Search results

1

Granulomatous prostatitis after intravesical immunotherapy mimicking prostate cancer

100%

Białek W., Rudzki S., Iberszer P., Wronecki L.

Journal of Ultrasonography

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2016

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vol. 16

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issue 67

404-410

EN

Intravesical immunotherapy with attenuated strains of Mycobacterium bovis is a widely used therapeutic option in patients with non-muscle-invasive transitional cell carcinoma of the bladder. A rare complication of intravesical therapy with the Bacillus Calmette-Guérin vaccine is granulomatous prostatitis, which due to increasing levels of prostate-specific antigen and abnormalities found in transrectal examination of the prostate may suggest concomitant prostate cancer. A case of extensive granulomatous prostatitis in a 61-year-old patient which occurred after the first course of a well-tolerated Bacillus Calmette-Guérin therapy is presented. Due to abnormalities found in rectal examination and an abnormal transrectal ultrasound image of the prostate with extensive infiltration mimicking neoplastic hyperplasia a core biopsy of the prostate was performed. Histopathological examination revealed inflammatory infiltration sites of tuberculosis origin.

PL

Immunoterapia dopęcherzowa oparta na podawaniu atenuowanych szczepów Mycobacterium bovis jest szeroko stosowaną opcją terapeutyczną u pacjentów z przejściowonabłonkowym rakiem pęcherza moczowego nienaciekającym mięśniówki. Rzadkim powikłaniem dopęcherzowej terapii szczepionką Bacillus Calmette-Guérin jest ziarniniakowe zapalenie stercza, które ze względu na narastanie swoistego antygenu sterczowego oraz nieprawidłowości w badaniu przezodbytniczym stercza może sugerować współistnienie raka stercza. Przedstawiono przypadek rozległego ziarniniakowatego zapalenia stercza u 61-letniego pacjenta, które wystąpiło po pierwszym kursie dobrze tolerowanej terapii Bacillus Calmette-Guérin. Z powodu nieprawidłowego badania per rectum oraz obrazu stercza w USG przezodbytniczym z rozległym naciekiem naśladującym rozrost nowotworowy wykonano biopsję rdzeniową stercza. Badanie histopatologiczne ujawniło nacieki zapalne pochodzenia gruźliczego.

2

Acute Ischemia of the Lower Extremity During Renal Transplantation – Case Report

100%

Krupiński R., Wolski A., Bicki J., Rudzki S.

Polish Journal of Surgery

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2015

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vol. 86

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issue 8

374-376

EN

Acute ischemia of the lower extremity during renal transplantation is a rare complication of such procedure, but if it occurs, requires immediate vascular repair. This paper present one case of such complication that occurred during many years of renal transplantation at the Department of General and Transplantation Surgery, Public Hospital No. 4 in Lublin. Furthermore, a method to solve this problem is presented.

3

Capillary hemangioma of the testis. A case report of a rare benign tumor

100%

Białek W., Rudzki S., Wronecki L.

Journal of Ultrasonography

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2016

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vol. 16

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issue 64

87-93

EN

This paper presents the case of a very rare capillary hemangioma of the testis in a 23-yearold patient. Physical examination revealed a tumor located in the upper pole of the left testis, which was suspected of being malignant due to its significantly increased density and irregular contours. Blood levels of the following tumor markers were determined: alpha-fetoprotein, human chorionic gonadotropin and lactate dehydrogenase. No abnormalities were found in any of these tests. A gray-scale ultrasound scan of the scrotum revealed a lesion located in the upper pole of the left testis, 24 mm in diameter with slightly decreased echogenicity and irregular contours, which suggested infiltration of the tunica albuginea of the testis. Color and power Doppler scans demonstrated a dense network of blood vessels and increased blood flow in the lesion described. In addition, 3D ultrasound scan images were obtained, which allowed for a thorough determination of the topography of the lesion. No abnormalities were found in the patient’s medical history, physical examination or ultrasound scan of the right testis. Taking into account the suspected malignancy with signs of infiltration of the tunica albuginea of the upper pole of the testis a decision was made to remove the left testis together with the spermatic cord using the inguinal approach. A histopathological examination of the whole specimen revealed a multifocal capillary hemangioma of the testis, signs of testicular fibrosis and significant atrophy of the spermatogenic epithelium of the seminiferous tubules. Immunohistochemistry: CD31 (+), CD34 (+), FVIII (−), vimentin (+), CK MNF116 (−), mesothelial cells (−), calretinin (−), MIB-1 = 8.4%. The tumor described is one of the few benign lesions originating from the tissues of the testis for which partial resection of the organ may be considered. Intraoperative histopathological examination and resection of the lesion with the preservation of a healthy tissue margin may be considered in patients with a single testis in whom the tumor is found to have a very rich vascular network and the levels of tumor markers are normal.

