Tematem pracy jest omówienie ponad 10-letniej działalności Gabinetu Stopy Cukrzycowej przy Katedr... more Tematem pracy jest omówienie ponad 10-letniej działalności Gabinetu Stopy Cukrzycowej przy Katedrze i Klinice Chorób Metabolicznych Collegium Medicum Uniwersytetu Jagiellońskiego w Krakowie. W niniejszej pracy przedstawiono podstawy patofizjologiczne zespołu stopy cukrzycowej, charakter tego schorzenia i najczęściej spotykane obrazy kliniczne. Ponadto, zaprezentowano argumenty uzasadniające taki model opieki nad chorymi, czyli konieczność tworzenia wielodyscyplinarnych zespołów pracowników służby zdrowia. Przedstawiono zarówno zalety takiego modelu, jak i trudności, na jakie napotyka on w obecnym systemie opieki zdrowotnej. Omówiono strukturę, wyposażenie jednostki i wyniki leczenia chorych w ciągu 11 lat działalności. Pokazano również, w jaki sposób zespół leczący zdobywa doświadczenie oraz prowadzi działalność edukacyjno-naukową. O skuteczności tego modelu opieki świadczy duża liczba wyleczeń przy małym procencie amputacji kończyn. Ważne, że istnieje możliwość porozumienia dla dob...
The authors tested a bee-hive product propolis as a drug to treat patients operated for goitre, p... more The authors tested a bee-hive product propolis as a drug to treat patients operated for goitre, patients with wounds and ulcerations difficult to heal and patients with non-specific rectal inflammation. They also tested the effectiveness of propolis as supplementary means in eradicating treatment of Helicobacter pylori. It was found that the drug was tolerated very well, practically had no side-effects and was highly effective. Preparations of propolis can be successfully used in surgery.
According to the 2012 statistics of the International Agency for Research on Cancer (IARC), gastr... more According to the 2012 statistics of the International Agency for Research on Cancer (IARC), gastric cancer is the fifth most common malignancy, and the third leading cause of cancer-related deaths worldwide. Conventional chemotherapy and radiation have shown limited efficacy for advanced gastric cancer, showing an overall survival (OS) rate of ~10 months. Trastuzumab, a monoclonal antibody against human epidermal growth factor receptor 2 (HER2), is the first approved molecularly targeted agent for HER2-overexpressing gastric cancer, which was found to prolong the OS and the progression-free survival (PFS) of patients. However, HER2 overexpression is present only in a minority of patients with gastric cancer. Hence, other targeted agents are urgently needed. Ramucirumab, a novel human IgG1 monoclonal antibody that selectively targets the extracellular domain of VEGF receptor 2 (VEGFR2), is regarded as a new standard secondline treatment for patients with advanced gastric cancer. The combination of two or more targeted agents directed against two different molecular targets may improve the survival of patients with advanced gastric cancer. Although great efforts have been made, the effect of targeted therapy for gastric cancer is limited. One key reason is that participants in clinical trials for new targeted agents were not selected by detection of the targeted molecule. Here, we review clinical trials related to molecular targets such as anti-epidermal growth factor receptor signaling including anti-HER2 and anti-EGFR1, anti-VEGF signaling, anti-mammalian target of rapamycin (mTOR), tyrosine kinase inhibitors (TKIs) and anti-MET. Contents 1. Introduction 2. Anti-EGFR signaling 3. Anti-VEGF signaling 4. Tyrosine kinase inhibitors 5. mTOR inhibitors 6. Anti-MET pathway 7. Other target agents and future directions 8. Conclusions
For over a century duodenogastric reflux (DGR) has been considered the main cause of the primary ... more For over a century duodenogastric reflux (DGR) has been considered the main cause of the primary or secondary alkaline gastritis. In the first case it occurred in patients who had not been operated earlier, in the latter one in those after surgery of stomach, duodenum, gallbladder and bile ducts. Since first time many reports of clinical and experimental studies have demonstrated destructive effect of pancreatic enzymes, bile acids and their by-products on stomach mucose producing in consequence non-specific histologic lesions. It has been also observed that duodenogastric reflux plays the basic role in the patho-genesis of gastritis and other GI tract diseases (gastric ulcer, reflux oesophagitis, progressing metaplasia or oesophageal and gastric cancer). As far as diagnosing of alkaline gastritis requires histologic confirmation, duodenogastric reflux brings many more problems. However, the progress in medicine and technology allow direct measurement of quality and quantity of this...
