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Biomedical subjects

K Nowak

Publications and source records attributed to K Nowak.

At least 37 records · Page 2Linked to original sources

[The usefulness of ultrasonic examination for diagnosis of congenital lateral and medial neck cysts].

In the study results of ultrasound examination of 169 patients treated in ENT Department in Poznań with clinical suspicion of congenital neck cyst were analysed. It was made methodic evaluation of ultrasound examination and confrontation of ultrasound attributes characteristic for each type of cyst--complicated and uncomplicated by inflammation. Results were compared with intraoperative.

Adolescent↗

[Measurement of vascular density in proliferative lesions of the thyroid gland].

In the present study vascular density was measure in histopathological slides of the simple goiter (15 cases) and of the same proliferative condition of the thyroid gland (113 cases) including adenoma (29 cases) and carcinoma (16 cases). Epithelial antibody CD31 and vWF identified vessels with the help of semiautomatic image analysis system. It has been shown that the highest values were typical for neoplastic tumors. However significant overlap has been shown. Statistically significant differences were very weakly seen between neoplasm's and thyroid hyperfunction. Also differences between carcinomas and adenomas were of low significance. Probably this is because of great heterogeneity of carcinomatosus neoplasms included in this study. Unexpectedly there were also no statistically significant differences between simple goiter, hyperplasia and thyroid hyperfunction.

Adenoma↗

Proliferation index and karyometric features of pancreatic intraductal proliferative lesions.

The increasing frequency and poor prognosis in pancreatic cancer prompt us to search for morphological lesions being a substrate for its development. Studies of autopsy and surgically resected material as well as recent molecular studies have proved that one of the possible pathways of pancreatic neoplasia is the intraepithelial proliferation--dysplasia--cancer sequence. In the present paper we studied the proliferative activity (Ki-67 index) in pancreatic intraepithelial proliferative lesions and its correlation with geometric features of cell nuclei as signs of increasing dysplasia. The studies were carried out in a group of 35 patients operated on for pancreatic cancer, chronic pancreatitis and other conditions not associated with the pancreas. We used immunohistochemical methods and basic morphometric parameters. The results of our studies indicate that the cell proliferative activity depends both on the type of epithelial proliferation and underlying pancreatic disease. The values of Ki-67 index are significantly different in low-grade proliferation (flat and papillary hyperplasia) and high-grade proliferation (atypical papillary hyperplasia and carcinoma in situ). A set of karyometric features correlates with Ki-67 index but there is no single feature which would have a diagnostic value.

Aged↗

CD44 isoforms expression in intraductal and invasive pancreatic cancer and its correlation to p53 gene mutations.

The expression of the CD44 antigen and its isoforms is found in many normal and malignant tissues. Numerous studies indicate that the antigen affects the course of the disease, and its v6 isoform exerts a particularly negative effect on the prognosis. High CD44s (standard) and v6 isoform expression has been noted in pancreatic cancer. A similarly common genetic change in pancreatic cancer is the p53 gene mutation. The aim of the investigation was to study the expression of the CD44s and CD44v6 antigens in invasive and intraductal pancreatic cancer and its possible correlation to the p53 gene mutations. Immunohistochemical studies were carried out in 12 patients operated on for pancreatic cancer, in whom intraductal cancer had been detected in addition to infiltrating cancer. The results indicate that pancreatic cancer is characterized by a high, yet independent expression of CD44s and the p53 protein. CD44s expression shows no correlation with the degree of tumor differentiation, while v6 expression is higher in cancers with higher histological malignancy grades. Intraductal pancreatic cancers show a similarity to invasive cancers with respect to CD44s and v6 expression, what indicates that already at the stage of its intraductal growth pancreatic cancer manifests the presence of properties affecting its invasiveness and tendencies to metastasizing.

Adenocarcinoma↗

Effect of Helicobacter pylori infection, smoking and dietary habits on the occurrence of antrum intestinal metaplasia. Clinico-epidemiological study in Poland.

