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Krzyżewski RM, Kliś KM, Kwinta BM, Stachura K, Popiela TJ, Brzegowy P, Łasocha B, Urbanik A, Grodzicki T, Milczarek O, Gąsowski J. The influence of embolization of internal carotid artery aneurysms on arterial tortuosity: a prospective cohort study. J Vasc Interv Radiol 2024:S1051-0443(24)00293-8. [PMID: 38677411 DOI: 10.1016/j.jvir.2024.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 03/28/2024] [Accepted: 04/17/2024] [Indexed: 04/29/2024] Open
Abstract
PURPOSE To compare quantitative tortuosity descriptors of Internal Carotid Artery (ICA) on aneurysmal and non-aneurysmal side before and after embolization of aneurysm and to determine possible factors associated with its change. MATERIAL AND METHODS An analysis of 52 patients with intracranial aneurysm, treated with endovascular procedure, was performed. Based on their Digital Subtraction Angiography images, obtained prior to the procedure and after first follow-up examination, tortuosity of ICA, both on the side of embolization and on the other side was analysed. For each patient tortuosity descriptors were calculated: Relative Length, Sum of Angle Metrics, Triangular Index, Product of Angle Distance, and Inflection Count Metric. To represent changes in tortuosity, for each descriptor delta value (Δ) was defined as value of the descriptor prior to embolization - value of the descriptor on follow-up examination. RESULTS In the follow-up We found no statistically significant changes in tortuosity on non-embolized side. On the embolized side SOAM (2.89±0.92 vs. 2.38±0.94;p<0.001), PAD (5.01±1.83 vs. 3.95±1.72 ;p<0.001) and ICM (12.18±4.55 vs. 9.76±4.04 vs.;p = 0.006) was significantly higher after embolization than before embolization. Mean ΔRelative Length (-0.02 [-0.045--0.002] vs. -0.01 [-0.02-0.003];p - 0.003),ΔProduct of Angle Distance (0.84 [0.30 - 1.82] vs. 0.10 [-0.001 - 1.10];p<0.001) and ΔInflection Count Metric (2.05 [0.42 - 3.50] vs. 0.27 [0.02 - 2.16];p = 0.004) were significantly higher on the embolized side. CONCLUSION Following study showed that embolization may increase the tortuosity of ICA.
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Affiliation(s)
- Roger M Krzyżewski
- Department of Neurosurgery and Neurotraumatology, Jagiellonian University Medical College, Kraków, Poland
| | - Kornelia M Kliś
- Department of Neurosurgery and Neurotraumatology, Jagiellonian University Medical College, Kraków, Poland.
| | - Borys M Kwinta
- Department of Neurosurgery and Neurotraumatology, Jagiellonian University Medical College, Kraków, Poland
| | - Krzysztof Stachura
- Department of Neurosurgery and Neurotraumatology, Jagiellonian University Medical College, Kraków, Poland
| | - Tadeusz J Popiela
- Department of Radiology, Jagiellonian University Medical College, Kraków, Poland
| | - Paweł Brzegowy
- Department of Radiology, Jagiellonian University Medical College, Kraków, Poland
| | | | - Andrzej Urbanik
- Department of Radiology, Jagiellonian University Medical College, Kraków, Poland
| | - Tomasz Grodzicki
- Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Kraków, Poland
| | - Olga Milczarek
- Department of Children's Neurosurgery, Jagiellonian University Medical College, Faculty of Medicine, Institute of Pediatrics, Cracow, Poland
| | - Jerzy Gąsowski
- Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Kraków, Poland
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Matusik PS, Mikrut K, Bryll A, Podolec M, Popiela TJ, Matusik PT. Prominent crista terminalis mimicking a right atrial mass: a systematic literature review and meta-analysis. Acta Radiol 2024:2841851241242461. [PMID: 38619912 DOI: 10.1177/02841851241242461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
The crista terminalis is an anatomical structure localized on the posterolateral wall of the right atrium (RA). We performed a systematic review of the literature and meta-analysis concerning cases of unusual prominent crista terminalis mimicking RA mass. Moreover, we described the differential diagnosis of cardiac masses with the use of echocardiography, computed tomography, and cardiac magnetic resonance (CMR). We also emphasize the potential importance of this structure in electrophysiological procedures, including its role in exaggerated arrhythmias. Prominent crista terminalis may be a potential obstacle during invasive cardiac procedures or catheter ablation target. In analyzed cases, the crista terminalis was often erroneously interpreted as pathologic and at first confused with a thrombus or tumor during transthoracic echocardiography examination. The correct final diagnoses were mostly made with used transesophageal echocardiography or CMR. The most important imaging findings suggestive of prominent crista terminalis rather than tumor were a similar echogenicity/intensity with adjacent myocardium, the location on posterolateral wall of the RA, the phasic change in size, and no enhancement after contrast injection. We describe up to date and detailed imaging features for the differential diagnostics of selected intracardiac masses using various imaging techniques, including multimodality cardiac imaging. Familiarity with the anatomy and the imaging findings of the prominent crista terminalis will reduce misdiagnosis and avoid additional tests and unwarranted clinical interventions, while in patients considered for invasive cardiac procedures it might increase their efficacy and safety.
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Affiliation(s)
- Patrycja S Matusik
- Department of Diagnostic Imaging, University Hospital, Kraków, Poland
- Chair of Radiology, Jagiellonian University Medical College, Kraków, Poland
| | - Katarzyna Mikrut
- Department of Cardiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Amira Bryll
- Department of Diagnostic Imaging, University Hospital, Kraków, Poland
- Jagiellonian University Medical College, Kraków, Poland
| | - Mateusz Podolec
- Department of Coronary Artery Disease and Heart Failure, St John Paul II Hospital, Kraków, Poland
- Center for Innovative Medical Education, Jagiellonian University Medical College, Kraków, Poland
| | - Tadeusz J Popiela
- Department of Diagnostic Imaging, University Hospital, Kraków, Poland
- Chair of Radiology, Jagiellonian University Medical College, Kraków, Poland
| | - Paweł T Matusik
- Department of Electrocardiology, Institute of Cardiology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
- Department of Electrocardiology, St John Paul II Hospital, Kraków, Poland
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Krzyżewski RM, Kliś KM, Kwinta BM, Stachura K, Piotrowicz K, Popiela TJ, Frączek MJ, Grodzicki T, Gąsowski J. Possible association between β-blocker use and a risk of intracranial aneurysm rupture. Pol Arch Intern Med 2024; 134:16642. [PMID: 38164646 DOI: 10.20452/pamw.16642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
INTRODUCTION Aneurysmal subarachnoid hemorrhage is a devastating type of stroke, associated with high mortality and morbidity. One of modifiable risk factors of aneurysm rupture is hypertension, however, it is still not clear whether any particular antihypertensive drugs play a significant role in the prevention of aneurysm rupture. OBJECTIVES We decided to investigate whether there is any association between acetylsalicylic acid, α-blockers, β‑blockers, angiotensin‑converting enzyme inhibitors, angiotensin II receptor blockers, calcium channel blockers, diuretics, statins, and anticoagulants and a risk of intracranial aneurysm rupture. PATIENTS AND METHODS We retrospectively analyzed 334 patients with ruptured and unruptured intracranial aneurysm. Based on logistic regression models, we obtained unadjusted and adjusted odds ratios (ORs) of subarachnoid hemorrhage associated with the use of vasoactive medications and with indices of tortuosity. RESULTS We found that β‑blocker intake was significantly related to higher tortuosity of the cerebral arteries. Also, the intake of β‑blockers (OR, 0.41; 95% CI, 0.21-0.77; P = 0.01) and statins (OR, 0.23; 95% CI, 0.05-0.68; P = 0.01) significantly decreased the risk of aneurysm rupture, a result driven by a decreased rupture risk of anterior circulation aneurysms. No such association was found for the posterior part of the cerebral circulation. CONCLUSIONS Aneurysm located in the anterior cerebral circulation might be less likely to rupture if patients receive β‑blockers or statins.
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Affiliation(s)
- Roger M Krzyżewski
- Department of Neurosurgery and Neurotraumatology, Jagiellonian University Medical College, Kraków, Poland.
| | - Kornelia M Kliś
- Department of Neurosurgery and Neurotraumatology, Jagiellonian University Medical College, Kraków, Poland
| | - Borys M Kwinta
- Department of Neurosurgery and Neurotraumatology, Jagiellonian University Medical College, Kraków, Poland
| | - Krzysztof Stachura
- Department of Neurosurgery and Neurotraumatology, Jagiellonian University Medical College, Kraków, Poland
| | - Karolina Piotrowicz
- Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Kraków, Poland
| | - Tadeusz J Popiela
- Department of Radiology, Jagiellonian University Medical College, Kraków, Poland
| | - Maciej J Frączek
- Department of Neurosurgery and Neurotraumatology, Jagiellonian University Medical College, Kraków, Poland
| | - Tomasz Grodzicki
- Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Kraków, Poland
| | - Jerzy Gąsowski
- Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Kraków, Poland
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Kliś KM, Wójtowicz D, Kwinta BM, Stachura K, Popiela TJ, Frączek MJ, Łasocha B, Gąsowski J, Milczarek O, Krzyżewski RM. Association of Arterial Tortuosity with Hemodynamic Parameters-A Computational Fluid Dynamics Study. World Neurosurg 2023; 180:e69-e76. [PMID: 37544598 DOI: 10.1016/j.wneu.2023.07.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 07/29/2023] [Accepted: 07/31/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND Tortuosity of intracranial arteries has been proven to be associated with the risk of intracranial aneurysm development. We decided to analyze which aspects of tortuosity are correlated with hemodynamics parameters promoting intracranial aneurysm development. METHODS We constructed 73 idealized models of tortuous artery (length: 25 mm, diameter: 2.5 mm) with single bifurcation. For each model, on the course of segment before bifurcation, we placed 1-3 angles with measures 15, 30, 45, 60, or 75 degrees and arc lengths 2, 5, 7, 10, or 15 mm. We performed computational fluid dynamics analysis. Blood was modeled as Newtonian fluid. We have set velocity wave of 2 cardiac cycles. After performing simulation we calculated following hemodynamic parameters at the bifurcation: time average wall shear stress (TAWSS), time average wall shear stress gradient (TAWSSG), oscillatory shear index (OSI), and relative residence time (RRT). RESULTS We found a significant positive correlation with number of angles and TAWSS (R = 0.329; P < 0.01), TAWSSG (R = 0.317; P < 0.01), and negative with RRT (R = -0.335; P < 0.0.01). Similar results were obtained in terms of arcs lengths. On the other hand, mean angle measure was negatively correlated to TAWSS (R = -0.333; P < 0.01), TAWSSG (R = -0.473 P < 0.01), OSI (R = -0.463; P < 0.01), and positively to RRT (R = 0.332; P < 0.01). On the basis of the obtained results, we developed new tortuosity descriptor, which considered angle measures normalized to its arc length and distance from bifurcation. For such descriptor we found strong negative correlation with TAWSS (R = -0.701; P < 0.01), TAWSSG (R = 0.778; P < 0.01), OSI (R = -0.776; P < 0.01), and positive with RRT (R = 0.747; P < 0.01). CONCLUSIONS Hemodynamic parameters promoting aneurysm development are correlated with larger number of smaller angles located on larger arcs.
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Affiliation(s)
- Kornelia M Kliś
- Department of Neurosurgery and Neurotraumatology, Jagiellonian University Medical College, Kraków, Poland.
| | - Dominika Wójtowicz
- Anaesthesiology and Intensive Care Clinical Department, University Hospital of Krakow, Kraków, Poland
| | - Borys M Kwinta
- Department of Neurosurgery and Neurotraumatology, Jagiellonian University Medical College, Kraków, Poland
| | - Krzysztof Stachura
- Department of Neurosurgery and Neurotraumatology, Jagiellonian University Medical College, Kraków, Poland
| | - Tadeusz J Popiela
- Department of Radiology, Jagiellonian University Medical College, Kraków, Poland
| | - Maciej J Frączek
- Department of Neurosurgery and Neurotraumatology, Jagiellonian University Medical College, Kraków, Poland
| | - Bartłomiej Łasocha
- Department of Radiology, Jagiellonian University Medical College, Kraków, Poland
| | - Jerzy Gąsowski
- Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Kraków, Poland
| | - Olga Milczarek
- Department of Children's Neurosurgery, Jagiellonian University Medical College, Faculty of Medicine, Institute of Pediatrics, Kraków, Poland
| | - Roger M Krzyżewski
- Department of Neurosurgery and Neurotraumatology, Jagiellonian University Medical College, Kraków, Poland
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Śmierciak N, Krzyściak W, Szwajca M, Karcz P, Bryll A, Popiela TJ, Donicz P, Turek A, Aleksandrovych V, Pilecki M. Benefits and Meaning of Lipids Profile in Relation to Oxidative Balance and Brain Morphology in Schizophrenia. Int J Mol Sci 2023; 24:11375. [PMID: 37511134 PMCID: PMC10379229 DOI: 10.3390/ijms241411375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 06/30/2023] [Accepted: 07/05/2023] [Indexed: 07/30/2023] Open
Abstract
Schizophrenia is characterized by complex metabolic dysregulations and their consequences. Until now, numerous theories have explained its pathogenesis, using a spectrum of available technologies. We focused our interest on lipid profile-periphery high-density cholesterol level and lipoproteins in the human brain and compared magnetic resonance imaging (MRI) scans of patients with schizophrenia and the healthy group. Detailed analysis of biochemical parameters was performed using magnetic resonance spectroscopy. Our study aimed to reveal correlations between periphery high-density lipoproteins levels and lipoproteins in the brain, depicted in MRI scans, and parameters of peripheral oxidative stress expressed as paraoxonase. Patients with schizophrenia have decreased levels of high-density lipoproteins, low paraoxonase activity, and slightly raised sodium in the blood. Positive significant correlations between serum high-density cholesterol and anterior cingulate cortex, unique brain area for schizophrenia pathophysiology, MR spectroscopy signals, and diffusion have been revealed. To our knowledge, this is the first study to describe the effect of an anterior cingulate disorder on high-density cholesterol levels on the development of schizophrenia.