Zespół stopy cukrzycowej Dziesięcioletnie doświadczenia gabinetu stopy cukrzycowej-model krakowsk... more Zespół stopy cukrzycowej Dziesięcioletnie doświadczenia gabinetu stopy cukrzycowej-model krakowski The diabetic foot syndrome. 10 years of experience of diabetic foot ward in Cracow STRESZCZENIE Tematem pracy jest omówienie ponad 10-letniej działalności Gabinetu Stopy Cukrzycowej przy Katedrze i Klinice Chorób Metabolicznych Collegium Medicum Uniwersytetu Jagiellońskiego w Krakowie. W niniejszej pracy przedstawiono podstawy patofizjologiczne zespołu stopy cukrzycowej, charakter tego schorzenia i najczęściej spotykane obrazy kliniczne. Ponadto, zaprezentowano argumenty uzasadniające taki model opieki nad chorymi, czyli konieczność tworzenia wielodyscyplinarnych zespołów pracowników służby zdrowia. Przedstawiono zarówno zalety takiego modelu, jak i trudności, na jakie napotyka on w obecnym systemie opieki zdrowotnej. Omówiono strukturę, wyposażenie jednostki i wyniki leczenia chorych w ciągu 11 lat działalności. Pokazano również, w jaki sposób zespół leczący zdobywa doświadczenie oraz prowadzi działalność edukacyjno-naukową. O skuteczności tego modelu opieki świadczy duża liczba wyleczeń przy małym procencie amputacji kończyn. Ważne, że istnieje możliwość porozumienia dla dobra chorego nawet mimo braku przychylności ze strony administracji.
problemem nie tylko onkologicznym, ale przede wszystkim zdrowotnym współczesnego społeczeństwa w ... more problemem nie tylko onkologicznym, ale przede wszystkim zdrowotnym współczesnego społeczeństwa w Polsce i na świecie. Badania nad jakością życia w chorobach przewlekłych są cennym źródłem informacji medycznych, dopełniających dane diagnostyczne i laboratoryjne. Celem badań była wstępna ocena jakości życia chorych na raka odbytnicy po zabiegu operacyjnym i chemioterapii, a także poznanie najczęstszych dolegliwości fizycznych i psychicznych wpływających na jakość życia badanych. Oceny jakości życia, prowadzone wśród 35 chorych z rakiem odbytnicy, u których wykonano przednią resekcję odbytnicy, wskazują, że mimo pozytywnego skutku leczenia (usunięcie raka, brak przerzutów), chorzy silnie przeżywają swój stan, a zaburzenia psychologiczne mają podobne nasilenie, jak dolegliwości fizyczne w tej grupie badanych. Większość badanych – 18 osób (52%) – oceniła swoją jakość życia jako dobrą i bardzo dobrą. Średnia tych ocen wskazuje, że pacjenci oceniają swoją jakość życia w skali Rotterdam jak...
