Biomedical subjects
Publications and source records attributed to M Wilk.
In 15-year-old girl with lichen sclerosus diagnosed 4 years ago described nephritis development in systemic sclerosis without skin manifestations of scleroderma (sclerodermia sine sclerodermia). Raynaud's phenomenon, typical microcirculatory abnormalities in capilaroscopy and positive antinuclear antibodies were observed.
16 women with prolonged pregnancy and indications to induction of labour were involved into prospective analysis. Sixty of them were given 50 micrograms of Mizoprostol straight into posterior vaginal fornix (only once). In 56 women the labour was induced by intravenous administration of 5 IU Oxytocin. Effectiveness and safety of both preparations used in labour induction were compared. Non-significant higher effectiveness and significant faster induction of uterine contractions by Oxytocin was found. Mizoprostol administration significantly shortens duration of the first labour period. Eventually, time from the medicine administration until the labour in both groups was comparative.
Scintigraphic diagnosis, based on functional image interpretation, becomes more accurate and meaningful when supported by corresponding anatomical data. In order to produce anatomical images that are inherently registered with images of emission computerised tomography acquired with a gamma camera, an X-ray transmission system was mounted on the slip-ring gantry of a GEMS Millennium VG gamma camera. The X-ray imaging system is composed of an X-ray tube and a set of detectors located on opposite sides of the gantry rotor that moves around the patient along with the nuclear detectors. A cross-sectional anatomical transmission map is acquired as the system rotates around the patient in a manner similar to a third-generation computerised tomography (CT) system. Following transmission, single-photon emission tomography (SPET) or positron emission tomography (PET) coincidence detection images are acquired and the resultant emission images are thus inherently registered to the anatomical maps. Attenuation correction of the emission images is performed with the same anatomical maps to generate transmission maps. Phantom experiments of system performance and examples of first SPET and coincidence detection patient images are presented. Despite limitations of the system when compared with a state of the art CT scanner, the transmission anatomical maps allow for precise anatomical localisation and for attenuation correction of the emission images.
AIMS: Our study was aimed at determining whether beneficial modification of carbohydrate metabolism can be obtained after a short-term training program and whether it is associated with an increase in binding and degradation of (125)I-insulin by erythrocyte receptors that suggests a decrease in insulin resistance. METHODS: The study was conducted in a group of 20 patients aged 56 +/- 1.9 years (mean +/- SEM), within 1 to 6 months after coronary bypass surgery. All patients completed 15 training sessions based on 30 min of cycling with a constant load. Before and after a 3-week training program, glucose, insulin, and C-peptide blood levels, as well as binding and degradation of (125)I-insulin by erythrocyte receptors, were determined. RESULTS: A statistically significant decrease was found in the blood glucose level, from 111.2 +/- 4.2 to 97.8 +/- 3.5 mg/dL (p < 0.01); this decrease was not accompanied by significant insulin concentration changes. There was also a significant increase in insulin binding, from 0.535 +/- 0.059 to 0.668 +/- 0.042 pg (125)I/10(11) RBCs (p < 0.01), and degradation from 7.64 +/- 0.54 to 9.49 +/- 0.58 pg (125)I/10(11) RBCs (p < 0.05). CONCLUSION: The results indicated that even short-term endurance training in patients rehabilitated after coronary bypass surgery induced favorable modification of glucose metabolism, presumably caused by a decrease in insulin resistance.
OBJECTIVES: Safety and effectiveness testing of Misoprostol use at prolonged pregnancies. DESIGN: Prospective, clinical study. MATERIAL AND METHODS: 50 pregnant women with prolonged pregnancy, monocyesis, cephalic longitudinal foetus lie, existing foetal membranes and lack of spontaneous delivery action. Women were given 50 micrograms Misoprostol (Cytotec) to posterior vaginal fornix in case to provoke delivery. Effectiveness of inducing, delivery lasting, way of its finishing and infant condition at birth were controlled. Results were matched with control group of 35 patients with physiological pregnancy, who delivered in spontaneous partus. RESULTS: Effective provocation was observed at 38 pregnant. Natural way delivery was observed at 40 patients. In 10 cases caesarean section was done. Lasting time of birth, way of finishing, infant condition at birth and number of complication do not differ statistically between examined and control group. CONCLUSION: Misoprostol can be effective and save of delivery induction in prolonged pregnancy.
Ultrasound examination with 7.0 MHz transvaginal transducer was performed in 136 pregnant women between 5 and 12 weeks of pregnancy. Yolk Sac diameter and Crown-Rump Length were measured. It was observed that absence of YS or its diameter greater than 7 mm was usually associated with poor pregnancy outcome.
UNLABELLED: Position in labour depends mostly on women's preferences, and is chosen instinctively in order to reduce labour pain. Between two different positions: vertical and horizontal, the first of them seems to guarantee more convenient gas exchange in maternal lungs. DESIGN: To prove that the vertical position in labour increase spirometry parameters in comparison with horizontal one. METHODS: Women were divided into two groups according to position in labour and spirometry examination were performed in second period of labour. Group I were composed of 17 women in vertical position whereas group II--19 women in horizontal one. RESULTS: Whole of analysed spirometral parameters had higher values in group I (8.2%-17.1%), but the increase wasn't statistically significant (p < 0.05).
