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Biomedical subjects

T Stefaniak

Publications and source records attributed to T Stefaniak.

At least 19 recordsLinked to original sources
PubMed2006

Endoscopic transpapillary stenting of pancreatic duct disruption.

BACKGROUND/AIMS: Endoscopic transpapillary stenting of the pancreatic duct is increasingly being used in the management of pancreatic duct disruption. In contrast to its more established role in pancreatic duct obstruction, little is reported on the spectrum of indications and outcome in management of pancreatic duct disruption. METHODS: The indication for and outcome of transpapillary pancreatic duct stenting was analysed retrospectively in a UK supra-regional specialist pancreatobiliary centre, between January 1998 and August 2004. RESULTS: Data were obtained on 30 patients (19 male, 11 female, median age 53 years). The main indications for pancreatic duct stenting were: pancreatic pseudocyst, pancreatic ascites, pancreatic duct leak following necrosectomy, and pancreaticopleural fistula. The median duration of stenting was 6 weeks for fistulae and 10 weeks for pseudocysts. Twenty-one patients (70%) had complete resolution. After a median follow-up of 45 months, no recurrence was noted in successfully treated patents. CONCLUSION: Endoscopic transpapillary pancreatic duct stenting is an increasingly valuable treatment option in the management of pancreatic fistulae and pseudocysts.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed2006

Chromosome instability in a calf with amelia of thoracic limbs.

We report here on a case of a Holstein-Friesian male calf with the congenital total absence of thoracic limbs (amelia). Cytogenetic study showed a high rate of chromosome instability, represented by chromosome or chromatid breaks and gaps in 46% of the analyzed metaphase spreads. Moreover, 12% of the spreads appeared to be polypolid. The number of micronuclei also was significantly higher when compared to control animals. This paper discusses the association between chromosome instability and limb malformation.

Animals↗
PubMed2005

A comparison of two invasive techniques in the management of intractable pain due to inoperable pancreatic cancer: neurolytic celiac plexus block and videothoracoscopic splanchnicectomy.

BACKGROUND AND AIMS: Pancreatic cancer is characterized by a constant deterioration in quality of life, excruciating pain and progressive cachexia. The aim of this study was to compare the effectiveness of two invasive methods of pain treatment in these patients: neurolytic coeliac plexus block (NCPB) and videothoracoscopic splanchnicectomy (VSPL) to a conservatively treated control group concerning pain, quality of life and opiates' consumption. PATIENTS AND METHODS: Fifty nine patients suffering from pain due to inoperable pancreatic cancer were treated invasively with NCPB (N=35) or VSPL (N=24) in two non-randomised, prospective, case-controlled protocols. Intensity of pain (VAS-pain), quality of life (FACIT and QLQ C30) and opioid intake were compared between the groups and to a control group of patients treated conservatively before the procedure and after 2 and 8 weeks of follow-up. The analysis was performed retrospectively using meta-analysis statistics. RESULTS: Both methods of invasive pain treatment resulted in significant reduction of pain (VSPL effect size=11.27, NCPB effect size=7.29) and fatigue (effect sizes, respectively, 1.23 and 3.37). NCPB improved also significantly physical, emotional and social well-being (effect sizes, respectively, 2.37, 4.13 and 7.51) which was not observed after VSPL. No influence on ailments characteristic for the disease was demonstrated. Mean daily opioid consumption was significantly decreased after both procedures. There was no perioperative mortality and no major morbidity. CONCLUSION: Both NCPB and VSPL provide significant reduction of pain and improvement of quality of life in inoperable pancreatic cancer patients. They present rather similar efficacy, but lower invasiveness of NCPB, in combination with its more positive effect on quality of life, pre-disposes it as being the preferred method.

Adult↗
PubMed2004

[Imaging in parathyroid gland diseases with relation to surgery].