Sabe-se que a dependência a cocaína nas suas diversas formas é atualmente um relevante problema d... more Sabe-se que a dependência a cocaína nas suas diversas formas é atualmente um relevante problema de saúde pública no Brasil. Segundo Carlini et al, 2005, a prevalência do consumo de crack nas grandes cidades brasileiras chega a 0,7%, sendo que os adolescentes constituem uma população em faixa etária vulnerável. Frente a isso, torna-se necessário compreender as alterações fisiológicas desencadeadas pelo uso do crack. Estudos em ratos sugerem que o Brain-derived neurotrophic factor (BDNF)-contribui para a fissura que ocorre após o período inicial de abstinência à cocaína. Desta forma, nossa hipótese é de que haverá variação nos níveis séricos de BDNF em adolescentes usuários de crack após período de abstinência. O presente estudo consiste em um ensaio clínico de séries temporais que objetiva comparar os níveis sanguíneos de BDNF em usuários de crack em dois cenários: recentemente após o uso de crack e depois de 20 dias de abstinência. Sujeitos e métodos: adolescentes de ambos os sexos, com idades entre 12 e 17 anos, usuários de crack, que tenham feito uso recente da droga, residentes na Grande Porto Alegre, encaminhados para internação no HPSP e que consentirem participar da pesquisa terão seus níveis sanguíneos de BDNF medidos por procedimento padrão no momento da baixa hospitalar e após 20 dias de abstinência. Resultados preliminares mostraram a existência de uma diferença estatisticamente significativa dos níveis de BDNF em pacientes que tenham feito uso recente de crack em relação ao níveis obtidos após 20 dias de abstinência (médias de 23,73 ng/mL x 27,93 ng/mL respectivamente, com p <0,01), sugerindo que o uso de crack reduz o BDNF sanguíneo e a abstinência leva a um incremento dessa medida.
The paper describes > 10-year activities of the Diabetic Foot Centre of the Department of Meta... more The paper describes > 10-year activities of the Diabetic Foot Centre of the Department of Metabolic Diseases. The pathophysiology of the diabetic foot syndrome, nature of the disease and most common clinical manifestations have also been presented. The need for a multidisciplinary approach to the management of such patients was emphasized. Advantages of the proposed model and difficulties encountered in our healthcare system were identified. The organizational structure, equipment, and 11-year results were discussed. The way how to gain experience and carry out educational and research activities was also summarized. In conclusion, the main argument for the efficacy of the proposed model is a high rate of cure and low rate of amputation meaning that even without administrative backup it is possible to achieve positive results to the benefit of affected patients.
OBJECT OF RESEARCH Evaluation of methods and outcomes of inguinal region haernias' treatment ... more OBJECT OF RESEARCH Evaluation of methods and outcomes of inguinal region haernias' treatment with the use of synthetic implants. MATERIAL An analysis of 867 patients operated with the use of synthetic implants between 1999 and 2005 has been made (PHS, Robbins-Rutkow). The group consisted of 695 men, and 172 women and the average age was 44.5 years. In 860 (99%) patients a subarachnoid anaesthesia and in (1%) patients a local anaesthesia were performed. All patients received antibiotic prophylaxis. RESULTS Between 1999-2005 867 surgical treatments of the inguinal region haernias were performed using synthetic implants--PHS 363 (41.9%), Robbins-Rutkow 504 (58.1%). Most patients received subarachnoid anaesthesia (99%). Only 1% of the patients were given local anaesthesia due to the load pertaining to internal medicine and the presence of spondylosis. Complications which occured after surgery were: suppuration of the wound in 17 patients (2%), hematoma in the wound in 8 patients (1%...
Hernia (Greek kele/hernios--bud or offshoot) was present in the human history from its very begin... more Hernia (Greek kele/hernios--bud or offshoot) was present in the human history from its very beginning. The role of surgery was restricted to the treatment of huge umbilical and groin hernias and life-threatening incarcerated hernias. The treatment of groin hernia can be divided into five eras. The oldest epoch was ancient era from ancient Egypt to 15th century. The Egyptian Papirus of Ebers contains description of a hernia: swelling that comes out during coughing. Most essential knowledge concerning hernias in ancient times derives from Galen. This knowledge with minor modifications was valid during Middle Ages and eventually in the Renaissance the second era of hernia treatment began. Herniology flourished mainly due to many anatomical discoveries. In spite of many important discoveries from 18th to 19th century the treatment results were still unsatisfactory. Astley Cooper stated that no disease treated surgically involves from surgeon so broad knowledge and skills as hernia and i...
