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Purpose: Despite major advances in cardiology dyslipidemia continues to be underdiagnosed and undertreated. The study aimed to evaluate current prevalence of dyslipidemia and treatment efficacy in both coronary and non-coronary subjects., Methods: 17,065 subjects aged 30-95 years (20.51%--coronary heart disease (CHD) patients), seeking medical help for disparate reasons from 675 family physicians, were randomly enrolled. Family physicians completed pertinent questionnaires against available medical records and measured patients' lipid levels during a single appointment., Results: Dyslipidemia was detected in 73% of the CHD subjects vs. 46% of the non-CHD ones (p = 0.00001); its severity differing regionally. Hypolipemic treatment was administered to 82% of the CHD subjects vs. 12% of the non-CHD ones (p = 0.00001). Mean concentrations of LDL-cholesterol were higher in the treated subjects (p = 0.00002). Only 10% of the CHD subjects and 20% of the non-CHD ones were treated effectively for dyslipidemiae., Conclusions: Dyslipidemia was found widely prevalent nationwide, as well as poorly pharmacologically controlled in both primary and secondary prevention. Diversity of economic factors notwithstanding, this was mainly attributable to ineffective patient educational policies, meriting therefore immediate expansion and enhancement of existing disease management system in terms of adequate monitoring and effective treatment of key coronary risk factors.

In this study, for the first time, Clostridium histolyticum lethal factor was purified by ammonium sulfate precipitation of culture broth, centrifugation through an Amicon filter device and hydrophobic interaction chromatography. The purified lethal factor was devoid of proteolytic activity. At a concentration of 150 ng mL(-1) the lethal factor killed 50% of HeLa cells within 24 h of exposure. Abrogation of actin filaments, activation of caspases, fragmentation of nuclear DNA as well as ultrastructural changes indicated that the cell death occurred by apoptosis. The apoptotic action of the lethal factor is in agreement with changes induced in animal tissues by administration of C. histolyticum culture medium.

The long-term outcome of peripheral nerve injury is often unsatisfactory, especially if the injury resulted in a gap between transected nerve stumps. Brain-derived neurotrophic factor and its receptor, trkB, are strongly implicated in the early phase of axonal regeneration after injury. We examined the role of trkB in long-term functional and morphological outcome of peripheral nerve injury. The sciatic nerve was transected in wild-type and heterozygous trkB-deficient mice. The nerve was either left cut or immediately sewn up or the gap injury model was performed. The gap was provided with autologous or cross (obtained from other genetic group) graft. Sciatic nerve function as well as autotomy was assessed during 16-week follow-up. The long-term functional outcome of nerve cut or immediately rejoined did not differ between wild-type and trkB-deficient mice. Gap injury provided with nerve graft resulted in better functional outcome in trkB-deficient mice than wild-type animals. Sixteen weeks after the surgery, the animals were sacrificed and histological evaluations were performed. The number of nerve fibres regenerating into the distal stump of transected and rejoined nerves did not differ between wild-type and trkB-deficient animals. TrkB deficiency markedly increased the number of Schwann cells as well as mast cells at the injury site and in the distal stump of the regenerating nerve. TrkB deficient nerves also showed higher expression of bcl-2 protein but lower of trkA and NGF than wild-type ones. Our results show for the first time the possible deleterious role of trkB receptor in long-term outcome of peripheral nerve injury.

Clostridium histolyticum vacuolating cytotoxin was partially purified from culture broth using ammonium sulfate precipitation, gel filtration and hydrophobic interaction chromatography. The toxin caused vacuolization of HeLa cells visible under a light microscope after 2 h and distinct after 8 h. Transmission electron microscopy revealed the presence of numerous vacuoles, condensation of the mitochondrial matrix, increased cytoplasm density and increased amounts of heterochromatin. Apoptosis was not detected either by electron microscopy or by an apoptosis/necrosis discrimination assay with fluorescein-labeled annexin V and propidium iodide, or DNA fragmentation assay. Calcium ion influx was detected by flow cytometry after labeling cells with Fluo-4 AM. Vacuolation of HeLa cells by C. histolyticum cytotoxin was inhibited by bafilomycin A1, suggesting involvement of H+ -ATPase in the formation of vacuoles.

