Biomedical subjects
Publications and source records attributed to Z Puchalski.
The literature concerning of prevalence and meaning of middle molecular peptids in experimental and clinical pathology has been reviewed. Middle molecular peptids have been extracted for the first time from plasma of the patients with renal insufficiency by Babb in 1970.
The choice treatment of medullary thyroid carcinoma (MTC) is total thyroidectomy. It is difficult to evaluate effectiveness of chemotherapy due to the rare incidence of MTC. Gemcitabine is a new drug of antimetabolite nucleoside group used in treatment of cancers since 1996. The aim of this study was to evaluate the influence of gemcitabine on proliferation and neuroendocrine activity of human TT cell line derived from MTC. The cells were exposed to gemcitabine in the concentration of 10, 25 and 50 microg/ml for 24 hours. Immunocytochemical examinations were carried out by the method of avidin-biotin peroxidase complex (ABC) according to Hsu et al. to detect calcitonin, chromogranin A, synaptophysin and neuron-specific enolase in TT cells. A concentration-dependent inhibitory influence of gemcitabine on proliferative activity of TT cells was observed. It was also shown that the immunostaining was reduced, especially in case of neuron-specific enolase. Only the reaction detecting calcitonin was enhanced in persistin
The aim of this study was to carry out histomorphological and immunohistochemical analysis of thyroid C cells in 30 patients with simple goitre and hyperactive goitre including Graves-Basedow (G-B) disease, treated surgically. Four tissue samples were always taken from the same internal parts of the gland where the number of C cells in physiological conditions was the highest. C cells were detected in paraffin sections after impregnation with silver salt (Grimelius method) or immunohistochemically, with antibodies against calcitonin, synaptophysin, chromogranin A and neuron-specific enolase. Distinctly less numerous C cells were found in simple and hyperactive goitre than in normal thyroid parenchyma. The majority of C cells showed weak intensity of the examined immunohistochemical reactions. C cells were not observed at all in the texture of nodules well separated by the connective tissue. Proliferative changes concerned only follicular cells.
The aim of this study was to determine the incidence of cysts and cystoid-solid lesions in thyroid carcinomas basing on preoperative ultrasonographic examinations (USG), fine needle aspiration biopsy (FNAB) and postoperative histopathological examinations. 661 patients with different thyroid disorders were treated surgically. Carcinoma was found in 46 patients (3.9%). Papillary carcinoma was predominant (n = 34). Of the 46 patients with carcinoma, preoperative USG examination revealed cystic or cystoid-solid lesions in 18 patients (39%). FNAB of this 18 patients was positive in 5 cases, negative in 4 and suspect in 9. In 6 cases the neoplastic lesion was strictly connected with cysts (foci in the wall or in solid masses within the cyst) and in the remaining 12 patients lesions were found in the vicinity of the neoplastic focus. We conclude that malignant neoplasms of the thyroid gland are frequently (in approximately 40%) accompanied by cystic and cystoid-solid lesions, FNAB diagnostic material should be obtained even through several USG-controlled punctures and negative FNAB does not exclude thyroid carcinoma, particularly in nodular-cystoid goitre.
Non-invasive diagnostics development, and particularly introduction of ultrasound to everyday medical practice contributed to early detection of tumour lesions in the liver. The aim of the research was to analyse the patients with tumour lesions of livers in the north-eastern region of Poland. 325 patients with tumour lesions in livers underwent surgical treatment between year 1978 and 2000. In 197 patients metastatic malignant tumours were found in livers, while in 24 cases--primary malignant neoplasms of the organ. In the remaining cases benign tumours, mostly non-parasitic cysts were found. Out of 325 patients, who were surgically treated, 80 underwent resection procedures of liver parenchyma with tumour, 17--enucleation of tumour lesion with the enclosing capsula, 14--abscess drainage with necrotic mass evacuation. In 11 cases of non-parasitic as well as parasitic cysts fenestration was performed due to high risk of surgery, while in the remaining patients laparotomy was only performed and segments for histopathologic examination were taken due to the progression of the neoplasmatic disease. In the patients who had undergone resections of liver parenchyma in the postoperative course we noted complications such as: prolonged cholerrhagia from peritoneal cavity, stress duodenal ulcers complicated by bleeding, bleeding from liver parenchyma at the section line, jaundice as well as cisterns of fluid at the parenchyma section line. Mortality in the patients after the resection procedures of liver in our material was 7.5%. The development of diagnostics contributed to early detection and surgical treatment of tumour lesions of liver. The observation of our patients showed that resection procedures in benign tumours lead to complete recovery, while in malignant lesions--to clearly prolonged survival.
