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A new series of tetrahydroacridine derivatives with the fluorobenzoyl moiety was synthesized and evaluated for cytotoxic activity against lung cancer cell lines A549 and colorectal cancer HT29. The cytotoxic activity of the compounds was compared on the somatic cell line—EAhy926. Compounds showed high cytotoxic activity on A549 cells (IC50 183.26–68.07 μM) and HT29 cells (IC50 68.41–19.70 μM), higher than controls—etoposide (IC50 451.47 μM) toward A549 and 5-fluorouracil (IC50 1626.85 μM) against HT29. Derivative 4 was the most cytotoxic to A549, whereas for the cell lines HT29 compound 6. Selected compounds showed similar cytotoxicity to the EAhy926 cell line (IC50 about 50 μM). In the hyaluronidase inhibition assay, all compounds exhibited anti-inflammatory activity, including 4 exhibiting the best inhibitory activity—IC50 of 52.27 μM when the IC50 heparin was 56.41 μM. Mathematical modeling was performed to determine LD50 after intraperitoneal, oral, intravenous and subcutaneous administration and to predict potential mutagenicity and carcinogenicity of the compounds analyzed. Obtained results showed that tested derivatives are slightly toxic compounds, and LD50 values (mg/kg) ranged from 680 to 1200 (oral rat model), the analyzed compounds have low mutagenic potential, and differences between derivatives are insignificant and very low probability of carcinogenicity. To confirm mathematical calculations, an in vivo test was carried out on a laboratory mouse model for two selected compounds. It allowed to qualify compounds: 6 to category 4 of the GHS scale, and 4 to category 3 of the GHS scale.

A series of nine tetrahydroacridine derivatives with iodobenzoic moiety were synthesized and evaluated for their cytotoxic activity against cancer cell lines—A549 (human lung adenocarcinoma), HT-29 (human colorectal adenocarcinoma) and somatic cell line—EA.hy926 (human umbilical vein cell line). All compounds displayed high cytotoxicity activity against A549 (IC50 59.12–14.87 µM) and HT-29 (IC50 17.32–5.90 µM) cell lines, higher than control agents—etoposide and 5-fluorouracil. Structure–activity relationship showed that the position of iodine in the substituent in the para position and longer linker most strongly enhanced the cytotoxic effect. Among derivatives, 1i turned out to be the most cytotoxic and displayed IC50 values of 14.87 µM against A549 and 5.90 µM against HT-29 cell lines. In hyaluronidase inhibition assay, all compounds presented anti-inflammatory activity, however, slightly lower than reference compound. ADMET prediction showed that almost all compounds had good pharmacokinetic profiles. 1b, 1c and 1f compounds turned out to act against chemoresistance in cisplatin-resistant 253J B-V cells. Compounds intercalated into DNA and inhibited cell cycle in G0/G1 phase—the strongest inhibition was observed for 1i in A549 and 1c in HT-29. Among compounds, the highest apoptotic effect in both cell lines was observed after treatment with 1i. Compounds caused DNA damage and H2AX phosphorylation, which was detected in A549 and HT-29 cells. All research confirmed anticancer properties of novel tetrahydroacridine derivatives and explained a few pathways of their mechanism of cytotoxic action.

The intention of these study was assess if the modified bacterial cellulose can be used as an artificial auricle skeleton. Introduction: The auricle is one part of the external ear. It consists of skin, cartilage muscles and adipose tissue, wherein the cartilage gives shape to the structure There are several indications for reconstruction, such as congenital anomalies, mechanical injuries and burns, and a range of methods have been proposed for complete reconstruction of the auricle. Matherial and methods: A bacterial cellulose membrane at least 25 mm in thickness was produced in vitro by Actobacter xylinum culture. The entire artificial human auricle skeleton was made to scale to allow its implantation into an animal model Wistar rats Forty rats were divided into four groups of 10 animals. Each group was assigned a different resection time: 14 days, 30 days, 90 days or 720 days. After each resection, an examination of the artificial skeleton and the tissues surrounding it was conducted. The surgical procedure was based on the Nagata technique Results: Resection after 14 , 30 , 90 and 720 days shows progression of healing process and integration of artificial skeleton in to the animal body. There are no signs of shape change and deterioration of the skeleton. Disscusion: Several surgical techniques and biotechnological methods have been developed over the past few years to improve the results of facial reconstruction. Other approaches can be used to create auricle cartilage which are based on scaffolds and chondrocytes. Conclusion: My findings indicate that modified bacterial cellulose can be used to form an effective artificial auricle which appears to maintain its shape and elasticity, with no signs of degradation being observed.

