), TPOAb (antibodies to thyroid peroxidase), TgAb (antibodies to thyroglobulin), selenium and prolactin were investigated in 210 randomly chosen women (89 with breast cancer and 72 with colorectal cancer after breast or abdominal surgery and 49 controls without oncological diseases). Eighty-four women with breast cancer were followed for a median of 136.0 months. The prevalence of positive titres of TPOAb (>60 kIU.l(-1)) was higher in the women with breast cancer as compared to positive titres in women with colorectal cancer and the controls (29.8 vs. 12.5 and 12.2%, respectively, P=0.016 and 0.036, respectively). Similarly, the prevalence of clinical, ultrasound and laboratory documented AITD was higher in women with breast cancer as compared to that in women with colorectal cancer and the controls (35.7 vs. 18.1 and 16.3%, respectively, P=0.014 and 0.029, respectively). We did not find any prognostic significance of FT4, TSH, TgAb, TPOAb, prolactin and the presence of AITD on relapse-free and overall survival among women with breast cancer. A negative prognostic significance of body mass index and serum levels of selenium on relapse-free survival was found. In conclusion, the prevalence of euthyroid AITD was higher in women with breast cancer as compared to euthyroid AITD in women with colorectal cancer and controls. The presence of AITD did not have an impact on the outcome of women with breast cancer.     

The production of mannan-binding lectin is dependent upon thyroid hormones regardless of the genotype: A cohort study of 95 patients with autoimmune thyroid disorders

Complement mannan-binding lectin (MBL) deficiency is associated with increased susceptibility to infections and autoimmune diseases. Previous studies suggested that the production of MBL is stimulated by thyroid hormones. The aim of our study was to investigate this association in patients with autoimmune thyroid diseases (AITD). Serum levels of MBL and parameters of the thyroid function were determined in 62 patients with Hashimoto's thyroiditis, 33 with Graves' disease and 47 blood donors. Follow-up measurements were performed after 6 to 24 months. MBL2 genotypes were determined using multiplex PCR and compared to 359 healthy Czech individuals. Serum levels of MBL tightly correlated with thyroid hormones, leading to strongly increased MBL levels in hyperthyroidism and decreased levels in hypothyroidism. With normalization of the thyroid function during follow-up, MBL levels decreased or increased respectively. The observed correlations were not due to MBL polymorphisms since the frequency of MBL2 polymorphisms in AITD patients was not different from the general population. We conclude that AITD are not associated with MBL polymorphisms. However, the MBL production is strongly dependent on thyroid function, regardless of the genotype.     

Toxicity and DNA damage in tobacco and potato plants growing on soil polluted with heavy metals

Heterezygous tobacco (Nicotiana tabacum var. xanthi) and potato (Solanum tuberosum var. Korela) plants were cultivated on soil from the site Strimice which is highly polluted with heavy metals and on nonpolluted soil from the recreational site Jezerí, both in North Bohemia, Czech Republic. The total content, the content of bioavailable, easily mobile, and potentially mobile components of heavy metals (Cd, Cu, Pb, and Zn) in the tested soils, and the accumulation of these metals in the above-ground biomass and roots of tested plants were analyzed by flame atomic absorption spectrometry or flameless atomic absorption spectrometry. The average tobacco leaf area and potato plant height were significantly reduced in plants growing on the polluted soil. We have measured the DNA damage in nuclei of leaves of both plant species using the Comet assay. A small but significant increase in DNA damage was noted in plants growing on the polluted soil versus controls. As the tobacco and potato plants with increased DNA damage were severely injured (inhibited growth, distorted leaves), this increase may be associated with necrotic or apoptotic DNA fragmentation. No increase in the frequency of somatic mutation was detected in tobacco plants growing on the polluted soil. Thus, the polluted soil probably induced toxic but not genotoxic effects on tobacco and potato plants.     

