Search results

1

The Discrete Vortex Method for estimating how surface roughness affects aerodynamic drag acting on a long cylinder exposed to wind

100%

Nowicki A.

Czasopismo Techniczne

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-

PL

This paper focuses on the aerodynamic drag force that acts on a long cylinder standing up to aerodynamic wind in the critical regime of the fluid flow. The core problem addressed here is how surface roughness of a high level and further increase of that level affects the drag. The research is based on computer simulations using the Discrete Vortex Method. A meshless version of the method was applied in order to let the boundary layer form freely in the way of a direct computer simulation. Fundamental ideas behind the Discrete Vortex Method, the original research program and the obtained results are presented. The main conclusion is that a small level of surface roughness may be neglected in engineering estimations.

2

Selected psychosocial aspects of life of patients with a stoma

64%

Nowicki A., Farbicka P.

OncoReview

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2016

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vol. 6

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issue 2

A72-76

EN

Cancer causes huge problems, physical and mental nature mainly. In particular, we cannot forget about the functioning of these patients in the social and spiritual spheres. The increasing trend of incidence of rectal cancer makes the disease is becoming a priority for doctors, nurses and psycho-oncologists. Despite the increasing quality of medical services, patients face a number of problems associated with cancer treatment, which may result in formation of a colostomy. The procedure, which is necessary to save the patient’s life, is often perceived by them as “mutilation”. Acceptance of the disease and satisfaction of life in patients with a stoma after the operation for rectal cancer are dependent on many factors. Social support, living conditions and the time elapsed since creation of the stoma have great impact. “Stoma nurse” plays an extremely important role. Seeing the difficulties in adapting the stoma she should verify the patient’s pessimism as to his/her own self, develops a sense of responsibility from minor to major issues and strengthen a sense of independence.

3

Introduction to ultrasound elastography

64%

Nowicki A., Dobruch-Sobczak K.

Journal of Ultrasonography

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2016

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vol. 16

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issue 65

113-124

EN

For centuries tissue palpation has been an important diagnostic tool. During palpation, tumors are felt as tissues harder than the surrounding tissues. The significance of palpation is related to the relationship between mechanical properties of different tissue lesions. The assessment of tissue stiffness through palpation is based on the fact that mechanical properties of tissues are changing as a result of various diseases. A higher tissue stiffness translates into a higher elasticity modulus. In the 90’s, ultrasonography was extended by the option of examining the stiffness of tissue by estimating the difference in backscattering of ultrasound in compressed and non-compressed tissue. This modality is referred to as the static, compression elastography and is based on tracking the deformation of tissue subjected to the slowly varying compression through the recording of the backscattered echoes. The displacement is estimated using the methods of cross-correlation between consecutive ultrasonic lines of examined tissue, so calculating the degree of similarity of ultrasonic echoes acquired from tissue before and after the compression was applied. The next step in the development of ultrasound palpation was to apply the local remote tissue compression by using the acoustic radiation force generated through the special beam forming of the ultrasonic beam probing the tissue. The acoustic radiation force causes a slight deformation the tissue thereby forming a shear wave propagating in the tissue at different speeds dependent on the stiffness of the tissue. Shear wave elastography, carries great hopes in the field of quantitative imaging of tissue lesions. This article describes the physical basis of both elastographic methods: compression elastography and shear wave elastography.