Introduction: The perforation of gloves during surgical procedures is quite common. A cheap and quite effective method of reducing the risk of blood-borne infections is wearing two pairs of gloves. Unfortunately, some surgeons are reluctant to it, and they report decreased dexterity and sensation. The aim of the study was to evaluate surgeons’ double-gloving practices to determine the factors related to compliance. Material and methods: An anonymous, 21-question survey in Polish was sent by post to 41 surgical departments. The questions concerned: demographic data, type of surgical gloves used, allergy to latex, number of surgeries performed, frequency of using double gloves and negative impressions from using them and finally, the frequency of needlestick injuries during surgical procedures. Results: We received 179 questionnaires back. More than 62% of the surgeons believe that double gloves provide better protection than a single pair, 24% do not believe in this, and 14% have no opinion. Only 0.6% of respondents always use double gloves during surgery, 19% double glove in at least 25% of cases and 68% do it occasionally. 13% of the surgeons declared that they had never worn double gloves. During high-risk procedures, 86% of respondents wear double gloves. About half of respondents (50.3%) report discomfort while wearing double gloves; 45% – decreased dexterity; about 30% complain of numbness and tingling; and 64% – decreased sensation. Conclusion: Due to the high number of surgical glove perforations and relatively high prevalence of needlestick injuries, it is necessary to use methods that reduce the risk of transmission of pathogens. The habit of using a double pair of gloves should be implemented especially among young surgeons starting to train in their specialities. Consequently, the period of initial discomfort will be combined with the acquisition of surgical skills, which will allow for gradual acclimatization.

INTRODUCTION Peripheral nerve disruptions, frequently occurring during limb injuries, give rise to serious complications of patients recovery resulting from limitations in neural tissue regeneration capabilities. To overcome this problem bridging techniques utilizing guidance channels gain their importance. Biodegradable polymeric tubes seem to be more prospective then non-degradable materials - no necessity of implant removal and possibilities of release of incorporated drugs or biologically active agents that may support nerve regeneration process are the main advantages. MATERIAL AND METHODS Polymer blend of commercial poly(L-lactic acid) (PLLA) and in-house synthesized poly(trimethylene carbonate) (PTMC) were processed in an organic solvent - phase inversion process on a supporting rod - to form a guidance porous tube of 1.1 mm inner diameter. In vivo experiments on rat's cut femoral nerve by using either the tubes or end-to-end suturing (control group) involved 22 and 19 rats, respectively. Motor recovery of operated limbs, neuroma occurrence and histopathology of explanted nerves were evaluated after 30, 60 and 90 days of implantation. RESULTS Motor recovery of the limbs was of similar rate for the two animal groups. The neuroma formation was evident in over 90% control specimens, while for the bridging group it was less than 40% of all evaluable samples (p = 0.0022). Biocompatibility of applied materials was affirmed by moderate tissue response. CONCLUSIONS Application of the biodegradable PLLA/PTMC polymeric tubes effectively supports regeneration of discontinued nerves. The applied material prevents neuroma formation, by reducing the scar tissue formation time and, thus, accelerating the process of neural tissue restoration.

Introduction Colonoscopy trainers have gained recognition for improving endoscopy skills and preparing for real procedures on humans. Unfortunately, due to their high price, commercial simulators are hard to obtain, especially for small medical centers. However, a solution might be to construct a device for themselves. Aim Our goal was to build a relatively cheap and easy-to-construct simulator for residents who want to start learning colonoscopy. Materials and methods The box model colonoscopy trainer was designed and constructed. The artificial colon was made from 2 layers of fabric and rubber rings between them. Velcro attached to the artificial colon and to the box, and the tarp straps that simulate peritoneal adhesions allow the bowel to be arranged in many different configurations. Moreover, some aspects of polypectomy training have been incorporated in the colonoscopy simulator. Results The self-constructed simulator was found to be an effective training device, with the total cost of parts not exceeding $30. Conclusions In this paper, we present the first homemade simulator for colonoscopy training. It offers the opportunity for skills acquisition in a preclinical setting.

