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Unlabelled: The goal of the study is to estimate emotional disorders rate in the group of morbidly obese patients. They were treated with with Roux--en-Y gastric bypass surgical procedure., Material and Methods: The study was carried out with Becks Depression Inventory (BDI) test among 10 females and 7 males. The test was performed three times in every patient-- once before the surgery and twice after the operation (in 2 and 6 month period)., Results: Before surgery we had 9 patients with mild and 3 with moderate depression. After two months there were 4 and after six only 3 patients with mild level of depression. Average results before surgery (in brackets 2 and 6 months after operation, respectively)--body mass: 135.1 (112.6 and 96.1) kg; BMI: 46 (38.2 and 32.7) kg/m2; BDI: 16.8 (9.7 and 7.8) points. Hospitalization mean time: 10.5 day., Conclusion: The rate and level of the emotional disorders (depression) in morbidly obese patients following bariatric surgical procedure measured with Becks Depression Inventory is reduced when compared with pre-operative values. These results need further research.

Background: Patients encountered in rheumatology practice often have concerns about radiation exposure from the imaging procedures used to diagnose and monitor their diseases. However, such imaging procedures normally deliver radiation doses that are associated with only a low level of risk., Objectives: To review and quantify the radiation doses delivered by the various imaging procedures commonly ordered in a rheumatology practice and to compare those doses with background radiation exposure in the United States., Methods: The authors reviewed and compiled literature on radiation exposure from background radiation and diagnostic imaging procedures. The review included a Medline search through December 2003., Results: Radiation doses from medical imaging procedures are so low that they do not have a clinically significant effect on mortality rates. In comparison to our normal daily exposures from naturally occurring background radiation and daily activities, the exposures from medical procedures are quite small. Moreover, the International Commission for Radiological Protection (ICRP) recommends that dose limits should not be applied to medical exposures in nonpregnant patients. Rather, the ICRP recommends that the medical exposure be justified and the protection be optimized so that the dose to the patient is as low as is compatible with the medical purpose., Conclusions and Relevance: Appropriate care of patients within the rheumatology practice frequently necessitates the use of imaging procedures that utilize ionizing radiation, such as radiographs, computed tomography scans, and bone densitometry. If ordered prudently, the benefits of these imaging procedures supersede the risks imposed by their radiation exposures.

Background: Impaired blood pressure (BP) variation, often found in obesity and hypertension, is associated with increased cardiovascular risk. The effect of obesity surgery on BP variation is unknown. We performed this study to investigate the effect of gastric bypass surgery on circadian BP variation in morbidly obese hypertensive subjects., Methods: The study group consisted of eight patients (mean age 35.0 +/- 9.1 years), with impaired circadian BP rhythm. Controls were eight well-matched subjects (34.6 +/- 9.8 years) with normal BP rhythm. All patients underwent gastric bypass surgery. The 24-h ambulatory BP measurements were performed before (baseline) and 8 weeks after gastric bypass surgery., Results: Mean body weight in the study group and controls decreased from baseline of 129.0 +/- 21.9 kg and 134.1 +/- 27.2 kg to 116.7 +/- 21.1 kg (by 9.5% +/- 2.1%) and 121.6 +/- 25.7 kg (by 9.3% +/- 1.7%) after the surgery, respectively (P < .0001 v baseline). Mean 24-h, daytime, and night-time BP values decreased significantly and similarly in both groups. In the study group mean 24-h systolic and diastolic BP decreased from 154.7 +/- 12.3 mm Hg and 105.6 +/- 8.1 mm Hg to 138.5 +/- 9.3 mm Hg and 90.8 +/- 6.7 mm Hg and in controls from 158.2 +/- 16.5 mm Hg and 106.2 +/- 10.0 mm Hg to 136.3 +/- 10.8 mm Hg and 92.9 +/- 6.3 mm Hg (P < .0001 v baseline), respectively. Circadian BP rhythm in the study group returned to the normal profile (mean systolic nocturnal fall increased from 4.0% +/- 2.4% to 16.4% +/- 4.0% and diastolic, from 5.1% +/- 3.0% to 17.3% +/- 5.5%; P < .0001 v baseline), whereas it remained normal in the controls., Conclusions: Surgery-induced body weight loss in morbidly obese hypertensive subjects with impaired circadian BP variation is not only associated with BP reduction, but also with the restoration of normal BP rhythm.

