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Biomedical subjects

Janusz Kowalewski

Publications and source records attributed to Janusz Kowalewski.

14 recordsLinked to original sources
PubMed2006

[Bone marrow isolated micrometastases of non-small cell lung cancer].

UNLABELLED: The ability to detect occult systemic metastases in patients with operable NSCLC could have a significant impact on the management of the disease. The aim of the study was to detect occult micrometastatic tumor cells in bone marrow in patients with resectable NSCLC. MATERIAL AND METHODS: A total of 35 patients (29 men, 6 women), age between 47 and 78 (mean 61.6) were included in the study. In each of the patients bone marrow aspirates from the ribs were sampled during surgery. Both the tumor and the bone marrow aspirate were examined histologically and immunocytochemically with the cytokeratin: AE1/AE3, CAM 5,2, CK-7, CK-18. The presence of grow factors CD 31 and CD 34 were examined as well. RESULTS: No evidence of micrometastases or tumor cells in bone marrow was found in histological examination. Cytokeratin positive (CAM 5,2 +) cells were detected in 33 cases (94.23%) of the tumors and in 21 cases (60.00%) of bone marrow samples. The statistically significant correlation between the presence of CAM 5,2 in tumors and bone marrow was found (p = 0.049). Cytokeratin positive cells were detected in all the 35 tumors (AE1/AE3), in 20 tumors--57.14% (CK-7) and in 23 tumors--65.71% (CK-18). Cytokeratin positive cells (CK-7) were detected in bone marrow sample in one patient only. CONCLUSIONS: Immunocytochemical examination with the use of cytokeratin CAM 5,2 is of use to detect occult micrometastatic tumor cells in bone marrow in NSCLC patients. However, no correlations were found between the presence of cytokeratin CAM 5,2 in bone marrow or tumor and patients' age, sex and the histological type of NSCLC its degree of malignancy and stage.

Aged↗
PubMed2006

[Morgagni's hernia--still a difficult diagnostic problem].

Morgagni's hernia due to its non-specific symptoms and signs along with difficulties to detect it by x-ray imaging is still a disease difficult to diagnose. Patients suffering from this hernia are often treated unsuccessfully because of false diagnosis of other illnesses of the abdomen or thorax. It is only detailed diagnostics that can lead to a proper diagnosis. The authors present the current status of knowledge of Morgagni's hernia, its most common signs and symptoms and available diagnostic and therapeutic methods.

Diagnosis, Differential↗
PubMed2006

[Bacteriological and mycological analysis of material taken from lower respiratory tract in patients with malignancy].

UNLABELLED: The immunosuppression and incorrect function of the natural protection mechanisms are conducive to lower respiratory tract infections. The patients with malignancy, especially with lung cancer, belong to the group at higher risk to develop an infection due to accumulation of numerous risk factors. OBJECTIVE: The aim of this study was to assess the occurrence of bacteria and fungi in materials taken from lower respiratory tract from the patients treated in Thoracic Surgery and Clinical Department of Thoracic Surgery and Tumours from 2000 to 2004. The frequency of occurrence of alert-pathogens was also analyzed. MATERIAL AND METHODS: The retrospective analysis was carried out among 102 positive samples (sputum--68, bronchial secretion--32 and bronchoalveolar lavage--2). The material was obtained from patients treated due to lung cancer (n=84), pulmonary metastases (n=6), primary neoplasms of the chest wall (n=2), lymphoma of the mediastinum (n=3), mesothelioma (n=1) and other malignancies (n=6). The examinations were conducted in compliance with the current procedures, generally accepted in microbiological laboratories. RESULTS: Seventy examined patients (68.63%) had bronchial colonization with bacteria being the potential etiologic agents of lower respiratory tract infections. The presence of yeast-like fungi was confirmed in 62 patients (60.78%). The most frequent strains isolated were: Enterobacteriaceae (40.86%), followed by Staphylococcus aureus (21.51%), Haemophilus influenzae (16.13%) and Streptococcus pneumoniae (7.53%). The nonfermenting gram-negative rods Pseudomonas spp. and Acinetobacter spp. occurred as follows: 6.45% and 3.23%. Among yeast-like fungi the most common species isolated was Candida albicans (63.77%) which occurred more frequently in sputum than in bronchial secretion (p < 0.0004). The strains of Enterobacteriaceae and nonfermenting gram-negative bacillus producing extended-spectrum beta lactamase (ESBL) were not discovered like MBL (metallo- beta lactamase) positive strains. All of the Staphylococcus aureus strains were sensitive to the methicillin. Haemophilus influenzae did not show ampicillin resistance. We observed two strains Streptococcus pneumoniae which were penicillin intermediate but susceptible to the third-generation cephalosporins. CONCLUSIONS: Identification of the potential etiological agents of lower respiratory tract infections can be useful in the rational management of the antibiotics policy in the patients with maliganacy.