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Affiliation(s)
- Natalia Śmierciak
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Jagiellonian University Medical College, 31-501 Krakow, Poland
| | - Wirginia Krzyściak
- Department of Medical Diagnostics, Jagiellonian University Medical College, 30-688 Krakow, Poland
| | - Marta Szwajca
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Jagiellonian University Medical College, 31-501 Krakow, Poland
| | - Paulina Karcz
- Department of Electroradiology, Jagiellonian University Medical College, 31-126 Krakow, Poland
| | - Amira Bryll
- Department of Radiology, Jagiellonian University Medical College, 31-501 Krakow, Poland
| | - Tadeusz J Popiela
- Department of Radiology, Jagiellonian University Medical College, 31-501 Krakow, Poland
| | - Paulina Donicz
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Jagiellonian University Medical College, 31-501 Krakow, Poland
| | - Aleksander Turek
- Doctoral School of Medical and Health Sciences, Jagiellonian University Medical College, 31-530 Krakow, Poland
| | - Veronika Aleksandrovych
- Department of Pathophysiology, Jagiellonian University Medical College, 31-121 Krakow, Poland
| | - Maciej Pilecki
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Jagiellonian University Medical College, 31-501 Krakow, Poland
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Matusik PS, Popiela TJ, Darma A, Gul EE, Matusik PT. Multiparametric Cardiac Magnetic Resonance and Arrhythmias in Myocarditis. J Clin Med 2023; 12:3754. [PMID: 37297951 PMCID: PMC10253391 DOI: 10.3390/jcm12113754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 05/26/2023] [Indexed: 06/12/2023] Open
Abstract
Myocarditis is an inflammatory disease of the myocardium with a wide range of potential etiological factors, including a variety of infectious agents (mainly viral), systemic diseases, drugs, and toxins.
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Affiliation(s)
- Patrycja S. Matusik
- Department of Diagnostic Imaging, University Hospital, 30-688 Kraków, Poland
| | - Tadeusz J. Popiela
- Chair of Radiology, Jagiellonian University Medical College, 31-501 Kraków, Poland
| | - Angeliki Darma
- Department of Cardiac Electrophysiology, Heart Centre of Leipzig, 04289 Leipzig, Germany
| | - Enes E. Gul
- Division of Cardiac Electrophysiology, Madinah Cardiac Centre, Madinah 42351, Saudi Arabia
| | - Paweł T. Matusik
- Department of Electrocardiology, Institute of Cardiology, Faculty of Medicine, Jagiellonian University Medical College, 31-202 Kraków, Poland
- Department of Electrocardiology, The John Paul II Hospital, 31-202 Kraków, Poland
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Krzyżewski RM, Kliś KM, Kwinta BM, Łasocha B, Brzegowy P, Popiela TJ, Gąsowski J. Subarachnoid Hemorrhage from Ruptured Internal Carotid Artery Aneurysm: Association with Arterial Tortuosity. World Neurosurg 2022; 166:e84-e92. [PMID: 35811029 DOI: 10.1016/j.wneu.2022.06.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/18/2022] [Accepted: 06/20/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Many researchers have found a correlation between tortuous arteries and development of aneurysms in cerebral arteries. We decided to determine whether tortuosity of the internal carotid artery can be related to its aneurysm rupture. METHODS We retrospectively analyzed the internal carotid artery anatomy of 149 patients with internal carotid artery aneurysms. For each patient, we calculated relative length (RL), sum of angle metrics (SOAM), triangular index (TI), product of angle distance (PAD), and inflection count metrics (ICM). RESULTS A total of 33 patients (22.15%) had subarachnoid hemorrhage. These patients had significantly lower SOAM (0.31 ± 0.17 vs. 0.42 ± 0.21; P < 0.01), TI (0.27 ± 0.09 vs. 0.31 ± 0.11; P = 0.03) and ICM (0.25 ± 0.11 vs. 0.31 ± 0.17; P = 0.04). In multivariate logistic regression analysis, higher SOAM (odds ratio, 0.780; 95% confidence interval, 0.619-0.961; P = 0.025) remained independently associated with lower risk of internal carotid artery aneurysm rupture. In addition, we found significant positive correlation of aneurysm dome size with SOAM (R = 0.224; P = 0.013) and PAD (0.269; P < 0.01). Our study also showed that age (R = 0.252; P = 0.036), Glasgow Coma Scale score (R = -0.706; P < 0.01), and TI (R = -0.249; P = 0.042) were independently correlated with modified Rankin Scale score on discharge. CONCLUSIONS Lower tortuosity might be a protective factor against internal carotid artery aneurysm rupture and poor outcome after subarachnoid hemorrhage. Higher tortuosity is correlated with internal carotid artery aneurysm growth.
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Affiliation(s)
- Roger M Krzyżewski
- Departments of Neurosurgery and Neurotraumatology, Jagiellonian University Medical College, Kraków, Poland.
| | - Kornelia M Kliś
- Departments of Neurosurgery and Neurotraumatology, Jagiellonian University Medical College, Kraków, Poland
| | - Borys M Kwinta
- Departments of Neurosurgery and Neurotraumatology, Jagiellonian University Medical College, Kraków, Poland
| | - Bartłomiej Łasocha
- Department of Radiology, Jagiellonian University Medical College, Kraków, Poland
| | - Paweł Brzegowy
- Department of Radiology, Jagiellonian University Medical College, Kraków, Poland
| | - Tadeusz J Popiela
- Department of Radiology, Jagiellonian University Medical College, Kraków, Poland
| | - Jerzy Gąsowski
- Departments of Internal Medicine and Gerontology, Jagiellonian University Medical College, Kraków, Poland
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Śmierciak N, Szwajca M, Popiela TJ, Bryll A, Karcz P, Donicz P, Turek A, Krzyściak W, Pilecki M. Redefining the Cut-Off Ranges for TSH Based on the Clinical Picture, Results of Neuroimaging and Laboratory Tests in Unsupervised Cluster Analysis as Individualized Diagnosis of Early Schizophrenia. J Pers Med 2022; 12:jpm12020247. [PMID: 35207735 PMCID: PMC8874519 DOI: 10.3390/jpm12020247] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/05/2022] [Accepted: 02/07/2022] [Indexed: 11/16/2022] Open
Abstract
Thyroid abnormalities, including mild forms of hypothyroidism and hyperthyroidism, are reported as risk factors for the development of a number of neuropsychiatric disorders, including schizophrenia. The diagnostic process still takes into account the extreme ranges of the accepted reference values for serum TSH since the concentration of free thyroxine in the serum does not change by definition. TSH mU/L cut-off values in psychiatric patients are currently clinically considered in the case of extremely high serum TSH levels (>4.0 mU/L). The results obtained in this study suggest that the clinically significant value has a lower TSH cut-off point with an upper limit of 2–2.5 mU/L. The criteria for the differential diagnosis of patients with schizophrenia, however, mainly take into account statutory reference ranges without a background related to the history of thyroid diseases in the family. The results indicate the need to lower the upper cut-off values for TSH among patients with early psychosis, which is related to the potential clinical significance of the obtained values both in the field of clinical evaluation and neuroimaging and laboratory evaluation parameters. The cut-off points obtained with the prior available knowledge coincided with the values established in the unsupervised clustering method, which further confirms the legitimacy of their use in the individualized diagnosis strategy of schizophrenia.
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Affiliation(s)
- Natalia Śmierciak
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Jagiellonian University Medical College, Kopernika 21a, 31-501 Krakow, Poland; (N.Ś.); (M.S.); (P.D.); (A.T.)
| | - Marta Szwajca
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Jagiellonian University Medical College, Kopernika 21a, 31-501 Krakow, Poland; (N.Ś.); (M.S.); (P.D.); (A.T.)
| | - Tadeusz J. Popiela
- Department of Radiology, Jagiellonian University Medical College, Kopernika 19, 31-501 Krakow, Poland;
- Correspondence: (T.J.P.); (W.K.); (M.P.)
| | - Amira Bryll
- Department of Radiology, Jagiellonian University Medical College, Kopernika 19, 31-501 Krakow, Poland;
| | - Paulina Karcz
- Department of Electroradiology, Jagiellonian University Medical College, Michałowskiego 12, 31-126 Krakow, Poland;
| | - Paulina Donicz
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Jagiellonian University Medical College, Kopernika 21a, 31-501 Krakow, Poland; (N.Ś.); (M.S.); (P.D.); (A.T.)
| | - Aleksander Turek
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Jagiellonian University Medical College, Kopernika 21a, 31-501 Krakow, Poland; (N.Ś.); (M.S.); (P.D.); (A.T.)
- Doctoral School of Medical and Health Sciences, Jagiellonian University Medical College, Łazarza 16, 31-530 Krakow, Poland
| | - Wirginia Krzyściak
- Department of Medical Diagnostics, Jagiellonian University Medical College, Medyczna 9, 30-688 Krakow, Poland
- Correspondence: (T.J.P.); (W.K.); (M.P.)
| | - Maciej Pilecki
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Jagiellonian University Medical College, Kopernika 21a, 31-501 Krakow, Poland; (N.Ś.); (M.S.); (P.D.); (A.T.)
- Correspondence: (T.J.P.); (W.K.); (M.P.)
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Kot A, Polak J, Klepinowski T, Frączek MJ, Krzyżewski RM, Grochowska A, Popiela TJ, Kwinta BM. Morphometric analysis of the lumbar vertebrae and intervertebral discs in relation to abdominal aorta: CT-based study. Surg Radiol Anat 2021; 44:431-441. [PMID: 34874459 PMCID: PMC8917002 DOI: 10.1007/s00276-021-02865-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 11/24/2021] [Indexed: 11/30/2022]
Abstract
Purpose Although lumbar discectomy is the most common procedure in spine surgery, reports about anatomical relations between discs and prevertebral vessels are limited. Aim of this research was to investigate morphometric of the lumbar region and the relations between intervertebral discs (IVDs) and abdominal aorta. Methods 557 abdominal computed tomography scans were assessed. For each spinal column level from Th12/L1 down to L4/L5, we investigated: intervertebral disc’s and vertebra’s height, width, length, and distance from aorta or common iliac artery (CIA). Those arteries were also measured in two dimensions and classified based on location. Results 54.58% of patients were male. There was a significant difference in arterial-disc distances (ADDs) between genders at the levels: L1/L2 (1.32 ± 1.97 vs. 0.96 ± 1.78 mm; p = 0.0194), L2/L3 (1.97 ± 2.16 vs. 1.15 ± 2.01 mm; p < 0.0001), L3/L4 (2.54 ± 2.78 vs. 1.71 ± 2.61 mm; p = 0.0012), also for both CIAs (left CIA 3.64 ± 3.63 vs. 2.6 ± 3.06 mm; p = 0.0004 and right CIA: 7.96 ± 5.06 vs. 5.8 ± 4.57 mm; p < 0.001)—those ADDs were higher in men at all levels. The length and width of IVD increased alongside with disc level with the maximum at L4/L5. Conclusion Bifurcations of the aorta in most cases occurred at the L4 level. Collected data suggest that at the highest lumbar levels, there is a greater possibility to cause injury of the aorta due to its close anatomical relationship with discs. Females have limited, in comparison to males, ADD at L1/L2, L2/L3, and L3/L4 levels what should be taken into consideration during preoperative planning of surgical intervention.
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Affiliation(s)
- Anna Kot
- Department of Orthopedics, Traumatology, Microsurgery and Hand Surgery, Specialist Hospital, Jasło, Poland
| | - Jarosław Polak
- Department of Neurosurgery and Neurotraumatology, Jagiellonian University Medical College, Kraków, Poland
| | - Tomasz Klepinowski
- Department of Neurosurgery, Pomeranian Medical University, Szczecin, Poland
| | - Maciej J Frączek
- Faculty of Medicine, Jagiellonian University Medical College, Św. Anny Street 12, 31-008, Kraków, Poland.
| | - Roger M Krzyżewski
- Department of Neurosurgery and Neurotraumatology, Jagiellonian University Medical College, Kraków, Poland
| | - Anna Grochowska
- Department of Radiology, Jagiellonian University Medical College, Kraków, Poland
| | - Tadeusz J Popiela
- Department of Radiology, Jagiellonian University Medical College, Kraków, Poland
| | - Borys M Kwinta
- Department of Neurosurgery and Neurotraumatology, Jagiellonian University Medical College, Kraków, Poland
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10
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Łasocha B, Grochowska AM, Wrona P, Brzegowy PJ, Pułyk R, Słowik A, Latacz PR, Popiela TJ. Venous return in acute ischaemic stroke patients measured during computed tomography angiography of head and neck. Neurol Neurochir Pol 2021; 55:462-468. [PMID: 34477214 DOI: 10.5603/pjnns.a2021.0060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/21/2021] [Accepted: 06/22/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The aim of this study was to analyse the general features and usefulness of the time elapsed between the start of contrast agent infusion and its appearance in the aortic arch in acute ischaemic stroke patients subjected to baseline computed tomographic angiography. This is, to the best of our knowledge, the first study of this parameter in a clinical context. We will refer to it hereafter as 'needle-to-aorta delay' (NAD). MATERIAL AND METHODS The following were recorded: the time it took iodinated contrast media to reach the aorta, the site of occlusion, and automatic perfusion assessments of infarct and salvageable tissue volumes. Demographic data such as age and sex, comorbidities, and clinical factors including heart rate, blood pressure, time elapsed from symptom onset, initial stroke severity, and course of disease, were also assessed. RESULTS We analysed 252 cases of stroke. NAD correlated with tissue at risk volume, and was greater for patients with hypertension and atrial fibrillation. The observed time was significantly shorter with less favourable core-to-penumbra ratios. No link was found between NAD and either the rate of infarct progression or the long-term clinical result. CONCLUSIONS Although no clinical benefit was proven as a result of measuring the time it took contrast media to reach the aorta, our study implies that not only is the brain subject to circulation, but it may also affect its functioning.