The purpose of the study was to assess risk factors for intestinal metaplasia arising from H. pylori-related chronic gastritis in a subset of the population referred to endoscopic examinations due to dyspeptic complaints. We aimed specifically to establish whether H. pylori itself may be responsible for the occurrence of intestinal metaplasia and to which extent the metaplasia may be associated with life style factors such as cigarette smoking, alcohol consumption or dietary habits. The study was carried out in a sample of 1290 outpatients referred for the first time to gastroenterologic outpatient clinics in 6 university centers in Poland. The study methods covered standardized health interviews, endoscopy and histology of gastric antral specimens taken at endoscopy. The interviews performed by trained interviewers sought information on tobacco and alcohol intake, diet, socioeconomic status, and other variables. In non-ulcer dyspepsia subjects there was 54.9% H. pylori related gastritis and 25.1% of non-H. pylori-related gastritis. The corresponding rates in the group of ulcer dyspepsia were 67.5% and 20.5%. The increased risk of chronic gastritis in antrum was associated with Helicobacter pylori infection (OR = 2.28; 95% CI:1.93-2.69), and with gastric peptic ulcer (OR = 1.88; 95% CI:1.20-2.94). In the non-ulcer dyspepsia the prevalence of metaplasia was 11.1% and in ulcer dyspepsia 19.7%. The risk of intestinal metaplasia within antrum depended greatly upon the presence of gastric peptic ulcer (OR = 3.85; 95% CI:2.35-6.32) and increased with age (OR = 1.05; 95% CI:1.04-1.07), smoking cigarettes currently or in the past (OR = 1.42; 95% CI:1.10-1.84), higher frequency of drinking vodka (OR = 1.32, 95% CI:1.01-1.75) and antral chronic gastritis (OR = 1.31; 95% CI:1.00-1.70), however, it was inversely related to daily consumption of fresh fruits or vegetables (OR = 0.59; 95% CI:0.38-0.93). The results of the study suggest that there is no sufficient evidence supporting the hypothesis about an association between H. pylori gastritis and intestinal metaplasia, however, the transition of gastritis to metaplasia depends greatly on life style factors such as cigarette smoking or vodka drinking and is impeded by daily consumption of fresh fruits or vegetables.

Alcohol Drinking↗

[The historical significance of the Polish medical faculty in Edinburgh].

The Polish Medical Faculty at the University of Edinburgh was a unique phenomenon in the history of universities. Established during the Second World War in 1941 as an entirely autonomous Polish academic institution, the Faculty trained 228 doctors and awarded 19 PhD degrees during its nine years of formal existence (1941-1949). In reviewing its almost 60-year old history, seen in the context of the involvement of the elite of both the political and academic establishments, the splendour of various celebrations and its graduates devotion in keeping the "Edinburgh experiment" alive, the author makes a case for the long-term historical and psychological significance of events well outlasting the period of formal activity of the Faculty. The history of the Faculty is well documented, but the long term outcome in terms of its lasting historical importance is gradually emerging with the passage of time. It has become an indisputable testimony to the generosity and hospitality of the Scottish (political and) academic establishment and a lasting proof of the special liaison between the Scots and the Poles. The Faculty's importance and psychological significance to the rich historical heritage of Polish medicine and the notion of patriotism and loyalty to Polishness have become apparent in the ensuing decades of its carefully maintained tradition. The existence of the Polish Medical Faculty has become an extraordinary asset in the history of Scottish universities, but for the Polish tradition both in Poland and throughout its rich diaspora it constitutes an increasingly valuable historical event which deserves to be cultivated and passed on to younger generations so that it may continue bringing further dividends, so important to national identity, achievement, dignity and pride.

Faculty, Medical↗

[The assessment of hepatic enzymes' levels in children treated for leukemia and non-Hodgkin's lymphomas].

