Human genetics. Testing telomerase.
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Adult↗
Biomedical subjects
R Marciniak
Publications and source records attributed to R Marciniak.
Axial bone mineral density in patients with acromegaly.
RATIONALE AND OBJECTIVES: The purpose of this study was to assess the influence of long-term elevated levels of growth hormone and insulin-like growth factor I on bone mineral density (BMD) of the spine in patients with acromegaly. MATERIALS AND METHODS: The spinal BMD in 40 patients with acromegaly was measured with quantitative computed tomography. The result was expressed as the mean of six measurements of consecutive vertebral bodies and as a z score. Twenty age- and sex-matched healthy persons also underwent spinal BMD measurement and served as controls. RESULTS: In 36 of the 40 patients, the BMD z score ranged within 2 standard deviations (SDs) above or below the mean. Only two patients (one man and one woman) had enhanced BMD loss (below 2 SD). Two other female patients had BMD values of more than 2 SD above the mean. Differences between patient subgroups were not statistically significant, but a statistically significant (P < .05) positive correlation was found between basal serum concentration of growth hormone and spinal BMD for the entire patient group. No correlation between BMD and basal serum concentration of insulin-like growth factor I was found. CONCLUSION: Hypersecretion of growth hormone in patients with acromegaly, regardless of other factors, has no evident effect on BMD of the lumbar spine.
Acromegaly↗
Endoscopical and histological aspects of inflammatory changes in J-pouch mucosa.
The aim of the study was endoscopic and histological evaluation of mucosal inflammatory changes in the ileal reservoir after restorative proctocolectomy with ileoanal anastomosis (IPAA) because of FAP (27 patients) and ulcerative colitis (34 patients). Endoscopic symptoms of pouchitis (edema, granularity, contact bleeding, loss of vascular pattern, mucus, erosions) were found in 13 patients (4 were operated on because of FAP, 9 because of UC). A statistically significant difference (p < 0.0001) was found between endoscopic inflammatory index in UC (4.0 +/- 0.5) and in FAP (1.00 +/- 0.00). The endoscopic changes were correlated with the Moskowitz histological classification, in 12 acute score and in 6 chronic score were above 4 points. In 18 patients histological diagnosis of pouchitis was made (5 in FAP, 13 in UC). Acute pouchitis occurred in 12 patients and chronic in 6. In one patient histological changes resembled Crohn's disease. Regular endoscopic control with histological examination and verification of inflammatory lesions in the ileal reservoir is necessary.
Adenomatous Polyposis Coli↗
[Typing of methicillin resistant strains of S. haemolyticus isolated from patients and from the hospital ward environment].
Biotyping, antibiograms and fingerprinting were used to determine the relation of 16 methicillin-resistant S. haemolyticus isolated from drains in patients who underwent intraabdominal surgery to 9 methicillin-resistant strains of S. haemolyticus isolated at the same time from hospital environment. The comparison of biochemical properties of the examined strains showed a large variety of biochemical profiles as well as antibiotic patterns of susceptibility. The differences in sensitivity to the antibiotics used were not distinct. Biotyping and antibiograms did not permit determination of the relation of the investigated strains. Only the results of fingerprinting allowed for the division of the 25 examined strains into three genotypes demonstrating three main patterns of PCR products. 16 strains of 25 showed the same pattern of PCR products. This results suggests the presence of a source of infection on the clinical ward. A nurse may have been the source of infection because the same genotype of S. haemolyticus was isolated from her nasal anterior as from the majority of patients.
Cross Infection↗
[Peritonitis determined by the site of intra-abdominal surgery].
The aim of this study was to determine bacterial flora infecting the peritoneal cavity during intraabdominal surgery by site of operation. Three groups of patients were examined. 29 patients who underwent surgery on the stomach, duodenum, biliary tract or pancreas, 15 patients operated on because of acute appendicitis and 63 patients operated on because of colon or rectum tumours. At the end of the operation but before closure cultures were obtained by swab from the completed anastomosis site. Samples were placed into transport medium and transported promptly to the laboratory. The results of the bacteriological examinations showed that the peritoneal cavity of all patients operated on were infected with bacteria characteristic for the digestive tract, especially by Enterobacteriaceae spp., Enterococcus spp. and Bacteroides spp. From patients operated on because of rectum or colon tumours 3 or 4 bacterial species were isolated most often and they were often infected with P. aeruginosa and C. albicans. This was in contrast to patients from the other groups. In patients infected with polymicrobial flora, B. fragilis and E. coli or enterococci and E. coli and enterococci were most often seen.
