Jan Kochanowicz

Dietary habits and selenium, glutathione peroxidase and total antioxidant status in the serum of patients with relapsing-remitting multiple sclerosis

BackgroundDietary habits and adequate dietary intake of antioxidants in the diet may be one of the most important environmental factors for the prevention of Multiple Sclerosis (MS).ObjectivesThe aim of this study was to estimate selenium (Se) concentration, glutathione peroxidase (GSH-Px) activity and total antioxidant status (TAS) in the serum of patients with MS and the influence of dietary habits on the status.Methods101 patients with relapsing-remitting MS (aged 18-58 years), as well as control group of 63 healthy people (aged 19-65 years) were studied. Food-frequency questionnaires were implemented to collect the dietary data. Se concentration in the serum samples was determined by atomic absorption spectrometry. GSH-Px activity and TAS in examined serum was measured using the ready-made sets of tests by Randox Laboratories Ltd., UK.ResultsSerum Se concentration and GSH-Px activity in the serum of patients with MS (55.2±16.2 μg/L, 6676.1±2386.4 U/L; respectively) were significantly decreased (p<0.01, p<0.05; respectively) compared with control group (79.2±20.6 μg/L, 8029.9±2650.1 U/L; respectively). A significant correlation (r=0.39, p<0.01) was observed between Se concentration and GSH-Px activity in the serum of examined patients. TAS value in the serum of patients with MS (1.03±0.37 mmol/L) was also significantly lower (p<0.01) than in healthy volunteers (1.48±0.41 mmol/L). Frequent consumption of poultry, bakery products, pulses and fish seemed to increase serum Se concentration in the group of patients; whereas frequent consumption of butter, wholegrain bread, sweet beverages and sugar was found to accompany with lower values of Se in the serum. We have observed significant decrease TAS (p<0.05, p<0.01; respectively) in the serum of smokers and those patients who received immunomodulatory drugs (0.95±0.39 mmol/L, 0.92±0.34 mmol/L; respectively) compared with no-smoking patients and not taking immunomodulators (1.14±0.33 mmol/L, 1.31±0.31 mmol/L; respectively).ConclusionsSerum Se concentration, GSH-Px activity and TAS value were significantly lower in patients with relapsing-remitting MS compared with healthy volunteers. Dietary habits have a significant influence on Se status. Smoking cigarettes and intake of immunomodulatory drugs therapy have a negative impact on TAS of examined patients.

TNF-α and sICAM-1 in intracranial aneurismal rupture

IntroductionSubarachnoidal hemorrhage (SAH) occurring after aneurismal rupture produces an inflammatory response in the cerebral circulation. Tumor necrosis factor (TNF)-α is a major cytokine in this process. Adhesion molecules provide information on inflammatory reactions taking place in the walls of blood vessels. Clinical evidence suggests a role of soluble intercellular adhesion molecule (sICAM)-1 in early hemorrhagic events. This study aimed to evaluate the implementation of early TNF-α and sICAM-1 serum measurement for the prognosis of patient outcome after intracranial aneurismal rupture.Materials and MethodsThe study consisted of 27 patients with a diagnosis of intracranial aneurysm. SAH was evaluated on admission according to the Fisher scale, patients-consciousness with the Glasgow Coma Scale, clinical grading with the Hunt and Hess scale, and clinical outcome with the Glasgow Outcome Scale (GOS). Blood samples were drawn within 72 h after arrival at the emergency room. Serum concentrations of TNF-α and sICAM-1 were assayed with the ELISA method.ResultsThe initial serum TNF-α concentration in the aneurismal patients was low and did not correlate with radiological and clinical scores. The serum sICAM-1 level positively correlated with the severity of bleeding assessed by the Fisher scale and negatively with the patient’s scoring in the GOS.ConclusionsThis study demonstrated the absence of a systemic TNF-α-mediated inflammatory response at the onset of subarachnoid hemorrhage. Early measurement of serum sICAM-1 levels offers a potential prognostic value in the assessment of patients-outcome after brain aneurismal rupture.