PL

Od stuleci badanie palpacyjne tkanek stanowi ważne narzędzie diagnostyczne. Nowotwory są zazwyczaj wyczuwane palpacyjnie jako tkanki twardsze od otoczenia. Istotność palpacji związana jest z zależnością wielu zmian tkankowych od ich własności mechanicznych. Palpacyjna ocena twardości lub sztywności tkanek opiera się na fakcie, że wiele chorób powoduje zmiany ich własności mechanicznych. Zwiększona sztywność tkanki oznacza zwiększony moduł sprężystości. W latach 90. ultrasonografia została rozszerzona o opcję badania sztywności tkanek, polegającą na ocenie różnicy w rozproszeniu ultradźwięków na tkance nieuciśniętej i uciśniętej. Jest to statyczna metoda elastografii kompresyjnej. Polega ona na wolnozmiennym ucisku badanego obszaru tkanki i ocenie jej odkształcenia poprzez śledzenie zmian w echach ultradźwiękowych rejestrowanych w kolejnych chwilach uciskania. Wielkość przemieszczenia wyznacza się metodami korelacji wzajemnej pomiędzy następującymi po sobie liniami obrazowymi, a więc obliczając stopień podobieństwa ech ultradźwiękowych przed uciskiem i po ucisku. Kolejnym krokiem w rozwoju palpacji ultradźwiękowej było zastosowanie do lokalnego, zdalnego ucisku tkanki, akustycznej siły promieniowania generowanej przez odpowiednie formownie wiązki ultradźwiękowej sondującej badany narząd. Akustyczna siła promieniowania powoduje niewielkie odkształcenie lub przemieszczenie się tkanki, w wyniku czego powstaje fala ścinania rozchodząca się w tkance z różną prędkością, zależną od sztywności tkanki. Elastografia fali ścinania niesie ogromne nadzieje w zakresie ilościowego obrazowania lokalnych zmian własności tkanki. W artykule opisane zostały podstawy fizyczne obu typów elastografii: kompresyjnej i fali ścinania.

4

Standardy badań ultrasonograficznych Polskiego Towarzystwa Ultrasonograficznego – aktualizacja. Badanie żył kończyn dolnych

64%

Małek G., Nowicki A.

Journal of Ultrasonography

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2014

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vol. 14

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issue 58

287-296

EN

This article has been prepared on the basis of the Ultrasonography Standards of the Polish Ultrasound Society (2011) and updated based on the latest findings and reports. Ultrasound examination of the lower extremity veins is relatively easy and commonly used to confirm or rule out venous thrombosis. However, a relatively easy compression test frequently requires experience, particularly in situations when imaging is difficult (due to lymphedema, dressing or thick tissues). The technique is time-consuming and requires assessment of each deep vein every 1 cm. Lesions in the deep veins cannot be ruled out when the vessels are assessed in only 2–3 points – a full examination is needed. The value of the method is the highest when the proximal section is assessed and the lowest when crural veins are evaluated. Doppler sonography is the basic method used when patients are prepared for a surgery of varicose veins. The assessment of the superficial veins prior to this procedure is tedious and requires knowledge of anatomy together with numerous variants. A considerable challenge is posed by re-assessment of recurrent varicose veins following a previous surgery. The Standards include anatomic nomenclature proposed by the Polish Society for Vascular Surgery and Polish Society of Phlebology, which should facilitate communication with clinicians. The most beneficial patient positions have been thoroughly discussed in terms of safety and effectiveness of the examination. Sometimes during such an examination, no venous pathology is found, but other changes with symptoms that suggest deep thrombophlebitis are detected. In such a situation, it is necessary to conduct an initial (or complete, if possible) assessment of lesions as well as provide recommendations connected with further, more detailed diagnosis.

PL

Pracę przygotowano na podstawie Standardów badań ultrasonograficznych Polskiego Towarzystwa Ultrasonograficznego (2011) i zaktualizowano, opierając się na najnowszych doniesieniach z piśmiennictwa. Badanie ultradźwiękowe żył kończyn dolnych jest metodą względnie prostą i powszechnie stosowaną do rozpoznawania lub wykluczania zakrzepicy żylnej. Z założenia prosta w wykonaniu próba uciskowa bardzo często wymaga dużego doświadczenia, zwłaszcza w sytuacjach utrudniających obrazowanie (obrzęk chłonny, opatrunek czy duża grubość tkanek). Technika badania jest pracochłonna i wymaga oceny każdej żyły głębokiej co 1 cm. Nie można więc wykluczyć zmian w układzie żył głębokich, oceniając naczynia tylko w 2–3 punktach – konieczne jest pełne badanie. Wartość metody jest największa w ocenie żył odcinka proksymalnego, najmniejsza zaś w ocenie żył podudzia. Ultrasonografia dopplerowska stanowi podstawową metodę w przygotowaniu pacjenta do operacji żylaków. Ocena żył powierzchownych przed tym zabiegiem jest żmudna i wymaga znajomości anatomii wraz z licznymi odmianami. Dużym wyzwaniem bywa ocena żylaków nawrotowych, po wykonanej wcześniej operacji. W standardzie uwzględniono mianownictwo anatomiczne zaproponowane przez Polskie Towarzystwo Chirurgii Naczyniowej i Polski Towarzystwo Flebologiczne, co powinno ułatwić komunikację z klinicystami. Szczegółowo omówiono proponowane podczas badania pozycje, najbardziej korzystne ze względu na bezpieczeństwo pacjenta i efektywność wyniku. Wielokrotnie podczas tego badania nie znajduje się patologii żylnej, ale inną, dającą objawy sugerujące zapalenie zakrzepowe żył głębokich. W takiej sytuacji konieczna jest wstępna ocena zmian (lub gdy to możliwe – pełna) i dalsze ukierunkowanie bardziej szczegółowej diagnostyki.