Bronchoalveolar Lavage Fluid↗
PubMed2006

[Magnetic resonance imaging in the diagnosis of retrosternal anterior diaphragmatic hernia in an adult man].

The study presents a case report of a retrosternal anterior diaphragmatic hernia in a 46-year-old man presented with abdominal pain, nausea, dyspnoea and treated previously as for chronic pancreatitis. A strong suspicion of the diaphragmatic hernia was generated after chest radiograph. However, the exact diagnosis of the Morgagni hernia was established by magnetic resonance imaging. The hernia was repaired through thoracic incision. The postoperative course proved uneventful: the patient was discharged from the hospital 10 days after surgical intervention.

Diagnosis, Differential↗
PubMed2005

Oxidative DNA damage and antioxidant vitamin level: comparison among lung cancer patients, healthy smokers and nonsmokers.

In the present study, we examined whether the level of 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxodGuo) in leukocyte DNA is higher in lung cancer patients compared to controls. Factors that may influence oxidative stress, such as antioxidant vitamins, were also determined. These parameters were analyzed in 4 groups of subjects: smokers with lung cancer, ex-smokers with lung cancer, healthy smokers with comparable smoking status and healthy nonsmokers. The 8-oxodGuo mean level in leukocytes of lung cancer patients reached values of 9.22/10(6) dGuo molecules (smokers) and 11.16/10(6) dGuo molecules (ex-smokers). These values were significantly higher than in DNA of healthy smokers and nonsmokers, where mean levels reached 6.99/10(6) dGuo molecules and 5.98/10(6) dGuo molecules, respectively. Mean levels of vitamin C in the plasma of controls and lung cancer patients were 56.17 microM (nonsmokers), 26.34 microM (healthy smokers), 23.83 microM (cancer patients, smokers) and 29.19 microM (cancer patients, ex-smokers). The difference between nonsmokers and the 3 other groups was statistically significant. Vitamin E level was significantly reduced in the plasma of cancer patients (smokers 19.94 microM, ex-smokers 19.59 microM) compared to healthy smokers (28.93 microM). No changes in vitamin A concentration were found. Our results suggest that a high level of 8-oxodGuo in leukocyte DNA and a low concentration of vitamin E in the blood may predict lung cancer risk. However, it is also possible that these phenomena may simply result from disease development.

8-Hydroxy-2'-Deoxyguanosine↗
PubMed2005

Contribution of hMTH1 to the maintenance of 8-oxoguanine levels in lung DNA of non-small-cell lung cancer patients.

