Eyeball muscles' diameters versus volume estimated by numerical image segmentation.

PURPOSE: To determine the clinical usefulness of the numerical segmentation image technique (NSI) in estimating the volume of extraocular muscles and to compare this value to widely used measurements of single diameters of the muscles. METHODS: Forty-five patients underwent magnetic resonance examinations in 1.5-T scanner. SE T1 sequences in transversal and coronal planes were provided and data were sent to a personal computer, where the degree of exophthalmos, horizontal diameter of medial rectus muscles, and vertical diameter of inferior rectus muscles were determined on the basis of two-dimensional images. The quantity estimation of all eye muscles volumes using NSI application in three-dimensional space was carried out with use of level set segmentation algorithm. RESULTS: A strong correlation between the total eye muscle volume and degree of exophthalmos was determined. The usefulness of measuring single diameters for estimating the muscles' enlargement was confirmed. The difference between a single muscle's volume and its width also was confirmed. Estimates of muscle volume correlate with the degree of exophthalmos more accurately than measurements of single diameters. CONCLUSIONS: The NSI technique is a clinically useful application, providing objective data calculated individually for each orbit. It allows an objective estimation of the pathologic processes leading to exophthalmos and may be especially helpful in monitoring discrete changes in the muscles volume during treatment.

Advanced tracheal carcinoma--a therapeutic significance of HDR brachytherapy in palliative treatment.

The purpose of this study was to determine the benefit of high dose rate endotracheal brachytherapy as an exclusive palliative treatment of obstructive tracheal cancer. Thirty-five patients with advanced tracheal carcinoma were treated between May 1999 and March 2001 in Greatpoland Cancer Center. They were qualified for brachytherapy due to life-threatening situations. Fourteen patients were irradiated using three fractions 7.5 Gy each one every week, six patients received three fractions 10 Gy each one every week and fifteen patients received one fraction of 10 Gy. Survival time was compared with chosen clinical factors (age, sex, Karnofsky status, tumor location, lymph nodes involvement and percent of obturation) and prescribed dose. The median survival (Kaplan-Meier) for all patients was 6.6 months. Patients with an endoscopically controlled complete remission 4 weeks after the treatment had a significantly better survival in comparison to patients with a partial remission or no change of tumor size (p=0.0003). Univariate analysis revealed significant difference between patients with Karnofsky score equal with 60 or lower (28/35, 80%) and higher than 60 (7/35, 20.0%) (p=0.005). Difference between the grade of tumor obturation (more than 60% of tracheal lumen (27/35, 77.1%), 60% or lower (8/35, 22.9%) was found in univariate analysis (p=0.04). In multivariate analysis statistically important prognostic factor for survival was Karnofsky score (p=0.04). Statistical analysis revealed no differences in survival according to sex and age (p=0.43 for age, p=0.19 for sex), tumor localization (p=0.13), lymph node involvement (p=0.48) or fractionation scheme (p=0.62). Exclusive HDR brachytherapy of advanced tracheal carcinoma was a safe palliative method of treatment and caused in many patients prolonged survival and improved quality of life. Most important prognostic factor for survival, confirmed in both univariate and multivariate analysis, was Karnofsky score.

Hepatoprotective effect of the extract and isocytisoside from Aquilegia vulgaris.

The hepatoprotective effect of the ethanol extract (AvEE) and the main fl avonoid compound 4'-methoxy-5,7-dihydroxy fl avone 6-C-beta-glucopyranoside (isocytisoside, ISOC) from the leaves and stems of Aquilegia vulgaris L. were studied using the CCl(4)-induced hepatotoxicity test. The acute toxicity test in mice showed that AvEE can be classi fi ed as nontoxic since a dose of 3000 mg/ kg did not cause mortality. The barbiturate-induced sleeping time prolonged by CCl(4) administration to mice was signi fi cantly reduced after AvEE treatment proving the protective effect of the extract on microsomal drug-metabolizing enzymes.AvEE and ISOC administered to rats 48 h, 24 h and 2 h before, and 6 h after CCl(4) intoxication caused a signi fi cant decrease in the CCl(4)-induced elevation of hepatic enzymes activity in serum, i.e. sorbitol dehydrogenase (SDH), glutamate oxaloacetate and glutamate pyruvate transaminases (GOT, GPT). Both substances induced CCl(4)-diminished erythrocyte superoxide dismutase (SOD) and reduced the activities of glutathione peroxidase (GPx) and glutathione reductase (GR) preliminarily enhanced by CCl(4). The hepatoprotective properties of AvEE and ISOC were con fi rmed by pathomorphological examination of the liver.

Effect of genotype on selected clinical features of Polish cystic fibrosis adults.

