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Biomedical subjects

Predrag Pesko

Publications and source records attributed to Predrag Pesko.

9 recordsLinked to original sources
PubMed2006

Intraoperative endoscopy in obstructive hypopharyngeal carcinoma.

AIM: To demonstrate the necessity of intraoperative endoscopy in the diagnosis of secondary primary tumors of the upper digestive tract in patients with obstructive hypopharyngeal carcinoma. METHODS: Thirty-one patients with hypopharyngeal squamous cell carcinoma had been operated, with radical intent, at our Institution in the period between 1978 and 2004. Due to obstructive tumor mass, in 7 (22.6%) patients, preoperative endoscopic evaluation of the esophagus and stomach could not be performed. In those patients, intraoperative endoscopy, made through an incision in the cervical esophagus, was standard diagnostic method for examination of the esophagus and stomach. RESULTS: We found synchronous foregut carcinomas in 3 patients (9.7%). In two patients, synchronous carcinomas had been detected during preoperative endoscopic evaluation, and in one (with obstructive carcinoma) using intraoperative endoscopy. In this case, preoperative barium swallow and CT scan did not reveal the existence of second primary tumor within esophagus, despite the fact that small, but T2 carcinoma, was present. CONCLUSION: It is reasonable to use intraoperative endoscopy as a selective screening test in patients with obstructive hypopharyngeal carcinoma.

Adult↗
PubMed2005

Low plasma ghrelin level in gastrectomized patients is accompanied by enhanced sensitivity to the ghrelin-induced growth hormone release.

Ghrelin is a brain-gut peptide with potent GH-releasing activities. It has been suggested that the majority of circulating ghrelin originates from the stomach, with a smaller portion from the small intestine. Gastrectomy (GASTRX) significantly reduces circulating ghrelin concentrations. The implication of decreased circulating ghrelin on the somatotropic axis post GASTRX has not been studied. Therefore, we aimed to investigate the somatotropic axis in 10 gastrectomized patients who underwent total GASTRX for various reasons at least 2 yr ago. At baseline circulating total ghrelin, GH, IGF-I, and IGF binding protein (IGFBP)-3 levels were measured. The GH stimulation test consisted of an insulin-induced hypoglycemia, ghrelin in two iv bolus doses (0.1 and 1 microg/kg), and a GHRH test. GH sensitivity was assessed by an IGF-I generation test. All the tests were performed 2 wk apart. At baseline serum ghrelin levels were reduced by 55% in GASTRX patients, compared with the control group (P < 0.05). IGF-I (P < 0.05) and IGFBP-3 (P < 0.01) levels were also significantly lower than in controls. GH response to the insulin-induced hypoglycemia test in both GASTRX and control subjects was of similar magnitude, whereas circulating plasma ghrelin levels in GASTRX patients were not modified during hypoglycemia. Both doses (0.1 and 1.0 microg/kg) of ghrelin stimulated GH release significantly more in GASTRX than control subjects, respectively (peak mean GH +/- se: 18.2 +/- 5.6 vs. 5.4 +/- 1.3 microg/liter, P < 0.03; and 58.7 +/- 7.5 vs. 35.3 +/- 1.9 microg/liter, P < 0.01). There was no difference in GHRH-induced GH response between GASTRX patients and control subjects (P > 0.05). Concomitantly, increased increments in IGF-I and IGFBP-3 to a single bolus of GH were found (P < 0.03). In conclusion, our data suggest that low circulating ghrelin levels, found in GASTRX patients, are accompanied by enhanced ghrelin sensitivity with respect to GH response. This is associated with increased GH responsiveness. GASTRX is a state of acquired chronic hypoghrelinemia that may require replacement with ghrelin, and it is tempting to speculate that this may affect the GH-IGF-IGFBP axis.

Adult↗
PubMed2005

Expression of p53 protein in Barrett's adenocarcinoma and adenocarcinoma of the gastric cardia and antrum.