The aim of this study was to examine the relevance of expression profiling of 4 genes involved in... more The aim of this study was to examine the relevance of expression profiling of 4 genes involved in the action of gemcitabine among patients with pancreatic ductal-cell adenocarcinoma (PDAC). A group of 100 patients who underwent pancreatic resections for PDAC and received adjuvant chemotherapy with gemcitabine between 2007 and 2010 was identified. Expression of mRNAs for human equilibrative nucleoside transporter 1 (hENT1), ribonucleotide reductase subunits (RRM1, RRM2), and deoxycytidine kinase (dCK) was examined by quantitative real-time polymerase chain reaction, normalized to glyceraldehyde-3-phosphate dehydrogenase (GAPDH), and dichotomized into groups of low and moderate/high expression levels grouped by tertiles. Significantly better median survival times were found for high/moderate expression levels of hENT1 (27.9 vs 12.4 months, P = 0.001) and dCK (19.7 vs 10.5 months, P = 0.003), as well as low expression of RRM1 (23.4 vs 11.4 months, P = 0.027). A Cox proportional hazards model identified low expression of hENT1 (hazard ratio [HR], 3.38; 95% confidence intervals [CI], 2.28-10.50) and dCK (HR, 2.24; 95% CI, 1.63-3.39), and high/moderate levels of RRM1 (HR, 1.65; 95% CI, 1.23-2.45) as negative prognostic factors. Expression of hENT, RRM1, and dCK genes provides important prognostic information for PDAC patients treated with adjuvant gemcitabine.
We describe a rare case of incercerated femoral hernia containing appendix. Femoral hernias are q... more We describe a rare case of incercerated femoral hernia containing appendix. Femoral hernias are quite rare comparing to inguinal hernias, and might be more difficult to doagnose. During diagnosis and differentiation of femoral hernia possible cimplications such as incarceration of urinary bladder or intestin must be considered.
Tematem pracy jest omówienie ponad 10-letniej działalności Gabinetu Stopy Cukrzycowej przy Katedr... more Tematem pracy jest omówienie ponad 10-letniej działalności Gabinetu Stopy Cukrzycowej przy Katedrze i Klinice Chorób Metabolicznych Collegium Medicum Uniwersytetu Jagiellońskiego w Krakowie. W niniejszej pracy przedstawiono podstawy patofizjologiczne zespołu stopy cukrzycowej, charakter tego schorzenia i najczęściej spotykane obrazy kliniczne. Ponadto, zaprezentowano argumenty uzasadniające taki model opieki nad chorymi, czyli konieczność tworzenia wielodyscyplinarnych zespołów pracowników służby zdrowia. Przedstawiono zarówno zalety takiego modelu, jak i trudności, na jakie napotyka on w obecnym systemie opieki zdrowotnej. Omówiono strukturę, wyposażenie jednostki i wyniki leczenia chorych w ciągu 11 lat działalności. Pokazano również, w jaki sposób zespół leczący zdobywa doświadczenie oraz prowadzi działalność edukacyjno-naukową. O skuteczności tego modelu opieki świadczy duża liczba wyleczeń przy małym procencie amputacji kończyn. Ważne, że istnieje możliwość porozumienia dla dob...
The authors tested a bee-hive product propolis as a drug to treat patients operated for goitre, p... more The authors tested a bee-hive product propolis as a drug to treat patients operated for goitre, patients with wounds and ulcerations difficult to heal and patients with non-specific rectal inflammation. They also tested the effectiveness of propolis as supplementary means in eradicating treatment of Helicobacter pylori. It was found that the drug was tolerated very well, practically had no side-effects and was highly effective. Preparations of propolis can be successfully used in surgery.
