HPV-pozytywny rak jamy ustnej - etiologia i czynniki ryzyka.

HPV oral infection is one of a etiological risk factors of oral and pharyngeal squamous cell carcinoma development. HPV-positive OSCC seems to have better prognostics and to be more susceptible to treatment than cancer with major a etiological factors being alcohol or tobacco. Therefore, qualifying a patient to an appropriate OSCC group is vital. The aim of this work is to present HPV infection risk factors, as well as the implications of such infection. This should facilitate creating awareness in this matter among the patients.Zakażenie wirusem HPV w jamie ustnej jest jednym z czynników etiologicznych rozwoju raka płaskonabłonkowego jamy ustnej (OSCC) oraz gardła środkowego. HPV (+) OSCC związany z obecnością zakażenia wirusem HPV w jamie ustnej wydaje się wiązać z lepszym rokowaniem i odpowiedzią na leczenie niż rak, którego głównymi czynnikami etiologicznymi są alkohol czy tytoń. Dlatego też bardzo istotna jest kwalifikacja pacjenta do odpowiedniej grupy. Celem tej pracy jest przedstawienie czynników ryzyka infekcji wirusem HPV oraz implikacji, jakie niesie ze sobą zakażenie. Wiedza ta ułatwi lekarzom zwiększanie świadomości pacjentów

Pancreatic islet transplantation in a simultaneous pancreas and kidney transplant recipient — a case report

Beta cell replacement allows for adequate blood glucose control, reduced progression or even reversal of microvascular complications, and improves the quality of life. Simultaneous pancreas and kidney transplantation is the best therapeutic option for patients with type 1 diabetes and end-stage renal disease resulting from diabetic nephropathy. However, when pancreas transplantation is contraindicated or unavailable, pancreatic islet transplantation is an alternative minimally invasive procedure. We report a patient after earlier simultaneous kidney and pancreas transplantation with a failed pancreas graft, and no option for pancreas retransplantation. In this patient pancreatic islet transplantation was performed. The latter resulted in an improved blood glucose control, restoration of hypoglycaemia awareness, and improved quality of life with stable good function of the kidney allograft.Beta cell replacement allows for adequate blood glucosecontrol, reduced progression or even reversal ofmicrovascular complications, and improves the qualityof life. Simultaneous pancreas and kidney transplantationis the best therapeutic option for patients withtype 1 diabetes and end-stage renal disease resultingfrom diabetic nephropathy. However, when pancreastransplantation is contraindicated or unavailable, pancreaticislet transplantation is an alternative minimallyinvasive procedure. We report a patient after earliersimultaneous kidney and pancreas transplantationwith a failed pancreas graft, and no option for pancreasretransplantation. In this patient pancreatic islettransplantation was performed. The latter resultedin an improved blood glucose control, restoration ofhypoglycaemia awareness, and improved quality oflife with stable good function of the kidney allograft

Obsydian i szkło w chirurgii

Chirurgia to temat tak rozległy i skomplikowany jak ludzkie ciało. Specjalizacje są coraz węższe, narzędzia coraz bardziej precyzyjne, historia coraz dłuższa. Największy postęp dokonał się w niej w ciągu ostatnich 100–150 lat, co nie zmienia faktu, że o wiele, wiele wcześniej ludzie badali ciała i sięgali po sposoby równie niebezpieczne co ostateczne, żeby pozbyć się bólu lub przynajmniej go zmniejszyć, usunąć zmianę skórną (np. narośl), czy oczyścić ropiejącą ranę. Do tych celów starano się znaleźć możliwie najostrzejsze narzędzie. Zanim doszliśmy do ostrzy stalowych, doskonale sprawdzały się naturalne surowce… przede wszystkim obsydian

Hypoxic hepatitis as a complication of newly diagnosed type 1 diabetes in a teenager

Hypoxic hepatitis is a rare complication of type 1 diabetes with unknown prevalence in Pediatrics. We present a case report of an 11-year-old boy admitted to the ER in the spring of 2020 (the beginning of the COVID19 pandemic in Poland) due to nausea, abdominal pain, and weight loss. A diagnosis of type 1 diabetes accompanied by severe ketoacidosis (pH 6.9, blood glucose 632mg/dl, ketone bodies in urine – 150mg/dl) was made. The hyperglycemia, ketoacidosis, and water-electrolyte disturbances were treated in the Pediatric Intensive Care Unit. On day 4, the boy developed fulminant septic shock with high aminotransferases (AST 9026 U/l, ALT 3559 U/l). CT scan revealed hepatic enlargement and steatosis. Acute viral hepatitis was suspected. The levels of anti-CMV IgM and IgG antibodies were slightly elevated. At autopsy, the liver was enlarged, with petechial bleedings on the surface. The liver parenchyma was congested, with signs of steatosis. Microscopically, there was extensive centrilobular necrosis, acute passive sinusoidal congestion, and steatosis of hepatocytes. There were no signs of CMV infection. Based on the entire clinicopathological picture, the patient was diagnosed with hypoxic hepatitis, complicated by septic shock and multiple organ failure

