Publications by authors named "Katarzyna Gruszczynska"

34 Publications

Assessment of Post-Stroke Consequences in Pediatric Ischemic Stroke in the Context of Neuroimaging Results-Experience from a Single Medical Center.

Children (Basel) 2021 Apr 8;8(4). Epub 2021 Apr 8.

Department of Diagnostic Imaging, Radiology and Nuclear Medicine, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland.

Arterial ischemic stroke (AIS) in children is a rare condition; its frequency is estimated at 0.58 to 7.9 new onsets in 100,000 children per year. The knowledge on risk factors, clinical outcomes and consequences of pediatric AIS is increasing. However, there are still many unknowns in the field. The aim of the study was to analyze the clinical presentation of pediatric AIS and its consequences according to the neuroimaging results and location of ischemia. The research was retrospective and observational. The analyzed group consisted of 75 AIS children (32 girls, 43 boys), whereby the age of the patients ranged from 9 months to 18 years at stroke onset. All the patients were diagnosed and treated in one tertiary center. The most frequent stroke subtype was total anterior circulation infarct (TACI) with most common ischemic focus location in temporal lobe and vascular pathology in middle cerebral artery (MCA). The location of ischemic focus in the brain correlated with post-stroke outcomes: intellectual delay and epilepsy, hemiparesis corresponded to the location of vascular pathology. A correlation found between ischemic lesion location and vascular pathology with post-stroke consequences in pediatric AIS may be important information and helpful in choosing proper early therapy. The expected results should lead to lesser severity of late post-stroke outcomes.
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http://dx.doi.org/10.3390/children8040292DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8068320PMC
April 2021

Local electromechanical alterations determine the left ventricle rotational dynamics in CRT-eligible heart failure patients.

Sci Rep 2021 Feb 5;11(1):3267. Epub 2021 Feb 5.

Department of Cardiology and Structural Heart Disease, Medical University of Silesia, Ziołowa 45-47, Katowice, Poland.

Left ventricle, LV wringing wall motion relies on physiological muscle fiber orientation, fibrotic status, and electromechanics (EM). The loss of proper EM activation can lead to rigid-body-type (RBT) LV rotation, which is associated with advanced heart failure (HF) and challenges in resynchronization. To describe the EM coupling and scar tissue burden with respect to rotational patterns observed on the LV in patients with ischemic heart failure with reduced ejection fraction (HFrEF) left bundle branch block (LBBB). Thirty patients with HFrEF/LBBB underwent EM analysis of the left ventricle using an invasive electro-mechanical catheter mapping system (NOGA XP, Biosense Webster). The following parameters were evaluated: rotation angle; rotation velocity; unipolar/bipolar voltage; local activation time, LAT; local electro-mechanical delay, LEMD; total electro-mechanical delay, TEMD. Patients underwent late-gadolinium enhancement cMRI when possible. The different LV rotation pattern served as sole parameter for patients' grouping into two categories: wringing rotation (Group A, n = 6) and RBT rotation (Group B, n = 24). All parameters were aggregated into a nine segment, three sector and whole LV models, and compared at multiple scales. Segmental statistical analysis in Group B revealed significant inhomogeneities, across the LV, regarding voltage level, scar burdening, and LEMD changes: correlation analysis showed correspondently a loss of synchronization between electrical (LAT) and mechanical activation (TEMD). On contrary, Group A (relatively low number of patients) did not present significant differences in LEMD across LV segments, therefore electrical (LAT) and mechanical (TEMD) activation were well synchronized. Fibrosis burden was in general associated with areas of low voltage. The rotational behavior of LV in HF/LBBB patients is determined by the local alteration of EM coupling. These findings serve as a strong basic groundwork for a hypothesis that EM analysis may predict CRT response.Clinical trial registration: SUM No. KNW/0022/KB1/17/15.
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http://dx.doi.org/10.1038/s41598-021-82793-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7865069PMC
February 2021

Analysis of Point Shear Wave Elastography and Biochemical Markers for the Detection of Liver Fibrosis.

Medicina (Kaunas) 2021 Jan 6;57(1). Epub 2021 Jan 6.

Department of Radiodiagnostics and Invasive Radiology, School of Medicine in Katowice, Medical University of Silesia, 40-752 Katowice, Poland.

This work focuses on the possibility of using the point shear wave elastography (pSWE) method for detecting biochemical markers in diffuse liver diseases. Additionally, this study addresses the issue of the influence of ultrasound factors on the pSWE quality indicators of the obtained measurements. A pSWE examination was performed on 139 patients (69 female and 70 male) diagnosed with diffuse liver disease. The average age for all patients was 50.7 ± 15.0 years (female: 52.7 ± 15.2 years; male: 48.8 ± 14.6 years). Of these 139 patients, 65 met the inclusion criteria regarding biochemical parameters. The pSWE quality indicators were related to abnormalities found in B-mode ultrasound. A strong positive correlation was found between the results of the pSWE and all biochemical indexes analysed, with the exception of age/platelet count (PLT), for which an average correlation was obtained. The greatest correlation was observed between the elastography and King's Score index. There was no correlation observed between elastography and any of the analysed parameters or biochemical indexes considered. The pSWE measurements were impaired by factors such as thick soft tissue, uneven hepatic surface, hepatomegaly and female gender. No statistically significant difference in pSWE quality indicators parameters was found between disease entities. pSWE seems to be a complementary method for detecting biochemical indexes, but its results can be influenced by numerous factors.
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http://dx.doi.org/10.3390/medicina57010040DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7825115PMC
January 2021

Leukoencephalopathy with Calcifications and Cysts-The First Polish Patient with Labrune Syndrome.

Brain Sci 2020 Nov 18;10(11). Epub 2020 Nov 18.

Department of Medical Genetics, Medical University of Warsaw, 02-106 Warsaw, Poland.

Leukoencephalopathy with calcifications and cysts (LCC) is a triad of neuroradiological symptoms characteristic of Labrune syndrome, which was first described in 1996. For 20 years, the diagnosis was only based on clinical, neuroradiological and histopathological findings. Differential diagnosis included a wide spectrum of diseases. Finally, in 2016, genetic mutation in the gene was confirmed to cause Labrune syndrome. The authors describe a case of a teenage girl with progressive headaches, without developmental delay, presenting with calcifications and white matter abnormality in neuroimaging. Follow-up studies showed the progression of leukoencephalopathy and cyst formation. The first symptoms and initial imaging results posed diagnostic challenges. The final diagnosis was established based on genetic results. The authors discuss the possible therapy of LCC with Bevacizumab.
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http://dx.doi.org/10.3390/brainsci10110869DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7698922PMC
November 2020

Neuroimaging of Basal Ganglia in Neurometabolic Diseases in Children.