Sex steroids are known to affect immune responses; however, information on immunomodulatory effects of estrogen/progesterone hormone replacement therapy (HRT) is still limited. Therefore, the present study aimed to investigate the effect of estrogen/medroxyprogesterone HRT on natural killer (NK) cell cytotoxicity and immunoregulatory cytokine (IL-2, IL-4 and IFN-gamma) release by phytohemaglutinin (PHA)-stimulated peripheral blood mononuclear cells (PBMC) from 15 selected healthy postmenopausal women. NK cell cytotoxicity, cytokine production and serum levels of 17beta-estradiol (E2), progesterone (P) and FSH were tested in each patient before and after 90-days HRT. NK cell cytotoxicity was tested by (51)Cr-release assay using K562 erythroleukemic cells as target. Specific cytokine production and serum hormone levels were evaluated by enzyme-linked immunosorbent assay (ELISA) and immunochemiluminescent assays, respectively. HRT resulted in a significant decrease of Kupperman index, an increase of E2 and a decrease of FSH levels. These changes were associated with a significant decrease of NK cell cytotoxicity, IL-2 and IFN-gamma production. The levels of IL-4 production remained unchanged. Changes of NK cell cytotoxicity and cytokine release in individual patients did not correlate with changes of serum sex hormone levels. Nevertheless, the present results imply strongly that estrogen/progesterone HRT may affect cell-mediated immunity, thus being a potential factor influencing development and course of autoimmune disorders and neoplastic diseases.

Medulloblastoma (MB) is the most common malignant brain tumour in children. Its aetiology is unknown, although several signalling pathways controlling cell proliferation are thought to participate in the progress of the neoplasm. Mutations of the genes encoding proteins participating in the pathways triggered by embryonic growth factors like Sonic hedgehog (Shh) or WNT are often found in MB. Another model of MB development is overexpression or mutation of several types of growth factor receptors, including IGF-IR, EGF-R and PDGFR, that have the ability to activate cellular kinases responsible for promoting cell proliferation. In order to test this hypothesis, in the current paper we tested the activation of two kinases, Akt/PKB (protein kinase B) and Erk (extracellular signal-regulated kinase) and their substrates in 10 sporadic medulloblastoma cases. We show that MBs are a highly heterogeneous group of tumours that show upregulation of various signalling pathways. Nevertheless, both Akt and Erk may contribute to the progression of MB, triggering, at least in some cases, the mTOR (mammalian target of rapamycin) pathway, controlling translation of several cell cycle-related proteins. We hypothesize that Akt and Erk activation may also be associated with downregulation of protein phosphatase 2A (PP2A).

Clostridium histolyticum culture supernatant contains numerous enzymes, which exert a cytotoxic effect on host cells. This includes lethal toxin, clostripain and high-potassium-sensitive toxin. Since the number of C. histolyticum infections increased during the last several years, it seems worthwhile to evaluate whether protease inhibitors, used for the treatment of many diseases, could influence toxicity, and thus, pathogenicity of C. histolyticum. In this study we evaluated in vitro the influence of four common protease inhibitors: aprotinin, phenylmethylsulphonyl fluoride (PMSF), l-1-chloro-3-[4-tosylamido]-7-amino-2-heptanone-HCl (TLCK) and chymostatin on the toxicity of C. histolyticum supernatant towards human epithelial HeLa cells. We show that aprotinin has no effect, while PMSF, TLCK and chymostatin potentiate the cytotoxic activity of C. histolyticum, probably by hindering natural defence mechanisms of cells. In addition, PMSF and TLCK block clostripain enzymatic activity, while chymostatin leaves it intact. Elevated cytotoxicity of the supernatant is not related to the quantity of high-potassium-sensitive toxin, as was reported previously, since desalted supernatant still exerted its strong toxic effect. Our results show that addition of protease inhibitors for treating diseases complicated by concurrent C. histolyticum infection must require special attention.

