Introduction:Surgery is supposed to modulate the production of carbon monoxide by the reduction of heme oxygenase activity or transcriptional regulation of inducible heme oxygenase. On the other hand, the inhalation of tobacco smoke can substantially raise the level of carboxyhemoglobin in the blood. Furthermore, methemoglobin is maintained at a constant level. However, excessive production of methemoglobin relative to total methemoglobin reductase activity results in methemoglobin increase.Aim:The aim of our study was to investigate the perioperative variations of carboxyhemoglobin and methemoglobin during urologic surgeries, and at the same time to evaluate the changes in methemoglobin as a possible indicator of nitric oxide generation. Our second aim was to evaluate the effect of preoxygenation on the level of carboxyhemoglobin and methemoglobin and the influence of blood transfusion on their changes.Material and methods:The study included 30 patients scheduled for urologic surgery under general endotracheal anesthesia, aged 18–60 years without any history of respiratory disease, divided into two groups. The study group comprised patients who were smoking cigarettes or tobacco pipe, while the control group included non-smokers. In both groups carboxyhemoglobin (COHb) and methemoglobin (MetHb) levels were determined preoperatively, after preoxygenation, and postoperatively.Results:COHb levels were decreased postoperatively in both groups. The average values of COHb between the two groups were statistically significantly different (p=0.00). MetHb levels increased postoperatively in the group of smokers and decreased in the group of non-smokers. There were no statistically significant differences in the average postoperative MetHb levels between the two groups.Conclusion:Changes in carboxyhemoglobin and methemoglobin concentrations in arterial blood occur during urologic surgery, although these amplitudes are small when compared with carbon monoxide intoxication and methemoglobinemia. It is likely that organ perfusion and functions are affected by these monoxide gas mediators during urologic surgery.

Introduction: The inhalation of tobacco smoke can substantially raise the level of carboxyhemoglobin in the blood. Determination of the level of carboxyhemoglobin and methemoglobin can identify patients with increased risk for development of postoperative pulmonary complications. Material and Methods: Thirty patients scheduled for elective urologic surgery under general endotracheal anesthesia were allocated in two groups (n = 15 each). The study group comprised patients who were smoking cigarettes or tobacco pipe, while the control group included non-smokers. In both group's carboxyhemoglobin and methemoglobin levels were determined preoperatively, after preoxygenation, and one hour after completing the anesthesia. Postoperative pulmonary complications were assessed and recorded during the period of hospitalization. Results: The average values of carboxyhemoglobin between the two groups were statistically significantly different. Postoperative carboxyhemoglobin was higher in smokers compared to control non-smokers group (p = 0.000). On the other hand, methemoglobin was higher in the control non-smokers group compared to smokers, but without statistical significance (p = 0.88). Regarding postoperative pulmonary complications, 13.3% of the patients in the control non-smokers group and 26.6% of the patients in smokers group had pulmonary complications. Conclusion: In our sample there was a difference between the incidence rates of postoperative pulmonary complications; however, we cannot confirm the hypothesis that carboxyhemoglobin and methemoglobin can serve as predictors for postoperative pulmonary complications.

Introduction: Matrix metalloproteinases are produced by tumour cells, hence, they may be associated with tumour progression including invasion, migration, angiogenesis and metastasis. Finding prognostic markers to better identify patients with higher risk for poor survival would be valuable in order to customize pre-and postoperative treatment as well as to enable closer follow-up of these patients. Aim of our study was to examine MMP-2, MMP-7 and MMP-9 serum levels and correlated them with pathological data such as stage of the colorectal cancer (CRC) and outcome. Methods: The investigation included 82 patients with operable CRC without distant metastases, who had underwent blood tests in order to determine the MMP-2, MMP-7 and MMP-9 serum levels in the following time periods: preoperatively, 3, 6, 9 and 12 months postoperatively. Results:The values of the investigated MMPs decrease postoperatively and start to increase 6 month later in patients of all stages of the disease, reaching the highest value 12 month postoperatively with statistically important differences of MMP-2, MMP-7 and MMP-7 serum levels in terms of disease staging and defi ned points of time. Analysis of the results showed that the MMP-2 serum levels obtained 3 and 12 months postoperatively, than MMP-7 serum levels 12 months postoperatively and the MMP-9 serum levels in all analyzed points in time were in signifi cant association with the CRC patients'outcome. Conclusion: The MMP-2, MMP-7 and especially MMP-9 serum values could be important indicators for diagnosis of the patients with CRC and for monitoring of disease progression.

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