Biocompatibility of modified bionanocellulose (BC) and porous poly(ϵ caprolactone) (PCL) were compared to UHMWPE. For all the materials lack of cytotoxic effect to mouse fibroblasts was observed in vitro. In vivo study, subcutaneous implantations in Wistar rats, lasted for seven, 14, and 30 days. Subsequently the composition of surrounding tissue and explants surface changes was evaluated. No symptoms of acute inflammation were observed. Surrounding tissue thickness, the number of granulocytes, lymphocytes, macrophages, and blood vessels differed in time and revealed regular healing process. It is concluded that investigated PCL and BC are the materials with superior biocompatibility with high application potential.

Surgical gloves provide a protective barrier against blood-born pathogens. Studies reveal glove perforation rates of up to 45%, which are often unrecognized by the surgeon or nurse. The goal of this study was to evaluate how often glove perforation occurs after laparoscopic and open cholecystectomy.Gloves from the operating surgeon and the first assistant were collected after operation and tested immediately using two methods : 1. Water leak test - the approved standardized method to detect holes after filling up the gloves with 1000ml of water. 2. Electrical resistance test - method to detect gloves conductivity immersed in saline bath.Altogether, 376 gloves were studied. The overall perforation rate was 8%. Perforations more frequently were observed after laparoscopic than open cholecystectomy. The gloves worn by the operator were more likely to be perforated than those worn by the assistant surgeon in both types of operations. The most common site of perforation was in the index finger of the non- dominant hand. Thirty percent of gloves conducted electrical current, while 22% of them had no macroscopic evidence of perforation.Many of gloves might have microperforations that can not be detected using water leak test.

Introduction The subject of the experiment was bacterial nanocellulose, a natural polymer produced by bacteria - Gluconacetobacter xylinus. Following a specific modification process a cartilage-like material for restoration of damaged tissues may be produced. The obtained implants with excellent biocompatibility, mouldability, biophysical and chemical properties perfectly fit the needs of reconstructive surgery. The goal of the experiment was to develop and analyze cellulosic guidance channels in vivo for the reconstruction of damaged peripheral nerves. Material and methods The experiments were conducted on Wistar rats, femoral nerve. Cellulose was produced according to a self-patented method. In the experimental group tubulization was applied, whereas in the control traditional end-to-end connection was used. Observation time was 30, 60, 90, and 180 days. Results evaluation included histological analysis and postoperative observation of motor recovery. Results The overgrowth of connective tissue and disorganisation of neural structures was evident in 86.67% of control specimens, while for cellulosic group it was only 35% (p = 0.0022). Tubulization prevented the excessive proliferation of connective tissue and isolated from penetration with scar tissue. Autocannibalism, being probably an evidence of neurotrophic factors amassment, was observed in cellulosic group but not in the control one. Motor recovery did not differ significantly (p > 0.05). Biocompatibility of implants was affirmed by very small level of tissue response and susceptibility to vascularisation. Conclusions Cellulosic neurotubes effectively prevent the formation of neuromas. They are of very good biocompatibility and allow the accumulation of neurotrophic factors inside, thus facilitating the process of nerve regeneration.

Surgical site infection (SSI) makes patient care more expensive by prolonging antibiotic usage and hospital stay. Negative pressure wound therapy (NPWT) has been recently reported as a preventive strategy to avoid SSI. We present a simple and low-cost vacuum dressing that may improve surgical wound healing and prevent high-risk wounds from complications.

Scientific achievements enabled tremendous progress of surgical minimally invasive methods in the 20 th century. Laparoscopy and endoscopy became everyday diagnostic and therapeutic tools of modern medicine. Despite its irrefutable opportunities and advantages, classical minimally invasive surgery still has substantial limitations. These include: two-dimensional visualization without depth, a small field of view, and the necessity of precise hand-eye coordination. That is why pressure is placed on manufacturers of endoscopic devices to surmount these technical obstacles. To write this paper we searched databases for articles on new means of visualization in laparoscopic surgery. We discuss augmented reality, three-dimensional vision and image-guided surgery.

Accurate diagnosis of acute appendicitis (AA) is still a problem and is not always easy, even for experienced surgeons. Studies have shown that 20 to 30% of the appendices removedwere normal. Therefore, various scoring systems have been developed to aid in the diagnosis of doubtful cases and reduce the number of unnecessary appendectomies.The aim of this study was to assess the diagnostic value of different scoring systems in acute appendicitis.Material and methods. The study involved 94 patients who underwent laparotomy due to suspected acute appendicitis. Medical examination at hospital admission was performed by a resident and a general surgery specialist. The probability of AA was evaluated using six different scoring systems: Alvarado, Fenyo, Eskelinen, Ohman, Tzankis, and RIPASA. The resident calculated the results in individual systems. The decision to perform the operation was taken by a specialist surgeon who did not know the results.Results. Normal appendix was removed in 26% of cases. Eskelinen, RIPASA and Alvarado systems showed highest sensitivity (99%, 88% and 85%, respectively). Tzankis and Fenyo systems showed highest specificity (62% and 50%, respectively).Conclusions. Our study has shown limited value of scoring systems for the diagnosis of acute appendicitis. The systems may improve diagnostic accuracy as they require obtaining a more detailed medical history, and making a more thorough and organized data analysis. However, the scoring systems should be treated only as an aid to diagnosis

