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S Markiewicz

Publications and source records attributed to S Markiewicz.

At least 19 recordsLinked to original sources
PubMed1996

Tissue-specific activity of the gammac chain gene promoter depends upon an Ets binding site and is regulated by GA-binding protein.

The gammac chain is a subunit of multiple cytokine receptors (interleukin (IL)-2, IL-4, IL-7, IL-9, and IL-15), the expression of which is restricted to hematopoietic lineages. A defect in gammac leads to the X-linked severe combined immunodeficiency characterized by a block in T cell differentiation. In order to better characterize the human gammac promoter and define the minimal tissue-specific promoter region, progressive 5'-deletion constructs of a segment extending 1053 base pairs upstream of the major transcription start site were generated and tested for promoter activity in various hematopoietic and nonhematopoietic cell types. The -1053/+34 construct allowed promoter activity only in cells of hematopoietic origin, and tissue specificity was conserved in all other constructs tested. The region downstream of -90 appeared critical for basal promoter activity. It contains two potential Ets binding sites conserved in the murine gammac promoter gene, one of which was found essential for functional promoter activity as determined by mutational analysis. The functional Ets binding site was found to bind Ets family proteins, principally GA-binding protein and Elf-1 and could be transactivated by GABPalpha and -beta synergistically. These results indicate that, as already reported for the IL2Rbeta promoter, GA-binding protein is an essential component of gammac basal promoter activity. Although GABP expression is not restricted to the hematopoietic lineage, its interaction with other specific factors may contribute to the tissue-specific expression of the gammac gene.

Animals↗
PubMed1996

Causes of failures of laparoscopic antireflux operations.

BACKGROUND: Three factors determine the successful outcome after an antireflux operation for gastroesophageal reflux disease (GERD): indication for surgery, choice of the operative procedure, and quality of the operation. Laparoscopic treatment has not changed these concepts. The factor most likely to have been modified is the technical quality of the operative procedure. We evaluated 26 patients presenting with failure after laparoscopic antireflux surgery to determine the causes. METHODS: Nineteen patients came from our series of 503 laparoscopic antireflux procedures and seven patients were referred from other centers. Preoperative, peroperative, and postoperative data were retrospectively reviewed to analyze the responsible factor(s). RESULTS: Nine patients presented with a sphincter mechanism failure to control reflux, 14 patients had severe dysphagia, 3 patients presented with severe epigastric pain. The first operation was a Nissen-Rossetti fundoplication in 17 patients. The technical quality of the operative procedure was the responsible factor in 22/26 patients. The choice of the type of operation was questionable in five patients. Eight patients underwent successful endoscopic treatment, reoperation was necessary in 10 patients. Four patients underwent medical therapy, and four patients had no treatment. CONCLUSIONS: The laparoscopic Nissen-Rossetti fundoplication was associated with a higher rate of failures, in terms of recurrent disease or severe dysphagia. The use of this technique was related to the laparoscopic inexperience of the surgeon, leading to a wrong application of the original procedure. Partial posterior fundoplication and total fundoplication with division of the short gastric vessels are obviously associated with a better outcome, if the selection of the operation is based on a strict preoperative physiopathological evaluation of the disease.

Adult↗
PubMed1995

[Laparoscopic surgery of gastroesophageal reflux].

Complete fundoplication according to Nissen's technique and partial posterior hemifundoplication (Toupet's and Lind's techniques) are effective treatments for gastrooesophageal reflux. Their application in open surgery has already been largely assessed. Since 1991, these operations have been performed by laparoscopic surgery. In this study, the course of 368 patients treated via a laparoscopic approach was evaluated. For 363 patients (98.6%), the operation was completed under laparoscopic control with no operative mortality. The operative morbidity was 4%. Two patients (0.5%) had to be reoperated 6 and 8 months after the initial operation for persistent dysphagia. In september 1993, 126 patients with a minimum postoperative follow-up of 12 months (median: 16.2 months) accepted a follow-up assessment. Visick I and II score were observed for 90.4% of patients. These short-term results are encouraging and suggest that the results obtained are comparable to those of conventional surgery, with a lower morbidity and a reduced hospital stay. Precise selection of patients and surgical techniques is essential.

Adolescent↗
PubMed1994

Laparoscopic highly selective vagotomy.

Between February 1991 and August 1992, 35 patients underwent laparoscopic highly selective vagotomy (HSV) for recurrent duodenal ulcer disease. An antireflux procedure was also performed in 25 of these patients. There was no 30-day mortality and morbidity. The mean operating time was 110 (range 85-205) min for HSV and 155 (range 100-300) min for vagotomy and antireflux repair. Follow-up is short but initial postoperative gastric acid secretion studies have demonstrated results similar to those obtained after conventional open HSV. The main advantage of laparoscopic HSV is the reduction of 70 per cent in hospital stay and 50 per cent in the overall recovery period compared with open surgery.

