Lukasiewicz A.,Regional Specialist Hospital |
Skopinska-Wisniewska J.,Regional Specialist Hospital |
Marszalek A.,Regional Specialist Hospital |
Molski S.,Regional Specialist Hospital |
Drewa T.,Regional Specialist Hospital
Plastic and Reconstructive Surgery | Year: 2013
BACKGROUND:: Intraperitoneal placement of polypropylene mesh leads to extensive visceral adhesions and is contraindicated. Different coatings are used to improve polypropylene mesh properties. Collagen is a protein with unique biocompatibility and cell ingrowth enhancement potential. A novel acetic acid extracted collagen coating was developed to allow placement of polypropylene mesh in direct contact with viscera. The authors' aim was to evaluate the long-term influence of acetic acid extracted collagen coating on surgical aspects and biomechanical properties of polypropylene mesh implanted in direct contact with viscera, including complications, adhesions with viscera, strength of incorporation, and microscopic inflammatory reaction. METHODS:: Forty adult Wistar rats were divided into two groups: experimental (polypropylene mesh/acetic acid extracted collagen coating) and control (polypropylene mesh only). Astandardized procedure of mesh implantation was performed. Animals were killed 3 months after surgery and analyzed for complications, mesh area covered by adhesions, type of adhesions, strength of incorporation, and intensity of inflammatory response. RESULTS:: The mean adhesion area was lower for polypropylene mesh/acetic acid extracted collagen coating (14.5 percent versus 69.9 percent, p < 0.001). Adhesion severity was decreased in the experimental group: grades 0 and 1 were more frequent (p < 0.04 and p < 0.002, respectively) and grade 3 was less frequent (p < 0.0001). An association between adhesion area and severity was found (p < 0.0001). Complications, strength of incorporation, and intensity of inflammatory response to the mesh were similar. CONCLUSIONS:: Visceral adhesions to polypropylene mesh are significantly reduced because of acetic acid extracted collagen coating. The collagen coating does not increase complications or induce alterations of polypropylene mesh incorporation. © 2013 by the American Society of Plastic Surgeons.
Mazurak M.,Regional Specialist Hospital |
Kusa J.,Regional Specialist Hospital
Kardiochirurgia i Torakochirurgia Polska | Year: 2014
In 1933, three doctors from the Massachusetts General Hospital in Boston, Paul Dudley White, William Franklin Bland, and Joseph Garland, described a case of an anomalous origin of the left coronary artery arising from the pulmonary artery (ALCAPA) in a three-month-old boy. The infant died following two weeks of hospitalization. The child's father was Dr. Aubrey Hampton, a radiologist and colleague of White, Bland, and Garland. The paper presents a perspective view on the occasion of the 80th anniversary of the first clinical description of ALCAPA.
Pawlowska E.,Regional Specialist Hospital |
Bianek-Bodzak A.,Medical University of Gdańsk
Polish Journal of Radiology | Year: 2011
Background: Peyronie's disease (PD) is characterized by the formation of fibrous tissue plaques within the tunica albuginea, usually causing a penile deformity and a subsequent erectile dysfunction. Diagnosis of PD is based on medical and sexual history, physical examination and imaging examinations, i.e.: ultrasound, color Doppler ultrasound, magnetic resonance and X-ray mammography. Material/Methods: Ultrasound appears superior to all other methods for depicting calcifications, with the detection rate of 100%. It is safe, non-invasive, repeatable and reliable. It should be a method of choice in most standard cases of Peyronie's disease. With color Doppler ultrasound (CDU), one can find hyperperfusion around the plaques as a sign of inflammation in the active state of the disease. CDU is useful in diagnosing erectile dysfunction which is observed in most cases of PD. Results: MR is superior to US and X-ray as regards the detection of periplaque inflammation, though this information can be obtained from medical history and penile plaque palpation. MR, being an expensive imaging modality, should be reserved for special cases, i.e.: plaques located at the penile basis, a suspicion of malignant disease, and prior penile surgery. Conclusions: X-ray mammography is the most accurate in showing calcifications as well as the angle of penile curvature. However, the possibility of obtaining this information does not justify the use of ionizing radiation for that purpose. © Pol J Radiol.
Matysiak-Lusnia K.,Wrocław University |
Matysiak-Lusnia K.,Regional Specialist Hospital
Anaesthesiology Intensive Therapy | Year: 2016
Vitamin D deficiency is a commonly observed global phenomenon, both in the general population and in hospitalized patients, including critically ill patients. Vitamin D deficiency is associated with multiple adverse health outcomes, including increased morbidity and mortality in the general population and in critically ill patients. Vitamin D is a fatsoluble vitamin that plays an important role in bone metabolism. However, Vitamin D is also a steroid hormone that exerts multiple pleiotropic effects. Vitamin D regulates immunity, inflammation, cell proliferation, differentiation, apoptosis, and angiogenesis. There is growing evidence of a close relationship between vitamin D insufficiency and various systemic disorders, i.e., type II diabetes, certain types of cancer, obesity, and cardiovascular morbidities. The purpose of this article is to present the current knowledge on the relationship between vitamin D status and critical illness.
