J R Ladny

Medical University of Bialystok, Belostok, Podlasie, Poland

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Publications (41)13.66 Total impact

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    ABSTRACT: Background/Aim: Type 1 diabetes is one of the most common chronic diseases in children. The aim of the study was to evaluate the catabolism of glycoconjugates in saliva of children with type 1 diabetes, by measurement of the activity of N-acetyl-β-D-hexosaminidase (HEX) in their saliva. Material/Methods: The study was performed in 65 children with type 1 diabetes and 39 healthy children. Salivary HEX activity was determined spectrophotometrically by the method of Zwierz et al. in the modification of Marciniak et al. Protein was determined by the bicinchoninic acid method (BCATM Assay Protein Kit). Concentration of the HEX activity was expressed in pKat/mL and HEX specific activity in pKat/μg of protein. Results: A significant increase in the concentration and the specific activity of HEX in the saliva of children with type 1 diabetes, compared to healthy children, was found. Conclusions: Type 1 diabetes increases salivary catabolism of glycoconjugates reflected by the significant increase in the activity of HEX in the saliva of children with type 1 diabetes compared to healthy children. The salivary HEX activity may be used in the diagnosis of children with type 1 diabetes after confirmation of our results on a larger cohort of children with type 1 diabetes.
    Postępy Higieny i Medycyny Doświadczalnej (Advances in Hygiene and Experimental Medicine) 01/2013; 67:996-999.
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    ABSTRACT: In hospital patients suffering from adverse clinical and biochemical symptoms of malnutrition, it is often necessary to employ parenteral nutrition to avoid the body's tissue becoming broken down by being metabolised. Thus, the patient's welfare and survival can be supported throughout any periods of medical crisis. Two of the enzymes responsible for metabolising glycoconjugates are alpha-fucosidase (FUC) and beta-glucuronidase (GLU), present in lysosomes. They release fucose or glucuronic acid from the non-reducing end of oligosaccharide chains. To determine the effect of parenteral nutrition administered to ill patients, on glycoconjugate metabolism, by measuring serum and urinary activities of FUC and GLU. Material and methods. Blood samples and the daily urine collection were taken from 23 patients' who had been undergoing parenteral nutrition for either 5 or 10 days, as well as from a baseline sample. Enzyme activities in serum and urine were determined by the method of Zwierz et al. Serum FUC activities were significantly lower after 10 days compared to 5, (p< 0.0172), whereas GLU activities were significantly lower after both 5 and 10 days, (p< 0.0007 and p< 0.0208 respectively), compared to levels before starting parenteral nutrition. GLU activities were however higher after 10 days than those after 5 days, (p< 0.0023). In urine, FUC activities were significantly decreased after 10 days compared to 5 days after starting parenteral nutrition, (p< 0.0245). Urine GLU activities were unaffected by parenteral nutrition nor was any effect seen on FUC or GLU activities when calculated per 1mg creatinine. Serum FUC and GLU activities can be used for assessing the effect of parenteral nutrition on glycoconjugate metabolism. The significant decreases of serum GLU activity observed after 5 and 10 days, may serve to indicate that the components of parental nutrition are appropriate and that the body has become suitably adapted to this form of nutrition.
    Roczniki Państwowego Zakładu Higieny 01/2013; 64(3):235-41.
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    ABSTRACT: Introduction: Beta-galactosidase (GAL) is a lysosomal exoglycosidase involved in the catabolism of glycoconjugates through the sequential release of beta-linked terminal galactosyl residues. The stimulation of activity of exoglycosidases and other degradative enzymes has been noted in cancers as well as in alcohol and nicotine addiction separately. This is the first study to evaluate the activity of the serum senescence marker GAL in colon cancer patients with a history of alcohol and nicotine dependence, as a potential factor of worse cancer prognosis. Material and Methods: The material was serum of 18 colon cancer patients and 10 healthy volunteers. Ten colon cancer patients met alcohol and nicotine dependence criteria. The activity of beta-galactosidase (pkat/ml) was determined by the colorimetric method. Comparisons between groups were made using the Kruskal-Wallis analysis and differences evaluated using the Mann-Whitney U test. Spearman's rank correlation coefficient was used to measure the statistical dependence between two variables. Results: The activity of serum GAL was significantly higher in colon cancer patients with a history of alcohol and nicotine dependence, in comparison to colon cancer patients without a history of drinking/smoking (p=0.015; 46% increase), and the controls (p=0.0002; 81% increase). The activity of serum GAL in colon cancer patients without a history of alcohol/nicotine dependence was higher than the activity in the controls (p = 0.043; 24% increase). Discussion/Conclusion: Higher activity of beta-galactosidase may potentially reflect the accelerated growth of the cancer, invasion, metastases, and maturation, when alcohol and nicotine dependence coincide with colon cancer. For a better prognosis of colon cancer, alcohol and nicotine withdrawal seems to be required.