41 women in prolonged pregnancy were involved into anonymous researches. By the use of survey created in IVth Obstetrics and Gynaecological Department of Silesian Medical School and STAI Spielberger questionnaire and AS Cattell questionnaire and K test MPI Eyseneck Scale--the structure, level of intensity and crystallisation fear was examined. The expectation and wishes of women were known. The general psychological characteristic was done and dominant strategies of coping with difficult situations were isolated. Higher fear levels, mostly of reactive genesis and crystallised mainly on the pregnancy, higher level of ergic tension and suspicion and high level of psychic integration and strong ego were observed.
Capillary electrophoresis has been applied to separate and determine N-acetylcysteine (NAC) and related impurities. Determination conditions were found to be optimum with 100 mmol/l borate as the buffer, pH 8.40. The limit of detection was established for each substance examined. The method has been validated by examining linearity ranges, precision and repeatability. The method was used to determine the content of NAC in, and purity of, pharmaceutical preparations. The major impurities (N,N-diacetylcystine, N,S-diacetylcysteine and cystine) were determined at levels of 0.1%.
We have investigated the influence of physical training on exercise-induced changes in free radical activity in patients after myocardial infarction. Seventeen patients admitted to the cardiac rehabilitation center performed a bicycle ergometry before and after a 3-week endurance training program. The oxygen consumption and carbon dioxide production were measured and the ECG and the systemic blood pressure were monitored during the tests. Blood samples for acid-base equilibrium, lactic acid levels and hydrogen peroxide concentrations were collected directly before and after each exercise test. Exercise-induced increases in systolic blood pressure, heart rate and rate-pressure product as well as lactic acid concentrations were significantly less marked during the bicycle ergometry performed after the rehabilitation program. During the initial exercise test hydrogen peroxide levels increased significantly from 7.15+/-0.74 micromol/l before to 9.09+/-1.04 micromol/l 3 min after the test (P=0.0229). In contrast, no significant changes in hydrogen peroxide concentrations were observed during the exercise test performed after the training (6.31+/-1.05 micromol/l before the test, 5.85+/-1.08 micromol/l after the test, P=0.201). These observations suggest that physical training may have a beneficial influence on free radicals' generation in patients after myocardial infarction.
The present study was undertaken to evaluate the contribution of pinhole-single photon emission computed tomography (P-SPECT) to scintigraphy of the thyroid gland. Thirty-six patients, referred for thyroid scintigraphy because of palpatory or ultrasonographic findings, were studied after intravenous administration of technetium-99m pertechnetate (222 MBq) using a rectilinear scanner and a single-headed rotating gamma camera equipped with a pinhole collimator. P-SPECT study was acquired on a 128 x 128 matrix, in 30 projections over 180 degrees and an acquisition time of 40 seconds per step. After transaxial reconstruction, coronal slices were compared with planar views obtained by the scanner. The size of the thyroid gland obtained by P-SPECT matched the life-size image of a rectilinear scan, and it clearly delineated the shape and borders of two huge multinodular glands. Its major contribution was in its improved resolution. Pinhole-SPECT identified 21 foci not visualized on planar views, 19 cold lesions, and 2 "warm" nodules embedded in normal tissue of 13 patients. Furthermore, it clearly delineated 18 discrete ill-defined nodules of 13 patients, (single in 4 patients and multiple in 9 patients): 16 cold lesions, and 2 hot foci. When a distinct palpable nodule was present, whether cold (22 lesions) or hot (2 foci), SPECT was of no additional diagnostic value. However, when the palpable nodule was a toxic one, the contralateral suppressed lobe was visible on SPECT only. Two ultrasonographic findings, of 3- and 5-mm in diameter, were neither identified on planar views nor on P-SPECT. In conclusion, P-SPECT of the thyroid gland improves delineation of huge multinodular glands and detection of small nodules (within the resolution of the camera) that could otherwise have been overlooked on planar views of a thyroid scanner. It allows for definition of tracer uptake in tiny discrete nodules and in multinodular goiter, and is a better guide to the physician in fine-needle aspiration of the cold areas.
We report on seven examples of this rare, only recently described benign tumor, which presented clinically as solitary elevated nodules on the lower (n = 5) and upper (n = 2) extremity, measuring between 0.6 and 1.1 cm in diameter. Histologically, all tumors were well-defined with a characteristic epidermal collarette. There were abundant (60-80%) epithelioid cells with prominent cytoplasm, a vesicular nucleus and inconspicuous nucleolus, as well as a number of dilated blood vessels. Immunohistologically, tumor cells did not react with monocyte/macrophage antibodies (KP1, MAC387). In addition, there was no evidence of myofibroblastic differentiation (alpha-smooth muscle actin and desmin negative). Thus, while immunohistological markers are helpful to exclude the diagnosis of other tumors, they do not shed light on the differentiation of epithelioid cell histiocytomas. The present cases are identical to those described originally. Recently similar lesions have been described in deeper parts of the corium as well as more cellular forms. Epithelioid cell histiocytoma represents a characteristic, poorly known variant within the spectrum of benign fibrous histiocytomas; it needs to be distinguished clinically and histopathologically especially from Spitz nevus.
