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Biomedical subjects

Jerzy Sowiński

Publications and source records attributed to Jerzy Sowiński.

At least 19 recordsLinked to original sources
PubMed2006

Acute myocardial infarction during high-dose methylprednisolone therapy for Graves' ophthalmopathy.

Management of Graves' ophthalmopathy includes high-dose glucocorticoids. Glucocorticoids may have many side effects, and therefore their use should always be carefully considered. Here we present the case of a woman who received high doses of methylprednisolone (1 g iv daily) for active Graves' ophthalmopathy, and developed severe hypertension followed by myocardial infarction on the fifth day of treatment. Before the myocardial infarction, the patient was in good condition, normotensive, non-diabetic, non-obese. Except hypothyroidism after radioiodine treatment (euthyroid under substitutional therapy), she suffered from no other diseases. There had been one episode of chest discomfort in her past history. We conclude that myocardial infarction may develop in patients treated with high-dose glucocorticoids for Graves' ophthalmopathy, and increased blood pressure may herald this complication.

Aged↗
PubMed2006

[Usefullness of scintigraphy with somatostatin analogues in the imaging of insulinoma of the pancreas].

We present a case of a 74-years-old female with insulinoma of the pancreas. Neuroglycopenic symptoms (Whipple's triad) and a positive fast test established the diagnosis. The fast was terminated after 5 hours and 40 minutes because of neuroglycopenic symptoms with the serum glucose and insulin levels of 40 mg/dl and 34,01 microU/ml respectively. The tumor was invisible in ultrasound, abdominal CT scan and MRL The only means that enabled preoperative visualization was 111-Indium labeled octreotide scintigraphy (OctreoScan). Laparotomy was performed, and a tumor was disclosed in intraoperative ultrasonography within the head of the pancreas. The tumor of 37 mm diameter was excised. Histopatological examination revealed benign insulinoma. After surgery the symptoms alleviated completely. The patient with proper glucose levels and insulin concentration of 3,04 microU/ml was discharged in good health. This case confirms high usefulness of preoperative OctreoScan and intraoperative ultrasonography in the approach to a patient with insulinoma.

Aged↗
PubMed2006

[Adiponectin and its role in the pathogenesis of obesity, diabetes mellitus and insulin resistance].

The paper reviews the structure and role of adiponectin in the regulation of metabolic balance. Adiponectin is the most abundant adipocytokine that is produced exclusively in the fat tissue. Its high concentration protects from diabetes mellitus, atherosclerosis and insulin resistance, its low concentration increases the risk of these disorders. The adiponectin gene is one of the many candidate genes in type 2 diabetes. Adiponectin binds to two types of receptors: 1 and 2, encoded by two genes: AdipoR1, and AdipoR2, respectively. The receptors are found in all tissues, with type 1 predominant in the muscles, and type 2 in the liver. Most importantly, the role of adiponectin in the body and the results of animal model experiments suggest the possible future use of adiponectin in the treatment of diabetes, atherosclerosis and obesity.

Adiponectin↗
PubMed2006

[Adrenal tumours in a selected 10-years surgical material].

UNLABELLED: The aim of the study was to analyze the number and proportions of different adrenal tumours resected during the last 10 years in our centre. Besides, we seek correlations between the size of tumours and the age and body mass indexes (BMI) of the examined patients. MATERIAL AND METHODS: The tumours where measured on CT and MRI before surgery, and on pathological examination after resection. The examined group consisted of 69 patients, 22 males and 47 females, mean age 50.51 +/- 12.26 yrs. In 45 (65.22%) cases the right adrenal was affected, in 21 (30.43%)--the left, in 3 (4.35%)--both. RESULTS: 12 adrenocortical cancers, 20 phaeochromocytomas, 9 cortisol-secreting adenomas, 4 aldosteronomas, 18 hormonally inactive adenomas, 6 miscellaneous tumours were found. Malignant tumours where significantly larger than benign (12.20 +/- 6.81 vs 6.71 +/- 5.62 cm, p < 0.005). We observed no correlation between the age and preoperative tumor size (p = 0.1756), between the age and pathological tumor size (p = 0.3601), and between BMI and the preoperative and histopathologic size (p = 0.4204, and p = 0.6478, respectively). CONCLUSIONS: The most common tumour was phaeochromocytoma. Most tumours where found in the right adrenal. The malignant tumours where larger than benign ones. No correlations between age and BMI, and tumour size where demonstrated.

