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Biomedical subjects

Maciej Owecki

Publications and source records attributed to Maciej Owecki.

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

[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

[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↗
PubMed2004

The efficacy of octreotide LAR (long acting release) treatment in patients with somatotropinoma, and mixed pituitary tumours.

OBJECTIVE: The efficacy of somatostatin analogues in the treatment of acromegaly is not always equal and therefore we wanted to evaluate the efficacy of therapy with octreotide long acting release (LAR) in patients with monohormonal tumours (somatotropinomas) in comparison to individuals with mixed pituitary tumours secreting alpha-subunit. METHOD: The 35 acromegalic patients (18 males and 17 females), aged 41.8 +/- 8.8 years, were divided into 2 groups according to the secreted hormones: 1 with mixed pituitary tumours with elevated growth hormone and alpha-subunit concentrations, the other with isolated growth hormone hypersecretion and normal alpha-subunit levels. The groups included 19 patients (9 males and 10 females), aged 40.1 +/- 7.1 years (mean +/- SD), and 16 patients (9 males and 7 females) aged 43.8 +/- 8.8 years (mean +/- SD), respectively. RESULTS: The decrease of GH and IGF-I levels after octreotide LAR treatment were observed in both groups. However, the reduction of GH and IGF-I concentrations was not equal in both groups and the differences between both groups were statistically significant (P = 0.01 for GH levels, and P = 0.047 for IGF-I levels). CONCLUSIONS: After octreotide LAR treatment, the decrease of GH level and of mean IGF-I values was greater in patients with mixed pituitary tumours and high alpha-subunit concentrations than in patients with isolated GH hypersecretion and normal alpha-subunit levels.

Acromegaly↗
PubMed2004

[Primary clear cell carcinoma of the thyroid--case report].

UNLABELLED: We present a case of a 59-year old woman in whom incidentally a thyroid nodule of 10 mm diameter was discovered. A fine needle aspiration biopsy was performed and it revealed follicular tumour. The patient was referred to surgery and she had a subtotal thyreoidectomy performed with a part of the left lobe spared. The histopathological examination of the nodule led to a different diagnosis. The diagnosis was clear cell carcinoma in the thyroid, probably metastatic, the most probable primary site being the kidney. A computed tomography scan of the kidneys and abdomen was performed but it revealed no changes. The patient has been seen for a year in follow-up, with CT scans performed every six months that revealed no changes. The patient has been in good condition during the whole period of observation. CONCLUSIONS: We describe an extremely rare case of a primary thyroid clear cell carcinoma.

Adenocarcinoma, Clear Cell↗
PubMed2004

[Polycystic ovary syndrome associated with remarkable hyperprolactinemia--case report].

UNLABELLED: Polycystic Ovary Syndrome is a common disorder in young women but its etiology and pathogenesis are not completely understood. Clinical manifestations include irregular menses, hirsutism, and acne. An inappropriate secretion of many hormones is observed, including elevated serum prolactin concentrations. It is difficult to precise the level of prolactin elevation, few studies report the values of serum prolactin, most authors describe solely mild prolactin elevation. We report a case of an 18-years-old female with an extremely high serum prolactin concentration of 2364 microU/ml (reference range 70-510 microU/ml) observed in the course of PCOS. In this patient MRI scan ruled out the presence of a pituitary adenoma. Menstrual disturbances occurred after the first menses, including oligomenorrhea and secondary amenorrhea. Hirsutism was present. The patient's height, weight and BMI were 167 cm, 106 kg, and 38 kg/m2, respectively. The hormone serum concentrations: free testosterone--4.4 pg/ml (rr 0.4-2.6 pg/ml), follitropin (FSH)--5.14 mU/ml, lutropin (LH)--8.76 mU/ml, dehydroepiandrostendion sulfate (DHEA-S)--564.8 microg/dl (rr for menstruating women 70.0-300.0 microg/dl), insulin 22.0 microU/ml (rr 3.0-17.0 microU/m). Fasting plasma glucose was 70 mg/dl, and in 2-hours OGTT it was 135 mg/dl. Intravaginal USG revealed ovaries typical for PCOS, i.e. polycystic-appearing ovaries (PAO). CONCLUSIONS: functional hyperprolactinemia in PCOS may be remarkably high, reaching concentrations similar to those in pituitary prolactinomas.