BACKGROUND: The level of 8-oxoguanine (8-oxoG), a general marker of oxidative DNA damage, in DNA is the result of both an equilibrium between the rates of its formation and removal from DNA by DNA repair enzymes and the removal of 8-oxodGTP from the cellular nucleotide pool by hydrolysis to 8-oxodGMP, preventing its incorporation into DNA. To determine the contribution of each component to the level of 8-oxoG in DNA, we compared 8-oxoG-excising activity (encoded by hOGG1), 8-oxodGTPase activity (encoded by hMTH1), and 8-oxoG levels in DNA from tumors and surrounding normal lung tissues from non-small-cell lung cancer patients. METHODS: We measured the level of 8-oxoG in DNA of 47 patients by high-performance liquid chromatography/electrochemical detection (HPLC/ECD), hOGG1 activity in tissue extracts of 56 patients by the nicking assay using an oligodeoxynucleotide containing a single 8-oxoG, and hMTH1 activity in tissue extracts of 33 patients by HPLC/UV detection. All statistical tests were two-sided. RESULTS: The 8-oxoG level was lower in tumor DNA than in DNA from normal lung tissue (geometric mean: 5.81 versus 10.18 8-oxoG/10(6) G, geometric mean of difference = 1.75; P<.001). The hOGG1 activity was also lower in tumor than in normal lung tissue (geometric mean: 8.76 versus 20.91 pmol/h/mg protein, geometric mean of difference = 2.39; P<.001), whereas the hMTH1 activity was higher in tumor than in normal lung tissue (geometric mean: 28.79 versus 8.94 nmol/h/mg protein, geometric mean of difference = 0.31; P<.001). The activity of hMTH1 was three orders of magnitude higher than that of hOGG1 (nanomoles versus picomoles per hour per milligram of protein, respectively). CONCLUSIONS: Several different components contribute to the maintenance of 8-oxoG levels in human DNA, with the greatest contributor being the removal of 8-oxodGTP from the cellular nucleotide pool by hMTH1.

Adult↗
PubMed2005

[Procedure in case of exposure of hospital's workers to HBV, HCV and HIV].

The aim of this study was to show our own experiences in the treatment our hospital's workers after the exposition of potentially infectious material. The register of the occupational exposition was established on 1st January 2001. 43 cases of occupational exposition to potentially infectious material were noted down, since the beginning of the observation to 31st October 2004. The persons who were injured, represented different professional groups: 9 physicians, 19 section nurses, 13 operative nurses and 3 maintenance workers. The exposition was caused by needle pricks during blood collection or injections (34 cases), as a result of a scalpel or other surgical instrument cut (2 cases), a splash of infectious material on the skin and conjunctivae (4 cases) and in the singular cases as a result of a bite by a stimulated patient, a medical waste cut in a rubbish bag or the hospital equipment. It was determined in the immunological examinations that among patients being the source of infection were: 1 person HBsAg(+), 5 persons anti-HCV(+), 37 persons HbsAg (-), 33 persons anti-HCV(-) and 5 persons HBsAg(?) and HCV(?). One medical unvaccinated worker was exposed to the HBsAg(+) blood. The specific treatment was administered by the application of 1 dose of anti-HBs immunoglobulin and realization of a series of protective vaccinations against HBV. 4 persons are being observed due to an exposition to HCV(+) blood. In all cases until now the treatment has been finished without a diagnosis of the occupational infection.

Female↗
PubMed2004

[Long-term results after resection of IIIA-N2 non-small cell lung cancer and complementary mediastinal irradiation].

The authors present a retrospective evaluation of long-term results of treatment of patients with IIIA-N2 non-small cell lung cancer (NSCLC), operated and subjected to complementary irradiation of mediastinum in the years 1987-1990. 60 patients were observed: 10 women and 50 men, aged 37-74 years (mean age 56). In all patients a radical resection of lung parenchyma with the primary tumour and mediastinal lymphadenectomy were performed. The one-year survival was 63% (38 patients), three-year survival--15% (9 patients) and five-year survival 13% (8 patients). It was found that the five year-survival in patients with IIIA-N2 NSCLC, in whom a combined therapy was applied (surgery and irradiation), was low, and the most common cause of death in the first three years of follow-up were distant metastases. Moreover it was observed that the number of mediastinal lymph node groups had a great influence on the time of survival.