Introduction: During laparoscopy, the monitor is usually placed near the operating table, at eye level, which signifi- cantly affects hand-eye coordination. First, it is impossible for the surgeon to simultaneously observe the operative field and hand movement. Second, the axis of view of the endoscope rarely matches the natural axis of the surgeon's sight: it resembles a direct view into the operative field. Finally, as the arms of the tools act as levers with a fulcrum at the site of the skin incision, the action of the tool handles is a mirror image of the movement of the tool tips seen on the monitor. Studies have shown that a neutral position with the head flexed at 15-45° is the most ergonomically suitable. Aim: To evaluate whether the level of monitor placement exerts an influence on laparoscopic performance. Material and methods: A group of 52 students of medicine were asked to pass a thread through 9 holes of different sizes, placed at different levels and angles, using a self-made laparoscopic simulator. Each student performed the task four times in two monitor positions: at eye level, and placed on a simulator. The order of monitor placement was randomized. Results: The task was performed more quickly when the monitor was placed on the simulator and the sight was forced downwards. Lower placement was also found to be more beneficial for students with experience in laparoscopy. Conclusions: New technologies which place the display on the patient, thus improving the ergonomics of the oper- ation, should be developed.

Introduction: Laparoscopic trainers have gained recognition for improving laparoscopic surgery skills and preparing for operations on humans. Unfortunately, due to their high price, commercial simulators are hard to obtain, especially for young surgeons in small medical centers. The solution might be for them to construct a device by themselves. Aim: To make a relatively cheap and easy to construct laparoscopic trainer for residents who wish to develop their skills at home. Material and methods: Two laparoscopic simulators were designed and constructed: 1) a box model with an optical system based on two parallel mirrors, 2) a box model with an HD webcam, a light source consisting of LED diodes placed on a camera casing, and a modeling servo between the webcam and aluminum pipe to allow electronic ad- justment of the optical axis. Results: The two self-constructed simulators were found to be effective training devices, the total cost of parts for each not exceeding $100. Advice is also given for future constructors. Conclusions: Home made trainers are accessible to any personal budget and can be constructed with a minimum of practical skill. They allow more frequent practice at home, outside the venue and hours of surgical departments. What is more, home made trainers have been shown to be comparable to commercial trainers in facilitating the acquisition of basic laparoscopic skills.

Introduction Peripheral nerve disruptions, frequently occurring during limb injuries, give rise to serious complications of patients recovery resulting from limitations in neural tissue regeneration capabilities. To overcome this problem bridging techniques utilizing guidance channels gain their importance. Biodegradable polymeric tubes seem to be more prospective then non-degradable materials – no necessity of implant removal and possibilities of release of incorporated drugs or biologically active agents that may support nerve regeneration process are the main advantages. Material and methods Polymer blend of commercial poly(L-lactic acid) (PLLA) and in-house synthesized poly(trimethylene carbonate) (PTMC) were processed in an organic solvent – phase inversion process on a supporting rod – to form a guidance porous tube of 1.1 mm inner diameter. In vivo experiments on rat's cut femoral nerve by using either the tubes or end-to-end suturing (control group) involved 22 and 19 rats, respectively. Motor recovery of operated limbs, neuroma occurrence and histopathology of explanted nerves were evaluated after 30, 60 and 90 days of implantation. Results Motor recovery of the limbs was of similar rate for the two animal groups. The neuroma formation was evident in over 90% control specimens, while for the bridging group it was less than 40% of all evaluable samples (p = 0.0022). Biocompatibility of applied materials was affirmed by moderate tissue response. Conclusions Application of the biodegradable PLLA/PTMC polymeric tubes effectively supports regeneration of discontinued nerves. The applied material prevents neuroma formation, by reducing the scar tissue formation time and, thus, accelerating the process of neural tissue restoration.

