Rydygier Memorial Hospital

Kraków, Poland

Rydygier Memorial Hospital

Kraków, Poland
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Skalski A.,AGH University of Science and Technology | Heryan K.,AGH University of Science and Technology | Jakubowski J.,Rydygier Memorial Hospital | Drewniak T.,Specialized Municipal Hospital G Narutowicz
Metrology and Measurement Systems | Year: 2017

With development of medical diagnostic and imaging techniques the sparing surgeries are facilitated. Renal cancer is one of examples. In order to minimize the amount of healthy kidney removed during the treatment procedure, it is essential to design a system that provides three-dimensional visualization prior to the surgery. The information about location of crucial structures (e.g. kidney, renal ureter and arteries) and their mutual spatial arrangement should be delivered to the operator. The introduction of such a system meets both the requirements and expectations of oncological surgeons. In this paper, we present one of the most important steps towards building such a system: a new approach to kidney segmentation from Computed Tomography data. The segmentation is based on the Active Contour Method using the Level Set (LS) framework. During the segmentation process the energy functional describing an image is the subject to minimize. The functional proposed in this paper consists of four terms. In contrast to the original approach containing solely the region and boundary terms, the ellipsoidal shape constraint was also introduced. This additional limitation imposed on evolution of the function prevents from leakage to undesired regions. The proposed methodology was tested on 10 Computed Tomography scans from patients diagnosed with renal cancer. The database contained the results of studies performed in several medical centers and on different devices. The average effectiveness of the proposed solution regarding the Dice Coefficient and average Hausdorff distance was equal to 0.862 and 2.37 mm, respectively. Both the qualitative and quantitative evaluations confirm effectiveness of the proposed solution. © 2017 Polish Academy of Sciences. All rights reserved.


Chrapusta A.,Rydygier Memorial Hospital | Kropotov J.D.,Russian Academy of Sciences | Pachalska M.,Andrzej Frycz Modrzewski University | Pachalska M.,Center for Cognition and Communication
Annals of Agricultural and Environmental Medicine | Year: 2017

Introduction. There is a lack in the worldwide literature of reports on the Neuromarkers of Post-Traumatic Stress Disorder (PTSD) in patients after bilateral hand amputation The aim of this study was to test a hypothesis regarding developing Post-Traumatic Stress Disorder (PTSD) in a patient after bilateral hand amputation with the use of Event Related Potentials (ERPs). On the basis of previous research, the amplitudes of P3 ERP components elicited in the cued GO/NOGO tasks have been chosen as candidates for neuromarkers of PTSD. Case study. A 24-year-old patient had undergone bilateral hand amputation 12 months previously. The patient was repeatedly operated on (he had undergone successful bilateral hand replantation) and despite the severity of the injuries, he recovered. However, the patient complained of flashbacks, anxiety and sleep difficulties. Specialist tests showed the presence of PTSD. The patient participated in the cued GO/NOGO task (Kropotov, 2009) with recording 19-channel EEG. P3 GO and NOGO waves in this task were found to be significantly smaller, in comparison to a group of healthy control subjects of the same age (N=23) taken from the HBI normative database (https://www.hbimed.com/). This observed pattern of ERP waves in the patient corresponds to the pattern found in PTSD patients. Conclusions. ERPs in a GO/NOGO task can be used in the assessment of the functional brain changes induced by chronic PTSD. © 2017, Institute of Agricultural Medicine. All rights reserved.


Heiss M.M.,Witten/Herdecke University | Murawa P.,Wielkoposka Cancer Center | Koralewski P.,Rydygier Memorial Hospital | Kutarska E.,Center of Oncology of Poland | And 16 more authors.
International Journal of Cancer | Year: 2010

