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Biomedical subjects

P Nowacki

Publications and source records attributed to P Nowacki.

At least 37 records · Page 2Linked to original sources
PubMed1995

[Dysfunction of the blood-brain barrier in patients with acute leukemias or lymphomas of high grade malignancy].

In 38 patients with acute leukemias or non-Hodgkin's lymphomas of high malignancy the blood-brain barrier (BBB) was prospectively analysed by means of QAlb value (QAlb = cerebrospinal fluid albumin/serum albumin). Cerebro-spinal fluid and serum were taken before each intrathecal methotrexate administration according to central nervous system (CNS) prophylaxis or treatment of CNS involvement by neoplasm. Patients were divided into two groups. Group I consisted of 5 individuals with clinical manifestations of CNS involvement by leukemia or lymphoma. Group II contained 33 patients without neurological symptoms. Besides, group II was subdivided into other two groups: group IIa-patients with BBB analysis before cytostatics application, and group IIb-patients in which BBB was analysed after the administration of at least one cycle of protocols, used in general chemotherapy, including intrathecal methotrexate injection. In group I BBB changes were observed in 10 out of 12 assessments (sensitivity 83.3%). In group II BBB impairment was revealed in 11 out of 52 assessments (specificity 78.8%). The differences in QAlb values between groups I and II were statistically significant (p = 0.0008), whereas there were no significant differences between QAlb values in groups IIa and IIb. Basing on their investigations, the authors conclude that neoplasm invading CNS should be considered as essential risk of BBB impairment, whereas intrathecal and general chemotherapy appear to be less important in BBB injury.

Adolescent↗
PubMed1995

Central nervous system leukostasis in patients with leukemias and lymphomas.

The clinical and neuropathological investigations have been done on 133 autopsied patients died of leukemia or non-Hodgkin's lymphoma of high malignancy. A study was performed to analyse the role of various factors particularly with respect to adhesion and aggregation in the CNS leukostasis development. The findings were also designated to evaluate the distribution of leukostasis in different CNS regions and to recognize its intensity in various CNS vessels. Basing on the studies the authors conclude that the risk of CNS leukostasis increases evidently when the leukocyte counts are elevated above 50 G/l. The adhesion and aggregation of leukemic and lymphomatous cells as well as local anatomical factors in the CNS vessels play and important role in the CNS leukostasis development, which is more intensive in the white matter and leptomeninges. The medium-sized vessels are much involved, whereas cortical capillaries are relatively less affected by leukostasis. The CNS leukostasis appears to be dynamic and reversible phenomenon, which undergoes fluctuations according to the leukocyte counts increase or decrease.

Adolescent↗
PubMed1995

Cavernous angioma of brain stem mimicking multiple sclerosis.

A 14-year-old boy was admitted to our Department due to peripheral palsy of right VII and bilateral of the VI cranial nerves, spasticity, cerebellar symptoms as well as to dysphagia and dysarthria. In general, he was hospitalized 13 times because of the disease of a relapsing-remitting and next progressive course. He died 31 years after onset of the disease. Multiple sclerosis was diagnosed. Brain autopsy revealed tumor involving almost all brain stem structures and a part of right cerebellar hemisphere. Histologically, cavernous angioma was diagnosed.

Adolescent↗
PubMed1994

Multiple disseminated meningioma. Case report.

A case of 32-year-old woman was described in which progressive bilateral hearing and visual loss, hypokinesia, epileptic focal seizures were present. The brain CT-scan after a few years of the disease onset, showed the presence of multiple extracerebral tumors. Multiple meningiomas were diagnosed, probably associated with von Recklinghausen's disease. On the post-mortem examination 48 tumors of the different size and location in subdural space were found. Histologically transitional meningiomas with predominance of fibroblastic component were diagnosed. It was very interesting that apart from intracranial location of meningiomas, the same type of tumor was found within thoracic spinal root. The authors discuss the mechanisms of the development of multiple meningiomas and its association with neurofibromatosis.

Adult↗
PubMed1993

Hemiballismus in patient with blastic phase of chronic myelogenous leukemia.

The authors report the clinical course and neuropathological findings in the case of hemiballismus due to leukemic infiltration of the subthalamic nucleus. The symptoms were observed in a 19-year-old patient with blastic phase of chronic myelogenous leukemia, two weeks before death, when what is called the "critical point" developed (white cell count beyond 100 G/l and thrombocytopenia less than 50 G/l). The investigation are considered to confirm the role of the "critical point" in the development of central nervous system leukemic complications.

Adult↗
PubMed1993

Intravascular coagulation in the central nervous system in patients with acute myeloblastic leukemias.

The frequency and distribution of intravascular coagulation (IVC) were studied in brains of 121 patients who had died due to acute myeloblastic leukemias type M1 or M2. The IVC within the brain was observed in 59% of cases, more frequently in patients treated with polychemotherapy, especially according to TAD or VAPA protocols. The microthrombi were found predominantly in capillaries and small venous vessels. IVC was more frequent in cerebral and cerebellar white matter and in the neighbourhood of lateral ventricles (hippocampus, thalamus). In patients who had developed brain hemorrhage in the course of primary neoplasmic disease IVC was very frequent phenomenon, thus IVC is considered to be an important factor in the development of CNS hemorrhages in myeloblastic leukemias, irrespective of thrombocytopenia related to bone marrow involvement.

Adolescent↗
PubMed1993

["Critical point" as a risk factor of central nervous system hemorrhagic complications in patients with blastic phase of chronic myelogenous leukemia].