Adolescent↗
PubMed2004

[Selective estrogen receptor modulators--mechanism of action and clinical use].

Recently new drugs with mixed action on estrogen receptors have become available on the market. In some tissues they act like agonists, in others like antagonists of estrogen receptors. The drugs are called selective estrogen receptor modulators--SERMs. Basing on the world literature this article discusses the latest views on the mechanism of SERMs' action and their influence on the bone, the breast, the female reproductive organ and metabolism.

Humans↗
PubMed2004

[Graves ophthalmopathy with coexisting tumor of the right orbit and hyperprolactinemia--case report].

Ophthalmopathy is a typical manifestation of Graves disease. Although most commonly ophthalmopathy affects both eyes, sometimes it is localized in only one orbit; neoplastic process must be considered then. The coexistence of a tumor of the orbital area and Graves ophthalmopathy is extremely rare. We present a case of a 42-years-old female with bilateral Graves ophthalmopathy, and a coexisting tumor of the right orbit. Magnetic resonance imaging of the orbits revealed a thickening of both rectus inferior extraocular muscles typical for Graves ophthalmopathy. An irregular low-signal mass was observed at the apex of the right orbit; it did not compress the optic nerve. The mass enhanced with gadolinium contrast, with its largest length of 4 cm, height of 2.5 cm, and the largest transverse diameter of 3 cm. It extended along the right trigeminal nerve into the right cavernous sinus, sella turcica, compressed the optic chiasm and penetrated into the right orbital inferior fissure. The tumor infiltrated the dura matter, and surrounded the intracranial part of the right optic nerve but did not cause its compression. Secondary amenorrhoea was present in this patient, probably due to hyperprolactinemia caused by the tumor (the plasma prolactin 1652 ulU/ml, RR 70.00-510.00). The patient was treated with radioiodine for hyperthyroidism and referred to neurosurgeons. Stereotactic therapy and surgery were considered in her case.

Adult↗
PubMed2004

[The mechanisms of inheritance of diabetes mellitus].

Diabetes is a genetic disease with a complicated mechanism of inheritance. The work presents contemporary views on genetic background of this disease. HLA phenotypes associated with type 1 diabetes as well as polygenic background of type 2 diabetes are discussed.

Diabetes Mellitus, Type 1↗
PubMed2003

[Polymorphism of the sulfonylurea receptor gene in type 2 diabetes mellitus].

Sulfonylureas are used in treatment of diabetes. Resistance to these derivatives is a therapeutical problem. Sulfonylureas act through sulfonylurea receptor 1 (SUR1) in the beta cell. SUR1 also enhances a physiological secretion of insulin induced by an increase of glucose concentration. It may be expected that polymorphism of SUR1 gene can lead to beta cell dysfunction and resistance to sulfonylureas. The aim of this study was to examine the frequency of polymorphism in exon 22 of SUR1 gene and its correlation with type 2 diabetes mellitus and sulfonylurea treatment failure. The group consisted of 42 patients with type 2 diabetes. The controls were 46 persons with proper glucose tolerance. Polymorphism was found in 5 patients and in 1 control person. Neither statistically significant difference of polymorphism frequency nor correlation between polymorphism and sulfonylurea failure was found due to a low number of cases. Polymorphism of exon 22 of SUR1 gene appeared more frequent in diabetic than in non-diabetic subjects but this was statistically not significant.

ATP-Binding Cassette Transporters↗
PubMed2003

[Molecular basis of oral hypoglycemic sulfonylurea action].

Sulfonylureas are commonly used antidiabetic oral agents. They act through a receptor in the beta cell membrane, which is called the sulfonylurea receptor 1 (SUR1). SUR1 together with Kir 6.2 protein assembles into a potassium channel, playing a key role in the regulation of insulin secretion. The work discusses up to date views on the structure and function of sulfonylurea receptors and potassium channels as well as clinical implications of their disturbances.

ATP-Binding Cassette Transporters↗