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Biomedical subjects

Robert Rzepko

Publications and source records attributed to Robert Rzepko.

11 recordsLinked to original sources

Angiomyolipoma of the larynx: case report.

The authors present the report of the first ever case of angiomyolipoma arising in the larynx. The tumor was found in a 61-year-old man and was resected through laryngofissure. Histopathologic examination of the tumor revealed numerous smooth muscle cells, mature adipose tissue and numerous thin and large irregular vessels. Both histological and immunohistochemical findings were typical for tumors of the mucocutaneous angiomyolipoma group.

Angiomyolipoma↗

Microscopic colitis in routine colonoscopies.

Lymphocytic colitis (LC) and collagenous colitis (CC), both known as microscopic colitis (MC), are uncommon entities with increasing incidence as more clinicians take biopsies from macroscopically normal colons and as pathologists use more rigorous diagnostic criteria to be confident of the diagnosis. Information on the incidence of this type of colitis is limited and based on reported cases. The purpose of this work is to estimate the incidence of LC and CC in reviewed routine colonoscopies. We reviewed 2815 colonoscopies performed at a tertiary referral center with an open-access service using restricted histological criteria in order to establish the frequency rate of LC and CC in routine colonoscopic biopsy material. Cases suspicious for MC were stained with Masson's trichrome or Congo red stain and immunohistochemically for lymphocytes, where appropriate. Review of routine colonoscopic biopsies showed that MC is underreported in our colonoscopic material. Incidence rates of LC and CC (0.9 and 0.4, respectively) were based on morphological assessment of colonoscopic biopsies using stringent criteria together with clinical data and after differentiation with other lesions which can mimic MC. The 10.2% rate of this type of colitis in patients with chronic watery diarrhea indicates the necessity to consider these lesions in older individuals with diarrhea and normal endoscopical colonic mucosa.

Adult↗

Cerebellopontine angle tumours: radiologic-pathologic correlation and diagnostic difficulties.

A group of 119 cases of cerebellopontine angle (CPA) tumours was studied looking at the pathological composition, relative incidence of tumour types, their radiological features and the pathological-radiological correlations. Tumours with preoperative radiological diagnosis and verified pathologically were analyzed. Histopathologically the material consisted of 77 schwannomas and 42 non-acoustic tumours. Radiological retrospective evaluation of CT and/or MRI documentation was performed in 84 patients. The tumours were classified according to Koos's staging scale. Diagnostic discrepancies (histopathological vs radiological) according to the clinical stage of CPA tumours were analyzed. In our series non-acoustic tumours made up 37% of CPA lesions. Sharp tumour-pyramis angle and intracanalicular fraction are not exclusive features of schwannomas. Tumours in stage IV are the most heterogeneous and diagnostically difficult group.

Adolescent↗

Neutrophil engagement and septic challenge in acute experimental pancreatitis in rats.

AIM: To investigate the influence of neutrophil adhesion molecule blockade with monoclonal antibody (MoAb CD11b) and E. coli lipopolysaccharide (LPS) administration on experimental acute pancreatitis (AP). METHODS: AP was induced by four ip injections of cerulein (Cn) at 1-h intervals. MoAb CD 11b and LPS were administered at the beginning of the experiment. RESULTS: The neutrophil count and chemiluminescence were diminished at the beginning of AP. The oxidative stress parameters were found within the pancreatic gland. MoAb CD 11b used for AP resulted in a significant reduction of pancreatic infiltration and pancreatitis oxidative stress parameters. Serum interleukin-6 (IL-6) was not detected in AP animals, whereas high serum IL-6 concentration was noted only in animals receiving LPS. CONCLUSION: Neutrophils are involved in pancreatic damage in the early stage of AP. Neutrophil infiltration reduction protects the pancreatic gland from destruction during AP. LPS does not change the early course of Cn pancreatitis in rats.

Acute Disease↗

Pregranulomatous phase of sarcoidosis: immunohistochemical diagnosis.

Histopathological confirmation of clinical suspicion of sarcoidosis is based on the finding of non-caseating granulomas in biopsy material, usually in prescalene lymph nodes or in transbronchial lung biopsies. Lymph node reactive sinus histiocytosis (RSH) seen in relation to various inflammatory and non-inflammatory diseases can mimic the pregranulomatous phase of sarcoidosis (PSH). Differentiation of sinus histiocytosis based on histopathological features alone is limited. The purpose of this study is immunohistochemical determination of lymph node cellular response in granulomatous sarcoidosis, the PSH and RSH using a immunohistochemistry employing a panel of antibodies. Patient groups under study each contained 25 patients and included: those with clinical picture of sarcoidosis and non-caseating granulomatous lymphadenitis; those with confirmed sarcoidosis and with sinus histiocytosis without granuloma formation in lymph nodes; and finally, those without sarcoidosis and with "reactive" sinus histiocytosis in lymph nodes. Lymph node biopsy tissue was fixed in buffered formaldehyde, routinely processed to paraffin wax blocks, cut into 4-microm-thick sections, stained with hematoxylin and eosin and immunohistochemically labelled using a triple-layer APAAP protocol with purified polyclonal antibodies directed against SP 70 and SP90 from Mycobacterium tuberculosis and monoclonal antibodies against CD22, CD4, CD8, CD56, and CD68. Intensity of immunolabelling was assessed semiquantitatively by two independent observers. An increased CD4:CD8 ratio, moderate increase of immunolabelling for CD68 and slight decrease in immunolabelling for CD20, CD56, and SP90 was indicative of PSH when compared with RSH. The most notable difference between the studied groups was a difference in immunoreactivity to SP70 and CD4 antibodies. Lymph nodes with pregranulomatous sinus histiocytosis labelled with both antibodies. This profile of immunolabelling can be used in the differentiation of this condition from reactive sinusoidal lesions.

