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Wyświetlanie 1-10 z 13
Tytuł:
Magnetic resonance venography of chronic cerebrospinal venous insufficiency in the patients with associated multiple sclerosis
Autorzy:
Ludyga, Tomasz
Zaniewski, Maciej
Hartel, Marcin
Kluczewska, Ewa
Simka, Marian
Kostecki, Jacek
Opis:
Background: Multiple sclerosis (MS) is a chronic disease with not well understood etiology. Recently, a possible association of MS with compromised venous outflow from the brain and spinal cord has been studied (chronic cerebrospinal venous insufficiency – CCSVI). Angioplasties of internal jugular veins (IJV) and azygous vein (AV) have given promising results, with improvements in patients' clinical status. Material/Methods: 830 patients with clinically defined MS were scanned from the level of sigmoid sinuses to the junction with brachiocephalic veins, as well as at the level of AV. T2-weighted, 2D TOF and FIESTA sequences were used. Results: The examination revealed a slower blood flow in IJVs, in 98% of patients: on the right side – in 6%, on the left side – in 15%, on both sides with right-side predominance – in 22%, on both sides with left-side predominance – in 34%, bilaterally with no side predominance – in 19%. In 2%, there was a slower blood flow in IJVs, vertebral veins and subclavian veins and also in the left brachiocephalic vein. Moreover, in 5% of patients there was a decreased blood flow in the azygous vein. Conclusions: Abnormal flow pattern in IJVs is more common on the left side. Less often it can be found in azygous vein and in brachiocephalic veins. Further research is needed to investigate the significance of CCSVI in MS patients. The protocol we described can be used for most of modern magnetic resonance units.
Dostawca treści:
Repozytorium Uniwersytetu Jagiellońskiego
Artykuł
Tytuł:
Perfuzja w raku stercza : korelacja pomiędzy p-TK a badaniem histologicznym : opis przypadku
Perfusion of prostate cancer : correlation between p-CT and whole-mount pathology : case report
Autorzy:
Stelmach, Andrzej
Hartel, Marcin
Jaszczyński, J.
Anioł, Joanna
Konopka, Marcin
Łuczyńska, Elżbieta
Szczudło, Joanna
Opis:
Background: Prostate cancer is the second most common form of cancer among malignant neoplasm for men in Poland, next to lung cancer, as far as frequency is concerned. Incidence of this kind of neoplasm increases by about 3 % annually. In the last decade a growing number of this type of diseases has been observed and its detections are closely related to the development of biochemical (PSA - prostate-specific antigen) and diagnostic imaging technologies. Case Report: A 60-year-old patient was diagnosed in the Oncology Institute because of an increasing level of PSA in his blood. The PSA level in March 2005 was 10,4 ng/ml. There was a slight increase of PSA during the year, up to 1,5 ng/ml (this is less than 25% / year). The patient came for the following check up to repeat the core-needle sextant biopsy, to exclude neoplasmatic process. Before operation the patient's prostate was tested by p-CT. The parametric maps revealed some disturbances of blood flow parameters. Blood flow - BF, blood volume - BV, mean transit time - MTT and permeability surface - PS were noted in the form of their asymmetry within peripheral zone in the right lobe. A pathological focus with increased BF, BV, PS and decreased MTT was revealed on the right side. This examination suggested that neoplasmatic process might be localized in this area. Core needle biopsy taken from the suspicious region revealed prostate cancer. That was also confirmed in histopathology examination after radical prostatectomy. Conclusions: P-CT examination can be performed during classical CT exam and it leads to obtaining morphological and functional data at the same time. P-CT examination allowed us to localize pathological process and helped to continue its verification by other diagnostic methods.
Dostawca treści:
Repozytorium Uniwersytetu Jagiellońskiego
Artykuł
Tytuł:
Prawostronny łuk aorty : opis dwóch przypadków
Right aortic arch : a report of two cases
Autorzy:
Konopka, Marek
Krzych, Łukasz
Hartel, Marcin
Goliszek, Leszek
Pilch-Kowalczyk, Marek
Pilch-Kowalczyk, Joanna
Opis:
Background: A right aortic arch (RAA) is a rare congenital abnormality not always clinically manifested. The most common symptoms include dysphagia, dyspnoea on exertion, stridor, and bronchitis, resulting from a vascular ring around the trachea or esophagus. Asymptomatic cases may be viewed in adulthood. Case report: The report presents two cases of RAA found coincidentally in adult patients diagnosed using conventional chest X- ray and computed tomography (CT). Case 1 presents an abnormal course of the aortic arch, first manifested as dyspnoea in adulthood. Case 2 presents RAA with the right subclavian artery as a separate branch associated with an abnormal course of the left subclavian artery. Asymptomatic esophageal compression was also found. The abnormality was accompanied by numerous atherosclerotic lesions in peripheral vessels. Abnormal blood flow conditions might have contributed to a faster progression of atherosclerosis. Conclusions: RAA may remain asymptomatic for the entire life. Symptoms are caused by compression of the surrounding structures or impaired blood flow. RAA may be associated with malformations of its branches.
