Bilateral thalamic stroke after tonsillectomy in patient with collateral extracranial anastomosis : case report

Haemorrhage remains the most frequent and serious complication of tonsillectomy. When bleeding is recurrent, gushing, and ceases spontaneously, pseudoaneurysm of the injured artery in the proximity of the tonsillar bed should be suspected. Haemorrhage related to pseudoaneurysm occurs most commonly in the first 30 days after surgery. It can sometimes be excessive and requires a revision procedure such as external carotid artery (ECA) ligation or embolisation. During those procedures, ECA should be checked for possible anastomoses, otherwise the bleeding may persist despite the intervention. We report an unusual case of a patient with recurrent post-tonsillectomy haemorrhage due to pseudoaneurysm of the facial artery, which persisted after ECA ligation because of the presence of collateral occipital-vertebral anastomosis. Due to the recurrence of bleeding episodes, endovascular treatment was implemented. However, the embolisation was complicated by bilateral thalamic stroke with unclear mechanism. This case highlights the importance of anastomosis between ECA and the vertebrobasilar system, both in recurrence of significant post-tonsillectomy bleeding and in potential thromboembolic complications. Therefore, ECA ligation should always be accompanied by exclusion of possible anastomoses. In cases of non-life-threatening bleeding, embolisation seems to be the proper and more selective therapy

Conjugated metallothionein-carbon-doxorubicin nanotransporter for targeted breast cancer therapy.

Metalothionein (MT) is a polypeptide of molecular weight in the range of 6-10 kDa. MT typically contains 60 to 68 amino acid residues. MT is characterized by its unique content of metal ions as well as its sulfur content. Higher MT levels were observed in proliferating cells. This fact demonstrates the importance of MT in the process of cellular regulation (relationship to cancer). The most widely used drug for patients with breast cancer metastases is an anthracycline antitumor antibiotic doxorubicin (DOX). However, the clinical use of DOX is limited by dose-related heart muscle damage (cardiomyopathy), more prevalent with increasing cumulative doses. For this reason, creation of novel pharmaceutical formulations based on using alternative methods as nanocarriers for targeted drug delivery to tumour cells is a crucial task in modern pharmacology. The aim of this work was to design a nanotechnological construct. The construct is designed as two separate nanotransporters. The nanotransporter (A) is formed by an antibody-modified AgNPs particle and a carbon nanotube with encapsulated DOX (AgNPs/Ab1/MWCNT/DOX/ODN1). The nanotransporter (B) is engineered with SPION particle modified with antibody and with bound MT (SPION/Ab2/MT/ODN2). Construct AgNPs/Ab1/MWCNT/DOX/ODN1-SPION/Ab2/MT/ODN2 is formed using an oligonucleotide anchor. Individual parts of the nanotransporter were studied using appropriate methods. The presence of MT was monitored electrochemically by Brdicka method in connection with the transfer technique (AdTSV). Characteristic MT signals RS2CO (-1.15 V), Cat1 (-1.25 V), Cat2 (-1.45 V), Cat3 (-1.75 V) were observed at accumulation time of 120s. SDS PAGE confirmed the presence of MT on SPION nanoparticles at sizes 7 to 15 kDa. The DOX signal was fluorometrically monitored (Em 590 nm, Ex 490 nm). AgNPs sizes ranged from 15-20 nm, and the SPION nanoparticles ranged from 20-50 nm. Additionally, used AgNPs nanoparticles exhibited significant antiproliferative activity (growth inhibition by 20-40%) on a model culture S. Cerevisiae. Created nanoconstruct A showed growth inhibition for S. Cerevisiae by more than 50%. The nanoconstruct after these various analysis shows a high potential as an anticancer drug and may be an innovative way how to deal with the breast cancer in a targeted therapy

Repeating enlargement, recanalisations, and subarachnoid haemorrhages after middle cerebral artery aneurysm embolisation using pCONus stent and coils : a case report

Purpose: Large and wide-necked bifurcation aneurysms remain technically challenging to treat by the endovascular approach. Several endovascular strategies have been established in recent years for treating wide-necked bifurcation aneurysms, such as balloon-assisted coiling, stent-assisted coiling, waffle cone technique (WCT), and intrasaccular flow disruptors. Case report: A 64-year-old woman was diagnosed with three intracranial aneurysms of the right and left middle cerebral artery and right internal carotid artery. She was qualified for endovascular treatment of the left middle cerebral artery (LMCA) aneurysm because it posed the greatest risk of rupture. Due to complicated morphology, a pCONus stent and coils were chosen for treatment. Three months later the right middle cerebral artery aneurysm was embolised and the woman was scheduled for second-stage treatment of the LMCA aneurysm. One week before the planned admission the woman was diagnosed with subarachnoid haemorrhage (SAH) in the region of the previously treated LMCA aneurysm, and the second-stage treatment was conducted with a good result. The woman was discharged in improved condition. Three months later the woman was once again admitted with SAH - an enlarged LMCA aneurysm was observed and immediate third-stage embolisation was performed, but due to complications of SAH the woman eventually died. Conclusions: On the basis of the presented case we would like to emphasise the importance of sufficient initial coil packing and frequent control of neck region of the aneurysm for the long-term stability and safety after pCONusassisted coiling of intracranial aneurysms