PL

W niniejszej pracy przedstawiono przypadek bardzo rzadko występującego naczyniaka krwionośnego włośniczkowego jądra u 23-letniego pacjenta. Guz zlokalizowany w badaniu fizykalnym w górnym biegunie jądra lewego ze względu na znacznie wzmożoną spoistość i nieregularne obrysy budził podejrzenie nowotworu złośliwego. Oznaczono stężenia markerów nowotworowych we krwi: alfa-fetoproteiny, gonadotropiny kosmówkowej oraz dehydrogenazy mleczanowej, nie stwierdzając odchyleń od normy w żadnym z tych badań. W badaniu ultrasonograficznym moszny wykonanym w skali szarości w górnym biegunie jądra lewego zaobserwowano ognisko o średnicy 24 mm o nieznacznie obniżonej echogeniczności i nieregularnych obrysach, sugerujących naciekanie błony białawej jądra. W opcji dopplera kolorowego i dopplera mocy stwierdzono gęstą sieć naczyń krwionośnych oraz wzmożone przepływy krwi w opisywanej zmianie. Dokonano również akwizycji obrazów w ultrasonograficznym badaniu trójwymiarowym, które pozwoliło na poznanie dokładnej topografii ogniska. W badaniu podmiotowym, przedmiotowym oraz ultrasonograficznej ocenie jądra prawego nie stwierdzono nieprawidłowości. Biorąc pod uwagę podejrzenie nowotworu złośliwego, o cechach naciekania błony białawej górnego bieguna jądra, pacjenta zakwalifikowano do usunięcia jądra lewego wraz z powrózkiem nasiennym z dostępu przez kanał pachwinowy. W badaniu histopatologicznym całego preparatu stwierdzono wieloogniskowego naczyniaka krwionośnego włośniczkowego jądra, cechy włóknienia jądra oraz znacznego stopnia atrofię nabłonka plemnikotwórczego kanalików nasiennych. Immunohistochemicznie: CD31 (+), CD34 (+), FVIII (−), wimentyna (+), CK MNF116 (−), komórki mezotelialne (−), kalretynina (−), MIB-1 = 8,4%. Opisywany nowotwór jest jedną z nielicznych niezłośliwych zmian wywodzących się z tkanek jądra, w przypadku których można rozważać resekcję częściową narządu. U pacjentów z jądrem jedynym, u których stwierdza się guz o bardzo bogatej sieci naczyń, przy prawidłowych stężeniach markerów nowotworowych można rozważać śródoperacyjne badanie histopatologiczne i resekcję zmiany z zachowaniem marginesu zdrowych tkanek.

4

Nutritional Treatment a Various Clinical Setting - Practical Considerations

100%

Rudzki S., Matras P., Matuszek M.

Polish Journal of Surgery

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2011

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vol. 83

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issue 12

681-687

5

TRUS-guided drainage of the ectopic ureter entering the prostatic urethra and TRUS-guided transurethral neo-orifice formation using holmium laser

88%

Białek W., Mey E., Kawecki P., Styliński R., Rudzki S.

