Biomedical subjects
E Jassem
Publications and source records attributed to E Jassem.
[Bacterial diagnosis of tuberculosis using the PCR technique].
At the beginning of 80-ties new system BACTEC for mycobacteria culture has been introduced. So time of this culture has been shortened to 1-3 weeks. At the end 80-ties Polymerase Chain Reaction (PCR) technique was started and at present it is used in many laboratories in order to get information about genetic material of mycobacteria in different biological samples. Most often insertive factor IS 6110, located in chromosome Myc. tub. complex, is used. DNA amplification occurs in three stages: 1) DNA denaturation. 2) addition of starters (primers): 3) elongation of starter with d NTP synthesis. PCR technique identifies genetic material (DNA) of mycobacterium which is presented in a given biological sample. Positive PCR result not necessarily means that active disease takes place.
[Non-sporeforming anaerobic bacteria in bronchoalveolar lavage fluid of patients with pneumonia during the course of lung cancer].
The aim of this study was to assess the occurrence of non-sporeforming anaerobes in bronchoalveolar lavage in patients with pneumonia coexisting with lung cancer. Material consisted of 40 patients with lung cancer. Bronchoalveolar lavage was performed before administration of antimicrobial treatment and obtained material was cultivated in anaerobic and aerobic conditions. Quantitative assessment of anaerobic bacteria and their susceptibility to common antimicrobial agents were also performed. Peptostreptococcus, Prevotella, Fusobacterium and Bacteroides were the most common anaerobes. Among aerobic bacteria, the most frequent were G-negative bacilli. G-negative anaerobes were susceptible to most tested agents, whereas G-positive rods were resistant to metronidazole and tinidazole. This study demonstrates presence of non-sporeforming anaerobic bacteria in lower respiratory tract infections accompanying lung cancer.
[New imaging methods in diagnosis of lung cancer].
The paper reviews new imaging methods allowing more precise diagnosing and staging of lung cancer. From among the methods currently used in clinical practice computed tomography and nuclear magnetic resonance were reviewed. Advantages and limitations of these techniques were presented. As for isotopic tests we reviewed single photon emission computed tomography and positron-emission tomography as well as novel endoscopic methods--lung imaging fluorescence bronchoscopy and video assisted thoracoscopy.
[Mutation of gene p53 in lung cancer].
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[Gall bladder tuberculosis and stomach cancer].
The case of a seventy year old woman with delayed diagnosis of stomach cancer due to misinterpretation of signs and symptoms is presented. A few months earlier a gall bladder tuberculosis was found in this patient. Abdominal symptoms which appeared afterwards were therefore interpreted as manifestation of tuberculosis until the thorough examination allowed diagnosing a gastric cancer.
[Stomach neoplasm with pulmonary dissemination--diagnostic difficulties].
The case of nineteen years old patient with a milliary-like lesions in the lung due to gastric carcinoma is presented. Rapid progression and atypical course of the disease were a cause of difficulties in establishing a proper diagnosis.
[Occurrence of non-spore forming anaerobic bacteria in the upper airways of patients with chronic obstructive pulmonary disease].
The aim of this study was to assess the occurrence of anaerobic non-sporeforming bacteria upper airways flora in the exacerbation of COPD. Sputum from 35 COPD patients was sent to the laboratory in sterile, filled with CO2 containers and cultured under anaerobic conditions. In all patients bacteriological tests were positive. The most common anaerobic bacteria were as follows: Peptostreptococcus - in 28 pts, Fusobacterium - in 27 pts, Bacteroides - in 26 pts and Prevotella in 24. Less common were: Propionibacterium, Actinomyces, Eubacterium, Porphyromonas and Peptococcus. The susceptibility to most common antimicrobial agents was evaluated. All anaerobic bacteria show a significant sensitivity to amoxicillin either with clavulanic acid or ampicillin with sulbactam. Gram-positive rods were resistant to metronidazole and tinidazole.
[Prognostic value of neuron enolase levels in serum of patients with lung neoplasms].
The aim of this study was to assess a prognostic value of serum specific enolase (NSE) measurement in lung cancer patients. Total number of 105 patients entered the study, including 36 patients with small cell carcinoma and 69 patients with non small cell carcinoma (21-squamous cell carcinoma, 32-adenocarcinoma, 14-large cell carcinoma). Elevated NSE level was observed in 47 (44.8%) patients: in 75% of SCLC patients and 29% of NSCLC patients (p < 0.001). Median survival in NSCLC patients with elevated NSE levels was 27 weeks and in those with normal values-59 weeks. The probability of one year survival in both groups was 22% and 45% respectively (p = 0.27). Median survival in SCLC patients with elevated NSE test was 30 weeks and in those normal levels-61 weeks and the probability of one years survival in both groups was 26% and 62%, respectively (p = 0.34).
[The role of serum markers in diagnosis and treatment monitoring in patients with lung cancer].
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Combination chemotherapy with cyclophosphamide, epirubicin and etoposide in small cell lung cancer.
