Ulevičius, Jonas

Tikslas. Įvertinti imuninio atsako, susijusio su periferinio kraujo vienbranduolėmis ląstelėmis (PKVL), pokyčius po chirurginio kiaušidžių vėžio (KV) gydymo. Metodai. Atliktas perspektyvusis stebimasis tyrimas, į kurį įtrauktos 23 pacientės, sergančios III-IV stadijos КV ir kurioms atlikta citoredukcinė operacija, ir 23 kontrolinės grupės moterys. Tirta periferinio kraujo ląstelių sudėtis, PKVL subpopuliacijos, jų funkcinis aktyvumas, citokinų raiška PKVL ir jų kiekis serume. Rezultatai. KV sergančioms pacientėms prieš operaciją nustatytas sumažėjęs CD8+ T ląstelių kiekis, padidėjusi М2 monocitų dalis ir pakitusi citokinų raiška. Ankstyvuoju laikotarpiu po operacijos šie imuninės sistemos slopinimo požymiai išliko, be to, sumažėjo PKVL metabolinis aktyvumas ir fagocitozė bei padidėjo IL-6 kiekis serume. Išvados. KV sergančių pacienčių imuninės sistemos pokyčiai rodo galimą priešnavikinio imuniteto slopinimą, kuris išlieka ankstyvuoju laikotarpiu po operacijos.

Ovarian cancer (OC) is the eighth most common cancer among women worldwide. It is often diagnosed at advanced stages, and despite current treatment options, the overall 5-year survival rate remains approximately 49%. Surgery is a cornerstone of OC treatment; however, it causes significant tissue injury and immune alterations, which—based on evidence from other malignancies—may contribute to metastasis formation. Immune changes in OC patients during the early postoperative period remain poorly investigated. Aim of the study: to investigate postoperative changes in the immune response related to peripheral blood mononuclear cells (PBMCs) following surgical treatment for OC. Objectives: to assess changes in peripheral blood cell composition in OC patients; to evaluate the impact of OC and surgical trauma on PBMC subpopulations and function, PBMC expression of immune-related proteins, and serum levels of these proteins. Methods: a prospective observational study was conducted, including 23 women with stage III–IV OC undergoing cytoreductive surgery and 23 healthy controls. Conclusions: PBMC analysis revealed that OC patients exhibit significant immune suppression and alterations associated with a tumor-promoting environment. These immune changes persisted in the early postoperative period, with additional tumor-promoting features emerging during this phase.

Straipsnyje aptariamas itin retas klinikinis atvejis, kai nėštumo laikotarpiu diagnozuota dviejų vaisiaus chromosomų anomalija: 11p15 duplikacija ir 4p16.3 delecija, atitinkamai lemianti Beckwith-Wiedemann arba Silver-Russell ir Wolf-Hirschhorn sindromus, kuriems būdingas sutrikęs vaisiaus augimas ir vystymasis. Literatūroje aprašomi tik pavieniai atvejai, kai gimsta gyvi naujagimiai. Šiuo atveju vaisiaus žūtis nustatyta 37 nėštumo savaitę.

Ovarian cancer (OC) poses a significant global health challenge with high mortality rates, emphasizing the need for improved treatment strategies. The immune system's role in OC progression and treatment response is increasingly recognized, particularly regarding peripheral blood mononuclear cells (PBMCs) and cytokine production. This study aimed to investigate PBMC subpopulations (T and B lymphocytes, natural killer cells, monocytes) and cytokine production, specifically interleukin-1 beta (IL-1β), interleukin-4 (IL-4), interleukin-6 (IL-6), interleukin-10 (IL-10), interleukin-12 (IL-12), and tumor necrosis factor alpha (TNFα), in monocytes of OC patients both preoperatively and during the early postoperative period. Thirteen OC patients and 23 controls were enrolled. Preoperatively, OC patients exhibited changes in PBMC subpopulations, including decreased cytotoxic T cells, increased M2 monocytes, and the disbalance of monocyte cytokine production. These alterations persisted after surgery with subtle additional changes observed in PBMC subpopulations and cytokine expression in monocytes. Considering the pivotal role of these altered cells and cytokines in OC progression, our findings suggest that OC patients experience an enhanced pro-tumorigenic environment, which persists into the early postoperative period. These findings highlight the impact of surgery on the complex interaction between the immune system and OC progression. Further investigation is needed to clarify the underlying mechanisms during this early postoperative period, which may hold potential for interventions aimed at improving OC management.

