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M Sosnowski

Publications and source records attributed to M Sosnowski.

At least 19 recordsLinked to original sources
PubMed2006

A large germline deletion in the Chek2 kinase gene is associated with an increased risk of prostate cancer.

BACKGROUND: Germline mutations in the Chek2 kinase gene (CHEK2) have been associated with a range of cancer types. Recently, a large deletion of exons 9 and 10 of CHEK2 was identified in several unrelated patients with breast cancer of Czech or Slovak origin. The geographical and ethnic extent of this founder allele has not yet been determined. PARTICIPANTS AND METHODS: We assayed for the presence of this deletion, and of three other CHEK2 founder mutations, in 1864 patients with prostate cancer and 5496 controls from Poland. RESULTS: The deletion was detected in 24 of 5496 (0.4%) controls from the general population, and is the most common CHEK2 truncating founder allele in Polish patients. The deletion was identified in 15 of 1864 (0.8%) men with unselected prostate cancer (OR 1.9; 95% CI 0.97 to 3.5; p = 0.09) and in 4 of 249 men with familial prostate cancer (OR 3.7; 95% CI 1.3 to 10.8; p = 0.03). These ORs were similar to those associated with the other truncating mutations (IVS2+1G-->A, 1100delC). CONCLUSION: A large deletion of exons 9 and 10 of CHEK2 confers an increased risk of prostate cancer in Polish men. The del5395 founder deletion might be present in other Slavic populations, including Ukraine, Belarus, Russia, Baltic and Balkan countries. It will be of interest to see to what extent this deletion is responsible for the burden of prostate cancer in other populations.

Checkpoint Kinase 2↗
PubMed2005

Absence of implicit and explicit memory during propofol/remifentanil anaesthesia.

BACKGROUND AND OBJECTIVE: High doses of opioid associated with low doses of hypnotic is a popular anaesthetic technique since the use of remifentanil has become widespread. This type of anaesthesia could result in a higher incidence of implicit memory. METHODS: Ten patients were anaesthetised with a target-controlled infusion of remifentanil (target concentration of 8 ng mL(-1)) combined with a target-controlled infusion of propofol with progressive stepwise increases until loss of consciousness was reached. A tape containing 20 words was then played to the patients. Bispectral index (BIS, Aspect Medical Systems, Newton, MA, USA) was continuously monitored during the whole study period. Implicit and explicit memories were tested between 2 and 4 h after recovery. RESULTS: Loss of consciousness was obtained with a mean calculated propofol plasma concentration of 1.3 +/- 0.4 microg mL(-1). At this low hypnotic concentration no implicit or explicit memory was found in the three postoperative memory tests. Median (range) BIS value during word presentation was 93 (80-98). CONCLUSIONS: In our group of young American Society of Anesthesiologists (ASA) I/II patients, no explicit or implicit memory was found when the calculated concentration of propofol combined with a high concentration of remifentanil was maintained at the level associated with loss of consciousness with high BIS values.

Acoustic Stimulation↗
PubMed2001

Scatterplots of RR and RT interval variability bring evidence for diverse non-linear dynamics of heart rate and ventricular repolarization duration in coronary heart disease.

OBJECTIVE: QT interval prolongation and increased spatial QT dispersion are important factors increasing the risk in coronary heart disease. The authors studied the spontaneous beat-to-beat variability of ventricular repolarization (RT intervals) in normal subjects and in patients after myocardial infarction (MI) in order to define the determinants of abnormal temporal dispersion. METHODS: Seventy-six patients with a history of MI (17 female, 59 male, aged 52 +/- 10 years) comprised the study group. Forty-seven patients had preserved left ventricular ejection fraction (EF > or = 40%, MI-A) and 29 patients had left ventricular dysfunction (EF < 40%, MI-B). Twenty healthy volunteers (6 female, 14 male, aged 25 +/- 5 years) were included as the control group. An ECG signal of 512 heartbeats was recorded in the supine position. After analogue-to-digital conversion (16 bit, 2 kHz), the fiducial points of the R wave and T wave were determined. The RR and RT variability (V) assessed in the time domain as the standard deviations of RR and RT (ms), as well as the coefficients of scatterplots of RR and RT intervals. RESULTS: As expected, the standard deviation of RR was significantly reduced in MI patients. The magnitude of RTV in the time domain was similar in the controls and in both subgroups of MI patients. The complexity of heart rate variability (HRV) was slightly, but significantly, reduced in the MI-B group, but not significantly in the MI-A heart group. The complexity of RTV behaved in the opposite manner, being increased in both MI subgroups with the lower mean in the MI-B patients. The different behaviour of HRV and RTV was indicated by the increased ratio of RR/RT coefficients, which reached a significantly greater value in the MI-B group. CONCLUSION: The authors have described different patterns of scatterplot of short-term HRV and RTV in normal subjects, which confirmed that RTV is a less complex phenomenon than HRV. In patients after MI, the complexity of HRV diminishes, while the complexity of RTV increases. These opposing changes are more pronounced in patients with left ventricular dysfunction. A possible prognostic value of this feature is unknown and remains to be elucidated in future prospective studies.