From March 1987 to February 1991, 136 patients with untreated small cell lung cancer (64 patients with limited disease and 72 with extensive disease), were treated as part of a prospective multi-center study, with a combination of cyclophosphamide 1000 mg/m2 i.v. on day 1, epirubicin 70 mg/m2 i.v. on day 1 and etoposide 100 mg/m2 i.v. on days 1, 3 and 5. Courses were repeated every 3 weeks. One-hundred thirty-four patients were evaluable. There were 42 (31%) complete responses and 66 (49%) partial responses for an overall response rate of 80% (95% confidence interval 71-87%). A complete response was seen in 24 patients (38%) with limited disease and in 18 patients (26%) with extensive disease, while a partial response was observed for 31 (48%) and in 35 (50%) patients, respectively. The median duration of response for all patients was 8.9 months (range, 1-60+ months). The median duration of survival for the entire group was 11.4 months (12.5 months for limited disease and 9.8 months for extensive disease). The 2-year survival rate for the whole group was 13%. The main side-effects were myelosuppression, alopecia, nausea and vomiting. Grade 4 toxicity was seen in 8.5% of patients. In conclusion, the studied regimen was found to be active and well tolerated and may be considered as an alternative to standard chemotherapy combinations in SCLC.
[Paraneoplastic syndromes in lung cancer].
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[Treatment monitoring of patients with small cell lung cancer by determining levels of serum neuron specific enolase].
The correlation between response to chemotherapy and the serum level of neuron specific enolase NSE as well as value of the test for predicting relapse has been evaluated in 41 patients with small cell lung carcinoma (SCLC). A significant decrease of the mean NSE level in comparison with the pretreatment value was observed (p = 0.01). At the time of relapse the mean level increased significantly (p = 0.005). In 9 out of 19 responders to chemotherapy (47.3%) increase of the NSE level above the normal value preceded clinically diagnosed relapse by 3-6 weeks. These results demonstrate the usefulness of the test in treatment monitoring of patients with SCLC.
[Rapid preliminary diagnosis of anaerobic bacterial infections. I. Natural fluorescence of pus, purulent fluids and dressing under UV radiation].
For evaluation of usefulness of natural fluorescence of clinical materials in UV radiation as rapid diagnostic method of infections with anaerobes, 405 samples of pus, bloody-purulent fluids, blood, wound secretions, dressings and other materials were investigated. Occurrence of red-brick UV fluorescence of clinical materials was compared with results of culture aimed at isolation of non-sporeforming anaerobes from "B. melaninogenicus group (P. melaninogenica, P. intermedia and P. saccharolytics). Significant correlation red-brick fluorescence of clinical materials resulting from UV irradiation with presence in these materials of anaerobes such as P. melaninogenica, P. intermedia and P. asaccharolytics was detected. Investigation of clinical materials with application of fluorescence in UV radiation lasts only 1-2 minutes and together with preparation and microscopical inspection which is Gram-stained--only 15-20 min. Positive results of this test may constitute a basis for rapid, preliminary identification of the etiologic factor and for direction of chemotherapy in the early period of infection.
Serum neuron-specific enolase and lactate dehydrogenase as predictors of response to chemotherapy and survival in non-small cell lung cancer.
The prognostic value of serum neuron-specific enolase (NSE) and lactate dehydrogenase (LDH) was prospectively assessed in 42 patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) treated within two chemotherapy trials. Pretreatment NSE levels ranged from 4.6 to 34.6 ng/mL (median value, 7.5) and were above 10 ng/mL in ten patients (23.8%). LDH levels varied between 85 U/L and 2,484 U/L (median value, 220) and were above 250 U/L in 12 patients (29.3%). Elevated levels of both enzymes were significantly more common in patients with metastatic disease than in those with locoregional disease (40% v 9% for NSE and 40% v 18% for LDH, respectively). Strong positive correlation (correlation factor 0.693) was found between NSE and LDH serum levels. The levels of both markers did not correlate with age, sex, previous therapy, performance status, or histology. Responses to chemotherapy were seen more frequently in patients with elevated NSE levels (six of ten, 60%) than in those with normal values (seven of 32, 22%; P = .02). Similar correlation was found for LDH: Response was seen in seven of 12 patients with elevated levels (58%) and in six of 29 (21%) of those with normal values (P = .02). In a logistic regression analysis, both markers considered individually remained significant when adjusted by sex, age, performance status, prior therapy, histology, and extent of disease. Three pretreatment characteristics, high levels of NSE and LDH (both considered as continuous variables) and metastatic disease, were found to be associated with shorter survival; with adjustment for extent of disease, however, NSE and LDH were no longer correlated with shorter survival. These data suggest potential clinical value of NSE and LDH determination in treatment selection of NSCLC patients.
[Broncho-alveolar carcinoma--clinical picture and treatment methods].
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[Evaluation of the activity of angiotensin I converting enzyme (ACE) and of humoral immunity in patients with active pulmonary sarcoidosis].
In a group of 20 patients with active pulmonary sarcoidosis and in 20 healthy subjects, serum levels were determined of angiotensin I converting enzyme, immunoglobulins, and of the third and fourth complement components. An increased level of IgG and IgM was found in patients with sarcoidosis, as compared with the control group. High ACE levels were observed in the second and third phase of the disease. A tendency was also observed for simultaneous increase of IgG and ACE levels in patients with sarcoidosis.