Role of Adipose Tissue Hormones in Pathogenesis of Cryptoglandular Anal Fistula

The cryptoglandular perianal fistula is a common benign anorectal disorder that is managed mainly with surgery and in some cases may be an extremely challenging condition. Perianal fistulas are often characterized by significantly decreased patient quality of life. Lack of fully recognized pathogenesis of this disease makes it difficult to treat it properly. Recently, adipose tissue hormones have been proposed to play a role in the genesis of cryptoglandular anal fistulas. The expression of adipose tissue hormones and epithelial-to-mesenchymal transition (EMT) factors were characterized based on 30 samples from simple fistulas and 30 samples from complex cryptoglandular perianal fistulas harvested during surgery. Tissue levels of leptin, resistin, MMP2, and MMP9 were significantly elevated in patients who underwent operations due to complex cryptoglandular perianal fistulas compared to patients with simple fistulas. Adiponectin and E-cadherin were significantly lowered in samples from complex perianal fistulas in comparison to simple fistulas. A negative correlation between leptin and E-cadherin levels was observed. Resistin and MMP2 levels, as well as adiponectin and E-cadherin levels, were positively correlated. Complex perianal cryptoglandular fistulas have a reduced level of the anti-inflammatory adipokine adiponectin and have an increase in the levels of proinflammatory resistin and leptin. Abnormal secretion of these adipokines may affect the integrity of the EMT in the fistula tract. E-cadherin, MMP2, and MMP9 expression levels were shifted in patients with more advanced and complex perianal fistulas. Our results supporting the idea of using mesenchymal stem cells in the treatment of cryptoglandular perianal fistulas seem reasonable, but further studies are warranted.

Colorectal Cancer: Is it Still a Disease of the Elderly?

<b><br>Introduction:</b> Colorectal cancer is becoming an increasingly significant health issue, being one of the more commonly diagnosed malignancies. Colorectal tumors account for 10% of all malignant cancers in women and 12% in men. Incidence is higher in the male population, especially among younger individuals. It is commonly believed that colorectal cancer is predominantly associated with advanced age. However, colorectal surgeons, who specialize in the treatment of this type of cancer, are observing a growing number of cases among middle-aged and younger individuals.</br> <b><br>Aim:</b> The aim of our study was to investigate whether colorectal cancer still predominantly affects elderly individuals, how frequently it is diagnosed in younger patients, and whether the location of tumors in the intestines of younger patients aligns with data from elderly individuals.</br> <b><br>Materials and methods:</b> The study was conducted retrospectively and included a cohort of 1771 patients who underwent surgical procedures due to colorectal cancer between 2012 and 2015 at the Department of General and Colorectal Surgery at the Medical University of Łódź and between 2014 and 2017 at the Department of General Surgery with a Division of Surgical Oncology at the District Health Center in Brzeziny. Data were analyzed regarding the frequency of colorectal cancer occurrence by age, tumor location in different age groups, and disease stage according to age. Age groups included <40 years, 41-50 years, 51-70 years, and >70 years.</br> <b><br>Results:</b> The study encompassed a total of 1771 patients, with 988 (55.79%) being males and 783 (44.21%) females. The mean age of the patients was 65.27 11.12 years. The highest number of cases was observed in the age range of 60-70 years and 70-80 years. It was found that colorectal tumors in males more frequently occurred on the left side of the colon and rectum, while in females, they were more commonly located on the right side of the colon, which was statistically significant (P = 0.007). Younger age groups of patients (<40 years, 40-50 years) had a similar male-to-female ratio, whereas in age groups above 50 years, males significantly outnumbered females (P = 0.049). The study revealed that in the group of patients below 40 years of age, an advanced stage of colorectal cancer was significantly more common; stage D occurred over twice as often as in the 51-70 age group and over three times as often as in the >70 age group.</br> <b><br>Conclusions:</b> The incidence of colorectal cancer in Poland is steadily increasing, with a growing number of diagnoses in younger individuals. Research findings demonstrate that males, especially those in younger age groups, are at a higher risk of developing colorectal cancer. A higher disease stage is more frequently observed in younger patients, possibly due to delayed diagnosis and symptomatic treatment. Screening programs should be adjusted to the changing age groups at higher risk. Our study underlines the need to raise public awareness regarding colorectal cancer, particularly among the younger population.</br>.

Risk factors and clinical characteristics of rectal cancer recurrence after radical surgical treatment

<b><br>Introduction:</b> Recurrence of rectal cancer affects from 4% to even 50% of patients after surgical treatment. The incidence may be influenced by numerous factors depending on the patient, the characteristics of the tumor and the type and quality of the surgical technique used.</br> <b><br>Aim:</b> The aim of this study was to assess the clinical characteristics of rectal cancer recurrence, identify potential risk factors and role of patient surveillance after primary resection of rectal cancer.</br> <b><br>Materials and methods:</b> The study comprised patients operated on due to recurrence of rectal cancer at the Department of General and Colorectal Surgery of Medical University of Lodz between 2014 and 2020, who were in the follow-up program at the hospital's outpatient clinic after the primary surgery. Risk factors for disease recurrence were sought by analyzing the characteristics of the primary tumor, treatment history and postoperative care.</br> <b><br>Results:</b> Twenty-nine patients were included in the study, the majority (51.7%) of the patients were men. The largest group was represented by patients with stage II and III disease. The most frequently performed primary surgery was low anterior resection (LAR) (62.8%). 35% of patients received neoadjuvant treatment prior to primary surgery. We demonstrated that the lack of neoadjuvant treatment before primary surgery increases the risk of cancer recurrence nine times. Higher stage of disease at the point of primary surgery is associated with nearly seven times the risk of recurrence compared to stage I disease.</br> <b><br>Conclusions:</b> Optimal preoperative staging, reasonable neoadjuvant treatment, proper surgical technique and precise follow-up regimen are essential for further improvement of rectal cancer outcomes.</br>.

The Role of Chronic Fatigue in Patients with Crohn's Disease

Crohn's disease (CD) is a chronic, relapsing disorder belonging to inflammatory bowel diseases (IBD). It is manifested by relapsing transmural inflammation found in any segment of the gastrointestinal tract. Chronic fatigue is a common and underrecognized symptom of CD for which the prevalence is much higher in the population of CD patients compared to the healthy population. It stems from an intricate web of interactions between various risk factors, and its pathophysiology is still not fully understood. The implementation of routine screening and a holistic, multidisciplinary approach involving psychological support may be crucial in the management of CD patients with chronic fatigue. There is currently no single intervention aimed at decreasing fatigue alone, and its treatment is especially difficult in patients with fatigue persisting despite clinical and endoscopic remission. Extensive research is still needed in order to be able to predict, prevent, identify, and ultimately treat fatigue associated with CD. The aim of this review is to summarize the knowledge on the etiology, diagnosis, and treatment of chronic fatigue in CD patients.

Rectal Cancer: Are 12 Lymph Nodes the Limit?