5

Satisfaction with life after radical treatment of cancer

51%

Nowicki A., Duba P., Lemanowicz M.

OncoReview

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2017

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vol. 7

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issue 4

192-198

EN

Introduction: Cancer treatment is multidisciplinary in its character and places a heavy burden on the patient. Quality of life is a concept that is closely related to the satisfaction with life. Cancer patients’ satisfaction with life, especially after recovery, is an increasingly examined indicator of treatment quality. Aim of the study: Evaluation of satisfaction with life in patients after radical cancer treatment. Material and methods: The study included 100 people, 81 women and 19 men of all ages, following radical treatment of various cancers. The study was conducted in 2016 at the Centre of Oncology in Bydgoszcz. The study used the Satisfaction with Life Scale (SWLS), adapted by Z. Juczyński, as well as a sociodemographic data questionnaire. Results: In general, cancer patients have an average level of satisfaction with life – the average score was 22.37 and 6.19 sten. The greatest satisfaction with life (average points) was reported for professionally active people – 22.67, patients between 41–50 years old – 23.5, patients with secondary education – 23.4, and patients with at least one child – 22.73, though the differences were not statistically significant. Additionally, patients 3–5 years after treatment declared a higher satisfaction with life – 23.05, as did patients without concomitant diseases – 22.77, though again the results were statistically non-significant. Conclusions: In general, patients after radical anti-cancer treatment have an average satisfaction with life, and in half of them satisfaction with life is high, regardless of the duration and type of cancer. Sociodemographic factors have no impact on the satisfaction with life scores.

6

The influence of socio-demographic factors on making a decision related to the disease and treatment in women with breast cancer

51%

Nowicki A., Wiśniewska K., Rhone P.

OncoReview

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2015

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vol. 5

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issue 3

A125-132

EN

Introduction. Socio-demographic factors may affect the decision making associated with the disease and the long-term results of treatment. Objective. Exploring the relationship between socio-demographic factors of women treated for breast cancer and decision- making associated with the disease and treatment. Material and methods. The study involved 100 women aged 30 to 72 (mean: 57 years) who were treated at the Oncology Center in Bydgoszcz in 2013–2014 due to breast cancer. A survey questionnaire on socio-demographic factors and data on knowledge about prevention and disease was used in the study. Results. The number of women performing breast self-examination decreased with age; 83% of patients over 50 years old and 76% (p = 0.0001) over 69 years old underwent mainly mammography (p = 0.03). Self-detection of breast tumor also decreased with age and was detected more frequently by the medical personnel (p = 0.0001). More educated women (85%) examined themselves more often than those with primary and vocational education (p = 0.001). According to our assessment, the number of women with knowledge about cancer decreased with age (p = 0.004). The same was true for women in a very good and good financial situation, with 94% of them declaring a higher knowledge level (p = 0.001). Conclusions. Women’s knowledge about breast cancer is not satisfactory, especially in older and less educated women. They obtain knowledge from the Internet mainly and from the medical staff in the smallest degree. Young women up to 49 years of age perform self-examination to detect breast cancer most often, while older women use mammography. Almost all women immediately report to the doctor and are admitted to clinics after detecting lesions with mammography or self-examination.

7

Depression and Anxiety Before and After Breast Amputation in Women

51%

Nowicki A., Szwed A., Laskowski R.