Insight into the history of anatomopathological museums – Part 1. From casual assemblages to scientific collections

We present a short history of anatomopathological museums in Europe. In the first part we provide an insight into the beginnings from the Renaissance until the middle of the 19th century. We assess forms of acquisition and exhibition of the specimens concerning the steps of medicine and pathology development. The prototypes were “curiosities of nature” collections starting in the 15th century. The next milestone collections focusing on the human body were those of Frederik Ruysch in the Netherlands (17th century). In the 18th century teachers in surgical and anatomical schools realized the educational power of such collections. Anatomopathology as a separate medical discipline was developing in parallel. At that time museums such as the one established by Honoré Fragonard in Paris, the Hunterian in Glasgow and Narrenturm in Vienna were created. At Polish universities in Cracow and Vilnius, such museums were beginning to emerge at the beginning of the 19th century. Anatomopathological collections became more popular, gathering specimens: osteological, dry and mummified, as well as wet – embedded in alcohol, formalin, and mysterious mixtures. They provide a wealth of important data for scientific, medical, historical and even ethical areas, as well as methods and concepts of conservation and even recreation of human body parts

Tumor Heterogeneity at Protein Level as an Independent Prognostic Factor in Endometrial Cancer

Intratumor heterogeneity implies heterogeneous protein function, facilitating tumor adaptation which results in therapeutic failure. We hypothesized that tumor heterogeneity at protein level may influence the course of the disease. As a single biopsy might not represent the full biologic complexity of the tumor, we have analyzed immunohistochemically four different cores obtained from each primary tumor within the cohort of 364 patients with endometrial cancer (EC). The following proteins were examined: estrogen receptor 1 (ESR1), progesterone receptor, epidermal growth factor receptor, v-erb-b2 erythroblastic leukemia viral oncogene homolog 2, receptor tyrosine-protein kinase erbB-3, v-erb-b2 avian erythroblastic leukemia viral oncogene homolog 4, phosphatidylinositol-4,5-bisphosphate 3-kinase, phosphorylated v-akt murine thymoma viral oncogene homolog 1, v-myc avian myelocytomatosis viral oncogene homolog, DNA topoisomerase II alpha 170 kDa (TOP2A), cyclin-dependent kinase inhibitor 2A (CDKN2A), tumor protein p53, RAD21 homolog, S. pombe, and runt-related transcription factor 1. Particularly strong correlation was found between TOP2A and CDKN2A heterogeneity and higher stage of the disease (P = .0002 and P = .0003, respectively). Most correlations with clinicopathologic data were observed for ESR1 heterogeneity that correlated with non-endometrioid carcinomas (P=.02), higher stage (P=.005), grade (P=.01), and the presence of metastases (P = .01). Thirty-nine (11.0%) patients were classified as “globally heterogeneous”. Cumulative tumor heterogeneity strongly correlated with the presence of metastases, higher stage, and higher grade of the disease (all P b .05). It also carried negative prognostic value (P=.0008). We show that the degree of heterogeneity in EC might serve as a clinically valid molecular marker

Central nervous system autopsy — a neuropathological procedure based on multidisciplinary pathoclinical cooperation

Introduction: Neuropathological brain and spinal cord post mortem examination is a distinct procedure that still plays an important role in modern medicine. In front of increasing amounts of clinical and genetic data, together with important developments in the field of neuroimaging, the Polish Association of Neuropathologists have updated their recommendations regarding central nervous system (CNS) examination. These guidelines are aimed at neuropathologists, pathologists and clinicians.Aim of the study: Presentation of the outlined recommendations as their goal is to improve the quality, informativity, and cost effectiveness of CNS post mortem examinations. A comprehensive study of the literature was conducted to provide a clinical background of neuropathological autopsy. There are numerous open questions in neuroscience, and new strategies are required to foster research in CNS diseases. These include the challenge of organizing brain banks tasked with managing and protecting detailed multidisciplinary information about their resources. Complex neuropathological analyses of post mortem series are also important to assess the effectiveness of diagnostics and therapy, identify environmental impact on the development of neurological disorders, and improve public health policy. The recommendations outline the need for collaboration between multiple specialists to establish the proper diagnosis and to broaden knowledge of neurological disorders