Lymph node dissection is a crucial element of oncologic rectal surgery. Many guidelines regard the removal of at least 12 lymph nodes as the quality criterion in rectal cancer. However, this recommendation remains controversial. This study examines the factors influencing the lymph node yield and the validity of the 12-lymph node limit. Patients with rectal cancer who underwent low anterior resection or abdominoperineal amputation between 2000 and 2010 were analyzed. In total, 20,966 patients from 381 hospitals were included. Less than 12 lymph nodes were found in 20.53% of men and 19.31% of women (p = 0.03). The number of lymph nodes yielded increased significantly from 2000, 2005 and 2010 within the quality assurance program for all procedures. The univariate analysis indicated a significant (p < 0.001) correlation between lymph node yield and gender, age, pre-therapeutic T-stage, risk factors and neoadjuvant therapy. The multivariate analyses found T3 stage, female sex, the presence of at least one risk factor and neoadjuvant therapy to have a significant influence on yield. The probability of finding a positive lymph node was proportional to the number of examined nodes with no plateau. There is a proportional relationship between the number of examined lymph nodes and the probability of finding an infiltrated node. Optimal surgical technique and pathological evaluation of the specimen cannot be replaced by a numeric cut-off value.

Squamous Cell Carcinoma of perineal area developed from the Buschke-Löwenstein tumor

The Buschke-Löwenstein tumor is a rare disease associated with human papillomavirus infection. The condition manifests with an ulcerative, exophytic tumor localized in the perineal area. Generally considered as non-cancerous, the growth may develop malignant transformation. Our manuscript highlights the importance of early diagnosis with histopathological analysis.

Increased GPR35 expression in human colorectal and pancreatic cancer samples: A preliminary clinical validation of a new biomarker

BACKGROUND

G protein-coupled receptor 35 (GPR35) is involved in carcinogenesis; however, limited experimental data are available on its actual expression in patients with colorectal cancer (CRC) and pancreatic adenocarcinoma (PDAC).

OBJECTIVES

We aimed to measure the relative expression of GPR35 in samples from patients with CRC or PDAC.

MATERIAL AND METHODS

Using real-time polymerase chain reaction (RT-PCR), we have examined GPR35 expression in surgery samples from 40 CRC and 17 PDAC patients, and performed analysis of the results.

RESULTS

The analysis of GPR35 expression in patients with CRC revealed correlations between relative GPR35 mRNA expression and several tumor characteristics, with statistical significance for higher American Joint Committee on Cancer (AJCC) stages, T stages and histological grades. GPR35 expression was significantly higher in tumor samples compared to the paired healthy samples collected from the same patient. Similar, although not statistically significant trends were found in PDAC tumor samples for sex (lower expression in women) and for samples with no nodal involvement (lower expression). Samples with higher tumor T stages and higher histological grades or considered inoperable had higher GPR35 expression.

CONCLUSIONS

We have identified correlations which confirm our expectation of high GPR35 expression in CRC and PDAC. Our findings suggest the prognostic value of GPR35 testing in patients with an increased risk of CRC or PDAC development, and warrant further clinical confirmation.

On the Way to Improve Diagnostic Marker Panel for Acute Appendicitis in Adults: the Role of Calprotectin

Calprotectin is a positive acute-phase protein participating in innate immune responses and inflammatory processes. This protein is produced mainly in neutrophils, which infiltrate inflamed tissues and then increase the level of calprotectin in plasma, urine, or body secretions. Its measurement is used in the diagnosis of many inflammatory diseases of the gastrointestinal tract. Here, we reviewed the studies evaluating the utility of calprotectin when the patient is suspected of acute appendicitis, one of the most common causes of abdominal pain. Fecal and serum calprotectin provide clinicians additional information as compared to routinely performed laboratory analyses. Moreover, among all forms of the protein, the fecal calprotectin seems to be a particularly promising biomarker due to its high resistance to degradation in the stool. In the future, innovative methods in the form of neural networks may play a valuable role in developing such panels. These findings are important because current literature showed that sensitive and specific markers of acute appendicitis are still urgently needed.

Polymorphism association of NIL1, NIL2, CYP1A1 xenobiotic metabolism genes and their expression with the risk of colorectal cancer in the Polish population

&lt;b&gt;Introduction:&lt;/b&gt; Colorectal cancer (CRC), despite intensive research on the improvement of diagnosis and treatment, is still the second most deadly cancer in Poland in terms of mortality. One of the factors predisposing to a higher risk of CRC may be the individual differences in the effectiveness of proteins responsible for the metabolism of xenobiotics - it seems that the removal of potentially harmful exogenous substances significantly reduces the risk of carcinogenesis. &lt;/br&gt;&lt;/br&gt; &lt;b&gt;Aim:&lt;/b&gt; In this work, we analyzed the effect of polymorphisms of genes responsible for metabolizing xenobiotics on the risk of CRC - rs72554606 polymorphism of N AT 1 gene, rs1799930 polymorphism of N AT 2 gene and rs1799814 polymorphism of CYP1A1 gene, as well as the level of expression of these genes. &lt;/br&gt;&lt;/br&gt; &lt;b&gt; Conclusions:&lt;/b&gt; The results indicate that the GC genotype for N AT 1 and the GA genotype for CYP1A1 may increase the risk of CRC, and in those already diagnosed with colorectal cancer, the expression level of NAT1 is significantly lower than in the control. We believe that these factors may have potential prognostic and diagnostic significance in the treatment of CRC.

Small-molecule inhibitors of the PERK-mediated Unfolded Protein Response signaling pathway in targeted therapy for colorectal cancer

The newest data has reported that endoplasmic reticulum (ER) stress and PERK-dependent Unfolded Protein Response (UPR) signaling pathway may constitute a key factors in colorectal cancer (CRC) pathogenesis on the molecular level. Nowadays used anti-cancer treatment strategies are still insufficient, since patients suffer from various side effects, that are directly evoked via therapeutic agents that are characterized by non-specific action in normal and cancer cells. Thereby, the main aim of the presented research was to analyze the effectiveness of the small-molecule PERK inhibitor NCI 12487 in an in vitro cellular model of CRC. The study was performed on colorectal cancer HT-29 and normal human colon epithelial CCD 841 CoN cell lines. The cytotoxicity was measured by XTT assay, evaluation of apoptosis was performed by caspase-3 assay, whereas cell cycle analysis via the propidium iodide (PI) staining. Results obtained have demonstrated that investigated compound is selective only for HT-29 cancer cells, since at 25 µM concentration it significantly decreased HT-29 cells viability in a dose- and time-dependent manner, evoked increased caspase-3 activity and arrest in G2/M phase of the cell cycle. Moreover, NCI 12487 compound markedly decreased HT-29 cells viability, increased caspase-3 activity and percentage of cells in sub-G0/G1, thus promoted apoptosis of cancer HT-29 cells with induced ER stress conditions. Thus, based on results obtained in this study it may be concluded that small-molecule modulators of the PERK-dependent UPR signaling pathway may constitute an innovative, targeted treatment strategy against CRC.

Colitis-Associated Colorectal Cancer in Patients with Inflammatory Bowel Diseases in a Tertiary Referral Center: A Propensity Score Matching Analysis

Background: Inflammatory bowel disease (IBD) is a risk factor in developing colitis-associated colorectal cancer (CA-CRC). CA-CRC causes the death of about 15% IBD patients and the risk is 1.5–2.4 fold higher among IBD sufferers than in the general population. The dysplasia CA-CRC develops in a different mechanism in comparison to sporadic colorectal cancer (CRC). This study aimed at evaluating the surgical treatment and its outcomes as well as 5-year survival rates in the CA-CRC and sporadic CRC patients. Materials and methods: This single-center, retrospective, propensity score-matched case-control study was conducted with 2204 patients operated on due to primary CRC, who were hospitalized from 2003 to 2019. The CA-CRC group consisted of 49 patients with CRC in the course of IBD. The sporadic CRC group was selected with the propensity score matching technique and comprised 98 patients with sporadic CRC who did not have clinical or histopathological features characteristic for IBD. Results: CA-CRC is characterized by a more aggressive clinical course. Surgical treatment of CA-CRC involves more palliative operations and is related with a higher risk of perioperative and postoperative complications. Further studies of CA-CRC risk factor stratification and the development of molecular markers hold promise in reducing CRC in IBD patients in the future were warranted.