Brain Sci 2020 Nov 12;10(11). Epub 2020 Nov 12.

Department of Pediatric Neurology, Faculty of Medical Science in Katowice, Medical University of Silesia, 40-055 Katowice, Poland.

Diseases primarily affecting the basal ganglia in children result in characteristic disturbances of movement and muscle tone. Both experimental and clinical evidence indicates that the basal ganglia also play a role in higher mental states. The basal ganglia can be affected by neurometabolic, degenerative diseases or other conditions from which they must be differentiated. Neuroradiological findings in basal ganglia diseases are also known. However, they may be similar in different diseases. Their assessment in children may require repeated MRI examinations depending on the stage of brain development (mainly the level of myelination). A large spectrum of pathological changes in the basal ganglia in many diseases is caused by their vulnerability to metabolic abnormalities and chemical or ischemic trauma. The diagnosis is usually established by correlation of clinical and radiological findings. Neuroimaging of basal ganglia in neurometabolic diseases is helpful in early diagnosis and monitoring of changes for optimal therapy. This review focuses on neuroimaging of basal ganglia and its role in the differential diagnosis of inborn errors of metabolism.
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http://dx.doi.org/10.3390/brainsci10110849DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7697699PMC
November 2020

Hand Injuries in the Polish Silesian Paediatric Population-An Exploratory Cross-Sectional Study of Post-Traumatic X-rays.

Medicina (Kaunas) 2020 Oct 20;56(10). Epub 2020 Oct 20.

Department of Diagnostic Imaging, School of Medicine in Katowice, Medical University of Silesia, 40-752 Katowice, Poland.

In the paediatric population, hand injuries are one of the most frequent injuries and the second most frequent area of fracture. It is estimated that hand injuries account for up to 23% of the trauma-related causes of emergency department visits. Not only are they a significant factor in health care costs, but they may also lead to detrimental and long-term consequences for the patient. The discrepancy observed between the published studies suggests a geographical variation in their epidemiology. The aim of this study is to determine the localisation of injuries and fractures involving the hand in the paediatric population of the Polish Silesia region. This exploratory cross-sectional study involved 1441 post-traumatic hand X-ray examinations performed at the Department of Diagnostic Imaging of the John Paul II Upper Silesian Child Health Centre in Katowice between January and December 2014. The study group consisted of 656 girls and 785 boys who were 11.65 ± 3.50 and 11.51 ± 3.98 years old, respectively (range: 1-18 years). All examinations were evaluated for the location of the injury and presence of fracture(s). Finger injuries were dominant ( = 1346), with the fifth finger being the most frequently injured ( = 381). The majority of injuries were observed among children who were 11 years old ( = 176), with a visible peak in the 11- to 13-year-old group. A total of 625 bone fractures were detected. Fractures of the proximal phalanges ( = 213) and middle phalanges ( = 159) were most common, and fifth finger ( = 189) predominance was again observed. A gender-independent positive correlation was found between patients' age and finger injuries ( < 0.01) as well as metacarpal injuries ( < 0.01). There was no correlation between patients' age and fractures in these locations ( > 0.05). Metacarpal injuries ( < 0.01), finger injuries ( < 0.01), fractures ( = 0.01), and fractures with displacement ( = 0.03) were more common among males regardless of age. The results indicate that 11-year-old boys are at an increased risk of hand injuries and fractures. The distal and middle phalanges of the right hand, especially of the fifth digit, were the most susceptible to fracture localisation. Thus, injuries in these areas should be perceived as most likely to cause fractures and therefore demand careful examination.
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http://dx.doi.org/10.3390/medicina56100550DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7590142PMC
October 2020

Management of patients with COVID-19 in radiology departments, and indications regarding imaging studies - recommendations of the Polish Medical Society of Radiology.

Pol J Radiol 2020 29;85:e209-e214. Epub 2020 Apr 29.

Department of Diagnostic Imaging, Centre of Postgraduate Medical Education, Warsaw, Poland.

The pandemic involving COVID-19 caused by the SARS-CoV-2 coronavirus, due to its severe symptoms and high transmission rate, has gone on to pose a control challenge for healthcare systems all around the world. We present the second version of the Recommendations of the Polish Medical Society of Radiology, presuming that our knowledge on COVID-19 will advance further rapidly, to the extent that further supplementation and modification will prove necessary. These Recommendations involve rules of conduct, procedures, and safety measures that should be introduced in radiology departments, as well as indications for imaging studies.
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http://dx.doi.org/10.5114/pjr.2020.95022DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7218443PMC
April 2020

Serum Concentrations of Osteogenesis/Osteolysis-Related Factors and Micro-RNA Expression in ST-Elevation Myocardial Infarction.

Cardiol Res Pract 2019 2;2019:1420717. Epub 2019 Jun 2.

Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland.

Background: Atherosclerosis and bone metabolism share similar molecular and cellular mechanisms. This study aims to evaluate (1) serum concentration of osteogenesis/osteolysis factors panel (Dickkopf-related protein 1 (DKK-1), TNF-, -terminal atrial natriuretic peptide (NT-proANP), thrombospondin-2 (TSP-2), osteoprotegerin (OPG), osteocalcin (OCN), osteopontin (OPN), fibroblast growth factor 23 (FGF-23), soluble receptor activator of nuclear factor-kappaB ligand (sRANKL), tumor necrosis factor-related apoptosis-inducing ligand (TRAIL), proprotein convertase subtilisin/kexin type 9 (PCSK9)), (2) serum expression levels of micro-RNA- (miR-) 24-1 and miR-6802, and (3) assess their correlation with myocardial injury and LV remodeling and function in the acute phase of STEMI and after 3 months.

Methods: Study enrolled 25 STEMI patients (mean age 55.4 ± 8.96 years). Blood samples were collected 4 days and 3 months after myocardial infarction. Serum concentrations of osteogenesis/osteolysis factors were measured using the Luminex assay. Analysis of miR-24-1, and miR-6802 expression was performed with qPCR. LV function and remodeling were assessed by MRI during index hospitalization and 3 months later.