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Affiliation(s)
| | - Anna M Grochowska
- Chair of Radiology, Jagiellonian University Medical College, Krakow, Poland
| | - Paweł Wrona
- Chair of Neurology, Jagiellonian University, Medical College, Krakow, 31-501, Poland
| | - Paweł J Brzegowy
- Chair of Radiology, Jagiellonian University Medical College, Krakow, Poland
| | - Roman Pułyk
- Chair of Neurology, Jagiellonian University, Medical College, Krakow, 31-501, Poland
| | - Agnieszka Słowik
- Chair of Neurology, Jagiellonian University, Medical College, Krakow, 31-501, Poland
| | - Paweł R Latacz
- Chair of Neurology, Jagiellonian University, Medical College, Krakow, 31-501, Poland
| | - Tadeusz J Popiela
- Chair of Radiology, Jagiellonian University Medical College, Krakow, Poland
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11
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Luczynska E, Rudnicki W, Kargol J, Szpor J, Hodorowicz-Zaniewska D, Wysocki PJ, Gorski M, Popiela TJ. Primary bilateral angiosarcoma of the breast treated with neoadjuvant chemotherapy combined with propranolol. Breast J 2021; 27:781-786. [PMID: 34263505 DOI: 10.1111/tbj.14272] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 06/27/2021] [Accepted: 06/29/2021] [Indexed: 11/28/2022]
Abstract
A case report of bilateral primary angiosarcoma treated with neoadjuvant chemotherapy was presented. A routine diagnostic mammography and ultrasound examinations indicated abnormalities in both breasts of the patient, confirmed on MRI as large bilateral masses. Core needle biopsy revealed angiosarcoma G1. The treatment agreed during the interdisciplinary meeting involved chemotherapy combined with simultaneous blockade of beta-adrenergic receptors, followed by bilateral simple mastectomy. This case highlights the importance of a patient-focused care.
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Affiliation(s)
| | - Wojciech Rudnicki
- Electroradiology Department, Jagiellonian University Medical College, Cracow, Poland
| | - Jaromir Kargol
- Faculty of Medicine, University of Rzeszow, Rzeszow, Poland
| | - Joanna Szpor
- Chair of Pathomorphology, Jagiellonian University Medical College, Cracow, Poland
| | - Diana Hodorowicz-Zaniewska
- General, Oncological, and Gastrointestinal Surgery, Jagiellonian University Medical College, Cracow, Poland
| | - Piotr J Wysocki
- Department of Oncology, Jagiellonian University Medical College, Cracow, Poland
| | - Mateusz Gorski
- University Center for Breast Diseases, University Hospital in Cracow, Cracow, Poland
| | - Tadeusz J Popiela
- Chair of Radiology, Jagiellonian University Medical College, Cracow, Poland
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12
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Hodorowicz-Zaniewska D, Zurrida S, Kotlarz A, Kasprzak P, Skupień J, Ćwierz A, Popiela TJ, Maciejewski A, Basta P. A Prospective Pilot Study on Use of Liquid Crystal Thermography to Detect Early Breast Cancer. Integr Cancer Ther 2021; 19:1534735420915778. [PMID: 32340499 PMCID: PMC7235966 DOI: 10.1177/1534735420915778] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Background: Breast cancer is the most common cancer in women. While
mammography is the standard for early detection in women older than 50 years of
age, there is no standard for younger women. The aim of this prospective pilot
study was to assess liquid crystal contact thermography, using the Braster
device, as a means for the early detection of breast cancer. The device is
intended to be used as a complementary tool to standard of care (sonography,
mammography, etc). Patients and Methods: A total of 274 consecutive
women presenting at Polish breast centers for prophylactic breast examination
were enrolled to receive thermography; 19 were excluded for errors in
thermographic image acquisition. The women were divided according to age (n =
135, <50 years; n = 120, ≥50 years). A control population was included (n =
40, <50 years; n = 23, ≥50 years). The primary endpoint, stratified by age
group, was the C-statistic for discrimination between breast
cancer and noncancer. Results: In women with abnormal breast
ultrasound (n = 95, <50 years; n = 87, ≥50 years), the
C-statistic was 0.85 and 0.75, respectively (P
= .20), for discrimination between breast cancer and noncancer. Sensitivity did
not differ (P = .79) between the younger (82%) and older women
(78%), while specificity was lower in the older women (60% vs 87%,
P = .025). The false-positive rate was similar in women
with normal and abnormal breast ultrasound. Positive thermographic result in
women with Breast Imaging Reporting and Data System (BIRADS) 4A on ultrasound
increased the probability of breast cancer by over 2-fold. Conversely, a
negative thermographic result decreased the probability of cancer more than
3-fold. Breast size and structure did not affect the thermography performance.
No adverse events were observed. Conclusions: Thermography
performed well in women <50 years of age, while its specificity in women ≥50
years was inadequate. These promising findings suggest that the Braster device
deserves further investigation as a supporting tool for the early detection of
breast cancer in women younger than 50 years of age.
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Affiliation(s)
| | | | | | | | | | - Anna Ćwierz
- Ludwik Rydygier Memorial Specialized Hospital, Krakow, Poland
| | - Tadeusz J Popiela
- Jagiellonian University, Krakow, Poland.,University Hospital in Krakow, Poland
| | | | - Paweł Basta
- Jagiellonian University, Krakow, Poland.,University Hospital in Krakow, Poland
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13
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Luczynska E, Pawlak M, Piegza T, Popiela TJ, Heinze S, Dyczek S, Rudnicki W. Analysis of background parenchymal enhancement (BPE) on contrast enhanced spectral mammography compared with magnetic resonance imaging. Ginekol Pol 2021; 92:92-97. [PMID: 33448005 DOI: 10.5603/gp.a2020.0169] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 10/12/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES With the growing number of new breast cancer cases in women, new methods of imaging arise. Contrast enhanced spectral mammography (CESM) and magnetic resonance imaging (MRI) are comparable methods regarding sensitivity. The aim of this study is to check if analysis of background parenchymal enhancement on CESM can improve its usefulness. MATERIAL AND METHODS A total of 64 patients with breast lesions found previously on ultrasound or mammography underwent MRI and CESM within less than one month. On MRI the contrast enhancement kinetics and visual BPE were evaluated. On CESM the enhancement of lesions was noted as well as a quantitative level of BPH. The gathered data was analysed in terms of patterns and relations. RESULTS A total of 66 lesions were identified both on MRI and CESM, including 11 (17%) benign and 55 (83%) malignant lesions. Among malignant lesions 13 (20%) were assessed as intraductal and 42 (64%) as infiltrating carcinomas. The study showed correlation between the level of enhancement on CESM and the type of kinetic curve on MRI and lesion enhance-ment on CESM as well as confirmed the fact that the BPE is a destimulant in both methods of imaging. CONCLUSIONS Evaluation of BPE level on CESM can help reading radiologists to define a lesion as malignant with higher probability than based only on the qualitative lesion enhancement level.
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Affiliation(s)
| | - Marta Pawlak
- Maria Sklodowska-Curie National Research Institute of Oncology in Cracow, Poland, Poland
| | - Tomasz Piegza
- Maria Sklodowska-Curie National Research Institute of Oncology in Cracow, Poland, Poland
| | - Tadeusz J Popiela
- Chair of Radiology, Jagiellonian University Medical College, Cracow, Poland, Poland
| | - Sylwia Heinze
- Maria Sklodowska-Curie National Research Institute of Oncology in Cracow, Poland, Poland
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14
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Matusik PS, Łoboda P, Krzanowska K, Popiela TJ, Heba G, Pawlik W. Presence of retained calcified fibrin sheath after central venous catheter removal: A systematic literature review. J Vasc Access 2020; 23:644-652. [PMID: 33143527 DOI: 10.1177/1129729820969328] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Central venous catheters (CVC) are used in many clinical settings for a variety of indications. We performed a systematic literature review concerning case reports of retained calcified fibrin sheaths after dialysis CVC removal. The aim of our study was to systematize the knowledge regarding clinical management of this phenomenon, placing special emphasis on diagnostic radiological features in different imaging modalities, including chest radiography, echocardiography, computed tomography, and magnetic resonance imaging. We discuss the most common risk factors associated with this CVC complication. In our review, we found eight cases of hemodialysis patients. The most common risk factors associated with calcified fibrin sheath formation in the analyzed cases were pro-thrombotic and pro-calcification factors related to patient comorbidities, and prolonged catheter dwell time. Differentiating between a calcified fibrin sheath (present in about 6% of patients with long-term indwelling CVC as diagnosed by computed tomography) and a retained catheter tip can be challenging. The initial diagnosis based on imaging methods was incorrect in most of the analyzed cases. This suggests that some cases of retained fibrin sheaths may remain undetected or misinterpreted. This is important in patients with known pro-thrombotic and pro-calcification risk factors and prolonged catheter dwell time. Therefore, implementation of preventive strategies, familiarity with radiological findings of this phenomenon, comparison with previous imaging studies, and an overall comprehensive assessment with clinical data is imperative.
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Affiliation(s)
| | - Piotr Łoboda
- Department of Diagnostic Imaging, University Hospital, Cracow, Poland
| | - Katarzyna Krzanowska
- Department of Nephrology, Jagiellonian University Medical College, Cracow, Poland
| | - Tadeusz J Popiela
- Jagiellonian University Medical College, Faculty of Medicine, Chair of Radiology, Cracow, Poland
| | - Grzegorz Heba
- Second Department of Cardiology, Institute of Cardiology, Jagiellonian University, Cracow, Poland
| | - Wiesław Pawlik
- Department of Diagnostic Imaging, University Hospital, Cracow, Poland
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15
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Krupa K, Brzegowy P, Kucybała I, Łasocha B, Urbanik A, Popiela TJ. Endovascular embolization of wide-necked bifurcation aneurysms with the use of pCONus device: A systematic review and meta-analysis. Clin Imaging 2020; 70:81-88. [PMID: 33130244 DOI: 10.1016/j.clinimag.2020.10.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 09/24/2020] [Accepted: 10/12/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND The following study aimed to summarize the overall safety and efficacy of the pCONus device in the treatment of wide-necked bifurcation aneurysms. MATERIAL AND METHODS Major electronic medical databases were thoroughly searched to identify relevant studies. Data regarding the type of included studies, type of aneurysm and its location, treatment results measured in Raymond-Roy Occlusion Class (RROC) and its complications, as well as patients' neurological outcome at the discharge were extracted from the eligible studies and included in the meta-analysis. The subgroup analyses dependent on the aneurysm rupture status were also conducted. RESULTS A total of 8 studies (198 patients with 200 aneurysms) were included in this meta-analysis. The most common localization of the treated aneurysms was the middle cerebral artery with its pooled prevalence estimate (PPE) of 44.5%. Immediately after the procedure, RROC I (complete obliteration of the aneurysm) was observed in 46.8%, RROC II in 32.9%, while RROC III (residual aneurysm) in 20.3% of the patients. In a short-term follow-up, PPE of RROC I was 55.0%, RROC II 29.0%, and RROC III 16.1%. The PPE of intraprocedural complications was 17.3%, the most frequent were thromboembolic events, which were observed in 12.1% of all procedures. Poor neurological outcome at the discharge was noted with PPE of 9.6%. CONCLUSIONS The effectiveness and safety of wide-necked bifurcation aneurysm treatment utilizing the pCONus device is moderate. There is still a need for a consensus regarding the effective antiplatelet regimen in furtherance of diminishing the rate of thromboembolic events.
