Cause of pain in patients surgically treated for cholelithiasis and post-cholecystectomy syndrome]

Cholecystectomy does not mean an end of all problems in every patients because some of operated patients continue to complain. Usually such complaints are called post-cholecystectomy syndrome. Eighty three patients, who underwent cholecystectomy were examined. Postoperative complications were excluded, and post-cholecystectomy syndrome diagnosed because of persisting complaints. Definite additional disease associated with gastric and duodenal disorders was found in about 50% of all examined patients (56 cases). In further 23 patients repeated diagnostic tests enabled to establish probable reason of the disorders. The studies have shown that disorders noted after cholecystectomy and termed as post-cholecystectomy syndrome are as much as in 63% of patients not related to previous surgery. Therefore, this widely used name should not be applied to all complaints following cholecystectomy, and attempts of finding other causes of the ailments including other organs diseases should be undertaken.     

Assessment of micronucleus frequency in normal oral mucosa of patients exposed to carcinogens

OBJECTIVE: To assess the presence of micronuclei in exfoliated oral mucosal cells collected from 3 anatomic sites in patients exposed to tobacco and alcohol. STUDY DESIGN: Smears were prepared with normal oral mucosal cells obtained from the lower lip, tongue border and floor of the mouth of 21 controls, 28 tobacco users and 19 tobacco/alcohol users. Slides were stained with Feulgen stain for quantification of micronucleated cells, karyorrhexis and "broken eggs." RESULTS: The groups were similar in terms of the mean number of micronucleated cells and cells undergoing karyorrhexis. In the comparison of anatomic sites, the mean number of cells undergoing karyorrhexis was higher on the lower lip than on the tongue border or floor of the mouth (all groups). A significantly higher number of broken eggs was observed in the control group when compared to the tobacco and tobacco/alcohol groups at all anatomic sites. CONCLUSION: The higher number of broken eggs in patients not exposed to tobacco and/or alcohol suggests that this nuclear alteration may be associated with DNA repair or a healthy mucosa. A trend toward an increased number of micronucleated cells was observed for tobacco and/or alcohol users at all anatomic sites.     

Adhesion of oral streptococci from a flowing suspension to uncoated and albumin-coated surfaces

A flow cell system was developed which allowed the study of bacterial adhesion to solid substrata at well-defined shear rates. In addition, the system enabled the solid surfaces to be coated with a proteinaceous film under exactly the same shear conditions. In this flow cell system, adhesion of three strains of oral streptococci from a phosphate-buffered solution onto three different substrata was studied as a function of time in the absence and presence of a bovine serum albumin (BSA) coating at a shear rate of 21 s-1. To obtain a wide range in surface free energies (gamma) representative strains (gamma b 38-117 mJ m-2) and solid substrata (gamma s 20-109 mJ m-2) were selected. The number of bacteria adhering was counted microscopically. In the absence of a BSA coating a linear relation was found between the number of bacteria adhering at saturation (nb,s) and the calculated interfacial free energy of adhesion (delta Fadh) for each of the three strains. In the presence of a BSA coating the number of bacteria adhering was greatly decreased in all cases. However, despite the presence of the BSA coating there was still a linear relation between the number of bacteria adhering at saturation and the interfacial free energy of adhesion, calculated on the basis of the surface free energy of the uncoated substrata. It can be concluded that the bare, uncoated substratum still influenced bacterial adhesion in spite of the marked influence of a BSA coating.     

Thermodynamic Analysis of Growth Temperature Dependence in the Adhesion of Candida parapsilosis to Polystyrene

The purpose of this work was to study the adhesion to polystyrene of two Candida parapsilosis strains, grown at 22 and 37°C, in terms of hydrophobicity, surface charge, and interaction free energy. Growth temperature changed the surface properties of microorganisms, yielding a good correlation between thermodynamic predictions and adhesion behavior.     