Results: There were no significant differences in serum levels of osteogenesis/osteolysis factors and expression of miR-24-1 and miR-6802 between the acute phase and 3-month follow-up. The levels were similar in patients with at least ≥5% improvement of LVEF ( = 10) and those without improvement. There was a negative correlation between the OPG serum level and LVEF during the acute phase of myocardial infarction.

Conclusions: In STEMI patients, serum concentrations of osteogenesis/osteolysis factors, as well as miR-24-1 and miR-6802 expression, do not change significantly within the 3-month follow-up and are not correlated with LV remodeling and function.
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http://dx.doi.org/10.1155/2019/1420717DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6589187PMC
June 2019

Steroid metabolomic signature of liver disease in nonsyndromic childhood obesity.

Endocr Connect 2019 Jun;8(6):764-771

Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.

Objective: Analysis of steroids by gas chromatography-mass spectrometry (GC-MS) defines a subject's steroidal fingerprint. Here, we compare the steroidal fingerprints of obese children with or without liver disease to identify the 'steroid metabolomic signature' of childhood nonalcoholic fatty liver disease.

Methods: Urinary samples of 85 children aged 8.5-18.0 years with BMI >97% were quantified for 31 steroid metabolites by GC-MS. The fingerprints of 21 children with liver disease (L1) as assessed by sonographic steatosis (L1L), elevated alanine aminotransferases (L1A) or both (L1AL), were compared to 64 children without markers of liver disease (L0). The steroidal signature of the liver disease was generated as the difference in profiles of L1 against L0 groups.

Results: L1 comparing to L0 presented higher fasting triglycerides (P = 0.004), insulin (P = 0.002), INS/GLU (P = 0.003), HOMA-IR (P = 0.002), GGTP (P = 0.006), AST/SGOT (P = 0.002), postprandial glucose (P = 0.001) and insulin (P = 0.011). L1AL showed highest level of T-cholesterol and triglycerides (P = 0.029; P = 0.044). Fasting insulin, postprandial glucose, INS/GLU and HOMA-IR were highest in L1L and L1AL (P = 0.001; P = 0.017; P = 0.001; P = 0.001). The liver disease steroidal signature was marked by lower DHEA and its metabolites, higher glucocorticoids (mostly tetrahydrocortisone) and lower mineralocorticoid metabolites than L0. L1 patients showed higher 5α-reductase and 21-hydroxylase activity (the highest in L1A and L1AL) and lower activity of 11βHSD1 than L0 (P = 0.041, P = 0.009, P = 0.019).

Conclusions: The 'steroid metabolomic signature' of liver disease in childhood obesity provides a new approach to the diagnosis and further understanding of its metabolic consequences. It reflects the derangements of steroid metabolism in NAFLD that includes enhanced glucocorticoids and deranged androgens and mineralocorticoids.
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http://dx.doi.org/10.1530/EC-18-0536DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6547308PMC
June 2019

Effects of trans-endocardial delivery of bone marrow-derived CD133+ cells on angina and quality of life in patients with refractory angina: A sub-analysis of the REGENT-VSEL trial.

Cardiol J 2018 ;25(4):521-529

Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Ziolowa 45/47, 40635 Katowice, Poland.

Background: The REGENT-VSEL trial demonstrated a neutral effect of transendocardial injection of autologous bone marrow (BM)-derived CD133+ in regard to myocardial ischemia. The current sub-analysis of the REGENT VSEL trial aims to assess the effect stem cell therapy has on quality of life (QoL) in patients with refractory angina.

Methods: Thirty-one patients (63.0 ± 6.4 years, 70% male) with recurrent CCS II-IV angina, despite optimal medical therapy, enrolled in the REGENT-VSEL single center, randomized, double-blinded, and placebo-controlled trial. Of the 31 patients, 16 individuals were randomly assigned to the active stem cell group and 15 individuals were randomly assigned to the placebo group on a 1:1 basis. The inducibility of ischemia, (≥ one myocardial segment) was confirmed for each patient using Tc-99m SPECT. QoL was measured using the Seattle Angina Questionnaire. Each patient completed the questionnaire prior to treatment and at the time of their outpatient follow-up visits at 1, 4, 6, and 12 months after cell/placebo treatment.

Results: The main finding of the REGENT-VSEL trial sub-analysis was that transendocardial injection of autologous BM-derived CD133+ stem cells in patients with chronic refractory angina did not show significant improvement in QoL in comparison to the control group. Moreover, there was no significant difference between cell therapy and placebo in a number of patients showing improvement of at least 1 Canadian Cardiovascular Society class during the follow-up period.

Conclusions: Intra-myocardial delivery of autologous CD133+ stem cells is safe and feasible but does not show a significant improvement in the QoL or angina pectoris symptoms in patients with chronic myocardial ischemia.
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http://dx.doi.org/10.5603/CJ.2018.0082DOI Listing
May 2019

The role of inflammation and potential pharmacological therapy in intracranial aneurysms.

Neurol Neurochir Pol 2018 Nov - Dec;52(6):662-669. Epub 2018 Aug 17.

Department of Radiology and Interventional Radiology, Medical University of Silesia, Katowice, Poland.

Intracranial aneurysms remain important clinical concern. There is relatively low risk of rupture of symptomless aneurysms incidentally found in MRA or CTA performed due to other indications. Not all of the intracranial aneurysms should or can be treated with neurosurgery intervention or endovascular embolization. Clinical strategy for small, symptomless, unruptured aneurysms is still questionable. Mechanisms underlying aneurysms formation, progression and rupture are poorly understood. Inflammation is one of the factors suspected to participate in these processes. Therefore the aim of this manuscript is to present current state of knowledge about the role of inflammation in the formation and progression of intracranial aneurysms and in their rupture process. Current knowledge about possible pharmacological treatment of intracranial aneurysms will also be presented. Macrophages infiltration seems to participate in the formation of intracranial aneurysms. Inhibition of signals sent by macrophages may prevent the aneurysms formation. Inflammation present in the wall of the aneurysm seems to be also related to the aneurysm's rupture risk. However it does not seem to be the only cause of the degeneration, but it can be a possible target of drug therapy. Some preliminary studies in humans indicate the potential role of aspirin as a factor that decrease the level of inflammation and lower the risk of rupture of intracranial aneurysms. However further research including a greater number of subjects and a prospective randomized design are necessary to assess the role of aspirin in preventing strategy for small, symptomless, unruptured intracranial aneurysms.
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http://dx.doi.org/10.1016/j.pjnns.2018.08.002DOI Listing
June 2019

Neurodegenerative changes detected by neuroimaging in a patient with contiguous X-chromosome deletion syndrome encompassing and genes.