Association of GEMIN4 gene polymorphisms with the risk of colorectal cancer in the Polish population

<br><b>Aim:</b> Gem-associated protein 4 (GEMIN4), a member of the GEMIN gene family, is a key compound of the regulating factors responsible for miRNA biogenesis. Genetic variability within this gene can alter the risk for development of colorectal cancer (CRC) as was shown for other genes involved in miRNA biogenesis. Therefore, presented study was intended to identify genetic variants of three single nucleotide polymorphisms (SNPs) in the GEMIN4 gene (rs1062923, rs2740348 and rs910925) and their relationship with CRC.</br> <br><b>Methods:</b> The study comprised 203 patients and 179 age and sex matched controls. Genotyping of GEMIN4 gene variants was done using Taqman® assay. The association of GEMIN4 variants with CRC was done by odds ratio analysis. Haplotype analysis was done to see the combined effect of studied variants on CRC.</br> <br><b>Results:</b> Patients carrying all variant genotypes for GEMIN4 rs1062923 (odds ratio [OR]= 0.205; 95% confidence interval [CI] = 0.1034–0.4065 for CC variant and [OR] = 0.1436; [CI] = 0.0869–0.2373 for CT variant, respectively) and GEMIN4 rs2740348 (odds ratio [OR] = 0.4498; 95% confidence interval [CI] = 0.2342–0.8637 for CC variant and [OR] = 0.3986; [CI] = 0.2043–0.7776 for CG variant, respectively) showed significant association in lower occurrence of cancer, whereas in case of GEMIN4 G/C rs910925 variant genotype, no significance correlation was found.</br> <br><b>Conclusion:</b> Our study gives a substantive support for the association between the GEMIN4 gene variants/miRNA biogenesis and CRC risk.</br>

Sexual activity in patients after proctocolectomy with ileal pouch-anal anastomosis

&lt;b&gt;Introduction:&lt;/b&gt; Proctocolectomy with ileal pouch-anal anastomosis is the gold standard in the surgical treatment of patients with ulcerative colitis, familial adenomatous polyposis and other colorectal diseases requiring colectomy. The treatment consists in removing the large intestine and creating an intestinal reservoir from the last ileum loop and then anastomosing the intestinal reservoir with the anal canal. Like any surgical procedure, RPC-IPAA also carries the risk of complications, both early and late. Late postoperative complications include sexual dysfunction. &lt;br&gt;&lt;b&gt;Aim:&lt;/b&gt; The main goal of the following work is to assess the quality of life and sexual activity in patients having undergone the RPC-IPAA procedure at the General and Colorectal Surgery Clinic. &lt;br&gt;&lt;b&gt;Material and methods:&lt;/b&gt; The study group consisted of patients aged 19-79 who had been subjected to RPC-IPAA procedures at the General and Colorectal Surgery Clinic in years 2010-2019. The study was conducted on the basis of a survey consisting of 50 questions about the social and mental condition, medical history and previous treatment as well as the quality of sexual life before and after surgery. The scale used for the assessment of the quality of sex life consisted of 5 grades: very low, low, medium, high, very high. Thirty subjects (21 men and 9 women) took part in the survey. Ulcerative colitis (86.6%) was the most common reason for qualification for restorative proctectomy among the examined patients; less common reasons included familial adenomatous polyposis (13.3%) and synchronous colorectal cancer (3.3%). A vast majority of the surgeries had been performed after 10 years' duration of ulcerative colitis, and the intestinal reservoir had been functioning for over a year at the time of the examination. In addition, the effect of taking steroids and the impact of early postoperative complications on the quality of sex life of patients was assessed. &lt;br&gt;&lt;b&gt;Results:&lt;/b&gt; High or very high sexual activity before surgery was reported by 46% of patients whereas low or very low quality was reported by 13%. The rest of the responders assessed their pre-operative sexual activity as average. After surgery, 23% of patients rated their sexual activity as high or very high while 36.6% of patients rated it as low or very low (P = 0.07). It was also noted that taking corticosteroids before surgery decreased the quality of sex life after surgery (P = 0.07 for activity, P = 0.04 for quality). None of the women surveyed used artificial moisturizing of intimate places during sex. Only 1 person stated that they started using artificial moisturization of intimate places after the procedure (P = 0.5). None of the men surveyed had used pharmacological agents to help them obtain an erection before surgery while as many as 33% of responders reported the need for their use after surgery (P = 0.008). Other postoperative sexual dysfunctions were also registered, such as dyspareunia (13.3%), sensory disorder within the intimate region, fecal incontinence, and urinary incontinence. &lt;br&gt;&lt;b&gt;Conclusions:&lt;/b&gt; To sum up, sexual activity and quality of sexual life deteriorated after RPC-IPAA in our patients.

Assessment of DNA damage profile and oxidative /antioxidative biomarker level in patients with inflammatory bowel disease

&lt;b&gt;Aim:&lt;/b&gt; The purpose of this study was to investigate the oxidative DNA damage, pro-antioxidant status in Polish patients with inflammatory bowel disease (IBD). &lt;br&gt;&lt;b&gt;Methods:&lt;/b&gt; Oxidative DNA damage was measured by comet assay techniques; nitric oxide (NO) and plasmatic lipid peroxidation (MDA) as oxidative stress were valuated by colometric methods; superoxide dismutase (SOD1), catalase (CAT) and glutathione peroxidase (GPx1) as antioxidative defense were determined by spectrophotometric methods. &lt;br&gt;&lt;b&gt;Results:&lt;/b&gt; The level of oxidative DNA damage in IBD patients was significantly higher in relation to controls (P = 0.01). Alike, in control subject as well as in patients with IBD, lymphocytes are characterized by complete repair of DNA damage. A significant decrease of SOD (P = 0.031), CAT (P = 0.006), GPx1 (P = 0.001) activity was seen in IBD patients vs control. MDA (P = 0.001) and NO (P = 0.001) concentrations were significantly increased in IBD patients as compared to healthy subjects. &lt;br&gt;&lt;b&gt;Conclusions:&lt;/b&gt; Our results may be due to the induction of DNA repair genes which may occur at the stage of the pathological changes (IBD) that may be caused by excessive oxidative stress. However, the cause of this relationship, and whether it is direct or indirect, remains to be explored.

Current concepts in the pathogenesis of cryptoglandular perianal fistula

Cryptoglandular perianal fistula is a common benign anorectal disorder that is managed mainly with surgery. A fistula is typically defined as a pathological communication between two epithelialized surfaces. More specifically, perianal fistula manifests as an abnormal tract between the anorectal canal and the perianal skin. Perianal fistulas are often characterized by significantly decreased patient quality of life. The cryptoglandular theory of perianal fistulas suggests their development from the proctodeal glands, which originate from the intersphincteric plane and perforate the internal sphincter with their ducts. Involvement of proctodeal glands in the inflammatory process could play a primary role in the formation of cryptoglandular perianal fistula. The objective of this narrative review was to investigate the current knowledge of the pathogenesis of cryptoglandular perianal fistula with the specific aims of characterizing the potential role of proinflammatory factors responsible for the development of chronic inflammation. Further studies are crucial to improve the therapeutic management of cryptoglandular perianal fistulas.