UNLABELLED: Cystic fibrosis (CF), the most common autosomal recessive disorder of Caucasians, is caused by the mutations in the gene encoding CFTR (Cystic Fibrosis Transmembrane Conductance Regulator) protein. Until now, approximately 1000 mutations of the CFTR gene have been described. The genotype-phenotype relationships in CF are still not completely understood. This study was undertaken in an attempt to characterise the distribution of CFTR mutations and their effect on selected clinical parameters in a group of Polish CF adults. A total number of 38 adult CF patients (mean age 21.6 +/- 6.8); 18 females & 20 males were enrolled in the study. The CFTR gene identification was conducted with the use of PCR & InnoLipa-CF set. The assessed clinical parameters included: age at diagnosis, age, lung function test, X-ray scored in Brasfield score, weight & height. We found that: (1) the genotypes of the studied population were unevenly distributed (65.8%- genotype deltaF508/M), (2) a high percentage of 3849+10kbC-->T was noted, (3) patients homozygous for the deltaF508 mutation were diagnosed significantly earlier and had a lower body mass index, (4) no differences were observed in the patients' length of life or the progression of lung disease. CONCLUSIONS: 1. In comparison to other populations, Polish adult CF patients display a relatively higher frequency of mild mutations. 2. Late diagnosis of CF in the studied group may be partially caused by a high percentage of CFTR mutations connected with the mild course of the disease that are difficult to identify. 3. Cystic fibrosis should be more commonly taken into consideration in the differential diagnosis in adult patients with milder symptoms.

[Diagnostic problems in a rapid course of Wegener's disease with sudden sensorineural hearing loss]. / Trudnosci diagnostyczne w przypadku choroby Wegenera o gwaltownym przebiegu z objawami usznymi.

A rapid course of Wegener's disease with a sudden sensorineural hearing loss was described. The definitive diagnosis was established post mortem.

[Meigs syndrome--diagnostic difficulties]. / Zespól meigsa--trudnosci diagnostyczne.

Meigs' syndrome in 68 years woman with pleural effusion and ovarian tumour was described. The cause of the pleural liquid in Meigs' syndrome is still not clear. New views on the pathogenesis and diagnostic methods of pleural liquids causes were presented.

[Pulmonary alveolar proteinosis--diagnostic problem]. / Proteinoza pecherzyków plucnych. Problem diagnostyczny.

A case of a 37 years old woman with suspicion of sarcoidosis is presented. However, the course of disease was not typical for sarcoidosis. The previous diagnosis was verified. The results of bronchoalveolar lavage and histological examination of lung biopsy sample revealed features characteristic for pulmonary alveolar proteinosis. The diagnostic methods, clinical course of disease and the ways of treatment are presented.

[In vitro susceptibility to antifungal agents of Candida strains isolated from patients with various diseases of the respiratory tract]. / Wrazliwosc na leki przeciwgrzybicze in vitro szczepów Candida wyizolowanych od chorych na rózne choroby ukladu oddechowego.

The aim of the study was the estimation of in vitro susceptibility to antifungal agents of yeast isolated from sputum of 70 respiratory diseases patients using the disc-diffusion method-antimycogram. The following agents were tested: amphotericin B, 5-fluorocytosine, nystatin, ketoconazole, fluconazole. Only Candida strains were isolated from sputum, 82% of them were Candida albicans. We noted differences in susceptibility to antimycotics of Candida strains. The best antimycotic in vitro was 5-fluorocytosine. 54% of isolated Candida strains were resistant to 1 or more antimycotics.

[Chylothorax in the course of squamous cell lung cancer]. / Wylew chlonki do jamy oplucnej w przebiegu raka plaskonablonkowego pluca.

Chylothorax is a rare condition which might be caused by trauma of the chest, malignant tumors, congenital malformation, or inflammation of lymphatic nodes. It occurs as a complication of malignancy in about 50% of all cases, either as the first and the only symptom or at a very late stage of the disease. We presented a case of the 62 year old male with squamous cell cancer of the right lung, treated by chemo- and radiotherapy. Leakage of lymph to the pleura complicated the clinical status of the patient. Due to the primary disease the patient was treated symptomatically, in the hospital and later on in the out-patient clinic. Actually, eleven years after being diagnosed, despite massive fibrosis of the right lung the patient is doing relativity well, working part time.

[Long-term corticosteroid therapy as a risk factor of osteoporosis in patients with asthma and chronic bronchitis]. / Dlugotrawla kortykosteroidoterapia jako czynnik ryzyka wystapienia osteoporozy u chorych na astme i przewlekle zapalenie oskrzeli.

This work evaluates frequency of steroid induced osteoporosis according to kind of steroid drugs (systemic, inhaled), dose and duration of treatment. In group of 80 young patients with asthma and chronic bronchitis the following examinations have been used: biochemical markers of bone turnover, X-ray of thoracic lumbar part of vertebral column and bone density in quantitative computed tomography of vertebrae L2-L4. Osteoporosis appeared in patients chronically treated with systemic steroids (prednisone) and in patients treated with inhaled steroids in typical dose as well. Usefulness of biochemical markers of bone turnover in connection with quantitative computed tomography in diagnostic of steroid induced osteoporosis has been confirmed.