Kochman P.,Regional Specialist Hospital |
Stompor T.,University of Warmia and Mazury
Polish Annals of Medicine | Year: 2016
Introduction Gout remains one of the most frequent diseases of joints and soft tissues. Apart from symptomatic gout, uric acid is also involved in pathogenesis and progression of several other diseases such as chronic kidney disease, hypertension, metabolic syndrome and cardiovascular disease. Aim To describe the role of uric acid in the development of chronic diseases such as chronic kidney disease, hypertension, metabolic syndrome and cardiovascular disease. We also aimed to discuss the role of uric acid in the development of gout, considered the most typical manifestation of hyperuricemia. The important task of our work was also identification of 'classical' and newest therapeutic strategies aimed to lower uric acid level and to improve the diseases that might be triggered with hyperuricemia. Material and methods We searched the latest literature in the field identifying studies describing the different roles of uric acid in the development of several diseases. We also found and described latest clinical trials focused on therapeutic lowering of hyperuricemia. Discussion Increasing evidence suggests contribution of uric acid in the development of chronic diseases, including chronic kidney disease, cardiovascular disease, hypertension and metabolic syndrome. The development of these pathologies may be controlled by effective lowering of hyperuricemia using both 'classical' drugs (i.e. allopurinol) and the newer agents (i.e. febuxostat). Conclusions Uric acid contributes to the development of several chronic, potentially life-threatening diseases. Hyperuricemia control should be considered as one of the strategies in their treatment. © 2016 Warmińsko-Mazurska Izba Lekarska w Olsztynie.
Rzaca M.,Regional Specialist Hospital |
Tarkowski R.,Wroclaw Medical University
Cryobiology | Year: 2013
Introduction: Paget's disease of the nipple is a rare form of breast malignancy. Underlying breast cancer, either in situ or invasive accompanies lesions of the nipple in most of the cases. The connection between both entities and their exact origin remains unclear. Nevertheless, underlying ductal breast cancer is often confined to the central, subareolar part of the breast. Radical mastectomy, although successful, seems to be too mutilating treatment in the era of breast sparing surgery. Studies describing breast conserving surgery performed without adjuvant treatment are rare and the patients not numerous. Due to low incidence of the disease, there are no randomised trials conducted which could show the optimal method of treatment. Materials and methodsWe performed cryosurgery of the affected nipple-areola complex (NAC) in treatment of six patients with Paget's disease of the nipple who presented general contraindications or lack of consent for surgery. Results: With a follow up ranging from 60 to 121. months (average 94) we obtained very good results in terms of disease specific survival: there were two cases of recurrent disease, confined to the scar and treated successfully with cryosurgery again; four patients are alive without disease. Death was not related to cancer in the remained two cases. Conclusions: Cryotherapy is successful form of treatment of localised Paget's disease of the nipple - especially in face of contraindications for surgery or lack of patient's agreement for operational treatment. © 2013 Elsevier Inc.
Beltowski J.,Medical University of Lublin |
Wojcicka G.,Medical University of Lublin |
Jamroz-Wisniewska A.,Medical University of Lublin |
Wojtak A.,Regional Specialist Hospital
Peptides | Year: 2010
Apart from controlling energy balance, leptin, secreted by adipose tissue, is also involved in the regulation of cardiovascular function. Previous studies have demonstrated that acutely administered leptin stimulates natriuresis and vascular nitric oxide (NO) production and that these effects are impaired in obese animals. However, the mechanism of resistance to leptin is not clear. Because obesity is associated with chronically elevated leptin, we examined if long-term hyperleptinemia impairs acute effects of leptin on sodium excretion and NO production in the absence of obesity. Hyperleptinemia was induced in lean rats by administration of exogenous leptin at a dose of 0.5 mg/kg/day for 7 days, and then acute effect of leptin (1 mg/kg i.v.) was studied under general anesthesia. Leptin increased fractional sodium excretion and decreased Na+,K+-ATPase activity in the renal medulla. In addition, leptin increased the level of NO metabolites and cyclic GMP in plasma and aortic wall. These acute effects of leptin were impaired in hyperleptinemic animals. In both control and hyperleptinemic groups the effect of leptin on Na+ excretion and renal Na+,K+-ATPase was abolished by phosphoinositide 3-kinase (PI3K) inhibitor, wortmannin, but not by protein kinase B/Akt inhibitor, triciribine,. In contrast, acute effect of leptin on NO metabolites and cGMP was abolished by triciribine but not by wortmannin. Leptin stimulated Akt phosphorylation at Ser473 in aortic tissue but not in the kidney, and this effect was comparable in control and hyperleptinemic groups. These results suggest that hyperleptinemia may mediate "renal" and "vascular" leptin resistance observed in obesity. © 2009 Elsevier Inc. All rights reserved.
