Band 9, Heft 2

Pseudomonas aeruginosa (P. aeruginosa) is one of the most important opportunistic pathogens. The pathogenicity of P. aeruginosa has been associated with multiple bacterial virulence factors. The aim of this study was to evaluate the association between P. aeruginosa strains obtained from various clinical samples and resistance to antibiotics and pathogenicity factors, such as resistance to serum bactericidal activity and biofilm formation. This study included 121 P. aeruginosa strains isolated from clinical samples; 65 of the isolated P. aeruginosa strains were carbapenem-resistant, and 56 were carbapenem-sensitive. Carbapenem-resistant P. aeruginosa strains were more often resistant to the majority of tested antibiotics, compared to carbapenem-sensitive strains. We did not find any statistically significant difference between resistance to carbapenems and serum resistance and ability of tested P. aeruginosa strains to produce biofilms. Carbapenem-resistant P. aeruginosa strains were recovered from the urinary tract significantly more often (75.0%) than carbapenem-sensitive P. aeruginosa strains (25.0%). Carbapenem-sensitive P. aeruginosa strains were recovered significantly more often from the respiratory tract than carbapenem-resistant strains, 60.0% and 40.0%, respectively. All the P. aeruginosa strains recovered from blood were serum-resistant. P. aeruginosa strains recovered from the respiratory tract and wounds were significantly frequently serum sensitive, 95.6% and 56.6%, respectively. We did not find any differences in biofilm production among the P. aeruginosa strains recovered from different sources.

To investigate the mechanism in Scutellarein-induced apoptosis of SAS human tongue cancer cells, inhibitory effects of Scutellarein on SAS cells were detected by MTT assay. Cell apoptosis was analyzed by flow cytometry. Ultrastructural changes of SAS cells were observed by transmission electron microscopy (TEM). Mitochondrial transmembrane potential (ΔΨm) were analyzed by JC-1 [5,5,6,6-Tetrachloro-1,1,3,3-tetraethylbenzimidazolylcarbocyanine iodide]. Western blotting was used to examine the expression level of Bcl-2, Bax and caspase-3 in SAS cells treated with Scutellarein. Scutellarein inhibited the proliferation of SAS cells in a time and dose-dependent manner and increased the percent of apoptotic cells. The mitochondrial cristae were swollen and had vacuolar degeneration. ΔΨm decreased when the concentration of scutellarein increased. Scutellarein effectively up-regulated the expression of mitochondrial Bax and caspase-3 and down-regulated the expression of Bcl-2. Scutellarein induces apoptosis of SAS human tongue cancer cells via activating mitochondrial signaling pathway.

Intravascular large B-cell lymphoma (IVLBCL) is a rare subtype of extranodal diffuse large B-cell lymphoma (DLBCL) characterized by selective growth of neoplastic cells within the vascular lumen. IVLBCL involves all types of organs and mostly is associated with poor prognosis, but patients with cutaneous variant have significantly better survival. In this article we report a case of 80-year-old woman with prominent cutaneous manifestation of intravascular large B-cell lymphoma.

The GRP78 (glucose-regulated protein 78) is a major endoplasmic reticulum (ER) chaperone facilitating proper folding of the newly synthesized proteins. By the interaction with caspases, GRP78 has antiapoptotic properties allowing cells to survive under stress condition. GRP78 expression and its association with tumor proliferation, metastasis and resistance to chemotherapy were observed in solid tumors. There are limited data on the expression and impact of this protein on the clinical course and treatment response in acute myeloid leukemia (AML). The aim of this study was to evaluate the expression of GRP78 mRNA in patients with de novo AML. These results were compared to healthy controls, blast phenotype, molecular and cytogenetic status and clinical features of AML. 101 non-M3 AML patients and 26 healthy individuals were included in this study. The expression of GRP78 mRNA in bone marrow was analyzed by real-time quantitative polymerase chain reaction (RQ-PCR). We demonstrated increased GRP78 mRNA expression in AML patients compared to healthy controls, although this difference was statistically significant only in CD34+ leukemias. There was also no significant correlation between GRP78 mRNA expression and complete remission rate, relapse-free survival and overall survival. These results indicate that GRP78 expression is increased in CD34+ leukemias and has no prognostic impact on clinical outcome in AML.

A case is presented of a operated giant pedunculated vulvar lipoma weighing 14 kg in a patient with concomitant inoperable giant ventral postoperative hernia, complete diastasis of the anterior abdominal wall musculature and endometrial adenocarcinoma.

Several case reports have associated the combined use of thyroid drugs and oral anticoagulants, like coumarin, with overanticoagulation. However, this effect has never been described for phenprocoumon, a coumarin derivate that is widely prescribed in continental European countries and in Latin America. We describe a 62-year-old female who had an unexpectedly labile anticoagulation profile when levothyroxine (Puran T4®) was added to her drug therapy regimen, which included phenprocoumon (Marcoumar®). This resulted in an elevated international normalized ratio (INR) that was unrecordable and bleeding (macroscopic hematuria) that required hospitalization and treatment with vitamin K. The patient had been taking phenprocoumon for almost ten years for systemic embolism prophylaxis because of her history of mechanical bileaflet mitral valve prosthesis. One month before the events described, the patient was prescribed sodium levothyroxine (50 mcg daily) to treat hypothyroidism (TSH = 40 µU/mL; reference range, 0.40–4.0 µU/mL). Approximately 3 weeks prior to initiation of levothyroxine treatment, her INR was 2.8. A drug interaction was therefore suspected. The Horn Drug Interaction Probability Scale (DIPS) indicated a probable interaction between oral phenprocoumon and levothyroxine in this case. Clinicians should be aware that levothyroxine may interact with oral phenprocoumon, resulting in overanticoagulation.