According to the 2012 statistics of the International Agency for Research on Cancer (IARC), gastr... more According to the 2012 statistics of the International Agency for Research on Cancer (IARC), gastric cancer is the fifth most common malignancy, and the third leading cause of cancer-related deaths worldwide. Conventional chemotherapy and radiation have shown limited efficacy for advanced gastric cancer, showing an overall survival (OS) rate of ~10 months. Trastuzumab, a monoclonal antibody against human epidermal growth factor receptor 2 (HER2), is the first approved molecularly targeted agent for HER2-overexpressing gastric cancer, which was found to prolong the OS and the progression-free survival (PFS) of patients. However, HER2 overexpression is present only in a minority of patients with gastric cancer. Hence, other targeted agents are urgently needed. Ramucirumab, a novel human IgG1 monoclonal antibody that selectively targets the extracellular domain of VEGF receptor 2 (VEGFR2), is regarded as a new standard secondline treatment for patients with advanced gastric cancer. The combination of two or more targeted agents directed against two different molecular targets may improve the survival of patients with advanced gastric cancer. Although great efforts have been made, the effect of targeted therapy for gastric cancer is limited. One key reason is that participants in clinical trials for new targeted agents were not selected by detection of the targeted molecule. Here, we review clinical trials related to molecular targets such as anti-epidermal growth factor receptor signaling including anti-HER2 and anti-EGFR1, anti-VEGF signaling, anti-mammalian target of rapamycin (mTOR), tyrosine kinase inhibitors (TKIs) and anti-MET. Contents 1. Introduction 2. Anti-EGFR signaling 3. Anti-VEGF signaling 4. Tyrosine kinase inhibitors 5. mTOR inhibitors 6. Anti-MET pathway 7. Other target agents and future directions 8. Conclusions
For over a century duodenogastric reflux (DGR) has been considered the main cause of the primary ... more For over a century duodenogastric reflux (DGR) has been considered the main cause of the primary or secondary alkaline gastritis. In the first case it occurred in patients who had not been operated earlier, in the latter one in those after surgery of stomach, duodenum, gallbladder and bile ducts. Since first time many reports of clinical and experimental studies have demonstrated destructive effect of pancreatic enzymes, bile acids and their by-products on stomach mucose producing in consequence non-specific histologic lesions. It has been also observed that duodenogastric reflux plays the basic role in the patho-genesis of gastritis and other GI tract diseases (gastric ulcer, reflux oesophagitis, progressing metaplasia or oesophageal and gastric cancer). As far as diagnosing of alkaline gastritis requires histologic confirmation, duodenogastric reflux brings many more problems. However, the progress in medicine and technology allow direct measurement of quality and quantity of this...
Zespół stopy cukrzycowej Dziesięcioletnie doświadczenia gabinetu stopy cukrzycowej-model krakowsk... more Zespół stopy cukrzycowej Dziesięcioletnie doświadczenia gabinetu stopy cukrzycowej-model krakowski The diabetic foot syndrome. 10 years of experience of diabetic foot ward in Cracow STRESZCZENIE Tematem pracy jest omówienie ponad 10-letniej działalności Gabinetu Stopy Cukrzycowej przy Katedrze i Klinice Chorób Metabolicznych Collegium Medicum Uniwersytetu Jagiellońskiego w Krakowie. W niniejszej pracy przedstawiono podstawy patofizjologiczne zespołu stopy cukrzycowej, charakter tego schorzenia i najczęściej spotykane obrazy kliniczne. Ponadto, zaprezentowano argumenty uzasadniające taki model opieki nad chorymi, czyli konieczność tworzenia wielodyscyplinarnych zespołów pracowników służby zdrowia. Przedstawiono zarówno zalety takiego modelu, jak i trudności, na jakie napotyka on w obecnym systemie opieki zdrowotnej. Omówiono strukturę, wyposażenie jednostki i wyniki leczenia chorych w ciągu 11 lat działalności. Pokazano również, w jaki sposób zespół leczący zdobywa doświadczenie oraz prowadzi działalność edukacyjno-naukową. O skuteczności tego modelu opieki świadczy duża liczba wyleczeń przy małym procencie amputacji kończyn. Ważne, że istnieje możliwość porozumienia dla dobra chorego nawet mimo braku przychylności ze strony administracji.