    Postępy Higieny i Medycyny Doświadczalnej (Advances in Hygiene and Experimental Medicine) 01/2013; 67:896-900.
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    ABSTRACT: Background. Severe periodontitis leading to tooth loss is found in 5-15% of most populations worldwide. Aim. The applicability of salivary β -hexosaminidase ( β -HEX A%, percentage of β -HEX A isoenzyme to total β -HEX) and β -HEX B% ( β -HEX B/ β -HEX) indexes was investigated as a possible marker of periodontitis. Methods. Thirty three alcohol-dependent smokers (AS) and 32 healthy controls (C) were enrolled in the study. The activity of β -HEX was measured spectrophotometrically. Results. β -HEX A% was significantly higher and β -HEX B% was lower in AS than in C group. We found a significant correlation between β -HEX A% and gingival index (GI) and an inverse correlation between β -HEX A% and salivary flow (SF), in all groups. Salivary β -HEX A% index in smoking alcoholics at 0.23 had excellent sensitivity (96%) and specificity (91%); the AUC for β -HEX A% was high (0.937). There were no correlations between amount/duration-time of alcohol drinking/smoking and β -HEX A% or β -HEX B%. We found significant correlations between the time period of denture wearing and GI, papilla bleeding index (PBI), and decayed missing filled teeth index (DMFT) and between GI and the amount of smoked cigarettes per day. Conclusion. Bad periodontal state was most likely due to the nicotine dependence. Salivary β -HEX A% is a promising excellent marker for the diagnosis of periodontitis.
    Disease markers 01/2013; 35(5):457-463. · 2.14 Impact Factor
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    ABSTRACT: Background: Carnitine transports fatty acids from the cytoplasm to the mitochondrial matrix, where the fatty acids are oxidized. Chronic alcohol consumption reduces the concentration of carnitine and interferes with oxidative processes occurring in the cell. Aim: The assessment of carnitine concentrations in plasma of chronically intoxicated alcohol dependent persons in a 49-day abstinence period. Material/Methods: The study included 31 patients (5 women and 27 men) aged from 26 to 60 years (44.6± 8.9) and 32 healthy subjects (15 women and 17 men) aged 22-60 years (39.8± 9.4). The patients' alcohol dependence ranged from 2 to 30 years (13.6± 7.5). Examined subjects consumed 75-700 g of ethanol/day (226.9± 151.5). Plasma concentrations of free and total carnitine were measured three times: at the first (T0), 30th (T30) and 49th (T49) day of hospital detoxification. Free (FC) and total (TC) carnitine were determined by the spectrophotometric method. Plasma acylcarnitine (AC) concentration was calculated from the difference between TC and FC; then the AC/FC ratio was calculated. To determine statistically significant differences for related variables, Student's t-test was used. Results: At T0, alcoholics had significantly lower concentration of FC and TC (p < 0.05) in plasma, as compared to the control group. In comparison to controls, at T30, plasma TC and FC (p < 0.01) as well as AC (p < 0.001) were reduced. The lowest concentration of TC, FC and AC (p < 0.001)was found at T49. The ratio of AC/FC at T0 had a tendency to be higher in alcoholics than in the control group (p = 0.05), whereas at T49 it was significantly lower in alcoholics as compared to the control subjects (p < 0.05). Conclusions: Chronic alcohol intoxication causes a plasma deficiency of carnitine. Forty-nine days of abstinence showed a significant decrease in the concentration of TC, FC and AC. Further research is necessary to clarify whether a low level of plasma carnitine after chronic alcohol intoxication is caused by the uptake of blood carnitine by tissues such as liver or muscles. In alcoholics the supplementation of carnitine is recommended in the case of a low level of plasma carnitine.