Use of Small-molecule Inhibitory Compound of PERK-dependent Signaling Pathway as a Promising Target-based Therapy for Colorectal Cancer

BACKGROUND

Colorectal cancer constitutes one of the most common cancer with a high mortality rate. The newest data has reported that activation of the pro-apoptotic PERK-dependent unfolded protein response signaling pathway by small-molecule inhibitors may constitute an innovative anti-cancer treatment strategy.

OBJECTIVE

In the presented study, we evaluated the effectiveness of the PERK-dependent unfolded protein response signaling pathway small-molecule inhibitor 42215 both on HT-29 human colon adenocarcinoma and CCD 841 CoN normal human colon epithelial cell lines.

METHODS

Cytotoxicity of the PERK inhibitor was evaluated by the resazurin-based and lactate dehydrogenase (LDH) tests. Apoptotic cell death was measured by flow cytometry using the FITCconjugated Annexin V to indicate apoptosis and propidium iodide to indicate necrosis as well as by colorimetric caspase-3 assay. The effect of tested PERK inhibitor on cell cycle progression was measured by flow cytometry using the propidium iodide staining. The level of the phosphorylated form of the eukaryotic initiation factor 2 alpha was detected by the Western blot technique.

RESULTS

Obtained results showed that investigated PERK inhibitor is selective only toward cancer cells, since inhibited their viability in a dose- and time-dependent manner and induced their apoptosis and G2/M cell cycle arrest. Furthermore, 42215 PERK inhibitor evoked significant inhibition of eIF2α phosphorylation within HT-29 cancer cells.

CONCLUSION

Highly-selective PERK inhibitors may provide a ground-breaking, anti-cancer treatment strategy via activation of the pro-apoptotic branch of the PERK-dependent unfolded protein response signaling pathway.

Phantom pain as an adverse effect after maggot (Lucilia sericata) debridement therapy: a case study

Maggot debridement therapy, also known as larval therapy, is a well known method of treatment for hard-to-heal and intractable wounds. This case study describes severe phantom pain as a rare adverse event of maggot therapy in patients after post-traumatic amputation of the leg. We also hypothesise and discuss the possibility that the phantom pain may be a result of maggot activity, not only through tissue debridement but also through nerve nourishment and nerve regeneration.

The influence of bowel preparation on postoperative complications in surgical treatment of colorectal cancer

Introduction Colorectal cancer is the most common gastrointestinal cancer treated by departments and surgical clinics in Poland. Currently, the biggest challenge of surgery is to reduce the number of leaks in the bowel anastomoses and postoperative wound infections to a minimum. Objective Whether bowel preparation before surgery affects the early results of treatment? Methods The study was retrospective and included patients operated electively on one surgical center due to colorectal and rectal cancer in years 2013-2018. Patients who underwent surgery were divided into two groups in the study. The first was 109 patients with mechanical bowel irrigation. The second group of 118 patients, in addition to mechanical bowel preparation, received an oral antibiotic. Results The studied groups did not differ significantly in terms of traits that could affect the results of treatment within 30 days of surgery. Postoperative mortality was 0,9% and 0,85%. Complications: leakage of the bowel anastomosis 1,8% and 1,7%, postoperative obstruction 3,7% and 5,0%, wound dehiscence 2,75% and 0,85%, infection of the surgical site 13,8% and 3,4% respectively in the first and second group of patients. Conclusion 1. Mechanical bowel preparation in combination with the oral supply of antibiotic significantly reduces the frequency of surgical site infection compared to the mechanical rinsing itself. 2. Type of preparation of the intestine before the surgery does not significantly affect postoperative mortality and other complications, including anastomotic leak, but may be important for the frequency of postoperative wound dehiscence.

Sexual dysfunctions following low anterior resection of the rectum in rectal cancer patients

INTRODUCTION

Low anterior resection of the rectum (LAR) is a treatment of choice in patients with diagnosed low rectal cancer. Rectal cancer surgery has a close relationship with the urinary-sexual organs and also with related nerves and nerve plexus. Thus, the sympathetic and parasympathetic nerves of the pelvic area may be damaged. As a result of this, the important point is the sexual function loss following rectal surgeries. The aim of the study was to investigate the sexual disorders in patients with rectal cancer who underwent LAR.

MATERIALS AND METHODS

In this retrospective study the sexual activity, comfort of the experience, quality of sexual life (QoSL) during 3 periods were analyzed: before surgery, a month after and half a year after surgery. Analysis of demographic characteristics, comorbidities, previous surgeries, toumor characteristics and adjuvant therapy as was performed.

RESULTS

Most patients (64/100, 64%) expressed that LAR operation has strongly affected their QoSL, 32 patients reported the mild decrease in QoSL, while only 4 patients stated that did not experience any changes in QoSL. QoSL was assessed in 3 different periods of time: before the operation, 1 month after and 6 months after the operation (22,6±3.7 vs. 11.3±7,9 vs. 17,0±6.3; p&lt;0.0001 respectively). The decreased QoSL one and six months after the surgery were significantly lower in patients with diagnosed hypertension and higher BMI (p=0.0283).

CONCLUSIONS

Sexual disorders after LAR for rectal cancer are often underestimated and it is very important to be aware of them. In our study, it was determined that male sex, higher BMI and hypertension are related to impair of sexual dysfunction after LAR. We observed that the most severe complaints related to sexual activity occur one month after the procedure, after 6 months in most of the patients&apos; sexual disorders were decreased approaching the initial state.

Presacral tumors: diagnosis and treatment - a challenge for a surgeon

INTRODUCTION

Presacral tumors are a rare group of heterogeneous lesions located in a potential space referred to as the retrorectal or presacral space. Lack of characteristic symptomatology and difficult anatomical localization make the diagnosis and management challenging for a surgeon. The aim of this study was to analyze cases of presacral tumors that underwent surgical treatment with regard to diagnostics, methods and outcomes.

MATERIAL AND METHODS

The study enrolled patients who underwent surgical treatment at the Department of General and Colorectal Surgery, Medical University of Lodz. The data was analyzed for age, gender, clinical symptoms, type of diagnostic procedures conducted, histopathology results, type of treatment implemented, intra- and perioperative complications as well as early and long-term treatment outcomes.

RESULTS

The study enrolled 29 patients who underwent surgical treatment for presacral tumors. Malignant tumors accounted for 34% of all cases (n = 10), and 80% of them occurred in men. Benign cases accounted for 66% of cases (n = 19), and they occurred predominantly in women (58%). Malignant lesions were more common in men (p < 0.05). The average age of patients with benign tumors was lower than that of patients with malignant tumors (p < 0.05). The transsacral approach was used in 51% of patients, abdominal laparotomy in 41% and a combined approach in 7%. Cure was achieved in 72% of patients, including 67% who were cured after their initial surgery.

CONCLUSIONS

Presacral tumors are more common in men and more commonly are malignant tumors in this group. The success rate of surgical treatment is 72%, and selection of the surgical approach does not affect the final treatment outcome.