Polish Journal of Surgery

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2008

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vol. 80

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issue 7

377-384

EN

Breast cancer is the most frequent malignancy in women. The diagnosis of neoplastic disease produces or deepens anxiety and depression in a patient.The aim of the study was to assess the influence of surgery and socio-demographic factors on the level of anxiety and depression in women suffering from breast cancer.Material and methods. 50 women (30-71 years old, mean age 54.7 years) with breast cancer were enrolled into the study. They were assessed two times - before and after surgery. To evaluate the level of depression BECK scale was used. It consists of 21 points that determine the level of depression. HAD scale containing seven descriptions of a patient's status was used to assess the level of anxiety.Results. Most of patients (17(34%) women had vocational education. More than half of the analyzed women were free of depression both before and after surgery, 50 % and 60% respectively. 2% of all women had extremely deep depression preoperatively. A normal and high level of anxiety before surgery was felt by 21 (42%) and 21 (42%) women respectively.A high level of anxiety was found in 15 patients (30%) postoperatively. The level of depression after surgery decreased in 32 women and psychological status was deteriorated in 9 patients according to BECK scale. The level of anxiety after surgery decreased in 30 patients and deteriorated in 8 cases according to HAD scale. The intensity of anxiety decreased after surgical treatment. The most intensive increase in depression was observed in women with secondary education (51 points) before surgery and 35 points in women with vocational education after surgery. The highest level of anxiety before surgical treatment was found in women with secondary as well as vocational education (21 points). Whereas the highest level of anxiety after surgery was observed in patients with secondary education. (21 points). The hardest depression was observed in working patients (51 points) preoperatively and they still had the hardest depression (35 points) postoperatively, too. The level of anxiety was highest in working women both preoperatively and postoperatively (21 points). The most intensive depression before surgery was observed in women at middle social status (35 points) and this tendency was observed also after surgery. The level of anxiety before surgery was the highest in women with good and middle social status (21 points). After surgery it was the highest in patients with middle social status (21 points). The most intensive depression before surgical treatment was found in patients between 51 and 60 years old (51 points). The hardest depression after surgery was observed in women between 41 and 50 years old (35 points). The highest level of anxiety was felt by patients between 41 and 50 and between 51 and 60 years old (21 points) preoperatively and in women between 51 and 60 years old (21 points) postoperatively.Conclusions. The intensity of depression and anxiety in women with breast cancer decreased significantly after mastectomy. Patients with university education had lower levels of anxiety and depression both before and after surgery. Working women with average social status had the highest levels of anxiety and depression both before and after surgical treatment. The age of a patient did not influence significantly on the levels of anxiety and depression both before and after surgery.

8

Evaluation of the quality of life of women treated due to breast cancer using amputation or breast conserving surgery in the early postoperative period

51%

Nowicki A., Licznerska B., Rhone P.

Polish Journal of Surgery

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2015

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vol. 87

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issue 4

174-180

EN

Selection of the treatment method in breast cancer patients and its consequences may affect their quality of life through somatic, psychical, and social factors. The aim of the study was early evaluation of the quality of life of women after mastectomy vs. breast conserving surgery. Material and methods. The study included 100 women aged 31 to 79 years (mean: 57) who underwent surgery due to breast cancer (amputation: 52; breast conserving surgery: 48 women) at the Cancer Centre in Bydgoszcz in 2014. The QLQ C-30 and QLQ BR-23 questionnaires were used to evaluate the quality of life of the patients 3 months after surgery. Results. In the Global Health Status/QoL domain, the mean score for women after amputation and breast conserving surgery was 49 and 53, respectively; for Physical Functioning, the scores were 70 and 75, and for Role Functioning, 62 and 68, respectively. For Cognitive Functioning, the mean score was 74 and 73; for Emotional Functioning - 62 and 68, and for Social Functioning 64 and 60, respectively. The difference in the arm symptoms domain was significant at 46 and 33 points, respectively (p = 0.004). The patients treated with breast conserving surgery had a better body image than women after amputation - the mean score was 52 and 66, respectively (p = 0.01). Conclusions. With respect to Global Health Status/QoL and Physical Functioning, the quality of life of women in the early postoperative period was similar in women after breast amputation and those who underwent breast conserving surgery. Patients treated with breast conserving surgery had a better score for body image, while those who underwent amputation more often suffered from arm symptoms, such as pain, oedema, and problems with raising of the limb.

9

The quality of life, general health, and pain sensations after treatment in the assessment of breast cancer patients

51%

Nowicki A., Trybulska J., Rhone P.