    Postępy Higieny i Medycyny Doświadczalnej (Advances in Hygiene and Experimental Medicine) 01/2013; 67:548-52.
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    ABSTRACT: INTRODUCTION Changes in the structure of membrane glycoconjugates and in the activity of glycosidases and proteases is significant in the progress of tumor formation. OBJECTIVES To investigate the association of the specific-activity of lysosomal exoglycosidases: N-acetyl-β-D-hexosaminidase (HEX), its isoenzymes A (HEX A) and B (HEX B), β-D-galactosidase (GAL), α-fucosidase (FUC) and α-mannosidase (MAN) with the activity of cathepsin D (CD) in serum, urine and carcinoma tissue of patients with colon adenocarcinoma. PATIENTS AND METHODS In serum, urine and fragments of carcinoma tissue of 12 patients with confirmed histopathologically colon adenocarcinoma, the specific-activity of HEX, HEX A, HEX B, GAL, FUC and MAN, and CD were assayed. RESULTS Lysosomal exoglycosidases and CD have a similar specific-activities in the tissue of colon adenocarcinoma and urine, which are higher than in serum (with the exception of urine which had the highest specific-activity of CD). A positive correlation was found between specific-activity of CD and the specific-activity of HEX, HEX A, FUC and MAN in carcinoma tissue and urine as well as between CD and GAL in urine of patients with colon adenocarcinoma. Negative correlations were observed between the concentration of protein and: the specific activity of HEX, HEX A, FUC, MAN and CD in carcinoma tissue and urine, and GAL in urine. CONCLUSIONS Increased degradation and remodeling of glycoconjugates in the colon adenocarcinoma tissue is reflected by the increased specific-activities of exoglycosidases and CD. There is a high impact of exoglycosidase action on tissue degradation and a potential role for exoglycosidases in the initiation of proteolysis.
    Polskie archiwum medycyny wewnȩtrznej 10/2012; · 1.83 Impact Factor
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    ABSTRACT: The purpose of the study was evaluation the effect of chronic alcohol intoxication and smoking, on the concentration and output of salivary lysozyme. In the study participated 37 persons, consisted of 17 male smoking patients after chronic alcohol intoxication (AS), and 20 control nonsmoking male social drinkers (CNS) with no history of alcohol abuse or smoking. For all participants the DMFT index (decayed, missing, or filled teeth), gingival index (GI) and papilla bleeding index (PBI) were assessed. Resting whole saliva was collected 24 to 48 hours after chronic alcohol intoxication period. Level of lysozyme was assessed by radial immunodiffusion method. The differences between groups were evaluated using Mann-Whitney "U" test. Salivary flow (SF) was significantly lower in smoking alcohol dependent persons than in the control group. It was found a tendency to increase in the concentration of lysozyme and significantly lower lysozyme output in smoking persons chronically intoxicated by alcohol, as compared to the control group. Gingival index was significantly higher in smoking alcohol dependent persons than in the control group, whereas there were no significant differences in PBI and DMFT indexes between these groups. There were no significant correlations between the amount/number and length of alcohol consumption as well as cigarette smoking, and the concentration as well as the output of lysozyme. There were also no significant correlations between salivary lysozyme output/concentration and SF. In conclusion, reduced salivary flow and salivary lysozyme output may impair innate immunity of the oral cavity. Reduced levels of salivary flow and salivary lysozyme output seem to be more likely to be the result of ethanol action than smoking. We confirmed that persons addicted to alcohol and cigarettes have worse periodontal condition than general population, which partially may be due to the decreased protective effect of reduced salivary flow and lysozyme output.
    Folia Histochemica et Cytobiologica 01/2012; 50(4):609-12. · 1.10 Impact Factor
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    ABSTRACT: The relationship between alcohol consumption and glycoconjugate metabolism is complex and multidimensional. This review summarizes the advances in basic and clinical research on the molecular and cellular events involved in the metabolic effects of alcohol on glycoconjugates (glycoproteins, glycolipids, and proteoglycans). We summarize the action of ethanol, acetaldehyde, reactive oxygen species (ROS), nonoxidative metabolite of alcohol--fatty acid ethyl esters (FAEEs), and the ethanol-water competition mechanism, on glycoconjugate biosynthesis, modification, transport and secretion, as well as on elimination and catabolism processes. As the majority of changes in the cellular metabolism of glycoconjugates are generally ascribed to alterations in synthesis, transport, glycosylation and secretion, the degradation and elimination processes, of which the former occurs also in extracellular matrix, seem to be underappreciated. The pathomechanisms are additionally complicated by the fact that the effect of alcohol intoxication on the glycoconjugate metabolism depends not only on the duration of ethanol exposure, but also demonstrates dose- and regional-sensitivity. Further research is needed to bridge the gap in transdisciplinary research and enhance our understanding of alcohol- and glycoconjugate-related diseases.