The purpose of this study was to determine the frequent of serum aminotransferase elevation in children with leukemias and non-Hodgkin's lymphomas and define the cause of this pathology. In the serum of 43 children the bilirubin concentration, activities of aspartic aminotransferase (AspAT), alanine aminotransferase (AlAT) and gammaglutamylotranspeptidase (GGTP) were measured before treatment, during and after intensive chemotherapy. 43 patients 8 (65%) had bilirubin concentration above 1.2 mg/dl and/or aminotransferase activities above 100 U/l. The most possible causes of the liver damage in the patients were: hepatotoxicity of chemotherapy, virus or bacterial infections and leukemic or lymphomatous involvement of the liver.

Adolescent↗

[Cytoprotective effect of amifostine in children during induction therapy according to BFM-83: report on cases].

Amifostine is the agent of proved cytoprotective activity against alkylating drugs and rubidomycine. Its protective effect against other cytotoxic drugs is doubtful. BFM-83 induction therapy for ANLL (ARA-C + RUB + VP-16) which is applied to children with acute non-lymphoblastic leukemia (ANLL) commonly contributes to severe adverse reactions. We administered amifostine to three children: 2 boys with ANLL (7 and 11 yrs) and 1 girl with MDS (3 yrs) during etoposide and rubidomycine induction therapy in order to decrease chemotherapy-related adverse reactions. Doses of amifostine were 740 mg/m2, 910 mg/m2 and 910 mg/m2 respectively. Efficacy of the therapy was evaluated on the base of blast decline in the bone marrow, efficacy of the cytoprotection by myelo and nephrotoxicity symptoms analysis. Chemotherapy-related adverse effects in the children protected by amifostine were less severe and observed by the shorter periods as compared with the historical control group of 20 patients treated according to BFM-83 without cytoprotection. These cases show the potential beneficial effect of amifostine during BFM-83 induction therapy for ANLL. The further randomised clinical study of the proposed cytoprotection should be performed to establish its value.

Amifostine↗

[The use of hematopoietic growth factors G-CSF/GM-CSF in the treatment of neutropenia in children with acute lymphoblastic leukemia and non-Hodgkin's lymphomas].

Maximal intensification of antineoplastic therapy is currently a predominant trend in the treatment regimens for acute leukemias and lymphomas. However, by such approach myelosuppression and counteracting its sequelae become paramount problems. Hematopoietic growth factors G-CSF/GM-CSF play a great role in this aspect of the therapy. Effects of 35 courses of G-CSF/GM-CSF were evaluated in 19 children with ALL and NHL and compared with 21 episodes of neutropenia in 15 historical controls. In the treatment group time of neutropenia was approx. 3 times shorter as compared with a control group. Fever accompanying neutropenia occurred less frequently and lasted shorter in the treatment group. Also, symptoms of infection subsided faster. Subjective life quality was better in children receiving growth factors.

Adolescent↗

[Central venous lines in children with cancers].

Authors analyzed clinical aspects of central venous lines in children with cancer. In 25 patients central venous catheters with subcutaneous ports and in 34 patients lines with external ending were inserted. Catheters were left in place respectively 62-836 days and 4-365 days. During that time 10 catheters were removed due to occlusion, leakage, local infection or sepsis. The causes of these complications were analyzed in discussion.

Adolescent↗

[The case of neurofibromatosis type ! in a 5-year-old boy].

In the work we present the case of a 5-year-old boy who was admitted to the clinic because of the tumour in mediastinum. According to the results of the investigation the diagnosis of Recklinghausen disease was made. The tumour was situated in the region of pharynx, neck and mediastinum. The diagnosis was based on the characteristic features in the physical examination (café-au-laît spots, freckles in armpits and grains) and accessory investigations (x-ray, CT, NMR and histopathology). In the boy's family this disease was not noticed, although in his mother we observed café-au-laît spots on the skin of abdomen. Despite the fact that the diagnosed disease is known as a mild one (from the histopathological point of view) in the case of our patient it turned out to be much more clinically malignant because of the localization of the tumour. This situation forced us to the application of much more aggressive treatment (chemotherapy, operation).

Cafe-au-Lait Spots↗

[Diagnostic problems in coexistence of paranasal sinusitis with cerebral tumor].