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vol. 8

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issue 2

54-59

EN

Introduction: General quality of life, health, and sensation of pain caused by cancer are connected with the physical, mental and social state of a human being. Aim of the study: The aim of the study is self-assessment of life quality, general health, and pain sensations in breast cancer patients after adjuvant therapy with chemo- and radiotherapy. Material and methods: The study was carried out in 2016 at the Professor Franciszek Łukaszczyk Oncology Clinic in Bydgoszcz. 56 women with breast cancer were qualified for the study, upon completion of treatment. Socio-demographic and clinical data was used, questions 29 and 30 from the QLQ C30 questionnaire, and the Memorial Pain Assessment Card. Results: Generally, the average self-assessment of health and life quality was 4.98 and 5.18 points, respectively. Age, education, marital status and the place of residence did not have any influence on the self-assessment of health and life quality (p > 0.05). 46 women (82.1%) did not take analgesics. Those patients who did not take analgesics assessed their health and life quality better, with the average scores of 5.3 and 5.63 points, respectively. The average for pain intensity was 2.05 on a 0–11 scale. Most women – 14 (25%) – assessed their mood as very good. The mood average was 2.91 points. Only the administration of analgesics influenced the mood score (p = 0.001). Conclusions: Women with breast cancer after radical treatment assess their health and life quality as good. Those not taking analgesics assess their health and life quality better and are decidedly in a better mood than those taking such medications. Socio-demographic factors do not influence self-assessment of health, life quality, or pain intensity.

10

Knowledge about prevention, risk factors and treatment in women with diagnosed breast cancer. Whether the disease affects their healthy behaviour?

51%

Nowicki A., Rusak K., Rhone P.

OncoReview

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2015

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vol. 5

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issue 2

A81-90

EN

Objective. The assessment of knowledge about prevention and risk factors of women with diagnosed breast cancer. Material and methods. The study involved 100 women aged from 28 to 82 years (median 56.2 years) who were treated at the Oncology Center in Bydgoszcz in 2014 for breast cancer. Author’s original questionnaire containing questions on knowledge about breast cancer as well as environmental and demographic data was used in this research. Results. Self-examination of a breast was made by 83% of women, 85% of women benefited from invitations for mammography. 56% of women knew how often mammography should be repeated but only 28% knew at what age it should be started. Tumor in a breast (20.5%) and “pulling” nipples (14.4%) were the most frequently reported symptoms of a cancer. In terms of risk factors, genetics (32.2%) and unhealthy lifestyle (16.3%) were the factors pointed by women most often. Every third women indicated only one factor while every four indicated three factors. 69% of the respondents increased their knowledge after falling ill, from the Internet (20.5%) as well as from information leaflets and brochures (16.6%). Women’s knowledge about breast cancer was at the edge of low and average levels and the average value was 11.7 points. More knowledge had women with higher education 12.95 points, single 12.9 and young women 12.3. Conclusions. The knowledge about the disease among women with diagnosed breast cancer was unsatisfactory and did not depend on age, marital status, place of residence, type of work but on education level only. Older and uneducated women had less knowledge, particularly about factors increasing the risk of developing the disease. The Internet, information leaflets and brochures were the primary source of knowledge about the disease, not a doctor or a nurse. Women with breast cancer were aware of the importance of preventive tests. They declared that they can perform self-examination. The most frequently reported symptoms of cancer are tumor and “pulling” nipples.

11

Analysis of 7965 screening colonoscopies and treatment results of detected colorectal cancers – experiences of one center

51%

Nowicki A., Kula Z., Lemanowicz M.

OncoReview

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2016

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vol. 6

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issue 3

A134-142

EN

Introduction: Colorectal cancer is one of the most common cancers in both sexes and is one of the leading causes of death in Poland and the world. An effective method to prevent the development of colorectal cancer (CRC) is the detection of polyps during a screening colonoscopy and their removal. Objective: The aim of the study was to evaluate results of screening for early detection of colorectal cancer by colonoscopy. Material and methods: The study was based on analysis of medical records of 7965 patients who underwent colonoscopy as part of the National Screening Program (NSP) for Early Detection of Colorectal Cancer in the 2000–2014 period. Results: Polyps were removed in 2900 (36.4%) patients, among whom 1885 (23.6%) had adenomas, which were more frequent in men (32.9%). Tubular adenomas were observed in 1685 patients (21.1%), tubulo-villous adenomas were detected in 157 patients (2%) and villous adenomas – in 43 (0.5%) of them. Sixty-three (0.79%) colorectal cancers were detected in various clinical stages, including adenocarcinoma in situ in 3 patients. Probability of 5-year survival rate of colorectal cancer amounted to 74% while 10-years survival was reached in 63% of patients. Conclusions: The detection rate of polyps, adenomas and carcinomas thanks to screening colonoscopy was 36.4%, 23.6% and 0.79% respectively, while the probability of 5-year survival was 74%. An improvement in the quality of colonoscopy was observed in subsequent years of the NSP, which translated into better detection of adenomas.

