Monika Knakiewicz

Wroclaw Medical University, Vrotslav, Lower Silesian Voivodeship, Poland

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Publications (7)3.72 Total impact

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    ABSTRACT: Background One of the most important prognostic indicators in gastric cancer is the presence of metastases in lymph nodes. Even now, little is known about lymphangiogenesis in neoplastic tissue, and little is also known about the transmission of a neoplastic cell from the tumor mass into a lymphatic vessel. Methods This study examined the relationships between the density of lymphatic vessels (LVD) stained immunohistochemically with lymphatic vessel endothelial hyaluronan receptor-1 (LYVE-1) and D2-40 (podoplanin) antibodies, the expression of vascular endothelial growth factor (VEGF)-C/D, selected clinical and pathomorphological factors, and the 5-year overall survival of gastric cancer patients. Results Statistical analysis showed no impact of increased intratumoral or peritumoral LVD on gastric cancer patient survival, irrespective of the protein used to stain lymphatic vessels. Analysis showed that the probability of overall survival was decreased in the cases with enhanced VEGF-D immunoreactivity (P = 0.0045). Conclusion The study showed that the studied markers cannot be used to determine the required extent of the surgical procedure, as they have no statistically significant correlation with the degree of progression of the cancer, the stage of the disease assessed according to the TNM 5th classification of malignant tumors, clinicopathological features, and patient survival. VEGF-D is the only marker that can be regarded as an unfavorable prognostic indicator for patients with advanced gastric cancer.
    Full-text · Article · Dec 2012 · Gastric Cancer
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    Monika Knakiewicz · Julia Rudno-Rudzińska · Wojciech Kielan
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    ABSTRACT: Liposarcomas are rare neoplasms most often localized in the retroperitoneal space. Due to there localization, slow growth, and long latency period they often attain large sizes, infiltrating surrounding tissues and organs, before being diagnosed.The study presented the case analysis, diagnostics, multistage surgical treatment and chemotherapy and recurrence rate, as a consequence of the primary tumors' properties. Surgery remains the main method of treatment considering patients' diagnosed with liposarcomas.The role of chemotherapy in the management of the above-mentioned remains an unsolved issue.
    Preview · Article · Aug 2010 · Polish Journal of Surgery
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    ABSTRACT: The aim of the experimental research was to assess the impact of a high damage to brachial plexus elements on the condition of neurons of spinal cord anterior horns. The research was conducted on 12 rabbits, in which the ventral branches of spinal nerves C5-Th1 were severed. During dissections carried out 7, 30, 60, 180 days after the operation the cervicothoracic segment of the spinal cord was collected. The material was subjected to microscopic histological and ultrastructural examinations, which showed that where brachial plexus elements had been severed some of the neurons of spinal cord anterior horns had died and that the process intensity depended on the time that had passed after the injury.
    No preview · Article · Jan 2009
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    ABSTRACT: The aim of the study. Retrospective analysis of indications for splenectomy in hematological diseases, positive effect of this operation and correlations between objective prognostic factors and good response to splenectomy in patients with different hematological indications for splenectomy. Material and methods. 98 adult patients with hematological disorders, who were splenectomised in the years 1994 - 2004. We evaluated the effects of splenectomy in patients with hematological diseases as defined by patient documentation from the 2nd Department of General and Oncological Surgery, Department of Hematology and Hematological Ambulance and the questionnaires that patients completed by themselves. Results. The beneficial effect of splenectomy was observed in the majority of cases of idiopathic thrombocytopenic purpura (41 of 53 patients), acquired hemolytic anemia (2 of 3 patients) and hereditary spherocytosis (8 of 9 patients). Surgery can provide a high frequency of durable response for adult patients with benign hematological disorders. In malignant hematological diseases, splenectomy eliminates consequences of hypersplenism or splenomegaly. Splenectomy in patients with malignant hematological disorders can improve their condition and relieve symptoms of hypersplenism and splenomegaly to improve their quality of life. There were early complications in 11 patients (11.3%). Mortality was 2%. Late complications appeared in 24 patients out of 96 patients, who survived the perioperative period. The most common late complication was moderate respiratory infections. Conclusions. Splenectomy is the most common operation in patients with hematological disorders. Indications for splenectomy have been hindered by the lack of any objective prognostic factors of good postoperative response. Nevertheless, the effect of splenectomy is positive in many patients with benign and malignant hematological diseases.