Introduction Heme oxygenase 1 (HO-1) is a critical intracellular enzyme implicated in ovarian cancer (OC) progression (1,2), but the role of HO-1 in the immune response beyond the tumour site, particularly in peripheral blood mononuclear cells (PBMCs), remains insufficiently investigated (3,4). Aim This study aimed to explore the association between HO-1 mRNA expression in PBMCs, serum levels, and advanced OC stages.

Surgical treatment is a cornerstone of ovarian cancer (OC) therapy and exerts a substantial influence on the immune system. Immune responses also play a pivotal and intricate role in OC progression. The aim of this study was to investigate the dynamics of immune-related protein expression and the activity of peripheral blood mononuclear cells (PBMCs) in OC patients, both before surgery and during the early postoperative phase. The study cohort comprised 23 OC patients and 20 non-cancer controls. A comprehensive analysis of PBMCs revealed significant pre-operative downregulation in the mRNA expression of multiple immune-related proteins, including interleukins, PD-1, PD-L1, and HO-1. This was followed by further dysregulation during the first 5 post-operative days. Although most serum interleukin concentrations showed only minor changes, a distinct increase in IL-6 and HO-1 levels was observed post-operatively. Reduced metabolic and phagocytic activity and increased production of reactive oxygen species (ROS) were observed on day 1 post-surgery. These findings suggest a shift towards immune tolerance during the early post-operative phase of OC, potentially creating a window for treatment. Further research into post-operative PBMC activity could lead to the development of new or improved treatment strategies for OC.

Introduction (case reports only) Nocturnal enuresis is a significant problem among children: 25% of 5-year-olds have nocturnal enuresis episodes, but only 2 % carry the symptoms into adulthood. Amid women who experienced nocturnal enuresis in childhood, the pathology reoccurs during pregnancy in over 64 % of the cases. The aim of this case report is to present the recurrence of nocturnal enuresis during pregnancy. Results (oral/poster only) A 20 years old primiparous woman presented at 20 weeks of gestation complaining of involuntary nocturnal urination episodes. The complains started at the 8th week of gestation. The patient‘s urinary incontinence episodes were occurring only once during the night. Episodes of enuresis repeated from several times per week to every night. Occurrence of enuresis episodes had no correlation with specific food and fluid consumption, lifestyle or stress level. The patient experienced similar symptoms in childhood. No thorough neurological or urological examination was performed at that time and the patient was only treated for suspected urinary tract infections with no relief of symptoms. At the age of 16 spontaneous remission was achieved and enuresis did not reoccur until the first trimester of this pregnancy. Pelvic floor muscle training and relaxation exercises before sleep were recommended during the pregnancy to avoid nocturnal enuresis, however no substantial effect was observed. The patient reported slight improvements of the symptoms during the second trimester, but the problem persisted and even worsened during the third trimester of pregnancy. Summary (case reports only) A female patient experienced childhood nocturnal enuresis up until 16 years old. After spontaneous remission symptoms reoccurred during the first trimester of pregnancy and continued during the pregnancy. Conservative treatment showed no effect. Conclusions The cause of nocturnal enuresis is known to be multifactorial. Here we report a clinical case of nocturnal enuresis during adulthood and pregnancy as a possible risk factor for reocurrence.