problemem nie tylko onkologicznym, ale przede wszystkim zdrowotnym współczesnego społeczeństwa w ... more problemem nie tylko onkologicznym, ale przede wszystkim zdrowotnym współczesnego społeczeństwa w Polsce i na świecie. Badania nad jakością życia w chorobach przewlekłych są cennym źródłem informacji medycznych, dopełniających dane diagnostyczne i laboratoryjne. Celem badań była wstępna ocena jakości życia chorych na raka odbytnicy po zabiegu operacyjnym i chemioterapii, a także poznanie najczęstszych dolegliwości fizycznych i psychicznych wpływających na jakość życia badanych. Oceny jakości życia, prowadzone wśród 35 chorych z rakiem odbytnicy, u których wykonano przednią resekcję odbytnicy, wskazują, że mimo pozytywnego skutku leczenia (usunięcie raka, brak przerzutów), chorzy silnie przeżywają swój stan, a zaburzenia psychologiczne mają podobne nasilenie, jak dolegliwości fizyczne w tej grupie badanych. Większość badanych – 18 osób (52%) – oceniła swoją jakość życia jako dobrą i bardzo dobrą. Średnia tych ocen wskazuje, że pacjenci oceniają swoją jakość życia w skali Rotterdam jak...
Sabe-se que a dependência a cocaína nas suas diversas formas é atualmente um relevante problema d... more Sabe-se que a dependência a cocaína nas suas diversas formas é atualmente um relevante problema de saúde pública no Brasil. Segundo Carlini et al, 2005, a prevalência do consumo de crack nas grandes cidades brasileiras chega a 0,7%, sendo que os adolescentes constituem uma população em faixa etária vulnerável. Frente a isso, torna-se necessário compreender as alterações fisiológicas desencadeadas pelo uso do crack. Estudos em ratos sugerem que o Brain-derived neurotrophic factor (BDNF)-contribui para a fissura que ocorre após o período inicial de abstinência à cocaína. Desta forma, nossa hipótese é de que haverá variação nos níveis séricos de BDNF em adolescentes usuários de crack após período de abstinência. O presente estudo consiste em um ensaio clínico de séries temporais que objetiva comparar os níveis sanguíneos de BDNF em usuários de crack em dois cenários: recentemente após o uso de crack e depois de 20 dias de abstinência. Sujeitos e métodos: adolescentes de ambos os sexos, com idades entre 12 e 17 anos, usuários de crack, que tenham feito uso recente da droga, residentes na Grande Porto Alegre, encaminhados para internação no HPSP e que consentirem participar da pesquisa terão seus níveis sanguíneos de BDNF medidos por procedimento padrão no momento da baixa hospitalar e após 20 dias de abstinência. Resultados preliminares mostraram a existência de uma diferença estatisticamente significativa dos níveis de BDNF em pacientes que tenham feito uso recente de crack em relação ao níveis obtidos após 20 dias de abstinência (médias de 23,73 ng/mL x 27,93 ng/mL respectivamente, com p <0,01), sugerindo que o uso de crack reduz o BDNF sanguíneo e a abstinência leva a um incremento dessa medida.
The paper describes > 10-year activities of the Diabetic Foot Centre of the Department of Meta... more The paper describes > 10-year activities of the Diabetic Foot Centre of the Department of Metabolic Diseases. The pathophysiology of the diabetic foot syndrome, nature of the disease and most common clinical manifestations have also been presented. The need for a multidisciplinary approach to the management of such patients was emphasized. Advantages of the proposed model and difficulties encountered in our healthcare system were identified. The organizational structure, equipment, and 11-year results were discussed. The way how to gain experience and carry out educational and research activities was also summarized. In conclusion, the main argument for the efficacy of the proposed model is a high rate of cure and low rate of amputation meaning that even without administrative backup it is possible to achieve positive results to the benefit of affected patients.