Insulinoma tumors are often difficult to detect, as the symptoms largely precede occurrence of a visualized tumor. We report the case of an insulinoma patient with long delayed diagnosis and marked adaptation to extreme hypoglycemia. The patient with a 7-yr history of seizures was found to have plasma glucose concentration during a starvation test as low as 16 mg/dl, with no clinically significant symptoms and concomitant normal plasma insulin levels: 10-30 microIU/ml. All attempts to localize a tumor with repeated abdominal ultrasound examinations or computed tomography scanning were unsuccessful. The patient did not tolerate the introduced oral treatment with diazoxide. Once it had become technically available, endoscopic ultrasonography of the pancreas was performed. It revealed a 10 mm tumor in the pancreatic head. The tumor was subsequently removed surgically. During the operation plasma insulin concentration rose almost 15-fold, which confirmed the insulin-secreting character of the growth. Microscopic examination revealed benign insulinoma, with partially trabecular structure. One month after the operation the patient had normal plasma glucose values of 60-120 mg/dl, but she constantly complained of excessive thirst, which occurred soon after the operation and slowly subsided in the following weeks. In conclusion, the present report demonstrates that insulinoma should be considered and searched for in every case of hypoglycemia associated with normal insulin levels. It also confirms the essential role of endoscopic ultrasonography in the diagnosis of insulin-secreting tumors.

Background: The differentiation of chronic pancreatitis (CP) from pancreatic adenocarcinoma (PA) remains the great challenge for clinicians. The purpose of this study was to compare the prevalence of K-ras and c-erbB-2 mutations in PA and CP in order to evaluate their usefulness in differential diagnosis of those diseases., Methods: The study included 49 patients who underwent Whipple resection or distal pancreatectomy for pancreatic adenocarcinoma (26 subjects) or chronic pancreatitis (23 subjects). DNA from pancreatic tissue was analyzed for K-ras codon 12 and c-erbB-2 mutations with PCR amplifications., Results: The K-ras gene mutation has been shown in 20 (76.9%) PA cases and in 8 (34.8%) CP cases (p<0.01). Prevalence of c-erbB-2 amplification in patients with PA was 17 (65.3%), which was not different from CP, 16 (56.5%) (p=0.58). There was a significant correlation between K-ras mutation and lymph node metastases (p=0.025) as well as between K-ras mutation and G3 tumor differentiation (p=0.037). Overall median survival in patients with PA was 9.5 mo. There was no relationship between presence of K-ras (p=0.58) or c-erbB-2 (p=0.17) mutation and survival time in PA patients., Conclusion: Those results may indicate that both K-ras and c-erbB-2 play a role in pancreatic carcinogenesis, however only K-ras may provide an additional tool in differential diagnosis of CP and PC.

Background: Bariatric surgery may be associated with surgical complications. The aim of the study was to identify significant risk factors for postoperative complications in patients undergoing Roux-en-Y gastric bypass (RYGBP)., Methods: The study consisted of 75 consecutive patients undergoing RYGBP. Full medical examination was performed, and the following parameters were assessed in the fasting state: plasma glucose, insulin, leptin, serum lipids, liver function tests, and lipoprotein Lp(a). All subjects had oral 75 g glucose tolerance test before the surgery. All complications occurring within 6 months after the RYGBP were recorded. The patients were divided into Group 1 - patients in whom complications occurred, and Group 2 - patients with no complications in the 6-month period., Results: Postoperative complications occurred in 16 patients (wound infection, hernia, splenic injury, gastro-jejunal obstruction, duodenal ulcer, lower limb deep vein thrombosis). 3 significant risk factors for postoperative complications within 6 months after gastric bypass were found: 1) fasting plasma glucose >/= 6.0 mmol/l (OR 11.0; 95% confidence interval (CI) 2.1-77.3), 2) age >/=40 years (OR 5.89, 95% CI 1.35-29.4), and 3) BMI >/=45 kg/m(2) (OR 4.1, 95% CI 1.04-17.2)., Conclusion: RYGBP is associated with increased risk of developing early postoperative complications in subjects with even slightly elevated fasting plasma glucose, age >/=40 and BMI >/=45 kg/m(2).