Clinical and neuropathological investigations have been performed on 29 patients deceased due to blastic phase of chronic myelogenous leukemia. The authors tried to determine if the risk of death due to hemorrhagic complications in the central nervous system (CNS) increased in the period of blastic phase with simultaneous hyperleukocytosis above 100 G/l and thrombocytopenia below 25 G/l. The results have revealed that in the above mentioned period named "critical point" the probability of death due to hemorrhages is over 7 times as high as during hyperleukocytosis without thrombocytopenia and almost twice as high as during thrombocytopenia without hyperleukocytosis.

Adult↗
PubMed1992

Impairment of peripheral nervous system in patients with non-Hodgkin's lymphomas treated with CBVPM/AVBP and CHOP schedules.

Clinical examination and conduction velocity measurements in peripheral nerves have been done on 56 patients with non-Hodgkin's lymphomas of high malignancy (NHL). It is suggested that: the evaluation of the influence of chemotherapy on peripheral nervous system (PNS) is possible by means of systematic neurological and electroneurographic studies; electroneurographic assessment is most important in the diagnosis of early subclinical stages of peripheral neuropathy; toxic influence of CBVPM/AVBP protocol on PNS is greater than CHOP schedule; impairment of PNS due to chemotherapy is reversible in patients during complete remission (CR).

Adolescent↗
PubMed1992

Impairment of vertebral canal nervous structures after intrathecal prophylaxis in non-Hodgkin's lymphomas.

Neuropathological analysis of spinal cord and spinal roots as well as spinal leptomeninges after intrathecal methotrexate (MTX) therapy was performed in 44 cases of non-Hodgkin's lymphomas of high malignancy. It was showed that MTX applied according to the program applied as a prophylaxis against lymphomatous infiltrations in the central nervous system, caused demyelination of spinal roots and fibrosis of leptomeninges and their blood vessels. However, it does not affect spinal cord structures. Described morphological changes remained clinically mute, therefore they do not seem counterindicate prophylactic intrathecal MTX application.

Adolescent↗
PubMed1990

Cerebellar degenerative changes in patients with acute leukaemias and non-Hodgkin's lymphomas.

In patients with neoplasms located outside the central nervous system can appear degenerative changes within nervous tissue. Neuropathological investigations have been done on 101 cases with acute Non-Lymphoblastic Leukaemias (ANLL) and Non-Hodgkin's Lymphomas (NHL). Cerebellar degenerative changes especially granular layer rarefaction or atrophy appear more frequently in ANLL than in NHL.

Adult↗
PubMed1990

[Degenerative changes within the nervous system in non-hodgkin's lymphoma].

The purpose of the paper was an attempt to become better acquainted with the character and incidence rate of degenerative changes within the nervous system in non-Hodgkin's lymphomas. Neuropathological studies were carried out in 30 patients, aged 17-75 years, deceased due to: lymphoblastic lymphoma (15 cases), centrocytic (5 cases), immunoblastic (4 cases), centroblastic (3 cases) and immunocytic lymphoma (3 cases). The investigations revealed that degenerative changes prevail in the peripheral nervous system: within the spinal roots in the form of primary demyelination and within peripheral nerves of axonal degeneration.

Adolescent↗
PubMed1989

[Degenerative changes in the cerebellum in adult non-lymphoblastic leukemia].

Neuropathological investigations have been performed on 61 patients of both sexes, aged 17-60 years, deceased owing to nonlymphoblastic leukemias. The cerebellar degenerative changes appeared in 51 percent of cases mainly in the grey matter. Distinct rarefaction or atrophy of the cerebellar granular layer and the dentate nuclei were frequent phenomena. The following classification of the cerebellar granular layer damage was used: I degrees - focal rarefaction, II degrees - diffuse distinct rarefaction, III degrees - focal atrophy, IV degrees - diffuse atrophy. The investigations suggest that polychemotherapy is one of the causes of cerebellar degenerative changes, especially atrophy of the granular layer and dentate nuclei, as well as demyelination. In leukemias of short duration more frequently than in the remaining cases lymphocytic perivenous infiltrations appeared in the white matter. It seems to be a consequence of immunopathological reactions between the neoplasm and the nervous tissue in cases with more dynamic course of the disease.

Adolescent↗
PubMed1989

[Clinical diagnosis of Jakob-Creutzfeldt syndrome--analysis of 6 cases].

The authors present an analysis of the clinical course of 6 cases of Creutzfeldt-Jakob disease (patients were aged from 27 to 59 years). The diagnosis was established during the life of the patients. In the neurological status dementia and syndromes of pyramidal and extrapyramidal lesions predominated. Neuropathological examinations in 5 cases demonstrated also considerable cerebellar damage, however, clinical signs of this damage were noted in two patients only. EEG findings were of greatest importance among the laboratory investigations.

Adult↗
PubMed1989

[The role of leukemic conversion in the development of lymphoma infiltration of the nervous system].

On the basis of neuropathologic studies in 22 patients died from ML it was found that lymphoma cells in the brain and spinal cord were in the form of leukostasis, infiltrations usually limited to perivascular spaces, infiltrations in hemorrhagic foci and their vicinity. In cerebrospinal meninges, spinal roots and peripheral nerves we observed leukostasis and intraparenchymatous infiltrations. It was found that the most important role in the development of lymphoma infiltrations in the nervous system was played by hematogenic metastases whose development in the brain and spinal cord was promoted by leukemic conversion with high leukocytosis. In contrast, marked dissemination of lymphoma cells to peripheral blood is not indispensible for the development of infiltrations in the cerebrospinal meninges and peripheral nervous system.

Acute Disease↗