Anastomosis, Surgical↗
The level of MAP kinase activity in the stomach stump in rats after subtotal gastrectomy.
MAPK (Mitogen-Activated Protein Kinase) is one of the elements of kinase cascades (MAPK, MEK-MAP kinase, kinase, Raf-1, Ras) regulating cellular proliferation and differentiation processes. It seems that the changes in its number and activity may be the factor having influence on carcinogenesis. In some human carcinomas a significant increase of its activity is observed, in others a decrease of its activity is described. Our research aimed at the evaluation of the dynamics of precancerous and cancerous changes in the stomach stump in rats after the experimental, partial stomach resection. Apart from histological and ultrastructural examination we also determined the activity of the sub-unit p42 MAP kinase. The material comprised segments of gastric mucosa of the stomach stump of 15 rats after subtotal gastrectomy. Part of the rats after the procedure were administered carcinogen orally (MNNG). On the histological and ultrastructural examination we used routine methods, the activity of MAP kinase was determined by western-blotting method with the use of IgG against MAPK p42, Santa Cruz #154). In 8 examined rats we observed the increase of MAP kinase activity. We established probable correlation (without statistical analysis, regarding miserly material) between the increase of MAPK activity and histological and ultrastructural changes. Among three cases diagnosed as adenoma tubulare in two we observed the increase of MAPK activity. A clear increase of this kinase was also present in the stomach stump of a rat, which was diagnosed as adenocarcinoma. On the basis of our research carried so far we think that the increase of the MAPK activity may be one of the causes of the neoplasm development. It seems important to obtain the confirmation of our results and to establish a possible usefulness of MAPK activity determination as a prognostic indicator in case of the neoplasm of stomach stump.
Animals↗
Ethanol consumption and susceptibility of the pancreas to cerulein-induced pancreatitis.
Despite the fact that alcoholism is one of the major causes of pancreatitis, the pathogenesis of this disorder remains obscure. Factors such as the pattern of ethanol consumption, diet, and genetic predisposition may be contributing factors. The failure to produce alcoholic pancreatitis in experimental animals suggests that experimental provision of ethanol may only increase the predisposition to pancreatitis. To test this possibility, we developed an assay system using the in vitro model of cerulein-induced pancreatitis. In this system, pancreatic lobules were first exposed to a supraphysiologic concentration (10(-6) M) of the cholecystokinin analogue, cerulein, after which homogenates were incubated for up to 6 h. Activation of trypsinogen and chymotrypsinogen was observed only in cerulein-treated preparations. We then investigated the effects of the duration of ethanol feeding on cerulein-induced changes in rat pancreas. The pancreata from rats fed ethanol for 9-12 months were more susceptible to cerulein-induced activation of chymotrypsinogen compared to the pancreata from pair-fed control animals. This susceptibility also paralleled morphologic changes, such as dilatation of endoplasmic reticulum, only in the ethanol-fed group. In contrast, during the early stages (up to 3 months) of ethanol consumption, there was resistance (p < 0.01) to cerulein-induced changes. These results suggest that long-term ethanol consumption increases susceptibility to pancreatitis and raises the possibility that a similar mechanism may operate in human alcoholics.
Alcoholism↗
Ultrastructural changes in the small bowel epithelium after total gastrectomy.
The purpose of the study was to analyze ultrastructural changes in the small bowel mucosa in patients after total gastrectomy. We studied mucosal specimens obtained from 25 patients during control gastroscopy. The specimens were routinely processed for examination in transmission electron microscopy. Early after the operation (up to 6 months) we observed marked inflammatory reaction, disordered architecture of the small bowel mucosa epithelium, the presence of dysplasia-like changes and foci of dysplasia. Later on the structure of the mucosa returned to normality. Only a few dysplastic changes were seen. No relationship was found between altered epithelial structure and type of operation. In conclusion, the epithelium of the small bowel does not transform to a gastric type epithelium.
Adult↗
[Analysis of aerobic and anaerobic bacterial flora colonizing drains after surgical abdominal incisions].