Journal of Ultrasonography

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2018

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vol. 18

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issue 74

255-264

EN

A fifty-nine year-old male was hospitalized for exacerbation of chronic pancreatitis. As a gigantic cyst of the pancreatic tail was identified, it was fused with the jejunal loop. Due to persistent fever and severe symptoms in the storage and voiding phases, the patient was referred to a urologist. Because transrectal ultrasound examination revealed a fluid collection resembling the left seminal vesicle filled with purulent material, a transrectal puncture procedure was performed. The analysis of computed tomography scans led to the diagnosis of duplicated collecting system of the left kidney with the enormous ureter of the upper moiety that entered the prostate gland. In order to permanently decompress the hydronephrosed upper moiety of the left kidney, the patient was deemed eligible for endoscopic treatment. A transurethral incision through the bladder wall and the adjacent segment of the ectopic ureter was made with holmium laser under transrectal ultrasonography guidance, thus creating a neo-orifice of this ureter.

PL

Pięćdziesięciodziewięcioletni mężczyzna został hospitalizowany z powodu zaostrzenia przewlekłego zapalenia trzustki. Rozpoznawszy olbrzymią torbiel ogona trzustki, dokonano jej zespolenia z pętlą jelita czczego. Ze względu na uporczywą gorączkę i nasilone objawy w fazie napełniania i wydalania moczu pacjent został skierowany na konsultację urologiczną. Ponieważ w przezodbytniczym badaniu ultrasonograficznym rozpoznano zbiornik płynowy przypominający pęcherzyk nasienny lewy wypełniony ropną treścią, dokonano jego punkcji z dostępu przezodbytniczego. Analiza obrazów tomografii komputerowej pozwoliła rozpoznać zdwojenie układu kielichowo-miedniczkowego nerki lewej z olbrzymim moczowodem górnego segmentu uchodzącym do stercza. W celu trwałego odbarczenia wodonerczowego segmentu górnego nerki lewej zakwalifikowano pacjenta do leczenia endoskopowego. Pod kontrolą przezodbytniczego badania ultrasonograficznego, przy użyciu lasera holmowego, dokonano przezcewkowego nacięcia przez ścianę pęcherza i przylegającego odcinka moczowodu ektopowego, wytwarzając nowe ujście moczowodu.

6

Own Experience in Treatment of Autoimmune Goiter in the Last Decade

76%

Rudzki S., Matuszek M., Nowakowski A., Matuszek B., Matras P., Wojewoda K.

Polish Journal of Surgery

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2010

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vol. 82

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issue 2

63-68

EN

The aim of the study. The study was intended to be a retrospective analysis of clinical data concerning patients operated on for autoimmune goitre in the period 1998-2008, in the 1st Department of General and Transplant Surgery of the Medical University in Lublin.Material and methods. 1157 patients were operated on for various goitre forms. This group included 134 patients with Graves' and Hashimoto's disease associated goitre, which accounted for 11% of all goitre patients undergoing the surgery. Major indications to surgical treatment of the Graves' disease included progressive exophthalmos, goitre with compression symptoms, hoarseness, and uncertain biopsy diagnoses. As regards Hashimoto's disease, goitre with compression symptoms or with tumour-like changes, and ambiguous biopsy diagnoses were the factors qualifying the patient for surgical treatment. Statistical analysis was conducted using STATISTICA 6.0 PL software, the chi2 test was performed, and the statistical significance was established at p<0.005.Results. Graves' disease associated goitre was operated on in 72 patients, including 53 cases (39.5%) where infiltrative ophthalmopathy was also observed. Hashimoto's disease associated goitre was operated on in 62 patients. Early paralysis of the recurrent laryngeal nerve occurred in 10 (13.9%) patients operated on for Graves' disease, and in 5 (8.1%) patients operated on for Hashimoto's disease. As regards patients operated on for non-autoimmune goitre, early paralysis of the recurrent laryngeal nerve was observed in 29 (3%) cases. Post-surgical tetany was observed in 11.1% of Graves' disease patients, and in 8% of Hashimoto's disease patients. Finally, temporary post-surgical tetany was found in 2% of patients with non-autoimmune goitre.Conclusions. The type of goitre being operated on has a significant impact on the incidence of early post-surgical complications. In general, the incidence of early post-surgical complications is higher in the case of patients operated on for autoimmune-type goitre, compared with patients with non-autoimmune goitre. Yet this method is both safe and efficient. Total thyroid removal should be the treatment applied in the case of progressive orbitopathy associated with Graves' disease.