The activity of class I, II, III and IV of alcohol dehydrogenase (ADH) isoenzymes and aldehyde dehydrogenase (ALDH) in brain cancer.

The brain being highly sensitive to the action of alcohol is potentially susceptible to its carcinogenic effects. Alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) are the main enzymes involved in ethanol metabolism, which leads to the generation of carcinogenic acetaldehyde. Human brain tissue contains various ADH isoenzymes and possess also ALDH activity. The purpose of this study was to compare the capacity for ethanol metabolism measured by ADH isoenzymes and ALDH activity in cancer tissues and healthy brain cells. The samples were taken from 62 brain cancer patients (36 glioblastoma, 26 meningioma). For the measurement of the activity of class I and II ADH isoenzymes and ALDH activity, the fluorometric methods were used. The total ADH activity and activity of class III and IV isoenzymes were measured by the photometric method. The total activity of ADH, and activity of class I ADH were significantly higher in cancer cells than in healthy tissues. The other tested classes of ADH and ALDH did not show statistically significant differences of activity in cancer and in normal cells. Analysis of the enzymes activity did not show significant differences depending on the location of the tumor. The differences in the activity of total alcohol dehydrogenase, and class I isoenzyme between cancer tissues and healthy brain cells might be a factor for metabolic changes and disturbances in low mature cancer cells and additionally might be a reason for higher level of acetaldehyde which can intensify the carcinogenesis.

Median nerve conduction impairment in patients with diabetes and its impact on patients' perception of health condition: a quantitative study.

IntroductionImpaired mobility and compromised manual dexterity leading to difficulties with the activities of daily living (ADL) are an inherent part of the clinical picture in diabetes. Hand function in diabetes is influenced by a variety of pathologies: the median nerve, the most important nerve of the hand, can suffer from metabolic disturbances, ischemia and/or entrapment neuropathies. The resulting deterioration in functional capacity is likely to have significant consequences for the ability to perform ADL, influencing adjustment to diabetes and affecting quality of life. The aim of the present study was to examine the influence of hand function as measured by median motor nerve conduction on quality of life, taking into account various aspects of functioning in patients with diabetes, including activities of daily living, psychological status and acceptance of illness.Patients and methodsSeventy one hospital patients with diabetes participated in the study. Electrophysiological recordings of conductance in the median nerve were obtained for both hands and the relationship between hand function and functional status (BI), depression and anxiety (HADS), adjustment to illness (AIS) and their effect on quality of life (SF-36v2 and QLI) was studied.ResultsDamage to the median nerve of the left hand was associated with significant differences in functioning in the physical, but not the mental component of the SF-36v2, p = 0.03 and in functional status (p = 0.006). QOL was associated with depression, patient age, acceptance of illness, functional ability and to a small, but significant extent with median nerve damage to the right hand on the measure of conduction velocities (R2 =0.726).ConclusionsNerve conductance studies demonstrated a small, but significant effect of hand function on quality of life. Impairment of the median nerve in the left hand was associated with functional difficulties in the activities of daily living and a diminished quality of life in the area of physical functioning. No dependencies of this kind were found for the right hand, which may reflect the greater compensatory capacity of the right hand resulting from improved efficiency due to practice.

Normal reference values of ratios of blood flow velocities in internal carotid artery to those in common carotid artery using Doppler sonography.

The ratios of of blood flow velocities in the internal carotid artery (ICA) to those in the common carotid artery (CCA) (VICA/VCCA) are used to identify patients with critical ICA narrowing, but their normal reference values have not been established. We provide reference data for the VICA/VCCA ratios for the peak systolic velocity (PSV), mean velocity (MV), and end‐diastolic velocity (EDV) measured in a large group of healthy subjects.