The clinical and histological diagnosis of sclerotic fibroma is important because of its potential association with Cowden's syndrome. Despite its distinctive histological appearance the lesion is often mis-diagnosed. We therefore present five of our own cases (2F, 3M) in which the tumor was located on the head (n = 2), arm (n = 2) and leg (n = 1), respectively. Clinically, the lesions were white to flesh-colored firm nodules ranging in size from 0.5 to 1.2 cm. None of our patients revealed any clinical evidence of Cowden's disease. Simple surgical excision seems to be curative. Histologically, they were well-circumscribed but not encapsulated dermal nodules composed of stori-form-arranged sclerosing collagen bundles and vimentin-positive fibroblastlike cells interspersed in three cases by a number of alpha-smooth-muscle actin-positive myofibroblasts. Approximately 50% of cells (dermal dendritic cells (DD)) also reacted for factor XIIIa evenly scattered throughout the lesion in contrast to the very few (< 5%) CD34+ DD found predominantly at the lower border, thus possibly reflecting the distribution of these cells in normal skin. Sclerotic fibroma expands the spectrum of fibrous lesions that may express alpha-smooth-muscle actin.
We describe a cutaneous angiomyxoma on the head of a 38-year-old man without evidence of Carney's complex. Complete excision of the tumor appeared to be curative. Histologic examination revealed fibroblast-like cells embedded in a well-demarcated, lobulate, mucinous, and vascularized stroma with a delicate reticulin network. Immunohistologically, the stromal cells were consistently positive for vimentin and focally positive for smooth muscle A-actin but were negative for desmin, KP1, MAC387, factor XIIIa, CD34, Leu-7, and S-100. Cutaneous angiomyxoma appears to represent a myofibroblastic neoplasm that should be distinguished from cutaneous focal mucinosis.
We report on three family members suffering from both autosomal dominant Hailey-Hailey disease and bipolar affective disorder. As molecular biology techniques have made the localization of genes causing simple Mendelian traits possible as a routine task, the gene for Hailey-Hailey disease will presumably be localized in the foreseeable future. The Hailey-Hailey gene and its chromosomal surrounding will then be a region of interest for linkage studies in bipolar affective disorder.
Chondroid syringoma belongs to the group of so-called mixed tumors, like pleomorphic adenomas of the lacrimal and salivary glands. The histogenesis of this tumour is still disputed, in particular with respect to its stromal component. The distribution of cytokeratins (CKs), CEA, EMA, vimentin, S-100 protein, desmin and actin [alpha-smooth muscle actin (alpha-SMA)] was investigated by immunohistological examination of paraffin sections from a chondroid syringoma of the apocrine type. The neoplastic formations have been classified into tubuloalveolar structures, solid nests/aggregations and stromal cells of varying morphology. The inner-most cells of tubuloalveolar structures were characterized by marked expression of CKs (KL1 and MNF116), CEA and EMA, while in the outer ones there was moderate expression of vimentin, S-100 was expressed to a lesser extent and KL1, weakly but there was marked and consistent expression of MNF116. Whereas the solid nests expressed vimentin, S-100 protein, MNF116 markedly and KL1 weakly, the stromal cells were consistently positive for vimentin, S-100 protein and, focally, CKs and alpha-SMA. Anti-alpha-SMA specifically detects myoepithelial cells. In addition, the partly overlapping immunoreactivity of the intermediate filaments, membrane proteins and proteins in the different structures may indicate a common clonal origin of all neoplastic cells in chondroid syringoma.
The histogenesis of cutaneous focal mucinosis (CFM) is controversial. Eleven cases of CFM (5F, 6M; mean age 51 years) from our routine files between 1986 and the present time have, therefore, been examined histopathologically and immunohistochemically. Histology revealed an increased number of fibroblast-like cells in early lesions, whereas they were diminished or predominantly at the margin in advanced ones. The myxomatous areas showed slight to absent reticulum formation. Similarly, elastic fibers were almost absent, and collagen fibers were fragmented and replaced by variable amounts of mucin. One specimen revealed an epithelial component within the lesion reminiscent of a poorly induced trichofolliculoma. Immunohistochemically, vimentin was consistently present and correlated with the number of fibroblast-like cells. A few (< 5%) CD34+ dermal dendritic cells (DDs) were focally seen within CFM. In contrast, FXIIIa+ DDs accounted for up to 30%. Fibroblast-like cells were negative for S-100 protein, Leu7, desmin and alpha-SMA. The epithelial component within one of our specimens seems to have been induced by CFM and is a feature also seen in (angio)-myxomas. CFM appears to be a mesenchymally derived lesion composed predominantly of fibroblasts. DDs do not form the major cell component but rather seem passively incorporated.
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