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We report the case of a 73-year-old man with massive swelling of the lower extremities, with a chronic and rather uncommon form of stasis dermatitis - stasis papillomatosis. The patient was also diagnosed with severe heart failure, including dilated cardiomyopathy, hypothyroidism that required a substantial dose of exogenous tyrosine, microcytic and megaloblastic anemia, iron deficiency, and type 2 diabetes. The cause of stasis dermatitis lesions is not completely understood. It may be caused by the allergic reaction to some epidermal protein antigen formation or chronic damage to the dermal-epidermal barrier that makes the skin more sensitive to irritants or trauma. It has, however, been suggested that the term stasis dermatitis should be used to refer only to cases caused by chronic venous insufficiency, which belongs to a group of lifestyle diseases and affects both women and men more and more frequently.

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INTRODUCTION: Glucocorticosteroids decrease the longitudinal growth of bones. It has been reported that skeletally immature rats on calcitonin treatment grow longer and slimmer. The aim of this study was to assess whether concomitant treatment with calcitonin would influence longitudinal growth and histology of epiphyseal plate in hydrocortisone-treated rats. MATERIAL AND METHODS: Fifty six growing male Wistar rats were randomly divided into two control and four experimental groups. Rats in the first two experimental groups were treated i.p. b.i.d. with hydrocortisone, while to the other experimental animals salmon calcitonin s.c. was administered concomitantly. The controls received appropriate vehicula. The rats were kept under standardised conditions. The first phase of the experiment was completed after 28 days and right femora and tibiae were harvested from groups and preserved in 4% buffered formalin. Lengths of the fresh femora were measured with an electronic caliper. After preservation, tibial bones were decalcified in 5% EDTA at room temperature. Paraffin-embedded coronal slices 10 µm thick from proximal tibia were taken and stained with hematoxylin/ eosin and alcian blue for histological assessment of the epiphyseal plate. A similar procedure was repeated after 56 days in the second phase of the experiment. RESULTS: The femora of hydrocortisone-treated rats were significantly shorter than those of controls, but after concomitant administration of salmon calcitonin the difference was insignificant. The histological assessment showed that depressed function of growth plate in hydrocortisone-treated animals after both phases of the experiment was partially reversed by salmon calcitonin treatment. CONCLUSIONS: Prolonged concomitant treatment with high-doses of salmon calcitonin partially reverses glucocorticoid-induced depression of rat growth plate.

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The aim of the study was to examine correlations between the content of iodides in 66 nodular goiters and 100 healthy human thyroid tissues (50- frozen and 50 formalin-fixed). A fast, accurate and precise ion chromatography method on IonPac AS11 chromatographic column (Dionex, USA) with a pulsed amperometric detection (IC-PAD) followed by alkaline digestion with tetramethylammonium hydroxide (TMAH) in a closed system and with the assistance of microwaves was developed and used for the comparative analysis of two types of human thyroid samples. Statistical analysis revealed over eightfold reduction of iodine concentration in the pathological tissues (the mean value was 77.13±14.02 ppm) in comparison with the control group (622.62±187.11 ppm for frozen samples and 601.49±192.11 ppm for formalin-fixed ones). A good correspondence (for 10 additional determinations) between the certified (3.38±0.02 ppm with variation coefficient (V.C.) of 0.59% for Standard Reference Material (SRM) NIST 1549-non-fat milk powder) and the measured iodine concentrations (3.52±0.29 ppm; V.C.=10%) was achieved. It was pointed out that the way of tissue preservation (either in formalin or by freezing) had no significant effect on the iodine determination result (α=0.1). Significantly lower iodide content was found in nodular goiter thyroid samples. The applied conditions of digestion, reinforced by the action of microwaves, brought about a decidedly shorter (less than 20 min) sample preparation time. Suitability of the developed IC method was supported by validation results.

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Ion chromatography followed by microwave-induced acid digestion was used to evaluate the serum levels of Fe(3+), Cu(2+), Ni(2+), Zn(2+), and Mn(2+) in patients with diagnosed type 2 diabetes and in healthy controls. Recoveries ranged from 98.0% to 102% for Fe(3+), from 89.9% to 100% for Cu(2+), from 87.9% to 102% for Zn(2+), and from 89.6% to 102% for Mn(2+) were determined by examining samples spiked with various amounts of all the studied ions. The time of mineralization longer than 28 min did not affect the assay values. Precision was assessed at four unique concentrations in replicates of six, on four separate occasions. RSD was determined to be 1.16% for Fe(3+), 5.20% for Cu(2+), 2.8% for Zn(2+), and 3.75% for Mn(2+). The accuracy results (values of RSD) were as follows: 5.16% for Fe(3+), 6.35% for Cu(2+), 4.9% for Zn(2+), and 7.23% for Mn(2+). The statistical analysis confirmed that mean concentrations of Fe(3+) and Zn(2+) did not differ significantly from analogous values in the control group. Patients who additionally suffered from hypertension had higher copper concentrations compared with diabetic patients. For diabetics the presence of Mn(2+) was not stated (LOD values amounting to 0.006 microg/mL). Ni(2+) was not detectable for either the studied group or the control group (LOD=0.006 microg/mL).

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The aim of this study was to estimate and compare the contents of selected metals in 65 pathological (diagnosed nodular goitre) and 50 healthy human thyroid tissues (taken during autopsies). Ion chromatography (IC) preceded by microwave mineralization was applied for the first time for determination of cadmium, cobalt, copper, iron, manganese, and zinc in human thyroid samples. The study proved that the concentrations of Cu(2+), Mn(2+), Fe(3+), and Zn(2+) were significantly higher in the control group (healthy thyroids) in comparison with the studied group (nodular goitre) (p<0.05), whereas for Co(2+) the difference between two means of concentration (healthy vs pathological thyroids) was not significant statistically at 0.05 significance level. Measurement accuracy was verified by measurements of NIST standard reference material (1566a Oyster Tissue). Very good precision (RSD below 5%) and recoveries (above 90%) were evaluated.

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The aim of the study is to present practical guidelines for the pre-operative management of patients taking commonly applied drugs that affect blood coagulation. In hospital practice it is the responsibility of an internist to evaluate the patient's condition before the patient undergoes surgery. Among the patients consulted by the internist prior to the surgery the number of patients taking the drugs affecting coagulation is on the increase. The surgery performed on these patients carries the increased risk of bleeding that may threaten health or even life of the patient.

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The aim of the study is to present practical suggestions of how to prepare a patient for thyroid gland surgery. Widespread distribution of thyroid diseases results in referring the patients for strumectomy. Proper preparation of the patient for the operation decreases the risk of perioperative complications to a minimum. Good co-operation in the team endocrinologist-anaestesiologist-surgeon is very important for the effective treatment.

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The aim of the study is to present practical suggestions as to substitutive administration of thyroxine in patients who underwent strumectomy. Hypothyerosis due to strumectomy is an indication for starting treatment with thyroxine. Until thyroid cancer is excluded on the basis of histopathological examinations the patient should not take thyroxine, as there may be a possibility for the need of scinthigraphy of the whole body. Proper management of the patient with hypothyreosis includes informing the patient about the necessity of regular taking the hormone and undergoing regular check-ups.

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