Band 8, Heft 2

Endometriosis is the disease which usually takes a wide range of time to be diagnosed. Recently, the investigators found that endometriosis could be diagnosed using the density of nerve fibers in eutopic endometrium after taking endometrium bioptate. The aim of the article is to summarize the existing literature on density of nerve fibers in eutopic endometrium in women with and without endometriosis. In this review were involved only those studies which used the same exclusion criteria and the same technology to detect nerve fibers in eutopic endometrium. Our review confirmed the position of all studies’ results that detection of specific nerve fibers within eutopic endometrium using minimally invasive endometrial biopsy technique could be widely used in clinical practice to diagnose endometriosis with high specificity and sensitivity.

We report on a patient with longstanding multicentric Castleman’s disease, hyaline-vascular type, who developed a follicular dendritic cell sarcoma, and finally presented a fatal paraneoplastic pemphigus. We review all four cases of such a triple association described in the literature so far.

Primary headaches are common disease of the modern society and it has high negative impact on the productivity and the life quality of the affected person. Unfortunately, the precise diagnosis of the headache type is hard and usually imprecise, thus methods of headache diagnosis are still the focus of intense research. The paper introduces the problem of the primary headache diagnosis and presents its current taxonomy. The considered problem is simplified into the three class classification task which is solved using advanced machine learning techniques. Experiments, carried out on the large dataset collected by authors, confirmed that computer decision support systems can achieve high recognition accuracy and therefore be a useful tool in an everyday physician practice. This is the starting point for the future research on automation of the primary headache diagnosis.

Musculoskeletal injuries in the non-elite athletes are a clinical entity that is being seen more frequently nowadays. The term “weekend warriors” applies to amateur participants in sports activities and is related to an increasing number of musculoskeletal injuries mainly due to overuse. Concomitant skeletal variations may as well predispose to trauma. We add to the literature two cases of multipartite patella in which locally injected ropivacaine (ropivacaine hydrochloride) and steroid (betamethasone acetate-betamethasone sodium phosphate) relieved the symptoms completely. Here, we describe the clinical, imaging features and the course of treatment.

The purpose was to evaluate the effects of extract of Rhodiola rosea on learning and memory processes on rats. The two series of experiments were carried out — on naïve rats and on rats with scopolamine-impaired memory. The passive avoidance tests were performed — step-down and step-through. The latency of reactions in seconds was observed in both tests. Naïve rats treated with the extract in showed the prolongation of latency of reaction of both step-down and step-through passive avoidances compared to the controls. Rats with scopolamine-impaired memory showed shorter latency of reaction in both passive avoidance tests compared to the controls. Rats treated with the extract of Rh. Rosea with scopolamine-impaired memory prolonged the latency in both passive avoidance tests compared to scopolamine group. It was found that the extract of Rh. Rosea improved performance during learning session, short and long memory retrieval tests in naïve rats. Scopolamine impaired the learning and memory retrieval of rats, but Rh. Rosea pretreatment improved performance and turned off the deterioration effect of scopolamine on these brain functions probably by non-specific mechanisms on cholinergic neurons. The studied plant extract can be a candidate for treatment of dementia and other memory disturbances.

Fibrolamellar hepatocellular carcinoma (FLH) is a rare variant of hepatocellular carcinoma that typically occurs in adolescents or young subjects in an otherwise normal liver. Correct recognition of FLH is extremely important, because a complete resection of the tumor can confer an excellent prognosis. FLHs can become large, exerting mass effects on adjacent organs before diagnosis. Unfortunately, there are very few imaging reports describing external compression of the stomach caused by a FLH. We report the case of a young female suffering from dyspepsia and abdominal pain caused by stomach compression resulting from a large FLH.

Introduction. Leukoplakias of the buccal cavity are premalignant lesions with a significant 0–20% potential for malignant transformation. In addition to active follow-up screening procedures, a number of surgical interventions are recommended for their removal. One of the preferred procedures is laser ablation with consecutive histopathology using one of the many types of lasers. The efficacy of such procedure with respect to the lesion location is, however, unclear. Many studies are contradictory. Some shows laser ablations as prevention of malignisation other see it as increased risk. Aim of this is to test treatment in different locations for two years. Material and method. An outpatient ablation by a 980mm diode laser of lesions on the tongue and in the lower buccal cavity (Group A) and lesions in other parts of the buccal cavity (Group B) were performed under local anaesthesia. In total, 76 lesions were treated in 66 patients. Recurrence after 1, 3, 6, 9, 12, and 24 months were followed up. Initially, all lesions were histopathologically tested. Concurrently, the subjective tolerance of the procedure was monitored, using a 1 (ideal) to 5 (worst) scale. Results. Clearing rate of lesions was of 84.6% for Group A and of 94.7% for Group B. In two patients (3% of Group A) malignant transformation occurred which was not observed in Group B. Patient toleration in various time intervals was always higher in Group B, but generally was very high in both groups. Conclusion. Malignant transformation of leukoplakias does occur even after laser ablation, and for this reason it is necessary to subject the patients to systematic follow-ups. It is significantly higher risk of recurrences and malign transformation in tongue and oral base. Laser ablation is a simple and well-tolerated procedure with high clearing rate.

