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EN
INTRODUCTION: Chemerin is an adipokine, whose pro-inflammatory and carcinogenesis-related properties have recently been emphasized. The aim of this study was to examine the concentrations of chemerin in the serum and saliva of healthy subjects and patients with colorectal cancer (CRC) in II and III stage of TNM (tumor, node, metastasis) classification as well as to assess the relationship between the results and the clinical and pathological parameters. MATERIAL AND METHODS: 52 persons were qualified to the study, divided into two equal groups – control and study with cancer in stage II N0 and in stage III N+ according to TNM classification. Inside the groups, subgroups of persons with normal body weight 18.5 ≤ BMI < 25 and obese and overweight persons with a BMI ≥ 25 were distinguished. Serum and saliva chemerin concentrations were determined by immunoenzymatic methods. RESULTS: The median concentrations of chemerin were significantly higher in the study group as compared to the control group both in serum (384.36 ng/ml vs. 170.53 ng/ml) and saliva (15.45 ng/ml vs. 4.57 ng/ml; p < 0.0001). In the subgroups with a BMI above and below 25, we found no significant differences in the concentrations of chemerin either group. There were no significant differences in the levels of chemerin in the serum or saliva between stage II and III stage of TNM (p = 0.82 and p = 0.52). CONCLUSIONS: The assessment of serum and saliva chemerin concentrations in patients with CRC suggests that chemerin may be a valuable biomarker for early diagnosis of CRC. The influence of BMI on the results seems to be insignificant in patients with CRC. It seems that in some cases an easily accepted saliva test can replace a serum one.
PL
WSTĘP: Chemeryna jest hormonem wydzielanym przez adipocyty. W ostatnim czasie zwraca się uwagę na jej właściwości prozapalne i związane z karcynogenezą. Celem pracy było zbadanie stężeń chemeryny w surowicy i ślinie osób zdrowych oraz chorych z rakiem jelita grubego (RJG) w II i III stopniu zawansowania według klasyfikacji TNM (tumor, node, metastasis), a także ocena związku uzyskanych wartości z otyłością oraz wybranymi parametrami kliniczno-patologicznymi. MATERIAŁ I METODY: Do badania zakwalifikowano 52 osoby, które podzielono na dwie równe grupy – kontrolną i badaną z nowotworem w II stopniu zaawansowania z cechą N0 oraz w III stopniu z cechą N+ według klasyfikacji TNM. Wewnątrz grup wyróżniono podgrupy osób o prawidłowej masie ciała (18,5 ≤ BMI < 25) oraz osoby otyłe i z nadwagą (BMI ≥ 25). Stężenia chemeryny w surowicy i ślinie oznaczano metodami immunoenzymatycznymi. WYNIKI: Mediany stężeń chemeryny były istotnie wyższe w grupie badanej w porównaniu z grupą kontrolną, zarówno w surowicy (384,36 ng/ml wobec 170,53 ng/ml), jak i ślinie (15,45 ng/ml wobec 4,57 ng/ml; p < 0,0001). W żadnej grupie w podgrupach z BMI powyżej i poniżej 25 nie znaleziono istotnych różnic w stężeniach badanej adipokininy. Nie odnotowano również istotnych różnic stężeń chemeryny w surowicy i ślinie między nowotworami w II i III stopniu zaawansowania TNM (p = 0,82 i p = 0,52). WNIOSKI: Ocena stężeń chemeryny w surowicy i ślinie u pacjentów z RJG sugeruje, że badana adipokina może być cennym biomarkerem wczesnej diagnostyki tego nowotworu. Wpływ BMI na uzyskane wyniki stężeń w surowicy i ślinie wydaje się nieistotny u chorych z RJG. Wydaje się, że w pewnych przypadkach łatwo akceptowane przez chorych badanie śliny może zastąpić badanie surowicy.
EN
Lymphangiomas constitute a group of very rare diseases and occur with a frequency of 1/250,000 to 1/20,000 of hospitalizations. Even though they are benign lesions, their complications may turn into a life-threatening condition. They usually occur in children (90%), they are either congenital or they appear before the child’s second birthday. Occassionally they are found in adults. Lymphangiomas are usually localized around neck, but also near armpits and in the groin area. Less than 1% of lymphagiomas are detected in the retroperitoneal space and intestinal mesentery. Vascular lesions derived from lymphatic vessels can be divided into ordinary ones, usually known as capillary, cavernous, and cystic. The cystic tumor (lymphangioma mesenteri) is the least common. It occurs mostly in the retroperitoneal space, mesentery of the colon, or extremely rarely in the mesentery of the small intestine. Preoperative diagnosis is difficult due to non-specific clinical symptoms and noncharacteristic image in the diagnostic tests. Lymphangioma complications, such as intestinal obstruction or perforation, and persistent pain, are the cause of exploratory laparotomy. Final diagnosis requires microscopic examination of material collected during an operation. This article presented the case of a 40-year-old female, operated due to the obstruction of the gastrointestinal tract, in whose case the lymphangioma was recognised in postoperative histopathological examination of the tumor from the jejunal mesentery. Since patients with these tumors have good chances of complete recovery - if there are no serious complications - it appears that the optimal therapeutic procedure should be early surgery, which reduces the possibility of complications.
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Primary Duodenal Carcinoma - Case Report

88%
EN
Duodenal carcinoma is a rare tumor of the gastrointestinal tract of an insidious and secretive course, often diagnosed during the advanced stage of the disease. The study presented a case of a female patient diagnosed with duodenal carcinoma, subjected to two-staged surgery. The initial surgical intervention consisted in the implementation of a gastrointestinal anastomosis, followed by radical surgery by means of Whipple's method performed after three years.
