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Pelvic exenteration (PE) is an operative method for one-moment removal of pelvic organs, including reproductive tract, bladder, and rectosidgmoid. It is most commonly indicated in gynecologic oncology for treatment of locally advanced cancer or recurrence with central localization. The purpose of this study was to evaluate survival rate and complications in different types of PEs performed for cervical, uterine, and ovarian cancer and to report the authors' experience. Patients undergoing PE for cervical, uterine, and ovarian cancer (n=46) were prospectively collected. Operative techniques types included total PE (n=9), anterior PE (n=14), posterior PE (n=7), and modified posterior PE (n=16). Overall intra- and postoperative complication rate was 34.8% for the series. Mild complications occurred in 28.2% and severe complications in 6.5%. Perioperative mortality was 2.2%. PE in patients with advanced stage of gynecological malignancies was associated with high complication rate and high perioperative mortality and morbidity. Therefore, operative techniques with proven safety should be used. Creating ureter anastomosis with incontinent urinary conduit from terminal ileum can be considered as such technique. Although all factors that impact negative on quality of life, PE remains an alternative for extending life of these types of patients. [ABSTRACT FROM AUTHOR]

Objective: The carotid stiffness is an important factor in the pathogenesis of cerebrovascular small vessel disease. Our study aimed to evaluate the relation of the local arterial stiffness of the common carotid artery (CCA) to the hemodynamic forces and blood viscosity in patients with cerebral lacunar infarctions (LI)., Methods: Twenty-two patients with chronic LI and 15 age-matched controls were examined. An ultrasound examination of the CCA intima-media thickness (IMT), the parameters of local CCA stiffness: distensibility (DC) and compliance coefficients (CC), α and β stiffness indices and pulse wave velocity (PWV) was performed. The local hemodynamic forces were calculated: circumferential wall tension (CWT) and wall shear stress (WSS). Whole blood viscosity (WBV) and shear stresses at shear rates of 0.277 s- 1 to 94.5 s- 1 were measured in patients and controls., Results: Higher values of IMT, a significant decrease of DC and CC and an increase of α and β stiffness indices and PWV in the LI patients compared to the controls were obtained. A parallel significant increase in CWT and a decrease in WSS was found. An increase in WBV and a significant increase in shear stresses were detected. In the LI patients, the increased stiffness indices were associated with an increase in age, cholesterol and WBV at higher shear rates in the left CCA. In the controls, the IMT and stiffness indices correlated significantly with the hemodynamic factors and WBV in both CCAs, while the stiffness indices correlated with the hemodynamic forces in the left CCA., Conclusion: The results of the present study demonstrate different associations of the local carotid stiffness indices with the hemodynamic forces and WBV in patients with LI and controls.

The dynamics of free radical processes during the acute stage of ischemic stroke and their relationship with the clinical status of patients were studied. An enhanced extracellular generation of reactive oxygen species (ROS) by peripheral phagocytes was observed in severe stroke patients during the whole acute stage. This generation correlated positively with the size of infarct, the severity of neurological deficit and handicap and correlated negatively with the improvement of the neurological status of patients. An increase in the activity of two enzymes from the antioxidant defense mechanism, catalase and glutathione peroxidase, was registered during the whole acute phase of stroke, regardless of its severity. The concentration of lipid peroxidation products increased over time. Blood concentration of thiobarbituric acid-reactive material (TBARM) correlated positively with the size of infarct, the severity of neurological deficit and handicap. In conclusion, extracellular ROS generation by phagocytes and blood TBARM concentration could be used as indicators for stroke outcome.

The activity of peripheral phagocytes to generate reactive oxygen species (ROS) was studied in healthy individuals and patients with ischaemic stroke. The aim was to clarify the relationship between phagocyte activity, the time elapsed after the onset of disease and stroke severity. The total and extracellular production of ROS were evaluated by luminol chemiluminescence. Simultaneously the plasma oxidant activity was determined. When stimulated by opsonized zymosan, phagocytes in patients with stroke (regardless of its severity) showed fast activation. The total ROS generation increased over time in all stroke cases studied. However, the extracellular ROS generation was found to be greater in patients with severe stroke than in those with mild neurological deficiency. When stimulated by formyl-methionyl-leucyl-phenylalanine, the total oxidative phagocyte capacity (regardless of stroke severity) increased over time, but there was no change in the amount of extracellularly generated ROS. In patients with stroke the oxidant activity of plasma was enhanced. We conclude that circulating phagocytes in patients with ischaemic stroke are primed for enhanced ROS production by opsonin receptor-mediated stimulation and for increased secretion of myeloperoxidase by opsonin receptor-independent stimulation. The enhanced extracellular generation of ROS through opsonin receptor-dependent stimulation may be considered an oxidative stress biomarker in cerebral ischaemia., (Copyright 2001 John Wiley & Sons, Ltd.)