Cent Eur J Immunol 2018 30;43(2):139-147. Epub 2018 Jun 30.

Department of Clinical Immunology, Institute of Paediatrics, Jagiellonian University Medical College, Cracow, Poland.

Introduction: In this study we describe a patient with gross deletion containing the BTK and TIMM8A genes. Mutations in these genes are responsible for X-linked agammaglobulinemia and Mohr-Tranebjaerg syndrome, respectively. X linked agammaglobulinemia is a rare primary immunodeficiency characterized by low levels of B lymphocytes and recurrent microbial infections, whereas, Mohr-Tranebjaerg syndrome is a progressive neurodegenerative disorder with early onset of sensorineural deafness.

Material And Methods: For neuroimaging, the magnetic resonance imaging and magnetic resonance spectroscopy of the brain were performed. Microarray analysis was performed to establish the extent of deletion.

Results: The first clinical symptoms observed in our patient at the age of 6 months were connected with primary humoral immunodeficiency, whereas clinical signs of MTS emerged in the third year of live. Interestingly, the loss of speech ability was not accompanied by hearing failure. Neuroimaging of the brain suggested leukodystrophy. Molecular tests revealed contiguous X-chromosome deletion syndrome encompassing BTK (from exons 6 through 19) and TIMM8A genes. The loss of the patient's DNA fragment was accurately localized from 100 601 727 to 100 617 576 bp on chromosome's loci Xq22.1.

Conclusions: We diagnosed XLA-MTS in the first Polish patient on the basis of particular molecular methods. We detected neurodegenerative changes in MRI and MR spectroscopy in this patient. Our results provide further insight into this rare syndrome.
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http://dx.doi.org/10.5114/ceji.2018.77383DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6102625PMC
June 2018

How does nonsyndromic craniosynostosis affect on bone width of nasal cavity in children? - Computed tomography study.

PLoS One 2018 13;13(7):e0200282. Epub 2018 Jul 13.

Department of Radiodiagnostics and Invasive Radiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.

Craniosynostosis is caused by premature fusion of one or more cranial sutures, restricting skull, brain and face growth. Nonsyndromic craniosynostosis could disturb the proportions of face. Although morphometric diameters of nasal cavity in healthy children are already known, they have not been established yet in children with nonsyndromic craniosynostosis. The aim our study was to check whether diameters of bone structures of nasal cavity in children with nonsyndromic craniosynostosis measured in CT are within normal range. 249 children aged 0-36 months (96 with clinical diagnosis of nonsyndromic craniosynostosis and 153 in control group) were included into the study. The following diameters were measured on head CT scans: anterior bony width (ABW), bony choanal aperture width (BCAW), right and left posterior bony width (between bone sidewall and nasal cavity septum-RPBW and LPBW). The study group has been divided into 4 categories, depending on child's age. The dimensions measured between bone structures of nasal cavity were statistically significantly lower in comparison to the control group. They did not depend on the sex for ABW, nor on age in groups 7-12 months and < 2 years for BCAW, RPBW and LPBW. The measured dimensions increased with age. In children with nonsyndromic craniosynostosis the diameter of pyriform aperture and bony choanal aperture were lower than in controls, what may be described as fronto-orbital anomalies. Morphometric measurements of anthropometric indicators on CT scans could be used as standards in the clinical identification of craniosynostosis type and may help in planning surgical procedures, particularly in the facial skeleton in children.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0200282PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6044528PMC
January 2019

Acute pancreatitis in children.

Prz Gastroenterol 2018 27;13(1):69-75. Epub 2017 Dec 27.

Department of Paediatrics, School of Medicine, Medical University of Silesia, Katowice, Poland.

Introduction: The acute pancreatitis is a rare disease, but it has started to be diagnosed more often in children.

Aim: The aim of the study was single-centre, retrospective analysis of the incidence, aetiology, and clinical course of acute pancreatitis in children.

Material And Methods: We analysed the medical records of patients with acute pancreatitis hospitalised in the Gastroenterology Unit of the Paediatrics Department, Medical University of Silesia from Jan 2004 to Dec 2013.

Results: There were 76 cases of acute pancreatitis among 51 children (average age: 12.07 years) hospitalised in the Gastroenterology Unit between January 2004 and December 2013. The diagnosis of acute pancreatitis was performed on the basis of INSPIRE criteria and modified Atlanta classification. Patients were divided into groups: I - 1-12 years old, which included 20 (39.21%) children and II - 13-18 years old, with 31 (60.78%) children. The idiopathic aetiology was the most common cause of acute pancreatitis, occurring in 22 (43.1%) children, and in 15 cases the aetiology of the disease was biliary (29.4%). Genetically determined causes were diagnosed in 8 (15.7%) patients, the mutation in four patients, mutation in in 1 child, and gene mutation in 1 child. Two children simultaneously had two genes mutations (, ), and during the considered period had more than one episode of acute pancreatitis.

Conclusions: Acute pancreatitis of idiopathic aetiology was most common among the examined children, and this should encourage the continued search for the causes of disease, especially genetic, and with particular emphasis on younger age group.
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http://dx.doi.org/10.5114/pg.2017.70470DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5894443PMC
December 2017

PRES in the course of hemato-oncological treatment in children.

Childs Nerv Syst 2018 04 2;34(4):691-699. Epub 2017 Dec 2.

Department of Pediatric Oncology, Hematology and Chemotherapy, Medical University of Silesia, Upper Silesia Children's Care Health Centre, 16 Medykow Str, 40-752, Katowice, Poland.

Introduction: Posterior reversible leukoencephalopathy syndrome (PRES) is a clinical syndrome of varying aetiologies, characterised by acute neurological symptoms of brain dysfunction with MRI abnormalities in posterior cerebral white and grey matter. In most cases, symptoms resolve without neurological consequences.

Aim: The aim of this paper is the analysis of predisposing factors, clinical outcomes and radiological features of PRES in eight children with hemato-oncological disease.