The purpose of this article is to present the current state of knowledge regarding the structure and functions of articular cartilage. Articular cartilage is constructed with hyaline cartilage tissue. It is composed of chondrocytes located in lacunae and the extracellular matrix. The chondrial matrix contains water, collagen, proteglycans, non-collagenous matrix proteins, and lipids. Articular cartilage is devided into four zones - superficial, intermediate, deep, and calcified - on the basic of morphology, the orientation of collagen fiber, and the proteoglycan content. The dominant collagen of this tissue is Type II collagen, which, together with smaller quantities of other collagens (i.e. Types IX and XII), forms a network of fibers, with large, aggregating proteoglycans and smaller, non-aggregating proteoglycans. Proteoglycans are proteins that contain covalently attached glycosaminoglycans (GAGs), with water between them. The large aggregating proteoglycans, called "aggrecans", form aggregates that bind hyaluronic acid, and together with collagen they are responsible for the mechanical properties of cartilage. The smallnonaggregating proteoglycans, decorin and fibromodulin, limit the formation of collagen fibres. Other proteins in the cartilage matrix - chondrocalcin and the N-propetide of Type II collagen - participate in fiber formation. Yet other proteins - chondronectin, fibronectin, vitronectin and thrombospondin - take part in the interaction between the chondrocytes and the matrix. Cartilage oligomeric matrix protein (COMP) prevents the vascularization of the cartilage and, perhaps, is responsible for the repair process. The proteins known as Cart-1 and CEP-68 participate in chondrogenesis, while tenascin and Mgp are considered to be cartilage calcification inhibitors. Apart from the structural elements, chondrocytes produce substances that fulfill purely physiological functions: enzymes and cytokines. The enzymes - which include metalloproteinases, adamalysins, serine and cysteine proteases and their inhibitors - participate in cartilage matrix reconstruction. The cytokines - IL-1, TNF-alfa, IL-6, IL-8, and LIF - stimulate the chondrocytes to produce an increased amount of enzymes, while IL-4 inhibits this process. Human articular chondrocytes exibit the constitutive expression of class I molecules of the major histocompatibility complex (MHC), molecules regulating the activation of the complement, and after activation (e.g. under the influence of IFN-alfa, IL-1, TNF-a or in the course of arthritis), also MHC class II and ICAM-1 intracellular adhesion molecules. Numerous studies have shown that chondrocytes also have tissue-specific antigens, which induce the production of antibodies in patients with cartilage grafts, as well as those with rheumatoid arthritis and osteoarthritis. Some of these antibodies react with type II collagen, others are directed against other proteins i.e. anchorin CII and CH65. the role of these diverse molecules, which are present in cartilage cells and separated from the immune system by the matrix, remains unclear.

Postoperative peridural fibrosis is unavoidable adverse effect of lumbar disc surgery. This process is disadvantageous both to the patient and to the surgeon. It is assumed that peridural fibrosis is responsible for as much as 25% of all Failed Back Surgery Syndrome. In case of reherniated discs requiring reoperation epidural scar may cause technical difficulties. Thus the prevention or inhibition of postoperative peridural fibrosis and adhesions is an essential goal for successful lower back surgery. The authors review new opinions on pathophysiology of peridural fibrosis, clinical aspects of the process, results of experimental approaches for limiting peridural fibrosis and perspective of anti-adhesion gel Adcon-L.

Purpose: Research was aimed at comparison of isolation methods as well as determination of growth and differentiation dynamics of rabbit corneal epithelium (CE) in vitro. Adhesion, growth and differentiation of CE cells growing on collagen membranes were evaluated., Material and Methods: Research was performed on the cells of rabbit corneal epithelium isolated mechanically or enzymatically (Dispase II) from comeas excised at the edge of limbus. CE cells were cultured in media with high or low contents of calcium, with addition of FCS, insulin, cholera toxin and EGF., Results: In comparison with mechanical isolation, enzymatic isolation yielded 4-5 times more living undifferentiated (CE) cells. The highest dynamics of in vitro growth was observed in primary cultures in low-calcium medium supplemented with the above substances. After 20 population doublings cells were differentiated and died. Only few cells on collagen membranes adhered to the collagen but did not enter division., Conclusions: Current research allowed for determination of methodology for CE excision and isolation. Optimal conditions for in vitro growth have been established. Growth dynamics and proliferation of CE in vitro have been evaluated. Growth of CE on standard collagen membrane has not been observed.

Adequate choice of fixation technique at craniocervical junction depends on many factors: anatomical conditions at fusion site (e.g. anterior dislocations of the odontoid and rupture of the transverse ligament are contraindications for direct odontoid screw fixation. Sublaminar wiring and interlaminar clamps are useless in case of deficiency of posterior bony elements of C1 and C2 whether a result of laminectomy or destruction), bone quality (osteopenic bone is contraindication for screw techniques either transarticular or transpedicular). Enclosing of occipital bone into instrumentation may be difficult in wire and clamping techniques. In contrast screw techniques allow for easy grip the occipital bone. Screw techniques seem ideal in cases requiring enclosing of the occipital bone. The fusion rate at C1/C2 level seems independent of fixation techniques. When supplemented with external immobilization even biomechanically inferior wiring or interlaminar clamping provide nearly 100 rate of fusion. Screw techniques are technically demanding but they seem the method of choice when occipital bone is to be enclosed in instrumentation.