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Affiliation(s)
- Kamil Krupa
- Department of Radiology, Jagiellonian University Medical College, 19 Kopernika Street, 31-501 Krakow, Poland; International Evidence-Based Anatomy Working Group (iEBA-WG), 12 Kopernika Street, 31-034 Krakow, Poland
| | - Paweł Brzegowy
- Department of Radiology, Jagiellonian University Medical College, 19 Kopernika Street, 31-501 Krakow, Poland
| | - Iwona Kucybała
- Department of Radiology, Jagiellonian University Medical College, 19 Kopernika Street, 31-501 Krakow, Poland.
| | - Bartłomiej Łasocha
- Department of Radiology, Jagiellonian University Medical College, 19 Kopernika Street, 31-501 Krakow, Poland
| | - Andrzej Urbanik
- Department of Radiology, Jagiellonian University Medical College, 19 Kopernika Street, 31-501 Krakow, Poland
| | - Tadeusz J Popiela
- Department of Radiology, Jagiellonian University Medical College, 19 Kopernika Street, 31-501 Krakow, Poland
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16
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Bryll A, Krzyściak W, Karcz P, Śmierciak N, Kozicz T, Skrzypek J, Szwajca M, Pilecki M, Popiela TJ. The Relationship between the Level of Anterior Cingulate Cortex Metabolites, Brain-Periphery Redox Imbalance, and the Clinical State of Patients with Schizophrenia and Personality Disorders. Biomolecules 2020; 10:E1272. [PMID: 32899276 PMCID: PMC7565827 DOI: 10.3390/biom10091272] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/17/2020] [Accepted: 08/28/2020] [Indexed: 01/10/2023] Open
Abstract
Schizophrenia is a complex mental disorder whose course varies with periods of deterioration and symptomatic improvement without diagnosis and treatment specific for the disease. So far, it has not been possible to clearly define what kinds of functional and structural changes are responsible for the onset or recurrence of acute psychotic decompensation in the course of schizophrenia, and to what extent personality disorders may precede the appearance of the appropriate symptoms. The work combines magnetic resonance spectroscopy imaging with clinical evaluation and laboratory tests to determine the likely pathway of schizophrenia development by identifying peripheral cerebral biomarkers compared to personality disorders. The relationship between the level of metabolites in the brain, the clinical status of patients according to International Statistical Classification of Diseases and Related Health Problems, 10th Revision ICD-10, duration of untreated psychosis (DUP), and biochemical indices related to redox balance (malondialdehyde), the efficiency of antioxidant systems (FRAP), and bioenergetic metabolism of mitochondria, were investigated. There was a reduction in the level of brain N-acetyl-aspartate and glutamate in the anterior cingulate gyrus of patients with schisophrenia compared to the other groups that seems more to reflect a biological etiopathological factor of psychosis. Decreased activity of brain metabolites correlated with increased peripheral oxidative stress (increased malondialdehyde MDA) associated with decreased efficiency of antioxidant systems (FRAP) and the breakdown of clinical symptoms in patients with schizophrenia in the course of psychotic decompensation compared to other groups. The period of untreated psychosis correlated negatively with glucose value in the brain of people with schizophrenia, and positively with choline level. The demonstrated differences between two psychiatric units, such as schizophrenia and personality disorders in relation to healthy people, may be used to improve the diagnosis and prognosis of schizophrenia compared to other heterogenous psychopathology in the future. The collapse of clinical symptoms of patients with schizophrenia in the course of psychotic decompensation may be associated with the occurrence of specific schizotypes, the determination of which is possible by determining common relationships between changes in metabolic activity of particular brain structures and peripheral parameters, which may be an important biological etiopathological factor of psychosis. Markers of peripheral redox imbalance associated with disturbed bioenergy metabolism in the brain may provide specific biological factors of psychosis however, they need to be confirmed in further studies.
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Affiliation(s)
- Amira Bryll
- Department of Radiology, Jagiellonian University Medical College, Kopernika 19, 31-501 Krakow, Poland;
| | - Wirginia Krzyściak
- Department of Medical Diagnostics, Jagiellonian University, Medical College, Medyczna 9, 30-688 Krakow, Poland;
| | - Paulina Karcz
- Department of Electroradiology, Jagiellonian University Medical College, Michałowskiego 12, 31-126 Krakow, Poland;
| | - Natalia Śmierciak
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Jagiellonian University, Medical College, Kopernika 21a, 31-501 Krakow, Poland; (N.Ś.); (M.S.); (M.P.)
| | - Tamas Kozicz
- Department of Clinical Genomics, Center for Individualized Medicine, Mayo Clinic, Rochester, MN 55905, USA;
| | - Justyna Skrzypek
- Department of Medical Diagnostics, Jagiellonian University, Medical College, Medyczna 9, 30-688 Krakow, Poland;
| | - Marta Szwajca
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Jagiellonian University, Medical College, Kopernika 21a, 31-501 Krakow, Poland; (N.Ś.); (M.S.); (M.P.)
| | - Maciej Pilecki
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Jagiellonian University, Medical College, Kopernika 21a, 31-501 Krakow, Poland; (N.Ś.); (M.S.); (M.P.)
| | - Tadeusz J. Popiela
- Department of Radiology, Jagiellonian University Medical College, Kopernika 19, 31-501 Krakow, Poland;
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17
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Matusik PS, Bryll A, Matusik PT, Pac A, Popiela TJ. Electrocardiography and cardiac magnetic resonance imaging in the detection of left ventricular hypertrophy: the impact of indexing methods. Kardiol Pol 2020; 78:889-898. [PMID: 32598106 DOI: 10.33963/kp.15464] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Discrepancies between increased left ventricular mass (LVM) and electrocardiographic (ECG) criteria for the diagnosis of left ventricular hypertrophy (LVH) are described in the literature. AIMS This study aimed to evaluate the usefulness of ECG criteria in the diagnosis of LVH, as determined by cardiac magnetic resonance (CMR) imaging, using various LVM indexing methods. METHODS We included 53 patients who underwent CMR imaging and had electrocardiograms of appropriate quality available in their medical records. The majority of the study patients had cardiovascular diseases. We defined CMR‑LVH as increased LVM, also assessed after LVM indexing to body surface area (LVM/BSA), height1.7, height2.7, or as the percentage of predicted LVM (%pLVM). To determine ECG‑LVH, 10 different ECG-LVH criteria were used. RESULTS The prevalence of CMR‑LVH ranged from 11% (for %pLVM) to 72% (for LVM/BSA). At the same time, for a single criterion, the prevalence of ECG‑LVH ranged between 1.9% (for R wave amplitude in lead V5 / V6 greater than 2.6 mV, Sokolow-Lyon product, and Gubner-Ungerleider criterion) and 45.3% (for Peguero-Lo Presti criterion), showing high sensitivity, from 55.3% (95% CI, 38.3-71.4) to 100% (95% CI, 54.1-100). The sensitivity of ECG‑LVH criteria when all criteria were applied together ranged from 57.9% (95% CI, 40.8-73.7) to 100% (95% CI, 63.1-100). The best performance regarding the endpoint of CMR‑LVH diagnosis after LVM indexing was achieved by the Peguero-Lo Presti and Cornell criteria (area under the curve, 0.621-0.876; P, 0.001-0.17). CONCLUSIONS Thediagnosis of LVH strongly depends on ECG- and CMR‑based definitions. ThePeguero-Lo Presti criterion and the Cornell criteria, which are sex‑specific, may provide the highest level of diagnostic accuracy and should be considered when screening patients with cardiovascular diseases for LVH.
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Affiliation(s)
| | - Amira Bryll
- Department of Radiology,Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Paweł T Matusik
- Department of Electrocardiology, Institute of Cardiology,Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland; Department of Electrocardiology, John Paul II Hospital, Kraków, Poland.
| | - Agnieszka Pac
- Chair of Epidemiology and Preventive Medicine,Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Tadeusz J Popiela
- Department of Radiology,Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
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18
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Kliś KM, Krzyżewski RM, Kwinta BM, Łasocha B, Brzegowy P, Stachura K, Popiela TJ, Borek R, Gąsowski J. Increased tortuosity of basilar artery might be associated with higher risk of aneurysm development. Eur Radiol 2020; 30:5625-5632. [PMID: 32405752 PMCID: PMC7476915 DOI: 10.1007/s00330-020-06917-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 03/23/2020] [Accepted: 04/23/2020] [Indexed: 01/30/2023]
Abstract
Objectives We analysed tortuosity of basilar artery (BA) to determine its relationship with the presence of aneurysm. Methods We retrospectively analysed 71 patients with BA aneurysms along with 71 age- and risk factors-matched control patients without BA aneurysm. From patients’ medical records, we obtained their history including previous and current diseases and medications. For each patient, we calculated relative length (RL), sum of angle metrics (SOAM), triangular index (TI), product of angle distance (PAD) and inflexion count metrics (ICM). We used t-test and Mann-Whitney U test for continuous variables and χ2 test for dichotomised variables. To find independent predictors of BA aneurysm, we employed logistic regression analysis. Results We found significant positive correlation between age and SOAM (R = 0.195, p = 0.02) and PAD (R = 0.199, p = 0.018). Our study also showed that patients with BA aneurysm had significantly higher SOAM (0.21 ± 0.16 vs. 0.11 ± 0.08; p < 0.01), PAD (0.30 ± 0.19 vs. 0.18 ± 0.11; p < 0.01), TI (0.23 ± 0.23 vs. 0.10 ± 0.16; p < 0.01) and ICM (0.20 ± 0.16 vs. 0.15 ± 0.11; p = 0.045). In multivariate logistic regression analysis, after adjustment for all possible confounders, SOAM (OR = 1.086; 95% CI 1.046–1.136; p < 0.01) and TI (OR = 1.004; 95%C: 1.002–1.006; p < 0.01) remained independently associated with higher risk of BA aneurysm. Conclusions Increased tortuosity of BA is associated with higher risk of its aneurysm development. Key Points • Basilar artery sum of angle metrics and product of angle distance are correlated with age. • Basilar artery tortuosity is independently associated with higher risk of its aneurysm development. • Basilar artery tortuosity is positively correlated with its diameter and bifurcation angle.
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Affiliation(s)
- Kornelia M Kliś
- Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland.,Faculty of Computer Science, Electronics and Telecommunications, AGH University of Science and Technology, Kraków, Poland.,TENSOR- Team of NeuroSurgery-Oriented Research, Jagiellonian University Medical College, Kraków, Poland
| | - Roger M Krzyżewski
- TENSOR- Team of NeuroSurgery-Oriented Research, Jagiellonian University Medical College, Kraków, Poland. .,Department of Neurosurgery and Neurotraumatology, Jagiellonian University Medical College, Macieja Jakubowskiego 2 Street, 30-688, Kraków, Poland.
| | - Borys M Kwinta
- TENSOR- Team of NeuroSurgery-Oriented Research, Jagiellonian University Medical College, Kraków, Poland.,Department of Neurosurgery and Neurotraumatology, Jagiellonian University Medical College, Macieja Jakubowskiego 2 Street, 30-688, Kraków, Poland
| | - Bartłomiej Łasocha
- Department of Radiology, Jagiellonian University Medical College, University Hospital, Kraków, Poland
| | - Paweł Brzegowy
- Department of Radiology, Jagiellonian University Medical College, University Hospital, Kraków, Poland
| | - Krzysztof Stachura
- Department of Neurosurgery and Neurotraumatology, Jagiellonian University Medical College, Macieja Jakubowskiego 2 Street, 30-688, Kraków, Poland
| | - Tadeusz J Popiela
- Department of Radiology, Jagiellonian University Medical College, University Hospital, Kraków, Poland
| | - Radosław Borek
- 1st Department of Internal Medicine with Cardiology Subdivision, Blessed Marta Wiecka District Hospital, Bochnia, Poland
| | - Jerzy Gąsowski
- TENSOR- Team of NeuroSurgery-Oriented Research, Jagiellonian University Medical College, Kraków, Poland.,Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Kraków, Poland
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Kliś KM, Krzyżewski RM, Kwinta BM, Stachura K, Popiela TJ, Gąsowski J, Długopolski J. Relation of Intracerebral Hemorrhage Descriptors with Clinical Factors. Brain Sci 2020; 10:brainsci10040252. [PMID: 32344613 PMCID: PMC7226419 DOI: 10.3390/brainsci10040252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 04/16/2020] [Accepted: 04/20/2020] [Indexed: 11/16/2022] Open
Abstract
The association between intracerebral hemorrhage (ICH) shape and a poor treatment outcome has been established by few authors. We decided to analyze whether computationally assessed hemorrhage shape irregularity is associated with any known predictors of its poor treatment outcome. We retrospectively analyzed 48 patients with spontaneous intracerebral hemorrhage. For each patient we calculated Fractal Dimension, Compactness, Fourier Factor and Circle Factor. Our study showed that patients above 65 years old had significantly higher Compactness (0.70 ± 0.19 vs. 0.56 ± 0.20; p < 0.01), Fractal Dimension (0.46 ± 0.22 vs. 0.32 ± 0.20; p = 0.03) and Circle Factor (0.51 ± 0.25 vs. 0.35 ± 0.17; p < 0.01). Patients with hemorrhage growth had significantly higher Compactness (0.74 ± 0.23 vs. 0.58 ± 0.18; p < 0.01), Circle Factor (0.55 ± 0.27 vs. 0.37 ± 0.18; p < 0.01) and Fourier Factor (0.96 ± 0.06 vs. 0.84 ± 0.19; p = 0.03). In conclusion, irregularity resulting from the number of appendices can be a predictor of ICH growth; however, the size of those appendices is also important. Shape roughness better reflects the severity of brain tissue damage and a patient’s general condition.
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Affiliation(s)
- Kornelia M. Kliś
- Faculty of Medicine, Jagiellonian University Medical College, 31-008 Kraków, Poland;
- Faculty of Computer Science, Electronics and Telecommunications, AGH University of Science and Technology, 30-059 Kraków, Poland
- TENSOR - Team of NeuroSurgery-Oriented Research, Jagiellonian University Medical College, 31-008 Kraków, Poland;
| | - Roger M. Krzyżewski
- TENSOR - Team of NeuroSurgery-Oriented Research, Jagiellonian University Medical College, 31-008 Kraków, Poland;
- Department of Neurosurgery and Neurotraumatology, Jagiellonian University Medical College, 30-688 Kraków, Poland; (B.M.K.); (K.S.)