Dostawca treści:
Repozytorium Uniwersytetu Jagiellońskiego
Artykuł
Tytuł:
Small volume of the posterior cranial fossa and arterial hypertension are risk factors of hemifacial spasm
Autorzy:
Malec-Litwinowicz, Michalina
Hartel, Marcin
Grabska, Natalia
Rudzińska-Bar, Monika
Szczudlik, Andrzej
Wójcik-Pędziwiatr, Magdalena
Opis:
Objectives: So far, there are only two studies evaluating the relation between the small volume of the posterior cranial fossa (VPCF) and the occurrence of HFS, both on Asian population. The aim of the study was to determine small VPCF and arterial hypertension (AH), as risk factors for hemifacial spasm (HFS) and their relation to neurovascular conflict (NVC) in Polish Caucasian-origin patients. Materials and methods: The study included 60 patients with idiopathic HFS and 60 healthy volunteers matched by sex and age. AH was defined according to WHO. The VPCF measured the volume of the prepontine, prespinal and both cerebellopontine angle cisterns in MRI scans. Results: There were no significant differences between occurrence of AH and the VPCF of patients and controls but the mean VPCF in women was significantly smaller than in men, In the multivariate regression analysis model only NVC was the statistically significant. In the subgroup of >50-year-old patients the most dominant risk factor was NVC (OR 71.09; 95% CI 21.08–239.77; p = 0.0000), followed by the AH duration (OR 1.07; 95% CI 1.00–1.16; p = 0.047). In the subgroup of <50 years, NVC was also the dominant risk factor, followed by the lower VPCF (Walad test: OR 0.4; 95% CI 0.16–1.04; p = 0.045). Conclusion: There was no significant difference in VPCF and in frequency of AH diagnosis in HFS patients and age- and sex-related controls, but the logistic regression analysis showed that small VPCF and AH duration are risk factors of HFS in younger and older patients respectivel
Dostawca treści:
Repozytorium Uniwersytetu Jagiellońskiego
Artykuł
Tytuł:
Czynniki determinujące jakość życia chorych na połowiczy kurcz twarzy
Factors affecting the quality of life in hemifacial spasm patients
Autorzy:
Szczudlik, Andrzej
Malec-Litwinowicz, Michalina
Grabska, Natalia
Wójcik, Magdalena
Hartel, Marcin
Szubiga, Michał
Rudzińska-Bar, Monika
Opis:
Background and purpose Hemifacial spasm (HFS), a movement disorder manifested by unilateral spasms of the muscles innervated by the facial nerve, interferes with social life in about 90% of patients, causing social isolation and depression and having a significant impact on the quality of life. The aim of the study was to assess factors affecting the quality of life in patients with HFS in respect of influence of the severity of depression symptoms and botulinum toxin type A (BTX-A) therapy. Material and methods Eighty-five out of 129 patients included in the HFS database of the Movement Disorders Out-patient Clinic, Department of Neurology, University Hospital, Cracow who fulfilled the inclusion criteria and had no exclusion criteria (suffering from concomitant movement disorders, other severe chronic diseases or cognitive impairment) were studied. Demographic and clinical data (age at onset, disease duration and accompanying symptoms) were collected. Severity of HFS was assessed by the five-point clinical scale and seven-point Clinical Global Impression scale. Quality of life was assessed with the HFS-36 questionnaire and severity of depressive symptoms was evaluated with the Beck Depression Inventory. HFS-36 was performed twice, before BTX-A injection and two weeks later. Results The mean global score of HFS-36 was 47 ± 31 (maximum: 140 pts). Decreased HFS-36 score resulted from divergent deterioration in all subscales included in the questionnaire. Independent risk factors of deterioration in HFS-36 were increased severity of HFS and depressive symptoms as well as accompanying trismus. The HFS-36 score depended on the number and type of accompanying symptoms as well. Botulinum toxin type A therapy led to a significant improvement of HFS-36, particularly high in patients with multiple (> 4) HFS-related symptoms. Conclusions The HFS-36 score depends mostly on severity of HFS, depressive symptoms and occurrence of accompanying trismus. It improves after BTX-A treatment.