Material And Methods: We analysed the medical records of eight hemato-oncological patients aged from 3.0 to 16.1 years. The mean of age at primary diagnosis was 8.5 years.

Results: All patients had both clinical and radiological PRES features. Seven out of eight underwent intensive chemotherapy regimens. Time elapsed from start of treatment to the occurrence of PRES ranged from 6 to 556 days. In one case, PRES occurred before chemotherapy and was the first symptom of cancer. Most (six of eight) patients had history of hypertension (> 95pc) and some (two of eight) occurred electrolyte imbalance-mainly hypomagnesaemia. Patients presented headache (seven of eight), disturbances of consciousness (six of eight), seizures (six of eight), visual changes (four of eight) and vomiting (three of eight). MRI demonstrated abnormalities in seven children: typical cerebral oedema in the white matter of the occipital to the parietal lobes. Most patient lesions in the MRI shrunk after 4 weeks, and clinical symptoms of PRES disappeared completely within a few hours to few days.

Conclusion: PRES may complicate oncological treatment in children. Hypertension is the most important risk factor of PRES. PRES should be included in differential diagnosis in all patients with acute neurological symptoms.
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http://dx.doi.org/10.1007/s00381-017-3664-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5856901PMC
April 2018

Evaluation of Endovascular Embolization of Cerebral Aneurysms by Hydrogel Coils.

Pol J Radiol 2017 10;82:203-208. Epub 2017 Apr 10.

Department of Radiology and Interventional Radiology, Medical University of Silesia, Katowice, Poland.

Background: Hydrogel coils were created to improve the chances of an effective endovascular treatment of cerebral aneurysms. Achieving a high packing density of coils in the lumen of aneurysms can decrease the risk of recurrence. The aim of the present study is to report our initial experience on the effectiveness and safety of endovascular treatment of intracranial aneurysms with the use hydrogel coils.

Material/methods: Sixty patients (age: 28-72 years) (45 women, 15 men) were treated. In 18 patients (30%), subarachnoid hemorrhage was present. Digital subtraction angiography (DSA) of cerebral vessels with rotational scanning was performed. Image analysis was performed by the Philips Integris 3D RA device,which is a specialized workstation (Three-Dimensional Rotational Angiography). 3D reconstructions of cerebral arteries were created based on the data. Sixty-six cerebral aneurysms were embolized with hydrogel coils, which expand in contact with blood. reaching the maximum diameter in about 20 minutes. In 29 aneurysms (43.9%), the effect of the procedure was confirmed on a follow-up DSA after 8.0±4.1 months from the initial treatment.

Results: A complete embolization was performed in 55 aneurysms (83.3%), and partial embolization in 11 aneurysms (16.7%). In 6 aneurysms (9.1%), re-embolization was necessary and it resulted in a complete embolization of 5 aneurysms. On a follow-up DSA, complete embolization was present in 25 aneurysms (86.2%), and partial embolization in 4 aneurysms (13.8%), respectively.

Conclusions: Endovascular embolization with hydrogel coils is an effective and safe treatment method for cerebral aneurysms, although it carries the risk of some complications.
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http://dx.doi.org/10.12659/PJR.895675DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5395136PMC
April 2017

Effects of Transendocardial Delivery of Bone Marrow-Derived CD133 Cells on Left Ventricle Perfusion and Function in Patients With Refractory Angina: Final Results of Randomized, Double-Blinded, Placebo-Controlled REGENT-VSEL Trial.

Circ Res 2017 Feb 30;120(4):670-680. Epub 2016 Nov 30.

From the Third Division of Cardiology (W.W., T.J., A.M.-W., Z.P., W.R., A.B., W.W., J.C., B.O., W.C., W.W., S.D., G.S., T.P., A.O., M.T.), Department of Hematology and Bone Marrow Transplantation (M.M., M.D.-M.), and Division of Diagnostic Imaging (K.G.), Medical University of Silesia, Katowice, Poland; Department of Nuclear Medicine Hospital John Paul II, Kraków, Poland (M.K.); 2nd Department of Cardiology and Cardiovascular Interventions (Ł.R., W.Z.) and Department of Angiology (Ł.P.), University Hospital, Krakow, Poland; Krakow Cardiovascular Research Institute, Kraków, Poland (Ł.P., W.Z.); and Department of Vascular Surgery, Medical University of Silesia, Katowice, Poland (W.K.).

Rationale: New therapies for refractory angina are needed.

Objective: Assessment of transendocardial delivery of bone marrow CD133 cells in patients with refractory angina.

Methods And Results: Randomized, double-blinded, placebo-controlled trial enrolled 31 patients with recurrent Canadian Cardiovascular Society II-IV angina, despite optimal medical therapy, ≥1 myocardial segment with inducible ischemia in Tc-99m SPECT who underwent bone marrow biopsy and were allocated to cells (n=16) or placebo (n=15). Primary end point was absolute change in myocardial ischemia by SPECT. Secondary end points were left ventricular function and volumes by magnetic resonance imaging and angina severity. After 4 months, there were no significant differences in extent of inducible ischemia between groups (summed difference score mean [±SD]: 2.60 [2.6] versus 3.63 [3.6], =0.52; total perfusion deficit: 3.60 [3.6] versus 5.01 [4.3], =0.32; absolute changes of summed difference score: -1.38 [5.2] versus -0.73 [1.9], =0.65; and total perfusion deficit: -1.33 [3.3] versus -2.19 [6.6], =0.65). There was a significant reduction of left ventricular volumes (end-systolic volume: -4.3 [11.3] versus 7.4 [11.8], =0.02; end-diastolic volume: -9.1 [14.9] versus 7.4 [15.8], =0.02) and no significant change of left ventricular ejection fraction in the cell group. There was no difference in number of patients showing improvement of ≥1 Canadian Cardiovascular Society class after 1 (41.7% versus 58.3%; =0.68), 4 (50% versus 33.3%; =0.63), 6 (70% versus 50.0%; =0.42), and 12 months (55.6% versus 81.8%; =0.33) and use of nitrates after 12 months.

Conclusion: Transendocardial CD133 cell therapy was safe. Study was underpowered to conclusively validate the efficacy, but it did not show a significant reduction of myocardial ischemia and angina versus placebo.

Clinical Trial Registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01660581.
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http://dx.doi.org/10.1161/CIRCRESAHA.116.309009DOI Listing
February 2017

Coronary atherosclerotic plaque burden and composition by CT angiography in Caucasian and South Asian patients with stable chest pain.