Association of XRCC6 C1310G and LIG4 T9I polymorphisms of NHEJ DNA repair pathway with risk of colorectal cancer in the Polish population

Introduction: Colorectal cancer is the second most common cancer worldwide. DNA double strand breaks (DSBs) are the most dangerous lesions which can lead to carcinogenesis. Nonhomologous end joining (NHEJ) is an important pathway, that allows for recovering DNA by direct end joining. The XRCC6 and LIG4 genes encode respectively Ku70 protein and human ATP-dependent DNA ligase, which are the components of the NHEJ repair pathway. The aim of our study was to evaluate the influence of XRCC6 C1310G and LIG4 T9I genes polymorphisms on colorectal cancer risk among Polish population. Materials and method: Genotyping was performed using TaqMan probes based on analysis of PCR products amplified in Real Time PCR. The research has been carried out on the material obtained from 100 patients with colorectal cancer and 100 cancer-free individuals who were age and sex-matched as a control group. The results were developed using the chi – squer test and odds ratio (OR). Results: Odd ratio analysis indicates reduced risk of colorectal cancer for LIG4 T9I polymorphism in heterozygotus model C/T (OR= 0.2717 95% CI= 0.1247-0,5918) and homozygous model T/T (OR= 0.3593 95% CI= 0.1394-0.9266). Similar situation we observed for XRCC6 C1310G gene polymorphism, which indicated on heterozygotus variant C/G (OR= 0.1181 95% CI= 0.0145-0.964) and homozygotus variant G/G (OR= 0.0972 95% CI= 0.0097-0.9713) to decrease the risk of colorectal cancer. Conslusions: Our research revealed XRCC6 C1310G and LIG4 T9I polymorphisms are associated with diminished risk of colorectal cancer. However, to confirm obtained results, a further investigations should be carried out.

Preferences of patients with inflammatory bowel disease for receiving specialized health services using technology: the role of Internet and other sources of medical information

INTRODUCTION

It is notable that patients with inflammatory bowel disease (IBD) have insufficient knowledge about their disease and are willing to be more involved in their treatment. Nowadays medical information is easily available and health-related topics state the third most frequent reason for using the Internet. Therefore, patient's health-related self-awareness and willingness to take part in medical decisions have improved. The possibility of choice of specialized health services may have a positive effect on patient's satisfaction. The aim of the study was to characterize the extent of Internet use for health information among a representative sample of IBD patients and to examine the effects that Internet and other sources of information about specialized health services have on patients' choices of a doctor and hospital department.

MATERIALS AND METHODS

In total, 135 IBD patients admitted to the Department of General and Colorectal Surgery at Medical University of Lodz were asked to complete an anonymous questionnaire. Only 123 fully completed questionnaires were included for analysis. The study group involved 68 women and 55 men.

RESULTS

A total of 85.4% IBD patients used Internet in order to gather medical information about their disease. Age of those patients was significantly lower than of those patients who did not use Internet. The most reliable source of information about physicians was Internet. Opinions and recommendations gathered from the Internet have a notable influence on patients' preference of hospital department and attending physician.

CONCLUSIONS

A majority of patients used Internet as a source of medical information related to IBD. Opinions obtained from the Internet seem to be the most reliable regarding attending physicians treating IBD patients.

An association of the MCP-1 and CCR2 single nucleotide polymorphisms with colorectal cancer prevalence

The aim of the study: We evaluated the connection between the presence of the -2518 A/G MCP-1 as well as 190 G/A CCR2 polymorphic variants and colorectal cancer (CRC) occurrence. Material and methods: Study group consisted of subjects with different stages of CRC as well as healthy controls. Genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Results: W observed an association between the colorectal cancer and the GG genotype of the -2518 A/G MCP-1 single nucleotide polymorphism. No statistically significant correlation was found between CRC and the 190 G/A CCR2 polymorphism. Conclusion: The results of this study support the hypothesis that polymorphism in the MCP-1 gene may contribute to the etiology of colorectal cancer.

Inhibition of PERK-dependent pro-adaptive signaling pathway as a promising approach for cancer treatment

Endoplasmic Reticulum (ER) is an organelle that is vital for cell growth and maintenance of homeostasis. Recent studies have reported that numerous human diseases, including cancer, are strictly connected to disruption of ER homeostasis. In order to counteract adverse intracellular conditions, cancer cells induce protein kinase R (PKR)-like endoplasmic reticulum kinase (PERK)-dependent, pro-adaptive unfolded protein response (UPR) signaling branches. If ER stress is severe or prolonged, pro-adaptive signaling networks are insufficient, resulting in apoptotic cell death of cancer cells. The main aim: of the study was to evaluate the biological activity of a small-molecule PERK inhibitor GSK2606414 in two cancer cell lines - human neuroblastoma (SH-SY5Y) and human colorectal adenocarcinoma (HT-29) cell lines. We analyzed the level of phosphorylation of the eukaryotic initiation factor 2 (eIF2), which is the main substrate of PERK and a subsequent activator of UPR, which under long-term ER stress may evoke apoptotic death of cancer cells.

MATERIAL AND METHODS

In the study, we utilized commercially available cell lines of human colorectal adenocarcinoma HT-29 and human neuroblastoma SH-SY5Y. Cells were exposed to the tested PERK-dependent signaling inhibitor GSK2606414 in suitable culture media with addition of thapsigargin (500 nM) to induce ER stress. To identify the protein, Western blot with specific antibodies was used. Detection of immune complexes was performed using chemiluminescence.

RESULTS

We found a complete inhibition of p-eIF2α expression due to the GSK2606414 inhibitor in both cell lines, SH-SY5Y and HT-29.

CONCLUSIONS

Currently available cancer treatments are insufficient and cause various side effects. It has been assumed that utilization of small-molecule inhibitors of the PERK-dependent signaling pathway, like GSK2606414, may switch the pro-adaptive branch of UPR to its pro-apoptotic branch. It is believed that the tested inhibitor GSK2606414 may become a promising treatment for many cancer types.

Inhibition of PERK-dependent pro-adaptive signaling pathway as a promising approach for cancer treatment

Endoplasmic Reticulum (ER) is an organelle that is vital for cell growth and maintenance of homeostasis. Recent studies have reported that numerous human diseases, including cancer, are strictly connected to disruption of ER homeostasis. In order to counteract adverse intracellular conditions, cancer cells induce protein kinase R (PKR)-like endoplasmic reticulum kinase (PERK)-dependent, pro-adaptive unfolded protein response (UPR) signaling branches. If ER stress is severe or prolonged, pro-adaptive signaling networks are insufficient, resulting in apoptotic cell death of cancer cells. The main aim: of the study was to evaluate the biological activity of a small-molecule PERK inhibitor GSK2606414 in two cancer cell lines - human neuroblastoma (SH-SY5Y) and human colorectal adenocarcinoma (HT-29) cell lines. We analyzed the level of phosphorylation of the eukaryotic initiation factor 2 (eIF2), which is the main substrate of PERK and a subsequent activator of UPR, which under long-term ER stress may evoke apoptotic death of cancer cells. Material and methods: In the study, we utilized commercially available cell lines of human colorectal adenocarcinoma HT-29 and human neuroblastoma SH-SY5Y. Cells were exposed to the tested PERK-dependent signaling inhibitor GSK2606414 in suitable culture media with addition of thapsigargin (500 nM) to induce ER stress. To identify the protein, Western blot with specific antibodies was used. Detection of immune complexes was performed using chemiluminescence. Results: We found a complete inhibition of p-eIF2α expression due to the GSK2606414 inhibitor in both cell lines, SH-SY5Y and HT-29. Conclusions: Currently available cancer treatments are insufficient and cause various side effects. It has been assumed that utilization of small-molecule inhibitors of the PERK-dependent signaling pathway, like GSK2606414, may switch the pro-adaptive branch of UPR to its pro-apoptotic branch. It is believed that the tested inhibitor GSK2606414 may become a promising treatment for many cancer types.