We report a case of pancreatic solid pseudopapillary tumor that was diagnosed in a 36-year-old female patient. This neoplasm usually occurs in young women. Solid and cystic areas form a characteristic appearance of this tumor. Surgical resection is the mainstay of treatment and is possible in the majority of cases. Neoplasm is associated with a low-grade malignancy and a very good outlook.

UNLABELLED Modern methods of hernia tension free treatment use very wide range of modern biomaterials. Most of them are used transabdominal. For the best and most convenient treatment of large hernias would be a mesh suitable for intraperitoneal use with low adhesion ability to internal organs.THE AIM OF THE STUDY was to compare three types of intraperitoneal meshes. MATERIAL AND METHODS. The study compared three types of intraperitoneal meshes. Sub-chronic (14 days) and chronic (90 days) macro-and microscopic examination were performed on rats (n = 69). Properties of the polypropylene mesh (PLP), Dynamesh®-iPOM and polypropylene covered with chitosan (PLP+chitosan) were evaluated and compared. RESULTS. It has been shown that the test meshes differ slightly during the healing process. CONCLUSION The PLP+chitosan mesh had the best biocompatible features of them all.

Papillary thyroid microcarcinoma is a particular form of cancer of the thyroid gland. This term, according to the WHO classification, is applied to papillary tumors no larger than 1.0 cm in diameter, which are incidentally detected during the postoperative histopathological examination. In clinical practice, the term pertains to all papillary tumors of the size smaller than or equal to 1 cm. The aim of the study was to determine the prevalence of papillary thyroid microcarcinoma and its selected histopathological characteristics among patients with malignant cancer of the thyroid gland identified in our own material in the years 2000-2007. Material and methods. The study included 523 patients treated for thyroid carcinoma: 401 (76.7%) women and 122 (23.3%) men aged 12-83 years (mean 49.8 years). Surgeries were carried out according to the Polish Group for Endocrine Carcinomas recommendations, in compliance with the European consensus. Results. Papillary thyroid carcinoma was identified in the postoperative histopathological examination in 391 (74.8%) patients; 285 (72.9%) women and 106 (27.1%) men. Their age ranged from 14 to 75 years (mean 49.3 years). Among 391 cases, tumor progression classified according to the WHO criteria (3) was as follows: T1 in 260 (66.5%), T2 in 59 (15.1%), T3 in 53 (13.5%) and T4 in 19 (4.8%) patients. In 150 cases (38.4% of papillary tumors), the tumor fulfilled the morphological criteria for microcarcinoma (4) and was detected in 118 (78.7%) women and 32 (21.3%) men. Carcinoma was identified in the neutral goiter in 138 cases, and in 12 patients in hyperactive, including 9 in nodular and 3 in Graves’ goiters. The disease was suspected or diagnosed preoperatively or at surgery in 112 patients. Postoperative diagnosis was performed in 38 (25.3%) individuals with micrcarcinoma. Twenty-four (38%) of 63 patients with multifocal tumors were subjected to adjunctive surgery as their cancer diagnosis was made only postoperatively in the histopathological examination. The subcapsular location of microcarcinoma was found in 78 (49.4%) cases including capsular infiltration and extracapsular invasion in 14 patients. The exact histopathological examination showed multifocality in 63 (42%) cases and involvement of the local lymph nodes in 29 (19.3%) patients. In 21 cases, the central compartment lymph nodes were involved. The presence of metastases in the central and lateral lymph node compartment was observed in 5 cases; in 3 patients skip metastases were detected in the lateral compartment on the tumor side omitting the central compartment. No patient with microcarcinoma diagnosed between the years 2000 and 2007 revealed distant metastases. Conclusions. Due to contemporary diagnostics, papillary thyroid microcarcinomas – tumors up to 1 cm – are most commonly identified cancers of the thyroid gland. High accuracy of US-guided fineneedle aspiration biopsy of high resolution permits to diagnose the majority of these tumors prior to surgery.