Action Potentials↗
PubMed2000

Cardiac sympathovagal balance during endoscopic retrograde cholangiopancreatography.

BACKGROUND AND STUDY AIMS: Cardiopulmonary complications have been reported during upper gastrointestinal endoscopy and endoscopic retrograde cholangiopancreatography (ERCP). The aim of this study was to evaluate the sympathovagal response to the stretching of the common bile duct caused by contrast medium injection during ERCP. PATIENTS AND METHODS: The 16 patients included in the study were assigned to two groups according to the size of common bile duct. Group A consisted of patients with normal-sized bile ducts, while Group B patients had dilated common bile ducts. The heart rate variability (HRV) technique was used to assess the sympathovagal balance. The HRV data were gathered using the Holter technique, and frequency domain analysis revealed two main spectral components of HRV: low frequency (LF) and high frequency (HF). RESULTS: In patients with normal-sized bile ducts, contrast injection initiated a rapid increase in the power spectra (ms2) of both the HF and LF components. In patients with dilated common bile ducts, this phenomenon was not observed. CONCLUSIONS: During ERCP, contrast injection into a dilated common bile duct does not stimulate the autonomic nervous system in the same way as it does when the common bile duct is of normal size.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed2000

[The cause of myocardial infarction in pediatric patients].

Heart infarct in children seems to be more common than it is recognized. In the paper we discussed the most frequent causes of heart infarct as: congenital anomalies of coronary arteries (first of all anomalous origin of the left coronary artery), their post-inflammatory and post-operative stenosis, coronary thrombosis and embolism, coronary spasm, metabolic and proliferative diseases, coronary insufficiency, and the other ones (e.g. heart trauma).

Child↗
PubMed2000

[Laboratory diagnosis and some remarks concerning mortality and treatment of children with myocardial infarction].

There are presented in the paper laboratory findings, echocardiographic and radioisotope studies results, as well as heart catheterization including coronarography in the pediatric patients suffering from heart infarction. Mortality and malignant arrhythmias due to heart infarct in pediatric age are shortly discussed, too. At last there are some remarks concerning myocardial infarction treatment in children.

Arrhythmias, Cardiac↗
PubMed1999

[Importance of respiration for non-invasive assessment of cardiac autonomic control in patients with ischemic left ventricular dysfunction].