Evaluation of Effect CAT -262C/T, SOD + 35A/C, GPx1 Pro197Leu Polymorphisms in Patients with IBD in the Polish Population

Inflammatory bowel disease (IBD) are a heterogeneous group of disorders in the course dominated by chronic, recurrent gastrointestinal inflammation. It is believed that the activation of IBD occurs in patients with a genetic predisposition to their development. Chronic inflammation develops as a result of an excessive reaction of the immune system principally under the influence of environmental risk factors. Among them, it has been shown that the mechanism of oxidative stress is associated with the pathophysiology of inflammatory bowel disease, responsible for the commencement and progress of these diseases. The aim of the study was the relationship between single nucleotide polymorphisms (SNPs) of individual antioxidant enzymes, and the prevalence of inflammatory bowel disease that may be associated with increased levels of oxidative stress.

MATERIAL AND METHODS

A total of 111 IBD patients, including 65 patients with ulcerative colitis (UC) and 46 with Crohn's disease (CD) and 125 healthy controls recruited from the Polish population, were genotyped for CAT -262C / T (rs1001179), SOD + 35A / C (rs2234694), GPx Pro 197 Leu polymorphisms. Genotyping of CAT, SOD, GPx gene polymorphism was performed by a RFLP-PCR.

RESULTS

The performed analysis of genetic polymorphisms of antioxidant enzymes showed that polymorphic variant of the CAT -262 C / T may have protective effects in patients with ulcerative colitis in the range of genotype C / T; OR = 0.49 (0.25-0.99), p = 0.044. Trend protective, but statistically unrelated, it was also observed for genotype T / T and T allele of the same polymorphism and genotypes and alleles + 35A / C SOD1 in UC as well as polymorphic variants CAT -262 C / T, Pro197Leu of GPx1, + 35A / C SOD1 in CD. The results were compared with a control group of potentially healthy individuals without such diseases.

CONCLUSIONS

It has been shown that the polymorphism of antioxidant enzymes CAT gene -262 C / T may have protective effects in patients who are carriers of a genotype C / T at the UC. The potential protective effect without statistical relationships were also observed for other genotypes and alleles studied polymorphic variants of antioxidant enzymes in CD and CAT- 262C / T and + 35 A / C SOD1 in UC. Conducted our audit should be extended to more group of patients in order to assess whether or not to confirm the observed during analysis, the protective effect of CAT-262 C / T in ulcerative colitis and other trends observed for other polymorphic variants tested genes.

Risk factors of 30-day mortality following surgery for colorectal cancer

The 30-day mortality is one of the factors reflecting the quality of treatment. All these efforts focused on decreasing 30-day mortality will directly improve quality of care. The aim of the study was to identify risk factors of 30-day postoperative mortality in a cohort of patients operated on for colorectal cancer in one tertiary colorectal centre.

MATERIAL AND METHODS

Patients operated on due to colorectal cancer (CRC) between 2008 and 2014 were included in the study. 30-day mortality was assessed as an endpoint of the retrospective study. All records were collected from prospective database.

RESULTS

1744 patients were operated on due to CRC. The 30-day mortality was noted in 65 patients (3.5%). In multivariable analyses we revealed that spread disease and poor general condition at admission were risk factors of 30-day mortality: OR 2.35; 2.01-2.57 95%CI, p=0.03 and OR 2.18; 1.95-2.41 95% CI; p=0.01, respectively. Emergency surgery significantly increased the risk of 30-day mortality: OR 2.64; 2.45-2.87 95%CI; p=0.009. Low serum albumin concentration level and diabetes mellitus were additional risk factors for 30-day mortality, OR 1.65; 1.52-1.78 95%CI; p=0.01 and OR 1.67; 1.41-1.82 95%CI; p=0.03, respectively. Mortality was significantly higher after resection procedures than after only palliative operations: 4.21% vs 1.57%; p=0.002.

CONCLUSIONS

Emergent patients, patients with advanced disease and in poor general state have to be assessed by multidisciplinary team to prepare them to operation. Additionally to reduce the risk of 30-day mortality decision of extend of surgery should be made by experienced surgeons.

Patients' Awareness Of The Prevention And Treatment Of Colorectal Cancer

The aim of the study was to assess patients' awareness of the prevention and treatment of colorectal cancer.

MATERIAL AND METHODS

Patients diagnosed with colorectal cancer, hospitalised at the Department of General and Colorectal Surgery of the Medical University in Łódź during the period from January 2015 to April 2015, were asked to complete a questionnaire concerning their families' medical case record, factors predisposing them to the development of colorectal cancer, the tests applied in diagnostics, and the treatment process. The questionnaire comprised 42 closed-ended questions with one correct answer. A statistical analysis of all answers was carried out.

RESULTS

The study group consisted of 30 men and 20 women aged 27-94 years old. A strong, statistically significant negative correlation between a patient's age and his/her awareness of the prevention and treatment of colorectal cancer was noted (p<0.001; r= -0.51). The study demonstrated a statistically significant relationship between the occurrence of neoplasms in a patient's family (p=0.009) or, more specifically, the occurrence of colorectal cancer (p=0.008), and the awareness of the prevention programme. The women's group was characterised by statistically significantly greater awareness of colonoscopy as a screening examination (p=0.004).

CONCLUSIONS

Patients need more information on colorectal cancer, its risk factors, prevention, the treatment process, and postoperative care. Lack of awareness of the colorectal cancer issue can be one of the major factors contributing to the high incidence of this disease.

Treatment of Perianal Fistulas in Poland

A perianal fistula is a pathological canal covered by granulation tissue connecting the anal canal and perianal area epidermis. The above-mentioned problem is the reason for the patient to visit the surgeonproctologist. Unfortunately, the disease is characterized by a high recurrence rate, even despite proper management. The aim of the study was to determine the current condition of perianal fistula treatment methods in everyday surgical practice, considering members of the Society of Polish Surgeons.

MATERIAL AND METHODS

1523 members of the Society of Polish Surgeons received an anonymous questionnaire comprising 15 questions regarding perianal fistula treatment in everyday practice.

RESULTS

Results were obtained from 807 (53%) members. After receiving answers, questionnaire results were collected, analysed, and presented in a descriptive form.

CONCLUSIONS

Study results showed that most Polish surgeons choose the fistulectomy/fistulotomy method. Considering treatment of perianal fistulas the most important issue is to find the correct, primary fistula canal. Further methods should be individually selected for each patient. One should also remember that every fistula is different. Surgical departments that operate a small number of perianal fistulas should direct such patients to reference centers.