Hypocalcemia is the most frequent complication after thyroid surgery. Intraoperative measurement of parathormone levels (ioPTH) in patients undergoing thyroid surgery has been recently described as an accurate method of predicting postoperative parathyroid dysfunction. The aim of the study was to evaluate utility of ioPTH and parathormone level measured 24 hours after surgery (24PTH) as prognostic factors of hypoparathyroidism and consequent hypocalcemia.Fifty-four patients (50 females and 4 males) underwent 55 operations: subtotal thyroidectomy (44), total thyroidectomy (8), completion thyroidectomy due to goiter reoccurrence and cancer (2 and 1 patients, respectively). PTH and serum calcium levels were assessed one day prior to surgery, intraoperatively during wound closure, on the first postoperative day and 2 months after surgery. Hypoparathyroidism was defined as parathormone level less than 15 pg/ml.Seventeen patients presented ioPTH levels below 15 pg/ml. Twelve of them had low 24PTH levels. Only one patient with ioPTH (but not 24PTH) below 15 pg/ml developed persistent hypoparathyroidism, resulting in low parathormone level 2 months after surgery. Three investigated subjects with ioPTH greater than 15 pg/ml had low 24PTH levels but none of them developed persistent hypoparathyroidism. One patient with ioPTH and 24PTH within reference range presented hypoparathyroidism at the 2-month follow-up, presumably due to postoperative iodotherapy.This study suggests that ioPTH and 24PTH levels are not useful prognostic factors of persistent hypoparathyroidism but may indicate transient parathyroid gland dysfunction.

Neoangiogenesis is a significant event in a cascade of growth and progression of solid tumors. Assessment of the tissue expression and measurement of the concentrations of angiogenic and antiangiogenic factors, contributing to this process, in body fluids, can be used not only for an early diagnosis of tumors and their staging but also as an important parameter of treatment efficiency evaluation. The aim of this study is to evaluate the concentrations of crucial angiogenic cytokine VEGF and its soluble receptors in peripheral blood of patients with benign and malignant thyroid tumors. The study comprised 35 patients with thyroid cancer and 10 patients with follicular neoplasm, both diagnosed by means of ultrasound-guided fine-needle aspiration biopsy. For these patients surgical treatment was instituted. The examined angiogenic factors were determined preoperatively and 4 weeks after the surgical procedures. The results were compared with the control group which comprised 10 healthy individuals. Analysing obtained results, we demonstrated high VEGF concentrations and low soluble VEGF receptor concentrations in patients with benign and malignant thyroid tumors. This fact confirms a vital role of VEGF in angiogenesis of thyroid tumors and a hypothetical antiangiogenic activity of its soluble receptors. Disequilibrium of the above-mentioned angiogenic factor concentrations is probably essential for the growth and progression of benign and malignant thyroid tumors.

Neoplastic angiogenesis is an essential stage of growth, progression and invasion of solid tumours. The process of basement membrane degradation and remodelling of the extracellular matrix (EMC) involves proteolytic enzymes called metalloproteinases. Among the numerous proteolytic enzymes of this group the key role is played by metalloproteinase-2 (MMP-2) and tissue inhibitor of metalloproteinase 2 (TIMP-2). Tissue expression and concentration of these compounds in body fluids have been used in early diagnostics of tumours development, assessment of tumours advancement and treatment results monitoring. The aim of the study was to evaluate the concentration of MMP-2 and TIMP-2 in blood serum of patients with benign and malignant thyroid tumours and the effect of surgical treatment on these parameters in the postoperative period as well as assessment whether to MMP-2 and TIMP-2 serum concentration in patients with thyroid cancer positively correlates with the clinical staging classification of the International Union Against Cancer (UICC).The study group consisted of 53 patients with various types of thyroid cancer and 23 patients with benign thyroid tumours, while 26 healthy adults served as controls. According to clinical staging classification of thyroid cancer the 32 patients were classified with stage I, 6 with stage II, 8 with stage III and 7 with stage IV. We have found higher mean concentration of MMP-2 in 53 patients with thyroid cancer as compared to the control group and the group of 23 patients with benign thyroid tumours. All patients were treated operatively. Additionally, a significant effect of radical surgical treatment on mean concentration of MMP-2 and TIMP-2 in patients with papillary and follicular thyroid cancer was demonstrated.MMP-2 and its tissue inhibitor TIMP-2 apparently play a significant role in the pathogenesis of thyroid cancer. Evaluation of their concentration in peripheral blood serum may be useful for the differentiation between benign and malignant thyroid tumours. Serum MMP-2 and TIMP-2 concentrations in patients with thyroid cancer did not significantly correlate with the clinical staging of thyroid cancer.

Tumour growth and development depend on a complex cascade of angiogenic factors. The aim of the study is evaluation of the level of growth factors VEGF and bFGF, and adhesion molecules sICAM-1, sVCAM-1 in the serum of patients with papillary thyroid cancer. The study comprised 35 patients aged 21-68 years (mean age 46+/-14) who had papillary thyroid cancer diagnosed on the basis of thin needle aspiration biopsy, and were qualified for operative treatment. This group comprised 28 women and seven men. The control group was 26 healthy individuals. Serum concentrations of bFGF, VEGF, sICAM-1, and sVCAM-1 were evaluated by the enzyme-linked immunosorbent assay (ELISA) method. We have observed significantly higher mean concentrations of bFGF, VEGF, and sICAM-1 in the serum of patients with thyroid cancer compared with the control group. There was no significant difference between the sVCAM-1 concentrations of the thyroid cancer group and the control group.