Adolescent↗

Region-specific alterations of adenosine receptors expression level in kidney of diabetic rat.

Pathological alterations of renal function in insulin-dependent diabetes have been attributed to numerous factors, including adenosine. This study examined the expression levels of adenosine receptors (ARs) in the kidney of the streptozotocin-induced diabetic rat. In the diabetic kidney A1-AR mRNA levels increased 1.7- and 2.8-fold in cortex and medulla, respectively. This was accompanied by increased A1-AR protein levels in membranes of kidney cortex (1.5-fold) and medulla (threefold). A1-AR immunoreactivity increased strongly along medullar tubules especially in the collecting duct. The levels of A2a-AR mRNA increased twofold in diabetic kidney cortex but remained unchanged in medulla; however, A2a-AR protein levels increased more than threefold in cortex. Immunohistochemistry showed increased A2a-AR immunoreactivity in luminal membranes of cortical collecting ducts and in epithelial cells of preglomerular vessels. There were no significant changes in A2b-AR expression in diabetic kidney except in medullar membranes, where the receptor protein content decreased by 60%. A3-AR mRNA levels in diabetic kidney remained unchanged, but membrane-associated A3-AR protein levels increased by 70% in diabetic kidney cortex and decreased by 80% in medulla. These changes in ARs genes expression, receptor protein content, and cellular and tissue distribution, correspond to abnormalities characteristic of the diabetic kidney, suggesting involvement in pathogenesis of diabetic nephropathy.

Animals↗

Influence of molecule CD 11b blockade on the course of acute ceruleine pancreatitis in rats.

Polymorphonuclear cells (PMN) activation is an essential step in acute pancreatitis (AP). We investigated the activation status of PMN, oxidative stress and pancreatic damage in early stage of experimental ceruleine pancreatitis in rats. The PMN action was modulated by monoclonal antibody CD 11b administration. The circulating WBC and polymorphonuclear cells count was reduced after AP induction. Chemiluminescence of whole blood PMN was remarkably reduced in AP group and increased after MoAb CD 11b administration. The CD 11b blockade significantly reduced the WBC infiltration and malondialdehyde (MDA) concentration within pancreatic gland. These data suggest that activated PMN are an important factor in early AP pathogenesis. Neutrophil aggregation within pancreatic gland modulated by monoclonal antibody CD11b contribute to the extent of injury during the early stage of ceruleine experimental pancreatitis in rats.

Adjuvants, Immunologic↗

K-RAS point mutation, and amplification of C-MYC and C-ERBB2 in colon adenocarcinoma.

The routine multidisciplinary management of colon cancer is based mainly on tumor staging, histology, grading and vascular invasion. In this approach, important individual information derived from molecular characteristics of the tumor may be missed, especially since significant heterogeneity of molecular aberrations in cancer cells has been observed, and recognition of every of relationships between them may be of value. K-RAS, C-MYC and C-ERBB2 are protooncogenes taking part in carcinogenesis and tumor progression in the colon. They influence cell proliferation, differentiation and survival. K-RAS point mutation, as well as amplification of C-MYC and C-ERBB2 were searched in 84 primary colon adenocarcinomas resected with curative intent. Multiplex polymerase-chain reaction and restriction fragment length polymorphism were performed to assess codon 12 K-RAS point mutation. Amplification of C-MYC and C-ERBB2 genes was evaluated by densitometry after agarose gel separation of the respective multiplex PCR products. No relation was found among mutated and/or amplified genes, and between searched molecular aberrations and pathoclinical features. In multivariate analysis, nodal status appeared to be the only independent prognostic indicator. In colon adenocarcinoma, codon 12 K-RAS point mutation and amplification of C-MYC and C-ERBB2 seem to occur independently in the process of tumor progression. Amplification of C-ERBB2 tends to associate with more advanced stage of disease. Concomitant occurrence of codon 12 K-RAS mutation, C-MYC and C-ERBB2 amplification was of no prognostic value in respect to survival.

Adenocarcinoma↗

Immunocytes and activated stellate cells in pancreatic fibrogenesis.