- Correspondence: ; Tel.: +48-12-4248662
| | - Borys M. Kwinta
- Department of Neurosurgery and Neurotraumatology, Jagiellonian University Medical College, 30-688 Kraków, Poland; (B.M.K.); (K.S.)
| | - Krzysztof Stachura
- Department of Neurosurgery and Neurotraumatology, Jagiellonian University Medical College, 30-688 Kraków, Poland; (B.M.K.); (K.S.)
| | - Tadeusz J. Popiela
- Department of Radiology, Jagiellonian University Medical College, 30-688 Kraków, Poland;
| | - Jerzy Gąsowski
- TENSOR - Team of NeuroSurgery-Oriented Research, Jagiellonian University Medical College, 31-008 Kraków, Poland;
- Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, 30-688 Kraków, Poland
| | - Jacek Długopolski
- Department of Computer Science, AGH University of Science and Technology, 30-059 Kraków, Poland;
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Matusik PS, Bryll A, Matusik PT, Popiela TJ. Ischemic and non-ischemic patterns of late gadolinium enhancement in heart failure with reduced ejection fraction. Cardiol J 2020; 28:67-76. [PMID: 32037500 DOI: 10.5603/cj.a2020.0009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Revised: 09/27/2019] [Accepted: 11/03/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Late gadolinium enhancement (LGE) by cardiac magnetic resonance (CMR) may reveal myocardial fibrosis which is associated with adverse clinical outcomes in patients undergoing implantable cardioverter-defibrillator (ICD) placement. At the same time, transmural LGE in the posterolateral wall is related to nonresponse to conventional cardiac resynchronization therapy (CRT). Herein, the aim was to assess the presence and determinants of LGE in CMR in heart failure (HF) with reduced ejection fraction. METHODS Sixty-seven patients were included (17.9% female, aged 45 [29-60] years), who underwent LGE-CMR and had left ventricular ejection fraction (LVEF) as determined by echocardiography. RESULTS In HF patients with LVEF ≤ 35% (n = 29), ischemic and non-ischemic patterns of LGE were observed in 51.7% and 34.5% of patients, respectively. In controls (n = 38), these patterns were noted in 23.7% and 42.1% of patients, respectively. HF patients with LVEF ≤ 35% and transmural LGE in the posterolateral wall (31.0%) were characterized by older age, coronary artery disease (CAD) and previous myocardial infarction (MI) (61 ± 6 vs. 49 ± 16 years, p = 0.008, 100% vs. 40%, p = 0.003 and 78% vs. 25%, p = 0.014, respectively). In patients with LVEF ≤ 35%, LGE of any type, diagnosed in 86.2% of patients, was associated with CAD (68% vs. 0%, p = 0.02), while only trends were observed for its association with older age and previous MI (p = 0.08 and p = 0.12, respectively). CONCLUSIONS Among HF patients with LVEF ≤ 35%, clinical factors including older age, CAD, and previous MI are associated with transmural LGE in the posterolateral wall, while CAD is associated with LGE. This data may have potential implications for planning ICD and CRT placement procedures.
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Affiliation(s)
- Patrycja S Matusik
- Department of Radiology, University Hospital, Skawińska 8 Street, 33-332 Kraków, Poland
| | - Amira Bryll
- Department of Diagnostic Imaging, Jagiellonian University Medical College
| | - Paweł T Matusik
- Institute of Cardiology, Jagiellonian University Medical College, Prądnicka 80 Street, 31-202 Kraków, Poland. .,Department of Electrocardiology, The John Paul II Hospital, Prądnicka 80 Street, 31-202 Kraków, Poland.
| | - Tadeusz J Popiela
- Department of Diagnostic Imaging, Jagiellonian University Medical College
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21
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Brzegowy P, Polak J, Wnuk J, Łasocha B, Walocha J, Popiela TJ. Middle cerebral artery anatomical variations and aneurysms: a retrospective study based on computed tomography angiography findings. Folia Morphol (Warsz) 2017; 77:434-440. [PMID: 29235088 DOI: 10.5603/fm.a2017.0112] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 10/04/2017] [Accepted: 10/26/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND Anatomical variations of the middle cerebral artery (MCA) are an important clinical issue, due to high prevalence of intracranial aneurysms. Anatomical variations of vessels can lead to higher shear stress, which is thought to be the main factor leading to aneurysm formation and consequently to higher prevalence of aneurysms. The aim of this study was to evaluate anatomy of the MCA; to classify MCA aneurysms using computed tomography angiography and to correlate anatomical variations of MCA and circle of Willis with prevalence of MCA aneurysms. MATERIALS AND METHODS Two hundred and fifty patients without MCA aneurysms and 100 patients with unruptured MCA aneurysms were qualified for the study, with exclusion of patients after MCA clipping. Four aspects of MCA anatomy were evaluated: division point, its relation to the genu, distance to M1 division and the genu and domination of post-division trunks. RESULTS Middle cerebral artery bifurcation was found in 86.2% and trifurcation in 13.8% of the cases. 78.4% of MCAs divided before the genu, 19.2% in the genu and 2.4% after the genu. Upper branch domination was seen in 26%, lower branch in 25.4%, middle branch in 4% and no domination in 44.6% of the cases. In the study group 116 aneurysms were found. 86.2% of the aneurysms were located in M1 division point, 6.9% in M2 segment, 3.4% near lenticulostriatae arteries and 3.4% near early cortical branches. The only anatomical variation, which had significantly higher prevalence in patients with left MCA aneurysms, was domination of upper post-division trunk of MCA. No other statistically significant differences in circle of Willis and MCA variations were found between patients with aneurysms and without them. CONCLUSIONS The most common configuration of MCA is bifurcation before the genu with no dominating post-division trunk. Incidence of MCA aneurysms is not correlated with anatomical variations of MCA and the circle of Willis.
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Affiliation(s)
| | - J Polak
- Students' Scientific Group at the Department of Radiology, Faculty of Medicine, Jagiellonian University Medical College, Botaniczna 3, 31-503 Kraków, Poland.
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Kazmierczak W, Lazar A, Tomaszewska R, Popiela TJ, Koper K, Wicherek L, Dutsch-Wicherek M. Analysis of the intensity of immune cell infiltration and immunoreactivity of RCAS1 in diffuse large B-cell lymphoma of the palatine tonsil and its microenvironment. Cell Tissue Res 2015; 361:823-31. [PMID: 25773455 PMCID: PMC4550658 DOI: 10.1007/s00441-015-2157-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Accepted: 02/19/2015] [Indexed: 11/24/2022]
Abstract
Non-Hodgkin lymphoma of Waldeyer's ring constitutes a small percentage of cases of palatine tonsil malignancies and its precise etiology remains unknown. RCAS1 (receptor cancer-binding antigen expressed on SiSo cells) has been demonstrated to be associated with poor prognosis, the development of lymph node metastases and participation in tumor microenvironment remodeling. Our aim is to analyze the potential role of RCAS1 expression in the tumor and tumor microenvironment in the development of early-stage palatine tonsil B-cell lymphomas. We selected 20 patients and analyzed tissue samples from the lymphoma and tumor microenvironment of each patient and from a reference group of 20 patients with chronic tonsillitis. The presence of RCAS1 protein immunoreactivity was demonstrated in 65% of the examined tissue samples of diffuse large B-cell lymphoma and in 25% of the analyzed stromata in which it was exhibited by CD68-positive cells identified as macrophages and dispersed throughout the stroma. RCAS1 immunoreactivity in the lymphoma tissue samples remained at a level comparable with that of the reference and was significantly higher in these samples than in those from the stroma. Chronic inflammation of the palatine tonsils thus results in intensive infiltration by various types of immune system cells and in excessive RCAS1 immunoreactivity, both of which confirm the important regulatory role of RCAS1 in the immune response in the mucosa-associated lymphatic tissue of Waldeyer's ring. RCAS1 seems to be involved in creating tumor-induced inflammation in the tumor and its microenvironment.
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Affiliation(s)
- W Kazmierczak
- Department of Otolaryngology and Oncological Laryngology with Subdivision of Audiology and Phoniatry, Jurasz's University Hospital, Bydgoszcz, Poland
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Basta P, Koper K, Kazmierczak W, Wisniewski M, Makarewicz A, Dutsch-Wicherek M, Kojs Z, Popiela TJ, Slusarz R, Dubiel M, Wicherek L. The biological role of Treg cells in ectopic endometrium homeostasis. Histol Histopathol 2014; 29:1217-33. [PMID: 24831778 DOI: 10.14670/hh-29.1217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Although retrograde menstruation is observed in up to 90% of women, endometriosis actually develops in only 15% of women. There is considerable evidence in the literature that ectopic endometrial cells are able to evade immune surveillance and that the immune response in the microenvironment of ectopic lesions is limited. Endometriosis develops when a deficiency in the local immune response has been generated, and progression of the disease is related to the intensity of this process. Over the last couple of decades it has been well known that T regulatory lymphocytes (Tregs) play a crucial role in controlling a variety of physiological and pathological immune responses. In this review we have focused on the physiological alteration of Treg cell infiltration into the endometrium during the reproductive processes of women. We discuss how a disturbance in Treg cell expansion is involved in generating such pathological processes as miscarriage and ectopic pregnancy development. We hypothesize about the role Treg cells might play in the survival of endometriosis foci in ectopic localization and in the evasion of such lesions from host immune surveillance.
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Affiliation(s)
- Pawel Basta
- Department of Gynecology and Oncology, Lukaszczyk Oncological Center, Bydgoszcz, Poland
| | - Krzysztof Koper
- Department of Gynecology and Oncology, Lukaszczyk Oncological Center, Bydgoszcz, and Chair of Gynecology, Oncology and Gynecological Nursing, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, Torun, Poland
| | - Wojciech Kazmierczak
- Outpatient Unit of Otolaryngology, The Lukaszczyk Oncological Center, Bydgoszcz, Poland
| | - Michal Wisniewski
- Outpatient Chemotherapy Department, The Lukaszczyk Oncological Center, Bydgoszcz, Poland
| | - Adrianna Makarewicz
- Outpatient Chemotherapy Department, The Lukaszczyk Oncological Center, Bydgoszcz, and Chair and Clinic of Oncology and Brachytherapy of the Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, Torun, Poland
| | | | - Zbigniew Kojs
- Center of Oncology, Gynecologic Oncology Department, M. Sklodowska-Curie Memorial Institute, Krakow, Poland
| | - Tadeusz J Popiela
- Center of Oncology, Gynecologic Oncology Department, M. Sklodowska-Curie Memorial Institute, Krakow, Poland
| | - Robert Slusarz
- Chair of Gynecology, Oncology and Gynecological Nursing, Ludwik Rydygier Collegium Medicum, and Department of Neurological and Neurosurgical Nursing, Gynecology and Neonatology Collegium Medicum, Nicolaus Copernicus University, Torun, Poland
| | - Mariusz Dubiel
- Chair of Gynecology, Oncology and Gynecological Nursing, Ludwik Rydygier Collegium Medicum, and 9. Department of Maternal-Fetal Medicine, Gynecology and Neonatology Collegium Medicum, Nicolaus Copernicus University, Torun, Poland
| | - Lukasz Wicherek
- Department of Gynecology and Oncology, Lukaszczyk Oncological Center, Bydgoszcz, and Chair of Gynecology, Oncology and Gynecological Nursing, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, Torun, Poland.
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Popiela TJ, Brzegowy P, Kibil W. [Embolisation procedures in acute haemorrhage from lower gastrointestinal tract]. Przegl Lek 2013; 70:303-307. [PMID: 23944101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Colonoscopy remains a method of choice in the management of acute bleeding from the lower gastrointestinal tract. However, the efficiency of the method to locate the source of bleeding and control is significantly lower, when the patient cannot be prepared for the procedure. When the source of bleeding is not possible to locate by endoscopy, the patient usually undergoes major surgery with high risk of complications or even death. The study analyzed the effectiveness of angiography with embolisation of arterial vessels supplying lower gastrointestinal tract as the alternative for surgical operation in cases when endoscopic procedures are ineffective in locating the source of bleeding. The analysis was conducted in 27 patients fulfilling the above criteria. All patients underwent diagnostic angiography which localized the source of bleeding in 19/27 (70%) of them. Embolisation procedures performed in 11/27 (41%) patient, while successful control of bleeding was achieved in 9/11 (89%) of them. No complications were found in the analyzed group related to the performed intravascular procedures. Positive effect of angiography, when embolisation is not possible to perform, may be the indication for targeted therapeutic endoscopy or selective surgical resection of the intestinal segment. The embolisation is safe and effective method of controlling acute lower gastrointestinal tract bleeding with low risk of ischemic complications.
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Popiela TJ, Brzegowy P, Paciorek A. [Embolization procedures in acute haemorrhage from upper gastrointestinal tract]. Przegl Lek 2013; 70:308-312. [PMID: 23944102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Perioperative mortality in the pa tients with acute haemorrhage from upper gastrointestinal tract undergo ng unsuccessful routine endoscopic procedures is relatively high. The study evaluates the effective ness of upper gastrointestinal tract arterial vessels embolization as the alternative procedure to surgery. The analyses was conducted in 48 patients who underwent unsuccessful endoscopic procedures. All patients were subjected to diagnostic angiogra phy, which allowed to localize or con firm the haemorrhage site in 37 (77%) cases. Twenty eight (58%) out of 48 analyzed patients underwent embolizaion and hemorrhage was successfully controlled in 19 (68%) of these cases There were no complications in the analyzed group related to the perfor med intravascular procedures. Intravascular embolization of upper gastrointestinal tract is the alternative to surgical operations and effective method to be used in the treatment of acute haemorrhages from upper ga strointestinal tract in the patients who underwent unsuccessful endoscopic procedures.
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Brzegowy P, Popiela TJ. [Endovascular embolisation in epistaxis]. Przegl Lek 2013; 70:248-250. [PMID: 23944091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Epistaxis because of frequent occurrence is an important clinical problem. Endovascular embolisation plays important role in treatment of patients with epistaxis which not un. dergoing with conservative therapy,. The aim of this study is presentation of own experiences with embolisation in epistaxis. Embolisation was performed in 36 patients with epistaxis using different embolic materials: coils, a sponge, cyjanoacrylic glue, PVA. In 35 cases embolisation of external carotid artery branches was done. In one case of direct carotid-cavernous fistula em bolisation was performed through the internal carotid artery. Early success of embolisation was assessed in all cases. In 5 patients rebleeding occurred and additional embolisation or surgical procedure were done. There was no complica. tions after embolisation. Endovascular embolisation in epistaxis is en effective method and alternative to surgery.