Adrenal Gland Neoplasms↗
PubMed2006

[Subclinical hypothyroidism influences ventricular repolarization measured by QTc interval].

UNLABELLED: Thyroid disorders exert a major effect on cardiac function and on ECG. Few studies examined the effect of thyroid hormones on ventricular repolarization, measured by corrected QT interval (QTc). Prolonged QTc is associated with increased risk of arrythmias and cardiac mortality. The aim of this study was to examine the influence of subclinical hypothyroidism on ventricular repolarization measured by corrected QTc in standard 12-lead electrocardiogram. The examined group consisted of 32 patients with hypothyroidism, the controls were 39 healthy individuals. The mean corrected QTc was 0.434, SD +/- 0.0296 seconds and 0.414, SD +/- 0.0208 in the examined groups and in controls, respectively (p < 0.01). QTc did not correlate with free thyroxine concentrations (p = 0.4064). In the group with subclinical hypothyroidism we did not observe a significant difference in heart rate (74.3 vs. 73.7, SD +/- 13.58, NS). CONCLUSION: Corrected QT intervals were significantly prolonged in patients with subclinical hypothyroidism.

Arrhythmias, Cardiac↗
PubMed2005

Oxidative stress peripheral parameters in Graves' disease: the effect of methimazole treatment in patients with and without infiltrative ophthalmopathy.

OBJECTIVES: The study was designed to estimate the influence of hyperthyroidism and antithyroid treatment on oxidative stress peripheral parameters in Graves' disease patients with and without infiltrative ophthalmopathy. DESIGN AND METHODS: Free radical generation and scavenging plasma indices were determined in 47 patients with hyperthyroidism due to Graves' disease (22 with and 25 without infiltrative ophthalmopathy), as well as in 24 healthy volunteers after euthyroidism achievement with methimazole. RESULTS: In the hyperthyroid patients, hydrogen peroxide, lipid hydroperoxides, thiobarbituric acid-reacting substances, ceruloplasmin, superoxide dismutase, and catalase were increased. Glutathione peroxidase and glutathione reductase, however, were reduced. Methimazole treatment resulted in all markers being normalized in the patients without infiltrative ophthalmopathy, yet oxidative stress was still present in the ophthalmopathy group. CONCLUSION: We suggest that apart from the thyroid metabolic status influence, it is orbital inflammation that triggers changes in blood extracellular indices of reactive oxygen species metabolism.

Antithyroid Agents↗
PubMed2005

Fractionated dosage of radioiodine for the ablation of differentiated thyroid carcinoma.

In some countries with a limited number of specialized hospital beds for radionuclide therapy, ablation therapy (RIT) of differentiated thyroid carcinoma (DTC) is performed using a fractionated dosage of radioiodine. The aim of this study was to evaluate the early clinical outcome of ablation with fractionated doses of RIT in comparison to the ablation with a single dose. A subset of 386 subjects with DTC referred for the initial RIT was selected retrospectively for the study. Of these, 113 patients (29.3%) were treated with one (131)I dose of 2.2 GBq (group 1, RIT between 2001 and 2003) and 273 patients (70.7%) with fractionated doses (1.1 GBq + 1.1 GBq administered in 24 hour intervals) (group 2, RIT between 1999 and 2001). The early outcome of the initial RIT was evaluated 6-8 months later by radioiodine uptake test (RIU), thyroglobulin concentration, whole-body diagnostic scan, and neck ultrasound. On the basis of these results, the patients were classified as: CR, complete remission; NCR, no complete remission. Frequency of CR and NCR outcomes and the parameters measured during the follow-up evaluation in both groups were compared. CR outcome was found in 69 patients (61.1%) of group 1 and in 172 patients (63.0%) of group 2 (p = n.s.). No difference in measured parameters was found in both groups at the follow-up evaluation. In uncomplicated cases of DTC, RIT using a regimen of a fractionated dosage, is equally effective as the therapy with a single dose. No influence of stunning was observed in patients treated with a fractionated dosage, but the time interval between the doses was 24 hours.