    Folia Histochemica et Cytobiologica 01/2012; 50(1):1-11. · 1.10 Impact Factor
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    ABSTRACT: It was investigated the effect of chronic alcohol intoxication and smoking, on the output of salivary immunoglobulin A (IgA). In the study participated 37 volunteers: 17 male smoking patients after chronic alcohol intoxication (AS) and 20 control nonsmoking male social drinkers (CNS). The DMFT index (decayed, missing, or filled teeth), gingival index (GI) and papilla bleeding index (PBI) were assessed. Levels of IgA were determined by the enzyme-linked immunosorbent method. There were significantly decreased salivary flow (SF) and IgA output in AS, when compared to the CNS. There were no significant correlations between amount of alcohol/cigarettes as well as duration of alcohol intoxication/smoking, and SF or IgA output, and between IgA and SF. Gingival index was significantly higher in AS than in CNS, and inversely correlated with IgA. It is more probable that SF and IgA decrease, are the result of ethanol action than smoking. Worse periodontal state in smoking alcohol dependent persons than in controls, may be the result of lower IgA protection of the oral cavity due to its decreased output.
    Folia Histochemica et Cytobiologica 01/2012; 50(4):605-8. · 1.10 Impact Factor
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    ABSTRACT: Peroxidase is the most important antioxidant enzyme in saliva. Through peroxidation of thiocyanate inthe presence of H2O2, peroxidase catalyses the formation of bacteriocidic compounds such as hypothiocyanate.The purpose of this study was to evaluate the effect of chronic alcohol intoxication and smoking on the activityof oral peroxidase (OPO). A total of 37 volunteers participated in the study. This cohort consisted of 17 malealcohol-dependent smoking patients after chronic alcohol intoxication (AS group, alcohol + smoking) (meanage: 42 years; range: 26-55) (100-700 g/day of alcohol; 10-20 cigarettes/day) and 20 control male social drinkers(CNS group, control non-smokers) with no history of alcohol abuse or smoking (mean age: 42 years; range:30-53). Salivary peroxidase activity was measured by the colorimetric method. The differences between groupswere evaluated using the Mann-Whitney U test. There was significantly higher activity of OPO (p = 0.00001)and significantly lower salivary flow (SF) (p = 0.007) in alcohol-dependent smokers after chronic alcohol intoxicationcompared to the control group. OPO activity significantly correlated with the number of days of alcoholintoxication, but not with smoking. Gingival index (GI) was significantly higher in smoking alcohol-dependentpersons than in the control group, and correlated with OPO activity. The sensitivity of the OPO test was 70% insmoking alcoholics, while specificity was 95%. The increased activity of OPO suggests chronic oxidative stress ismore likely due to ethanol action than to smoking. Smoking alcohol-dependent persons have a worse periodontalstatus than controls. OPO activity as a marker of chronic alcohol abuse may help in the diagnosis of alcoholism.
    Folia Histochemica et Cytobiologica 01/2012; 50(3):450-5. · 1.10 Impact Factor
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    ABSTRACT: Alcoholism is one of the most frequent dependences among people, leading to damage of the liver and death of the person. Chronic alcohol consumption decreases fatty acid oxidation by interfering with carnitine metabolism and citric acid cycle activity. Block in activity of the citric acid cycle caused by alcohol and its metabolites is partially compensated by increased ketone body production, which results in ketosis. Chronic administration of alcohol induces liver injury, inflammation, cirrhosis, focal necrosis and steatosis. L-carnitine (L-3-hydroxy-4-N, N, N-trimethylaminebutyric acid) is an essential factor in fatty acid metabolism, which plays a major role in transport of activated long-chain fatty acids to sites of β-oxidation in mitochondria. Carnitine also stabilizes cell membranes by removing long-chain acyl-CoA and excess of the acyl group from the body. L-carnitine can be a useful and safe drug in the liver pathology induced by chronic ethanol exposure.