7

Evaluation of immature monocyte-derived dendritic cells generated from patients with colorectal cancer

76%

Maciejewski R., Radej S., Furmaga J., Chrościcki A., Rudzki S., Roliński J., Wallner G.

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vol. 85

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issue 12

714-720

EN

Dendritic cells are heterogeneous population of the leukocytes and most potent APC in activation of naive T lymphocytes. Therefore the DCs generated in vitro are under research for their application in anti-tumor immunotherapy. The aim of the study was generation of the immature dendritic cells from peripheral blood monocytes collected from colorectal cancer patients and comparison of their ability to endocytosis, cytokine production and immunophenotype to DCs generated from healthy donors. Material and methods. 16 adenocarcinoma stage II patients were included in the study. Dendritic cells were generated in the presence of rhGM-CSF and IL-4. PBMC were isolated from the blood of patients and 16 healthy donors - control group. Immunophenotype, ability of endocytosis of Dextran- FITC as well as intracellular IL-12 expression of the generated dendritic cells was measured using flow cytometry. The cytokines (IL-6, IL-10, IL-12p70, IFN-γ) concentration in the supernatants of DCs culture was measured by ELISA. Results. The percentage of the immature dendritic cells and expression of CD206 and CD209 antigens was significantly higher in patients group (p <0.05 and p <0.001 respectively). Significantly (p <0.001) higher expression of the antigens which initiate the Th2 immune response (CD80-/CD86 + and B7-H2 + / CD209 +) was in the patients group. There were no differences in endocytosis ability and the cytokines (IL-6, IL-10, IL-12p70, IFN-γ) concentration between investigated groups. Conclusions. High immature markers expression on the generated dendritic cells together with identical endocytosis ability in patients group is advantageous in antitumor autologous cells immunotherapy planning. However there is one troubling fact - high expression of markers, which may induce tolerance to particular antigen. It seems to be more reasonable to use the autologous DCs in the antitumor immunotherapy, especially due to the incompatibility in allogenic cells in the context of HLA complex.

8

Varices of the Descending Duodenum Explored During Emergency Gastro-Duodenal Resection for Upper Gastrointestinal Haemorrhage. Case Report

76%

Rudzki S., Dryka T., Wilczyński P., Bernat P., Bicki J., Furmaga J., Piłat J.

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vol. 85

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issue 5

279-283

EN

Upper gastrointestinal haemorrhage is a major medical emergency and accounts for approximately 7,000 admissions to hospitals in Scotland each year. Over the last 10 years there has been a number of improvements in diagnosis and conservative management of the condition, which significantly reduced the ratio of life-threatening cases requiring an emergency surgery. Despite these achievements surgical intervention or, if accessible, endovascular procedures must be undertaken as emergency actions, should conservative management fail. Vascular malformations of the duodenum are less frequent causes of upper GI bleeding. Duodenal varices found endoscopically occur in 0.4% of patients with portal hypertension (PHT) and are believed to be caused mainly by liver cirrhosis, idiopathic PHT, extrahepatic PHT, or previous surgical trauma. The duodenal bulb is their most common site, followed by the second portion of the duodenum. Forty per cent of patients with PHT have duodenal varices at angiography; however, their penetration unusually affects submucosa, hence no symptoms develop. Isolated bleeding duodenal varices are scarcely reported in literature, although present a significant surgical problem: massive haemorrhage combined with failure to identify them as a source has led to catastrophic outcomes with mortality rate of 40%. The case hereby presented is unique in several aspects. Duodenal varices were explored on emergency laparotomy rather than on prior endoscopies, which, performed by the same well-established endoscopists, were twice negative. This corresponds to the study by Cottam et al. stating that duodenal varices may not penetrate the submucosa, hence haemorrhages of their origin may even be more difficult to diagnose on endocsopy. Secondly, the haemorrhage here reported was undoubtedly a life-threatening condition that required a multidisciplinary team to be managed successfully. Along with Shirashi et al. we confirm that surgical ligation followed by the excision of duodenal / small intestinal varices may be an effective method of their management - both cases have been free of recurrence at 15 months postoperatively. In contrast to the study by Hashizume et al. the duodenal varices here presented were not associated with portal hypertension (PTH). Finally, duodenal varices located in the posterolateral aspect of the descending duodenum are less common as the majority of cases reported so far were of duodenal bulb location.