Adolescent↗
PubMed2005

Radioiodine treatment of hyperthyroidism in patients with low thyroid uptake.

BACKGROUND: The aim of the study was to analyze the effectiveness of radioactive 131I in hyperthyroid patients with confirmed lowered iodine uptake as compared to patients with an uptake of over 30%. MATERIAL AND METHODS: We retrospectively analyzed 53 consecutive patients aged from 29 to 84 (mean age 60 years) suffering from hyperthyroidism caused by Graves' disease or toxic nodular goitre. The patients were divided into 2 sub-groups: the 1st with a maximum iodine uptake of 18.7 +/- 3.2% (range, 11-23%) - 24 patients; the 2nd with a maximum iodine uptake of 27.1 +/- 2.1% (range, 24-30%) - 29 patients. The control group consisted of 50 patients treated with 131I with an iodine uptake of over 30%. Each patient was evaluated before, and 6 months after, treatment for fT3, fT4 and TSH with ECLIA; TRAb with RIA; ultrasound with a 7.5 MHz linear probe. The volume of the thyroid gland was determined using the Gutekunst method. All these factors underwent statistical analysis and were considered along with the results of clinical examinations. RESULTS: Clinical remission of hyperthyroidism was evident in 79.3% of both sub-groups, in total (83.3% and 75.3%, respectively). TSH was normalized in 62.3% of these patients (54.2% and 69.0%, respectively). The mean range of TSH levels increased from 0.081 microU/ml to 4.0 microU/ml after therapy; that is, from 0.087 microU/ml to 4.97 microU/ml in the 1st sub-group and from 0.076 microU/ml to 3.3 microU/ml in the 2nd sub-group. The volume of the thyroid gland was uniformly significantly lower, with a mean range of 40.5 ml before treatment and 21.7 ml afterwards. The results seen in both sub-groups were similar; only age and dose of radioiodine were slightly higher in the 1st, while mean uptake was higher in the 2nd. By comparison of these results to those of the control patients, we observed that the values of TSH, as well as thyroid volume and evidence of clinical remission, reflected those found in the control group. The mean dose of 131I was lower in the control group, that is 11.3 m Ci, as compared to the sub-groups as a whole, specifically, 15.7 mCi. The mean age of patients in the control group was slightly less than that of the study group (50.8 and 60, respectively). CONCLUSIONS: 1. The results of the treatment of patients with a low iodine uptake are similar to the results obtained in the group of patients with iodine uptake above 30% and therefore low iodine uptake should not be a contraindication for isotope I-131 therapy. 2. Additionally, we have demonstrated that a statistically significant decrease in thyroid volume is observed in all patients after the iodine isotope treatment which indirectly proves the effectiveness of the prescribed treatment, and that low thyroid iodine uptake is more frequently observed in elderly patients and in patients treated with iodine or anti-thyroid drugs.

Adult↗
PubMed2005

[Prolonged ventricular repolarization measured by QTc interval in hyperthyroidism].

UNLABELLED: Thyroid dysfunction exerts an effect on cardiac function and on an electrocardiographic curve. Few studies analyzed the influence of thyroid hormones on heart repolarization. Heart repolarization is assessed in every-day-practice with corrected QT interval in ECG. Prolonged QTc is associated with increased risk for heart rythm disturbances and mortality. The aim of this study was to assess the effect of hyperthyroidism on heart repolarization, measured with QT corrected by Bazett's formula. MATERIAL AND METHODS: The study group included 68 hyperthyroid patients (30 males, 38 females, mean age 39+/-10 yrs) and the controls were 39 in age and sex matched healthy subjects. TSH and free thyroxine were assessed. The QTc was measured in a standard 12 lead ECG. RESULTS: In the study group the heart rhythm was faster when compared to controls (91.8 vs.73.7, SD+/-16.11, p<0.0001). The mean corrected QT (QTc) was 0.430, SD+/-0.0273 sec., in controls respectively: 0.414, SD+/-0.0208 sec., p<0.01. QTc did not correlate with free thyroxine concentrations (p=0.2785). CONCLUSIONS: Corrected QT intervals were significantly prolonged in hyperthyroid patients, although they did not reach high values.