Influence of Smoking Cigarettes on Cerebral Blood Flow Parameters

Introduction: While chronic cigarette smoking can lead to increased risk of stroke, the acute effects of smoking have not been established. We studied the changes in blood flow parameters in the major cerebral arteries caused by smoking one cigarette. Method: Using transcranial color-coded sonography (TCCS), we studied the anterior cerebral artery (ACA), middle cerebral artery (MCA), posterior cerebral artery (PCA), and the internal carotid artery (ICA) of 36 healthy male volunteers before and after they smoked one cigarette. Results: Blood flow velocity increased to a different degree in all but one of the arteries examined after participants smoked a single cigarette: The end diastolic velocity increased significantly by 7.8% in the PCA, 8% in the ACA, and 14.4% in the MCA. The peak systolic velocity increased significantly by 7.5% in the MCA. Blood flow velocity remained unchanged in the ICA only. Blood pressure and heart rate increased as did the flow velocity ratio for the MCA/ICA. The pulsatility index decreased after smoking from 0.92 ± 0.13 to 0.87 ± 0.14 in the MCA, 0.93 ± 0.15 to 0.87 ± 0.13 in the ACA, and 0.95 ± 0.17 to 0.89 ± 0.16 in the PCA. Conclusions: The results suggest that the direct effect of smoking on cerebral circulation includes peripheral vasodilatation with possible constriction of the main trunk of the basal cerebral arteries.

The Interaction of Bee Products With Temozolomide in Human Diffuse Astrocytoma, Glioblastoma Multiforme and Astroglia Cell Lines

In the present study, we investigated the influence of extracts from Salix spp. honey (ESH), beebread (EBB), and royal jelly (ERJ) with and without temozolomide (TMZ) on cell lines derived from a patient with diffuse astrocytoma (DASC), human glioblastoma multiforme (U87MG), and normal human astroglia (SVGp12). DASC was identified by immunocytochemistry. TMZ (20 μM) in combination with ESH (30 μg/mL), EBB (50 μg/mL), and ERJ (30 μg/mL) has stronger cytotoxic activity on U87MG cells after 72 h (20.0, 26.5, and 29.3% of control, respectively) than TMZ alone (about 6% of control). An increase of the cytotoxic effect and inhibition of DNA synthesis in SVGp12 were detected after administering TMZ with the studied extracts. NF-κB p50 subunit was reduced in U87MG cells after treatment with ESH (70.9%) and ESH + TMZ (74.7%). A significant decline of MMP-9 and MMP-2 secretion in cultured U87MG was detected after incubation with EBB (42.9% and 73.0%, respectively) and EBB + TMZ (38.4% and 68.5%, respectively). In conclusion, the use of bee products may increase the cytotoxic effect of TMZ in U87MG but also in SVGp12 cell line. It is important to note that the U87MG cells were sensitive to natural bee products, although there was no influence of natural bee products on the DASC cells.

Ophthalmic manifestation of skull base metastasis from breast cancer

Summary Background There is a vast discrepancy between the incidence of skull base metastases reported in vivo and at autopsy. Asymptomatic character or unspecific symptoms make the diagnosis difficult, particularly in patients with no history of cancer. Our case illustrates a skull base metastasis from breast cancer, detected in a diagnostic process initiated by ophthalmologic examination. Case Report We report the case of a 53-year-old woman complaining of ptosis and diplopia, with concomitant loss of skin sensation within the right half of the forehead, and without any other worrisome symptoms or signs. Ophthalmic examination revealed impairment in eye movements, slight proptosis and corneal hypoesthesia on the right side, with normal pupillary light reflexes. The anterior and posterior segments of the eye were normal. Based on CT and MRI, an extensive tumor was detected, infiltrating the right orbit and the frontotemporal region of the skull base, and producing edema of the adjacent aspects of the brain. Aside from partial palsy of the oculomotor nerve and the ophthalmic division of the trigeminal nerve, no abnormalities were found on neurological examination. Explorative craniotomy and histopathological findings revealed a skull base metastasis from breast cancer. Conclusions Diplopia, ptosis, proptosis, and ophthalmic nerve sensory loss may be the only manifestation of a skull base metastasis. Careful ophthalmologic examination is crucial in early detection of this life-threatening condition.