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Affiliation(s)
- Paweł Brzegowy
- Katedra Radiologii, Uniwersytet Jagielloński, Collegium Medicum
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Brzegowy P, Popiela TJ, Urbanik A. [Results of stent assisted endovascular treatment of intracranial aneurysms]. Przegl Lek 2013; 70:251-254. [PMID: 23944092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Aim of the study was presentation of own experiences with stent assisted endovascular treatment of cerebral aneurysm. Employment of cerebral stents extended endovascular embolisation technique to wide neck cerebral aneurysms. From March 2007 and October 2011 40 patients - 28 (70%) women and 12 (30%) man with 43 intracranial aneurysms were treated with stent assisted embolisation technique. All aneurysms were saccular, 27 (79.4%) situated on internal carotid artery, 4 (11.8%) on basilar artery, 2 (5.9%) on posterior cerebral artery, 1 (2.9%) on vertebral artery. 3 (9%) aneurysms were ruptured and rest 31 (91%) were unruptured. Control angiography revealed in 16 (37%) cases complete embolisation, in 15 (34.8%) residual and in 10 (23.2%) uncompleted embolisation. Complications appeared in 4 (9%) cases - 3 times acute stent thrombosis and once intracranial bleeding. Stent assisted endovascular treatment of intracranial aneurysm allows to effectively treatment of wide neck aneurysm and decreases amount of recanalisation . However more complicated technique and higher risk of complication require experience and appropriate qualification for that treatment.
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Affiliation(s)
- Paweł Brzegowy
- Katedra Radiologii, Uniwersytet Jagielloński, Collegium Medicum
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Kibil W, Hodorowicz-Zaniewska D, Popiela TJ, Kulig J. Vacuum-assisted core biopsy in diagnosis and treatment of intraductal papillomas. Clin Breast Cancer 2012; 13:129-32. [PMID: 23127339 DOI: 10.1016/j.clbc.2012.09.018] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Revised: 09/27/2012] [Accepted: 09/28/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND The aim of this study was to assess the value of mammographically-guided and ultrasonographically-guided vacuum-assisted core biopsy (VACB) in the diagnosis and treatment of intraductal papillomas of breast and to answer the question of whether biopsy with the Mammotome (Mammotome; Cincinnati, OH) allows the avoidance of surgery in these patients. PATIENTS AND METHODS In the period 2000 to 2010, a total of 1896 vacuum-assisted core biopsies were performed, of which 1183 were ultrasonographically guided and 713 were mammographically guided (stereotaxic). RESULTS In 62 patients (3.2%) histopathologic examination confirmed intraductal papilloma, and in 12 patients (19.4%) atypical lesions were also found. Open surgical biopsy specimens revealed invasive cancer in 2 women these 12 women (false-negative rate, 16.7%; negative predictive value, 83.3%). Biopsy specimens from the remaining 50 patients (80.6%) revealed papilloma without atypia, and further clinical observation and imaging examinations did not show recurrence or malignant transformation of lesions. Hematoma developed in 3 (4.8%) patients as a complication of biopsy; surgical intervention was not required in any of the patients. CONCLUSION VACB is a minimally invasive and efficient method for diagnosing intraductal papilloma of the breast. If histopathologic examination confirms a benign lesion and corresponds to the clinical presentation, surgery may be avoided. However in all cases, histopathologic diagnosis of papilloma with atypical hyperplasia or a suspected malignant lesion in imaging examinations, despite negative biopsy results, should always be an indication for surgical excision.
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Affiliation(s)
- Wojciech Kibil
- Ist Chair of General Surgery and Clinic of General, Oncological and Gastroenterological Surgery, Jagiellonian University Medical College, Krakow, Poland.
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Dobrowolska-Bak M, Popiela TJ, Urbanik A. [Hemobilia as a late complication after laparoscopic cholecystectomy--endovascular treatment]. Przegl Lek 2012; 69:379-381. [PMID: 23276042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
A case of 57-year-old woman with hepatic artery pseudoaneurysm associated with fistula into the biliary tract following laparoscopic cholecystectomy. Because of mechanical barrier presence, constricted the blood vessel leading blood into the aneurysm, endovascular embolization with histoacrylate glu was used as a treatment. The use of histoacrylate glu is an effective alternative in hepatic artery pseudoaneurysms treatment, which allowed to get haemostasis by endovascular embolization, especially in cases when it is impossible to use standardly applied microcoils.
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Affiliation(s)
- Małgorzata Dobrowolska-Bak
- Katedra Radiologii Uniwersytet Jagielloński Collegium Medicum Zakład Diagnostyki Obrazowej Szpitala Uniwersyteckiego w Krakowie.
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Buczek M, Popiela TJ, Urbanik A. [Pseudoaneurysma as iatrogenic complication of renal biopsy: management by transcatheter embolization]. Przegl Lek 2012; 69:357-359. [PMID: 23276035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Renal arterial hemorrhage following percutaneous procedures is a rare but severe complication. Hyper-selective renal artery embolization is the first-choice treatment option. We present a case of massive hematuria due to renal pseudoaneurysm developing after biopsy that was managed with transcatheter embolization with coils.
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Affiliation(s)
- Magdalena Buczek
- Katedra Radiologii Uniwersytet Jagielloński Collegium Medicum Zakład Diagnostyki Obrazowej Szpitala Uniwersyteckiego w Kirakowie.
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31
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Gorczyca M, Popiela TJ, Urbanik A. [Endovascular treatment of wide-necked posterior cerebral artery aneurysm using stent]. Przegl Lek 2012; 69:289-291. [PMID: 23276016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Wide-necked intracranial aneurysms can be treated surgically or endovasculary. Endovascular treatment of aneurysm may be proceed by coil placement into the sack of aneurysm through the stent mesh. The present case report thrombosis of wide-necked posterior cerebral artery aneurysm induced by deployment of stent without using coils.
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Affiliation(s)
- Michał Gorczyca
- Katedra Radiologii Uniwersytet Jagielloński Collegium Medicum, Zakład Diagnostyki Obrazowej Szpitala Uniwersyteckiego w Krakowie.
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Łasocha B, Popiela TJ, Brzegowy P, Urbanik A. [Gastroduodenal artery false aneurysm]. Przegl Lek 2012; 69:363-365. [PMID: 23276037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Among visceral arteries false aneurysms most commolny occur in hepatic arteries and their branches. In gastroduodenal artery, the disesase develops in less than 1.5%, although the risk of rupture reaches 70%. A male aged 53, diagnosed with chronic pancreatitis was referred to CT-angiography of aorta with suspicion of gastrodudodenal artery aneurysm. The exam was suggestive for an aneurysm placed near body of pancreas. Admitted a few days later to angiography, the patient was diagnosed with a pseudoaneurysm of gastrodudodenal artery which was subsequently embolized. Although the aneurysm was not as clearly visible in angiography compared to CT, the supplying vessel was explicitly defined, allowing its selective embolizing with coils.
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Affiliation(s)
- Bartłomiej Łasocha
- Katedra Radiologii Uniwersytetu Jagiellońskiego Collegium Medicum Zakład Diagnostyki Obrazowej Szpitala Uniwersyteckiego w Krakowie.
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Popiela TJ, Urbanik A, Brzegowy P, Dobrowolski Z, Lipczyński W. [Baloon dilatation of benign ureteroileal anastomotic strictures]. Przegl Lek 2010; 67:275-278. [PMID: 20687359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The study is presenting own experience with the use of percutaneous balloon angioplasty in the patients with the strictures of ureteroenteric anastomoses. A study group consisted of 11 patients with urinary bladder cancer in whom ureteroenteric anastomosis was performed. All patients developed in the postoperative period ureter strictures or the stenosis at the junction point of ureteroenterostomy resulting in retention of urea in the ureter and pyelocalyceal system requiring percutaneous nephrostomy. High-pressure balloon catheter inserted through the nephrostomy was placed centrally in the point of stenosis. The catheter was insufflated with physiological saline solution and contrast agent until ballon waisting disappeared. Subsequently temporary double-J catheter with diameter of 9 F or 12F was inserted and remained in place for the period of 1-6 months. All patients were followed-up for 2 years, and underwent control USG and CT examinations. Fourteen urethral dilatations of bilateral strictures were performed in 3 patients and in 9 patients with unilateral strictures. In 10 (71%) cases the symptoms of stenosis disappeared for the period of 1 year. Procedure of ballon dilatation follow by introduction of the double-J catheter should be method of first choice in all cases of benign ureteroileal anastomotic strictures.
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Affiliation(s)
- Tadeusz J Popiela
- Katedra Radiologii Uniwersytet Jagiellońliski Collegium Medicum, Zakład Diagnostyki Obrazowej Szpitala Uniwersyteckiego w Krakowie.
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Popiela TJ, Urbanik A, Słowik A. [Results of thrombolyses procedures in acute ischemic cerebral stroke realized in Kraków 2004-2007--Grant Ministry of Science and Information]. Przegl Lek 2010; 67:284-288. [PMID: 20687361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
To lower the number of complications of acute cerebral ischemic stroke and to reduce the time of rehabilitation in these patients it is necessary to induce treatment within the first 3 hours of the onset of the stroke. Early intervention however, is possible only in cases with the confirm localized ischemic focus visualized in one of the diagnostic imaging methods. The most widespread is CT, hovewer the first symptoms of ischemic stroke can be seen not beforel2 hours of the onset. The study evaluated the effectiveness of early diagnostics of ischemic stroke using perfusion CT (pCT) with subsequent intravenous or intra-arterial thrombolysis. The patients with ischemic stroke confirmed by pCT and qualified to thrombolysis in the first 3 hours of the onset of the stroke were randomly selected to intravenous or intra-arterial thrmobolysis. Those, who were 3 to 6 hours of the onset of the stroke were qualified to intra-arterial thrombolysis. A study group consisted of 377 patients hospitalized due to ischemic stroke. Of these pCT was performed in 76 cases, intravenous thrombolysis in 4 and intra-arterial thrombolysis in 2. Clinical condition substantially improved in 3 patients. Obtained results indicate the necessity to introduce pCT to the routine diagnostics of the acute ischemic stroke. A small number of patients eligible for thrombolysis does not allow to compare the effectiveness of intra-arterial and intravenous thrombolysis, however the project allowed to work out the efficient system of diagnostics and treatment of the acute ischemic stroke in the area of Krakow based on the standards used in the European countries.
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Affiliation(s)
- Tadeusz J Popiela
- Katedra Radiologii Uniwersytet Jagielloński Collegium Medicum, Zakład Diagnostyki Obrazowej Szpitala Uniwersyteckiego w Krakowie.
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Brzegowy P, Urbanik A, Popiela TJ. [Application 3D DSA and angiographic CT in interventional neuroradiology]. Przegl Lek 2010; 67:300-305. [PMID: 20687364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
AIM Modern angiographs used in interventional neuroradiology are equipped with advanced imaging techniques like three-dimensional angiography (3D DSA) and Angiographic CT. The aim of this paper is presentation of application these methods based on our experience. METHOD Both method--Angiographic CT and 3D DSA--use "C" arm rotation technique around the patient. Obtained data are processed to three-dimensional images (in 3D DSA) or (in Angiographic CT) to computer tomography (CT)--like reconstruction: multiplanar (MPR), maximum intensity (MIP) and volume rendering (VR). DISCUSSION Angiography 3D DSA is nowadays a basic method in diagnostics of cerebral aneurysms. Three-dimensional images allow for precise evaluation of the aneurysm, qualification for treatment, facilitate embolisation procedures and evaluation of efficiency of the treatment. Angiographic CT (like CT) allows for evaluation of the most important brain structures like: ventricular system, subarachnoid cisterns and less brain tissue. The main application of this technique is evaluation of endo-vascular procedures in respect of hemorrhagic complications. Possibility of quick imaging of the brain and detection of intracranial hematoma, intraventricular hemorrhage with developing hydrocephalus, brain edema, allows for immediately reaction. CONCLUSION 3D DSA and Angiographic CT are methods which in interventional neuroradiology make easier preparing the diagnosis of vascular pathologies and performing intravascular treatment. Angiographic CT allows for quick evaluation of potential complications after endovascular procedures without transfer patient outside angiographic room.
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Affiliation(s)
- Paweł Brzegowy
- Katedra Radiologii Uniwersytet Jagielloński Collegium Medicum, Zakład Diagnostyki Obrazowej Szpitala Uniwersyteckiego w Krakowie.
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Popiela TJ, Sikora J, Klimek M, Basta P, Niemiec T, Dobrogowski J, Kotlarz A, Rudnicka-Sosin L, Dutsch-Wicherek M. The analysis of CD34 antigen immunoreactivity level in invasive ductal breast cancer with respect to the presence of lymph node metastases. Neuro Endocrinol Lett 2008; 29:443-446. [PMID: 18766141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/28/2008] [Accepted: 06/20/2008] [Indexed: 05/26/2023]
Abstract
BACKGROUND Angiogenesis is a basic process that enables neoplasms to thrive. Microvessel density (MVD) evaluation is an accepted parameter for assessing the angiogenesis process within a tumor. The aim of the present study has been to assess the number of microcapillaries in both invasive ductal breast cancer with the presence of metastases in regional lymph nodes and in invasive ductal breast cancer without such metastases. METHODS The CD34 antigen immunoreactivity level was assessed by immunohistochemistry in both types of invasive ductal breast cancer. Tissue samples were obtained from 40 patients and were divided into two groups according to whether or not there were lymph node metastases. RESULTS The patients with lymph node metastases exhibited statistically significantly higher numbers of stained microcapillaries than the patients who did not have lymph node metastases. CONCLUSION Thus the number of stained microcapillaries as evaluated by using the CD34 immunoreactivity level seems to be a useful predictor for the development of local lymph node metastases in female invasive ductal breast cancer.