BACKGROUND/AIM: Most studies of esophageal and gastric adenocarcinomas have shown a very high rate of p53 gene mutation and/or protein overexpression, but the influence of the tumour site upon the frequency of p53 protein expression has not been evaluated (gastroesophageal junction, Barret's esophagus, and antrum). The aim of our study was to analyze the correlation between the selected clinico-pathological parameters, and p53 protein overexpression in regards to the particular tumour location. METHODS: The material comprised 66 surgical specimens; 10 were Barrett's carcinomas, 25 adenocarcinomas of the gastric cardia (type II adenocarcinoma of the esophagogastric junction - EGJ), and 31 adenocarcinomas of the antrum. Immunostaining for p53 protein was performed on formalin-fixed, paraffin-embedded tissue sections, using the alkaline phosphatase antialkaline phosphatase (APAAP) method. The cases were considered positive for p53 if at least 5% of the tumour cells expressed this protein by immunostaining. RESULTS: There was no significant difference observed between the studied groups in regards to age, sex, Lauren's classification and tumour differentiation. There was, however, a significant difference observed in the depth of tumour invasion between Barrett's adenocarcinoma and adenocarcinoma of the cardia compared with the adenocarcinoma of the antrum. Namely, at the time of surgery, both Barrett's adenocarcinomas and adenocarcinomas of the cardia, were significantly more advanced comparing with the adenocarcinomas of the antrum. Overexpression of p53 was found in 40% (4/10) of Barrett's adenocarcinomas, 72% (18/25) of adenocarcinoma of the cardia and 65% (20/31) of adenocarcinoma of the antrum. No significant differences in p53 expression in relation to sex, type (Lauren) of tumour, depth of invasion, lymph node involvement, or tumour differentiation were observed in any of the analyzed groups of tumours. Patients with more advanced Barrett's adenocarcinoma and in the cases of lymph node invasion revealed tendency for the greater p53 positivity compared with the early forms and lymph node-negative cases; however, this difference was not significant according to the statistical analysis. With regard to adenocarcinoma of the cardia, higher rates of p53 positivity were recorded in poorly differentiated, more advanced cases with lymph node invasion. Nevertheless, none of these differences was statistically significant. On the contrary, in the patients with adenocarcinoma of the antrum, greater p53 positivity was revealed in early forms without lymph node involvement, but the observed difference was not statistically significant. CONCLUSION: No significant differences in p53 protein expression in terms of sex, type (Lauren) of tumour, depth of invasion, lymph node involvement, or tumour differentiation were observed in any of the analyzed groups of tumours (Barrett's adenocarcinoma, adenocarcinoma of the cardia and adenocarcinoma of the antrum).

Adenocarcinoma↗
PubMed2004

Down-regulation of secretory leukocyte protease inhibitor expression in gastric mucosa is a general phenomenon in Helicobacter pylori-related gastroduodenal diseases.

BACKGROUND: Secretory leukocyte protease inhibitor (SLPI) represents a multifunctional protein of the gastric mucosa exerting anti-microbial and anti-inflammatory effects. Recently, a local down-regulation of antral SLPI expression in Helicobacter pylori (Hp)-infected healthy volunteers was demonstrated. AIM: To analyze mucosal SLPI expression in patients with various gastroduodenal disorders. METHODS: The prospective study included 90 patients with following gastroduodenal disorders diagnosed: gastric cancer (GC, n=22), duodenal ulcer (DU, n=17), Hp-positive dyspeptic patients (NUD, n=31) and Hp-negative NUD (n=20). During esophagogastroduodenoscopy, biopsies were taken each from antrum, corpus and tumor. SLPI expression was analyzed by quantitative RT-PCR and ELISA. RESULTS: Antral SLPI levels were reduced in all Hp-infected patients (NUD, DU, GC) by about 75% (1,494-1,826 pg/50 microg protein) compared to Hp-negative NUD (6,563 pg/50 microg protein, p<0.001, ANOVA). Tumor tissue had twofold higher SLPI levels than surrounding tumor-free gastric mucosa (3,900 vs. 1,826 pg/50 microg protein, p=0.013), but revealed reduced SLPI levels compared to Hp-negative NUD patients (p=0.067). No differences were found between SLPI expression of intestinal and diffuse GC. SLPI transcript levels were unchanged throughout all groups and locations implying that transcriptional regulation of SLPI is not involved. CONCLUSION: Local down-regulation of SLPI in antral mucosa is a general phenomenon of Hp-related diseases.