UNLABELLED: Respiratory rate is an important factor influencing heart rate variability (HRV), but is usually ignored in the studies in patients with ischaemic heart disease (IHD). This factor may significantly contribute to the changes in HRV in ischaemic left ventricular impairment. We examined 186 patients with IHD (46 females, 140 males), including 54 pts with left ventricular ejection fraction < 40% and 132 pts with preserved LVEF (> or = 40%). HRV was evaluated in supine and standing position from short-term ECG (512 beats, 1 kHz, 12 bit) in time- (mean RR interval--RRI, and standard deviation of RRI-SD-RR) and frequency-domain (FFT). Power spectral density of high and low frequency (HF 0.14-0.5 and LF 0.04-0.15 Hz) was estimated and expressed as log-values. The frequency of respiration (fResp, Hz) was defined as the frequency of maximum HF power. RESULTS: Patients with LVEF < 40% had shorter RRI in supine (879 + 157 vs 942 +/- 147 ms, p < 0.05), but similar in standing. FResp was greater both in supine (0.308 +/- 0.05 vs 0.274 +/- 0.047 Hz) and in standing (0.329 +/- 0.055 vs 0.274 +/- 0.047, all p < 0.001) in low, as compared to preserved LVEF. As expected, HRV parameters were more reduced in LVEF < 40%. The differences of raw values were as follows: SD-RR 29 +/- 16 vs 34 +/- 15 i 27 +/- 13 vs 31 +/- 12 ms, both p < 0.05, HF 3.21 +/- 0.36 vs 3.33 +/- 0.32, p < 0.05 and 3.19 +/- 0.32 vs 3.21 +/- 0.29 p > 0.1, LF 3.41 +/- 0.33 vs 31.49 +/- 0.30 and 3.52 +/- 0.30 vs 3.61 +/- 0.32, p < 0.05, ANOVA). The differences were observed despite adjustment for age, sex and RRI. When fResp was added as covariate they became not significant. CONCLUSION: Patients with left ventricular dysfunction had faster rate of respiration. This finding may explain, in part, reduced HRV in these patients. The rate of respiration should be taken into account for correct interpretation of HRV analysis.

Autonomic Nervous System↗
PubMed1998

Ureteroscopy in the treatment of ureteral stones: over 10 years' experience.

OBJECTIVE: Rapid development of endourology and the invention of more and more advanced ureteroscopes and other instruments used in ureteral lithotripsy have made the traditional methods of treatment become very rare. METHODS: We present our experience in ureteral lithotripsy resulting from 1,982 ureteroscopy (URS) procedures, performed because of ureteral stones. Before URS, percutaneous nephrostomy tube (PCNT) was created in 264 (16.7%) cases. We also present our own technique, called the 'Jeromin maneuver', which involves pressing the abdominal wall by the assistant's hand, facilitating URS in difficult cases. RESULTS: Good results after the first URS procedure of removing ureteral stones were obtained in 1, 364 (86.6%) patients out of 1,575. In the remaining 211 (13.4%) cases, URS was performed two or more times. The overall failure rate was 3.6%. In the vast majority of cases, URS procedures were performed without dilatation of the ureteral orifice and splinting. The most important complications of URS were: perforation of the ureteral wall with periureteral leak which necessitated surgery (4 patients), ureteral stenosis which necessitated endoscopic reparation (4 patients) and stenosis of the ureteral orifice which necessitated endoscopic reparation in 2 patients. CONCLUSIONS: Routine dilatation of the ureteral orifice before the URS procedure and splinting with a D-J catheter are unnecessary; in case of a narrow ureter and very large prostatic adenoma, URS should not be attempted, because of the high risk of serious damage of the ureter. URS is a safe procedure but requires a highly experienced urologist.

Adolescent↗
PubMed1998

[Expression of fetal antigens of gonocytes in the investigation of pathogenesis of germinal cell neoplasia].

Expression of fetal antigens of germinal cells reacting with antibodies M2A and TRA-1-60 has been studied in fetal germinal cells-gonocytes (G) persisted in gonads of prepubertal boys because of male pseudohermaphroditism (MP) and in germinal carcinoma cells in situ (CIS) of adult men. The presence of G and CIS cells was detected immunohistochemically by identification of placental like alkaline phosphatase (PLAP). CIS cells showed expression of M2A in all adult men and additionally TRA-1-60 in one case. These antigens were present in G cells only in 2 out of 6 G bearing testes of boys with MP (30%). G cells were not found in testes of 3 other older boys with MP. So, in 1/3 cases of children with MP G cells show similar features like CIS cells during the prepubertal period indicating that they are able to enter malignant transformation in early prepubertal testis. Although total frequency of occurrence of G cells in MP boys was 2/3 (60%), their malignant transformation may be lower.

Antigens, Neoplasm↗
PubMed1997

[Comparison of clinical and histopathologic diagnosis for early stages of advanced nonseminomatous germ cell testicular tumors].