Malignant ascites is a common manifestation of advanced cancers, and treatment options are limited. The trifunctional antibody catumaxomab (anti-epithelial cell-adhesion molecule x anti-CD3) represents a targeted immunotherapy for the intraperitoneal (i.p.) treatment of malignant ascites secondary to epithelial cancers. In this phase II/III trial (EudraCT 2004-000723-15; NCT00836654), cancer patients (n = 258) with recurrent symptomatic malignant ascites resistant to conventional chemotherapy were randomized to paracentesis plus catumaxomab (catumaxomab) or paracentesis alone (control) and stratified by cancer type (129 ovarian and 129 nonovarian). Catumaxomab was administered as an i.p. infusion on Days 0, 3, 7 and 10 at doses of 10, 20, 50 and 150 g, respectively. The primary efficacy endpoint was puncture-free survival. Secondary efficacy parameters included time to next paracentesis, ascites signs and symptoms and overall survival (OS). Puncture-free survival was significantly longer in the catumaxomab group (median 46 days) than the control group (median 11 days) (hazard ratio = 0.254: p < 0.0001) as was median time to next paracentesis (77 versus 13 days; p < 0.0001). In addition, catumaxomab patients had fewer signs and symptoms of ascites than control patients. OS showed a positive trend for the catumaxomab group and, in a prospectively planned analysis, was significantly prolonged in patients with gastric cancer (n = 66; 71 versus 44 days; p = 0.0313). Although adverse events associated with catumaxomab were frequent, they were manageable, generally reversible and mainly related to its immunologic mode of action. Catumaxomab showed a clear clinical benefit in patients with malignant ascites secondary to epithelial cancers, especially gastric cancer, with an acceptable safety profile. © 2010 UICC.


Juszczak K.,Rydygier Memorial Hospital | Juszczak K.,Jagiellonian University | Drewa T.,Nicolaus Copernicus University
Central European Journal of Urology | Year: 2014

Introduction The definitive therapy in case of pheochromocytoma is complete surgical resection. Improper preoperative assessment and medical management generally places the patient at risk for complications, resulting from an adrenergic crisis. Therefore, it is crucial to adequately optimize these patients before surgery. Optimal preoperative medical management significantly decreases morbidity and mortality during the tumor resection. Material and methods This review addresses current knowledge in pre- and intraoperative assessment of a patient with pheochromocytoma. Results Before surgery the patient is conventionally prepared with α-adrenergic blockade (over 10-14 days) and subsequently, additional β-adrenergic blockade is required to treat any associated tachyarrhythmias. In preoperative assessment, it is obligatory to monitor arterial blood pressure, heart rate, and arrhythmias and to restore the blood volume to normal. Conclusions In conclusion, due to the pathophysiological complexity of a pheochromocytoma, the strict cooperation between the cardiologist, endocrinologist, surgeon and the anaesthesiologist for an uneventful outcome should be achieved in patients qualified for the surgical removal of such a tumor.


Bokemeyer C.,University of Hamburg | Bondarenko I.,Dnepropetrovsk State Medical Academy | Hartmann J.T.,University of Tübingen | de Braud F.,Instituto Europeo Of Oncologia | And 5 more authors.
Annals of Oncology | Year: 2011

Background: The randomized phase II OPUS (Oxaliplatin and Cetuximab in First-Line Treatment of Metastatic Colorectal Cancer) study showed that tumor KRAS mutation status was predictive for outcome in patients receiving cetuximab plus FOLFOX-4 (oxaliplatin/5-fluorouracil/folinic acid) as first-line therapy for metastatic colorectal cancer (mCRC). Patients and methods: The biomarker analysis was extended through the use of additional DNA samples extracted from stained tissue sections. KRAS and BRAF tumor mutation status was determined for new (and for BRAF, existing) samples using a PCR technique. Clinical outcome was reassessed according to mutation status. Overall survival data are presented. Results: Of 315 KRAS evaluable patient samples (93%), 179 tumors (57%) were KRAS wild type. Eleven of 309 (4%) KRAS/BRAF evaluable tumors (all KRAS wild type) carried BRAF mutations. The addition of cetuximab to FOLFOX-4 significantly improved progression-free survival (hazard ratio 0.567, P = 0.0064) and response (odds ratio 2.551, P = 0.0027) in patients with KRAS wild-type tumors. A favorable effect on survival was also observed. Conclusions: These results confirm the efficacy of cetuximab plus FOLFOX-4 in the first-line treatment of patients with KRAS wild-type mCRC and confirm KRAS mutation status as an effective predictive biomarker. The small number of tumors with BRAF mutations precluded the drawing of definitive conclusions concerning the predictive or prognostic utility of this biomarker. © The Author 2011. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved.


