Biomedical subjects
Publications and source records attributed to Z Stelmasiak.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Multiple myeloma is characterized by the production of a monoclonal immunoglobulin. Myelomatous meningitis is a rare occurrence in multiple myeloma. The signs of meningeal myelomatosis include impairment of consciousness, cranial nerve palsies, convulsions and plasmatic cells in the cerebrospinal fluid. Atypical, plasmatic cells in the cerebrospinal fluid are an important finding for the diagnosis of meningeal myeloma. A combination of radiation therapy and chemotherapy is the usual treatment. Patients with meningeal myelomatosis can have a good response to treatment initially, but their prognosis is poor and death occurs within a few months. We present the case of a woman with myelomatous meningitis. Multiple myeloma was diagnosed by serum protein electrophoresis and bone marrow aspiration. This case and a review of the literature show that clinical manifestations of meningeal myeloma are non-specific.
OCSP classification based on neurological signs and syndromes contains four subtypes of ischaemic stroke: lacunar infarct (LACI), total anterior circulation infarcts (TACI), partial anterior circulation infarcts (PACI), posterior circulation infarcts (POCI). Literature reports suggest that this classification may be useful in estimation of after stroke complications and prognostication, and can raise the sensitivity of therapeutic clinical tests. The aim of this study was to estimate the occurrence of risk factors, accompanying complications and prognosis in a material of clinical records of 346 hospitalized patients. Attention is drawn to limited importance of brain CT as shown in frequent discordance between clinical syndromes and CT findings in establishing to which stroke subtype a given patient belongs. The results obtained in the study are highly similar to those reported from other clinical centres. It was found that PACI syndrome was most frequently occurring, and that TACI subtype was associated with the highest frequency of complications and risk factors, and worst prognosis. The prognosis was best in the LACI subtype. The subtype of OCSP classification seems to be determining the possibility of complications and prognosis, and could suggest the most effective medical treatment.
The significance of trace elements in the aetiopathogenesis of ALS is still unknown. Magnesium plays an essential role in fundamental cellular reactions. The aim of this study was to estimate total magnesium concentration in serum and cerebrospinal fluid of ALS patients. 15 persons with ALS and 12 controls took part in the examination. Magnesium was determined by spectrophotometric atomic-absorption method. Total magnesium concentration in serum of ALS patients was statistically insignificant lower than in the control group, but in cerebrospinal fluid was it statistically insignificantly higher than in the control group. Outcomes of our own investigations do not show any essential role of magnesium in the aetiopathogenesis of ALS.
The aim of the study was to present the intervertebral discitis of L5-S1 region and adjoining vertebrae in the course of staphylococcal sepsis. A 51-year-old man was treated in hospital because of sudden very strong pain in a lumbar-sacral region of spine with irradiation towards both legs. The patient had general symptoms of infection. The diagnosis of intervertebral discitis of L5-S1 region was made on the basis of magnetic resonance imaging and computed tomography. In case of radicular symptoms accompanied by very strong back pain, intervertebral discitis should be considered during diagnostic investigation.
Presented here is an unusual case of a 41-year-old man with idiopathic hypoparathyroidism strongly connected with dermatological, ophthalmological and neurological disorders. Since the age of 4 he had been treated ineffectively for mycosis resulting in complete baldness and atrophic nail plate changes. At the age of 35 he was diagnosed with idiopathic hypoparathyroidism. He underwent surgery twice due to bilateral cataract. CT scans of the head demonstrated numerous symmetrically located calcifications in both frontal lobes, subcortical nuclei, the paraventricular region, brain fornix, and both cerebellar hemispheres. The neuropsychological examination demonstrated the occurrence of psychosensory disorders under the form of hallucinations accompanied by a sense of fear and anxiety. It seems essential to investigate the parathyroid gland for any sign of pathology, especially amongst patients with severe dermatological and/or neuropsychological symptoms. Early diagnosis and treatment of patients with hypoparathyroidism may prevent the development of many serious complications or at least result in marked improvement of neurological manifestations.