Introduction/Background Heme-oxygenase 1 (HO-1), programmed cell death protein 1 (PD-1) ant it’s ligand (PD-L1) along with cytokines play an important role in ovarian cancer development. The changes of anti-cancer immunity in post-surgical period and its role in cancer progression are poorly understood. We intended to investigate HO-1, PD-1, PD-L1, immunosuppressive (IL-4) and proinflammatory (IL-1β, IL-6) interleukins expression in peripheral blood mononuclear cells (PBMCs). Methodology The peripheral venous blood samples were collected before and after surgery on the 1st, 3rd and 5th day from 10 controls and 9 ovarian cancer patients (FIGO stage III-IV) for PBMCs isolation with FICOL Paque Premium and targets mRNA expression analysis. RNA extraction and synthesis of cDNA, quantitative real-time PCR assays were performed. Results are presented as median with interquartile range. Results Median age of controls and cancer patients were 59 (26) and 58 (14) years respectively (p>0.05). The mRNA expression of all markers in PBMCs were significantly downregulated in cancer patients before surgery comparing to controls (p<0.05). Relative median expression of HO-1, IL-1β, IL-4, IL-6, PD-1 and PD-L1 in controls and cancer patients respectively were 0.97 (0.33) vs 0.66 (0.5), 0.87 (1.95) vs 0.07 (0.16), 0.86 (1.39) vs 0.43 (0.61), 0.98 (1.15) vs 0.03 (0.03), 0.99 (0.94) vs 0.32 (0.50), 1.18 (0.66) vs 0.26 (0.36). Significant post-surgical changes in IL-6 and PD-L1 expression were observed along with not significant fluctuations of other targets expression (figure 1). […]. Conclusion Investigated components of anticancer immunity and immunosuppression mechanisms are affected by cancer and surgical treatment. Therefore, PBMCs are worthy targets for detailed investigation in this field.

Antroji vadovėlio dalis skirta ginekologijos temoms pažinti ir suprasti. Ginekologija, išvertus iš graikų kalbos, yra sudurtinis žodis, susidedantis iš žodžių moteris ir mokslas. Tai, kai pir akušerija, yra vienas seniausių medicinos mokslų. Pirmosios žinios apie moters ligas bei jų aprašymai aptinkami Egipto Kahun ginekologijos papiruse, datuojamame 1800 pr. Kr., dar senesnis literatūros apie moterų ligas šaltinis – šumerų molinės lentelės. Įdomu tai, kad šiuose senovės raštuose aptariamos tos pačios temos kai pir šiuolaikinėje ginekologijoje: įvairios moterų ligos, nevaisingumas ir net kontracepcija, aišku, tik konservatyvioji gydymo dalis. Ilgą laiką gimda įvardijama kaip daugelio moters sisteminių ligų priešastis, kaip pavyzdžiui, isterijos (gr. Hysteria – gimda). Taigi, ginekologija, kai pir kitomis medicinos mokslo šakomis, besidomintys gali rasti daug įdomios ir naudingos informacijos. Tačiau svarbiausias šio vadovėlio tikslas – padėti studentams suprasti ir pažinti pagrindines, specifines moterų sveikatos problemas. Trumpai, aiškiai ir vaizdžiai išdėstyti jų etiologiją, patogenezę, diagnostikos ir gydymo principus, riziką ir prognozes. Pastebėta, kad studentai sunkiai įsisavina onkoginekologijos, uroginekologijos, ginekologinės endokrinologijos ir net kontracepcijos pagrindus. Tikimasi, kad vadovėlis padės pažinti bei suprasti ir šias temas. Vadovėlį rengė klinikos dėstytojai, gydytojai, savo srities specialistai. Rengėjai tikisi, kad pavyko pabrėžti svarbiausius aspektus, kurie turėtų būti naudingi bet kurios srities specialistams klinikinėje praktikoje ateityje, iki tol – Sėkmingai išlaikyti modulio, o vėliau ir baigiamąjį egzaminą.

OBJECTIVE: to evaluate the sexual behavior of Lithuanian high school students. STUDY DESIGN: School-based anonymous self-administered survey of high school students, conducted from February to June 2017. RESULTS: Of 167 invited schools, 113 (67.7%) agreed to participate in the survey with a response rate of 75% among invited students (8143/10,811). Respondents' median age was 18 (range 16-20) years. Nearly one third of students (31.3%) reported sexual intercourse with a median age at coitarche of 17 years. Most (82.9%) used contraception at coitarche. Contraception at coitarche was more common among those who were sober at coitarche (aOR 2.2, 95% CI 1.5-3.2). Students whose parents had discussed sex with them were more likely to plan coitarche (aOR 1.3, 95% CI 1.1-1.5). Students searching for information about sexual life more often had their coitarche sober than those not searching for information (29.7% (n = 60) vs 21.1% (n = 497, p = 0.006). CONCLUSIONS: Every fifth high school student reported contraceptive nonuse; however, only 6% indicated the use of reliable dual contraception during the first sexual intercourse. IMPLICATIONS: Efforts are needed to improve the sexual education offered to Lithuanian adolescents to ensure the many sexually active adolescents are aware of how to protect themselves from infection and undesired pregnancy.