Andrzej Jaworek

Publications of Andrzej Jaworek

• The +405 GG variant of vascular endothelial growth factor polymorphism is associated with poor prognosis in patients undergoing coronary artery bypass graft surgery.

  Authors: Maciej Pastuszczak, Agnieszka Branicka, Bogdan Jakiela, Ewa Stępień, Andrzej Jaworek, Anna Wojas-Pelc, Bogusław Kapelak, Jerzy Sadowski

  Polskie archiwum medycyny wewnetrznej. 11/2009; 119(11):719-725.

  INTRODUCTION: Coronary artery bypass graft (CABG) surgery is associated with systemic response and increased concentrations of numerous cytokines. Vascular endothelial growth factor (VEGF) relatedINTRODUCTION: Coronary artery bypass graft (CABG) surgery is associated with systemic response and increased concentrations of numerous cytokines. Vascular endothelial growth factor (VEGF) related pathway also seems to be involved in inflammatory response induced by CABG. OBJECTIVES: The aim of this study was to analyze the association between the VEGF gene +405 G>C polymorphism (linked to serum VEGF production), and the short-term clinical outcome during the in-hospital period (30 days) in patients undergoing CABG. PATIENTS AND METHODS: Genotyping for VEGF gene +405 G>C polymorphism was performed in 64 patients with coronary artery disease at a mean age of 66 years (76.6% males), with a mean EuroSCORE (European System for Cardiac Operative Risk Evaluation) of 2.5 (0-2 points: 50% patients, 3-4: 25%, >=5 points: 25%), who underwent CABG surgery. RESULTS: Twenty-one (33%) patients were homozygous for the +405 G allele, 40 (63%) were heterozygous, and 3 were homozygous for the +405 C allele. Ten patients died during the 30-day follow-up (7 subjects with +405 GG genotype, and the other 3 carriers of the +405 C allele). Using multivariate logistic regression analysis, the risk of death after CABG was increased in patients with +405 GG genotype (odds ratio [OR] = 6.7; 95% confidence interval [CI] 1.5-29.4) and with EuroSCORE >=5 points (OR = 4.4; 95% CI 1.1-18.1). CONCLUSIONS: The VEGF gene +405 G>C polymorphism might be a prognostic factor of an adverse postoperative course in patients undergoing CABG surgery. Apart from its proangiogenic action, VEGF may have additional, possibly proinflammatory properties.

• [Psychodermatology: psychological and psychiatrical aspects of dermatology]

  Authors: Hanna Korabel, Dominka Dudek, Andrzej Jaworek, Anna Wojas-Pelc

  Przegla̧d lekarski. 02/2008; 65(5):244-8.

  Psychodermatology descibes an interaction between dermatology and psychiatry and psychology. The incidence of psychiatric disorders among dermatological patients is estimated at about 30 to 60%. ItPsychodermatology descibes an interaction between dermatology and psychiatry and psychology. The incidence of psychiatric disorders among dermatological patients is estimated at about 30 to 60%. It appears that a significant group of patients who seek dermatologist's advice are those who can reveal psychiatric disorders. The most often diagnosed psychiatric disturbances are mood disorders, especially depressive, suicidal ideation and tendencies, anxiety disorders, obsessive disorders and delusional disorders. Knowledge of the psycho-dermatological diseases can contribute to more profitable therapy in both dermatology and psychiatry. This article characterises the particular disorders with their dermatological and psychological aspects. The basic principles of therapeutic interventions for each disorder are also discussed.

• [The latest diagnostical methods and therapy in melanoma]

  Authors: Anna Wojas-Pelc, Lidia Rajzer, Andrzej Jaworek, Wioletta Woźniak

  Przegla̧d lekarski. 02/2006; 63(8):674-80.

  Molecular biology, immunology, diagnostic and treatment of cutaneous melanoma have been analyzed on the basis of current literature due to the increasing frequency of this cancer. Due to theMolecular biology, immunology, diagnostic and treatment of cutaneous melanoma have been analyzed on the basis of current literature due to the increasing frequency of this cancer. Due to the increasing frequency of melanoma it is crucial to detect early the malignant lesions on the basis of physical examination and noninvasive diagnostic methods (dermatoscopy, videodermatoscopy with total body photography). Histopathological examination is conclusive. In diagnostic imaging of early stage melanoma it is very important to evaluate the regional lymph node. In clinical practice, the cross-sectional imaging modalities including computed tomography (CT), ultrasound and magnetic resonance (MR) are widely used to assess lymph nodes. Sentinel lymph node (SLN) biopsy is currenly a valuable and reliable diagnostic procedure for precise staging of patients with clinically no cutaneous melanoma. The presence of SLN metastases is the most important negative factor for clinical outcome in melanoma patients. Introduction of RT-PCR allowed to detect individual cancer cells in tested sample of blood or tissue. Surgical treatment is an essential therapeutic modality in patients with melanoma. Treatment of a primary melanoma involves local excision of the tumour with a margin of skin and subcutaneous tissue. The role of systemic therapy is still a matter of clinical trials. Today's systemic therapy modalities include the use of biological agents (e.g. interferon alfa and interleukin 2) and cytotoxic agents. The efficacy of different types of melanoma vaccines (antigenic, cellular, DNA, GMTV) has been analyzed in numerous clinical trials. Results of these trials are still unsatisfactory. Dendritic cells in melanoma therapy will be very important in the future. Dendritic cells are the most efficient stimulators of T lymphocyte response among professional antygen presenting cells (APC) and the only APC capable to prime naive T lymphocytes with the antygen. A response to weakly immunogenic and tolerogenic tumor antigens can be achived with the use of DC as APC. This review represents an attempt to discuss current evidence on the place of adjuvant and palliative systemic therapy in melanoma.