Expression of the PLS3 Gene in Circulating Cells in Patients with Colorectal Cancer

Circulating tumor cells (CTC) are cells in circulating blood that have the antigen and gene features of tumor cells of a specific type. Since they can be potentially used in diagnostics and monitoring of treatment of many tumors, they have been attracting attention of researchers worldwide. Plastin-3 (PL S3) is one of such markers of CTC. The aim of the study was to assess expression of PL S3 in CTC in patients with colorectal cancer, to conduct a statistical analysis and to demonstrate a link between expression of PL S3 and progress of the disease, level of CEA and Ca19-9 markers, gender and age of the patients.

MATERIAL AND METHODS

A group of 85 patients of the Department of General and Colorectal Surgery of the Medical University in Łódź were enrolled in this study. Circulating tumor cells were isolated from whole blood of patients with colorectal cancer and an analysis of PL S3 gene expression in CTC was conducted. The next step was to conduct a statistical analysis and to demonstrate a link between expression of PL S3 in patients' CTC and progress of the disease, level of CEA and Ca 19-9 markers, gender and age of the patients.

RESULTS

PL S3 is a marker which can be potentially used in prediction and monitoring of colorectal cancer. A link between expression of PL S3 in CTC of patients with colorectal cancer and metastasis to lymph nodes has been demonstrated. It may be of key importance how PL S3 could impact the qualification to supplementary cancer treatment in patients with stage II colorectal cancer. A link between expression of PL S3 gene in CTC and gender requires further in-depth studies. It is beyond doubt that PL S3 must be further investigated to determine its role in diagnostics, prediction, treatment and monitoring of treatment of colorectal cancer.

Comfort During Digital Rectal Examination - Patient Preference

The sex and age of the physician performing the digital rectal examination (DRE) procedure is one of the parameters influencing patients' comfort. It is postulated that the stress related to DRE during admission to the surgical ward may affect the compliance. The aim of the study was to characterize patients' preferences according to their sex, age, socioeconomic status and according to DRE-related variables.

MATERIAL AND METHODS

Patients admitted to the Department of General and Colorectal Surgery at Medical University in Łódź between October 2014 and June 2015 were asked to complete a questionnaire regarding their sex, age, ethnic background, socioeconomic status and preference for a physician performing the DRE during admission to the surgical ward.

RESULTS

The study enrolled 225 patients, 52% (n=117) women and 48% (n=108) men. Most patients 73.3% (n=244) expressed no preference for sex of the physician performing the DRE during admission, while 22.7% (n=51) preferred a same-sex physician. Analysis showed that the age, female sex, lower education status, small amount of comorbidities and number of hospitalizations, and no previous colonoscopy experience were all associated with preference for a same-sex physician.

CONCLUSIONS

In our study most patients expressed no preference for sex of the physician performing the DRE during admission to the surgical ward. However, over one-tenth of patients reported such preferences. Most of these patients preferred a same-sex physician. It is important to offer these patients the choice of physician performing the DRE. Addressing patients' preferences may improve the atmosphere in the clinical environment, reduce stress, and facilitate better treatment.

Impact of APEX Ile64val Gene Polymorphisms of DNA Repair Ber System on Modulation of the Risk of Colorectal Cancer in the Polish Population

Colorectal cancer (CRC) is one of the deadliest cancers which lie in the incidence of morbidity in second place. Intensive research is to determine and confirm the genetic basis of this disease, which is believed may have a direct relationship with the reduced efficiency of DNA repair systems. The aim of this study was to determine the effect of APEX gene polymorphism Ile64Val on increasing the risk of colorectal cancer in the Polish population.

MATERIAL AND METHODS

The blood samples collected from 150 patients diagnosed with colon cancer was used. The control group consisted of 150 healthy subjects. Genotyping was performed by TaqMan method.

RESULTS

The results indicate that genotype Ile Val is associated with an increased risk of colorectal cancer (OR 2.069; 95% CI 1,205-3,552; p = 0.008).

CONCLUSIONS

Based on these results, we conclude that the APEX gene polymorphism Ile64Val may be associated with an increased risk of colorectal cancer.

Formalin therapy for hemorrhagic radiation proctitis

BACKGROUND

Radiotherapy within pelvis is a vital component of curative therapy for urological, gynecological and rectal malignances. Rectum is especially vulnerable to secondary radiation injury resulting in proctitis. The most common and life-threatening symptom is rectal hemorrhage. Formalin application into the rectum causes local cauterization of telangiectatic mucosal vessels. The aim of our study was to assess the efficacy of local formalin application in patients with hemorrhagic radiation proctitis.

METHODS

A solution of 4.0% formalin was used in the treatment of 20 patients with clinical and proctoscopic evidence of radiadion proctitis. Treatment involved direct application of 4.0% formalin into the rectum. All patients were followed-up in terms of complete resolution of symptoms or recurrences of bleeding.

RESULTS

A total of 20 patients with a mean age of 69.7 (range, 57-80) years were followed for 51.2 (range, 1-93) months. The mean duration of symptoms was 4.5 (range, 1-10) months and the interval between the end of radiotherapy and symptoms was mostly between 5 and 30 months. Patients required an average of 2 (range, 1-5) formalin treatments. Of the 20 patients, 10 had complete resolution of their symptoms after their first treatment. In 10 patients bleeding recurred and they were offered another formalin instillation and/or 5-ASA suppositories and argon therapy. Complete resolution of symptoms was achieved in all patients.

CONCLUSIONS

Topical formalin instillation is effective, safe, and well-tolerated method for the patients with radiation proctopathy. This therapy may be repeated in case of recurrent bleeding and combined with other methods of treatment.

Evaluation of the early results of a loop stoma with a plastic rod in comparison to a loop stoma made with a skin bridge

Loop stoma allows reducing the percentage of anastomotic leak and re-operation caused by this complication. Our department has performed the loop stoma on a skin bridge since 2011. The aim of the study was to evaluate the early results of treatment after the skin bridge loop stoma creation in comparison with the stoma made on a plastic rod. Both groups had 20 patients.

MATERIAL AND METHODS

The study involved 40 patients with ileostomy, operated 2010-2013. We evaluated 20 patients with a loop ileostomy on a plastic rod, compared to 20 other patients with a skinbridge ileostomy. The study included 24 men and 16 women. Median age was 68.3. All evaluated patients were previously operated due to rectal cancer.

RESULTS

It has been shown that the surgical site infection is more common in the group with a plastic rod (5 vs 1 patient). Inflammation of the skin around the stoma occurred in 18 patients (90%) in the first group, while no such complication was found in patients in the second group. The average number of exchanged ostomy wafers was 2.9 per week in the first group of patients, and 1,1 in the second group (p 0.05).

CONCLUSIONS

The creation of the skin bridge stoma allows for tight fit of the ostomy appliance immediately after surgery completion. The equipment has stable and long-lasting contact with the skin, no skin inflammatory changes occur. Also the surgical site infection rates are lower in this group of patients. As perioperative patient does not require an increased number of ostomy appliance, the cost of treatment can be considered as an important aspect.

Evaluation Of Antioxidant Defense In Patients With Colorectal Carcinoma

Cancers are among the most feared diseases of modern civilization. In Poland, colorectal cancer is one of the tumors with the worst prognosis. The ability to cure is primarily dependent on the stage of the disease at the time of diagnosis.

was evaluate antioxidant response in patients with colorectal carcinoma.