Action Potentials↗
PubMed2005

[Depression and anxiety in patients with adrenal tumor incidentally found on abdominal imaging performed for other indications].

OBJECTIVE: The aim of this study was to assess the level of anxiety and depression in patients with non-secreting adrenal incidentaloma. MATERIAL AND METHODS: The study group comprised 26 patients (16 women, 10 men, mean age 45, SD 11 yrs). The Polish version of the State-Trait Anxiety Inventory was used to assess anxiety level, and the Beck Depression Inventory was used to measure depression symptoms. RESULTS: The anxiety level was increased (median: 45.6 for state, and 46.5 for trait), and mild depression was present, with 13.5 scores on Beck's scale. CONCLUSIONS: Adrenal incidentaloma is associated with increased anxiety and depression.

Adrenal Gland Neoplasms↗
PubMed2005

[Successful pharmacological treatment of hyperinsulinemic hypoglycemia with verapamil and amlodipine--case report].

UNLABELLED: We present a case of an 80-years-old female patient admitted to hospital because of recurrent losses of consciousness due to hypoglycemia, and because of hypertension. In view of the clinical picture (Whipple's triad) a suspicion of hypoglycemia due to an insulinoma of the pancreas aroused. The suspicion was confirmed by a positive fast test. The test was terminated after 22 hours with a glucose concentration of 2.0 mmol/l (36 mg/dl) and an insulin level of 16.19 microU/ml. No visual diagnostic was performed due to the lack of the patient's consent, thus no diagnosis of a tumor of the pancreas could be established. Hypertension was controlled with two calcium channel inhibitors: verapamil and amlodipine were administered orally, in doses of 120 mg and 10 mg per day, respectively. Both medications were chosen because of intolerance to other anti-hypertensive agents. During two-weeks treatment an increase of glucose concentrations and no hypoglycemic symptoms were observed. The patient did not agree to surgical intervention and therefore she was discharged in good general condition. CONCLUSION: we observe the efficacy of verapamil and amlodipine administered simultaneously in the medical treatment of endogenous hyperinsulinemic hypoglycemia. Their efficacy in the medical treatment of insulinoma requires further research.

Aged, 80 and over↗
PubMed2005

[Use of the lymphoscintigraphy in detection of sentinel lymph nodes of the neck].

Technique of the application of radioactive tracer to the primary tumor and lymphoscintigraphy with use of the stationary and handheld gamma probe was presented. Various types of the used radioactive tracers were characterized. Scintigraphical criteria for sentinel nodes recognition were discussed. Advantages and limitations of the use of lymphoscintigraphy for sentinel nodes detection were described. Necessity of further study to determine feasibility of sentinel nodes radiolocalization in stage N0 in head and neck cancer was pointed out.

Humans↗
PubMed2005

[Insulin resistance assessed with HOMA-IR in hyperthyroid patients].

UNLABELLED: Hyperthyroidism may influence sensitivity to insulin. The aim of study was to assess insulin resistance in hyperthyroid patients in correlation with the plasma free thyroxine (FT4) and thyreotropin (TSH) concentrations. MATERIAL AND METHODS: The study group consisted of 15 hyperthyroid patients (11 females, 4 males, mean age 50, 6 +/- 12, 36 yrs.). The controls were 17 healthy individuals (6 females, 11 males, mean age 55, 12 +/- 14, 17 yrs.). In the study group the mean FT4 was 33.1 +/- 20.1 pmol/l, TSH 0.034 +/- 0.066 pmol/l, glucose 5.00 +/- 0.56 mmol/l, insulin 7.19 +/- 3.59 microU/mL. In the controls respectively: 16.2 +/- 1.8 pmol/l, 1.24 +/- 1.07 pmol/l, 5.04 +/- 0.62 mmol/l, 7.24 +/- 4.06 microU/mL. Insulin resistance was calculated with HOMA-IR model, and the results were in the study group: mean 1.63 +/- 0.85, range from 0.46 to 3.67, median 1.38; in the controls respectively: 1.69 +/- 1.08, range from 0.36 to 4.47, median 1.42. RESULTS: Insulin resistance did not differ significantly between the groups (p=0.8860). FT4 and TSH did not influence insulin resistance in either group, the correlations were insignificant: for FT4 and for TSH p=0.5100 and p=0.5601 in the study group, and p=0.172 and p=0.4509 in the controls, respectively. CONCLUSION: Hyperthyroidism did not influence insulin resistance assessed with HOMA-IR model in vivo.