Eur Heart J Cardiovasc Imaging 2017 May;18(5):556-567

Centre for Advanced Cardiovascular Imaging, NIHR Cardiovascular Biomedical Research Unit at Barts, William Harvey Research Institute, Barts and The London School of Medicine, Queen Mary University of London and St Bartholomew's Hospital, 2nd floor, King George V Building, West Smithfield, London EC1A 7BE, UK.

Aims: South Asian (SA) patients are known to have an increased incidence of acute cardiovascular events compared with Caucasians. The aim of this observational study was to compare the prevalence of coronary stenoses, the amount and composition of coronary atherosclerosis in a cohort of Caucasian and SA patients with stable chest pain, in non-acute settings.

Methods And Results: The study protocol conformed to the ethical guidelines of the 1975 Declaration of Helsinki. In 963 consecutive Caucasian and SA patients undergoing coronary computed tomography angiography, atherosclerotic plaques were quantified using a semi-automated algorithm. The vessel per cent diameter and area stenosis were measured. Plaque composition was examined from the measurement of calcified, non-calcified, and total plaque burden. There were 420 Caucasian (238 males) and 543 SA (297 males) patients. Caucasian patients were older than SA patients (54.39 ± 11.65 vs. 49.83 ± 11.03 years) and had lower prevalence of diabetes (13.13 vs. 32.41%) and hyperlipidaemia (56.90 vs. 68.51%) (all P-values <0.001). After adjusting for differences in cardiovascular risk factors, there were no differences in per cent diameter and area stenosis, and no difference in the proportions of patients with one-, two-, or three-vessel disease. There was no difference in total plaque burden; however, the per cent non-calcified plaque composition was lower in Caucasians compared with SA (80.95 vs. 90.42%; P-value <0.001).

Conclusion: This study conducted in non-acute settings showed an ethnic difference in composition of coronary atherosclerotic plaque with lower non-calcified composition in Caucasian patients compared with SA patients, which was independent of age, diabetes, hyperlipidaemia, and the other available cardiovascular risk factors.
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http://dx.doi.org/10.1093/ehjci/jew085DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5837200PMC
May 2017

Perihepatic lymphadenopathy in children with chronic viral hepatitis.

J Ultrason 2015 Sep 30;15(62):337-8. Epub 2015 Sep 30.

Department of Radiology and Nuclear Medicine, Faculty of Medicine in Katowice, Medical University of Silesia in Katowice, Poland.

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http://dx.doi.org/10.15557/JoU.2015.0031DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4657397PMC
September 2015

Auxologic parameters and response to 2-year therapy with recombinant human growth hormone in growth hormone deficient children with an ectopic posterior pituitary.

Hormones (Athens) 2015 Jul-Sep;14(3):425-30

School of Medicine in Katowice, Department of Paediatrics, Paediatric Endocrinology and Diabetes, Katowice, Poland.

Background: Structural defects of the hypothalamic-pituitary area in MRI are suggested as being a more accurate marker of growth hormone deficiency (GHD) than laboratory assays.

Objective: To compare auxological characteristics in GHD children with normal pituitary (NP) function and with ectopic posterior pituitary (EPP), prior to therapy with recombinant human growth hormone (rhGH), extending the follow-up to two years following treatment.

Design: Eighty-six (86) GHD patients were divided into two groups depending on the pituitary MRI: the EPP (23 children, 3.2-16.8 years old) and the NP group (63 children, 3.3-14.8 years old). Height deficits in the population (hSD) and parents (hSD-mpSD) and the change of hSD and bone/chronological age ratio were assessed before and after 12 and 24 months of rhGH therapy.

Results: Height deficits before treatment were significantly greater in EPP compared to NP [median -4.07 (-7.06, -2.75) vs -3.15 (-4.9, -2.35) for hSD, and -3.65 (-7.06, -1.21) vs -1.83 (-4.31, -0.28) for hSD-mpSD; p<0.05]. Bone age was significantly delayed in the EPP group [0.62 (0.27, 0.92) vs 0.75 (0.21, 0.71); p<0.05]; differences remained significant during follow-up. After 12 months of rhGH therapy, EPP showed significantly greater catch-up growth compared to NP [ΔhSD=1.2 (0.42, 2.69) vs 0.74 (0.05, 1.48); p<0.05]. In the 2nd year, height velocity slowed down and was comparable in the two groups. At the conclusion of the study, hSD was similar in both groups, but hSD-mpSD was more deviated in EPP [-1.79 (-3.71, -1.21) vs -1.1 (0.98, -0.07); p<0.05].

Conclusions: The study showed relevant auxologic differences between EPP and NP children, as well as beneficial effects of rhGH therapy in both groups.
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http://dx.doi.org/10.14310/horm.2002.1576DOI Listing
May 2016

Nasal region dimensions in children: a CT study and clinical implications.

Biomed Res Int 2014 5;2014:125810. Epub 2014 May 5.

E.N.T. Department, School of Medicine in Katowice, Medical University of Silesia, 20-24 Francuska Street, 40-027 Katowice, Poland.

Atresias of nasal cavity, especially in young children, pose an essential problem in children's otolaryngology. Only a few morphometric studies of nasal cavity concerning healthy neonates and young infants without nasal stenosis are available. Multislice computed tomography is a perfect tool enabling a precise evaluation of anatomic structures. The aim of this study was a complex morphometric evaluation of clinically important bone and mucosal structures of nasal cavity and examination of their dependence on age and sex in children up to 3 years of age. 180 children, age range 0-3 years, were divided into 5 age groups, and measurements of 18 distances between skeletal structures and between mucosal structures of nasal cavity were performed on their CT scans. A correlation between the widths of selected bone structures was examined. There were no statistically significant differences in analyzed morphometric parameters between adjacent age groups. The differences were statistically significant only between extreme age groups. There was a correlation between evaluated structures and age. Our results are a valuable supplement of nasal cavity morphometric data of young children. They may be useful in setting reference values of evaluated parameters in children and in diagnosis and planning of surgical treatment in children's otolaryngology.
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http://dx.doi.org/10.1155/2014/125810DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4026915PMC
February 2015

Anomalous origin of the coronary artery from the wrong coronary sinus evaluated with computed tomography: "high-risk" anatomy and its clinical relevance.