Adult↗
PubMed2004

[Unsuccessful treatment of pneumothorax which was associated with hilar tumor].

The authors present a case of unsuccessful treatment of pneumothorax which was associated with hilar tumor. A typical underwater-seal system was installed in a 79-year-old patient, but the lung was still collapsed. Because of prolonged air leak, the patient was operated on. During the surgical procedure several bullae in the lung and the inoperable hilar carcinoma were diagnosed. Despite the absence of air leak, the failure of the lung to re-expand was noted postoperatively. However, recurrent air leak, subcutaneous emphysema and respiratory failure caused the patient's death.

Aged↗
PubMed2004

[Fine-needle aspiration biopsy under CT-guidance--usefulness in diagnosis of malignant lung tumors].

UNLABELLED: Aim of the study was to evaluate the usefulness of fine-needle aspiration biopsy (FNAB) in diagnosis of malignant lung tumors. MATERIAL AND METHODS: The results of 438 CT guided FNAB of lung lesions performed between Sep. 1st 1999 and Feb. 20th 2004 were evaluated. RESULTS: In 295 cases (67.35%) the cytological diagnosis of lung tumours were established by FNAB. The most common type of the tumours were: non-small cell lung cancer: 222 (50.69%) and small cell lung cancer: 49 (11.19%). 104 of these results were histologically verified and two false positive results were detected. In 143 cases (32.65%) however, the results established by FNAB were non-diagnostic. 63 of the lesions were verified and in 36 cases (57.1%) the malignant tumours were proved. The specificity of the method regarding malignant lesions reached 93.10%, and its sensitivity for patients with malignancy was 73.91%. The average diameter of the malignant tumour was 5.4+/-1.3 cm whereas in case of non-diagnostic results the diameter of the tumour was 4.1+/-1.6 cm. However, there was no significant difference between the two groups. The most common complication of FNAB was pneumothorax, which occurred in 22 patients (5.02%) and in 13 cases (2.97%) required drainage of the chest cavity. CONCLUSION: FNAB is a safe diagnostic method with high specificity and moderate sensitivity in detecting of malignant lung lesions.

Adult↗
PubMed2003

Products of oxidative DNA damage and repair as possible biomarkers of susceptibility to lung cancer.

The broad spectrum of oxidative DNA damage biomarkers [urinary excretion of 8-hydroxy-2'-deoxyguanosine (8-OH-dGuo) and 8-hydroxyguanine (8-OH-Gua)] and the level of oxidative DNA damage and repair in leukocytes DNA were analyzed in three groups of subjects: (a) lung cancer patients [all smokers (n = 51)]; (b) healthy smokers with comparable smoking status (n = 26); and (c) healthy nonsmokers (n = 38). The mean level of 8-OH-Gua in urine samples of 38 healthy nonsmokers reached a value of 1.783 +/- 0.785 nmol/day/kg. This level was significantly lower than that in the urine of the two smoker groups (cancer patients and healthy smokers), in whom the levels reached values of 2.319 +/- 1.271 and 2.824 +/- 0.892 nmol/day/kg, respectively. Urinary excretion of 8-OH-dGuo was similar in all groups of subjects. The level of 8-OH-dGuo in DNA isolated from leukocytes of cancer patients was significantly higher than that in DNA isolated from the group of healthy smokers and nonsmokers (9.44 +/- 4.77 versus 7.20 +/- 2.83 and 5.88 +/- 2.47 molecules/10(6) deoxyguanosine, respectively). Repair activity of 8-OH-Gua, as estimated by the nicking assay, was significantly higher in blood leukocytes of healthy volunteers (44.6 +/- 20.21 and 37.54 +/- 13.43 pmol/h/mg protein for smokers and nonsmokers, respectively) than in the leukocytes of lung cancer patients (24.56 +/- 11.28 pmol/h/mg protein). Because oxidative DNA insult represented by urinary excretion of oxidative DNA lesions was similar in both groups of subjects with similar smoking status, it appears likely that a higher rate of generation of oxidative damage in cellular DNA of lung cancer patients is a result of deficiency of the repair mechanism(s) in this group.

