Cryptosporidiosis in Patients with Colorectal Cancer

Parasitological examination of feces was carried out for 55 patients with diagnosed colorectal cancer before chemotherapy. Except for Cryptosporidium sp., no other intestinal parasites were found in the specimens; moreover, only the patients with watery diarrhea were Cryptosporidium sp.-positive by enzyme immunoassay. Prevalence of infection in the group of patients with diarrhea (23 persons) was 43.5%, whereas it was 18% for the entire group of patients under study. Coproantigens of this parasite were detected primarily in the patients with tumors located on the left side (in the sigmoid and descending colon).

[Vitamin C and uric acid concentrations in plasma and gastric mucosa in patients regularly consuming vegetables, fruits and fruit juices]

Vitamin C (Asc) as a reactive oxygen species scavenger inhibits detrimental oxidation reactions and counteracts formation of mutagenic compounds which damage DNA in the gastric and duodenal mucosa. It has been considered as an important factor in reducing risk of gastric carcinoma. However, the role of uric acid (UA) as an antioxidant factor and its influence on gastric mucosa has not been so well investigated. The aim of the study was to evaluate the relationship between vegetable, fruit and fruit juices intake and water soluble antioxidant (Asc and UA) concentrations in plasma and gastric mucosa. The study also assessed the prevalence and intensity of inflammatory changes in mucosa and Helicobacter pylori infection. 34 patients participated in the study. Asc and UA concentrations in plasma and gastric mucosa samples were examined with the use of liquid chromatography (HPLC) method. Histopathological examinations of gastric mucosa were also performed. Higher concentrations of Asc and UA in plasma and less frequent inflammatory changes of gastric mucosa were found in patients regularly consuming vegetables and fruits. It may suggest the protective effect of these compounds on mucosa. No significant relationship was found between H. pylori infection and antioxidant concentrations in plasma and gastric tissue in patients with chronic gastritis.

CONCLUSIONS

Diet rich in fruits, vegetables and fruit juices helps in reducing prevalence of inflammatory changes in gastric mucosa. It can be associated with higher Asc and UA concentrations in plasma and higher UA concentrations in gastric mucosa. Lower Asc and UA concentrations in patients with gastritis have no significant relationship with H. pylori infection.

[Strongyloidosis--a case report]

A case of Strongyloides stercoralis infection was described.

[Disseminated tuberculosis--diagnostic difficulties in a patient with chronic heart failure]

We presented case 64 year old patient with disseminated tuberculosis. The main symptom was fever and his death was due to respiratory and circulatory failure. In spite of extensive diagnostic research the aetiology of sepsis was not identified and the treatment was ineffective. In patients with severe disseminated tuberculosis the traditional diagnostic methods are often not effective.

[Effect of hydroxylation polymorphism on the concentration of propranolol in the blood of humans with hyperlipidemia]

An influence of hydroxylation phenotype on the concentration of propranolol [corrected] was examined in 52 subjects with hyperlipidemia divided into 4 groups: 1--control, normolipemic, 2--hypercholesterolemic, 3--hypertriglyceridemic, and 4--mixed-form hyperlipidemic. Each study group included extensive metabolizers and one subject characterized by a poor hydroxylation phenotype. Propranolol was given intragastrically at a single dose of 80 mg [corrected]. Blood was sampled within 24 hours following the drug administration. HPLC method was used for determining blood serum concentrations of propranolol. In each study group mean blood serum concentrations of propranolol in poor metabolizers were at maximum in subject with hypertriglyceridemia, at minimum in the normolipemic one, and intermediate in hypercholesterolemic (upper) and mixed-form hyperlipidemic ones. Lipid metabolic disturbances also affected blood serum concentrations. They were the highest in hypertriglyceridemic patients, whereas in hypercholesterolemic were, in early stage of observation, even lower then in normolipemic subjects. Blood serum concentrations of propranolol [corrected] attained minimal values in patients with mixed form of hyperlipidemia. In the light of the present study we can state that hyperlipidemia modifies the blood serum concentrations of propranolol [corrected]. Although, the type of hyperlipidemia and lipophilic propranolol are not the only determinants affecting blood serum concentrations of propranolol, but also a genetic factor, i.e. hydroxylation phenotype may play an important role.