Eur Radiol 2014 Oct 4;24(10):2353-9. Epub 2014 Jun 4.

Department of Radiology and Diagnostic Imaging, John Paul II Hospital, ul. Prądnicka 80, 31-202, Kraków, Poland,

Objective: The aim of the study was to assess coronary arteries arising from the wrong coronary sinus, including CT-evaluated high-risk anatomic features, clinical symptoms and cardiac events during follow-up.

Methods: A total of 7,115 patients scheduled for 64-slice or dual-source cardiac CT were screened for the presence of isolated anomalous origin of the coronary artery from the wrong coronary sinus.

Results: Anomalous origin of the coronary artery was found in 54 (0.76 %) patients (29 men, 25 women, mean age 60.9 ± 11.6 years). Sixteen (30 %) patients with abnormal right coronary origin (ARCA) more commonly had a slit-like orifice (15 vs. 3; p < 0.001), intramural course (15 vs. 3; p < 0.001) and interarterial course (11 vs. 0; p < 0.001) than 22 (41 %) and 13 (24 %) individuals with abnormal circumflex artery (ALCx) and left coronary artery (ALCA) origin, respectively. Patients with ALCA presented less frequently with chest pain than subjects with ARCA and ALCx (25 vs. 3; p = 0.03). Patients with ARCA tended to show higher occurrence of cardiac events in the follow-up than individuals with ALCA and ALCx (5 vs. 4; p = NS).

Conclusions: High-risk anatomy features are most common in patients with ARCA and these patients also have higher prevalence of chest pain and cardiac events in the follow-up than individuals with ALCA and ALCx.

Key Points: • Multislice computed tomography enables detection and evaluation of the coronary artery anomalies. • Anomalous anatomy of the coronary artery potentially influences the prevalence of adverse events. • Adverse events tend to be most common in anomalous right coronary arteries.
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http://dx.doi.org/10.1007/s00330-014-3238-2DOI Listing
October 2014

Mechanisms of functional mitral regurgitation in cardiomyopathy secondary to anterior infarction.

Eur J Cardiothorac Surg 2014 Jun 20;45(6):1089-96. Epub 2014 Feb 20.

2nd Department of Cardiac Surgery, Medical University of Silesia, Katowice, Poland.

Objectives: It remains unclear why some patients with cardiomyopathy secondary to anterior infarction do, and others do not develop functional mitral regurgitation (MR).

Methods: Thirty-six patients after anterior infarction with ejection fraction (EF) below 35%, 18 with no/trivial and 18 with moderate/severe MR, underwent cardiac magnetic resonance imaging. Parameters describing the geometry of the mitral valve, subvalvular apparatus and left ventricle were measured.

Results: The septolateral and commissure-to-commissure mitral annular diameters were bigger in patients with MR. The odds ratio (OR) of developing regurgitation was 25.0 (95% confidence interval [95% CI] 4.3-144.3; P < 0.001) for end-systolic septolateral mitral annulus diameter above 20 mm/m(2). MR was less likely in patients with straighter posterior papillary muscle (OR 0.040, 95% CI 0.007-0.23; P < 0.001-for the angle between muscle axis and mitral annulus plane >81°), and more likely (OR 7.9, 95% CI 1.6-39.4; P = 0.008) with posterior papillary muscle tethering >23 mm/m(2). Regurgitation was less likely (OR 0.032, 95% CI 0.003-0.33; P = 0.001) with anterolateral papillary muscle tip to ipsilateral mitral annulus distance in end-diastole longer than 13 mm/m(2). Left ventricular EF, volumes and the overall end-systolic and end-diastolic wall thicknesses did not differ between the groups. Patients with MR had thinner myocardium proximal to the base of the anterior and distal to the base of the posterior papillary muscle.

Conclusions: Inferior extension of anterior infarction and more leaning posterior papillary muscle are the major components resulting in the development of ischaemic MR in patients with cardiomyopathy secondary to anterior infarction. Shorter chordae tendineae may constitute the anatomical background that makes the development of ischaemic MR more likely.
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http://dx.doi.org/10.1093/ejcts/ezt660DOI Listing
June 2014

A duodenal duplication cyst manifested by duodenojejunal intussusception and chronic pancreatitis.

Surgery 2014 Sep 15;156(3):742-4. Epub 2013 Jun 15.

Department of Gastrointestinal Surgery, Medical University of Silesia, Medykow, Poland.

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http://dx.doi.org/10.1016/j.surg.2013.02.013DOI Listing
September 2014

Intervertebral disc calcification in children: Case description and review of relevant literature.

Pol J Radiol 2013 Jan;78(1):78-80

District Hospital of Orthopedics and Trauma Surgery, Piekary Śląskie, Poland.

Background: Intervertebral disc calcification is a rare condition in children; in most cases, it is asymptomatic and therefore not diagnosed.

Case Reports: In our study, we present a case of idiopathic intervertebral disc calcification within the cervical segment, at the level of C2/C3 and C4/C5 vertebrae in a 5-year-old girl with torticollis. Basic neurological examination supplemented by X-ray examination was performed, showing calcification within the cervical segment at the level of C2/C3 and C4/C5 vertebrae.

Conclusions: In order to complement the diagnostics, a CT scan of the cervical spine was performed; the scan confirmed the diagnosis and revealed additional calcification of the anterior longitudinal ligament at the level of C4/C5 vertebrae.
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http://dx.doi.org/10.12659/PJR.883773DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3596152PMC
January 2013

Acute intracranial in-stent thrombosis after angioplasty of middle cerebral artery symptomatic stenosis: a case report.

Neurologist 2012 Sep;18(5):290-5

Department of Neurology, Medical University of Silesia, Katowice, Poland.

Introduction: Intracranial atherosclerotic disease is one of the major risk factors of ischemic stroke. Percutaneous transluminal angioplasty with stent deployment may be effective for the treatment of symptomatic intracranial stenosis, however its value is yet to be determined. High possibility of serious periprocedural complications, such as acute in-stent thrombosis or stroke, narrows the current recommendations for this treatment to patients with high-grade stenosis (>70%), and to experienced neurointerventional centers.

Case Report: We present a 44-year-old male with symptomatic high-grade stenosis of the M1 segment of left middle cerebral artery, treated with percutaneous transluminal angioplasty with stenting. The procedure was complicated with acute in-stent thrombosis treated with intra-arterial thrombolysis, which resulted in a nondisabling stroke.