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MESH Headings
- Adult
- Aged
- Antigens, CD34/analysis
- Breast Neoplasms/blood supply
- Breast Neoplasms/metabolism
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/blood supply
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/secondary
- Female
- Humans
- Immunohistochemistry
- Lymph Nodes/metabolism
- Lymph Nodes/pathology
- Lymphatic Metastasis/pathology
- Middle Aged
- Neoplasm Invasiveness
- Neovascularization, Pathologic
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Affiliation(s)
- Tadeusz J Popiela
- 1st General Surgery Department of the Jagiellonian University, 40 Kopernik Str, 31-501 Krakow, Poland
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Popiela TJ, Wicherek L, Radwan M, Sikora J, Banas T, Basta P, Kulczycka M, Grabiec M, Obrzut B, Kalinka J. The differences in RCAS1 and DFF45 endometrial expression between late proliferative, early secretory, and mid-secretory cycle phases. Folia Histochem Cytobiol 2007; 45 Suppl 1:S157-S162. [PMID: 18292826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
Abstract
RCAS1 expression is related to the regulation of activated immune cells and to connective tissue remodeling within the endometrium. DFF45 seems to play an important role in the apoptotic process, most likely by acting through the regulation of DNA fragmentation. Its expression changes within the endometrium seem to be related to the resistance of endometrial cells to apoptosis. The aim of the present study was to evaluate RCAS1 and DFF45 endometrial expressions during ovulation and the implantation period. RCAS1 and DFF45 expression was assessed by the Western-blot method in endometrial tissue samples obtained from 20 patients. The tissue samples were classified according to the menstrual cycle phases in which they were collected, with a division into three phases: late proliferative, early secretory, and mid-secretory. The lowest level of RCAS1 and the highest level of DFF45 endometrial expression was found during the early secretory cycle phase. Statistically significantly higher RCAS1 and statistically significantly lower DFF45 endometrial expression was identified in the endometrium during the late proliferative as compared to the early secretory cycle phase. Moreover, statistically significantly higher RCAS1 and statistically significantly lower DFF45 expression was found in the endometrium during the mid-secretory as compared to the early secretory cycle phase. The preparation for implantation process in the endometrium is preceded by dynamic changes in endometrial ECM and results from the proper interaction between endometrial and immune cells. The course of this process is conditioned by the immunomodulating activity of endometrial cells and their resistance to immune-mediated apoptosis. These dynamic changes are closely related to RCAS1 and DFF45 expression alterations.
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Affiliation(s)
- Tadeusz J Popiela
- Department of Gynecology, Obstetrics and Oncology of the Jagiellonian University, Kraków, Poland
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Popiela TJ, Klimek M, Wicherek L, Dutsch-Wicherek M, Galazka K, Rudnicka-Sosin L. The characterization of the exposure to immune mediated apoptosis and the regulation of immune cytotoxic activity in the environment of a neoplasm and in decidua. Neuro Endocrinol Lett 2006; 27:779-85. [PMID: 17187008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/30/2006] [Accepted: 09/15/2006] [Indexed: 05/13/2023]
Abstract
Acquiring the immune-mediated apoptosis and the ability to regulate the cytotoxic immune response are the main phenomena playing fundamental roles in such situations as neoplasm survival and creation of immune tolerance during pregnancy. The aim of this study was to investigate these phenomena through the evaluation of metallothionein and RCAS1 proteins in neoplasm and its healthy environment (clear surgical margin), physiological conditions in placenta and its environment (decidua) and the comparison to non-neoplasmatic lesions originating from the environment (nasal polyps, endometriosis). We have shown that the growth of RCAS1 expression was simultaneous to the infiltration of activated immunological cells of tumor environment as well as decidua. The activity of immunological cells was in our study selectively suppressed. Metallothionein expression growth was also observed in healthy tumors stroma and in decidua probably in response to the growing cytotoxic activity and tumor spread. Alterations in RCAS1 and Metallothionein expression seem to be associated with local immune dysfunction in nasal polyps and endometriosis. In conclusion, the ability to compensate the growing cytotoxic immune response is physiologically observed in decidua, the lost of this ability in tumor environment might participate in the development of tumor spread.
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Popiela TJ, Rudnicka-Sosin L, Dutsch-Wicherek M, Klimek M, Basta P, Galazka K, Wicherek L. The metallothionein and RCAS1 expression analysis in breast cancer and adjacent tissue regarding the immune cells presence and their activity. Neuro Endocrinol Lett 2006; 27:786-94. [PMID: 17187007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/17/2006] [Accepted: 11/25/2006] [Indexed: 05/13/2023]
Abstract
INTRODUCTION The generation of proper immune response in the tumor environment seems to be essential in antitumor defense. RCAS1 expression has been shown to participate in the regulation of immune cytotoxic activity, metallothionein participates in the protection of cells against immune mediated apoptosis. Since MT and RCAS1 expression is observed within healthy tumor environment we aimed to focus on the proteins expression in tumor and its healthy adjacent tissue in invasive ductal breast cancer regarding the immune cells presence and activity. MATERIAL AND METHODS RCAS1, metallothionein, CD3, CD56, CD4, CD25, CD69, CD68 and CD16 antigens expression was assessed by immunohistochemistry in invasive ductal breast cancer. Tissue samples were obtained from 45 patients and were grouped according to the presence of lymph nodes metastases. Two groups were obtained: with and without lymph nodes metastases. RESULTS Significant differences were observed in RCAS1 and metallothionein expression in tumor and significant differences in metallothionein expression in healthy stroma regarding the presence of lymph nodes metastases. The significantly higher RCAS1 expression was noticed in tumor in comparison to stroma in patients with the presence of lymph nodes metastases. No such difference was observed in patients without the metastases. Significantly higher metallothionein expression was identified in tumor than in stroma in both groups of patients, with and without lymph nodes metastases. These changes in RCAS1 and metallothionein expression were significantly related with the changes in the number and activity of immune cells. CONCLUSION RCAS1 and metallothionein expression in breast cancer healthy stroma seems to be essential for the coexistence of cytotoxic immune cells and normal epithelial cells. The loss of the ability to compensate the growing cytotoxic immune response in the environment might participate in the development of tumor spread.
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MESH Headings
- Analysis of Variance
- Antigens, CD/immunology
- Antigens, CD/metabolism
- Antigens, Neoplasm/immunology
- Antigens, Neoplasm/metabolism
- Apoptosis/immunology
- Breast Neoplasms/immunology
- Breast Neoplasms/metabolism
- Carcinoma, Ductal, Breast/immunology
- Carcinoma, Ductal, Breast/metabolism
- Female
- Gene Expression Regulation, Neoplastic
- Humans
- Immune Tolerance/immunology
- Immunity, Cellular/physiology
- Lymphatic Metastasis/immunology
- Mammary Glands, Human/immunology
- Mammary Glands, Human/metabolism
- Metallothionein/immunology
- Metallothionein/metabolism
- Statistics, Nonparametric
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Affiliation(s)
- Tadeusz J Popiela
- 1st Department of General Surgery, Jagiellonian University, Krakow, Poland
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Wicherek L, Klimek M, Skret-Magierlo J, Czekierdowski A, Banas T, Popiela TJ, Kraczkowski J, Sikora J, Oplawski M, Nowak A, Skret A, Basta A. The obstetrical history in patients with Pfannenstiel scar endometriomas--an analysis of 81 patients. Gynecol Obstet Invest 2006; 63:107-13. [PMID: 17028436 DOI: 10.1159/000096083] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2006] [Accepted: 08/08/2006] [Indexed: 01/25/2023]
Abstract
INTRODUCTION The participation of immune tolerance during pregnancy was suggested to be an important factor predisposing to the implantation of decidual cells after cesarean section in Pfannenstiel scar. Delivery at term is related to the termination of immune tolerance to fetal antigens that is maintained throughout pregnancy. Substantial proportion of cesarean section deliveries is performed before the onset of true term labor. The aim of this study was to analyze the clinical symptoms of spontaneous beginning of labor in pregnant women in whom cesarean sections were performed and in whom Pfannenstiel scar endometriomas were observed during follow-up. MATERIALS AND METHODS We have retrospectively analyzed 81 patients following the surgical removal of scar endometrioma after cesarean section. Obstetrical histories of cesarean sections in the number of 5,370 preceding the occurrence of the scar endometrioma were analyzed. These data were collected in six different Gynecological and Obstetrical wards in Malopolska Province in Poland. Analysis of data was started by the retrospective evaluation of regular uterine contractions, uterine cervix ripening before cesarean section and the indications for surgery. RESULTS In 67 women from the group of 81 patients cesarean sections were performed with unripe uterine cervix and without the presence of regular uterine contractions. Elective indications for cesarean sections were predominant in this group of women. The relative risk of scar endometriomas occurrence following cesarean sections performed before onset of labor in comparison to cesarean sections following spontaneous onset of labor was statistically significantly higher [RR = 2.16, 95% CI = 1.21-3.83; OR = 2.18, 95% CI = 1.22-3.89]. CONCLUSIONS Cesarean section performed before spontaneous onset of labor may increase substantially the risk of occurrence of scar endometriomas.
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Affiliation(s)
- Lukasz Wicherek
- Department of Gynecology and Infertility, Jagiellonian University, Krakow, Poland.
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Wicherek L, Galazka K, Popiela TJ, Dutsch-Wicherek M, Czekierdowski A, Pabian W, Banas T, Migdal M, Klimek M. Metallothionein expression and infiltration of cytotoxic lymphocytes in uterine and tubal implantation sites. J Reprod Immunol 2006; 70:119-31. [PMID: 16427139 DOI: 10.1016/j.jri.2005.12.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2005] [Revised: 11/21/2005] [Accepted: 12/06/2005] [Indexed: 11/21/2022]
Abstract
INTRODUCTION In spite of increasing number of immune cells in the endometrium during the decidualization, the integrity of endometrial tissue in each menstrual cycle is maintained by adaptive changes in expression of several factors that regulate activity of immune cells and concomitant hormonal alterations during the menstrual cycle. This regulatory function of endometrium is also related to resistance to apoptosis, in which metallothionein (MT) may play a role. MATERIALS AND METHODS Study group included 26 women with spontaneous abortion and 18 patients with tubal ectopic pregnancy. Control group included 17 women whose endometrial tissue samples were taken during the normal secretory cycle phase. Expression of metallothionein (MT), CD56 and CD69 were assessed in tissue samples by immunohistochemistry. RESULTS The number of CD56-positive cells was significantly higher in women with ruptured than unruptured ectopics. MT expression was higher in tubal mucosa distant from the implantation site in ruptured compared to unruptured ectopics. It was found also to be significantly lower than in decidua taken from women with spontaneous abortion. CD69 expression was similar in women with spontaneous abortion as well as patients with ruptured ectopics compared to the control group. On the other hand, CD69 expression in unruptured ectopics was significantly lower than in women with spontaneous abortion and the control group. CONCLUSION The concentration of immune cells and increase of their activity in tubal mucosa, with insufficient protection against immune-mediated apoptosis assessed by MT expression, might result in tubal rupture during ectopic pregnancy.
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MESH Headings
- Abortion, Spontaneous/immunology
- Abortion, Spontaneous/metabolism
- Adult
- Antigens, CD/biosynthesis
- Antigens, CD/immunology
- Antigens, Differentiation, T-Lymphocyte/biosynthesis
- Antigens, Differentiation, T-Lymphocyte/immunology
- Apoptosis/immunology
- Apoptosis/physiology
- CD56 Antigen/biosynthesis
- CD56 Antigen/immunology
- Decidua/immunology
- Decidua/metabolism
- Embryo Implantation/immunology
- Embryo Implantation/physiology
- Fallopian Tubes/immunology
- Fallopian Tubes/microbiology
- Female
- Humans
- Immunohistochemistry
- Lectins, C-Type
- Lymphocytes/cytology
- Lymphocytes/immunology
- Metallothionein/biosynthesis
- Metallothionein/immunology
- Pregnancy
- Pregnancy, Ectopic/immunology
- Pregnancy, Ectopic/metabolism
- Uterus/immunology
- Uterus/metabolism
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Affiliation(s)
- Lukasz Wicherek
- Gynecology and Infertility Department, Jagiellonian University, 23 Kopernik Street, 30-501 Krakow, Poland.
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Arodź T, Kurdziel M, Popiela TJ, Sevre EOD, Yuen DA. Detection of clustered microcalcifications in small field digital mammography. Comput Methods Programs Biomed 2006; 81:56-65. [PMID: 16310282 DOI: 10.1016/j.cmpb.2005.10.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2004] [Revised: 10/02/2005] [Accepted: 10/04/2005] [Indexed: 05/05/2023]
Abstract
The most frequent symptoms of ductal carcinoma recognised by mammography are clusters of microcalcifications. Their detection from mammograms is difficult, especially for glandular breasts. We present a new computer-aided detection system for small field digital mammography in planning of breast biopsy. The system processes the mammograms in several steps. First, we filter the original picture with a filter that is sensitive to microcalcification contrast shape. Then, we enhance the mammogram contrast by using wavelet-based sharpening algorithm. Afterwards, we present to radiologist, for visual analysis, such a contrast-enhanced mammogram with suggested positions of microcalcification clusters. We have evaluated the usefulness of the system with the help of four experienced radiologists, who found that it significantly improves the detection of microcalcifications in small field digital mammography.
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Affiliation(s)
- Tomasz Arodź
- Institute of Computer Science, AGH University of Science and Technology, al. Mickiewicza 30, 30-059 Kraków, Poland.
