Ecchordosis physaliphora – opis przypadku i omówienie patologicznych pochodnych struny grzbietowej

Some notochord cells remain along the axis of the vertebral column after embryogenesis. These ‘notochordal remnants’ have some similarities, but their biological behaviour varies considerably. They can give rise to benign lesions such as ecchordosis physaliphora (EP) and ‘benign notochordal cell tumour’ (BNCT), or aggressive ones like chordoma. We review the problems of the differential diagnosis of notochordal remnants apropos of a case of the incidental autopsy finding of EP in a 78-year-old man, who died due to heart infarction. The 6-mm asymptomatic gelatinous lesion was fixed to the basilar artery on its ventral aspect. Small EPs can be easily overlooked in autopsy. Ecchordosis physaliphora and intradural chordoma share some similarities that may be misleading and may even result in the wrong diagnosis and therapy. The recently reported new entity BNCT poses a similar problem. We review the literature illustrating the most important features of notochord-derived lesions and discuss the relationships between these lesions with regard to molecular genetics.Podczas formowania się jąder miażdżystych na pozostałościach komórek struny grzbietowej rozwijają się zmiany podobne do siebie, mające jednak różny przebieg kliniczny. Niektóre z nich, takie jak ecchordosis physaliphora (EP) i notochordal benign cell tumour (NBCT), mają charakter łagodny, inne (np. struniak) – agresywny. Celem pracy jest przegląd najważniejszych cech zmian wywodzących się ze struny grzbietowej i ich diagnostyka różnicowa na podstawie przypadku EP stwierdzonego podczas autopsji mózgu 78-letniego mężczyzny zmarłego na atak serca. Galaretowaty guz o największym wymiarze 6 mm, przytwierdzony do brzusznej części tętnicy podstawnej nie dawał żadnych objawów. Ecchordosis physaliphora to zazwyczaj mały, bezobjawowy guzek, łatwy do przeoczenia podczas autopsji. Struniak i EP wywodzą się z tych samych komórek, lecz ze względu na podobieństwa mogą być ze sobą mylone, co skutkuje niewłaściwym rozpoznaniem i ewentualnym leczeniem. Podobny problem występuje w przypadku NBCT. W pracy poruszono również kwestię ich wzajemnego związku na podstawie badań genetycznych

"Ecchordosis physaliphora" : opis przypadku i omówienie patologicznych pochodnych struny grzbietowej

Podczas formowania się jąder mia¿d¿ystych na pozostałościach komórek struny grzbietowej rozwijają się zmiany podobne do siebie, mające jednak różny przebieg kliniczny. Niektóre znich, takie jak ecchordosis physaliphora (EP) i notochordal benign cell tumour(NBCT), mają charakter łagodny, inne (np. stru- niak) - agresywny. Celem pracy jest przegląd najważniejszych cech zmian wywodzących się ze struny grzbietowej iich dia­gnostyka różnicowa na podstawie przypadku EP stwierdzo­nego podczas autopsji mózgu 78-letniego mężczyzny zmarłego na atak serca. Galaretowaty guz o największym wymiarze 6 mm, przytwierdzony do brzusznej części tętnicy podstaw- nej nie dawał żadnych objawów. Ecchordosis physaliphora to zazwyczaj mały, bezobjawowy guzek, łatwy do przeoczenia podczas autopsji. Struniak iEP wywodzą się z tych samych komórek, lecz ze względu na podobieństwa mogą być ze sobą mylone, co skutkuje niewła­ściwym rozpoznaniem i ewentualnym leczeniem. Podobny problem występuje w przypadku NBCT. W pracy poruszo­no również kwestię ich wzajemnego związku na podstawie badań genetycznych.Some notochord cells remain along the axis of the vertebral column after embryogenesis. These ‘notochordal remnants’ have some similarities, but their biological behaviour varies considerably. They can give rise to benign lesions such as ecchordosis physaliphora (EP) and ‘benign notochordal cell tumour’ (BNCT), or aggressive ones like chordoma. We review the problems of the differential diagnosis of notochordal remnants apropos of a case of the incidental autopsy finding of EP in a 78-year-old man, who died due to heart infarction. The 6-mm asymptomatic gelatinous lesion was fixed to the basilar artery on its ventral aspect. Small EPs can be easily overlooked in autopsy. Ecchordosis physaliphora and intradural chordoma share some similarities that may be misleading and may even result in the wrong diagnosis and therapy. The recently reported new entity BNCT poses a similar problem. We review the literature illustrating the most important features of notochord-derived lesions and discuss the relationships between these lesions with regard to molecular genetics