Apoptosis is central to the biology of cutaneous malignant melanoma (CMM). The leucine zipper, down regulated in cancer 1 (LDOC-1) gene, is known to be a regulator of the nuclear factor kappa B (NF-kB) through inhibition of the same NF-kB. The poly (ADP-ribose) polymerase-1 (PARP1) gene plays an important role for the efficient maintenance of genome integrity. PARP-1 protein is required for the apoptosis-inducing factor (AIF) translocation from the mitochondria to the nucleus. We report here two interesting cases of family melanoma, a father and son 84 and 40 years old, respectively. The histological evaluation of the lesions of both men revealed diffused superficial melanoma with epithelioid cells. We evaluated the differential expression of LDOC-1 and PARP-1 mRNA in peripheral blood leukocytes of both the father and son. We found that both LDOC-1 and PARP-1 genes were down-regulated in both patients compared with those of controls. These data suggest that low levels of expression of LDOC-1 and PARP-1 mRNA may be associated with familial melanoma.

A case of sixteen-year-old boy with initial herpes simplex virus (HSV) and Epstein-Barr virus (EBV) encephalitis is reported. Herpesviruses are often found in cerebrospinal fluid (CSF) along with EBV. After eradication of HSV in CSF in this case, a positive polymerase chain reaction (PCR) to EBV in CSF remained along with a severe clinical picture (segmental myoclonus and Klüver-Bucy syndrome) and worsening of brain magnetic resonance imaging (MRI) findings. Neurological and psychological improvement occurred after treatment with intravenous immunoglobulin.

We report the case of an eighteen-month-old child who suffered a tympanic membrane perforation caused by a digital thermometer. This injury led to a CSF leak. The patient was followed conservatively with no surgical intervention or prophylactic antibiotic therapy and developed pneumococcal meningitis 7 days later. He was then treated with Ceftriaxone for 12 days with full recovery, from a short and long term perspective. Issues concerning the management of CSF leak will be discussed along with review of the literature. This is the first report of post-traumatic meningitis as a result of mild trauma not involving maxillofacial or basilar fractures. The aim of our report is to raise awareness to this cause of meningitis and to stress the importance of immunizing against Streptococcal pneumoniae, a measure which may have prevented the sequelae in our case.

Multiple sclerosis (MS) is an autoimmune disease with unclear etiopathogenesis. Some MS patients have anticardiolipin (ACL), anti-beta-2-glycoprotein-I (B2GPI) and anti-annexin V (AnV) antibodies. These antibodies can also be found in systemic lupus erythematosus with antiphospholipid syndrome (SLE/APS). The aim of our study was to compare the levels of ACL, B2GPI and AnV antibodies in MS and SLE/APS. Materials and methods: We investigated serum levels of IgG and IgM ACL, B2GPI and AnV in 21 MS patients, 30 SLE/APS patients and 30 controls using ELISA. Results: Mean levels of IgM and IgG ACL and B2GPI in MS were comparable with controls and lower than SLE/APS (p<0.05). Mean levels of IgM AnV in MS were higher compared to SLE/APS and controls (p<0.05); mean levels of IgG AnV in MS were higher than normal but similar to SLE/APS (p>0.05). Discussion: The results show that MS with negative “classic” autoantibodies (ACL and B2GPI) and without clinical data for antiphospholipid syndrome may have other positive antiphospholipid antibodies, such as AnV. Larger studies are needed to clarify whether AnV are epiphenomenon of the vascular and organ damage or they play a pathogenic role in the development of MS.

The aim of the study was to establish the importance of an additional measurement of subcutaneous adipose tissue thickness (SAT) on a predetermined position on the waistline, and its relation to waist measurements as an improvement of metabolic prediction in equally obese subjects. One hundred and forty two consecutive patients were enrolled in the study: stratified by weight as normal (body mass index — BMI 20–25 kg/m2), overweight (BMI 25–30 kg/m2) and obese (BMI >30 kg/m2); and by fasting glucose level as normoglycemic, impaired fasting glucose (IFG), or with type 2 diabetes mellitus (T2DM). SAT was measured in relaxed expiration, 3 cm left of the umbilicus, with ultrasound. Fasting blood samples for glucose, insulin and HbAlc were taken. Waist circumference was slightly higher in the IFG (112.8 cm) and normoglycemic groups (115.62 cm), compared to T2DM (108.15 cm). The T2DM group had a lower average SAT (2.7 cm) than both the IFG group (3.4 cm, p<0.01) and the normoglycemic group (4.2cm, p=0.001). The homeostatic model of assessment for insulin resistance (HOMA IR) was the lowest in normoglycemic and the highest in IFG group. Waistline radius to SAT ratio provides better insight into the deterioration of glucose metabolism than standard anthropometric markers of abdominal obesity in equally obese patients.

Fractures of the mandibular condylar processes are often-met injuries of lower region of face. The cause of that state is dynamic development of municipal transport and the increase of aggression in human relations. Many classifications of fractures of mandibular condylar processes are in literature. The choice of therapy is a subject for debate among doctors. Contemporary literature does not give an unequivocal answer to the question whether in the case of fractures of mandibular condylar processes non-invasive treatment should be applied or whether the method of surgical supply of fractures is better.

Tuberculosis (TB) is a disease particularly affecting the poorest socioeconomic groups. One such group in Central Europe are the homeless. We developed a prevention programme that targets, among others, homeless individuals in Warmia and Mazury Province (in the northeast of Poland). We investigated 121 homeless persons. We performed surveys, X-rays and microbiological tests of the sputum for TB. Five cases of pulmonary TB were found. The prevalence of TB in this community was estimated at 4132 per 100,000 (4.13%). Efficient TB control justifies continued prevention programmes aimed at the systematic monitoring of the homeless population.