Dysfunctions in the Mature Dendritic Cells Are Associated with the Presence of Metastases of Colorectal Cancer in the Surrounding Lymph Nodes

Dendritic cells play a key role in the antigen presentation and T cell activation. The aim of this study was a detailed analysis of the presence of mature dendritic cells (CD 83 positive) in colorectal cancer in correlation with selected clinicopathological parameters. The presence of mature dendritic cells (mDCs) was determined immunohistochemically using the anti-CD83 antibody. The morphometric analysis of the mDCs was performed in the normal colon wall adjacent to the cancerous tumor as well as in the front of the tumor and in the main mass of the cancerous tumor. Decrease in mDCs in the front and in the main tumor mass was observed. The increase in the number of mDCs in both of these locations was associated with the presence of metastases in the nearby lymph nodes (p<0.05 and p<0.01). Furthermore, the increase in the proportion of mDCs in the main tumor mass was associated with the presence of the invasion of tumor cells into the blood and lymph vessels (p<0.01). The increase in the amount of mDCs in the cancerous tumor is associated with the invasiveness of the tumor and especially with the metastasis to the surrounding lymph nodes

EFEKTYWNA STRATEGIA LOGISTYCZNA W PRZEDSIĘBIORSTWIE

The paper presents a general concept of a company’s logistic strategy and the factors increasing its effectiveness. Among these factors the paper presents the role of staff selection and training in the development and realization of the strategy. The paper also includes an attempt to define the logistic strategy

Assessment of the accuracy of preoperative imaging methods in the diagnosis of hepatic single-chamber echinococcosis

Echinococcosis is an infectious disease, caused by larval stages of cestode species of the genus Echinococcus. The course of the disease is determined on the basis of the location and larval size. In 80-95% of cases echinococcosis is located in the liver and lungs, rarely in the brain. Symptoms are usually uncharacteristic for an uncomplicated disease. The diagnosis of echinococcosis is based on imaging and immunodiagnostic tests. The aim of the study was to assess the accuracy of preoperative imaging methods in the diagnosis of hepatic single- chamber echinococcosis. Material and methods. Amongst the 110 patients with hepatic cysts diagnosed during the period between 2000 and 2009, a group of 30 subjects with suspicion of single-chamber echinococcosis (ultrasound and CT) was isolated. The imaging methods visualized structures typical for hydatid cysts: the mother cyst with satellite cysts called “ honeycomb appearance”, cysts with calcified walls and compartments, and endocyst separation called “water lily-sign”. The study group comprised 22 female and 8 male patients with an average age of 52±16.2 years. The histopathological examination of the excised cyst verified the diagnosis. Results. Single-chamber echinococcosis was finally recognized in 19 cases, while in the 11 remaining cases the parasitic disease was excluded. The sensitivity of imaging methods was estimated at 73.7%, specificity - 88.9%, negative predictive value - 61.5%, positive predictive value - 93.3%, Youden`s factor - 0.626, and Φ index - 0.586. Conclusions. In conclusion, the presence of an unilocular cyst with an uniform anechoic content can be a simple cyst or single-chamber echinococcus cyst. The typical, characteristic image of a hydatid cyst, such as the “water lily-sign” is rarely observed during imaging examinations. It has also been shown that cystic calcification, observed during ultrasonography and computed tomography was evidence of the parasitic character of the lesion

Hereditary mixed polyposis syndrome –- own experience

Hereditary mixed polyposis syndrome (HMPS) is a rare condition of unknown genetic origin. The paper presents 25-year clinical follow up in a female patient with multiple gastrointestinal tract polyps of varied histology. They most likely served as sites of multiple colorectal cancers development. The clinical course is interesting in terms of diagnostics and therapy. The patient required extended genetic testing, intensive conservative treatment and numerous surgical procedures. This is the first case of HMPS presented in Polish publications

Young Patient Age as the Cause of Delayed Diagnosis of Gastrointestinal Carcinoma

