Biomedical subjects

Ireneusz W Krasnodebski

Publications and source records attributed to Ireneusz W Krasnodebski.

9 recordsLinked to original sources

PubMed2006

Synchronous occurrence of gastrointestinal stromal tumors and other primary gastrointestinal neoplasms.

AIM: To review clinical and pathologic features of Gastrointestinal stromal tumors (GISTs) occurring synchronously with other primary gastrointestinal neoplasms. METHODS: Twenty-eight patients with primary GIST were treated at our institution between 1989 and 2005. Clinical and pathologic records were reviewed. RESULTS: The gastrointestinal stromal tumor occurred simultaneously with other primary GI malignancies in 14% of all patients with GIST. The synchronous stromal tumors were located in the stomach and were incidentally found during the operation. The coexistent neoplasms were colon adenocarcinoma, gastric cancer (2 cases) and gastric lymphoma. CONCLUSION: The synchronous occurrence of GISTs and other gastrointestinal malignancies is more common than it has been considered. The development of gastrointestinal stromal tumors and other neoplasms may involve the same carcinogenic agents.

Aged↗

PubMed2006

[Recurrent lower gastrointestinal bleeding due to a gastrointestinal stromal tumor (GIST) of the small intestine].

Gastrointestinal bleeding is a common cause of hospitalisation. In most patients, the origin and location of bleeding can be established in routine endoscopic and radiological examinations. The undiagnosed cases of so-called gastrointestinal bleeding of unknown origin require more sophisticated diagnostic methods. We present a case of 35-year old man with recurrent gastrointestinal bleeding due to a gastrointestinal stromal tumor of the jejunum that was revealed in the visceral angiography.

Adult↗

PubMed2006

[Late malignant melanoma metastases within the abdominal cavity imitating clinically and pathologically a gastrointestinal stromal tumor].

Melanoma is a malignant skin neoplasm that often metastasizes within the abdominal cavity. Melanoma metastases can develop even many years after the primary treatment. Clinical course, microscopic histology, and immunohistochemical profile of melanoma may imitate a gastrointestinal stromal tumor (GIST). We report a case of 55-year old man with a history of melanoma treatment 23 years earlier who presented with recurrent duodenal bleeding from a neoplastic tumor that was primarily diagnosed as GIST The histology of the tumor was reviewed and confirmed the diagnosis of metastatic melanoma.

Diagnosis, Differential↗

PubMed2004

Effective photoimmunotherapy of murine colon carcinoma induced by the combination of photodynamic therapy and dendritic cells.

PURPOSE: The unique mechanism of tumor destruction by photodynamic therapy (PDT), resulting from apoptotic and necrotic killing of tumor cells accompanied by local inflammatory reaction and induction of heat shock proteins (HSPs), prompted us to investigate the antitumor effectiveness of the combination of PDT with administration of immature dendritic cells (DCs). EXPERIMENTAL DESIGN: Confocal microscopy and Western blotting were used to investigate the influence of PDT on the induction of apoptosis and expression of HSP expression in C-26 cells. Confocal microscopy and flow cytometry studies were used to examine phagocytosis of PDT-treated C-26 cells by DCs. Secretion of interleukin (IL)-12 was measured with ELISA. Cytotoxic activity of lymph node cells was evaluated in a standard (51)Cr-release assay. The antitumor effectiveness of PDT in combination with administration of DCs was investigated in in vivo model. RESULTS: PDT treatment resulted in the induction of apoptotic and necrotic cell death and expression of HSP27, HSP60, HSP72/73, HSP90, HO-1, and GRP78 in C-26 cells. Immature DCs cocultured with PDT-treated C-26 cells efficiently engulfed killed tumor cells, acquired functional features of maturation, and produced substantial amounts of IL-12. Inoculation of immature DCs into the PDT-treated tumors resulted in effective homing to regional and peripheral lymph nodes and stimulation of cytotoxic activity of T and natural killer cells. The combination treatment with PDT and administration of DCs produced effective antitumor response. CONCLUSIONS: The feasibility and antitumor effectiveness demonstrated in these studies suggest that treatment protocols involving the administration of immature DCs in combination with PDT may have clinical potential.

Animals↗

PubMed2004

[Fournier's gangrene].

Fournier's gangrene is a necrotizing fasciitis of the genital and scrotal region due to infectious process. The gangrene is rare. Most cases are diagnosed in elderly patients with immunodeficiency, especially in diabetics or alcoholics. Currently a primary infection focus can be revealed in about 95% cases. The nidus is usually located in the genitourinary tract, lower gastrointestinal tract or skin. Fournier's gangrene is a mixed infection caused by both aerobic and anaerobic bacterial flora. The development and progression of the gangrene is often fulminating and can rapidly cause multiple organ failure and death. Early surgical debridement of necrotic tissues and antibiotics are fundamental in the treatment of Fournier's gangrene. Despite of advanced management mortality is still high and averages 20-30%.

Disease Progression↗

PubMed2004

[A case report of severe hypophosphatemia in the course of refeeding syndrome].

