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Biomedical subjects

R Jankowski

Publications and source records attributed to R Jankowski.

At least 91 records · Page 5Linked to original sources
PubMed1987

The liver in acquired immune deficiency syndrome: emphasis on patients with intravenous drug abuse.

To assess the spectrum of hepatic abnormalities in acquired immune deficiency syndrome (AIDS), we reviewed clinical, biochemical, and pathological material in 32 patients with AIDS. Eight-four percent of AIDS cases had a history of intravenous drug abuse. Ninety percent of AIDS patients has some liver biochemical abnormality at the first presentation of illness. During the course of AIDS, significant (p less than 0.05, paired Student's t test) rises in alkaline phosphatase and bilirubin occurred, without rises in aminotransferases. Mean abnormalities were mild, reflecting approximately 2-fold increases over baseline. Liver failure was not believed to contribute to the death of any AIDS patient. Pathological findings in AIDS included specific infectious diagnosis in 26%, granulomas in 16%, hemosiderosis in 26%, nonspecific abnormalities in 39%, cirrhosis in 23%, and chronic active hepatitis in 3%. AIDS cases were also compared to 10 selected age, sex, and epidemiologically similar non-AIDS patients. Although granulomas or infections were not seen in our comparison group, only the incidence of chronic active hepatitis was significantly different between the groups. If only those with intravenous drug abuse were studied, then none of 24 AIDS patients versus four of eight non-AIDS cases (p less than 0.005) had chronic active hepatitis. AIDS patients with specific hepatic infections tended to have a higher alkaline phosphatase and aspartate aminotransferase (p less than 0.05) than noninfected cases. However, substantial overlap existed, and no difference in hepatomegaly was noted. Ninety percent of AIDS patients were ingesting at least one potentially hepatotoxic drug. We conclude that AIDS patients have a high incidence of underlying hepatic abnormalities. However, clinical and biochemical abnormalities are similar in our selected liver biopsy patients with intravenous drug abuse with or without AIDS. As expected, AIDS patients have a higher incidence of hepatic granulomas and infections, but these patients were not clearly distinguishable from other AIDS cases. Histological examination showed a wide array of changes by light microscopy, but no specific lesion of AIDS was noted. The low incidence of chronic active hepatitis in this AIDS population may imply that the altered T lymphocyte function in AIDS could influence the course of liver disease in these patients.

Acquired Immunodeficiency Syndrome↗
PubMed1986

[Severe vitamin C deficiency and oral pathology. Apropos a case report of Barlow's disease].

Vitamin C deficiency is an exceptional findings but emphasis is placed on the need for detection of latent minimally symptomatic and intricate cases, as illustrated by a 3 1/2 year old child with a latent form of Barlow's disease. Although results of biologic tests were fairly typical, clinical signs were restricted to hypotrophy, gingivostomatitis and proctorrhagia. A literature review failed to determine whether or not specific oral manifestations could be associated with Barlow's disease.

Acute Disease↗
PubMed1985

Gastrointestinal manifestations of the acquired immunodeficiency syndrome: a review of 22 cases.

Patients with acquired immunodeficiency syndrome (AIDS) frequently have diarrhea and weight loss. We prospectively examined the upper and lower gastrointestinal tracts in 22 AIDS patients, although severe medical problems often precluded full evaluation. Ninety-six percent (21 of 22) lost weight, and 55% (12 of 22) had diarrhea. The mean (+/- SD) weight loss was 34 +/- 19 lb. Steatorrhea was found in 4 of 14 patients, and D-xylose tests were abnormal in 8 of 14 patients. Mean serum albumin was 3.3 +/- 0.8 g/dl. A significantly diminished plasma selenium level, which can influence immune function, was noted in these AIDS patients. Gastrointestinal infections were identified in 45% of patients. Although diarrhea and malabsorption were more common in the infected group, weight loss and albumin were similar in those with and without demonstrated infections. Flexible sigmoidoscopy showed that of 15 patients, there were two with Kaposi's sarcoma, 10 normals, and three with nonspecific endoscopic changes of colitis. Infection was documented in all patients with colitis. Panendoscopy of the upper gastrointestinal tract was positive for AIDS-related pathology in five of 10 patients, including two with Kaposi's sarcoma, one with Candida esophagitis, one with herpetic esophagitis, and one with gastroduodenitis (biopsy positive for cryptosporidia); five patients had a normal-appearing tract. Small bowel or colonic biopsies frequently showed nonspecific inflammatory changes, although pathogens were identified in six patients (27% of all biopsies). We conclude that a wide variety of gastrointestinal pathology, which includes infectious agents, neoplasms, and inflammatory changes, may occur in AIDS patients. Therefore, AIDS patients, particularly those with diarrhea or weight loss, deserve an intensive evaluation for remediable lesions of their gastrointestinal tracts.