    Postępy Higieny i Medycyny Doświadczalnej (Advances in Hygiene and Experimental Medicine) 01/2011; 65:645-53.
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    ABSTRACT: There were approximately 93,060 deaths from cancers in Poland in 2008, and about 105,000 are predicted for the year 2025. Early detection of cancer is a major problem throughout the world, which is why many researchers are still looking for specific and sensitive markers of malignant tumors. Our work is a review of recent publications on activity of N-acetyl-β-D-hexosaminidase (HEX) and its isoenzymes A (HEX A) and B (HEX B) as potential markers of malignant tumors. HEX is the most active of the lysosomal exoglycosidases, taking part in degradation of glycoconjugates (glycoproteins, glycolipids, proteoglycans). HEX cleaves N-acetyl-D-glucosamine and N-acetyl-D-galactosamine from non-reducing ends of oligosaccharide chains of glycoproteins, glycolipids and glycosaminoglycans. The activity of HEX, and its isoenzymes A (HEX A) and B (HEX B), was determined by spectrophotometric and isoelectric focusing methods. There was a statistically significant increase in activity of HEX in tumors of the kidney, pancreas, thyroid, colon, ovary, brain, salivary gland, stomach and larynx, which suggests potential applicability of HEX and its isoenzymes in cancer diagnosis.
    Postępy Higieny i Medycyny Doświadczalnej (Advances in Hygiene and Experimental Medicine) 01/2011; 65:752-8.
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    ABSTRACT: The purpose of the study was to assess the quality of performance of wideband, phase inversion harmonic power Doppler sonography in the diagnosis of focal nodular. During a period of one year, thirty-one patients with FNH previously confirmed by ultrasound-guided biopsy, surgical resection, dynamic helical computed tomography or magnetic resonance imaging were examined. The study protocol consisted of B-mode gray scale sonography, color Doppler, power Doppler examinations, and helical CT scans. Then PI scans were performed after the injection of 2.5 g of Levovist intravenously. The images obtained by the B-mode gray scale were typical for focal nodular hyperplasia in 13 lesions only (32.5%), and obtained by color, power Doppler sonography in 25 lesions (62%). On the contrary all patients with focal nodular hyperplasia were diagnosed based on the wide-band, phase inversion power Doppler sonography findings. The common enhancement pattern at pulseinversion harmonic US was filling in a central tumor artery with further centrifugal development of contrast. Then during early arterial phase, all typical anatomical features of FNH as 'star sign 'or 'spoke-wheel 'pattern were clearly visible .In 3 cases ,computed tomography and magnetic resonance imaging have failed to disclose pathology while phase inversion sonographic images were completely suggestive which was later confirmed by histologic examination. Our data demonstrates the usefulness of wide-band, phase inversion harmonic power Doppler sonography in the differential diagnosis of hepatic focal nodular hyperplasia by visualizing all characteristic anatomical details.
    Medical science monitor: international medical journal of experimental and clinical research 07/2004; 10 Suppl 3:17-21. · 1.36 Impact Factor
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    ABSTRACT: In men, androgens and especially testosterone are considered responsible for the much higher rate of coronary artery disease. The male gender is an independent coronary artery disease risk factor. An adverse correlation between endogenous testosterone levels and the extent of coronary atherosclerosis has been demonstrated in just one study. In our study, we investigated the associations between endogenous sex hormone levels and the extent of coronary atherosclerosis, ejection fraction of the left ventricle and coronary heart disease risk factors.
    Przegla̧d lekarski 02/2004; 61(8):876-9.