Dostawca treści:
Repozytorium Uniwersytetu Jagiellońskiego
Artykuł
Tytuł:
Wpływ toksyny botulinowej na zaburzenia słuchu w połowiczym kurczu twarzy
The influence of botulinum toxin on auditory disturbances in hemifacial spasm
Autorzy:
Zajdel, Katarzyna
Malec-Litwinowicz, Michalina
Hydzik-Sobocińska, Karolina
Hartel, Marcin
Składzień, Jacek
Wójcik, Magdalena
Rudzińska-Bar, Monika
Szczudlik, Andrzej
Opis:
Background and purpose: Hemifacial spasm (HFS) is frequently accompanied by other symptoms, such as visual and auditory disturbances or pain. The aim of the study was to assess the occurrence of auditory symptoms accompanying HFS using subjective and objective methods, their relation with other HFS symptoms, and their resolution after botulinum toxin (BTX-A) treatment. Material and methods: The occurrence of hypoacusis, ear clicks and tinnitus was assessed by questionnaire in 126 HFS patients from an electronic database which included medical data such as severity of HFS rated by clinical scale and magnetic resonance imaging focused on the presence of vascular nerve VII and VIII conflict. Forty consecutive patients treated with BTX-A and 24 controls matched by sex and age underwent laryngological examination including audiometry, tympanometry and acoustic middle ear reflex before injection and two weeks later. Results: About 45.2% of patients complained of auditory disturbances (31.7% hypoacusis, 30.2% ear clicks and 7.1% tinnitus) on the side of HFS. Auditory disturbances correlated with severity of HFS symptoms but not with age, disease duration, or neurovascular conflict with nerves VII and VIII. We did not find abnormalities in audiometric and tympanometric assessment in patients in comparison with controls. No abnormalities were detected in brainstem evoked potentials comparing the sides with and without HFS symptoms. Tinnitus and absence of ipsilateral acoustic middle ear reflex occurred more often in patients with auditory symptoms than those without them. BTX-A treatment caused resolution of subjective acoustic symptoms without any improvement in audiometric assessment. Conclusions: Auditory disturbances accompanying HFS are probably caused by dysfunction of the Eustachian tube, which improves after BTX-A treatment.
Dostawca treści:
Repozytorium Uniwersytetu Jagiellońskiego
Artykuł
Tytuł:
Rak kory nadnerczy w przedoperacyjnych badaniach obrazowych
Adrenocortical carcinoma in preoperative diagnostic imaging
Autorzy:
Więcek, Andrzej
Kiełtyka, Aleksandra
Ziaja, Jacek
Konopka, Marek
Kajor, Maciej
Hartel, Marcin
Król, Robert
Cierpka, Lech
Badura, Joanna
Gasińska, Teresa
Opis:
Background: Decisions concerning surgical treatment of patients with adrenocortical tumor without hormonal hyperactivity are based on tumor size exceeding 3-6 cm and morphological features of malignancy. The aim of the study was to analyze results of diagnostic imaging in patients with adrenocortical carcinoma (ACC). Material/Methods: Results of diagnostic imaging of 8 patients in whom postoperative pathological examination revealed ACC were analyzed. There were 3 women and 5 men in the analyzed group, with an age range of 32 to 75 years. Imaging was based on US and CT examination supported by MRI in 2 patients. The obtained results were compared with a group of 10 patients with adrenocortical adenoma (ACA). Results are presented as median values and 95% CI. Results: CT results of patients with ACC showed local spread into surrounding fat tissue in 87.5%, adjacent organ invasion in 75%, local lymph node enlargement in 75%, irregular tumor margins in 88%, and heterogeneous structure of all tumors. In patients with ACA, tumor heterogeneity was observed in 40% and local lymph node enlargement in 10%. ACC tumors were significantly larger than ACA ones [77 (66-97) vs. 31 (24-48) mm, respectively, p=0.0002] and more dense [60 (34-85) vs. 16 (10-26) HU, respectively, p=0.0007]. In arterial phase, enhancement of ACC tumors tended to be stronger compared with ACA [81 (29-162) vs. 55 (33-76), p=0.09]. On the basis of CT results, 1 patient was classified as stage II according to Mac Farlane, 6 as stage III, and 1 as stage IV. Intraoperative examination down-staged 2 patients from stage III to stage II. Conclusions: Computed tomography is a method that allows distinguishing adrenocortical adenoma from carcinoma as well as to determine the stage of adrenocortical carcinoma.
Dostawca treści:
Repozytorium Uniwersytetu Jagiellońskiego
Artykuł
Wyświetlanie 1-10 z 13

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