Juszczak K.,Jagiellonian University | Juszczak K.,Rydygier Memorial Hospital | Thor P.J.,Jagiellonian University
Advances in Clinical and Experimental Medicine | Year: 2012

The pathophysiology of functional disorders of the urinary bladder is still relatively poorly understood, although the mechanisms controlling the lower urinary tract function have been quite accurately described. The rich innervation of afferent and efferent urinary tract, multi-level neural control of micturition process, the diversity of the autonomic nervous system neurotransmitters, as well as "neuronal activity" of the urotelium determines the correct filling and emptying of the bladder. Functional diseases (OAB - such as overactive bladder) include sensory and/or motor dysfunction of the urinary bladder, leading to sleep disturbances, psychosomatic disorders, lower quality of life, etc. It is known that sensory afferent C fibers and vanilloid TRPV1 receptors are important in the pathogenesis of OAB. Modulation of the activity of these fibers and/or TRPV1 receptors by a number of substances (such as capsaicin, lidocaine, etc.) reduces the symptoms of OAB. Detailed knowledge of the neurophysiology of the lower urinary tract is a prerequisite for proper treatment of functional disorders of the urinary tract. The paper discusses the neurophysiologic basis, the importance of afferent C fibers and vanilloid TRPV1 receptors in lower urinary tract. © Copyright by Wroclaw Medical University.


Juszczak K.,Jagiellonian University | Juszczak K.,Rydygier Memorial Hospital | Kaszuba-Zwoinska J.,Jagiellonian University | Thor P.J.,Jagiellonian University
Journal of Physiology and Pharmacology | Year: 2012

The evidence of electromagnetic therapy (EMT) efficacy in stress and/or urge urinary incontinence, as well as in detrusor overactivity is generally lacking in the literature. The potential EMT action of neuromuscular tissue depolarization has been described. Because there is no data on the influence of pulsating electromagnetic fields (PEMF) on the urothelium, we evaluated the effect of PEMF stimulation on rat urothelial cultured cells (RUCC). In our study 15 Wistar rats were used for RUCC preparation. RUCC were exposed to PEMF (50 Hz, 45±5 mT) three times for 4 hours each with 24-hour intervals. The unexposed RUCC was in the same incubator, but in a distance of 35 cm from the PEMF generator. Annexin V-APC (AnV+) labelled was used to determine the percentage of apoptotic cells and propidium iodide (PI+), as standard flow cytometric viability probe to distinguish necrotic cells from viable ones. The results are presented in percentage values. The flow cytometric analysis was carried out on a FACS calibur flow cytometer using Cell-Quest software. In PEMF-unstimulated RUCC, the percentage of AnV+, PI+, and AnV+PI+ positive cells were 1.24±0.34%, 11.03±1.55%, and 12.43±1.96%, respectively. The percentages of AnV+, PI+, and AnV+PI+ positive cells obtained after PEMF stimulation were 1.45±0.16% (p=0.027), 7.03±1.76% (p<0.001), and 9.48±3.40% (p=0.003), respectively. The PEMF stimulation of RUCC induces apoptosis (increase of AnV+ cells) and inhibits necrosis (decrease of PI+ cells) of urothelial cells. This leads us to the conclusion that a low-frequency pulsating electromagnetic field stimulation induces apoptosis and diminishes necrosis of rat urothelial cells in culture.


Juszczak K.,Jagiellonian University | Juszczak K.,Rydygier Memorial Hospital | Ziomber A.,Jagiellonian University | Thor P.J.,Jagiellonian University
Journal of Physiology and Pharmacology | Year: 2011

The study investigated the mechanisms through which the hyperosmolarity might induce detrusor overactivity (DO). We compared the bladder activity in response to partial and complete blockade of TRPV1-6 and TRPA1 receptors. Experiments were performed on 42 rats. DO was induced by using hyperosmolar saline. All animals were randomly divided into six groups. The measurements represent the average of five bladder micturition cycles. Hyperosmolar saline induced DO. The complete blockade of TRPV1-6 and TRPA1 prevented DO. The partial blockade of TRPV1 didn't prevented DO. In the voiding phase periodical bladder contractions complexes occurred leading to slow urine flow due to bladder distension. Ruthenium red and capsaicin resulted in complete disorganisation of detrusor muscle contractility impairing urine voiding and leading to constantly lasting urine retention in healthy rats. Conclusions: hyperosmolarinduced DO is mediated by TRPV and TRPA1 channels; the hyperosmolar stimuli of urinary bladder might be transmitted mostly via ruthenium red sensitivity pathway.