Resistin as a Prooxidant Factor and Predictor of Endothelium Damage in Patients with Mild Acute Pancreatitis Exposed to Tobacco Smoke Xenobiotics

Objectives. The study was aimed to assess the influence of tobacco smoke exposure on the intensity of inflammation measured by IL-6, α1-antitripsin (AAT) and α1-acid glycoprotein (AGP) concentrations, and Cd level and oxidative stress intensity measured by advanced oxidation protein product (AOPP) concentration in the blood of healthy subjects and AP patients during hospitalization. Endothelin-1 (ET-1) and resistin concentrations, markers of endothelium injury, were determined. Results. An increased IL-6 concentration in healthy smokers compared to nonsmokers and AP patients compared to controls was shown. An increased AAT and AGP concentrations during hospitalization of AP patients were noted, in both smokers (AAT, AGP) and nonsmokers (AAT). In comparison to control groups, in AP patients, a 2-fold increased resistin concentration correlating with ET-1 concentration and decreased albumin concentration accompanied by increased AOPP concentration were demonstrated. AOPP concentration was higher in smokers with AP compared to nonsmokers and gradually enhanced during their hospitalization. Conclusions. Tobacco smoke exposure can have a proinflammatory effect in both healthy subjects and AP patients. Increased resistin concentration in AP patients negatively correlating with albumin concentration has prooxidative effect on this protein resulting in enhanced AOPP level. Increased resistin concentration can intensify AAT and AGP production during AP

The Influence of the Occupational Exposure to Heavy Metals and Tobacco Smoke on the Selected Oxidative Stress Markers in Smelters

The aim of the study was to verify if there is any association between exposure to Cu, Zn, Cd, Pb, As and the formation of malondialdehyde (MDA), 8-hydroxydeoxyguanosine (8-OHdG), advanced oxidation protein products (AOPP), and whether in this process cigarette smoking plays a role. The investigations were performed in the 352 smelters occupationally exposed to heavy metals and 73 persons of control group. Metals concentration was determined by atomic absorption spectrometry. MDA and AOPP concentrations were determined by spectrophotometric methods. The concentration of 8-OHdG was determined by ELISA method. It was demonstrated an increased Cu concentration in smoking smelters compared to non-smoking control group. It was noted no differences in Zn and Mg concentrations between the examined groups. Pb concentration was more than sixfold higher in the group of smoking smelters and about fivefold higher in the group of non-smoking smelters compared to the control groups (smokers and non-smokers). It was shown that Cd concentration in the blood was nearly fivefold higher in the smoking control group compared to the non-smoking control group and more than threefold higher in the group of smoking smelters compared to non-smoking. It was shown an increased As concentration (more than fourfold) and decreased Ca concentration in both groups of smelters compared to control groups. In groups of smelters (smokers and non-smokers), twofold higher MDA and AOPP concentrations, and AOPP/albumin index compared to control groups (smokers and non-smokers) were shown. Tobacco smoke is the major source of Cd in the blood of smelters. Occupational exposure causes accumulation of Pb in the blood. Occupational exposure to heavy metals causes raise of MDA concentration and causes greater increase in AOPP concentration than tobacco smoke

Zinc-modified nanotransporter of anticancer drugs for targeted therapy: biophysical analysis.

Modern anticancer therapy aims to increase the effectiveness of tumor treatment. The aim of this work was to propose a new nanotransporter for targeted delivery of anthracycline antibiotics, which is characterized by its bioavailability, increased uptake of the drug from the bloodstream at the site of tumor tissue and as well as low toxicity to non-target tissue. Chitosan nanoparticles have attracted great attention in the field of drug delivery due to their stability, low toxicity and easy preparation. Deacetylated chitosan skeleton is composed of glucosamine units and has a high density of charged amino groups which allow strong electrostatic interactions with biomolecules, transition metals (Zn, Se) and peptides. We obtained the encapsulation effectiveness of chitosan 20%. Electrochemical detection of the bounded Zn2+ ions into the chitosan structure showed shift from -0.99 to -0.93 V. This result proved the formation of a chitosan-zinc complex. The ability of metallothione in to quench the 2,2-diphenyl-1-picrylhydrazylradicalin the presence of 50 {aelig}M doxorubicin was confirmed by the change of relative absorbance in the range of 50 to 60%