Body Mass Index↗
PubMed2005

[Tobacco smoking in patients with hyperthyroidism].

The objective of this study was to determine the impact of cigarette smoking in hyperthyroidism patients. The study group included patients with Graves-Basedow disease (GB): n = 317 (32.9%), patients with Graves' ophthalmopathy (GO): n = 108 (11.2%), patients with toxic nodular goiter (TNG) n = 511 (53%) and 28 (2.9%) patients with toxic adenoma (TA). Evaluation of tabacco smoking and exposure to environmental tobacco smoke (ETS) was performed on the base of questionnaire acording to Fagerström test. The comparison of GO and GB indicate increased tabacco smoking in GO (OR = 0.36; 95%CI: 0.22-0.59). The frequencies of tacacco smoking displayed significantly increased in GB and TNG patients (OR=0.39; 95%CI: 0.28-0.56). Further analys of patients with GO and TA presented statistcal significance in group of smoking and non-smoking (OR=0.26; 95%CI: 0,073-0,95). In other cases we didn't found a significant influence of tobacco smoking on thyroid disease. The effect of smoking was more pronounced in Graves' patients (particulary in the patients with GO) than in other thyroid patients. Smoking among patients with thyroid disease (GO and GB disease) is associated with developing of anxiety and fright, depression and problems with social relations sphere.

Adolescent↗
PubMed2005

[Tobacco smoking in patients with multiple sclerosis--preliminary study].

Muliple sclerosis (MS) is a chronic disorder of autoimmune origin, affecting young people. The aim of our study was to evaluate the tobacco smoking in the patients with MS in the period of beginning the disease. The study included 58 MS patients (31 females, 27 males, mean +/- SD: age 32.15 +/- 6.28) with varying degrees of severity and types of MS (A. RRMS relapsing- remitting MS, B. SPMS - secondary-progressive MS and C. PPMS primary - progressive MS). Smoking status was determined by medical history and Fagerström test. In the examined group 38 (65.51%) persons were tobacco smokers, among them 21 (55.26%) females and 17 (44.74%) males. This preliminary analysis needs further thorough studies, f.e. the urine level of cotinine - as a main marker of tobacco smoking in MS patients.

Adult↗
PubMed2005

[Urinary cotinine in patients with hyperthyroidism].

The aim of our study was an analysis of cotynine, the main nicotine metabolite in the urine among hyperthyroid patients. The study group included 39 females and 4 males. The mean age was 35.59+/-14.22 yrs. (range: 18-73 yrs.; median: 32 yrs) among hyperthyroid patients suffering from: Graves-Basedow disease (GB), Graves' Ophtalmopathy (GO) and toxic nodular goiter (TNG). To evaluate the nicotine smoking intensity and ETS Environmental Tobacco Smoke, the urine analysis of cotynine level were performed. According to the statistical analysis using the Mann-Whitney test, the statistically significant difference between the level of cotynine among smokers suffering from GO and Graves-Basedow disease was revealed (p = 0.03). Similar results were obtained among the GO and TNG (p=0.02) using t-Student test with Welsch correction. To compare, there was no stastistically significant difference between the GB and TNG series (p=0.4). In the group of smoking patients with GO we found out incresed level of urine cotinine than in smoking patients with GB and TNG. We didn't found differences between GB and TNG in depends on an urine analysis of cotynine level.

Adolescent↗