Acquired Immunodeficiency Syndrome↗
PubMed1982

Hereditary angioneurotic edema: clinical management and case report.

Hereditary angioneurotic edema, although a rare clinical entity, can be fatal if diagnosis and appropriate therapy are not instituted before the performance of routine dental and oral surgical procedures. The pathophysiology, physical findings, and therapeutic treatment modalities have been reviewed, and a case involving both restorative and surgical dental intervention has been presented.

Adult↗
PubMed1979

Cysticercosis presenting as a mass lesion at foramen of Monro.

Cysticercosis is a parasitic infestation that commonly affects the central nervous system. This is a report of computed tomography findings in a patient with a noncalcified cyst causing asymmetric lateral ventricular obstruction at the foramen of Monro. The lesion was isodense and uniformly enhancing, an unusual finding possibly related to presentation early in the course of the disease. This disease should be considered in the differential diagnosis of the lesions at the foramen of Monro in patients with appropriate residence or travel history.

Adult↗
PubMed1977

[Combined therapy of ovarian cancer (author's transl].

Following the introduction of massive triple drug therapy with high doses of Endoxan, Proresid and Methotrexat instead of the earlier long-term Endoxan treatment in addition of surgery, percutaneous irradiation and intraperitoneal radio-gold, 3 year survival of advanced stages IIb-IV of ovarian carcinoma rose from 19.6% to 42.6%. The 3 year survival of all malignant ovarian tumors (primary or secondary) rose from 38.3% to 51.0%. Further development led to targeted multiple drug therapy (ultrahigh Endoxan, Proresid/VM26, Methotrexat and Adriblastin) according to oncobiogram. The main side-effects, their control and experience with combined chemotherapy and irradiation are described.

Cyclophosphamide↗
PubMed1975

The influence of selected cytostatics on human trophoblast in vitro.

The effect of cytostatics (Methotrexate, Oncovin and Dactinomycin) on early human trophoblast in vitro was studied by the tissue (organ) culture technique according to Trowell and by brief incubation with thymidine 3H. The cytostatics were tested by the method of Tanneberger in clinical and tenfold higher doses. The criteria for cytostatic efficacy were based an activity of DNA, histologic and histochemical changes, and secretion of hormonal chorionic gonadotropin. In vitro cultures of trophoblast were found to be a good model for evaluation of cytostatics, and the tested chemotherapeutics were effective chemotherapeutically. Upon addition to in vitro cultures they changed the structure and function of trophoblastic cells, resulting in depression of DNA resynthesis, histologic changes, changes in enzyme activities assessed histochemically, and impaired HCG secretion. The most pronounced effects were obtained with Dactinomycin or with a combination of Dactinomycin and methotrexate. Methotrexate alone had the weakest effect on DNA resynthesis and structure of the trophoblastic cells. The effect achieved with methotrexate after 120 hours was equal to the effect of Dactinomycin after 48 hours. Comparison of the histologic and hormonal results with DNA activity showed concordance between the intensity of morphologic and hormonal changes and impairment of nucleic acid functions.

Acid Phosphatase↗
PubMedDate not supplied

The nuclear protein import assay in vascular smooth muscle cells.

Nuclear protein import plays a critical role in both proliferation and apoptosis. Both actions are of great importance in vascular development and pathology. Consequently, a technique that would allow us to characterize import and identify novel cofactors important in modulating the process in smooth muscle cells is of great applicability. In this article, we describe a simple and reliable nuclear protein import assay that we have modified for use on aortic smooth muscle cells in culture. Briefly, the procedure permeabilizes the cells and analyzes the nuclear retention of a fluorescent import marker. Using this method, we are able to analyze the effect of agents on nuclear protein import. Most importantly, we are able to treat the cytosol, nucleus or the whole cell independently. This technique will allow for the identification and development of drugs to inhibit or stimulate the process and, potentially, to identify mechanistic insight into disease processes.