Fever as a cause of hypophosphatemia in patients with malaria

Hypophosphatemia occurs in 40 to 60% of patients with acute malaria, and in many other conditions associated with elevations of body temperature. To determine the prevalence and causes of hypophosphatemia in patients with malaria, we retrospectively studied all adults diagnosed with acute malaria during a 12-year period. To validate our findings, we analyzed a second sample of malaria patients during a subsequent 10-year period. Serum phosphorus correlated inversely with temperature (n = 59, r = -0.62; P<0.0001), such that each 1 degrees C increase in body temperature was associated with a reduction of 0.18 mmol/L (0.56 mg/dL) in the serum phosphorus level (95% confidence interval: -0.12 to -0.24 mmol/L [-0.37 to -0.74 mg/dL] per 1 degrees C). A similar effect was observed among 19 patients who had repeat measurements of serum phosphorus and temperature. In a multiple linear regression analysis, the relation between temperature and serum phosphorus level was independent of blood pH, PCO2, and serum levels of potassium, bicarbonate, calcium, albumin, and glucose. Our study demonstrates a strong inverse linear relation between body temperature and serum phosphorus level that was not explained by other factors known to cause hypophosphatemia. If causal, this association can account for the high prevalence of hypophosphatemia, observed in our patients and in previous studies of patients with malaria. Because hypophosphatemia has been observed in other clinical conditions characterized by fever or hyperthermia, this relation may not be unique to malaria. Elevation of body temperature should be added to the list of causes of hypophosphatemia.     

Thorough clinical evaluation of skin, as well as oral, genital and anal mucosa is beneficial in lichen planus patients

Lichen planus (LP) is a common mucocutaneous disease of unknown aetiology with various geographical prevalence, may be related to some serious disorders such as squamous cell carcinoma and often remains underdiagnosed. The aim of this retrospective study was to thoroughly determine localization and clinical characteristics of LP lesions in a cohort of 173 Slovenian patients in association to the presence of accompanying symptoms and history of potential stressful events. Isolated cutaneous lesions of LP were found in 56.6% and isolated oral LP in 3.5% of patients. Thirty-four percent presented orocutaneous LP, whereas genitocutaneous LP was noted in 1.2%, orogenito-cutaneous LP in 4% and orogenital LP in 0.5% of patients. Underlying stressful events were noted in 36 out of 137 (26.3%) patients. Despite obviously visible localization of the lesions various medical specialists should be familiar with LP and thoroughly examine the complete skin, as well as oral, genital and anal mucosa in each LP patient to avoid a delay in diagnosing this disease and possibly disclose a much serious underlying condition. Psychological support should be offered, if needed.     

In vitro analyses of tissue structure and interleukin-1beta expression and production by human oral mucosa in response to Candida albicans infections

Clinical and experimental observations suggest that oral epithelial cells play a key role in host defenses against candidal infections through cytokines and chemokines. We thus attempted to determine whether oral epithelial cells convey IL-1beta as a pro-inflammatory cytokine in response to Candida albicans infections. We created engineered human oral mucosa (EHOM), put them in contact with live and heat-inactivated C. albicans (10(5) yeast/cm2), and measured the expression of IL-1beta mRNA and protein. Tissue structure and C. albicans morphology were also evaluated. Only live C. albicans modulated IL-1beta expression and secretion. IL-1beta mRNA expression significantly increased during the early stages of infection and decreased during the later stages. The modulatory effect of C. albicans on IL-1beta expression was confirmed by the fact that increased amounts of inactive IL-1beta (33 kDa) were detected early during the infection which then dropped dramatically. There was a significant and time-dependent increase in the amount of the active form of IL-1beta (17 kDa) secreted into the supernatant by epithelial cells infected with live C. albicans. Histological features revealed damage to infected tissues (separation of epithelial cells, edema, vacuolization, reduction in thickness) compared to uninfected ones. Morphological analyses showed that C. albicans changed from a blastospore to a hyphal form at later infection periods. This transformation was very pronounced at 8 and 24 h post-infection. These results provide additional evidence for the contribution of oral epithelial cells to local defenses against exogenous stimulations such as C. albicans infections.     

Immunohistochemical and ultrastructural characteristics of the bronchial mucosa in chronic inflammation

The local immunity was studied using 31 biopsy samples obtained during bronchoscopy from patients with various forms of chronic bronchitis. Attenuated IgA synthesis by plasmatic cells of bronchial mucosa lamina propria and increased LgG synthesis were established. Enhanced IgG production and penetration of various agents into bronchial mucosa lamina propria cause local immunocomplex reaction involving microcirculatory bed and resulting in perivascular sclerosis. Repeated damaging and sclerotic processes lead to disconnection of epithelial-stromal links and altered cover epithelium differentiation. The role of immunopathologic reactions in the formation of vicious circle underlying morphogenesis of chronic bronchitis is suggested.