Clinico-pathological characteristics of colorectal cancer and serum anti-p53 antibodies

The purpose of this study was to correlate the presence of p53 antibodies in sera of patients with colorectal adenocarcinoma with size, site and stage of the tumour, age and sex of a patient and the level of carcinoembryonic antigen (CEA) in the serum. p53 antibodies were detected using enzyme-linked immunoabsorbent assay (ELISA). Serum p53 antibodies were detected in 30 of 145 patients (21%), mostly in Astler-Coller stage B1 (28% of patients). No association was found between p53 antibody status in stage A+B1+B2 vs stages C1+C2+D (22% vs 19%) i.e. between patients without and with metastases to regional lymph nodes and/or distant metastases. Serum p53 antibodies were detected in 9 of 34 patients (26%) with tumour localised in the right part vs 21 of 109 patients (19%) with tumours in the left part of the colon and in 18 of 96 (19%) of patients with tumours localised in rectosigmoideum vs 12 of 47 (26%) with tumours in the remaining colon. There was no significant correlation between serum anti p53 antibody and CEA statuses. Increased level of serum CEA was seen in 46/145 (32%) patients. Patients with C1+C2+D stage cancers had high serum CEA level more frequently than did patients with A+B1+B2 stage tumours (44% vs 19% respectively, p < 0.001). Of 102 cases with normal CEA level, 19 (19%) were positive for anti p53 antibodies. These results together with the literature data [11, 20] indicate that approximately 27% CEA negative patients may have serum p53 antibodies. Therefore simultaneous assessment of serum p53 antibodies and CEA seems to be useful for monitoring high risk patients and for postoperative patient monitoring.

Studies on the pharmacokinetics and pharmacodynamics of propranolol in hyperlipidemia

The lipophilic beta-adrenoreceptor antagonist propranolol has been studied to define its pharmacokinetic and pharmacodynamic characteristics in hyperlipidemic patients. A total of 48 subjects were allocated to four study groups: (1) healthy volunteers, (2) hypercholesterolemic patients, (3) hypertriglyceridemic subjects, and (4) patients with a mixed form of hyperlipidemia. Propranolol was given orally as a single dose of 80 mg. Heart rate was measured during 12 hours. At each point, the concentrations of propranolol were estimated. Moreover, heart rate and arterial systolic blood pressure were examined at rest and after a submaximal exercise test 3 hours after administration of propranolol (i.e., at the peak of propranolol concentration in the blood serum). A significant increase in the area under the serum concentration-time curve (AUC) by 39% and a reduction of the volume of distribution and total body clearance by 48% and 46%, respectively, without a significant change in the half-life time, were observed in patients with hypertriglyceridemia in comparison with the control group. The acceleration of exercise heart rate and the elevation of systolic blood pressure were comparable in all groups in the study, whereas blood serum concentrations of propranolol in patients with hypertriglyceridemia (group 3) and the mixed form of hyperlipidemia (group 4) were markedly altered from those observed in normolipemic subjects. No relationship between the concentration of propranolol and the heart rate in the group with hypertriglyceridemia was seen. In the light of this study, the authors suggest that lipid metabolism disturbances do not affect the pharmacodynamics of propranolol.

[Late results after extensive resection of the small intestine]

In eight patients (two women and six men) aged from 31 to 80 years, extensive resection of the small intestine had been performed before many years. The most frequent causes of the operation were thrombosis and embolism of the superior mesenteric artery (three cases each). In all patients the small intestine was resected, at least partially, and in two patients also hemicolectomy with resection of Bauhin valve was performed. The most frequent complaint reported by the patients is periodical diarrhoea which becomes more intense particularly after fat consumption. Laboratory investigations and absorption tests were carried out in the patients at least one year after the operation. In all patients impaired absorption and hypoalbuminaemia were found. No significant correlation was found between the extent and time after the resection and the degree of intensity of the observed abnormalities.