Background: The differentiation of chronic pancreatitis (CP) from pancreatic adenocarcinoma (PA) remains a great challenge. The purpose of the study was to compare the prevalence of p16 and K-ras mutation in PA and CP in order to evaluate their usefulness in differential diagnosis of those diseases., Methods: The study included 44 patients who underwent Whipple resection or distal pancreatectomy for PA (23 subjects) or CP (21 subjects). DNA from pancreatic tissue was analysed for K-ras mutation (codon 12) and p16 mutations with PCR amplifications., Results: The K-ras gene mutation has been shown in 17 (73,9%) cases with pancreatic adenocarcinoma which was significantly more often than in chronic pancreatitis - 9 (42,8%) (p<0,01). Prevalence of p16 mutations in patients with PA was 18 (78,3%) and with CP - 7 (33,3%) (p<0,01). K-ras and p16 mutations together have been observed in 16 (69,6%) cases in patients with PC and only in 3 (14,3%) - with CP (p<0,01). No statistically significant association between K-ras or p16 mutations and tumor size, sex or patient age has been observed., Conclusion: It is suggested that simultaneous measurement of K-ras and p16 mutations may provide an additional tool in differential diagnosis of chronic pancreatitis and pancreatic adenocarcinoma.

Liver hemangioma is the most common benign liver tumor. Giant hemangiomas can grow and give various clinical symptoms. We describe a case of rapid growth of liver hemangioma in a seventeen-year-old girl. She was treated with interferon alpha 2b for hepatitis C. About 12 months later she was admitted to the hospital with symptoms of large epigastric mass, anemia and thrombocytopenia. Ultrasound scan and computed tomography confirmed the clinical picture, suggesting giant liver hemangioma. During surgery large cavernous hemangioma deeply penetrating into normal liver parenchyma was found. In view of recent hepatitis C infection the resection procedure (left extended hemihepatectomy) was assessed as being dangerous for the patient's life. Ligation of the left branches of hepatic artery and portal vein reducing tumor blood supply was performed. The postoperative period was uneventful; the hemangioma in the left lobe had shrunk. Ultrasound and CT scans performed one and two years after surgery showed that the size of the hemangioma remained stable and the patient was asymptomatic. In this described case three potential factors stimulating the growth of hemangioma (puberty, hepatitis C infection and interferon treatment) are discussed. The potential role of vascular endothelial growth factor and fibroblast growth factor is raised.

This study evaluates the safety and clinical utility of rotational angiography in the diagnosis of coronary artery disease. High-speed rotational angiography is a newly available angiographic modality that gives a dynamic multiple-angle perspective of the coronary tree during a single contrast injection. We prospectively randomized 56 patients referred for diagnostic coronary angiography to either standard or rotational angiography. Contrast and radiation utilization were compared between the two groups. The number of additional cine acquisitions needed was used to determine adequacy of the diagnostic study protocol. Rotational angiography was successfully completed in all subjects. There was a 33% reduction in contrast utilization in the rotational group as compared to the standard group (35.6 +/- 12.6 vs. 52.8 +/- 10.7 ml, respectively; P < 0.0001). Additionally, there was a 28% reduction in total radiation exposure in the rotational group as compared to the standard group (39.0 +/- 18.5 vs. 53.9 +/- 23.4 Gycm(2), respectively; P = 0.01). Total whole-body radiation exposure to the primary operator was 144 mrem with rotational angiography and 170 mrem with standard angiography. Procedure time tended to be shorter for rotational angiography (353.9 +/- 146.7 vs. 396.8 +/- 165.8 s; P = 0.3). Rotational coronary angiography can be rapidly performed in any patient and provides a significant reduction in contrast and radiation utilization while at the same time providing adequate angiographic data to complement or replace standard coronary angiography in the evaluation of coronary artery disease., (Copyright 2004 Wiley-Liss, Inc.)

The traditional approach to treatment of certain malignant brain tumors involves permanent implantation of I seeds sequential to tumor's resection. This approach has recently been changed for patients with unifocal recurrent gliomas. What began during the 1990's as a large clinical trial utilizing GliaSite Radiotherapy System, is currently becoming standard of care. This radiotherapy system consists of an inflatable balloon catheter, 2, 3, or 4 cm diameter, which is surgically placed in the tumor resection cavity; its positioning and the level of conformity within the cavity are verified via MRI imaging with contrast. The balloon is then filled with appropriate volume of I in the liquid form. Radiation treatment prescription dose ranges from 40 to 60 Gy (4,000 to 6,000 rads). This is accomplished by allowing 2.77 to 16.6 GBq (75 to 450 mCi) of I to remain in the balloon for 3-5 d. Numerous technical, dosimetric, and logistical considerations arise when handling large quantities of iodine necessary to perform GliaSite procedures. They require coordination of efforts of several hospital departments and the institution's RSO-in our case, two RSOs, at the University of Colorado Hospital and University of Colorado Health Sciences Center hold separate radioactive materials licenses. Based on our experiences and those of others, we conclude that, with appropriate guidance and care, these procedures can be performed safely without excessive restrictions.