Juszczak K.,Jagiellonian University | Juszczak K.,Rydygier Memorial Hospital | Gil K.,Jagiellonian University | Wyczolkowski M.,Rydygier Memorial Hospital | Thor P.J.,Jagiellonian University
Journal of Physiology and Pharmacology | Year: 2010

Neurogenic inflammation is linked to urinary bladder overactivity development. Cyclophosphamide (CYP) damages allmucosal defence lines of urinary bladder and induces cystitis with overactivity. The aim of this study was to estimate the effect of CYP on rat urinary bladder function, histological structure and mastocytes numbers following acute and chronic CYP treatment. Fourty two female rats were divided into four groups: I (control), II (acute cystitis), III (chronic cystitis), IV (sham group). Acute and chronic cystitis were induced by CYP in single dose and four doses (1 st, 3 rd, 5 th, 7 th day), respectively. In group I-III the cystometric evaluation was performed. Sections of the bladder were stained with HE and toluidine blue for the detection of mastocytes. The severity of inflammation was examined according to mucosal abrasion, haemorrhage, leukocyte infiltration and oedema. Acute and chronic CYP treatment caused inflammatory macroscopic and microscopic changes (mucosal abrasion, haemorrhage, oedema) and increased infiltration of inflammatory cells in urinary bladder. Acute treatment induced the infiltration of mastocytes within bladder wall contrary to chronic one decrement. Acute treatment caused more severe mucosal abrasion, whereas chronic one revealed more developed haemorrhage changes. Additionally, cystometric evaluation revealed urinary bladder overactivity development in both types of cystitis. Basal pressure and detrusor overactivity index after acute treatment increased considerably in comparison with the increase obtained after chronic one. Our results proved that acute model of CYP-induced cystitis in rats is more credible for further evaluation of neurogenic inflammation response in pathogenesis of overactive bladder as compared to chronic one.


Juszczak K.,Jagiellonian University | Juszczak K.,Rydygier Memorial Hospital | Kaszuba-Zwoinska J.,Jagiellonian University | Chorobik P.,Jagiellonian University | And 2 more authors.
Cellular and Molecular Biology Letters | Year: 2012

Highly concentrated urine may induce a harmful effect on the urinary bladder. Therefore, we considered osmolarity of the urine as a basic pathomechanism of mucosal damage. The influence of both cyclophosphamide (CYP) and hyperosmolar stimuli (HS) on the urothelium are not well described. The purpose was to evaluate the effect of CYP and HS on rat urothelial cultured cells (RUCC). 15 Wistar rats were used for RUCC preparation. RUCC were exposed to HS (2080 and 3222 mOsm/l NaCl) for 15 min and CYP (1 mg/ml) for 4 hrs. APC-labelled annexin V was used to quantitatively determine the percentage of apoptotic cells and propidium iodide (PI) as a standard flow cytometric viability probe to distinguish necrotic cells from viable ones. Annexin V-APC (+), annexin V-APC and PI (+), and PI (+) cells were analysed as apoptotic, dead, and necrotic cells, respectively. The results were presented in percentage values. The flow cytometric analysis was done on a FACSCalibur Flow Cytometer using Cell-Quest software. Treatment with 2080 and 3222 mOsm/l HS resulted in 23.7 ± 3.9% and 26.0 ± 1.5% apoptotic cells, respectively, 14.3 ± 1.4% and 19.4 ± 2.7% necrotic cells, respectively and 60.5 ± 1.4% and 48.6 ± 5.3% dead cells, respectively. The effect of CYP on RUCC was similar to the effect of HS. After CYP the apoptotic and necrotic cells were 23.1 ± 0.3% and 17.9 ± 7.4%, respectively. The percentage of dead cells was 57.7 ± 10.8%. CYP and HS induced apoptosis and necrosis in RUCC. 3222 mOsm/l HS had the most harmful effect based on the percentage of necrotic and apoptotic cells. © 2012 © Versita Warsaw and Springer-Verlag Wien.

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