Conclusions: The procedure-related stroke in this patient was probably caused by middle cerebral artery perforator ostium occlusion with balloon predilatation and transient in-stent thrombosis related to insufficient antiplatelet pretreatment. Exhausted cerebrovascular reserve due to long-lasting high-grade intracranial stenosis should also be considered as a factor contributing to ischemic complications.
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http://dx.doi.org/10.1097/NRL.0b013e318266f5baDOI Listing
September 2012

Statistical agreement of left ventricle measurements using cardiac magnetic resonance and 2D echocardiography in ischemic heart failure.

Med Sci Monit 2012 Mar;18(3):MT19-25

Department of Radiology and Nuclear Medicine, Medical University of Silesia, Katowice, Poland.

Background: The aim of this study was to compare cardiac magnetic resonance imaging (CMR) with 2-dimensional echocardiography (2D echo) in the assessment of left ventricle (LV) function parameters and mass in patients with ischemic heart disease and severely depressed LV function. Although 2D echo is commonly used to assess LV indices, CMR is the state-of-the-art technique. Agreement between these 2 methods in these patients has not been well established.

Material/methods: LV indexed end systolic and diastolic volumes (EDVi and ESVi), indexed mass (LVMi) and ejection fraction (EF) were assessed in 67 patients (12 women), using 2D echo and CMR.

Results: According to statistical analysis (Bland-Altman), 2D echo underestimated LV EDV and ESV and overestimated EF and LVMi compared to CMR. The highest correlation between 2D echo and CMR was found for EDVi (R2=0.73, p<0.0001) and ESVi (R2=0.69, p<0.0001) and the lowest for EF (R2=0.21, p=0.001) and LVMi (R2=0.20, p=0.002). The maximal differences between 2D echo and CMR were found for highest mesurements of LV volumes and mass, and for lowest EF values.

Conclusions: There is moderate to strong correlation between CMR and 2D echo in the assessment of LV function parameters and mass in patients with ischemic heart failure. Between-method agreement depends on the degree of LV dysfunction. The results of assessment of the severely damaged LV obtained by the use of 2D echo should be interpreted with caution.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3560747PMC
http://dx.doi.org/10.12659/msm.882507DOI Listing
March 2012

Different algorithms for quantitative analysis of myocardial infarction with DE MRI: comparison with autopsy specimen measurements.

Acad Radiol 2011 Dec;18(12):1529-36

Department of Radiology, Erasmus MC, Universitair Medisch Centrum, Thoraxcenter, Ba 585, 's-Gravendijkwal 230, 3015 CE Rotterdam, the Netherlands.

Rationale And Objectives: To compare two semiautomated methods for measurement of infarcted myocardium area on delayed contrast enhanced magnetic resonance imaging, with histopathology findings as standard of reference.

Materials And Methods: Percentage area of myocardial infarction was measured in 10 Yorkshire landrace pigs manually and using two semiautomated methods. The first (standard deviation method) used two operator-selected regions of interest (ROIs) and nine different cutoff values (one to nine times the standard deviation of signal intensity in normal myocardium) to identify infarction. The second (threshold method) used threshold values based on percentages of maximum signal intensity to identify infarction. Results were compared with histopathology findings.

Results: Difference between percentage area of infarction obtained with standard deviation method and autopsy specimens was in the range: -13.5% to +13.2%. With threshold method (thresholds from 30% to 90% of signal intensity), difference was -15% to +23%. Manual contouring underestimated infarcted area by 2% comparing to autopsy results. The best agreement between histopathology and semi-automated software was achieved for 4 standard deviations with standard deviation method: difference -0.45%, and for a percentage threshold of 70% (difference +0.67%) with threshold method. However, with standard deviation method, there was statistically significant difference between ROIs based on their location in viable myocardium: mean difference 1.7 ± 4%, P < .0001.

Conclusion: Semiautomated measurement of myocardial infarcted area on delayed enhanced magnetic resonance images performs well compared to autopsy. The threshold method, based on percentages of maximum signal intensity is preferable over standard deviation method, which is more susceptible to variability from location of ROIs within viable myocardium.
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http://dx.doi.org/10.1016/j.acra.2011.08.002DOI Listing
December 2011

Usefulness of magnetic resonance findings of the hypothalamic-pituitary region in the management of short children with growth hormone deficiency: evidence from a longitudinal study.

Childs Nerv Syst 2012 Jan 21;28(1):121-7. Epub 2011 Sep 21.

Department of Paediatrics, Paediatric Endocrinology and Diabetes, Medical University of Silesia, Upper Silesia Centre for Child's Health ul. Medyków 16, 40-752 Katowice, Poland.

Purpose: The purpose of this study is to assess the relationship between magnetic resonance images (MRI) of the hypothalamic-pituitary (H-P) region and response to recombinant human growth hormone (rhGH) treatment in short children with growth hormone deficiency, basing on changes of auxologic parameters, as well as to answer the question if MRI may serve for selecting and monitoring the rhGH responders.

Patients And Methods: The study group comprised 85 children treated with rhGH, aged 7.3-18.7 years, followed for the mean period of 3.2 years (range, 2.1-9.5 years). Auxologic parameters (height deficit hSDS, deviation from the mid-parental height hSDS-mpSDS, bone delay index bone age/chronological age ratio (BA/CA)) were assessed before, during and at the end of rhGH treatment; growth velocity was calculated before and during rhGH therapy. Parameters were correlated with the MRI of the H-P region.

Results: Structural anomalies of the H-P region were found in 22 (25.9%) children: empty sella syndrome (ESS) in 12 (14.1%) patients, ectopic posterior pituitary (EPP) in ten (11.8%). Patients' height deficit and their deviation from parental height before rhGH therapy was significantly greater in the EPP group (median hSDS = -3.8; hSDS-mpSDS = -2.5), bone age delay was the greatest in the ESS group (median BA/CA = 0.69), after therapy - in the EPP group (median BA/CA = 0.82). Growth velocity improved in the first year of the rhGH therapy in all groups; however, the most significant acceleration was observed in the EPP group (median delta hSDS = 0.9), then stabilised and was comparable in all groups.

Conclusions: MRI may be helpful in predicting response to the rhGH treatment, providing midline abnormalities are taken into account.
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http://dx.doi.org/10.1007/s00381-011-1594-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3252499PMC
January 2012