EN
Calcifying fibrous tumor is a rare disease entity, usually concerning the soft tissues of the limbs, neck, trunk, or scrotum. Cases of the above-mentioned pathology have also been reported considering the pleural and peritoneal cavity, and small bowel mesentery. The essence of the disease, whose etiology and pathogenesis remains unclear, is the fibrous tissue infiltration and diffuse inflammation with focal calcifications. The study presented a case of a 27-year old male patient subjected to surgical intervention, due to an abdominal cavity tumor. The tumor was radically removed, and its character and definitive diagnosis were established postoperatively. After a seven-year follow-up period, recurrence was not observed.
EN
Wound healing is a complex pathophysiological process, in which platelets play a crucial role. Platelet alpha-granules release growth factors to the wound bed; the factors are necessary in the healing process. In chronic wounds, such as poorly healing lower-leg ulcers of venous origin, there is decreased activity of multiple growth factors, so the concept of exogenous delivery of such factors seems a logical strategy. Platelet-rich plasma therapy in patients with lower-leg ulcers of venous origin combined with conventional treatment methods (previously ineffective in these patients) seems, based on our observation, an important adjunct leading to recovery. The aim of the study was to present an original method of autologous platelet-rich plasma application through the creation of a sort of “biological chamber” containing a concentrate of growth factors. Material and methods. The described therapy was implemented in 10 patients, who had been ineffectively treated for more than one year in the outpatient setting. Patients with exacerbation of inflammatory process, signs of wound infection and ankle brachial pressure index < 0.8 were excluded from the study. After the application of platelet-rich plasma, further treatment was continued with the use of moist therapy and compression therapy according to a uniform regimen. Results. Complete healing was achieved within 4-10 weeks from the beginning of the product administration in all patients. Conclusion. The presented method seems technically simple, effective and relatively inexpensive
EN
INTRODUCTION: Colorectal cancer (CRC) is one of the most common cancers in the world, accounting for 10% of the annual global cancer incidence. This malignant neoplasm can remain asymptomatic for a long time and, despite medical advances, is too frequently diagnosed too late. The YKL-40 protein is a growth factor that stimulates endothelial cell migration, and plays a role in inflammation and neoplasia. The aim of the study was to assess the significance of YKL-40 as a biomarker in CRC and to determine the correlation between the serum YKL-40 levels in CRC patients and selected clinical and pathological parameters. MATERIAL AND METHODS: In a prospective study involving 133 patients over the age of 50, the serum YKL-40 protein level concentration was determined by the ELISA method. The patients were divided into two groups: 91 with CRC and 42 healthy. For the statistical analysis Student's t-test for independent data, the Mann-Whitney U test, and logistics regression were used. RESULTS: The YKL-40 serum concentration was significantly higher in the CRC patients (163 ± 36 μg/l) than the healthy patients (54 ± 20 μg/l; p < 0.0001). There was a statistically significant difference in the serum YKL-40 concentration between the early and intermediate stages of CRC. There was no correlation between the clinical parameters, i.e. sex, age and BMI and the serum YKL-40 protein concentration in the people with CRC. CONCLUSIONS: The YKL-40 protein seems to be a promising CRC biomarker. Its serum concentration is correlated with the stage of the cancer depending on the depth of the growth relative to the submucosa and may be a prognostic factor for an adverse prognosis of this cancer.
PL
WSTĘP: Rak jelita grubego (colorectal cancer – CRC) jest jednym z najczęstszych nowotworów na świecie – odpowiada za 10% rocznej globalnej zapadalności na raka. Przez długi czas może pozostać bezobjawowy i mimo postępu medycyny zbyt często zostaje zdiagnozowany za późno. Białko YKL-40 jest czynnikiem wzrostu stymulującym migrację komórek śródbłonka, odgrywającym rolę w stanach zapalnych oraz nowotworowych. Celem pracy była ocena znaczenia YKL-40 jako biomarkera w CRC oraz określenie powiązań stężeń YKL-40 w surowicy u chorych na CRC z wybranymi parametrami kliniczno-patologicznymi. MATERIAŁ I METODY: W badaniu prospektywnym, obejmującym 133 osoby powyżej 50 roku życia, oznaczono stężenie białka YKL-40 w surowicy metodą ELISA. Pacjentów podzielono na dwie grupy: 91 osób chorujących na CRC oraz 42 osoby zdrowe. W analizie statystycznej wykorzystano testy t-Studenta dla danych niezależnych, U Manna-Whitneya i regresję logistyczną. WYNIKI: Stężenie YKL-40 w surowicy było znacznie wyższe u chorych na CRC (163 ± 36 μg/l) niż u osób zdrowych (54 ± 20 μg/l; p < 0,0001). U osób z CRC nie wykazano zależności między parametrami klinicznymi, tj. płcią, wiekiem i wskaźnikiem masy ciała (body mass index – BMI), a stężeniem białka YKL-40 w surowicy. U chorych z CRC stężenie YKL-40 w surowicy statystycznie istotnie różniło się we wczesnym i średniozaawansowanym stadium nowotworowym. WNIOSKI: Białko YKL-40 wydaje się obiecującym biomarkerem CRC. Jego stężenie w surowicy jest skorelowane ze stopniem zaawansowania nowotworu zależnie od głębokości nacieku w stosunku do błony podśluzowej i może być czynnikiem rokowniczo niepomyślnym dla tego nowotworu.
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