The authors present their observations concerning application of imaging methods in disease staging procedures in 69 patients with low stage nonseminomatous germ cell testicular tumors (NSGCTT). The results of CT, USG, and lymphangiography examinations of the retroperitoneal lymph nodes were compared with the results of pathological examination of these nodes, removed during retroperitoneal lymphadenectomy. 29 patients had clinical stage I (no node involvement) and 40 patients had stage II disease (node metastases). After lymphadenectomy, in 31% of the patients, diagnosed clinically as stage I, the preliminary diagnosis was found to be false negative, and in 13.5% of the patients, diagnosed clinically as stage II, the preliminary diagnosis was found to be false positive. We assessed the value of the imaging methods by calculating the accuracy, the sensitivity and the specificity of each of them. The results are, respectively: 81%, 76% and 57% for CT; 79%, 76% and 51% for USG; and 77%, 77%, and 69% for lymphangiography. The authors conclude that retroperitoneal lymphadenectomy allows establishing of the most precise diagnosis and appropriate treatment in patients with nonseminomatous germ cell testicular tumors.

Adult↗
PubMed1996

The incidence of bovine diploid oocytes matured in vitro.

The present work describes a cytogenetic study of in vitro matured bovine oocytes to determine the proportion of unreduced oocytes carrying the diploid number of chromosomes. Studied oocytes were derived either from a pool of oocytes collected from several different donors, or from oocytes collected separately from individual donors. In vitro maturation was performed by culturing immature oocytes for 24 h in TCM199-medium supplemented with estrous cow serum and hormones at 39 degrees C in 5% CO2. Chromosomal complement of in vitro matured oocytes was studied by Giemsa-staining and produced analyzable results in approximately 60% of the cases. The results revealed that approximately 75% of oocytes had matured to the MII stage in both groups of oocytes studied. Of these MII oocytes, 11 and 12.4% (from the oocyte pool or from individual cows, respectively) contained the diploid set of chromosomes. The occurrence of diploid MII oocytes was not quite uniform among donors: 40.5% of all cows produced one, 18.9% produced two and 2.7% (one cow) produced three diploid MII oocytes. However, a positive relationship between the number of MII oocytes in general and diploid MII oocytes among individual donors was not found. The possible factors that may lead to the formation of diploid MII oocytes observed under IVM procedures are discussed. The results of this study showed a higher incidence of diploid oocytes in cattle than previously reported.

Journal Article↗
PubMed1996

[Qualifying patients with unstable angina for invasive tests based on electrocardiographic examinations].

In 40 patients with unstable angina pectoris a variety of electrocardiographic parameters were analysed. In all patients routine ECG, signal averaged high resolution ECG. 24 hour ECG recordings and heart rate variability analysis were performed at admission and repeated at 7 day of hospitalization. During second week patients underwent also exercise treadmill test. On basis of clinical presentation each patient was qualified to invasive investigation, 31 patients had need for urgent cardiac catherization (group I-urgent indications) and in the remaining 9 patients cardiac catherization was performed 3 months after the relief of acute symptoms (group II-non-urgent indications). The most impressive implications were draw from repeated 24 hour Holter ECG monitoring. In patients with urgent indications (gr. I) more frequent and severe ischemic episodes, as well as more frequent ventricular arrhythmias were observed. Patients from group I were unable to achieve higher grades on exercise treadmill test, while ST segment depression was comparable in both groups. Heart rate variability analysis showed greater disturbances of cardiac vagal control in group I. The number of critically stenosed vessels was similar in both groups, however left ventricular systolic dysfunction was observed mainly in patients with urgent indications for cardiac catherization.

Adult↗
PubMed1996

Hospital grand rounds in family medicine. Content and educational structure.

OBJECTIVE: To investigate hospital grand rounds in family medicine, to examine their content and organization, and to recommend improved educational structures for these ubiquitous continuing medical education events. DATA SELECTION: Retrospective analysis of titles and content of 358 family medicine grand rounds offered in the department of family medicine of a large urban hospital from mid-1983 to the end of 1994. FINDINGS: Only 10% of family medicine grand rounds were presented by family physicians. Most grand rounds were in the form of specialists exhibiting their own interests in a lecture format. Analysis of grand rounds titles showed no consistent pattern of topics but an emphasis on practical aspects of medical care. Patient-based presentations were uncommon, as were grand rounds with more than one speaker. CONCLUSIONS: The content and mix of topics appeared appropriate, but in the absence of a curricular structure, or evaluation of learning gain, it is difficult to assess the value of grand rounds.