Aerobic and anaerobic bacterial flora of post-operative incisions with drainage were examined. From each of 28 patients three specimens were taken; during operation (smear from peritoneal cavity), liquid from drain (taken at 3-th day after operation) and smear from drain taken at the end of drainage. Enterococci, Enterobacteriaceae spp. and anaerobes, especially Bacteroides spp. were most often isolated from specimens taken during operation. Enterococci and coagulase negative Staphylococci-often resistant to methicillin, were most often isolated from specimens taken at the end of drainage.
Abdominal Muscles↗
[Evaluation of bacterial flora in patients after intraabdominal surgical procedures throughout a 12 year period].
UNLABELLED: The aim of this study was to analyse the composition of the bacterial flora in 295 patients who underwent surgical treatment in our clinic throughout the period of 12 years. 448 specimens were bacteriologically examined. Bacterial pathogens were isolated from 390 (87.1%). Among aerobic bacteria, Enterococcus faecalis was the most often isolated (35.6% - from the peritoneum, 17.8% from the wound). Among anaerobic bacteria, Bacteroides fragilis - 44.9% were the most often isolated. 530 aerobic bacterial strains from Enterococcus, Enterobacteriaceae, Staphylococcus and the nonfermentable rods were carefully analysed. Special attention was paid to the development of the resistance to 3 antibiotics (cefoperazone, ciprofloxacin and gentamycin) in 3 time periods: from 1984 to 1987, from 1988 to 1992 and from 1993 to 1996. Resistance of the bacterial strains to cefoperazone was 38.7% in the first time period; 39.5% in the second; and later increased to 53.8%. Resistance to ciprofloxacin was identical in the first two periods - 10.3%; and subsequently, it increased to 22.6%. The increase of resistance to gentamycin was the most significant--it went up from 24.5% to 44.8 and then dropped to 40.3%. CONCLUSION: Constant monitoring of the bacterial flora enables rational antibiotic application, which is essential due to the observed increase of bacteria strain resistance.
Abdomen↗
[Reconstructive surgery of bile ducts from personal material].
In the years 1976-1996, 112 patients were treated surgically for the biliary tract injuries, 156 operations were performed upon them. The long term outcome was assessed in 85 patients along with the effectiveness of different surgical techniques. The best results (86.2%) were achieved when the repair was performed immediately on detecting the lesion, the results were less encouraging for the secondary repair. Perioperative mortality was 8.8%.
Adult↗
[Personal experiments in treating rectal rumors with the TEM technique].
Transanal Endoscopic Microsurgery (TEM) was introduced to clinical practice by Buess in 1983. After several years of gaining experience technique has been used for the excisions of rectal tumours. TEM enables excisions of the tumours localised in the rectum and distal portion of the sigmoid colon from 5 to 25 cm from the anal verge. Until now 13 patients have been operated using TEM method. The group includes also rectal cancers classified as pT-1 and G-1. Preliminary results are encouraging. The patients left the hospital four days after the procedure and started professional activity two weeks postoperatively. All the patients are followed-up: patients who had adenomas once a year and those with pT-1 low-risk rectal cancer-every three months in their first postoperative year and then in six month intervals. Local excision of the adenomas and early cancers of the rectum with the use of TEM proves to be an effective method of surgical treatment in a selected group of patients.
Adenocarcinoma↗
[Removal of rectal adenoma with the TEM technique].
The paper presents the operation of local excision of a rectal polyp using TEM technique. The operation was performed at our Department on the 12th of April 1996 with the instruments for transanal endoscopic microsurgery made by Wolf Company according to professor Buess. The patient was 49 year old woman, in whom rectoscopy revealed at 8 cm above the dantate line a cauliflower like lesion, 3 cm in diameter, bleeding on touch and not fixed to the underlying tissues. Transrectal sonography showed the tumor was confined to the mucosa with the absence of muscularis propria infiltration. During the operation the polyp was removed with the full thickness portion of rectal wall. Wound edges were approximated with Vicryl 3-0. Histopathology confirmed villous papillary adenoma with a mild focal epithelial dysplasia. The excision was complete. The postoperative course was free of any complications and the patient being appointed for a control, was discharged from the hospital four days after the surgery. On the follow ups she presented with no complaints. When preparing the instruments, it is important to fix the apparatus properly allowing enough room for the operator's hands and getting used to the stereoscopic view. A very helpful device is the instrument for monopolar coagulation, bipolar cutting, suction and flushing, lately introduced by professor Buess.
Adenoma↗
[Local excision of early rectal cancer].