Traumatic brain injury is a serious clinical problem connected with high mortality rate and long-term neurobehavioral and socioeconomic consequences. Pathomechanism of such insult is complex and not clear in all aspects as yet. Thus, a primary mechanistic insult to the brain initiates metabolic and inflammatory processes which exacerbate the primary traumatic injury to neurons, leading to secondary brain damage. In this paper we present the main components of destructive cascade with relevant theoretical strategy for neuroprotection. It should be emphasized that pathological processes involved in secondary brain damage are complex and interrelated. It makes blockade of a single mechanism unlikely to prevent either early or delayed cellular death.
INTRODUCTION: The aim of the investigation was to determine pleiotropic cytokine IL-6 concentrations in serum and CSF of MS patients, with regard to clinical circumstances. MATERIAL AND METHODS: The study covered 27 MS patients: 23-51 years old; in the 2-7 clinical stage according to Kurtzke's Scale; mean 3.6 +/- 1.8; disease duration time ranged between 2-22 years. Serum and CSF interleukin-6 were determined by the use of commercial ELISA kits. RESULTS: Increase of Il-6 in serum of MS patients was found (12.1 +/- 1.8 pg/ml) in comparison to the control group (6.6 +/- 4.5 pg/ml) (p = 0.03). Concentration of IL-6 in CSF of MS patients was 13.4 +/- 1.77 pg/ml and in the majority of patients it was higher than in the serum. The highest mean of IL-6 concentrations in serum and CSF have been found in patients at the longer disease duration time, although there were not statistically significant. We have found some degree of dependence between serum IL-6 concentration and the level of disability in Kurtzke's scale. CONCLUSIONS: IL-6 participation in the basic MS immune processes is confirmed by its elevated concentration in serum and CSF, its relation to disease severity with the more expressed rise in cerebrospinal fluid.
Platelet activation seems to play a critical role in a number of vascular diseases, including stroke. The aim of our study was whole-blood flow cytometry evaluation of platelet activation markers: P-selectin (CD62), glycoprotein-53 (CD63) and platelet-derived microparticle in vivo in patients with acute cerebral infarction. We investigated 50 patients (29 men and 21 women, mean age 67.8) with acute cerebral infarction. Parameters of platelet activation were measured on the 1st, 3rd and 7th day after stroke onset. Comparisons were made with 20 control patients matched age. Compared to controls (1.6 +/- 0.7%) the stroke patients showed higher expression of CD62 on the 1st (2.6 +/- 1.4%), 3rd (3.5 +/- 2.3%) and 7th (3.0 +/- 2.0%) day after stroke onset. The differences were statistically significant on all days (p < 0.05). Compared to controls (1.5 +/- 0.6%) the stroke patients had also higher expression of CD63 on the 1st (1.9 +/- 0.6%), 3rd (2.0 +/- 0.6%) day and they showed higher level of platelet-derived microparticles on the 3rd (13.0 +/- 3.0%) day after stroke onset. The differences were statistically significant (p < 0.05). Elevated expression of CD62, CD63 and platelet-derived microparticles level indicate platelet activation during the acute phase of ischaemic stroke. Flow cytometry is a useful tool for in vivo assessment of platelet activation.
BACKGROUND: The aim of this study was to determine the concentration of cytokine IL-6 in correlation with its soluble receptor sIL-6R in the serum and CSF of MS patients. MATERIAL AND METHODS: The study group consisted of 52 MS patients in clinical stage 2-7 according to the Kurtzke Scale (mean 3.6 +/- 1.8); the disease duration ranged from 2 to 22 years. The levels of interleukin-6 and sIL-6R in serum and CSF were determined using commercial ELISA kits. RESULTS: An significant increase of IL-6 (p=0.03) was found in the serum of MS patients (12.1 +/- 1.8 pg/ml) in comparison to the control group (6.6 +/- 4.5 pg/ml). The concentration of IL-6 in the CSF of MS patients was 13.4 +/- 1.77 pg/ml, and in the majority of patients was higher than in the serum. The highest mean IL-6 concentrations in serum and CSF were found in patients with a longer disease duration, although the differences were not statistically significant. We found some degree of dependence between the serum IL-6 concentration and the level of disability on the Kurtzke scale. The concentrations of sIL-6R in serum (34.0 +/- 39.0 pg/ml) and cerebrospinal fluid (1.4 +/- 3.3 pg/ml) were significantly higher in MS patients than in the controls. CONCLUSIONS: IL-6 and its soluble receptors are involved in a complex immunological reaction that is characteristic for MS. However, the significant differences in the results obtained here from those reported in other studies make it rather unlikely that IL-6 and its receptors could be used as surrogate markers of MS activity.
