Structure, treatment and success of treatment in invasive carcinomas of the uterine cervix

At the University Hospital Gynecological Department in Zagreb 1666 cancers of the uterine cervix were treated in the period of 4 years [1969--1972]. Among them were only 309 carcinomas in situ, the remaining 1357 were invasive. The distribution by stages was as follows: IA--75, IB--223, II--326, III--611, IV--122. Such unfavourable groups of cervical cancers proceed from the fact that cancer in situ and the early cancer stage I are often treated in other institutions; only the patients with advanced cancer, a poor general condition and those with various accompanying diseases are concentrated in the above quoted institution where there are technical possibilities and a team of surgeons and radiotherapists well educated in the treatment of cervical cancer. The authors present a five-year survival achieved by surgical, radiological, as well as by a combined method of treatment. The total cure rate for stage I was 87.6%, for stage II 64,4%, for stage III 34.4% and for stage IV 6.6%.     

The impact of the menstrual cycle and ondansetron on postoperative nausea and vomiting

The incidence of postoperative nausea and vomiting was studied in a prospective group of 94 women of child-bearing age (18-42 years), undergoing unilateral elective thyroid surgery. In a subgroup of 47 examinees the postoperative nausea and vomiting episodes were analyzed according to the time of surgery within their menstrual cycle: the highest occurrence was observed in the periovulatory and premenstrual periods (65.5% vs. 27.8%, p < 0.02). In the formal part of this study, 25 patients randomly received ondansetron (8 mg intravenous [i.v.]): they had significantly less postoperative nausea and vomiting than their 22 placebo controls (4 ml saline i.v.): 16.0% vs. 45.5% (p < 0.04). It is concluded that elective surgery in young and middle-aged female patients is best avoided premenstrually and in the middle of their cycle. In these very periods, however, ondansetron effectively reduces the incidence and intensity of postoperative nausea and vomiting by about 70%.     

Host fibrinogen stably bound to hemozoin rapidly activates monocytes via TLR-4 and CD11b/CD18-integrin: a new paradigm of hemozoin action

Natural hemozoin (nHZ), prepared after schizogony, consists of crystalline ferriprotoporphyrin-IX dimers from undigested heme bound to host and parasite proteins and lipids. Phagocytosed nHZ alters important functions of host phagocytes. Most alterations are long-term effects. We show that host fibrinogen (FG) was constantly present (at ~ 1 FG per 25 000 HZ-heme molecules) and stably bound to nHZ from plasma-cultured parasites. FG was responsible for the rapid 100-fold stimulation of reactive oxygen species production and 50-fold increase of TNF and monocyte chemotactic protein 1 by human monocytes. Those effects, starting within minutes after nHZ cell contact, were because of interaction of FG with FG-receptors TLR4 and integrin CD11b/CD18. Receptor blockage by specific mAbs or removal of FG from nHZ abrogated the effects. nHZ-opsonizing IgGs contribute to the stimulatory response but are not essential for FG effects. Immediate increase in reactive oxygen species and TNF may switch on previously described long-term effects of nHZ, largely because of HZ-generated lipo-peroxidation products 15(S,R)-hydroxy-6,8,11,13-eicosatetraenoic acid and 4-hydroxynonenal. The FG/HZ effects mediated by TLR4/integrins represent a novel paradigm of nHZ activity and allow expansion of nHZ effects to nonphagocytic cells, such as endothelia and airway epithelia, and lead to a better understanding of organ pathology in malaria.     

Neurological complications in renal transplant recipients

Renal transplantation is method of choice for treatment of patients with end-stage renal disease without contraindications for immunosuppressive therapy. Neurological complications occur frequently in renal transplant recipients. They may be the consequence of immunosuppressive treatment, but more often evolve as the consequence of previous disturbances which developed during the state of uraemia and treatment with dialysis. The most pronounced neurotoxic effect has calcineurin inhibitors tacrolimus and cyclosporine. The spectrum of neurological disturbances caused by calcineurin inhibitors range from very mild symptoms as paraesthesiae, tremor, headache or flushing, to severe changes that may cause lethal outcome. Peripheral neuropathies in renal transplant recipients may occur in the form of mononeuropathy or polyneuropathy. Cerebrovascular diseases are consequence of changes on blood vessels caused by uraemia, dialysis and side effects of immunosuppressive drugs. They cause death in 8% of renal transplant recipients. Central nervous system (CNS) infections usually occur during the first posttransplant year. Unclear symptomatology frequently postpones the diagnosis. Diagnostic evaluation should include magnetic resonance imaging for localization of the process, as well as lumbal puncture in cases without contraindications for the procedure, in order to determine the causative agent. Regarding the ominous prognosis of CNS infections in the immunocompromised host, only timely diagnosis may improve survival. The most common causative agents are Cryptococcus neoformans, Listeria monocytogenes and Aspergillus funigatus. Viral infections also occur, and are commonly caused by herpes virideae, varicella-zoster virus and papova virus. CNS infections clinically present as meningitis, progressive dementia or focal neurological defect. The most common primary brain tumors are B-cell lymphomas, but glioblastoma, hemangioblastoma, leiomyosarcoma or glioma may also occur. In cases of neurological posttransplant complications, optimal treatment should be guided by neurologist, nephrologist and infectologist, in some cases also by neurosurgeons.     

Metastases to the breast from small-cell lung cancer: MR findings. A case report

We report a case of blood-borne metastatic breast disease of small-cell lung cancer in a 44-year-old patient with no previous history of malignancy. The possibilities of MR in the early detection of breast metastases and their appearance on MR images are discussed.
Metastases to the breast should be considered when MR mammography of the breast reveals multiple, bilateral, well-defined lesions with ring enhancement and wash-out pattern.     

Metabolic turnover of catecholamines in the heart of rats after nonfatal burns

The content and metabolic turnover of noradrenaline (NA) and adrenaline (A) have been studied in the hearts of rats subjected to nonlethal scalding. The results of the study have shown that in an early phase of the general reaction of the organism to thermal trauma it has come to the decreased NA content while in the later phase the NA content was in the limits of control values. The increased contents of Na and A in the murine hearts after monoamineoxidase inhibition and injection of L-DOPA indicated the preservation of the synthesis and overtaking of catecholamines by the heart muscle. The increase of the metabolic turnover and shortening of the time of the metabolic turnover of NA and A have pointed that the increased NA content in the hearts of the traumatized animals is the consequence of the increased requirements of these catecholamines by the heart muscle in the early posttraumatic phase.