In this study, a molecular analysis of the methicillin-resistant coagulase-negative staphylococci strains was performed. The obtained results of the biochemical and drug resistant pattern investigations were insufficient to assess the relationship between the strains. Therefore genotyping by the restriction fragment length polymorphism analysis (PCR-RFLP) method was performed. Analyzed strains characterized presence of the mecA gene-PCR products. The PCR products were digested with DraI and TasI, and the fragments separated by agarose gel electrophoresis. Typing of the methicillin-resistant gene using PCR-RFLP showed that all MRCNS strains possess an identical restriction pattern of the mecA gene. This identical restriction pattern of the mecA gene in investigated strains may suggest an easy transfer of this gene between different staphylococci species and lead to the spreading of methicillin-resistant among hospital strains. Furthermore performing the comparison of different phenotype and genotype methods has shown that the PCR-RFLP method is quick and reliable, enabling the detection and estimation of the relationship between MRCNS strains.

Unlabelled: Morbid obesity defined as BMI > or = 40 kg/m2 is associated with serious co-morbidities e.g. hypertension, type 2 diabetes mellitus, cardiovascular disease, respiratory insufficiency, sleep apnea syndrome, estrogen-dependent tumors, and degenerative arthritis. Moreover, general results of lifestyle intervention and/or drug therapy in these patients are less than satisfactory. It is widely believed that obesity surgery including gastric by-pass has proved to be an effective method of achieving maintained body weight reduction. The aim of this study was to investigate change in body weight, prevalence of co-morbidities, and quality of life after Roux-en-Y gastric by-pass surgery. 56 patients who underwent Roux-en-Y gastric bypass in 1999-2001 were asked to answer a 42-question-questionnaire., Results: Complete answers were received from 36 subjects (mean (+/- SD) age 39 +/- 10 years, body weight 127.5 +/- 20.4 kg, BMI 4.40 +/- 5.6 kg/m2). Mean post-surgery follow-up time was 24 months. All patients reported significant weight loss (35.8 +/- 10.7 kg). A statistically significant decrease in prevalence of hypertension and various symptoms associated with cardiovascular disease, respiratory insufficiency, sleep apnea syndrome were noted as well as a significant improvement in quality of life., Conclusions: In morbidly obese patients Roux-en-Y gastric bypass is an effective and long-term well tolerated method of achieving stable weight reduction, leading to improvement in co-morbidities and quality of life.

Background and Aims: Gastrin stimulates mucosal growth of much of the gastrointestinal tract and has also been implicated in promoting growth of colonic tumors, but its role in colorectal carcinogenesis remains controversial. This study determined fasting serum gastrin levels before and after surgery for colorectal cancer (CRC) and the relationship to the clinical stage of the disease to investigate it possible prognostic role., Patients and Methods: Fasting radioimmunoassay gastrin, CA 19-9, and CEA levels were measured before and after surgery for CRC. Helicobacter pylori status was also assessed since it causes significant hypergastrinemia., Results: Mean fasting plasma gastrin level was significantly higher in CRC patients than in controls before surgery but not 59 days after surgery. Mean CEA and CA 19-9 levels were significantly higher in patients with CRC before surgery than after tumor resection. There was a significant positive correlation between the plasma gastrin, CEA, and CA 19-9 levels and the CRC stage (Dukes' classification)., Conclusion: The significance of gastrin as a marker for diagnosis or prognostic purposes in colorectal cancer needs to be further examined.