12

Satisfaction with life and health-promoting behaviours in the context of prevention and early detection of breast cancer in physically active women

51%

Nowicki A., Kosicka B., Lemanowicz M.

OncoReview

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2017

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vol. 7

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issue 1

5-14

EN

Objective: Assessment of the impact of life satisfaction in physically active women on their health promoting behaviours in terms of prevention and early detection of breast cancer. Materials and methods: The study, involving 100 women, was carried out in a fitness centre in Bydgoszcz in 2015. The research instruments used included the authors’ self-designed questionnaire and the SWLS life satisfaction score. Results: Women aged 25–34 constituted 57% of the study participants, with 82% of them domiciled in the city, and 74% of them holding secondary or higher education qualifications. 67% of them assessed their knowledge about breast cancer and breast cancer prevention programme as good, 65% of them believed it was impossible to protect oneself from cancer, 68% of them occasionally consumed alcohol. 89% of the respondents engaged in breast self-examination, and 68.4% of the subjects aged 25–34 considered excessive weight/obesity as a risk factor. 61.5% of women aged 45–60 were smokers. Respondents living in the city would dedicate one hour more for physical activity than those from the countryside. 93.2% of women with secondary/tertiary education carried out breast self-examination. Surveyed women received high scores on the scale of life satisfaction, averaging 25.69 points, they were less likely to smoke cigarettes, and more likely to engage in breast self examination (95.5%). Conclusions: Physically active women assess their knowledge on health-promoting behaviours well, lead a healthy lifestyle, and avoid breast cancer risk factors. Physically active women accomplish a high level of life satisfaction, which is especially true for married women with a higher education degree. On the other hand, life satisfaction does not correlate with age, place of residence or marital status. Women presenting a high level of life satisfaction are more involved in health-promoting behaviours, carry out regular breast self-examination, and undergo preventative medical check-ups.

13

Nowe trendy w obrazowaniu raka stercza metodą ultrasonografii przezodbytniczej

45%

Szopiński T., Nowicki A., Záťura F., Gołąbek T., Chłosta P.

Journal of Ultrasonography

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2014

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vol. 14

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issue 58

306-319

EN

Carcinoma of the prostate gland is the most common neoplasm in men. Its treatment depends on multiple factors among which local staging plays a significant role. The basic method is transrectal ultrasound imaging. This examination enables imaging of the prostate gland and its abnormalities, but it also allows ultrasound-guided biopsies to be conducted. A conventional gray-scale ultrasound examination enables assessment of the size, echostructure and outlines of the anatomic capsule, but in many cases, neoplastic lesions cannot be observed. For this reason, new sonographic techniques are implemented in order to facilitate detectability of cancer. The usage of contrast agents during transrectal ultrasound examination must be emphasized since, in combination with color Doppler, it facilitates detection of cancerous lesions by visualizing flow which is not observable without contrast enhancement. Elastography, in turn, is a different solution. It uses the differences in tissue elasticity between a neoplastic region and normal prostatic parenchyma that surrounds it. This technique facilitates detection of lesions irrespective of their echogenicity and thereby supplements conventional transrectal examinations. However, the size of the prostate gland and its relatively far location from the transducer may constitute limitations to the effectiveness of elastography. Moreover, the manner of conducting such an examination depends on the examiner and his or her subjective assessment. Another method, which falls within the novel, popular trend of combining imaging methods, is fusion of magnetic resonance imaging and transrectal sonography. The application of multidimensional magnetic resonance imaging, which is currently believed to be the best method for prostate cancer staging, in combination with the availability of a TRUS examination and the possibility of monitoring biopsies in real-time sonography is a promising alternative, but it is associated with higher costs and longer duration of the examination. This paper presents the most important novel trends in transrectal imaging in prostate cancer diagnosis based on the review of the articles available in the PubMed base and published after 2010.