[Acetylation phenotype in patients with lung cancer]. / Fenotyp acetylacji u chorych na raka pluca.

The acetylation phenotype is genetically predetermined. It might influence the development of several diseases. It can also be changed by the active process of diseases. The aim of the study was to determinate the acetylation phenotype of individuals with lung cancer. Sulfadimidine acetylation study was undertaken in 30 patients with lung cancer and 30 individuals of control group. There is a significantly higher proportion of slow acetylators in the group of patients with lung cancer than in those without the disease.

Neuroendocrine component of different types of the pulmonary carcinoma.

One hundred and seventy lung tumors were examined: 155 squamous cell carcinoma, 12 adenocarcinomas and 3 mixed adenosquamous carcinoma. In electron microscopic examination the neuroendocrine cells were found: in 31 cases of squamous carcinoma, in 9 cases of adenocarcinoma, and 1 case of mixed adenosquamous carcinoma.

Application of electron microscopy and immunocytochemistry in lung cancer diagnosis.

Using bronchofiberoscopy the biopsies of '50 small cell carcinomas of the lung (SCLC) were diagnosed. The material was studied by immunocytochemical methods for cytokeratins and in routine transmission electron microscopy. The presence of bundles of cytokeratins was specific for squamous epithelium, in all histological subtypes of small cell carcinomas. The number and distribution of cytokeratins were described. In whole material we found the neuroendocrine cells in which polymorphic neuroendocrine granules were present.

[Lung cancer simulating dissecting aneurysm of the aorta]. / Nowotwór pluca imitujacy przebieg tetniaka rozwarstwiajacego aorty.

The report analyzes a rare case of lung cancer presenting as a dissecting aortic aneurysm. A 59-year-old patient was admitted to the Department of Cardiosurgery of the Institute of Cardiology, Poznan Medical School, with a preliminary diagnosis of dissecting aneurysm of ascending aorta. The patient had hypertension treated for 5 years and 3 year history of retrosternal pains. He had smoked 20 cigarettes daily for 20 years. On admission a strong chest pain radiating into the ++inter-scapular region was reported. After two days the radiation extended into the lumbosacral area. Blood pressure was 180/100 mmHg. After 7 days paresis of the lower extremities occurred. Ecg showed only hypertrophy of the left ventricle. Chest X-ray revealed dilatation of the mediastinum and enlargement of the lungs, without focal changes. Echo (M + 2D + Doppler) suggested aortic wall dissection in the ascending part and the arch. The DSA examination did not reveal the dissection, which in turn suggested mediastinal tumor. TC presented an extensive infiltration of the upper-medial part of the right lung and invaded right mediastinum. The final diagnosis, oat cell carcinoma, was established after the histopathological analysis of a biopsy specimen taken in the course of bronchoscopy. The patient died at home after two months of oncological treatment. Autopsy was not performed. In spite of considerable progress of the diagnostic technics both dissecting aortic aneurysm and lung cancer still present a very difficult clinical problem.

Sex differences in adrenocortical structure and function. X. Lipid and corticosterone in the rat adrenal as affected by gonadectomy and testosterone or estradiol replacement.

Studies were performed on lipid and corticosterone content in adrenal glands of intact male and female rats and on their relation to gonadectomy and gonadal hormone replacement. Concentration of total lipid, total cholesterol, phospholipid and glycerides is similar in adrenals of adult male and female rats, however their content, due to larger adrenals, is markedly higher in females. Orchiectomy has no effect on concentration of lipid classes studied while their content in adrenals increased. Testosterone replacement resulted in an increase in concentration of total lipid and phospholipid and has no effect on total cholesterol and glyceride concentration. Ovariectomy evoked an increase in total lipid and phospholipid concentration, has no effect on glycerides and lowered total cholesterol concentration in rat adrenals, while estradiol replacement diminished concentration of all classes of lipids studied. Adrenal corticosterone concentration is higher in female than male rat while no differences in BT-positive steroid were observed. Orchiectomy increased corticosterone concentration, after testosterone administration the value did not differ from control. Ovariectomy has no effect and estradiol increases corticosterone concentration in the gland. Performed studies suggest that testosterone increases the concentration of main classes of lipids and decreases the corticosterone concentration in the rat adrenal cortex while estradiol has an opposite effect.

[Use of methylhippuric test in industry for assessing exposure to xylene]. / Zastosowanie testu methylohipurowego w warunkach przemyslowych dla oceny narazenia na ksylen.

Usefulness of methylhippuric test for the evaluation of exposure to xylene in industrial conditions were defined. The agreement between the magnitude of absorbed dose of xylene calculated on the basis of xylene concentration in the air and the dose calculated according to the rate of excretion of methylhippuric acid in the urine of workers exposed to solvent was found.