Biomedical subjects

A Wysocki

Publications and source records attributed to A Wysocki.

At least 19 recordsLinked to original sources

PubMed2003

Evaluation of the contamination degree of roe-deer with cadmium and polychlorinated biphenyls in Warmia and Mazury district.

The results of investigations concerning degree the contamination degree with cadmium and polychlorinated biphenyls (PCB's) of roe-deer organs hunt in seven selected areas of Warmia and Mazury voivodship are presented. The highest mean cadmium content in the organs investigated was found in the samples from Głebock area (liver - 0.0576 mg/kg, kidney - 3.351 mg/kg) and the lowest one was observed in the samples from Pisz area (liver - 0.181 mg/kg, kidneys - 1.653 mg/kg). Mean level of polychlorinated biphenyls residues in the roe-deer fat from Warmia and Mazury district was 0.004 mg/kg. The highest PCB's mean concentration was found in the roe-deer fat samples from Milomlyn area (0.008 mg/kg), and the lowest one in those from Głebock area (0.002 mg/kg). Presented levels of investigated xenobiotics do not make at present (except cadmium in kidney) any toxicological threats for venison consumers in Warmia and Mazury district.

Animals↗

PubMed2001

Abdominal malignancies missed during laparoscopic cholecystectomy.

BACKGROUND: We present our experience with intra-abdominal malignancies different from gallbladder cancer not diagnosed preoperatively and undiscovered during laparoscopic cholecystectomy METHODS: This study involved retrospective analysis of 10 patients hospitalized in the Second Department of General Surgery between 1993 and 2000. In all of them, laparoscopic cholecystectomy had been performed between one week and 21 months earlier. RESULTS: Primary or metastatic neoplasms were diagnosed in five men and five women patients ages 38 to 79 years. In three patients with colorectal cancer, a radical resection was possible. Nonresectable pancreatic cancer was found in three patients. In one of two patients with gastric cancer, palliative, distal gastrectomy was performed. In a patient who had small bowel cancer with metastasis to the ovary, a radical operation was possible. In one patient, liver metastasis from lung cancer was found. CONCLUSIONS: In patients with atypical symptoms of gallbladder lithiasis, a thorough workup before laparoscopic cholecystectomy should be performed. During the laparoscopic procedure, a detailed examination of the whole peritoneal cavity is essential. In cases of prolonged convalescence after laparoscopic cholecystectomy, a source of symptoms different from cholelithiasis should be suspected.

Abdominal Neoplasms↗

PubMed2001

Use of polypropylene prostheses for strangulated inguinal and incisional hernias.

We used monofilament polypropylene prostheses in 20 emergency operations for strangulated hernias. Sixteen of the operated patients had groin hernias (five of them recurrent), two had incisional and one had a Spigel's type hernia. Intestinal resection was performed because of bowel wall necrosis in one of the patients. During the postoperative period, we observed only one minor complication (a seroma formation). During the follow-up, no recurrence was observed. In our opinion, the use of monofilament polypropylene mesh in emergency hernia operations is safe, simple and effective.

Aged↗

PubMed2001

[Abdominal compartment syndrome: current view].

In the last few years, physiological changes, symptoms, diagnostic tools, and treatment of abdominal compartment syndrome interest surgeons, trauma surgeons and anaesthetists. Sudden, dangerous basic vital function deterioration in patients managed in the intensive care unit, may be results of abdominal compartment syndrome. Abdominal compartment syndrome is secondary to massive intraabdominal haemorrhages, hepatic or retroperitoneal space "packing", fluid collection in tissues, including abdominal organs. Circulatory, respiratory and kidney dysfunction occur, when intraabdominal pressure measured in urinary bladder is 25 H2O or higher. In this condition, rapid surgical decompression is necessary. During decompression abdominal organs reperfusion may produce arterial hypotension and asystole. Abdominal closure must prevent abdominal hypertension. Temporary plastic patch, simple and cheap is the most popular technique.

Abdomen↗

PubMed2001

[Type of surgery and mortality rate in perforated duodenal ulcer].