Active Transport, Cell Nucleus↗
PubMedDate not supplied

[Intraoral surgical approach to tumors destroying the axis. Report of three cases].

Primary and metastatic tumours of the axis vertebra are difficult surgical problems. The authors report 3 patients with axis tumours who underwent surgery in 1993 and 1994. Clinical symptoms and signs included pain in three, myelopathy in two, vertebrobasilar circulatory insufficiency and cranial nerve lesions in two patients. Tumours have been resected through transoral and posterior pharyngeal wall approach. The purpose of surgery was decompression of nervous and vascular structures, and histological verification of the tumour. Tumour pathology was diverse and included: multiple myeloma, chordoma and metastatic tumour from stomach. There were no postoperative complications and improvement of neurological conditions was observed.

Adolescent↗
PubMedDate not supplied

[Vertebral column primary neoplasms].

Clinical analysis was carried out in 53 cases treated surgically because of primary vertebral column neoplasms in Department of Neurosurgery in Poznań between 1976-1995. Plasmocytoma solitaire (9 cases), angioma (5 cases), osteoblastoma (4 cases) and aneurysmal bone cysts (4 cases) were observed most frequently. Neoplasms localization was as follows: cranio-vertebral junction (4 cases), cervical segment (14 cases), thoracic (23 cases) and lumbo-sacral segments (12 cases). Severe neoplastic vertebral column destruction was disclosed in 34 (64%) patients, but complete transversal spinal syndrome was noted only in 7 (13%) cases. Surgical procedures: posterior and latero-posterior approaches were applied in most cases while anterior and lateral approaches--were rarely used. In 3 cases two stage operations were performed. Intervertebral fusion or posterior autogenous graft was necessary in 39 cases.

Adolescent↗
PubMedDate not supplied

[Lumbar disk herniation treated by microsurgery].

Microsurgical technique was applied in 46 cases of lumbar disc herniation in the years 1993-1994. The group comprised 17 women and 29 men aged 17-46 years (mean age 39.54 +/- 8.72). Sciatic pain was present in 39 (85%) cases, in the remaining ones low back pain was the main symptom. Neurological deficit signs were noted in 21 (46%) cases. The authors discuss the indications to microdiscectomy, the microsurgical technique and outcomes. Microdiscectomy was carried out in cases selected strictly according to the result of neurological examination and radiological findings X-ray of lumbosacral region in 46 cases (100%), myelography in 11 (24%), CT in 4 (9%) and MRI in 31 (67%). MRI served for evaluation of signal intensity, site and site of disc hernia. In 31 cases the operation was done in patients with recognized unilateral and one-level disc hernia. Full remission of complaints was noted in 45 patients during follow-up over 2 years.

Adolescent↗
PubMedDate not supplied

[Acute sinusitus in adults. Management by general practitioners].

OBJECTIVE: Acute sinusitis is a common condition encountered in general practice and raises the question of appropriate management. Sufficient data are still lacking in the literature to provide a fully satisfactory response. METHODS: We conducted a survey among 193 physicians representative of the general practitioners in France to collect 755 cases of acute sinusitis treated in the outpatient setting from January 6 through March 15, 1999. We recorded clinical features and therapeutic management. RESULTS: Pain was the predominant clinical sign (97% of the patients). Facial pain with a highly suggestive localization and aggravated by pressure and headache were the most frequent. Most of the patients also had a nasal symptom (77%) and an infectious context (90%). Three circumstances had been pre-defined by the experts: unique acute sinusitis, acute episode of chronic sinusitis, and recurrent acute sinusitis. In 67% of the cases of unique acute sinusitis, the diagnosis of the general practitioner was confirmed a posterori by the experts. Few complementary tests were ordered (in 17% of the patients) mainly in fragile patients and mainly limited to a radiography of the sinus (81% of the complementary tests ordered). An oral antibiotic was almost always prescribed (96% of the patients) although antibiotics comprised only 29% of all prescriptions. General corticosteroid therapy (41%), local treatment (73%) and anti-cough or expectoration medications (52%) were also prescribed. Despite the painful nature of sinusitis, analgesics were only prescribed for 36% of the patients. CONCLUSION: This observational survey enabled us to describe the diagnostic and therapeutic strategy used by French general practitioners for acute sinusitis in adults. There was general agreement on the strategy that was well adapted to the patient profiles. An evaluation of the different classes of drugs prescribed, and their efficacy in the outpatient setting, that remains to be determined, was not however attempted.