Pineal cyst-related sleep disorders – a narrative review

The pineal gland is an endocrine gland, which is responsible for the human circadian rhythm, through the regulation of its hormone – melatonin. The most common pathology of a pineal gland is pineal cyst – its population incidence is estimated as 1-23%, depending on the publication. The most common symptoms of a pineal cyst include headache (87%), visual field defects (54%), nausea/vomiting (34%), and dizziness/vertigo (31%). Among the majority of patients with the asymptomatic pineal cyst, the wait-and-see strategy is proper.             According to the newest meta-analyze, the prevalence of sleep disturbances among patients with pineal cyst estimates to be 17%. The results of direct melatonin level measurements in pineal cysts remain unclear. The study focused on sleep disturbances in pediatric patients with pineal cysts and showed a significantly higher score on Sleep Disturbance Scale for Children (SDSC) in the domains of disorders of excessive sleepiness and disorders of initiating and maintaining sleep than the control groups. The impact of lesion on sleep quality correlated with its size.             The pineal cyst may be considered a rare, and potentially reversible, cause of sleep disorders. Nevertheless, according to the present reports (often opposite to each other), this thesis and the mechanism of its occurrence need to be further researched

High risk of invasive fungal disease in children undergoing hematopoietic cell transplantation or complex anticancer therapy: the adverse role of post-transplant CMV replication

Introduction: We analyzed the epidemiology and outcomes of treatment of invasive fungal disease (IFD) in children during anticancer therapy (PHO, pediatric hematology and oncology) or after hematopoietic cell transplantation (HCT) over a period of eight consecutive years in a single-center study. Material and methods: Overall, a total of 254 HCTs were performed, and 415 children were newly diagnosed for malignancy. Incidence, epidemiology and outcome of IFD were analyzed. Results: The cumulative incidence of any IFD was 32.6% in allo-HCT, 22.2% in PHO, and 6.0% in auto-HCT patients. The incidence of proven +probable IFD was 12.6%, 10.4%, and 6.0%, respectively. As many as 77.0% HCT and 67.4% PHO of fungal episodes occurred in acute leukemia patients: the highest incidence of any IFD was observed for acute lymphoblastic leukemia (29.3% in HCT; 40.5% in PHO) and for acute myeloblastic leukemia (51.1% in HCT; 65.0% in PHO) patients. There were no significant differences in the incidence of fungal infections in both allo-HCT and PHO patients between the 2-year periods. Factors contributing to an increased risk of IFD in allo-HCT patients were: CMV replication, and acute and chronic graft-versus-host disease (GvHD). Survival from IFD was 91.9% in PHO, and 78.1% in HCT patients. Fungal pneumonia in HCT patients resolved in 62.9%, while in PHO patients it resolved in 93.5%. Conclusions: The risk of IFD in allo-HCT patients is much higher than in auto-HSCT and PHO patients. The outcome of IFD is better in PHO and auto-HCT than in allo-HCT settings

External quality monitoring facilitates improvement in already well-performing stroke units: insights from RES-Q Poland

Introduction. The Registry of Stroke Care Quality (RES-Q) is used in Poland for quality monitoring by numerous hospitals participating in the Angels Initiative. Our aim was to assess the degree of improvement in highly stroke-oriented centres that report cases to the RES-Q each year. Material and methods. This retrospective analysis included Polish stroke units that from January 2017 to December 2020 contributed to the RES-Q at least 25 patients annually. Results. Seventeen out of 180 Polish stroke units reported patients each year (2017, n = 1,691; 2018, n = 2,986; 2019, n = 3,750; 2020, n = 3,975). The percentage of ischaemic stroke patients treated with alteplase remained stable (26%, 29%, 30% and 28%, respectively). The door-to-needle time progressively decreased, from a median 49 minutes to 32 minutes. The percentage of patients treated ≤ 60 minutes and ≤ 45 minutes significantly increased (from 68% to 86% and from 43% to 70%, respectively), with no change observed between 2019 and 2020. Despite a general improvement in dysphagia screening (81%, 91%, 98% and 99%), screening performed within the first 24h from admission became less frequent (78%, 76%, 69% and 65%). In-hospital mortality significantly increased (11%, 11%, 13% and 15%), while the proportion of patients discharged home remained stable. Conclusions. Quality-oriented projects facilitate the improvement of stroke care, even in centres demonstrating good baseline performance. Polish stroke units that consistently reported cases to the RES-Q demonstrated improvement in terms of door-to- -needle time and dysphagia screening. However, there is still a need to shorten the time to dysphagia screening, and carefully monitor stroke unit mortality following the COVID-19 pandemic