The role of adhesive molecules in the pathogenesis of adrenal gland tumours formation remains unclear. Here we present the concentrations of soluble vascular cell adhesion molecule-1 (sVCAM-1) and soluble intracellular adhesion molecule-1 (sICAM-1) in the blood of patients with adrenal "incidentaloma". We found that the mean concentrations of sVCAM and sICAM in the serum of the patients with adrenocortical cancers were significantly higher than those of the patients with benign adenomas or control cases. These results suggest that the levels of adhesion molecules may be a marker of malignancy of adrenal incidentalomas.

From 1974 to 1999, 1,001 patients were operated on for thyroid cancer, including 778 (78%) for differentiated thyroid cancer and 223 (22%) for other thyroid malignant neoplasms. Radical operations were performed in 716 (92%) patients with differentiated thyroid cancer and in 85 (38%) patients with other thyroid malignant neoplasms. After surgery, all patients underwent various methods of complementary treatment, depending on cancer type and grading (levothyroxine, 131I, radiotherapy and/or chemotherapy). These patients had no evidence of persistent disease after finishing treatment (Tg, CEA, calcitonin, scintigraphy). We observed recurrences of thyroid cancer, although macroscopic, microscopic, biochemical, and scintigraphic criteria of radicality were present. At 18 months' to 24 years' follow-up, we observed recurrences in 94 (11.7%) of 801 patients treated radically, including in 53 (7.4%) of 716 patients with differentiated thyroid cancer and in 41 (48%) of 85 patients with other thyroid malignancies. Among 37 patients with thyroid bed recurrence, 18 (48.6%) underwent radical operations and 19 (51.4%) palliative ones. Of 33 patients with regional lymph node recurrence, radical operations were performed in 26 (78.8%) and palliative ones in seven (21.2%). Of 24 patients with distant metastases, four (17%) (with single metastasis) underwent surgery (three radical operations and one palliative one). Other methods of treatment were used in the remaining patients. Occurrence of thyroid cancer recurrences in the thyroid bed and lymph nodes indicates that macroscopic, microscopic, and scintigraphic criteria of radicality are not sufficient. Recurrences after radical surgery are more infrequent in patients with differentiated thyroid cancers than in those with other thyroid malignant neoplasms. In many patients, thyroid bed and lymph node recurrences can be removed radically during surgery.

The role of adhesive molecules in the pathogenesis of adrenal gland tumours formation remains unclear. Here we present the concentrations of soluble vascular cell adhesion molecule-1 (sVCAM-1) and soluble intracellular adhesion molecule-1 (sICAM-1) in the blood of patients with adrenal “incidentaloma”. We found that the mean concentrations of sVCAM and sICAM in the serum of the patients with adrenocortical cancers were significantly higher than those of the patients with benign adenomas or control cases. These results suggest that the levels of adhesion molecules may be a marker of malignancy of adrenal incidentalomas.

From the contents: The urokinase receptor (uPAR, CD87) as a target for tumor therapy Molecular regulation of urokinase receptor (u-PAR) gene expression as one potential concept for molecular staging and therapy Stromal cell involvement in cancer Inhibition of the tumor-associated urokinase-type plasminogen activation system: effects of high level synthesis of soluble urokinase receptor in ovarian and breast cancer cells in vitro and in vivo Molecular mechanisms of carcinogenesis in gastric cancer Clinical implications of molecular diagnosis in HNPCC Minimal residual disease in gastric cancer Minimal residual disease in breast cancer and gynecological malignancies Clinical implications of the EGF-receptor/ligand system for tumor progression and survival in gastrointestinal carcinomas: evidence for new therapeutic options Minimal residual disease in the bone marrow and peripheral blood of patients with metastatic breast cancer Estrogen receptor (ER) expression profile of disseminated epithelial tumor cells in the bone marrow of breast cancer patients Detection of circulating tumor cells in blood using an optimized density gradient centrifugation Antitumoral and antimetastatic effects of continuous particle mediated cytokine gene therapy Genetic subtyping of renal cell carcinoma by comparative genomic hybridization Telomere length and hTERT expression in patients with colorectal carcinoma Evaluation of the level of bFGF, VEGF, sICAM-1, sVCAM-1 in the serum of patients with thyroid cancer.