Stompor T.,University of Warmia and Mazury |
Zabolcki M.,Olsztyn Municipal Hospital |
Pankrac K.,Regional Specialist Hospital
Polskie Archiwum Medycyny Wewnetrznej | Year: 2012
In this paper, the spectrum of renal involvement in the course of multiple myeloma (MM) is discussed. We describe the most important pathophysiological mechanisms underlying the development of renal complications observed in MM. In particular, we focused on the correlations between morphological changes in the kidneys and clinical signs and symptoms. Physicochemical characteristics of light chains that are synthesized in excess are critically important in the development of different types of renal involvement. It seems that patients with MM should be actively treated regardless of the type of lesions because the current methods allow to reverse renal lesions and reduce the negative effect of renal damage on prognosis in these patients. Copyright by Medycyna Praktyczna, 2012.
Sosnik H.,Regional Specialist Hospital |
Sosnik K.,Regional Specialist Hospital
Polish Journal of Pathology | Year: 2013
Uterine fatty lesions (UFLs) continue to arouse great interest because of their rare occurrence and unknown histogenesis. The aim of the study was to determine the occurrence of UFLs and the dynamics of their development, as well as to evaluate the histopathology and relationship with regressive stromal changes. 3750 uterine specimens were reviewed during the peri-od between 1984 and 2003. In the examined series of 3750 uteruses removed due to tumors or prolapse, 50 cases with four types of changes were chosen: adipocytic metaplasia of primary uterine leiomyomas (70% of cases), adipocytic metaplasia of interlobular stroma of primary uterine tumors (16%), adipocytic aggregates in the uterine muscle (8%), and pure lipomas (6%). Additionally, the cases were divided into three groups depending on the extent of fatty changes. Group 1 (48% of cas-es) consisted of cases in which less than 25% of the changes were present in the ex-amined material. In group 2 (28% of cases) the fatty changes were between 25 and 50%. In group 3 (16% of cases) fatty changes constituted more than 50% of the ex-amined specimen. The extent of adipocytic changes was connected with patient age, being significant between groups 1 and 3 (p < 0.01). Regressive stromal changes in leiomyomas occurred more often in middle-aged patients, with stage 2 lipomatosis than in other subgroups. Among 46 cases of UFLs two patients were diagnosed with a coexisting malignant uterine neoplasm (4.35%). In four patients with muscular lipo-matosis, two were diagnosed with a coexisting malignant uterine tumor too (50%). Conclusions: 1. Uterine fatty lesions are rarely diagnosed, although they occur more often than previously thought. 2. Mixed tumors predominate over pure lipomas. 3. The histogenesis of these lesions seems to be multi-factorial, considering the differ-ent types of UFLs. 4. The extent of uterine fatty metaplasia positively correlated with the age of operated women. 5. The coexistence of UFLs with other malignant uter-ine neoplasms is accidental.
Sosnik H.,Regional Specialist Hospital |
Sosnik K.,Regional Specialist Hospital
Polish Journal of Pathology | Year: 2010
The aim of the study was to verify the hypothesis that osseocalcineus metaplasia present in the tracheal cartilage is conditioned by its thickness. The study group comprised 78 male tracheas (age ranging between 19 and 84 years, mean = 56.5 years ±12.6 years), and 69 female tracheas (age ranging between 18 and 90 years, mean = 65.3 ±14 years). Tracheal transverse segments (every 4 cm) were collected for histopathological examinations from organs fixed in 10% formalin solution. Typical paraffin specimens, 5 μm thick, were measured in the horizontal position using the ocular micrometer (10: 100 Zeiss) and Semiplan 3.2/0.10 objective. Differences between mean patient group and subgroup values were statistically verified. P = 0.05 was considered as statistically significant. Osseocalcineus metaplasia occurred 2.5-fold more often in male patients, in spite of the higher mean age of female patients (p < 0.001). The average male cartilage thickness was 50.32 ±7.94 × 10-2 cm, while that of female patients was 38.44 ±4.44 × 10-2 cm (p < 0.001). The average height of male patients (168.63 ±27.14 cm) was significantly higher in comparison to female patients (157.2 ±5.78 cm) (p < 0.001). The thickness of tracheal cartilages in men was significantly greater in metaplastic tracheas than in tracheas without metaplasia, as well as in changed cartilages as compared to unchanged ones in the same trachea. Considering both genders, the thickness of tracheal cartilages positively correlated with patient age (men: +0.44; p < 0.001; women: +0.293; p < 0.014), whereas height did not correlate with cartilage thickness.