IThe present study outlines the case of a 30-year-old patient with central odontogenic fibroma. The tumour developed in the alveolar process of the maxilla in the area of 13–15. The study describes the clinical symptoms, the radiological image, treatment method and histopathological image of the tumour. The study also presents a one-year period of post-surgical observation.

The aim of the study was to evaluate 10-years of clinical material referring to the rare dental abnormality of double teeth. The study material consisted of case records, operation-books and radiographic or photographic documentation on patients treated in the Department of Oral Surgery, Silesian Medical University, Katowice, from the 1st of June 2000 to the 31st of May 2010. The following features were considered important: age and sex, the reason why the patient reported for treatment, general state of health, the time of recognition and type of double teeth, location of double teeth, complaints and disturbances connected with double teeth, types of radiographs, the radiographic and macroscopic appearance of double teeth and treatment method. Diagnoses were as follows: eight conrescent teeth, two fused teeth, two geminated teeth and one invaginated tooth. The anomaly of a deciduous tooth was referred to in one case only. Double teeth were most often seen in the region of maxillary incisors and molars but rarely in the mandible. The region of incisors was affected chiefly in children and the region of molars in adults. Double incisors are usually recognized prior to treatment whereas double molars as late as during their extraction. In many cases, neither intraoral radiographs nor pantomographs help to confirm double teeth or provide sufficient information to plan the treatment. In such a situation, CT or CBCT should be used in addition to imaging diagnostics. Double teeth among incisors are usually accompanied by occlusal disorders. Therefore the therapeutic management is conducted by a team, including orthodontists.

To investigate the adverse reactions of transcatheter arterial chemoembolization (TACE) combined with trastuzumab in the treatment of unresectable live cancer, 85 unresectable liver cancer patients were treated with 35 mg epirubicin, with lipiodol and gelatin sponge granule as the embolic agent, and trastuzumab (4mg/kg) was administered intravenously. All the adverse reactions were investigated by blood routine examination and the checking of liver, renal and thyroid functions on the postoperative 2nd and 30th day. No patients died of direct medication. The main adverse reactions included haematological toxicity, liver function lesion and postoperative syndromes such as nausea, vomiting, fever and liver area aching. Two days after the treatment, the amount of the serum total bilirubin (TB) and white blood cell (WBC) increased dramatically, while platelet (PLT) changed a little, and creatinine (Cr) and blood urea nitrogen (BUN) did not change at all. Thirty days after the treatment, blood routine, liver and renal functions were examined, demonstrating that the liver function remained unchanged, PLT decreased apparently, WBC was lower, and Cr and BUN changed slightly compared to those before the treatment. The combined treatment is safe for unresectable liver cancer and thus can be used as a routine intervention method.

In some countries the cervical cancer incidence and mortality rates are much higher compared to the European average. The differences of HPV and its type prevalence between countries and regions influence cervical cancer incidence and mortality. Regarding the differences in cervical cancer incidence and mortality in Lithuania and Belarus, the aim of this study was to describe HPV infection level and HPVs type distribution among two study groups of patients with moderate or severe cervical intraepithelial neoplasia (CIN2-3) and cervical cancer. Our data shows that 74.2% [95% CI: 63.64÷84.76] of Lithuanian patients with cervical cancer and 85.6% [95% CI: 85.53÷92.85] of the study group with CIN2-3 were HPV positive, while in the study groups of Belarusian patients HPV infection was detected in 92.6% [95% CI, 74.25÷98.71] and 65.4% [95% CI, 44.36÷82.06] cases respectively. HPV 16 was the most prevalent type in Lithuanian as well as in Belarusian patients of the study groups. HPV 18 in Lithuanian patients of the study group with cervical cancer was identified in 10.2% [95% CI: 1.73÷18.67] and in the study group with CIN2-3 — in 2.6% [95% CI: 0.95÷6.15] of cases. HPV 18 was not detected in Belarusian patients of both groups.

Carotid cavernous fistulas (CCF) are dural arteriovenous fistulas which include pathological communications between the arterial system and the venous cavernous sinus situated at the wall of the cavernous sinus. It can be demonstrated by wide range clinical presentations. The presented case shows a very modest clinical presentation of CCF which was present over a few months only as new daily persistent headache without initial positive findings on performed computer tomography of the head, but rapidly worsened over a period of few days.

Primary systemic therapy (PST) is a standard treatment for patients with locally advanced breast cancer. We report one of our patients to demonstrate the optimal use of FDG-PET-CT in the routine clinical workup during PST, especially when clinicians face contradictory clinical and pathological findings, and to show the advantages of this imaging modality in the decision-making process about the initial treatment choice. By reviewing the literature we would also like to confirm that FDG-PET-CT is highly sensitive in the measurement of the early therapeutic response and the prediction of the complete pathological remission, as early as after the first cycle of chemotherapy is administered.

In this letter, we share our concerns regarding fluctuations of homozygosity for ApoE/ɛ4 allele. It appeared that over time, expression of this gene raised the felled as reported by various researchers. Considering the diversity of phenotypic characteristics assigned to expression of ApoE/ɛ4, seems to be a potentially useful to direct practitioner on concrete figures related to the genetic propensity of many conditions, from circulatory to mental disorders.