Differential diagnosis between the intracranial complications of paranasal sinusitis and cerebral tumor belongs to very difficult tasks in otolaryngology and neurosurgery. Complications of sinusitis, such as intracranial abscess formation, are uncommon and often clinically unremarkable. The arising difficulties are even greater in inflammatory intracranial complications of sinusitis, giving symptoms similar to those of cerebral tumors. The illustrative case report was presented.

Aged↗

HER-2/Neu expression as a progression marker in pancreatic intraepithelial neoplasia.

Pancreatic intraepithelial neoplasia is only partially defined. Any attempt to establish the diagnostic criteria of early pancreatic carcinoma has been unsuccessful so far. In the present study we investigate expression of HER-2/neu in hyperplastic pancreatic duct epithelium. Material included resected pancreatic tissue obtained from 13 patients with pancreatic carcinoma, 11 with chronic pancreatitis, and 11 patients operated on for other reasons (gastric cancer, carcinoma of papilla Vateri). Hyperplasia of pancreatic duct epithelium was scored as: 1. flat mucosal hyperplasia FH, 2. papillary hyperplasia PH, 3. atypical papillary hyperplasia APH, 4. carcinoma in situ CIS. Immunohistochemical expression of HER-2/neu was studied with the biotin-streptavidin method. Results were scored as: 1+ barely perceptible light membranous rimming, 2+ light to moderate rimming, 3+ moderate to strong rimming. Expression of HER-2/neu paralleled with the hyperplasia grading, in most cases being negative in normal duct epithelium, weak in flat hyperplasia, and moderate to strong in atypical papillary hyperplasia and carcinoma in situ. In conclusion, HER-2/neu expression could be used as an additional marker of hyperplasia, dysplasia and atypia of pancreatic ductal and ductular epithelium in the process of pancreatic epithelial neoplasia. This could be especially useful in the cytological diagnosis of pancreatic intraepithelial neoplasia.

Adult↗

A topographic analysis of atrophic gastritis and stomach cancer risk. A clinicoepidemiological study in Poland.

The purpose of this cross-sectional study was to assess the relation between intestinal and diffuse stomach cancer at its various locations with topography of atrophic gastritis. The study population consisted of 3435 patients who reported over the period of 1991-1994 for the first time to gastroenterological outpatient clinics of 7 university medical centers in Poland. Among these subjects there were 131 histologically proved consecutive cases of gastric carcinoma. The reference group consisted of 1540 patients among whom endoscopic examination did not reveal peptic ulcers, polyps, deformations of antrum or bulbus duodenum and mucosa erosions. Gastroscopy on gastric cancer patients and the reference group was performed and biopsy specimens were obtained from the tumour and from the antrum and stomach corpus distant from the tumour. Among the gastric cancer cases there was a higher prevalence of atrophic gastritis in the intestinal than in the diffuse type. The highest prevalence of atrophic gastritis irrespective of its degree and stomach area was observed in the tumour-area of intestinal cancer located distally (78.9%), and the lowest in the tumour-free area in diffuse proximal cancer (18.5%). Prevalence of atrophic pangastritis (atrophic gastritis present both in the corpus and antrum) was also highest in intestinal distal cancer (69.2%) and lowest in diffuse proximal cancer (21.7%). The age-adjusted correlation coefficients between gastritis score in the tumour-area and tumour-free area were highly significant. It was shown that only atrophic pangastritis was significantly associated with gastric cancer irrespective of its histology and location (OR = 3.8, 95% CI:2.4-6.0), however, it was much stronger related to the intestinal gastric cancer (OR = 5.9, 95% CI: 3.1-11.0), than to the diffuse carcinoma (OR = 2.2, 95% CI: 1.1-4.3).

Adult↗

[Controlled clinical studies for topographic analysis of atrophic gastritis and stomach cancer].