OBJECT OF RESEARCH Evaluation of methods and outcomes of inguinal region haernias' treatment ... more OBJECT OF RESEARCH Evaluation of methods and outcomes of inguinal region haernias' treatment with the use of synthetic implants. MATERIAL An analysis of 867 patients operated with the use of synthetic implants between 1999 and 2005 has been made (PHS, Robbins-Rutkow). The group consisted of 695 men, and 172 women and the average age was 44.5 years. In 860 (99%) patients a subarachnoid anaesthesia and in (1%) patients a local anaesthesia were performed. All patients received antibiotic prophylaxis. RESULTS Between 1999-2005 867 surgical treatments of the inguinal region haernias were performed using synthetic implants--PHS 363 (41.9%), Robbins-Rutkow 504 (58.1%). Most patients received subarachnoid anaesthesia (99%). Only 1% of the patients were given local anaesthesia due to the load pertaining to internal medicine and the presence of spondylosis. Complications which occured after surgery were: suppuration of the wound in 17 patients (2%), hematoma in the wound in 8 patients (1%...
Hernia (Greek kele/hernios--bud or offshoot) was present in the human history from its very begin... more Hernia (Greek kele/hernios--bud or offshoot) was present in the human history from its very beginning. The role of surgery was restricted to the treatment of huge umbilical and groin hernias and life-threatening incarcerated hernias. The treatment of groin hernia can be divided into five eras. The oldest epoch was ancient era from ancient Egypt to 15th century. The Egyptian Papirus of Ebers contains description of a hernia: swelling that comes out during coughing. Most essential knowledge concerning hernias in ancient times derives from Galen. This knowledge with minor modifications was valid during Middle Ages and eventually in the Renaissance the second era of hernia treatment began. Herniology flourished mainly due to many anatomical discoveries. In spite of many important discoveries from 18th to 19th century the treatment results were still unsatisfactory. Astley Cooper stated that no disease treated surgically involves from surgeon so broad knowledge and skills as hernia and i...
The aim of this study was to examine the relevance of expression profiling of 4 genes involved in... more The aim of this study was to examine the relevance of expression profiling of 4 genes involved in the action of gemcitabine among patients with pancreatic ductal-cell adenocarcinoma (PDAC). A group of 100 patients who underwent pancreatic resections for PDAC and received adjuvant chemotherapy with gemcitabine between 2007 and 2010 was identified. Expression of mRNAs for human equilibrative nucleoside transporter 1 (hENT1), ribonucleotide reductase subunits (RRM1, RRM2), and deoxycytidine kinase (dCK) was examined by quantitative real-time polymerase chain reaction, normalized to glyceraldehyde-3-phosphate dehydrogenase (GAPDH), and dichotomized into groups of low and moderate/high expression levels grouped by tertiles. Significantly better median survival times were found for high/moderate expression levels of hENT1 (27.9 vs 12.4 months, P = 0.001) and dCK (19.7 vs 10.5 months, P = 0.003), as well as low expression of RRM1 (23.4 vs 11.4 months, P = 0.027). A Cox proportional hazards model identified low expression of hENT1 (hazard ratio [HR], 3.38; 95% confidence intervals [CI], 2.28-10.50) and dCK (HR, 2.24; 95% CI, 1.63-3.39), and high/moderate levels of RRM1 (HR, 1.65; 95% CI, 1.23-2.45) as negative prognostic factors. Expression of hENT, RRM1, and dCK genes provides important prognostic information for PDAC patients treated with adjuvant gemcitabine.
We describe a rare case of incercerated femoral hernia containing appendix. Femoral hernias are q... more We describe a rare case of incercerated femoral hernia containing appendix. Femoral hernias are quite rare comparing to inguinal hernias, and might be more difficult to doagnose. During diagnosis and differentiation of femoral hernia possible cimplications such as incarceration of urinary bladder or intestin must be considered.
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