BACKGROUND: Despite the progress in the imaging techniques, the satisfactory preoperative detection of the hyperactive parathyroid glands has not been guaranteed yet. Many complementary techniques have been introduced including ultrasound imaging, CT-scanning, MRI and scintigraphy, also supported by intraoperative methods (methylene blue injections, gamma-probing, intraoperative PTH level assessment) simplifying the detection of the glands and assuring the surgeon on the adequacy of his/her treatment. DESIGN: The authors describe the methods instituted nowadays, and compare their quality parameters, applicability, indications and limitations. The critical review is accompanied by a brief presentation of own experience including 172 cases of hyperparathyroidism treated in the Department of General, Gastroenterological and Endocrinological Surgery, Medical University of Gdansk, Poland between 1996 and 2003. CONCLUSIONS: The authors conclude that radionuclid-based methods (Tc (99m)-MIBI preoperative scintigraphy and Tc (99m)-MIBI intraoperative gamma-probing) seem to be the most effective in both preoperative and intraoperative detection of hyperfunctioning parathyroids. It is also suggested that the effectiveness of the imaging is higher in primary than in secondary hyperparathyroidism. It is underlined that the effectiveness of the operative treatment is strongly determined by the experience of the operating endocrine surgeon.

Diagnosis, Differential↗
PubMed2004

[Accessory spleens--diagnostic and therapeutic problem of the laparoscopic splenectomy in idiopathic thrombocytopenic purpura patients].

The preoperative detection of accessory spleens (AS) is essential in ITP patients. The aim of this study was to evaluate the reasons of failure and long-term results of laparoscopic splenectomy (LS) in patients with idiopathic thrombocytopenic purpura (ITP). Thirty-four ITP patients (27 females and 7 males) underwent LS between June 1998 and January 2001. Computed Tomography (CT) and sonography (US) were performed preoperatively to evaluate the size of the spleen and to detect the presence of possible accessory spleens which were found in two cases. AS were seen during laparoscopy in three cases. During follow-up (median time = 23 months), in three patients a low platelet count was seen after 5 months, 1.5 and 1.8 years pop. In all these cases scintigraphy was performed, which revealed in one case the residual accessory spleen. In the two other patients, inspite of thrombocytopenia no residual spleens were found. The authors conclude that laparoscopic splenectomy is a safe and effective procedure in patients with ITP. The problem of accessory spleens can be managed by careful videoscopic examination of the abdominal cavity during splenectomy. The use of the preoperative imaging techniques for detection of accessory spleens is limited by the insufficient sensitivity of the examination.

Adolescent↗
PubMed2004

Psychological factors influencing results of cholecystectomy.

BACKGROUND: Cholecystectomy is a surgical gold-standard procedure for gallbladder diseases, among which gallstones are the most frequent. Despite the introduction of minimally invasive surgery and broad access to ultrasound examination there is a group of patients in whom the surgery ailments persist. Those vague ailments can be perceived from a psychological point of view as somatization or even somatoform disorders. METHODS: The aim of the study, designed as a case-control study, was to evaluate psychological characteristics that may accompany the incidence of so-called post-cholecystectomy pain syndrome (PCPS). The study focused on 367 patients treated for gallstones in the Dept. of General, Gastroenterological and Endocrinological Surgery, Medical University of Gdańsk, Poland. At about a year after the operation, the patients received a questionnaire that included a structured interview and psychological assessment of social support and rumination. Those who revealed symptoms of PCPS were invited to the department for further medical and psychological evaluations. Psychosocial scores of PCPS and non-PCPS patients were compared. RESULTS: The PCPS patients did not present any dysfunction at the physical examination or in gastroduodenoscopy or sonography. However, they differed from the remaining. asymptomatic group in terms of lacking social support, as well as increased rumination. CONCLUSION: It is concluded that psychological variables may play an important role in the onset of subjective symptoms in at least a subgroup of the PCPS patients as a form of somatization. Psychological supportive and explanatory activities (cognitive and behavioural approach) may provide sufficient help.

Adult↗
PubMed2003

One hundred and ten consecutive uncomplicated retroperitoneal videoscopic adrenalectomies--Polish multicentre study.