Most patients diagnosed with gastrointestinal carcinomas are older people. The above-mentioned fact may lead to an erroneous finding that the problem does not concern patients aged between 20 and 30 years. Unfortunately, this assumption is often the reason for late diagnosis and delayed treatment of these malignancies. The study presented an example of three patients subject to surgical management of gastrointestinal carcinomas at the II Department of General and Gastroenterological Surgery, Medical University in Białystok

Blood serum levels of E-cadherin in patients with colorectal cancer

Introduction : Colorectal cancer is the second most common cancer in terms of incidence in Poland. It is also the second most common cause of cancer deaths in men and the third women. In 75–80% of cases, depending on sources, it is of an occasional nature, and in the remaining 20–25% it has a hereditary character. Aim : To compare the levels of E-cadherin in blood serum with some histopathological and clinical features. E-cadherin is an adhesion molecule, loss of function of which is suspected to influence both cancer progression and metastasis. Material and methods : The study group comprised 48 patients diagnosed with colorectal cancer treated surgically in the Second Department of General and Gastroenterological Surgery, Medical University Hospital in Bialystok. Results : As has been shown here, there is no statistically significant relationship between the levels of E-cadherin in blood serum and the possible prognosis to the progression of colorectal cancer. However, it was indicated that there appears to be a statistically significant relationship between blood serum E-cadherin levels and the levels of alanine aminotransferase and aspartate aminotransferase in patients with colorectal cancer. Conclusions : The authors suggest that this significance may require further study

Gas gangrene as a surgical emergency – own experience

In this paper the authors would like to present a correct procedure in both surgical and hyperbaric treatment of patients with gas gangrene admitted to a surgical department during ER. Gas gangrene is not very common these days, but when it comes to dealing with gangrenous infection in the emergency it is quite likely to make errors in both diagnostic and therapeutic manners. When there is a gas gangrene in a patient at the emergency time plays crucial role and the proper application of procedures is vital for the patient’s survival. 10 cases made the study group here, all of them were patients diagnosed and treated surgically due to gas gangrene. As shown here, It is important to perform a revision of surgical wounds after few hours since primary surgery and to begin hyperbaric treatment as quickly as possible. The findings and suggestions included in this study are supported by own experience of The 2nd Department of General and Gastrointestinal Surgery of Medical University in Białystok, Poland

Large pancreatic pseudocyst penetrating into posterior mediastinum

We report a rare case of a large mediastinal pancreatic pseudocyst compressing the left atrium and the esophagus and causing dyspnea, palpitations, and emesis. Chest radiograph was non-diagnostic, esophagogastroduodenoscopy showed diffuse extrinsic compression of the distal esophagus and gastric corpus, but a definitive diagnosis was confirmed by computed tomography. We decided to perform surgery due to the recurrence of the pancreatic pseudocyst, a history of unsuccessful radiologically guided external drainage a few years earlier, and a very large diameter of the pseudocyst causing acute cardio-pulmonary distress syndrome

Duża torbiel rzekoma trzustki penetrująca do śródpiersia tylnego

Przedstawiamy przypadek dużej torbieli rzekomej trzustki w śródpiersiu powodującej ucisk lewego przedsionka i przełyku, co objawiało się dusznością, kołataniem serca i wymiotami. Zdjęcie RTG klatki piersiowej było niediagnostyczne, w ezofagogastroduodenoskopii uwidoczniono rozlany zewnętrzny ucisk na dystalny odcinek przełyku i trzon żołądka, natomiast ostateczne rozpoznanie postawiono w oparciu o tomografię komputerową. Zdecydowano się na zabieg operacyjny z powodu nawrotowości torbieli rzekomej trzustki, wywiad nieskuteczności zewnętrznego drenażu torbieli pod kontrolą radiologiczną kilka lat przed hospitalizacją oraz dużą średnicę torbieli rzekomej, która powodowała ostrą niewydolność krążeniowo-oddechową