The aim of this study was to evaluate postoperative mortality in patients with perforated duodenal ulcer and concomitant peritonitis. In our department from 1962 to 1999 there were 625 patients operated on for that reason. The most common surgery performed was the "definitive" one, i.e. truncal vagotomy with pyloroplasty. Partial gastric resection was performed infrequent, and gastrectomy was done only exceptionally. Only in elderly with comorbid conditions (concomitant diseases or highly advanced purulent peritonitis) or in very young patients without prior history of ulcer disease, the perforation was sewed or closed by pyloroplasty (118 patients, 18.9%). Overall postoperative morbidity was 11.2% (70 patients died shortly after the surgery). Morbidity among patients in vagotomy and pyloroplasty group was 2.9%, in resection group--3.3% and among these with the perforation just sewed--45.8%. Two patients younger than 50 years died in postoperative course (0.57%). In patients between 50 and 69 years 29 deaths were observed (15.18%). There were 84 patients older than 70 years, and after the surgery 39 of them died (46.43%). It is important to notice, that even that in the oldest patients in 63 cases the perforation was just sewed (the less invasive procedure), 34 of them died. Vagotomy combined with pyloroplasty is valuable and safe procedure which is widely used in perforated duodenal ulcer. Postoperative morbidity is the highest among older patients, regardless of the procedure applied.

Adult↗

PubMed2001

[Single non-parasitic liver cysts].

Solitary non-parasitic cysts of the liver (NPHC) are rare. The incidence of NPHC on autopsy is 0.2% to 0.5% and on imaging from 2.5 to 4.6% of the population. They are more common in females than males. Congenital cysts can be solitary, multiple or involve the whole liver which is referred to as polycystic liver disease (PCLD). Post-traumatic, neoplastic and echinococceal cysts are acquired lesions. Imaging procedures (USS, CT, MRI) are essential in diagnosis of hepatic cysts. Further diagnostic procedures include cytological, bacteriological and biochemical analysis of cystic fluid. Cystography can exclude communication of the cyst with the ductal system. Serologic tests are used in hydatid disease and serum tumour markers (CEA, CA 19-9) are measured to aid in differential diagnosis of suspected neoplastic cysts. Various therapeutic methods are used in the treatment of solitary non-parasitic hepatic cysts. The simplest is percutaneous obliteration with, for example ethyl alcohol. Fenestration (deroofing) with excision of the cyst wall is increasingly more often performed laparoscopically. Conventional open deroofing is used exceptionally, mainly in complicated cases.

Cysts↗

PubMed2001

[Surgeons in Krakow between WWI and WWII].

During the war time when Polish borders had not been established yet, apart from having two surgical departments Jagiellonian University, Krakow had surgical departments in the Bonifratow, Izraelicki and Military Hospitals. More surgical departments were opened up in later years in pubic Health System Hospitals, among them were Narutowicz at near Pradnicka street and Sisters of Mercy at Lea street. Other well-known Krakow surgeons operated in smaller, private surgeries, such as: Dom Zdrowia (House of Health) or Zwiazkowy (Union) Clinic. At that time only 30 Surgeons worked in Kraków. They were outstanding specialists with a broad practice. Among them were Maksymilian Rutkowski, Jan Glatzel, Stanislaw Nowicki, Michal Hladij. Gradually, younger surgeons started to join them. they were: Jan Kowalczyk, Jerzy Jasienski, Stanislaw Kania, Wladyslaw Laszczak, Jozef Bugusz, Jozef Gasinski. Many of them who worked in the surgical hospitals in Krakow, left the city after obtaining a professorship (like Kornel Michejda, professor at the University of Wilno) or became heads of wards, like Zygmunt Drobniewicz, Alfons Mackowski and Tadeusz Guschlbauer. All of these surgeons were highly respected by the medical community as well as by the general public in their respective town and surrounding areas. A large income allowed that best of them to fund and supply their own wards. Occasionally, however, among the less successful surgeons, an uncompromising competition for patients developed. These events were disapproved and condemned by the medical establishment. Many surgeons led an active life outside of their profession. A surgeon with an exceptionally colorful personality was Jan Glatzel: witty, highly intelligent, a connoisseur of fine art, book lover with an active social life. Maksymilian Rutkowski was active in charitable organizations, helping to support Bratnia Pomoc Medykow. Michal Hladij, president of KS Cracovia, vice president of Krakowski Klub Automobilowy rendered his service to restore monumental cauldron in Rdzawka on the hillside of Obidowa. Others, like Dr Jozef Friszer, a former assistant in the Surgical Hospital, who also came from Krakow, later became and influential politician and the last prime Minister of the Second People's Republic.

Academic Medical Centers↗

PubMed2001

[Causes of intestinal obstruction].