Borrelia burgdorferi is an aetiological factor of borreliosis (Lyme disease). The main vectors of Borrelia burgdorferi are larvae, nymphs, and females of Ixodes ricinus. The aim of this paper was to analyse infection parameters of Borrelia burgdorferi in a selected populations of Ixodes ricinus. The study was conducted in Tarnowskie Góry administrative district (Krupski Młyn, Zielona, Lubliniec, Tarnowskie Góry, Swierklaniec, Tworóg, and Zbrosławice). A total of 85 ticks were collected with a piece of cloth dragged over the vegetation. The Borrelia burgdorferi infection was confirmed with a PCR method, using flagellin protein gene DNA amplification. DNA of Borrelia burgderferi sensu lato was present in 14 ticks, which constituted 16.5% of the population studied. The percentage of infected females and nymphs was 26.8%, 22.2%, and 5.6%, respectively. A high prevalence of the pathogen (50%) was in ticks revealed in the recreation areas and the community forest in Swierklaniec.

Recent studies have emphasized the importance of patient selection for the surgical resection of pancreatic adenocarcinoma based on reproducible prognostic factors. The aim of the study was to investigate the prognostic factors affecting long-term survival in patients with resectable and nonresectable pancreatic cancer and to evaluate their prognostic value. Forty six patients (25 women, 21 men, aged 44-80) with ductal adenocarcinoma of the pancreas were reviewed. Primary tumor size and regional enlargement of lymph nodes was assessed with enhanced CT scan. 13 patients were treated conservatively, 9 with standard Whipple procedure (pancreatoduodenectomy) and 24 - with palliative surgery. Survival probabilities were computed using univariate Kaplan-Meier analysis. Log-rank test was used to compare survival between groups. Overall median survival was 6 months with a 4 years survival of 2.2%. There was no difference in survival time (ST) between patients aged 65 years or younger and older (p=0.71). MeanST in patients after Whipple procedure was 10.3, after palliative surgery - 9.4 and after conservative treatment - 4.4 months (p<0.05). Thirty-day surgical mortality was 9.4%. ST was significantly longer in patients with tumors 3 cm or less of diameter compared with larger ones (p<0.05). Presenting signs and symptoms, like jaundice, diabetes, alkaline phosphatase, aspartate and alanine aminotransferase elevation and history of cholecystectomy did not have any significant impact on survival. The only significant independent factors improving survival were: operative treatment and tumor size smaller than 3 cm.

Background: Incisional hernia is a common problem following Roux-en-Y gastric bypass for morbid obesity., Patients and Materials: We report the preliminary results of nonrandomized prophylactic use of polypropylene mesh in a group of 60 consecutive patients. The patients with highest body mass index, and/or history of abdominal hernias and profound liver damage had abdominal wall reinforced with mesh during an operation. A year later the wound was assessed in all patients., Results: In standard wound closure group (n=48) incisional hernia was found in 9 cases (20%). None of the patients with inserted mesh (n=12) developed hernia. The length of hospital stay in mesh group was similar to that in the nonmesh group and shorter than in patients with hernia occurrence. Mesh insertion was complicated with wound discharge in three patients., Conclusions: In our opinion prophylactic use of polypropylene mesh in bariatric patients is highly effective in postoperative hernia prevention.

Background: Hepatitis A and B can be prevented by active immunization. The purpose of our study was to estimate the prevalence of viral markers of hepatitis A, B, and C among medical students, to assess the efficacy of vaccination against HBV infection after 4 years, and to evaluate the efficacy of vaccination against HAV infection., Material/methods: The study group consisted of 150 medical students, who were vaccinated with Engerix B at the beginning of medical studies. From this population we identified a subgroup of 45 students, in whom the presence of anti-HAV was not confirmed; they were then vaccinated with HAVRIX 1440. Viral markers for HAV, HBV, HCV were determined in this group., Results: In the group of 150 persons, we found anti-HBc in 8 students (5.3%), and HBsAg in 1 (0.7%), who did not have either HBeAg or anti-HBe. Anti-HBs antibodies were found in 146 students (97.3%); anti-HCV in 3 cases (2%), and anti-HAV in 15 cases (10%). After 2-fold vaccination against viral hepatitis A, 100% of the students presented with anti-HAV., Conclusions: The incidence of HBsAg and anti-HCV among our students is the same as in the general population, while the incidence of anti-HAV is much lower (10%). The presence of anti-HBs 4 years after vaccination was detected in 97.3% of the students, and anti-HAV 1 month after the complete course of vaccination in 100% of cases.