The authors discuss 56 patients operated for rectal cancer primarily estimated as noninvasive. Applied procedures were: local excision through stretched anus /46 cases/, Localio technique /6 cases/, rectotomy during a laparotomy /1 case/ and Transrectal Endoscopic Microsurgery /3 cases/. The patients were divided into 3 groups according to tumor's grading and staging. All patients with cancer infiltration limited to submusosal layer were cured. In the group of infiltrated muscularis layer 36.4% of patients had local recurrences. They were reoperated or irradiated. Two of them died due to cancer spread. The late results in patients with cancer invasion through muscularis layer were poor.
Adenocarcinoma↗
The influence of partial gastrectomy on the ultrastructural changes in the liver--an experimental animal model.
The aim of our studies was to evaluate the ultrastructural changes in the liver in rats after partial gastrectomy. The studied group consisted of 19 Wistar strain rats. In 15 animals partial gastrectomy was done. The control group underwent laparotomy, only. All tissue material was fixed and then prepared in a routinous way for histological and electron microscopy studies. During histological examinations no abnormalities were found. On the ultrastructural level (in tissue samples taken from animals, no more then 4 months after gastrectomy) we found mitochondrial degeneration, vacuolization of cytoplasm, abnormalities in the nuclei and increased activity of B-K cells. The focal necrosis of the hepatocytes was also observed. In tissue samples from animals after 4 to 12 months after primary operation we found increasing number and size of lipid vacuoles in the cytoplasm of hepatocytes The number of Ito cells increased, also. The gastrectomy caused only minimal ultrastructural changes in the liver tissue within the period of observation. Those changes described above may result from numerous metabolic derangements found after gastrectomy.
Animals↗
Ultrastructural changes in the small intestinal epithelium after total resection of the colon.
UNLABELLED: The aim of the study was to analyze ultrastructural changes in the mucosa of the small intestine after total resection of the colon in 29 patients (familial polyposis in 21, ulcerative colitis in 8). We studied specimens of the small intestinal mucosa obtained from ano- and rectoscopy. The specimens were routinely processed for transmission electron microscopy. Early after the operation (up to 4-5 months) we observed marked structural disorders of the mucosal epithelium and regenerative cell atypia (dysplasia-like changes). At 6 months after the operation we found rapidly progressing normalization of the epithelial mucosa and its mimicking the epithelium of the colon: increased amount of mucous cells, formation of vacuolized cells, almost complete atrophy of microvilli on the surface of enterocytes, increase of the intercellular space (retention space). Foci with dysplasia features were quite numerous in group I, in contrast to group II where they were sporadic. CONCLUSION: the epithelium of small intestinal mucosa has the ability of convergence towards the epithelium of colon.
Adenomatous Polyposis Coli↗
Telemedicine in rural areas. Experience with medical desktop-conferencing via satellite.
Cooperation between physicians in hospitals in rural areas can be assisted by desktop-conferencing using a satellite link. For six weeks, medical desktop-conferencing was tested during daily clinical conferences between the Virchow-Klinikum, Berlin, and the Medical Academy, Wroclaw. The communications link was provided by the German Telekom satellite system MCS, which allowed temporary connections to be established on demand by manual dialling. Standard hardware and software were used for videoconferencing, as well as software for medical communication developed in the BERMED project. Digital data, such as computed tomography or magnetic resonance images, were transmitted by a digital data channel in parallel to the transmission of analogue video and audio signals. For conferences involving large groups of people, hardware modifications were required. These included the installation of a video projector, adaptation of the audio system with improved echo cancellation, and installation of extra microphones. Learning to use an unfamiliar communication medium proved to be uncomplicated for the participating physicians.
Germany↗
CT appearance of shearing injuries of the brain.
Shearing injuries, also called diffuse axonal injuries, are a special kind of severe head trauma, usually caused by a motor vehicle accident, in which disruption of white matter axons takes place. Twelve cases of shearing injuries were diagnosed by computed tomography (CT). The typical CT findings were small hemorrhagic lesions in the cerebral white matter, most often in cerebral hemispheres and internal capsules. In most patients, hemorrhagic foci were multiple. Single lesions were found in only two patients. Features of brain edema were found in eight of ten early studies, and subarachnoidal hemorrhage only in three. Two patients also had subdural hematomas. CT appearance of the shearing injuries is characteristic, especially in connection with clinical data indicating a history of head trauma and severe state of the patient.
Accidents, Traffic↗