Diagnostyka ultrasonograficzna i wewnątrznaczyniowe udrożnienie tętnicy po embolizacji tętniaka mózgu powikłanej zakrzepem tętnicy szyjnej wewnętrznej

Streszczenie Powiklania zatorowo-zakrzepowe po leczeniu wewnątrznaczyniowym tetniakow mozgu stanowią zagrozenie zycia, ale wciąz leczone są najcześciej zachowawczo. Rzadko stosowaną alternatywą jest interwencja wewnątrznaczyniowa, ktorej skutecznośc ściśle zalezy od czasu jej przeprowadzenia. Niniejszy opis przypadku podkreśla uzytecznośc przezczaszkowej ultrasonografii z kolorowym obrazowaniem przeplywu krwi w szybkim rozpoznaniu roznicowym oraz skutecznośc natychmiastowej interwencji drogą wewnątrznaczyniową. U 50-letniej chorej po zabiegu ponownej embolizacji tetniaka tetnicy szyjnej wewnetrznej doszlo do wystąpienia objawow neurologicznych. Badanie dopplerowskie wykazalo zmniejszenie predkości przeplywu krwi w tetnicy środkowej mozgu, a angiografia – prawie calkowitą niedroznośc tetnicy szyjnej wewnetrznej. Podano heparyne, wykonano pilną trombektomie drogą wewnątrznaczyniową i zalozono do naczynia stent, uzyskując ustąpienie objawow. Przezczaszkowa ultrasonografia dopplerowska z kolorowym obrazowaniem przeplywu krwi pozwala szybko rozpoznac powiklania po embolizacji tetniakow mozgu związane z zaburzeniem przeplywu krwi w naczyniach wewnątrzczaszkowych. Umozliwia to szybką i skuteczną interwencje wewnątrznaczyniową w przypadku powiklan zatorowo-zakrzepowych.Thromboembolism after brain aneurysm embolization involves high morbidity/mortality and its conservative treatment is still a standard policy. We report the practical utility of transcranial colour-coded Doppler sonography (TCCS) in the early diagnosis and effectiveness of prompt intravascular intervention in the treatment of this condition. A 50-year-old woman developed acute neurological deficit after intravascular re-embolization of a brain aneurysm. Severely decreased blood flow velocity in the middle cerebral artery was revealed with TCCS and angiography confirmed nearly complete occlusion of the carotid artery. After heparin administration, intravascular thrombectomy was performed at the same session with implantation of a stent. The symptoms faded away within hours and the patient recovered fully. Prompt intravascular intervention could be a valuable and efficient alternative in the treatment of thromboembolism after embolization of cerebral aneurysm. TCCS enables early differential diagnosis of this potentially devastating sequel.

The diagnostic value of alcohol dehydrogenase (ADH) isoenzymes and aldehyde dehydrogenase (ALDH) measurement in the sera of patients with brain tumor

Introduction Alcohol dehydrogenase (ADH) isoenzymes and aldehyde dehydrogenase (ALDH) exist in the brain. Alcohol dehydrogenase and ALDH are also present in brain tumor cells. Moreover, the activity of class I isoenzymes was significantly higher in cancer than healthy brain cells. The activity of these enzymes in tumor tissue is reflected in the serum and could thus be helpful for diagnostics of brain neoplasms. The aim of this study was to investigate the potential role of ADH and ALDH as markers for brain tumors. Material and methods Serum samples were taken for routine biochemical investigation from 115 patients suffering from brain tumors (65 glioblastomas, 50 meningiomas). For the measurement of the activity of class I and II ADH isoenzymes and ALDH activity, fluorometric methods were used. The total ADH activity and activity of class III and IV isoenzymes were measured by the photometric method. Results There was a significant increase in the activity of ADH I isoenzyme and ADH total in the sera of brain tumor patients compared to the controls. The diagnostic sensitivity for ADH I was 78%, specificity 85%, and positive and negative predictive values were 86% and 76% respectively. The sensitivity and specificity of ADH I increased with the stage of the carcinoma. Area under receiver-operating characteristic curve for ADH I was 0.71. Conclusions The results suggest a potential role for ADH I as a marker for brain tumor.