The purpose of the study was to compare power 3-D with conventional 2-D sonography with color and power Doppler in assessment of tumor vascularity in small hepatic hemangiomas. The study group comprised 12 patients (7 males and 5 females) aged 28-60, (mean 44) with diagnosed hemangiomas. In all the patients 2-D and 3-D sonography was performed and their results were compared. Both color and power Doppler 2-D sonography failed to detect blood flow in the tumors. Blood flow signals were detected in 3-D power Doppler sonography. 3-D power Doppler is superior to 2-D color and power Doppler imaging in the detection of blood flow signal in hemangiomas.
During the past 21 years 222 patients with chronic pancreatitis have undergone surgery at the Department of General Surgery, Medical School Bialystok. In 117 cases (52.7%) resection was performed and 48 patients (21.6%) had anastomotic procedures and the rest of patients underwent bile duct anastomotic surgery or were re-operated on because of surgical complications. Based on the own clinical experience and the latest data from the world literature diagnostic criteria and indications for surgical treatment of chronic pancreatitis are shown below. Good results obtained in 192 cases (86%) strongly support our opinion that resection procedures in chronic pancreatitis are the most effective management however patients should be operated on in specialized centers with good diagnostic bases because a correct diagnosis is essential while choosing the appropriate line of treatment.
The authors present their own experience in the diagnosis and management of adrenal tumours and cysts. During the years 1980-2000, 74 patients were underwent surgical treatment. Of this group, 23 had Cushing's syndrome, 19 phaeochromocytomas, 4 Conn's syndrome, 2 virilising tumours, 2 adenocarcinomas, 2 ganglioneuromas, 7 adrenal cysts, 8 adenomas, 3 adenocortical carcinomas, 2 nodular hypertrophies, 1 myelolipoma and 1 liposarcoma. Treatment was effective in 73 (98.6%) of patients. We recommend the transperitoneal approach which allows the visual evaluation of both adrenals and extra adrenal tissue. We regard surgical intervention as being the only effective method of treating adrenal tumours.
UNLABELLED: Promising results of studies on different neoplasms, by means of morphometric analysis of argyrophilic nucleolar organizer regions (AgNORs), known as proliferative activity marker, made us undertake an attempt to evaluate of proliferative activity in Hürthle Cell Tumors using the same technique. 78 cases including 20 Hürthle Cell Carcinomas (HCC), 32 Hürthle Cell Adenomas (HCA) and 26 hyperplastic nodules with Hürthle Cell Metaplasia (HCM), diagnosed in the Department of Clinical Pathology, Medical Academy of Bialystok in the years 1990-2000, were subjected to analysis. For visualization of the NORs we used the D. Ploton et al. technique. Mean AgNOR count and NORDS (NOR distribution score--the percentage of nuclei with at least 5 argyrophilic granules) were estimated in each case in 100 randomly chosen nuclei. Non-parametric Mann-Whitney U-test was applied to determine statistically significant differences. RESULTS: Mean AgNoRs counts and NORDS values were 5.1 and 52%, 3.4 and 26%, 2.5 and 7% in HCC, HCA and HCM respectively. Statistically significant differences were found between AgNORs counts in carcinomas and adenomas (p<0.01), HCCs and HCMs (p<0.005) and betwveen NORDS in all groups (p<0.001).
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Surgical treatment of goitre in children and teenagers under 18 is relatively rare and undertaken for strict therapeutic indications. It still arouses much controversy among surgeons, being loaded with a high percentage of complications, usually distant ones. The aim of the study was to analyse the surgical treatment of various goitre types under the age of 18 basing on 65 operations performed in the years 1994-1998. Operations for non-toxic and hyperactive nodular goitre, including Graves-Basedow disease, were predominant. Five cases of thyroid carcinoma were found. No serious complications were observed during and after the surgery. Our own material and the 5-year observation reveal that surgical treatment of thyroid diseases in children and adolescents carried out for definite indications by an experienced operating team is successful and causes only few complications.
The aim of the study was presentation of our experiences in the diagnostics and treatment of pancreatic carcinoma in confrontation with current opinions. Between 1983 and April 1998 308 patients (198 males and 110 females with mean age 61 years) were treated at our department. In 211 cases tumor was primarily localized in the head and in 97 cases (31.5%) in the body or tail of pancreas. The diagnosis was determined on the basis of clinical symptoms and laboratory investigations. Diagnostic accuracy of performed investigations was as following. Ultrasonography-86%, CT-scan-95%, and ERCP-94%. Ultrasonography or CT guided biopsy and serodiagnostics improved detectability of resectionable carcinoma in the last past years. Among 308 patients, 292 underwent surgery. Since 1997 an intraoperative ultrasonography and cholangioscopy of common bile duct and Virsung were performed as a routine. The procedures depended on the localization and the grade of advance of the tumors. UICC classification of pancreatic tumors, pTNM (4th edition 1987) it was used. Only in 25 patients (8%) (tumors pT1a-bN0M0) it was possible to perform radical operation (resection of the pancreas). However in 172 patients (56%) only palliative procedures were done (pT2N1M0). In 95 patients (31%) only laparotomy and biopsy were performed (tumors pT2N1M1). The study shows that although diagnostic methods are improved, the tumors of the pancreas are diagnosed in stages making unable the radical procedures. Only about 10% of carcinomas are resectable. It is caused by with non-characteristic picture of the disease in its early stage.