Objective: The aim of the study was pineal gland function assessment on the base of daily rhythm study and mean daily melatonin (MEL) concentrations in serum in patients with colorectal carcinoma., Material and Methods: Studies were performed in 12 women at the age of 63.17+/-5.90 years and 21 men aged 58.95+/-11.32 years with large intestine adenocarcinoma. The control group consisted of 28 healthy volunteers at comparable age. During the circadian study blood samples for the measurement of melatonin (MEL) were collected every 4 hours during 12 h. MEL concentrations were assessed with the use of RIA methods. Statistical analysis of circadian rhythms of MEL was carried out with the use of cosinor method according to Halberg., Results: Existence of daily rhythm of MEL secretion was shown in all studied groups. A significant decrease of amplitude of rhythm and secretion of MEL at nocturnal hours in comparison with the control group was shown in the group of women with large intestine carcinoma. A significant decrease of mesor value and amplitude of MEL rhythm as a consequence of decrease of MEL secretion at nocturnal and morning hours was observed in the group of ill men., Conclusions: Decrease in melatonin circadian rhythm amplitude as a consequence of its lowered nocturnal secretion occurred in all patients with colorectal carcinoma. Abnormalities in daily rhythm of melatonin secretion were more intensified in men with large intestine carcinoma, which leads to suppression of mean daily hormone concentration.

Background and Objectives: There have been suggestions in literature that characteristic changes of bone mass in osteoporosis may be related to the melatonin (Mel): The aim of this study was to demonstrate whether pinealectomy and Mel administration can affect postmenopausal osteoporosis processes induced in female rats by way of ovariectomy., Methods: The study included 198 animals; 6 remained intact (0), 96 were ovariectomized (Ox), and the remaining ones underwent a sham operation (SOx). Two weeks after surgery, the rats were divided into eight groups: 1) SOx + SPx, 2) SOx + SPx + Mel, 3) Ox + SPx, 4) Ox + SPx + Mel, 5) SOx + Px, 6) SOx + Px + Mel, 7) Ox + Px, 8) Ox + Px + Mel. Animals from the 5th, 6th, 7th and 8th groups were pinealectomized (Px) while the remaining ones underwent a sham operation (SPx). Two weeks after surgery Mel (50microg/100g of bm) were administered intraperitoneally in rats in the 2nd, 4th, 6th and 8th groups while the remaining animals were administered with solvent only (5% solution of ethyl alcohol in physiological saline). Rats were administered the Mel solution or the solvent daily between 5 and 6 pm during a 4-week period. At the appropriate time, i.e. prior to surgery (group 0) and after 6, 12, 18 and 24 weeks from Px or SPx (time subgroups a, b, c and d) the animals were placed separately in metabolic cages (from 6.30 until 9.30 am) in order to collect urine aliquots for HYP and Ca determinations. The blood for the assay of ALP, PICP and ICTP was collected within the next 24 hours at 8 am (rats killed by decapitation)., Results: The study has shown that pinealectomy had inducing, while exogenous Mel suppressing effect upon the level of investigated markers of bone metabolism; these changes were more pronounced in ovariectomized rats. Administration of Mel only partially levelled changes of bone metabolism caused by pinealectomy. In rats with preserved pineal gland effect of Mel on bone turnover markers was less pronounced. After discontinuing administration of Mel distinct tendency to increase studied biochemical markers of bone metabolism was shown., Conclusion: Our findings suggest that Mel is an important modulator of experimental osteoporosis processes induced in female rats by way of ovariectomy.

Aim: We investigated whether there are differences in plasma gastrin, as compared with carcinoembryonic antigen (CEA) and cancer antigen (CA) 19-9 between patients with proximal and distal colorectal cancer. Gastrin concentration has also been analyzed, dependent on the tumor stage, in order to evaluate the possible prognostic role of this measurement., Methods: In 50 patients with colon cancer-fasting gastrin, CA 19-9 and CEA levels were evaluated., Results: Mean plasma-gastrin level in patients with distal tumor yielded 105.31 +/- 12.5 microU/L and was significantly higher than in patients with the proximal tumor site (42.2 +/- 3.1 microU/L) as well as in controls (p < 0.001). No significant difference was observed between mean plasma gastrin in patients with proximal tumors and the control group. The mean CEA plasma level was significantly higher (p < 0.01) in patients with distal tumors (9.1 +/- 1.1 ng/mL) than in those with proximal tumors (1.48 +/- 0.1 ng/mL). Similarly, the mean CA 19-9 plasma level was significantly higher (p < 0.01) in patients with distal tumor (19.9 +/- 2.1 U/mL) than in those with proximal tumor: 1.8 +/- 0.2 U/mL. The mean gastrin plasma, CA 19-9, and CEA level was significantly higher in group of Duke's stage C and D as compared to A and B., Conclusion: We speculate that observed differences in gastrin concentration in patients with distal and proximal tumors may contribute to the distinct pathogenesis and biological properties of those cancers. The significance of gastrin as a marker for diagnostic or prognostic purposes in colorectal cancer requires further study.