Adolescent↗
PubMed1994

Laparoscopic gastric vagotomies.

Recurrent duodenal ulcer remains a continuing challenge for medical care. Once popular, operations have almost vanished from surgical wards due to efficient medical treatment. The onset of laparoscopy and minimal invasive surgery has caused several teams to reconsider the position of surgical treatment in the disease. Various procedures are actually used, and, as no long-term follow-up is available, it is difficult to estimate which technique would be advisable. The authors compare the different procedures and the theoretical advantages and disadvantages of each one. The best technique has to be applicable in laparoscopy and achieve the best results for the patient.

Duodenal Ulcer↗
PubMed1994

[An unusual case of clear-cell carcinoma of the pancreas].

This case of clear-cell carcinoma of the pancreas was a rare for three reasons: a) discovery: the investigation was indicated after sudden digestive hemorrhage revealed by melena and anaemia; b) morphology: the tumour began in the head with a spheric tumoural bud and a pediculated extension into the duodenum; c) pathology a clear-cell tumour similar to the type seen in renal localizations. Only one other case of such a primitive tumour was found reported in the literature.

Adenocarcinoma, Clear Cell↗
PubMed1993

Colpocystodefecography.

PURPOSE: To assess, in one single procedure, a complete study of the female pelvis, including the Douglas pouch. METHODS: Colpocystodefecography (CCD) combines vaginal opacification, voiding cystography, and defecography. Three hundred examinations are reviewed. RESULTS: Thanks to the simultaneous visualization of the pelvic structures, CCD proved to be more useful than clinical evaluation to diagnose prolapses and particularly Douglas pouch hernias (enteroceles), the clinical diagnosis of which was missed in 93 of 111 cases. Moreover, in addition to morphologic and functional information, CCD brings about a new insight in the study of pelvic organs reciprocal influences, should they be positive (supporting function) or negative (external compression). Finally, significative pelvic surgery and particularly hysterectomy enhances greatly the risk of enteroceles. CONCLUSION: CCD is helpful in the preoperative staging, especially in the selection of the surgical procedure that will least likely predispose to possible late postoperative complications such as vaginal prolapses or enteroceles.

Adult↗
PubMed1993

Fine mapping of the human SCIDX1 locus at Xq12-13.1.

Previous linkage analysis of families with X-linked severe combined immunodeficiency (SCIDX1) mapped this locus to a large region encompassing about 10 to 20 cM at Xq12-21. We have analyzed in SCIDX1 families the segregation of 7 highly polymorphic microsatellites repeats localized to this region, including a new polymorphic microsatellite at the DXS135 locus described in this study, to refine the mapping of this disease locus. The observations of genetic recombinants within the previously defined SCIDX1-region allow us to establish new flanking markers at the DXS135 and DXS227 loci, which significantly reduce the region harboring the SCIDX1 locus to a distance estimated between 3 to 5 cM. The existence of multiple, highly polymorphic markers in the refined SCIDX1 region will greatly improve the accuracy of carrier detection and prenatal diagnosis for SCIDX1.

Alleles↗
PubMed1993

Laparoscopic Nissen fundoplication: detailed analysis of 132 patients.

With the world-wide use of laparoscopy, new applications have been found, particularly in the field of esophageal and gastric surgery. From January 1991 through April 1992, 132 patients underwent laparoscopic Nissen fundoplication. The indication for laparoscopic intervention was symptomatic gastroesophageal reflux disease (GERD) not responding to medical treatment. The preoperative assessment included esophagogastroscopy, barium meal, esophageal manometry, and, in selected cases, 24 h pH studies. There was no operative-related mortality. The overall morbidity was 7.5%. Ninety-eight patients were seen 3 months after surgery and evaluated for control of reflux symptoms. One patient complained of mild recurrence of reflux symptoms; however, endoscopic examination revealed no evidence of recurrent esophagitis. Three complained of occasional dysphagia and two, of mild dysphagia. One individual required reoperation for persistent, severe dysphagia. The excellent results observed so far with this procedure have led us to believe that laparoscopic Nissen fundoplication is the procedure of choice for patients with intractable GERD.

Adolescent↗
PubMed1991

Laparoscopic Nissen fundoplication: preliminary report.

Twelve patients presenting with symptomatic esophagitis associated with hiatal hernia and gastroesophageal reflux underwent operative management under laparoscopic guidance. The antireflux procedure employed was the Nissen fundoplication. The authors completed the operation laparoscopically in nine patients. Postoperatively, patients were evaluated with repeat fiberoptic endoscopy, esophageal manometry, and barium contrast studies. Postoperative results were considered excellent on the basis of these studies and complete control of symptoms. The mortality rate was 0%. The only major operative complication was a pneumonia that occurred in one patient. At 1 month follow-up, six patients were totally asymptomatic. The authors conclude that laparoscopic treatment of gastroesophageal reflux associated with a hiatal hernia is feasible by a procedure that has already proven its value during open surgery.

Adult↗