The purpose of this cross-sectional study was to assess the relation between intestinal and diffuse stomach cancer at its various locations with topography of atrophic gastritis. The study population consisted of 3435 patients who reported over the period of 1991-94 for the first time to gastroenterological outpatient clinics of 7 university medical centers in Poland. Among these subjects there were 131 histologically proved consecutive cases of gastric carcinoma. The reference group consisted of 1540 patients among whom endoscopic examination did not reveal peptic ulcers, polyps, deformations of antrum or bulbus duodenum and mucosa erosions. Among the gastric cancer cases there was a higher prevalence of atrophic gastritis in the intestinal than in the diffuse type. The highest prevalence of atrophic gastritis irrespective of its degree and stomach area was observed in the tumour-area of intestinal cancer located distally (78.9%), and the lowest in the tumour-free area in diffuse proximal cancer (18.5%). Prevalence of atrophic pangastritis (atrophic gastritis present both in the corpus and antrum) was also highest in intestinal distal cancer (69.2%) and lowest in diffuse proximal cancer (21.7%). For other types of cancer the prevalence rates of atrophic pangastritis was 50.0% in intestinal proximal cancer and 37.5% in diffuse distal carcinoma. The age-adjusted correlation coefficients between gastritis score in the tumour-area and tumour-free area were highly significant. It was shown that only atrophic pangastritis was significantly associated with gastric cancer irrespective of its histology and location (OR = 3.8, 95% CI:2.4-6.0), however, it was much stronger related to the intestinal gastric cancer panga (OR = 5.9, 95% CI: 3.1-11.0), than to the diffuse carcinoma (OR = 2.2, 95% CI: 1.1-4.3).

Adult↗

[The distribution of metastases to cervical lymph nodes of laryngeal and pharyngeal neoplasms. Comparison of clinical evaluations and assessment of surgical preparation].

The purpose of the study was a comparison of clinical and pathological assessment of cervical lymph nodes metastases in advanced carcinoma of larynx and the hypopharynx. The outspread, size and number of the nodes metastases to the particular regions of the neck was taken into analysis. The differences and occurrence in clinical and pathological assessment was pointed out.

Humans↗

[The Polish Medical Association, Londyn].

The Polish Medical Association, founded in 1944 in London and celebrating its Golden Jubilee in 1944, is a unique organisation of doctors brought together by the shared experience of serving in the Polish armed forces on the fronts of the II World War. Preparing themselves for the return to a free Poland and later facing the realities of the emigré existence, they formed an association based on an identity with patriotic ideals and espousing a loyalty to the national cause, solidarity with the aspirations and goals of the expatriate community and commitment to the integrity in the performance of their professional duties. It was created against a background of the already existing Polish Medical Faculty at the University of Edinburgh and supported by strong lobbying on the part of the Polish Government and the favourable political climate. The need for a professional body of Polish doctors became evident. During the first few years the Association, originally called the Polish Medical Association in the British Empire, numbered over 700 doctors and achieved notable succeses for its members. The most significant were the endeavours which contributed to the inclusion of the so-called Clause 5 of the Polish Resettlement Act 1947, which in practice allowed Polish doctors serving in the Polish forces under British command to obtain full medical registration. Almost 800 doctors benefitted from this legislature and by coincidence, with the introduction of the National Health Service, they constituted the single most significant injection of non-British doctors into the British health care system. Throughout the years the Association, which originally comprised doctors with an Army background acquired more and more civilian members. The second generation followed, smaller waves of post-war emigration brought in new members from Poland. With time the administrative structure of the Association--initially comprising ten divisions in the UK and overseas--has changed; the second generation--those already born and educated in the UK--joined the professional ranks, and later achieved the highest positions. The return of democracy to Poland, so eagerly awaited, has brought a new dimension to the Association's activities. Its original character, however--identity with the national ideals of dignity, honour, integrity--naturally, remains unchanged and deeply ingrained in the collective and individual consciousness of this unique group. The Association maintains active contacts with Poland's leading medical institutions and academic establishments and is the initiator of the ideal of integrated effort of the Polish emigré medical milieu and medicine in Poland--the ultimate goal is the long-term commitment to the health of the Polish nation.

History, 20th Century↗