INTRODUCTION AND AIMS: Chronic pancreatitis is a progressive chronic inflammatory disease characterized by irreversible destruction of exocrine pancreatic tissue and extensive fibrosis. Excessive alcohol consumption has been identified as the main etiologic factor of this disease in the Western world. Idiopathic pancreatitis accounts for approximately 30% of cases. An autoimmune mechanism may be involved in some patients, but this concept has not been generally accepted as a new clinical entity. The purpose of this work was to investigate the pathogenesis of pancreatic fibrosis and to establish the role of immunocytes and activated stellate cells in chronic pancreatitis, which was categorized into three groups: chronic alcoholic pancreatitis (AP), chronic idiopathic pancreatitis (IP), and chronic pancreatitis in the presence of pancreatic cancer (CA). METHODOLOGY: Fifty-one pancreatic tissue samples were studied histopathologically and immunohistochemically (AP, 16 samples; IP, 12; CA, 12; and samples of tissue with apparently normal pancreatic histology, 11). The following immunohistochemical stains were used: alpha-smooth muscle antibody, desmin, and synaptophysin, as markers of activated stellate cells; and laminin, fibronectin, and collagen IV, as markers of extracellular matrix (ECM) proteins. Immunocytes were stained with antibody to LCA, CD68 antibody (macrophages), and CD8 antibody (natural killer T cell subset), and mast cells were examined using the Giemsa method. Positively stained macrophages, lymphocytes, and mast cells were counted in three high-power fields of a light microscope. The immunoreactivity of activated stellate cells and ECM proteins was assessed by a semiquantitative method (0, lack of positive staining; 5, numerous cells with strong positive immunostaining). Results were assessed statistically. RESULTS: We found no statistical differences between cases of AP, IP, and CA in terms of total lymphocyte count (mean numbers: 416, 418, and 407 per three high-power fields, respectively). The percentage of CD8+ T cells in IP was statistically higher than that in AP. The macrophage count was significantly higher in the IP group than in the AP and CA groups. The mast cell count was markedly higher in the IP group than in the other groups. The stellate cell markers alpha-smooth muscle antibody and desmin showed slightly higher immunoreactivity in IP. The immunopositivity for synaptophysin was also higher in the IP group. There was a positive correlation between alpha-smooth muscle antibody, desmin, and synaptophysin expression and the degree of fibrosis. ECM protein markers showed no statistically significant differences between the three groups. CONCLUSION: Results of this work show that a significant number of IP cases might have an autoimmune etiology. There was a positive correlation between activated stellate cell marker expression and the degree of fibrosis.

Cell Count↗

Angiogenesis in glioblastoma--analysis of intensity and relations to chosen clinical data.

Microvascular proliferation (MVP) is one of the histopathological hallmarks of glioblastoma (GB). In this study angiogenic potential in GB was analysed according to the morphology of MVP and by assessment of vascular density. The analysis of relations of vascular parameters to chosen clinical features was performed. Tissue samples from 46 GB cases were examined. The clinical data included: patients' age (32-78 years), gender (17 women, 29 men), location (frontal lobe--13, temporal--18, parietal--14, two lobes--1) and tumour size in CT (2-9 cm). Tumour vascularisation was analysed morphologically and quantitatively. Histologically two types of MVP were distinguished: simple and glomeruloid. In vascular hot spots vessel density was assessed on sections immunostained for vWf. Simple type proliferation was found in all cases. Glomeruloid proliferation was found in 33 cases with mean age of patients 59.5 yrs, while in the group without glomeruloids mean age was 48 yrs (statistically significant difference, p < 0.01). Mean vascular density value in examined GB was 150.4 vessels/mm2 (median 141.5; SD--56.4) and younger age was related to higher vascular density (correlation coefficient R = -0.35; p = 0.017). Vascular parameters were related only to the patients' age among the analysed clinical data. The presented results show that morphologically microvascular proliferation is more intense in older GB patients, since higher vascular density is related to younger age. This observation may suggest the diversity of GB angiogenic potential depending on patients' age.

Adult↗

Microvascular density in chronic pancreatitis and pancreatic ductal adenocarcinoma.

Chronic pancreatitis and pancreatic adenocarcinoma represent two pathologic phenomena with marked production of connective tissue stroma containing numerous small blood vessels. The aim of this study was to characterise quantitatively the vascular supply of pancreatic adenocarcinoma and fragments of the periductal tissue collected from patients with chronic pancreatitis. The study material included 18 cases of pancreatitis and 22 cases of pancreatic ductal adenocarcinoma. Microvessels were marked using monoclonal anti-CD34 antibodies. The number of blood vessels in the fibrous stroma was significantly higher in the chronic pancreatitis samples compared to the pancreatic carcinoma group (mean vessel count 298 and 194 vessel/mm2; median 251 and 187 vessel/mm2 respectively; p<0.01). Distributions of the vascular diameter in both studied groups were very similar. The obtained results suggest that the development of vascular network accompanying chronic pancreatitis is more effective in some parts of pancreas compared to angiogenic intensity in pancreatic adenocarcinoma.

Blood Vessels↗