This is a case report of 53 year old male who underwent pancreatoduodenectomy for chronic pancreatitis. Two months after the operation the symptoms of severe malnutrition caused by nutrition digestive disorders developed. The patient was admitted to the hospital with the symptoms of severe malnutrition and general poor medical condition. The patient was put on total parenteral nutrition (TPN) after the preliminary treatment of water-electrolytes imbalance. After 3 days of TPN a severe hypophosphatemia occurred (serum level < or = 0.25 mmol/l). The refeeding syndrome developed despite the use of phosphate supplementation in the hypocaloric TPN regimen. The hypophosphatemia caused the life threatening neurological and cardiovascular symptoms. The patient was put on intensive infusion fluid therapy with phosphate supplementation and transient withdrawal of TPN, which resulted in the patient's recovery. This case confirms the risk of development of refeeding syndrome in the malnourished patients. It indicates the need of close monitoring of phosphate serum level and the need of phosphate supplementation especially during the first days of nutritional treatment in such patients.

Chronic Disease↗

PubMed2004

[Megacolon imitating emphysema in the course of diaphragmatic hernia].

A 61-year old man with fever, diarrhoea, weight loss has been admitted to the hospital. Nine years earlier an air bubble in the lower part of the left lung was recognised during the chest x-ray, four years later diagnostic studies have shown a megacolon situated in the chest that significantly pressed on the flesh of the left lung and shifted the mediastinum to the right side. At that time the patient did not agree for an operation treatment. He decided for surgery in May 2002. During the operation the presence of an enormous large intestine of the megacolon type has been determined which could be found there due to diaphragm loss. The megacolon and spleen were surgically removed and the injured diaphragm was sutured. After 2 years a clinical and functional examinations of the respiratory system were performed. There was an improvement of the exercise capacity, recession of restriction in functional examinations and an increase in body mass.

Diagnosis, Differential↗

PubMed2003

[Alteration of serum interleukin-1 receptor antagonist and interleukin-6 levels after surgical injury].

The aim of the study was to investigate alterations in systemic production of interleukin 1 receptor antagonist (IL-1Ra) and interleukin 6 (IL-6) following major abdominal surgery in oncologic patients and in patients after minor surgical trauma who had undergone open cholecystectomy (OC). Studies were carried out in 30 patients. The concentrations of IL-1Ra in oncologic patients (865 +/- 1021 pg/ml) before operation were significantly higher (p = 0.042) in comparison with OC group (466.16 +/- 389 pg/ml). There was a significant (p = 0.017) increase in the IL-1Ra level to 2735 +/- 1943 pg/ml on day 1 after major surgery and the IL-1Ra level remained significantly elevated until the day 10. The IL-1Ra values were significantly increased on day 1 after OC (843.93 +/- 627 pg/ml, p = 0.001) and remained significantly (p = 0.02) elevated until the 10 postoperative day. The IL-1Ra serum concentrations were significantly higher on day 1 to 10 after major surgery with complications compared with patients after OC and uneventful postoperative course. The preoperative concentrations of IL-6 in oncologic patients was 24.9 +/- 64 pg/ml and in OC patients 8.35 +/- 14 pg/ml. The level of IL-6 on the day 1 after the major operations was ten times higher (268.38 +/- 330 pg/ml, p = 0.002) and remained significantly elevated over the ten days period. The highest concentration of IL-6 was observed in oncologic patients with severe complications (384.7 +/- 484 pg/ml). The significantly lower level of IL-6 (p = 0.009) was seen after OC in patients with uneventful postoperative course (50.6 +/- 53 pg/ml on the 1st postoperative day) as compared to major surgery. We conclude that elevated serum concentrations of IL-1Ra and IL-6 on the day 1 following surgery represent early sensitive markers of the extent of surgical trauma. The monitoring of changes in IL-1Ra and IL-6 blood levels may be useful in early recognising of pathological response to surgical trauma in oncologic patients after major surgery with increased risk of the development severe complications.

Adult↗

PubMed2002

The soluble tumor necrosis factor receptor I is an early predictor of local infective complications after colorectal surgery.

The clinical implications of increased cytokine levels after major surgery remain unclear. In this study, systemic concentration of a spectrum of cytokines, including interleukins IL-6, IL-8, IL-10, IL-1ra, and soluble tumor necrosis factor receptor-I (sTNF-RI) was examined in patients with and without postoperative septic complications following colorectal surgery. Although there were no significant changes in IL-1beta, TNF-alpha, and IL-8 serum levels during the observation period, there was a significant rise in IL-6, IL-1ra, and sTNF-RI concentrations in the entire group of patients between postoperative day 1 and 14. There were no differences between the group without and with local complications when IL-6, IL-1ra, and IL-10 were examined. The serum levels of sTNF-RI, IL-1ra, and IL-6 were found to be sensitive indicators of the pro- and anti-inflammatory response to the surgical trauma, but only sTNF-RI turned out to be a sensitive early marker of local septic postoperative complications in patients with colorectal carcinoma.

Antigens, CD↗