Antibodies, Bacterial↗
PubMed2002

The relationship between gallbladder motility and the presence of enterogastric reflux.

BACKGROUND: The aim of the study was an estimation of the relation between the gallbladder (GB) motility function and the presence and quantity of enterogastric reflux (EGR). MATERIAL AND METHODS: We investigated 172 patients: 90 with physiological GB function (filling and emptying) (FGB), 21 with impaired GB function (prolonged filling and ejection fraction < 45%) and 61 with afunctional gallbladder (AGB) (without visualisation). The study was performed during 90 min (1 f/min) after i.v. application of 185 MBq 99m Tc-dietil IDA. After 30 min, a test meal was given while at the end the stomach was marked. According to the parameters from time activity curves over the stomach and hepatobiliary system, the index of EGR was calculated, while GB filling and ejection fraction were estimated from the GB time/activity curve. RESULTS: Most frequently, EGR occurs in AGB (47.5%), followed by IGB (43%) and FGB (41%), without significant differences (p > 0.05). The significantly (p < 0.05) highest value of EGR was obtained in the patients with AGB in comparison to IGB and FGB. EGR values were in correlation (r = 0.168, p < 0.05) with the functional status of the GB. In the patients with pathological values of EGR (> 10%), significantly higher values (p < 0.05) are obtained in AGB than in IGB and FGB. Also, these values were in correlation with the functional status of the GB (r = 0.284, p < 0.05). CONCLUSIONS: We can conclude that EGR occurs more frequently in the patients with afunctional GB in comparison with those with functional and decreased motor function. Also, EGR quantity is in correlation with the impairment of the GB function.

Journal Article↗
PubMedDate not supplied

[Prevalence and importance of nodal micrometastasis in patients with gastric adenocarcinoma].

Micrometastasis is a microscopic (less than 2 mm) deposit of malignant cells separated from the primary tumor. The incidence and importance of occult perigastric lymph node involvement were analyzed in 26 pN0 patients using the prospective method. The occult lymph node involvement was detected by immunohistochemical method using the anticytokeratin 8/18 antibody. Prevalence of clinically significant occult lymph node involvement (Mi+) was statistically significant, and found in 38.5% of pN0 patients. Out of tumor characteristics analyzed as possible predictors of occult lymph node involvement, the histological grade (GH) and the involvement of lymphatic vessels within gastric wall (pL1) had significant effect on the respective evaluation. The patients with histological grade 3 and 4 had occult lymph node involvement more often than those with grade 1 and 2 (p<0.05). More than 60% of pL1 patients had occult lymph node involvement LN (Mi+). Due to high prevalence of micrometastatic lymph node involvement, detection with specific immunohistochemical or molecular biology techniques should be a part of routine specimen examination in patients with pN0 gastric cancer.

Adenocarcinoma↗
PubMedDate not supplied

[Rosacea as a multisystemic disease].

Rosacea is a chronic skin disorder, affecting the face and chest, and develops mostly in the 3rd to 6th decades of life. It is characterized by erythema, telangiectasias, and recurrent flushings. During the time of this chronic inflammation, skin typically develops papules, pustules, and swelling. Ocular involvement occurs in 3 to 58% of patients with skin changes. Common ocular signs include blepharoconjunctivitis, meibomitis, and dry eyes. Rosacea keratitis, when present, however, has a poor prognosis and may lead to blindness. Among skin diseases, Helicobacter pylori infection has been often related with rosacea. A higher prevalence of indigestion and Helicobacter pylori infection in rosacea patients than in healthy controls has been reported. However, no causal relation has been identified. On the other hand, oral treatment with metronidazole is beneficial in all of three mentioned manifestations of rosacea (skin, eye, indigestion). There is obvious need for multidisciplinary approach, and investigation to rosacea.

Eye Diseases↗