AIM: The authors evaluate the effectiveness of videoscopic adrenalectomy (VA) for a variety of endocrine disorders. METHODS: One hundred and ten consecutive videoscopic adrenalectomies performed from October 1995 till December 2000 were reviewed and followed up for adequacy of surgical treatment in 2 surgical departments. There were 79 females and 31 males included in the study. The mean age was 48.0 years (range 23-71 years). Indications for the operations were: phaeochromocytomas (n=5), aldosterone-producing adenomas (n=19), cortisol-producing adenomas (n=10), Cushing's disease (n=3) and non-secreting tumours (n=72). RESULTS: There was no mortality and no morbidity both intraoperatively and in the postoperative course. In 8 cases conversion to open surgery was instituted - in 4 cases due to an unintended lesion of pertioneum without damage to the intraperitoneal organs. Mean operative time was 156 min (range 52-280 min), and estimated blood loss was 73 ml (range 20-300 ml). The average length of hospital stay was 2.9 days (range 2-7 days). None of the patients revealed either recurrence of hormonal hypersecretion or tumour mass in imaging studies during the follow-up period (range 1-34 months). CONCLUSION: 1. VA is recommended in patients with hormonally active tumours and in patients with benign adrenal masses of a diameter up to 6 cm. 2. VA is a safe and feasible procedure if performed by a team experienced in endocrine and endoscopic surgery. 3. VA is a procedure better than open adrenalectomy in management of small, non-malignant tumours because of the reduction of operative trauma.

Adrenal Gland Neoplasms↗
PubMed2002

Protein oxidation in male Syrian hamster kidney during estrogen-induced carcinogenesis.

Chronic administration of estradiol leads to generation of estrogen-dependent renal cancer in male Syrian hamsters within 9-12 months. The pathogenesis of this tumour is associated with oxygen free radicals, however, it is still not clear which metabolic pathway of estrogens is responsible for the generation of the radicals, and which part of the cell is mostly affected by it. The paper presents an experiment in which the protein oxidation measured by carbonyl groups level in 9-month estrogenization scheme. The level of carbonyl groups was significantly elevated starting from the 1st month of estrogenization until the 9th. The weight of the kidneys reflecting possible tumuorigenesis was also significantly increased in estrogenized group starting at the 2nd month of the experiment. The weight of the testes, a sign of adequate estrogenicity, was decreased dramatically in the estrogenized group from the first to the last month of experiment. The results suggest that the kidney of estrogenized male Syrian hamster suffers from oxidative stress affecting proteins.

Journal Article↗
PubMed2002

Transfer of maternal passive immunity to kids in goat herd.

The efficiency of tranfer of maternal immunity and its infuence on the kids' health was observed in a herd in which kids (n=20) had whole contact with the dam (n=13). The factors associated with dam, kid and human, which influence the efficiency of passive transfer were observed. It was estimated that the single-born kids reached higher serum gamma-globulin level (mean 23.14 g/dm3) than twin kids (mean 18.2 g/dm3) (p < 0.05). The gamma-globulin level was the highest in single-born kids at 48 h, and in twin kids in 24 h of life. The IgG class antibodies to herd-homologous strains of Pasteurella multocida and Escherichia coli were estimated using ELISA in sera, colostrum and milk whey samples of dams and sera of kids. It was found that maternal antibodies specific to these two facultative pathogens decreased in kids sera rapidly and the self humoral immune response occurred within the period of observation. Two kids delivered by goats with lowest hierarchic position in the herd showed failure of passive transfer, and died at the 10th and 12th weeks of life due to chronic infections induced by both above mentioned bacterial strains.

Animals↗
PubMed2001

The effect of Ureaplasma diversum activated mononuclear leukocytes on the development and interferon-tau production by bovine IVF-derived embryos.

Ureaplasma diversum is an opportunistic pathogen of the bovine genital tract causing herd outbreaks of granular vulvitis, abortion and infertility. Early embryonic death probably contributes to reduction of the reproductive performance in cows, however, pathogenesis of the disease remains obscure. The aim of the study was to examine whether activation of mononuclear leukocytes by U. diversum may affect embryo development and IFN-tau production. Bovine peripheral blood mononuclear leukocytes were cultured with U.diversum antigen for 24 h. The levels of IL-1, TNF-alpha, NO and GM-CSF in the cell culture supernatants were measured. IVF-derived embryos were cultured in the presence of supernatants from activated leukocytes. The development of embryos until day 6 postinsemination and the rate of morulae/blastocysts were determined. IFN-tau production in supernatants of cultured embryos was examined by inhibition of a virally-induced cytopathic effect. The results showed that U. diversum stimulated mononuclear leukocyte production of IL-1, TNF-alpha and NO. Supernatants from U. diversum-activated cells did not impair the rates of the embryo development and blastocyst formation. The products of activated leukocytes increased the IFN-tau production by cultured blastocysts. This suggest that U. diversum infection provides leukocyte-mediated signals for developing embryos for generation of additional production of cytokine - an important component of innate immunity.