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    ABSTRACT: To determine whether examination of hepatic focal nodular hyperplasia by wide-band, phase-inversion sonography offers any advantages over power and color Doppler sonography in the depiction of specific characteristics of these pathologies. Twenty-six patients were examined. The presence of focal nodular hyperplasia was confirmed by ultrasound-guided biopsy, surgical resection, dynamic helical computed tomography or magnetic resonance. All patients, prior to enhanced sonography, had undergone B-mode gray-scale sonography, color Doppler, and power Doppler examinations. After injection of 2.5 g of Levovist intravenously, analysis of the contrast agent arrival was performed by wide-band, phase-inversion power Doppler sonography. The B-mode gray-scale sonography, color and power Doppler sonography were non-specific for focal nodular hyperplasia in 14 cases in our examination. However based on the wide-band, phase-inversion power Doppler sonography findings all patients with focal nodular hyperplasia were diagnosed. All typical anatomic features of focal nodular hyperplasia such as "star sign" or "spoke-wheel" pattern were clearly visible. In 3 cases, computed tomography and magnetic resonance imaging had failed to disclose pathology while phase-inversion sonographic images were completely suggestive which was later finally confirmed by histologic examination. Our data demonstrate the usefulness of wide-band, phase-inversion power Doppler sonography in the differential diagnosis of hepatic focal nodular hyperplasia by visualizing all characteristic anatomic details.
    Hepato-gastroenterology 01/2004; 51(57):705-8. · 0.77 Impact Factor
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    ABSTRACT: This clinical study investigated the possible associations of male sex hormone with the extensiveness of coronary artery lesions, coronary heart disease risk factors and ejection fraction of the heart. Ninety six Caucasian male subjects were recruited, 76 with positive and 20 with negative coronary angiograms. Early morning, prior to haemodynamic examination all of them had determined levels of total testosterone, free testosterone, free androgen index (FAI), sex hormone-binding globulin (SHBG), oestradiol, luteinizing hormone, follicle-stimulating hormone, plasma lipids, fibrinogen and glucose. The ejection fraction and the extensiveness of coronary lesions of each subject was assessed on the basis of x-ray examination results using Quantitative Coronary Angiography (QCA) and Left Ventricular Analysis (LVA) packages on the TCS Acquisition workstation, Medcon. Men with proven coronary heart disease had significantly lower levels of total testosterone (11.9 vs 21.2 nmol/l), free testosterone (45.53 vs 86.10 pmol/l), free androgen index (36.7 vs 47.3 IU) and oestradiol (109.4 vs 146.4 pmol/l). The level of testosterone was negatively associated with the DUKE Index. The most essential negative correlation was observed between SHBG and atherogenic lipid profile (low high-density lipoprotein, high triglycerides). Ejection fraction was substantially lower in patients (51.85 vs 61.30) (without prior myocardial infarction) with low levels of free-testosterone (23.85 vs. 86.10 pmol/l) and FAI (28.4 vs 47.3 IU). A negative correlation was observed between total testosterone, free testosterone, FAI and blood pressure, especially with diastolic pressure. Men with proven coronary atherosclerosis had lower levels of endogenous androgens than the healthy controls. For the first time in clinical settings it has been demonstrated that low levels of free-testosterone was characteristic for patients with low ejection fraction. Numerous hypothesies for this action can be proposed but all require a proper evaluation process. The main determinant of atherogenic plasma lipid was low levels of SHBG suggesting its main role in developing atheroscerotic lesions.
    The Journal of Medical Investigation 09/2003; 50(3-4):162-9.
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    ABSTRACT: BACKGROUND. The aim of this study was to evaluate the efficacy of three-dimensional (3D) sonography in liver biopsies. Primarily, the diagnosis of hepatic tumors is based on 2D sonography. This method allows the noninvasive evaluation of the anatomical structure and tumor localization. Interpretation difficulties emerge most often during the assessment of tumor boundaries and their relationships to the blood vessels. The study included 19 patients, aged 40-75 years (average, 57.5 years) admitted to the Department of General Surgery due to diagnosed liver tumors. The livers of all the examined patients displayed focal changes. In order to obtain material for histopathologic examinations, percutaneous needle biopsies were performed, with no complications. 3D sonography generated more information about hepatic changes, due to imaging of multiplanar reconstructions in oblique presentations (which are impossible to present in classical 2D), and thus facilitated design of the biopsy. Evaluation of the biopsy needle visualization inside the tumor with the use of both the 2D and the 3D presentations depends on the subjective approach of the examiner. Based on our knowledge and experience in ultrasonography-guided needle biopsy, we believe 3D sonography-guided biopsy has high efficacy.