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Zabińska-Popiela M, Wicherek L, Gałazka K, Dutsch-Wicherek M, Kaim I, Popiela TJ, Krzysiek J, Basta A. [Comparative analysis of CD56 lymphocytes and CD69 antigen expression in endometrium during decidualization]. Przegl Lek 2006; 63:176-8. [PMID: 17083158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
INTRODUCTION The exceptionality of endometrium, differentiating it from other epithelial tissues is related with its ability to regulate the number and activity of infiltrating immunological cells according to menstrual cycle phases. The aim of this study was a comparative evaluation of the number of CD56 positive cells, as well the analysis of CD69 antigen expression during decidualization. MATERIALS AND METHODS The expression of CD56 and CD69 antigens was analyzed using the immunohistochemistry method in 20 decidual tissue samples derived after curettage following spontaneous abortion and in 38 endometrial tissue samples obtained during hysterectomy performed because of benign myoma diagnosis. The endometrial tissue samples were divided regarding to the menstrual cycle phases. Following phases were distinguished: early proliferative, mid-proliferative, late proliferative, early secretory, mid secretory and late secretory. RESULTS The higher CD56 positive cells were recognized in the endometrium during mid secretory cycle phase. The number of CD56 positive cells was significantly lower in endometrium, independent of menstrual cycle phase in comparison to endometrium following abortion. The expression of CD69 antigen was observed to increase beginning with early secretory cycle phase and remained at high level during the secretory cycle phase and the abortion. CONCLUSIONS The observed differences in the number of CD56 positive cells during decidualization without the changes in immune cells activity evaluated using CD69 antigen expression may indicate the participation of activated mononuclear cells in the normal development of pregnancy beginning with implantation.
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Affiliation(s)
- Marta Zabińska-Popiela
- Klinika Endokrynologii Ginekologicznej, Collegium Medicum, Uniwersytetu Jagiellońskiego w Krakowie
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Klimek M, Wicherek L, Galazka K, Tetlak T, Popiela TJ, Kulczycka M, Rudnicka-Sosin L, Dutsch-Wicherek M. Cycle dependent expression of endometrial metallothionein. Neuro Endocrinol Lett 2005; 26:663-6. [PMID: 16380693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/13/2005] [Accepted: 10/17/2005] [Indexed: 05/05/2023]
Abstract
OBJECTIVES Molecular changes observed in endometrium with respect to menstrual cycle changes seem to be crucial for the reproductive function. Accumulation of cytotoxic cells increases the exposure of endometrial cells to apoptosis. Protection against apoptosis may be reached by endometrial cells by self molecular regulation. Metallothionein was suggested to participate in this process. The aim of our study was to evaluate endometrial MT immunoreactivity with respect to the menstrual cycle phases. MATERIALS AND METHODS MT expression was assessed using immunohistochemistry method in 47 endometrial tissue samples derived from randomly selected patients with respect to the menstrual cycle phases--proliferative and secretory with distinguishing early, mid and late subphases in each. RESULTS MT expression changes were observed respectively to hormonal fluctuations with the highest level during mid secretory phase and its respective decrease during the early, late secretory and mid proliferative menstrual cycle phases. The lowest MT immunoreactivity level was disclosed during early proliferative phase. CONCLUSION Significant differences in MT expression observed in endometrium with respect to menstrual cycle changes might suggest MT participation in endometrial cells protection against apoptosis.
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Affiliation(s)
- Marek Klimek
- Department of Gynecology and Infertility, Jagiellonian University, Krakow, Poland
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Dutsch-Wicherek M, Popiela TJ, Klimek M, Rudnicka-Sosin L, Wicherek L, Oudinet JP, Skladzien J, Tomaszewska R. Metallothionein stroma reaction in tumor adjacent healthy tissue in head and neck squamous cell carcinoma and breast adenocarcinoma. Neuro Endocrinol Lett 2005; 26:567-74. [PMID: 16264399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/08/2005] [Accepted: 07/27/2005] [Indexed: 05/05/2023]
Abstract
INTRODUCTION An accumulation of genetic alterations forming the field of cancerization is an important event for the transformation from normal to cancer cell in multistep carcinogenesis. Histopathologically healthy tumor adjacent tissue might be considered as a cancerization field which is typified by genetic changes required for the development of cancer. Metallothionein (MT) is considered to be a protective and anti-apoptotic protein. The aim of our study was to evaluate the MT expression in head and neck squamous cells carcinoma and breast adenocarcinoma and their histologically healthy adjacent tissue. MATERIALS AND METHODS We have sampled 29 tissue samples in total derived from head and neck cancers and 29 samples of their clear surgical margins, 33 breast adenocarcinomas and 33 clear surgical margins. Antibody recognizing MT-1 was used for immunohistochemical analysis. RESULTS MT expression was revealed in 85,7% of head and neck cancers and 94% of breast adenocarcinomas. It was found in all tumor adjacent tissue. MT expression was statistically significantly higher in tumor adjacent tissue than in cancer tissue in cases with the presence of lymph node metastases in both, breast adenocarcinoma and head and neck squamous cell carcinoma. Generally stroma seems to respond to the presence of cancer by the expression of MT, even in tissues which normally do not express MT. CONCLUSIONS MT might be a normal or protective reaction of healthy adjacent tissue to the presence of tumor.
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Wicherek L, Popiela TJ, Galazka K, Dutsch-Wicherek M, Opławski M, Basta A, Klimek M. Metallothionein and RCAS1 expression in comparison to immunological cells activity in endometriosis, endometrial adenocarcinoma and endometrium according to menstrual cycle changes. Gynecol Oncol 2005; 99:622-30. [PMID: 16112719 DOI: 10.1016/j.ygyno.2005.07.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2005] [Revised: 06/24/2005] [Accepted: 07/05/2005] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Endometrium is a specialized organ in which phenomena controlling the level of cell proliferation and apoptosis are marked. The aim of our study was to determine the presence of proteins involved in apoptosis and proliferation: RCAS1, MT and the number of CD56-positive cells and their activity to elucidate their possible role in the development of adenocarcinoma and endometriosis. MATERIALS AND METHODS MT, RCAS1, CD56-positivity and CD69 expression were assessed in 55 tissue samples by Western blot and immunohistochemistry methods. RESULTS We found that endometrium during secretory menstrual cycle phase is characterized by significantly higher RCAS1 and higher MT expression than in proliferative phase. The number of CD56-positive cells and the CD69 antigen expression was significantly increased. Endometrial adenocarcinoma was characterized by significantly increased RCAS1 expression, while MT expression was comparable to the level found in the secretory phase. The number of CD56-positive cells was significantly decreased and their activity was comparable to the level found in the secretory phase. Endometriosis was accompanied by significantly lower RCAS1 and MT expressions, with lower number of CD-56 positive cells and lower expression of CD69 antigen in comparison to the secretory phase. CONCLUSIONS The ability of endometrium to determine cytotoxic activity (RCAS1 expression changes) and high protection against DNA damage (MT expression) with concomitant changes in the number of immune cells and their activity, observed in normal endometrium during the menstrual cycle phases seems to be fundamental for pathological features of endometrial adenocarcinoma and endometriosis.
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Affiliation(s)
- Lukasz Wicherek
- Gynecology and Infertility Clinic of Jagiellonian University, 23 Kopernika Street, 31-501 Krakow, Poland.
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Klimek M, Wicherek L, Popiela TJ, Skotniczny K, Tomaszewska B. Changes of maternal ACTH and oxytocinase plasma concentrations during the first trimester of spontaneous abortion. Neuro Endocrinol Lett 2005; 26:342-6. [PMID: 16136012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/15/2005] [Accepted: 07/27/2005] [Indexed: 05/04/2023]
Abstract
INTRODUCTION The labor at term finishes normal pregnancy. Both labor at term and first trimester spontaneous abortion are connected with increasing cytotoxic immune response within decidua. Th1 cytokines including IL-2 and INF-gamma are able to exert an effect on HPA axis and result in ACTH secretion. Oxytocinase serum level during pregnancy rises with the fetal development and arrest of oxytocinase serum growth might indicate the its development impairment, what might result in spontaneous abortion. MATERIAL AND METHODS The study group consisted of 27 patients with clinical symptoms of missed abortion. A control group consisted of 89 pregnant women, who were successfully treated because of infertility. Immunoassay was used to measure ACTH plasma concentration. Oxytocinase plasma activity was established using l-cystine-di-beta-naphthylamide as a substrate. RESULTS In the present study, significant increase in ACTH plasma concentration was observed during first trimester of spontaneous abortion. These patients were not characterized by significant increase of oxytocinase plasma level. CONCLUSIONS The observed ACTH rise during spontaneous abortion might be also related to the alterations at the maternal-fetal interface and the response of HPA axis to the growing cytotoxic activity.
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Affiliation(s)
- M Klimek
- Department of Gynecology and Infertility, Jagiellonian University, Krakow, Poland.
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Wicherek L, Klimek M, Czekierdowski A, Popiela TJ, Galazka K, Tetlak T, Gilowski A, Dutsch-Wicherek M. The placental RCAS1 expression during stillbirth. Reprod Biol Endocrinol 2005; 3:24. [PMID: 15963226 PMCID: PMC1184098 DOI: 10.1186/1477-7827-3-24] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2005] [Accepted: 06/17/2005] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Independently of the fetal death cause the beginning and course of stillbirth is closely related with the growing cytotoxic activity at the maternal-fetal interface. RCAS1 participates in the inhibition of maternal immune response during pregnancy. The alterations of RCAS1 protein expression in placental cells seem to determine the beginning of the labor and participate in the placental abruption. The aim of the present study was to investigate RCAS1 expression in placentas obtained following stillbirths or normal term births. METHODS RCAS1 expression was evaluated by Western blot method with the use of monoclonal anti-RCAS1 antibody in 67 placental tissue samples. Pregnant women were divided into four groups according to the mode of labor onset--spontaneous or induced, and the type of labor, stillbirth or labor at term. Placental beta-Actin expression was chosen as a control protein. Relative amounts of placental RCAS1 were compared with the use of Student's t-test, whereas beta-Actin control data were compared with the use of Mann-Whitney U test. RESULTS The average relative amount of RCAS1 was significantly lower in women with induced stillbirths than in women with induced labor at term. Similarly, significantly lower RCAS1 placental levels were observed in patients with spontaneous stillbirths than in women with spontaneous labor at term. Significant differences in RCAS1 expression were also observed with the respect to the beginning of the stillbirth: spontaneous and induced. Lowest RCAS1 placental levels were observed in women with spontaneous stillbirth. CONCLUSIONS These preliminary results indicate that the alterations of RCAS1 expression in the human placenta may be involved in the changes of maternal immune system that take place during stillbirth.
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Affiliation(s)
- Lukasz Wicherek
- Department of Gynecology and Infertility of Jagiellonian University, 23 Kopernik Str, 31–501 Krakow, Poland
| | - Marek Klimek
- Department of Gynecology and Infertility of Jagiellonian University, 23 Kopernik Str, 31–501 Krakow, Poland
| | - Artur Czekierdowski
- Ist Department of Gynecology of the Medical University in Lublin, 16 Staszica Str, 20–081 Lublin Poland
| | - Tadeusz J Popiela
- Radiology Department of Jagiellonian University, 19 Kopernik Str, 31–501 Krakow, Poland
| | - Krystyna Galazka
- Department of Pathomorphology Jagiellonian University, 17 Grzegórzecka, 31–531 Krakow, Poland
| | - Tomasz Tetlak
- Department of Gynecology and Infertility of Jagiellonian University, 23 Kopernik Str, 31–501 Krakow, Poland
| | - Andrzej Gilowski
- Department of Gynecology and Infertility of Jagiellonian University, 23 Kopernik Str, 31–501 Krakow, Poland
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Kłek S, Kulig J, Popiela T, Kołodziejczyk P, Szybiński P, Popiela TJ, Urbanik A. The value of modern ultrasonographic techniques and computed tomography in detecting and staging of pancreatic carcinoma. Acta Chir Belg 2004; 104:659-67. [PMID: 15663271 DOI: 10.1080/00015458.2004.11679639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE to assess the clinical value of ultrasonographic methods and computed tomography in diagnosing and staging pancreatic carcinoma. METHODS prospective clinical trial of 140 patients (64 women and 77 men; mean age 59,6) operated on for pancreatic carcinoma between 2000 and 2004. In each case helical CT, routine-, color- and power Doppler and 3-D USG were performed to detect and stage cancer. Analyses of accuracy, sensitivity, specificity, PPV and NPV of ultrasonographic methods and CT were made. RESULTS 3-D USG showed the best accuracy of local staging (T): 95.6%. CT was the most accurate in lymph node assessment: 91.3%. The accuracy of CT, 3-D USG and power-Doppler at detecting vascular infiltration was 93.1%. CONCLUSIONS diagnostic accuracy of modern ultrasound techniques is comparable to helical CT in detecting and staging pancreatic carcinoma. USG is recommended due to the relatively low cost, non-invasiveness and availability of the procedure.
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Affiliation(s)
- S Kłek
- 1st Department of General Surgery, Collegium Medicum Jagiellonian University, Krakow, Poland.
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Urbanik A, Chrzan R, Popiela TJ, Wojciechowski W, Podsiadło-Kleinrok B, Grotyńska M, Brzozowska-Czarnek A. [Role of computed tomography in diagnosis of the vascular system]. Przegl Lek 2003; 59:611-5. [PMID: 12638331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
CT Angiography (CTA) is becoming a popular method used in the diagnosis of the vascular system. The authors present own experience acquired from 163 CTA examinations. In 98 cases, the CT angiography images were the elprimary indications for surgery or intervention procedures. Follow-up CTA examinations were performed in 65 of the cases. CT angiography is a reliable method in vascular diagnostics. Further progress in the development of this technique will lead to the replacement conventional angiography in most clinical diagnostic indications.
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Affiliation(s)
- Andrzej Urbanik
- Katedra Radiologii Collegium Medicum Uniwersytet Jagielloński, 31-501 Kraków, ul. Kopernika 19.
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