8-Hydroxy-2'-Deoxyguanosine↗
PubMed2003

Decreased repair activities of 1,N(6)-ethenoadenine and 3,N(4)-ethenocytosine in lung adenocarcinoma patients.

To assess the role of oxidative stress and lipid peroxidation (LPO) in the pathogenesis of lung cancer, we measured the levels of 1,N(6)-ethenoadenine (epsilonA) and 3,N(4)-ethenocytosine (epsilonC) in the DNA by immunoaffinity/(32)P postlabeling (33 cases). We also measured the capacity for epsilonA and epsilonC repair (by the nicking assay) in normal and tumor lung tissues, as well as in blood leukocytes of lung cancer patients (56 cases). Repair activities for epsilonA and epsilonC were also assayed in leukocytes of healthy volunteers, matched with cancer patients for age, sex, and smoking habit (25 individuals). Up to 10-fold variations among individuals were observed both in adducts level and repair activities. No differences in epsilonA and epsilonC levels between tumor and nonaffected lung tissues were recorded. However, leukocytes accumulated a significantly higher number of DNA adducts than the lung tissues. Repair activities for both epsilonA and epsilonC were significantly higher in tumor than in normal lung tissue. No significant differences in epsilonA and epsilonC repair activities were associated with age, sex, or smoking habit. However, a significant difference in repair capacity was observed between two histological types of lung cancer, squamous cell carcinoma (SQ) and adenocarcinoma (AD). In individuals suffering from lung AD, epsilonA- and epsilonC-repair activities in normal lung and blood leukocytes were significantly lower than in SQ patients. Moreover, in nonaffected lung tissue of AD patients, the ratio epsilonA/epsilonC adducts was lower than in SQ patients. Differences have also been found between epsilonA and epsilonC repair activities of cancer patients and healthy volunteers. Repair capacity for epsilonA was significantly lower in blood leukocytes of lung cancer patients than in leukocytes of healthy volunteers (P = 0.012). This difference was even larger between healthy volunteers and patients developing inflammation-related AD (P = 0.00033). Repair activities for epsilonC were the same in leukocytes of healthy controls, all lung cancer patients, and SQ patients. However, individuals with ADs revealed significantly lower epsilonC-repair activity (P = 0.013). These results suggest that oxidative stress-mediated lipid peroxidation might contribute to induction and/or progression of lung cancer. Decreased activity of base excision repair pathway for epsilonA and epsilonC is associated particularly with inflammation-related lung AD.

Adenine↗
PubMed2003

[Coin lesion in the lung of patients with known malignancy].

Histological examination was performed on 93 pulmonary nodules resected in 90 patients with known malignancy. The diameters of the coin lesions on CT scan were 3-10 mm in 42 cases and 11-30 mm in 51 cases. The most common sources of the previous malignancy were: large bowel (20), breast (14), uterus (12), kidney (11) and larynx (7). In 84 cases the nodules were radically resected through "wedge" resection and in 9 cases lobectomy was performed. Most frequently, coin lesion was caused by metastases of known malignancy (in 69.9%), pulmonary fibrosis (in 11.8%) and by primary lung cancer (in 7.5%). In general, pulmonary nodules were found malignant in 78.5% and benign in 21.5% of the cases. In the subgroup of coin lesions of diameter between 11 and 30 mm malignancy was noted in 94.1%--significantly more frequently than in subgroup of diameter between 3 and 10 mm (59.5%). No significant correlation was found between histological type of pulmonary nodules (malignant or benign) and the type of primary malignancy as well as the time from the treatment of primary malignancy to the detection of the coin lesion.

Adolescent↗