In this review article the authors describe a phenomenon of "brain tolerance" which represents transient resistance of brain tissue to a lethal insult established by preconditioning with a mild insult of short duration. Tolerance evoked by brief ischemia resembles transient ischemic attack(s) (TIA) often preceding full-blown ischemic stroke in a clinical setting. A series of recent studies have described another relevant phenomenon termed "chemical preconditioning". Several substances interfering with cellular energy metabolism applied in subtoxic doses may provide protection against lethal insults of a different type. For example, 3-nitropropionic acid (3-NP), antibiotics erythromycin and kanamycin, acetylsalicylic acid, and 2-deoxyglucose have been shown to evoke tolerance. Recently, we have reported that NMDA receptor antagonists and 2-deoxyglucose used at relatively low doses were potent agents to potentiate the protective anticonvulsant effect induced by transient brain mild ischemia. Further studies are expected to prove similar action of these drugs in other experimental models. Based on the accumulated experimental and clinical data the brain tolerance subsequently reinforced by pharmacological intervention might become a successful prophylactic strategy against serious brain insults in patients.
The activity of thrombinogenesis process is shown by thrombin restrain reaction by its physiological inhibitor antithrombin III, as a result of which biologically nonactive thrombinantithrombin III complexes (TAT) are created. The aim of the study was to evaluate TAT complexes in the blood of ischaemic stroke patients. 25 persons with ischaemic stroke and 15 controls took part in the examination. Taking into consideration brain CT outcomes 2 groups of patients were selected: with ischaemic stroke of small and great extent. The patients were also divided into a group of patients with less severe and with more severe ischaemic stroke, and into a group of patients with ischaemic stroke with and without accompanying atrial fibrillation. TAT complexes were determined with an enzyme-linked immunosorbent assay method on days 1st, 5th, and 12th after ischaemic stroke onset. TAT complexes were significantly higher in patients with cerebral infarction than in controls, significantly higher in patients with ischaemic stroke of great extent compared to patients with ischaemic stroke of small extent, and significantly higher in patients with more severe cerebral infarction than in patients with less severe cerebral infarction. In patients with cerebral infarction and atrial fibrillation TAT complexes were significantly higher only on the 1st day of the disease compared to patients with cerebral infarction without atrial fibrillation. Our investigations confirm intense activity of thrombinogenesis process in ischaemic stroke patients.
Matrix metalloproteinase-9 (MMP-9) is a member of the family of zinc-dependent endopeptidases that degrade extracellular matrix proteins. It can be activated by serine proteinases or by superoxide radicals. The motor neurons in amyotrophic lateral sclerosis patients express significantly higher levels of MMP-9, suggesting a role in neurodegeneration. The aim of the study was to investigate MMP-9 in cerebrospinal fluid from amyotrophic lateral sclerosis patients. MMP-9 was measured by enzyme-linked immunosorbent assay ELISA in cerebrospinal fluid from 24 amyotrophic lateral sclerosis patients and 15 controls. The mean amyotrophic lateral sclerosis duration was 18 months. According to Munsat ALS Health State Scale, the patients were divided into four groups: mild, moderate, severe, terminal. The patients were also divided into groups with shorter (below 12 months) and longer (above 12 months) duration of the disease. MMP-9 level was insignificantly lower in the cerebrospinal fluid from amyotrophic lateral sclerosis patients compared with controls. MMP-9 level showed a tendency to decrease with clinical status worsening, however this correlation was not statistically significant. The difference between MMP-9 level in the cerebrospinal fluid between the groups of patients with shorter and longer duration of amyotrophic lateral sclerosis was not significant.
The concentration of pyruvate in the venous blood of 31 patients with stroke was determined by the enzymatic spectrophotometric method. The pyruvate concentration was raised on the 1st, 3rd and 10th days after stroke and this increase was statistically significant. Pyruvate concentration changes in venous blood were associated with severe clinical condition of the patients.