Shaping the organizational culture of the local government unit on the example of Communal and Municipal Office in Czerwionka-Leszczyny

Celem niniejszej pracy jest identyfikacja kultury organizacyjnej Urzędu Gminy i Miasta Czerwionka-Leszczyny, sporządzenie profilu tejże kultury i określenie jaki kierunek zmian jest najwłaściwszy. W pracy opisano istotę, funkcje oraz znaczenie kultury organizacyjnej we współczesnych organizacjach. Szczególną uwagę poświęcono modelowi wartości konkurujących K. S. Camerona i R. E. Quinna, który został wybrany do oceny kultury organizacyjnej w niniejszej pracy. Dokonano również charakterystyki badanego obiektu. Badania przeprowadzono za pomocą kwestionariusza OCAI, który został oparty na wspomnianym wcześniej modelu wartości konkurujących. Analiza przeprowadzonych badań umożliwiła sporządzenie obecnego profilu kultury w badanej organizacji. Zgodnie z wynikami badań kultura hierarchii obecnie silnie dominuje oraz istnieją duże rozbieżności pomiędzy stanem obecnym a pożądanym w organizacji. Dodatkowo badania potwierdziły, że profil kultury jest zgodny w większości z badanych obszarów funkcjonowania organizacji.The main aim of this master’s thesis is to identify an organizational culture in The Communal and Municipal Office in Czerwionka-Leszczyny, draw up a profile of this culture and to present the recommended directions of changes in the organizational culture. The work presents the essence, function and significance of organizational culture. Special attention is devoted to model of competing values of K. S. Cameron and R. E. Quinn, which was chosen to identify organizational culture in this case. The author also describes characteristics of observed local government unit. Survey was carried out using a questionnaire OCAI (Organizational Culture Assessment Instrument), based on the mentioned above model of competing values. The analysis of the conducted survey enabled the preparation of culture profile. The results show that currently hierarchy culture strongly dominates and there are a large discrepancies between current and desired state in the organization. In addition results confirmed that the profile of culture is consistent in most of the reviewed areas of the organization’s functioning

Electric Conductivity and Electrode Polarization as Markers of Phase Transitions

Dielectric polarization and electric polarization of electrodes are the common features of polar materials. We described methods to analyze their contributions and showed that both dependencies on temperature of dielectric conductivity and electrode polarization and the exponents characterizing these dependencies are excellent markers of phase transitions. Proposed methods were applied to several compounds, such as liquid crystals, pharmacological compounds, monoalcohols, polyalcohols, and various thermodynamic phases. Common behavior was noted for materials under study. In similar phases, various substances have the same values of the exponents characterizing electric conductivity and contribution from the electrode polarization. These exponents show discontinuities at phase transition temperatures between crystal-like and liquid-like phases

Distinguishing the Focal-Conic Fan Texture of Smectic A from the Focal-Conic Fan Texture of Smectic B

This publication presents methods of distinguishing the focal texture of the conical smectic phase A (SmA) and the crystalline smectic B phase (CrB). Most often, characteristic transition bars are observed in polarized light at the temperature point of the SmA–CrB phase transition. TOApy software transforms each image from a series of images recorded during POM observation to a function of light intensity versus temperature. Thermo-optical analysis is a powerful quantitative tool to notice this phase transition, but it has some limitations. The other applied method, the local binary pattern (LBP) algorithm, with high probability, detects differences between the textures of the conical focal fan of the SmA and CrB phases. The LBP algorithm is an efficient tool for texture classification