Alberta↗
PubMed1995

Heart rate variability. Is it influenced by disturbed sinoatrial node function?

Analysis of heart rate variability (HRV) is commonly used to assess the influences of the autonomic nervous system on the heart; however, its relation to the sinoatrial node function has not been clearly defined. In this study, the authors performed HRV investigations in 150 patients (51 women and 99 men; mean age, 49 years; range, 17-80 years) in whom clinical observation and electrophysiologic transesophageal studies proved sinoatrial node dysfunction (SAND) and in 50 healthy control subjects (19 women and 31 men; mean age, 37 years; range, 15-60 years). All examined subjects underwent transesophageal left atrial overdrive pacing for the evaluation of sinus node recovery. The HRV analysis was based on 1-minute esophageal electrocardiographic recordings. Two time-domain HRV variables were measured: variability range ([VR]) the difference between the longest and the shortest sinus cycle length, divided by basic sinus cycle length) and beat-to-beat variability ([DSCL]--the maximum difference between any two consecutive sinus cycle lengths) during a 1-minute recording. Because of the known effects of age and basic sinus cycle, statistically adjusted means of VR and DSCL were compared. In patients suffering from SAND, DSCL was significantly higher than in the control subjects (198 +/- 206 vs 98 +/- 89 ms, respectively), as was VR (30.3 +/- 23.3% vs 20.9 +/- 121.1%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

[Analysis of heart rhythm variability in evaluation of treatment for unstable angina pectoris].

Unstable angina pectoris is accompanied by several unfavourable autonomic disturbances. A noninvasive assessment of the autonomic cardiac control is possible by means of heart rate variability analysis (HRV). 26 patients with unstable angina pectoris were enrolled in the study. All patients received obligatory nitroglycerin and heparin intravenously within two days, and gallopamil (G) or metoprolol (M) together with aspirin or ticlopidine orally randomly, which were continued for 3 month or shorter if coronary revascularization was earlier performed. 512 R-R intervals was registered in each patient at 7th day of hospitalization and in 14th at the time of admission. Kardioassist v.1.0 system was used for heart rate variability analysis. After analog to digital conversion, with 12 bit resolution and 1000 Hz of sampling rate, seriogram of R-R intervals was obtained, and then power spectrum density was computed with the Fast Fourier Transform. Time-domain analysis provided mean (basic) R-R interval (BCL) and its standard deviation (SD-RR). In frequency-domain the following spectral variables were analysed: power spectral density (s2/Hz) of the high frequency component (aHF, 0.15-035 Hz), low frequency component (aLF, 0.05-0.15 Hz) and very low frequency component (aVLF, 0.004-0.05 Hz), percentage power of respective components (%HF, %LF and %VLF) and autonomic balance indices: aLF:aHF and %LF:%HF. These variables were compared in patients treated with G (13 patients) against those with M (13 patients). Additionally, the effects of treatment regimen was evaluated also in 14 patients, in whom HRV analysis was performed at admission and 7 days later.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Is modified retroperitoneal lymph node dissection (MRLND) still feasible in the treatment of patients with clinical stage I non-seminomatous testicular cancer?

The results of treatment by means of modified RLND in 52 patients with clinical stage I non-seminomatous testicular cancer are presented. Retroperitoneal lymph node metastases were found in 15 patients (28.8%) with clinical stage I (CS-I) diagnosed prior to surgery. They received chemotherapy according to PVB schedule. Ejaculation disturbances persisted in 4 patients (7.7%). Relapses occurred in 4 patients (7.7%) from the group without lymph node metastases, and complete remission occurred after adjuvant PVB chemotherapy. All patients are still alive. Among the analysed factors which might favour development of metastases, only neoplastic invasion of the blood vessels of the primary tumour was statistically significant. In the authors' opinion MRLND may still be used as a diagnostic and therapeutic method in clinical stage I non-seminomatous testicular cancer besides "watch policy" or primary chemotherapy.

Antineoplastic Combined Chemotherapy Protocols↗