Outcome of thirty patients with ANCA-associated renal vasculitis admitted to the intensive care unit

The natural course of as-yet-untreated ANCA-associated vasculitis (AAV) or complications of immunosuppressive treatment may result in rapid clinical deterioration with the need of admission to an intensive care unit (ICU). The aim of this retrospective study was to assess the outcome of patients with renal AAV admitted to the ICU in a single center. We reviewed the medical records of all 218 patients with AAV followed in our department between January 2001 and December 2006 and selected those admitted to the ICU. To assess the severity of critical illness, the Acute Physiology and Chronic Health Evaluation (APACHE II) and Sequential Organ Failure Assessment (SOFA) score on the first ICU day were calculated. Birmingham Vasculitis Activity Score (BVAS) was calculated to represent the total disease activity. Thirty patients with AAV (11 women, 19 men; mean age 61.5 +/- 13.2 years; 20 x cANCA, 10 x pANCA positive) were included. The most common reasons for ICU admission were as follows: active vasculitis (13 patients, 43.3 %), infections (7 patients, 23.3%), and other causes (10 patients, 33.3%). The in-ICU mortality was 33.3% (10 patients). The most common cause of death was septic shock (in 5 patients). The APACHE II (33.5 vs. 23.8) and SOFA scores (11.9 vs. 6.6), but not BVAS (11.5 vs. 16.1), were statistically significantly higher in non-survivors than in survivors (p < 0.01). In conclusion, the in-ICU mortality in AAV patients may be predicted by APACHE II and SOFA scores. While active vasculitis is the most frequent reason for ICU admission, the mortality rate is highest in patients with infectious complications.     

Building-specific factors affecting indoor radon concentration variations in different regions in Bulgaria

The study was conducted to assess the spatiality of the building factors’ effect on air quality through evaluation of indoor radon concentration in areas with different geology and geographical position. For that matter, a survey of indoor radon concentration was carried out in 174 kindergartens of three Bulgarian cities. The time-integrated measurements were performed in 777 ground floor rooms using alpha tract detectors, exposed for 3 months in cold period of 2014. The results of indoor radon concentrations vary from 20 to 1117 Bq/m³. The differences in the mean radon concentrations measured in the different cities were related to geology. The effect of building-specific factors: elevator, basement, mechanical ventilation, type of windows, number of floors, building renovation, building materials, type of room, type of heating, construction period, and availability of foundation on radon concentration variations was examined applying univariate and multivariate analysis. Univariate analysis showed that the effects of building-specific factors on radon variation are different in different cities. The influence of building factors on radon concentration variations was more dominant in inland cities in comparison to the city situated on the sea coast. The multivariate analysis, which was applied to evaluate the impact of building factors simultaneously, confirmed this influence too.     

Markers of lipid oxidative damage in the exhaled breath condensate of nano TiO2 production workers

Nanoscale titanium dioxide (nanoTiO₂) is a commercially important nanomaterial. Animal studies have documented lung injury and inflammation, oxidative stress, cytotoxicity and genotoxicity. Yet, human health data are scarce and quantitative risk assessments and biomonitoring of exposure are lacking. NanoTiO₂ is classified by IARC as a group 2B, possible human carcinogen. In our earlier studies we documented an increase in markers of inflammation, as well as DNA and protein oxidative damage, in exhaled breath condensate (EBC) of workers exposed nanoTiO₂. This study focuses on biomarkers of lipid oxidation. Several established lipid oxidative markers (malondialdehyde, 4-hydroxy-trans-hexenal, 4-hydroxy-trans-nonenal, 8-isoProstaglandin F2α and aldehydes C₆–C₁₂) were studied in EBC and urine of 34 workers and 45 comparable controls. The median particle number concentration in the production line ranged from 1.98?×?10⁴ to 2.32?×?10⁴ particles/cm³ with ～80% of the particles?<100?nm in diameter. Mass concentration varied between 0.40 and 0.65?mg/m³. All 11 markers of lipid oxidation were elevated in production workers relative to the controls (p?2 and markers of lipid oxidation in the EBC. These markers were not elevated in the urine samples. Lipid oxidation in the EBC of workers exposed to (nano)TiO₂ complements our earlier findings on DNA and protein damage. These results are consistent with the oxidative stress hypothesis and suggest lung injury at the molecular level. Further studies should focus on clinical markers of potential disease progression. EBC has reemerged as a sensitive technique for noninvasive monitoring of workers exposed to engineered nanoparticles.