9

Evaluation of factors associated with the nutritional mixture leading to liver complications in patients treated by means of parenteral nutrition at home

64%

Matras P., Żuchowska K., Banakiewicz K., Bobak A., Jajko K., Szypowski R., Zalewski G., Zieliński P., Rudzki S.

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vol. 85

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issue 12

681-686

EN

The major problem of total parenteral treatment consists in the balancing of the source and dose of the nutritional mixture, so as to not deepen malnutrition with a positive impact on the patients’ organism. The aim of the study was to evaluate selected factors that induce hepato-billiary complications in patients treated by means of parenteral nutrition at home. Material and methods. The retrospective study comprised 70 patients with biochemistry performed every three months. Considering statistical analysis patients were allocated to four groups, depending on the period of treatment. Group A analysis results were based on the activity of aminotransferases, group B on the activity of bilirubin. Both groups A and B were additionally divided into group I where we assigned normal values of control lab results, and group II with improper results after treatment. Results. Differences between groups Ia vs IIa were presented on the basis of the daily supply of glucose: mean- 2.52 vs 3.49 g/kg (p=0.000003), glucose/lipids ratio: mean- 3.76 vs 4.90 g/kg (p=0.0001), daily non-protein energy: mean- 16.73 vs 21.06 kcal/kg (p=0.0001). Differences between groups Ib vs IIb were presented on the basis of the daily supply of glucose: mean- 2.76 vs 3.46 g/kg (p=0.0007), glucose/lipids ratio: mean- 3.98 vs 5.13 g/kg (p=0.01), daily non-protein energy: mean-17.96 vs 20.36 kcal/kg (p=0.04). Based on the above-mentioned analysis the main goal in the prevention of hepatic complications should lead to the reduction of the dose of glucose. Increased glucose supply leads to increased number of hepato-billiary complications. Conclusions. Based on obtained results we were able to conclude that in case of liver complications associated with parenteral nutrition, proper management consists in the modification of nutritional mixtures (reduction in the daily glucose supply and change in the proportions of extra-protein energy). Such management has the greatest clinical effect. When determining the composition of the nutritional mixture one should adjust the glucose supply, so as to offset both sources of extra-protein energy

10

Prevalence of Legionella antibodies in immunocompromised patients

52%

Sikora A., Kozioł-Montewka M., Książek A., Grzebalska A., Bednarek-Skublewska A., Steć A., Rudzki S., Furmaga J., Paluch-Oleś J., Magryś A., Karaś M.

Open Medicine

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2013

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vol. 8

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issue 2

208-212

Refine search results

Granulomatous prostatitis after intravesical immunotherapy mimicking prostate cancer

Acute Ischemia of the Lower Extremity During Renal Transplantation – Case Report

Capillary hemangioma of the testis. A case report of a rare benign tumor

Nutritional Treatment a Various Clinical Setting - Practical Considerations

TRUS-guided drainage of the ectopic ureter entering the prostatic urethra and TRUS-guided transurethral neo-orifice formation using holmium laser

Own Experience in Treatment of Autoimmune Goiter in the Last Decade

Evaluation of immature monocyte-derived dendritic cells generated from patients with colorectal cancer

Varices of the Descending Duodenum Explored During Emergency Gastro-Duodenal Resection for Upper Gastrointestinal Haemorrhage. Case Report

Evaluation of factors associated with the nutritional mixture leading to liver complications in patients treated by means of parenteral nutrition at home

Prevalence of Legionella antibodies in immunocompromised patients