Twenty patients (14 men and 6 women) aged 61.9± 11.1 years with colorectal cancer were included in the study. Twenty healthy subjects (4 men and 16 women) aged 64 ± 15.3 years formed the control group. The erythrocyte activities of antioxidant enzymes, superoxide dismutase (SOD), and glutathione peroxidase (GPx),

A significant increase of GPx, and SOD (p < 0.05) were seen in patients compared to healthy controls.

The results indicate that the tested antioxidant enzyme activity of glutathione peroxidase and superoxide dismutase is increased in patients diagnosed with colorectal cancer compared to the control group.

Colorectal cancer mortality in Poland - analysis of regional variation

INTRODUCTION

In 1999 in Poland 7,139 people died of colon cancer, while in 2008 this number rose to 9,915. Among malignant tumours, colorectal cancer is the second most commonly occurring one, frequently leading to death. The main reason for this is the fact that in 50% of patients with this cancer the illness is diagnosed at an advanced stage already. The risk increases significantly after 60 years of age. The aim of study was analysing the mortality of patients with colorectal cancer over 10 years in Poland (1999-2008), in both men and women from all provinces in the country.

MATERIAL AND METHODS

The basis for the study was the number of deaths caused by colorectal cancer taking into account sex. Statistical data were drawn from the National Cancer Registry.

RESULTS

In 1999 in Poland 3,706 men and 3,433 women died of colorectal cancer, while in 2008 the number of deaths stood at 5,385 and 4,530 respectively. In the years 1999-2008, colorectal cancer mortality rates among men were approximately 1.5 times higher than among women, and the majority of provinces demonstrate an upward trend. Among women the differences in the values of the coefficients are less clear.

CONCLUSIONS

Early detection of cancer could significantly reduce mortality among patients with colon cancer. Screening for colorectal cancer and colonoscopy are tests that should permanently become a part of preventive measures aimed at detecting disease and teaching risk factors, particularly in males and people over 60 years of age.

Incidence of colorectal cancer in Poland in 1999-2008

INTRODUCTION

Malignant neoplasm of the colon is one of the most common gastrointestinal cancers and takes the second place in terms of incidence in the world. In Asian countries compared with Western countries the incidence is a bit lower. In recent years in Poland there has been a disturbing increase in the incidence of this cancer, particularly in the voivodships Mazowieckie, Slaskie, and Wielkopolskie.

MATERIAL AND METHODS

Statistical data from the National Cancer Registry on the incidence of colorectal cancer in Poland in 1999-2008, including the provinces which are grouped into provinces of Eastern, Western and Central Poland. We analysed data on both men and women, with the division of colon cancer, rectal folds esico and rectum. The analysis took into account the recognized incidence in absolute numbers and age-standardized incidence rates.

RESULTS

The incidence of colon cancer in 1999 was 3438 cases among men and 3476 women, while in 2008 this number increased in both men and women and for men was 4763, and 4340 for women. In all Polish provinces, in 1999, 2165 men and 1719 women, and in 2008, 3188 men and 2150 women suffered from rectal cancer.

CONCLUSIONS

In the years 1999-2008 there was an increase in incidence of cancer of the colon. In Poland, there are territorial differences in the incidence of colorectal cancer described by the standardized incidence ratio. The incidence in Western and Central Poland is generally higher than for Eastern Poland. Probably, these differences have multiple bases.

[Etiology of colorectal cancer and antioxidant barrier of the organism]

Colorectal cancer is a serious medical and economic problem in Poland, as the detection and results of its treatment are very low. Due to this fact, medical research is still conducted in order to find out the symptoms of this tumor and proper preventive measures. According to one hypothesis of carcinogenesis, the process of creating the tumor begins and develops when the balance between the production of reactive oxygen species (ROS) and their deactivation by the "antioxidant protective barrier of the organism" is disturbed. As a result of this theory, it has been decided to examine the plasma concentration of the dietary minerals which work as antioxidants. The results entailed conclusions which prove the free radicals theory of carcinogenesis. They also confirm the part which the antioxidant protective barrier plays in the defence against ROS and their carcinogenic consequences.

[Influence of copper (II) complex on the activity of selected oxidative enzymes]

Coxarthrosis results in physical limitations (hypokinesis) and a necessity to change one's life style to the one that does not require much movement. Physical inactivity leads rapidly to metabolic processes inhibition. The processes of protein, carbohydrate and lipid catabolism intensify. Abnormal metabolism of polyunsaturated fatty acids occurs, which consequently leads to the development of reactive oxygen species (ROS) and to the acceleration of lipid peroxidation. Therefore, it is well-founded to seek for a new group of compounds demonstrating interesting biochemical properties. Among such already known compounds are chromone, azole and flavone derivatives, known for their oxidative properties. The aim of the study was to assess the antioxidant enzymes: catalase (CAT) and glutathione peroxidase (GPX) in erythrocytes in 25 patients suffering from coxarthrosis in comparison with healthy persons.

MATERIALS AND METHODS

The activity of catalase was determined in erythrocytes using the method of Beers and Sizer at 240 nm on the Beckman spectrophotometer. The activity of glutathione peroxidase was estimated using the method of Little and O'Brien at 412 nm on the Beckman spectrophotometer. The research was conducted with the permit of the Bioethics Committee No RNN/260/08/KB dated 20.05.2008. Blood for the tests was taken from periulnar vein to anticoagulant tubes (EDTA). The group consisted of 25 patients hospitalized in the Trauma and Orthopaedic Ward of the Hospital in Łódź.

RESULTS

The results of the tests on erythrocytes in the patients with physical limitations reveal the increase of glutathione peroxidase and catalase activity by about 50% in all patients, who were administered the dichlorobis (N1-dichloromethyl-3,5-dimethylpyrazole, copper (II) compound in comparison to the control group, where the foregoing compound was not used.

CONCLUSION

The research results significantly emphasise that adding of new chemical compounds to blood in investigation of oxidative properties has a considerable influence on the activity of the selected enzymes (catalase and glutathione peroxidase) in comparison to the control group. The research reveals an increase of the activity of all antioxidant enzymes, where newly synthesized chemical compounds were used. The results of antioxidative capacity tests confirmed that complex compounds with Cu (II) ions have a significant influence on the antioxidative status. The studies on the foregoing enzymes also indicate that overproduced free radicals participate in the whole course of the coxarthrosis.

[Activity of selected antioxidant enzymes examination in people with colorectal cancer]

Colorectal cancer is a serious medical problem. According to one hypothesis of carcinogenesis, tumour creation process begins and develops when the balance between the production of reactive oxygen species (ROS) and their disactivation by the antioxidant protective barrier of the organism is disturbed. THE AIM OF THE STUDY was, following this theory, to examine the plasma concentration of the dietary minerals with antioxidant properties.

MATERIAL AND METHODS

The research material was the blood of 8 people, taken to vacuum test tubes with an anticoagulant - 4 ml of sodium heparin. The activity of catalase was marked following Beers method, while the activity of superoxide dismutase according to H.P. Misra and J. Fridovich method.

RESULTS

The results show that the copper complex added, i.e. dichlorine(3,4,5-trimethyl-N1 - pyrazol-1yl) Cu(II) from derivatives of azoles, has a large impact on the activity of selected enzymes. After adding it, their activity increased by ca 67% in comparison with the control group. It proves the efficacy of this compound.

CONCLUSIONS

The results prove the free radicals theory of carcinogenesis. They also confirm the part which the antioxidant protective barrier plays in the defense against ROS and their carcinogenic consequences.