Animals↗
PubMed2001

[Appendico-ileo-caecal intussusception as a cause of mechanical ileus].

The authors present a case of 34 years old male operated on for mechanical ileus caused by intussusception of unchanged appendix, cecum and terminal part of ileum. The paper presents possible mechanism of intussusception, diagnostic difficulties determined by non-characteristic symptoms and imaging examination results.

Adult↗
PubMed1998

Cross reactivities among some mammalian haptoglobins studied by a monoclonal antibody.

Mouse monoclonal antibody antihuman-Hp, product of clone 2.36.71.41 was found to recognize, however, with different affinities, the immunological determinant on haptoglobin of some mammals (goat, sheep, cow, horse, rabbit). The following differences in immunological cross reactivities were noticed: (i) haptoglobins present in sera of goat, sheep and cow (Artiodactyla, Bovidae) react in enzyme-linked immunosorbent assay (ELISA) and form precipitates in agarose gel; (ii) horse (Perissodactyla) and rabbit (Lagomorpha) haptoglobins react in ELISA, but they do not form precipitates; and (iii) haptoglobins of dog, fox, cat (Carnivora) and pig (Artiodactyla, Suidae) are not recognized by the tested monoclonal antibody either in ELISA or in agarose gel. This study suggests that monoclonal antibody, clone 2.36.71.41, recognizes the structure on haptoglobin around the disulphide bond linking two alpha chains. Antigenic structure of Bovidae haptoglobins is rather similar to human haptoglobin 2-2 (circular polymers) than to 2-1 type (linear polymers). Monoclonal antibody 2.36.71.41 could be used for classification of mammalian haptoglobins by epitope structure. It can distinguish polymeric haptoglobins similar to human type 2-2 from other mammalian haptoglobins.

Animals↗
PubMed1997

Haptoglobin concentration in blood sera of hoofed mammals in captivity.

There were 151 serum samples of the zoological species of hoofed animals from the Bovidae, Cervidae and Equidae families examined for the presence of haptoglobin (Hp). In the majority of samples the Hp levels were close to the ones defined in the related species of domestic animals (86.49, 52.38 and 69.7% in particular families, respectively). In females (13.94% in the Bovidae family, 63.64% in the Cervidae, 15% in the Equidae) more often than in males (11.11, 26.32 and 0%, respectively) the increased Hp concentrations were found. What is striking it is the relatively high frequency of the raised Hp concentrations occurrence in the Cervidae sera, which may be connected with the higher responsiveness to the factors inducing Hp rise in this family. The contribution of infectious, parasitic, stress-inducing factors and injuries is taken into consideration as the main cause of the raised levels occurrence in the sera of animals kept in zoological gardens. The obtained results suggest the potential usefulness of the Hp estimation as a routine examination in the diagnostics of the inflammation in wild species of Bovidae and Cervidae as well as in monitoring the animal well being in the zoological gardens.

Animals↗
PubMed1995

[The influence of phleum pratense and secale cercale allergens on selected functions of PMNL granulocytes].

The evaluation of granulocytes function (PMNL) at patients with pollinosis. There were 59 people examined and divided into: 30 patients with pollinosis, 29 healthy people. There were evaluated: absorption of isotope (phagocytic index) in our modification migration in vivo and the bacteriotoxic index. The function of granulocytes (postpreincubation) of allergens Phlenum pratens and Secale cercale in patients with pollinosis were changed more in comparison with the healthy people.

Adult↗
PubMed1993

Detection of the Haemophilus somnus antibodies in the bulls' reproductive tract fluids using the ELISA. I. Elaboration of the ELISA for the detection of the specific antibodies in the IgG, IgM and IgA classes.

The conditions of the ELISA for detecting the Haemophilus somnus antibodies in IgG, IgM and IgA classes were elaborated. The test was adapted for examining the seminal plasma, preputial washings and blood serum samples of bulls. In order to obtain the more precise evaluation of results, the tests were made for two different dilutions of the examined material. The arising out of this method difficulty in the evaluation of the intensity of reaction was solved by introducing the specific, semi-quantitative method of classification, using the eleven-degree scale. The mean arithmetic classificational values calculated from absorbance readings were called "absorbance index". The introduced parameter proved to be especially useful while comparing the reaction of antibodies in reproductive tract fluids samples.

Animals↗