During the respiratory burst, upon stimulation with both soluble and particulate matter, polymorphonuclear leukocytes (PMN) generate reactive oxygen species (ROS) and emit chemiluminescence (CL) as a result of metabolic activation. The measurement of CL has been demonstrated to be a useful tool for in vitro assessment of the opsonophagocytic function of PMN. Using component analysis of CL kinetics, we characterized the functional state of PMN by three parameters of the respiratory burst: capacity, effectiveness and velocity (CEV space). The possibility of delimiting eight different functional states of PMN is discussed. The CL kinetics shown by blood PMN in different functional states was analysed, and revealed six out of eight functional states. We conclude that CEV-estimated functional states of PMN are relative, depending on both PMN readiness to generate ROS and conditions of the CL test., (Copyright 2000 John Wiley & Sons, Ltd.)

A procedure for the determination of collagen concentration is described. It is simple and sensitive and is based on a modification of Lowry's method. The modification includes an initial heating of collagen samples in alkaline solution and changes in the concentrations of reagents used. It may be used for different collagen types, i.e. I, II, V and XI, from various sources as well as for gelatine. The influence of different buffers, salts, detergents, etc. on the precision of the method was studied. The precision of the measurements was not influenced by pH, the turbidity of the sample and the presence of certain salts, osmolytes and preservatives, routinely used in biochemical, microbiological and immunological experimental protocols. The modification is suitable for routine determinations of collagen concentration in a wide variety of samples.

The production of activated oxygen species (AOS) by neutrophils (PMNL) is thought to play a key role in the host defence against invading microorganisms. However, the oxygen metabolites are toxic not only to the invading bacteria but also to the surrounding tissue. The oxidative metabolites production can be evaluated by means of chemiluminescent methods. In this study, the possibility of a new analytical approach for quantitative assessment of chemiluminescent kinetics (AOS generation) of isolated PMNL was estimated. Based on the assumption that the kinetics of luminol-amplified chemiluminescence (LCL) of stimulated PMNL possesses a time-probabilistic nature, this kinetics was described with three components. These components, obtained from different investigated systems, were analyzed and a conclusion was made that the first and the second component represent the processes resulting in extra-and intracellular myeloperoxidase (MPO)-dependent light emission (AOS generation), respectively. The second component was found to be completely dependent on the stimulus ingestion. The third component was not completely MPO-dependent and complicated for interpretation. This component was weakly dependent on the stimulus ingestion, and presents at least some intracellular processes different from those presented by the second component. A conclusion is made that the examined approach for analysis of LCL kinetics allows an assessment of extra-and intracellularly generated quantities of AOS by stimulated PMNL. The assessment could be done for emitting systems in which no additional modifications are used.

Luminol chemiluminescence (LCL) is a simple, sensitive and time-saving tool to elucidate the oxidative activity of polymorphonuclear leukocytes (PMNL). In this study, a new approach for analysing the LCL kinetics, recorded from stimulated PMNL, and for a more accurate elucidation of their functional state, is proposed. This approach is based on the proposal that the LCL kinetics of stimulated PMNL is a result of time-probabilistic nature of the processes, leading to light emission. On this basis the LCL response was described by the parameters of a Poisson-type distribution. Relationships between these parameters and some factors influencing LCL kinetics (number of PMNL and erythrocytes, temperature, stirring) were investigated. The model descriptions of the LCL responses obtained had two components (modes). Their development in time was different. It was suggested, that the two phases of the model LCL response were connected with extracellular and intracellular LCL. The terms and the advantages of this approach for analysis of phagocyte oxidative capacity are discussed.

The effect of heart rate on the functional refractory period (FRP) of the atrioventricular node (AVN) is studied. A conclusion is reached that FRP, being a complex characteristic of AVN, should not be directly related to conduction time, but it can serve as a measure of the maximum moment acceleration which AVN is capable of transmitting to the lower-lying structures. It is proposed to use the coefficient of relative acceleration for quantitative estimation of the inert (dynamic) properties of the node at different heart rates. It is concluded that for a longer basic cycle length (BCL) AVN is characterized by greater reserve possibilities for transformation of accelerations of the input rhythm.