PL

Rak stercza to najczęstszy nowotwór u mężczyzn. Sposób leczenia zależy od wielu czynników, wśród których bardzo ważną rolę odgrywa ocena miejscowego stopnia zaawansowania. Podstawową metodą jest tutaj ultrasonografia przezodbytnicza. Badanie to pozwala nie tylko na zobrazowanie stercza i jego nieprawidłowości, lecz także na przeprowadzenie biopsji pod kontrolą ultrasonografii. Klasyczne badanie ultrasonograficzne w skali szarości umożliwia ocenę wielkości, echostruktury stercza i zarysów torebki anatomicznej, ale w wielu przypadkach nie uwidacznia zmian nowotworowych. Z tego powodu wprowadza się nowe technologie ultrasonograficzne, aby poprawić wykrywalność raka. Warto zwrócić uwagę na zastosowanie środków kontrastujących w trakcie badania przezodbytniczego, które wraz z obrazowaniem kolorowym dopplerem poprawiają wykrywalność raka: uwidaczniają przepływy niestwierdzalne bez wzmocnienia kontrastowego. Innym rozwiązaniem jest elastografia, wykorzystująca różnicę sztywności w obszarze nowotworowym i w zdrowym, otaczającym chorą tkankę miąższu stercza. Technika ta pozwala na wykrycie zmian niezależnie od ich echogeniczności, dzięki czemu uzupełnia klasyczne badanie przezodbytnicze. Ograniczać skuteczność elastografii mogą wielkość stercza i jego dość dalekie położenie w stosunku do głowicy. Z kolei sposób wykonania badania zależy od doświadczenia badającego i jego subiektywnej oceny. Inną metodą wpisującą się w modny obecnie trend łączenia metod obrazowania jest fuzja rezonansu magnetycznego i badania ultrasonograficznego przezodbytniczego. Wykorzystanie obrazowania wielopłaszczyznowego rezonansu, uznawanego obecnie za najlepszą metodę oceny stopnia miejscowego zaawansowania raka, w połączeniu z dostępnością TRUS i łatwością monitorowania biopsji pod kontrolą ultrasonografii w czasie rzeczywistym to bardzo obiecująca alternatywa – choć wiąże się ze znacząco większym kosztem i wydłużonym czasem badania. Na podstawie przeglądu artykułów dostępnych w bazie PubMed opublikowanych po 2010 roku przedstawiono najważniejsze kierunki rozwoju badania transrektalnego w diagnostyce raka stercza.

14

The influence of ionizing radiation on the properties of starch-PVA films

45%

Abramowska A., Cieśla K. A., Buczkowski M. J., Nowicki A., Głuszewski W.

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issue 3

669-677

EN

The cornstarch: poly(vinyl alcohol) (PVA) films characterized by the alternating ratio of starch:PVA (100:0, 80:20, 60:40, 40:60, 20:80, and 0:100) and containing 30% of glycerol were prepared by solution casting. The films were irradiated with an absorbed dose of 25 kGy with gamma rays in a vacuum and with fast electrons in the air. The films characterized by a high content of starch appeared stiff, while the films characterized by a high content of PVA were highly flexible. The tensile strength and flexibility, as well as swelling and hydrophilicity, increased with the increase in the PVA content in the films. However, the tensile strength and wetting angle values achieved a minimum at an intermediate composition. It was found that irradiation enables to reduce hydrophilicity of the films accompanied by a decrease in their flexibility. No general conclusion concerning the effect of irradiation on tensile strength and swelling behavior can be derived. An increase in the homogeneity of the films and an increase in the compatibility of their components was found by scanning electron microscopy (SEM). Strong interactions of the starch and the PVA components were discovered by diffuse reflectance spectroscopy. Degradation was found to be the prevailing process occurring in the films under the influence of irradiation. The possible accompanying crosslinking is discussed in terms of the gel content in the samples. Creation of various oxidation products in the films characterized by the modified composition was observed under the influence of irradiation carried out in the air. Basing on the obtained results it can be supposed that the selected starch-PVA compositions might appear useful as packagings of the products predicted for radiation decontamination.

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