    No preview · Article · Nov 2007 · Polish Journal of Surgery
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    ABSTRACT: The aim of the study was to investigate the role of certain clinical characteristics and laboratory examination results as prognostic factors for complications after splenectomy in patients with hematological disorders. Material and methods. Ninety-eight adult patients with hematological disorders who underwent splenectomy in our department between years of 1994 and 2004. A retrospective analysis of the medical records from patients who underwent splenectomy was conducted; we divided the patients into 6 groups with various postoperative complications; patients without complications after splenectomy were the control group (the seventh group). Then, we compared patients from groups 1 - 6 with patients from the control group (group 7) before and after splenectomy with regard to various parameters including age, sex, presence of splenomegaly or accessory spleen, the operation's duration, hemoglobin level, number of erythrocytes, leukocytes and plateletes, levels of protein and fibrinogen, activity of prothrombin, INR, APTT, TT, proteinogram and levels of IgG, IgM and IgA. Results. We found that postoperative complications, especially early complications, were more common in groups with malignant hematological complications and in older patients. Infection complications appear more often in men than in women with benign hematological disorders. The sustained platelet level elevation after splenectomy is positively associated with a higher number of thrombotic complications. Also, a lower level of gamma globulin, IgG and IgM after splenectomy correlated with a higher number of infection complications. Conclusions. Splenectomy in patients with hematological disorders is burdened with small risks of postoperative complications. Some clinical and laboratory parameters can be used to select the group of patients with higher risks of complications, but there remains a lack of objective prognostic factors which are sure in every clinical situation.
    No preview · Article · Nov 2007 · Polish Journal of Surgery
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    ABSTRACT: In this study we presented a case of prolonged detention of the temporary flexor tendon prosthesis after implantation in the hand. The silicone-rod removed after more than 5 years was subject to an examination: scanning microscopy, measurement of hardness, scanning differential calorimetry, spectroscopy in infra-red and resistance examinations. The obtained results were compared with a findings after examinations of the new, not used silicone-rod. The greatest changes were observed in maximum value of tensile strength (sigmaB) of the material after test of uniaxial tensile tests, which was about 30% smaller for a silicone-rod after implantation. The other result of investigations didn't reveal an important differences between a new and a used rod. The comparison of the tissue reaction was performed by collection a part of sheath in described case and a part of sheath produced around a rod after 10 weeks period of implantation. The generation of a capsules consisted of fibrous connective tissue with concomitant inflammation process was observed in both cases in histopathological view. Silicone rubber is a material which preserve its most important properties even after prolonged period of implantation.
    Full-text · Article · Feb 2007 · Polimery w medycynie
  • Jerzy Gosk · Monika Knakiewicz · Roman Wiacek · Paweł Reichert
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    ABSTRACT: In this study we presented essential historical data about application of the fibrin glue in microsurgical reconstructions of the peripheral nerves. The technique of the preparation of the fibrin glue and the most important aspects of the clinical practice were described. We presented also our own experience in the use of the fibrin glue (Tissucol Kit firmy Baxter AG, Beriplast P firmy Behring), in microsurgical reconstructions of the brachial plexus and peripheral nerves. The basic principles of management were emphasized and a few clinical cases were presented. Microsurgical reconstructions of the nerves with using of the fibrin glue are atraumatic and don't cause inflammation and granuloma formation. These methods allowed to while away the time of surgical procedure and allowed to perform a microsurgical reconstruction in difficult conditions. Microsurgical reconstructions of the nerves with fibrin glue application may be used individually or in connection with suture materials.
    No preview · Article · Feb 2006 · Polimery w medycynie