Mechanisms leading to induction of apoptosis by TNF family receptors involve intracellular activation of cysteinyl-aspartate-specific proteases (caspases). Caspase activation requires engagement of adaptor proteins. It is plausible, that caspase activation is sufficient for cell death in course of receptor-dependent induction of apoptosis. However, there are some data that programmed cell death involves also generation of ceramides, arachidonic acid metabolism, or MAP kinase (SAPK/JNK) activation. On the other hand, TNF receptor family triggers some protective, anti-apoptotic mechanisms, i.e. protein kinase C (PKC) and NF-kappa B. The outcome of induction of apoptosis by TNF receptor family depends on the cell type, its physiological condition and influence of environmental factors.

The authors estimated the frequency of Ménière's disease occurrence among patients of Department of Otolaryngology, University School of Medicine in Lodz in years 1986-1995. The incidence of Ménière's disease was evaluated as 0.46% of all clinic patients and as 1.7% of cases which were treated for aural diseases. Diagnosis was made on the basis of clinical symptomatology, exact medical examination and audiologic tests. The function of vestibular organs was assessed with the help of caloric tests with ENG recordings. Ménière's disease incidence has been the subject of many epidemiological papers in literature but the exact values are different. Perhaps it can be attributed to a variety of criteria applied in defining Ménière's disease or to epidemiological differences.

Purpose: Morphological characteristics of established cell line (RtCE) derived from rat anterior corneal epithelium., Material and Methods: Morphology of cultured RtCE cells was evaluated by light and electron microscopy. Anterior corneal epithelium of rat served as control., Results: Both in light and electron microscope we observed morphological similarity with anterior corneal epithelium (several layers of cells, numerous desmosomal connections). Moreover, similar morphological changes were observed in relation to the control material, i.e. degeneration and flattening of cells in superficial layers., Conclusions: The morphological analysis of RtCE cell line proves its usefulness for further cytomorphological, cytogenetical and functional analyses, as well as for evaluation of influence of different physico-chemical and biological factors on growth and regeneration of corneal epithelium in vitro.

The levels of type-I and type-II soluble TNF-alpha receptors (sTNF-Rs) were evaluated in sera from patients with various human-papillomavirus-(HPV)-associated benign and malignant anogenital lesions using specific enzyme-linked immunobiological assays. In patients with benign HPV6/11-associated condylomata acuminata, the levels of sTNF-RI were significantly increased, while sTNF-RII were in normal range. Both types of sTNF-Rs were in normal range in patients with benign HPV16-associated grade-I/II and grade-III cervical intra-epithelial neoplasia. However, their levels were significantly increased in patients with HPV16/18-associated squamous cervical cancer and anogenital Bowen's carcinoma. Sera from patients with condylomata acuminata and anogenital carcinomas displayed significantly increased TNF-alpha-inhibitory activity, as revealed by L929 cell-cytotoxicity assay. Increased serum TNF-alpha-inhibitory activity correlated with higher levels of sTNF-Rs. Furthermore, this inhibitory activity could be specifically abrogated by htr9 and utr1 monoclonal antibodies recognizing TNF-RI and TNF-RII respectively. Our results strongly suggest that serum sTNF-Rs may protect tumor cells from cytotoxic/cytostatic effects of locally released TNF-alpha, and that elevated levels of circulating sTNF-Rs may facilitate the growth of HPV-associated anogenital lesions.

Indications for hearing implants in profoundly deaf patients have been presented. Auditory pathway status was evaluated by application of electrical stimulation of cochlear nerve. The electrical stimulus originated from Cochlear Nerve Tester. Obtained sound sensations might be revealed on ABR pattern.

Authors have described their own method to prepare for prosthesis to reconstruction of transmissive system in tympanoplasty. Prosthesis PORP and TORP were prepared to use of simple apparatus from a polyethylene drain.

The authors report the clinical material from the Department of Neurosurgery, WAM in Lódź from the last 11 years including cases of damage to the deep branch of the ulnar nerve. In view of the importance of this branch for the function of the hand, damage to it requires very careful surgical management with autogenous graft. Sometimes this is technically difficult in view of the topographic conditions in this area. Damage to the deep branch of this nerve is usually associated with damage to the sensory part of the ulnar nerve, to the median nerve and tendons of finger flexors.

The authors present the first in the Polish literature group of 320 cases of autogenic nerve cable grafts. The overall results of this treatment are: very good and good in 43.3%, satisfactory in 29.1%, poor in 18.2%, bad in 9.4%. Nearly all bad results were obtained in grafting nerves in the lower extremity. A comparison of the results obtained with the classic nerve suture and short cable grafts shows a decidedly evident superiority of grafts over the classic suture. The advantages of grafts are discussed, particularly with respect to nerve blood supply. The importance of early surgical treatment and prolonged heat treatment is stressed.