The routine preoperative cytological evaluation of pathological changes of the thyroid more and more frequently reveals single or multiple Hürthl cells in the material obtained by the method of fine-needle aspiration biopsy (FNA). Hürthl cells are a degenerative form of epithelial follicular cells of the thyroid and cytological examination is insufficient for unequivocal differentiation between adenoma and carcinoma. Management of patients with FNA-diagnosed Hürthl cells arouses a number of controversies. Therefore, the authors of the present study subjected the thyroids of patients with cytologically diagnosed Hürthl cells to postoperative histopathological analysis. Appropriate surgical management was indicated.
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Thromboembolic events may complicate clinical course of chronic pancreatitis. It is accepted that trypsin plays a role in the pathogenesis of these abnormalities. However there is a lack of information about local activation of blood coagulation in pancreatic tissue in chronic inflammation and contribution of tissue factor (TF) to this process. Immunohistochemistry was applied to AMeX-fixed sections of tissues of ten cases of chronic pancreatitis to explore the presence and distribution of components of the coagulation system in situ. TF antigen was present in cells of ductules. Fibrinogen and fibrin were detected in the inflammatory infiltrates of the pancreatic tissue. The data suggest that there is local activation of blood coagulation in pancreatic tissue in chronic inflammation that depends on tissue factor.
Therapeutic results obtained in the management of severe acute pancreatitis (AP) complications are still unsatisfactory, and mortality rate is about 40%. An improvement in treatment effectiveness can be related to successful control of infections and prevention of uncontrollable sepsis. The aim of the study was evaluation of effectiveness of Tienam in the management of severe acute pancreatitis complications. The clinical material included 24 patients, treated for AP between 1994 and 1996. All of the patients were operated on and 19 of them required at least one reoperation. During primary surgery we performed necrosectomy and continuous peritoneal lavage. The analysis of cultures obtained from infected necrotic tissue, pancreatic abscesses and whole blood showed that the infections were caused mainly by Gram-negative bacteria. The highest efficiency in infections control was observed in the case of Tienam (15% resistant strains). The authors emphasize also the increasing role of Staphylococcus aureus and Candida albicans in secondary infections.
The aim of the study was to evaluate the influence of hydrocortisone (H) and dopamine (DA) on behaviour of tissue content of DA, NA and homovanillic acid (HVA) as well as adrenergic fibers (AF) in canine kidney during endotoxic shock (ES). Above changes were considered on the background of hemodynamic, biochemical and morphologic alterations. Investigations were carried out on 5 groups of animals: I-control, II-dogs in ES without treatment, III-dogs in ES treated with H, IV-ES treated with DA, V-animals treated with H and DA. It was shown that the amount of catecholamines add AF in group II was lower than in group I. In groups of animal treated we observed bigger of well preserved AF and catecholamines, and the image similar to the one observed in control group-I was observed in group V. It appears from the study conducted that AF show active role to the course of ES, and beneficial effect of the treatment applied can be results of its influence on the function of DA, NA and AF.
The production of tumor necrosis factor (TNF-alpha), and interleukin 1 beta (IL-1 beta), IL-6, sTNFR-p55, sTNFR-p75 and their pharmacomodulation were evaluated in a model of septic shock induced in CD-1 mice by cecal ligation and puncture (CLP). This model of sepsis, which resembles the clinical situation of bowel perforation and peritonitis with subsequent septic shock was compared with that induced by administration of pure endotoxin (LPS). TNF-alpha was detectable in serum, liver, spleen and lungs during the first 4 h, with a peak 2 h after CLP. IL-1 beta was measurable in serum after 24 h, and levels increased significantly in spleen and liver 4 and 8 h after CLP. IL-6 levels increased significantly in serum throughout the first 16 h after CLP. sTNFR-p55 and p75 increased in both models of shock but with different kinetics. Cytokines were also detectable after LPS injection, with kinetics similar to those after CLP but a significantly higher level. Pretreatment with dexamethasone (DEX) and ibuprofen (IBU), significantly reduced survival, while TNF did not affect it. Only pentoxifylline (PTX) significantly increased survival in mice with CLP. However DEX protected the mice from LPS mortality. In conclusion, by inhibiting TNF-alpha with DEX and PTX survival was reduced or unchanged respectively, suggesting that the modulation of this cytokine does not play significant role in sepsis and septic shock induced by CLP, unlike treatment with LPS. The negative effects of IBU suggests a protective role by prostaglandins in sepsis induced by LPS.