Tumour growth and development depend on a complex cascade of angiogenic factors. The aim of the study is evaluation of the level of growth factors VEGF and bFGF, and adhesion molecules sICAM-1, s VCAM-1 in the serum of patients with papillary thyroid cancer. The study comprised 35 patients aged 21–68 years (mean age 46±14) who had papillary thyroid cancer diagnosed on the basis of thin needle aspiration biopsy, and were qualified for operative treatment. This group comprised 28 women and seven men. The control group was 26 healthy individuals. Serum concentrations of bFGF, VEGF, slCAM-1, and sVCAM-1 were evaluated by the enzyme-linked immunosorbent assay (ELISA) method. We have observed significantly higher mean concentrations of bFGF, VEGF, and sICAM-1 in the serum of patients with thyroid cancer compared with the control group. There was no significant difference between the sVCAM-1 concentrations of the thyroid cancer group and the control group.

Stimulation of growth of endothelial cells from preexisting blood vessels, i.e., angiogenesis, is one of the essential elements necessary to create a permissive environment in which a tumor can grow. During angiogenesis, the matrix metalloproteinase (MMP) family of tissue enzymes contributes to normal (embriogenesis or wound repair) and pathologic tissue remodeling (chronic inflammation and tumor genesis). The proposed pathogenic roles of MMPs in cancer are tissue breakdown and remodeling during invasive tumor growth and tumor angiogenesis. Tissue inhibitors of metalloproteinases (TIMPs) form a complex with MMPs, which in turn inhibits active MMPs. Vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) are unique among mediators of angiogenesis with synergistic effect, and both can also be secreted by thyroid cancer cells. The goal of the study was to evaluate the plasma blood concentration of VEGF, bFGF, MMP-1, MMP-2, MMP-3, MMP-8, MMP-9, TIMP-1, and TIMP-2 in patients with cancer and in normal subjects. Twenty-two patients with thyroid cancers (papillary cancer, 11; partly papillary and partly follicular cancer, 3; anaplastic cancer, 5; medullary cancer, 3) and 16 healthy subjects (controls) were included in the study. VEGF, bFGF MMPs, and TIMPs were evaluated by enzyme-linked immunosorbent assay (ELISA). In patients with thyroid cancer, normal VEGF concentrations (74.29 +/- 13.38 vs. 84.85 +/- 21.71 pg/mL; p > 0.05) and increased bFGF (29.52 +/- 4.99 vs. 6.05 +/- 1.43 pg/mL; p < 0.001), MMP-2 (605.95 +/- 81.83 vs. 148.75 +/- 43.53 ng/mL; p < 0.001), TIMP-2 (114.19 +/- 6.62 vs. 60.75 +/- 9.18 ng/mL; p < 0.001), as well as lower MMP-1 (0.70 +/- 0.42 vs. 3.87 +/- 0.53; p < 0.001) levels have been noted. Increased plasma levels of MMP-3 and MMP-9 were also found in patients with medullary carcinoma. In conclusion, predominance of MMP-2 over TIMP-2 and TIMP-1 over MMP-1 as well as increased concentration of bFGF in peripheral blood are common features in patients with thyroid cancer.

Angiogenesis is one of the key stages in the development of neoplastic tumours, in which a small group of mutated cells transforms into a large malignant tumour metastasising to the neighbouring tissues and organs. The studies on the significance of neoangiogenesis in the progression of endocrine gland neoplasms have recently become one of the most rapidly evolving branches of molecular endocrinology. The induction of angiogenesis has been demonstrated to result from the imbalance between positive and negative factors which control this process. Our paper presents the results of current studies on the role of factors such as molecular markers of angiogenesis (e.g. vascular endothelial growth factor and basic fibroblast growth factor), metalloproteinases (which regulate the decomposition of the extracellular matrix) and their inhibitors, and adhesive molecules (e.g. soluble vascular cellular adhesion molecule-1 and soluble intracellular adhesion molecule-1) in the pathogenesis and diagnostics of endocrine gland tumours in humans. Also, we discuss new therapeutic strategies for inhibiting the growth of neoplasms by blocking the formation of blood vessels using angiogenesis antagonists, which inhibit various stages of angiogenesis. More and more data are being accumulated suggesting that these preparations could, in the near future, be used in the pharmacotherapy of some endocrine gland neoplasms.