Proof of medical causation is the key element in cases involving alleged radiation injury. Until 1993, the use of scientific testimony in the courtroom was governed by the Frye doctrine requiring that a theory be "generally accepted" before it can be the basis of an expert's opinion. Applying that rule trial courts adopted a "let it all in" approach resulting in a near overdose of pseudoscience presented to juries. With its decision in Daubert v. Merrell Dow Pharmaceuticals, Inc., 509 U.S. 579, 113 S. Ct. 2786 (1993), the U.S. Supreme Court announced a new five-factor, non-exclusive test for federal district courts to consider when assessing the opinion of scientific experts. The Court further directed that the trial courts, acting as a gatekeeper for expert evidence, must evaluate whether there is an adequate "fit" between the expert's data and the opinion offered. This article examines how the Daubert standard has been implemented in federal court to combat junk science. Examples from recent case law dealing with operational health physics issues are presented as an illustration of the use of the five-factor test to challenge questionable testimony on causation. Guidance is offered to prospective expert witnesses in radiation-related litigation to insure that proposed testimony will be admissible in district court.

Objective: To assess mean 24-h serum concentrations of dehydroepianrosterone (DHEAS) in postmenopausal women with asthma before and after hormone replacement therapy (HRT)., Methods: Studies were performed in 55 asthmatic and 20 healthy postmenopausal women aged 48-60 before HRT and after 6 months of transdermal 17b-estradiol (E2) and medroxyprogesterone acetate treatment (cyclical method). Serum DHEAS concentrations were assessed with the use of RIA method., Results: In the group of postmenopausal asthmatic women treated with glucocorticoids the mean 24 h DHEAS serum levels were lower than in a similar group not treated with glucocorticoids and a control group of healthy postmenopausal women. However, in both groups of asthmatic women (e.g. glucocorticoid treated and untreated) a significant increase of mean daily DHEAS levels after 6 months of HRT was observed. The hormone concentrations did not change in control group., Conclusions: Postmenopausal asthmatic women show diminished circadian dehydroepiandrosterone sulphate serum concentrations irrespective whether they were treated with glucocorticoids or not. However, after 6 months of hormonal replacement therapy in these groups increased levels of DHEA were found.

The case of rare localization of extrapulmonary tuberculosis--isolated tuberculoma of the liver--was described. The tumor was found accidentally, during abdominal ultrasound for benign prostatic enlargement. Computed enhanced tomography didn't explain the character of the tumor, so percutaneous thin-needle biopsy was performed. Preliminary histological report suggested primary liver cancer. Patient was operated on, tumor was removed with the margin of the healthy liver tissue. Histological examination of the specimen revealed the nature of the tumor. Diagnosed liver tuberculoma is usually treated without surgery.

Forty five patients with diffused peritonitis, complicated with septic shock and neutropenia, have been analysed. Granulocyte concentrate has been administered to 25 patients with negative results of tests detecting lymphocytotoxic and leuko-agglutinin antibodies. Such antibodies have been detected in 35.5% of all patients. These patients have not received granulocyte concentrate. During a 20-day follow up period, antibodies have been produced in 20% of granulocyte concentrate recipients. No signs of alloimmunisation have been noted in 49% of patients with severe peritonitis during the whole follow up period. Non-hemolytic symptoms after transfusions have been seen in 40% of granulocyte recipients and accompanied 16% of all transfusions. No correlation with the symptoms of alloimmunisation was noted.

The computer system of perinatal surveillance--KOMPOR-build by OBREAM-TEMED in Zabrze is described. This system enable to collect the personal data of patients, obstetrical anamnesis as well as very precise analysis "on line" of cardiotocographic records.

The manuscript outlines the results of a quick procedure for relative calibration of a well type Isotope Calibrator for brachytherapy sources. It is demonstrated that accuracy better than 5% is attainable. Some practical considerations with the possible pitfalls in the procedure are discussed.