    Journal of Hepato-Biliary-Pancreatic Surgery 02/2003; 10(1):87-9. · 1.60 Impact Factor
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    ABSTRACT: At present a pancreatic pseudocyst puncture guided by ultrasonography is a treatment of choice in the majority of hospitals. A classical two-dimensional sonography is usually implemented in these cases. However, its shortcomings, mainly in differential diagnosis, are acknowledged by most physicians. The real time monitoring of a fine-needle pseudocyst procedure by two-dimensional ultrasonography is of questionable reliability. In our study we evaluated the usefulness of three-dimensional sonography in the percutaneous fine-needle pancreatic pseudocyst puncture. We examined fifty-two patients diagnosed as having pancreatic pseudocysts on the basis of clinical symptoms and two-dimensional ultrasonography findings. Then the decision to qualify certain patients for the percutaneous fine-needle aspiration guided by ultrasonography was made on the basis of two- and three-dimensional scan results. The next step in our investigation was to implement color Doppler in order to visualize all blood vessels at the planned biopsy site. Three-dimensional sonography was used to monitor the tip of the needle making its way to the pancreatic pseudocyst and later inside the fluid collection. Pancreatic pseudocysts were diagnosed in all of the 52 cases. Three-dimensional sonography was more precise in visualizing the shape and size than two-dimensional ultrasound scans. Three-dimensional presentation can better visualize irregular shapes, local thickenings, and calcification of pseudocyst walls than classical two-dimensional ultrasound scans. The use of subtraction in three-dimensional scans of blood vessels increases the safety in performing biopsies. It makes the aspiration of cytologic materials much safer to perform. In our study we have shown that three-dimensional sonography collects extremely useful information about the status of the pseudocyst structure and it should become a complementary method to classical ultrasonography. This technique when used on a routine basis ought to help us change the inclusion criteria for guided biopsies.
    Hepato-gastroenterology 01/2001; 48(41):1308-11. · 0.77 Impact Factor
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    ABSTRACT: The aim of the study was presentation of our experiences in the diagnostics and treatment of pancreatic carcinoma in confrontation with current opinions. Between 1983 and April 1998 308 patients (198 males and 110 females with mean age 61 years) were treated at our department. In 211 cases tumor was primarily localized in the head and in 97 cases (31.5%) in the body or tail of pancreas. The diagnosis was determined on the basis of clinical symptoms and laboratory investigations. Diagnostic accuracy of performed investigations was as following. Ultrasonography-86%, CT-scan-95%, and ERCP-94%. Ultrasonography or CT guided biopsy and serodiagnostics improved detectability of resectionable carcinoma in the last past years. Among 308 patients, 292 underwent surgery. Since 1997 an intraoperative ultrasonography and cholangioscopy of common bile duct and Virsung were performed as a routine. The procedures depended on the localization and the grade of advance of the tumors. UICC classification of pancreatic tumors, pTNM (4th edition 1987) it was used. Only in 25 patients (8%) (tumors pT1a-bN0M0) it was possible to perform radical operation (resection of the pancreas). However in 172 patients (56%) only palliative procedures were done (pT2N1M0). In 95 patients (31%) only laparotomy and biopsy were performed (tumors pT2N1M1). The study shows that although diagnostic methods are improved, the tumors of the pancreas are diagnosed in stages making unable the radical procedures. Only about 10% of carcinomas are resectable. It is caused by with non-characteristic picture of the disease in its early stage.
    Wiadomości lekarskie (Warsaw, Poland: 1960) 02/1999; 52(9-10):480-7.
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    ABSTRACT: Therapeutic results obtained in the management of severe acute pancreatitis (AP) complications are still unsatisfactory, and mortality rate is about 40%. An improvement in treatment effectiveness can be related to successful control of infections and prevention of uncontrollable sepsis. The aim of the study was evaluation of effectiveness of Tienam in the management of severe acute pancreatitis complications. The clinical material included 24 patients, treated for AP between 1994 and 1996. All of the patients were operated on and 19 of them required at least one reoperation. During primary surgery we performed necrosectomy and continuous peritoneal lavage. The analysis of cultures obtained from infected necrotic tissue, pancreatic abscesses and whole blood showed that the infections were caused mainly by Gram-negative bacteria. The highest efficiency in infections control was observed in the case of Tienam (15% resistant strains). The authors emphasize also the increasing role of Staphylococcus aureus and Candida albicans in secondary infections.
    Przegla̧d lekarski 02/1998; 55(3):133-5.