Acute Disease↗
PubMedDate not supplied

[Dysontogenetic tumors of the vertebral column].

13 patients were managed surgically for dysontogenetic tumours of vertebral column between 1970 and 1997. 6 males and 7 females aged from 3 to 45 years (average age = 28.46 +/- SD 12.81 years). At the cranio-vertebral junction one tumour was localised. Other tumours were in different segments of vertebral column as follows: 3 cases in thoracic segment, 6--in lumbar and 2--in lumbo-sacral region. X-ray examination revealed coexistence of dysraphic or other spinal defects in 10 cases. Surgery was carried out in all cases using various technique. Histological examination disclosed: epidermoid cyst 6, dermoid cyst 3 and teratoma 4. Good results of treatment were achieved in 11 patients, while in 2 cases neurological deficit symptoms were exacerbated. In patients after teratoma removal post-operative radiotherapy was indicated.

Adolescent↗
PubMedDate not supplied

[Acrylic bone cement use for internal spondylodesis in neurosurgical operations].

Vertebral column stabilization relying on performing of surgical internal spondylodesis with acrylic bone cement (methylmethacrylate, MMA) was carried out in 27 cases treated surgically in Department and Clinic of Neurosurgery in Poznań from 1996 to 1999. The age of patients was 16-69 (mean age 50.29 +/- 15.29) years. Male patients predominated (2:1). The vertebral lesion was caused by neoplasm (55% of cases), degenerative disease (26%), trauma (19%). Pathological changes were found in cervical region in 16 (59%), in thoracic region in 6 (22%) and in lumbar region in 5 (19%) patients. The anterior surgical approach to vertebral column was chosen in 17 (63%), posterolateral approach in 8 (30%) and posterior approach in 2 (7%) patients. Bone acrylic cement was used for reconstruction of vertebral body damaged by neoplasm or trauma, whereas it substituted the removed intervertebral disc or vertebral body in degenerative diseases. The acrylic cement graft in all cases maintained the proper anterior and medial vertebral column alignment. Semiliquid acrylic cement was used for filling of defects after tumour removal in thoracic and lumbar vertebral bodies. Acrylic cement graft was properly prepared in cuboid form and was inserted into the intervertebral spaces in patients with trauma or degenerative diseases. In all cases involving bone acrylic cement, stabilization of the vertebral segment was completed by metallic implants (cervical plates, "Z" plates, intrapedicular screws and rods). No postoperative complications (wound infections or implant dislocation) were observed. Postoperative, neurological signs were intensified in 3 cases (12%) and were regressive. Mortality rate was 4%. This type of internal spondylodesis makes possible to restore the anterior and medial columns and immobilisation of the proper vertebral segments.

Adolescent↗
PubMedDate not supplied

[Diplomyelia and diastematomyelia. Case reports].

Diplomyelia and diastematomyelia. Case report. Three cases of diplomyelia [1] and diastematomyelia [2] were studied and treated between 1980 and 1990 years. All patients had symptomatic onset in adulthood. Pathological features were caused by localization on the lesion in cervical, thoracic and lumbar segment of the spinal cord. Plain X-rays showed a variety of osseous malformations associated with spinal dysraphism. The most usefull radiographic examination was computerized tomography (CT). Indications to surgical treatment are discussed.

Adolescent↗
PubMedDate not supplied

[Giant cell tumors of vertebral column].

Between 1962 and 1993 were treated at the Department of Neurosurgery, Medical Academy in Poznań 11 patients (10 women and 1 man) with giant-cell tumours of the spine. Their mean age was (26.27 +/- 17.56) years. In all patients pain was the presenting symptom and 10 had neurological deficits. The cervical, thoracic and lumbo-sacral spine was involved; 9 patients were treated surgically and 3 patients received adjuvant radiotherapy. The follow-up time was from 2 months to 30 years.

Adolescent↗