There were 468 patients (58% females and 42% males) operated for mechanical bowel obstruction over the period of 13 years, i.e. between 1987 and 1999 included into this study. In 82.3% of these patients the obstruction involved the small intestine; in this group 5.1% had multi-level obstruction related to massive carcinomatous dissemination. The remaining 17.7% of the patients had colonic obstruction. The most common cause of small bowel obstruction was intestinal strangulation (N = 352). Two thirds of those patients had strangulated hernias, and one-third--obstruction due to adhesions. In the former group, the majority of subjects suffered from femoral hernia incarceration, while inguinal hernia strangulation was somewhat less common. In 9 patients we observed rare small bowel obstruction caused by a gallstone. Of 83 patients with large intestine obstruction, in 80 (96.4%) obstruction was caused by a primary tumor. In the presented material we observed a higher rate of strangulated hernlas then the rate of obstruction due to adhesion, which is opposite to a typical pattern of developed countries. Most likely this difference results from a lower number of elective hernioplasty performed in Poland then in the USA and Western Europe.

Aged↗

PubMed2000

Association of ocular pressure and optic disc cup volume with red blood cell sodium-potassium ATPase inhibition.

PURPOSE: To determine if there were significant differences between the number of red blood cell ouabain binding sites in normals and untreated ocular hypertensives plus one open-angle glaucoma patient. METHODS: We measured the binding of (3)H ouabain to erythrocyte membranes of 23 normals, 25 ocular hypertensives and one open-angle glaucoma. We also measured the levels of plasma cortisol and digoxin in these subjects. Characteristics of cupping of the optic disc and thickness of the retinal nerve fiber layer, as well as area of optic disc pallor of these subjects were measured by stereophotogrammetry and by computerized image analysis from single and stereo photographs. RESULTS: The number of (3)H ouabain binding sites was observed to be significantly less in the ocular hypertensives and one glaucoma compared to the normals (p = 0.0009). In multi-variate analyses, to determine what other factors affected this difference, there was a significant negative association with mean intraocular pressure (p = 0.003) (average of both eyes) and total cup volume (average of both eyes) (p = 0.005), diagnosis of ocular hypertension and glaucoma (p = 0.0005) and male gender (p = 0.019). There was a significant positive association with plasma cortisol levels (p = 0.048), and diastolic blood pressure (p = 0.037). CONCLUSIONS: The number of (3)H ouabain binding sites in red blood cells decreases significantly with increasing ocular pressure and increasing cup volume indicating the possible presence of an increased systemic endogenous digoxin-like inhibitor and/or difference in the isozymes of Na(+), K(+)-ATPase which may be associated with increased levels of plasma cortisol in ocular hypertensives and glaucomas.

Binding Sites↗

PubMed2000

Perforated gastric ulcer.

BACKGROUND/AIMS: Reports about perforated gastric ulcer are scarce and thus it is difficult to settle for a uniform model of operative management. The purpose of the study was to review our experience with perforated gastric ulcer and evaluate the results of gastric resection vs. oversewing of the perforation. METHODS: Within 36 years 77 patients with peritonitis caused by histologically confirmed perforated gastric ulcer were operated. Furthermore, in another 7 microscopic examination revealed that perforation occurred within the gastric cancer. There were twice as many male as female patients. RESULTS: Recently, the overall postoperative mortality (20. 8%) tended to decrease markedly. 32 patients (mean age 49.9 years) were submitted to gastric resection and this procedure was associated with 2.9% mortality. All 3 subjects in whom vagotomy, pyloroplasty and wedge resection of the ulcer had been performed survived. In 40 patients (mean age 61.5 years) only a suture of the ulcer was performed. This procedure was associated with high mortality (1/3 of patients died). Selection criteria included poor general medical status, age, comorbidities, and substantial progression of the inflammatory process. CONCLUSION: Authors believe that emergency gastrectomy is a safe procedure; however, it might be performed without excessive operative risk in only half of the patients.

Adult↗

PubMed2000

[Does the laparoscopic technique influence the intraperitoneal tumor dissemination?].

UNLABELLED: Rapid tumour growth after laparoscopic surgery is a rare and mysterious problem. In seven years period (October 1992-31 June 1999) in the 2nd Department of Surgery at the Jagiellonian University in Cracow, we observed seven persons (five women and two men aged 45 to 70 years), who in short time after laparoscopic cholecystectomy, developed intra-abdominal cancer dissemination. In all cases before and during the operation gallbladder was unsuspected. In five patients, gallbladder cancer (T3) was found in routine postoperative microscopic examination. 18 to 65 days after laparoscopic cholecystectomy patients were operated on and in all cases reexcision was impossible because of micronodular tumour dissemination in peritoneal cavity. The next woman, six months after laparoscopic cholecystectomy, gastric cancer was diagnosed, and during the operation we found intraperitoneal micro-nodular tumour growth. Last patient 4 months after laparoscopic hernioraphy and cholecystectomy had pancreatic cancer subsequently portsite metastasis and intraabdominal cancer dissemination. CONCLUSIONS: Rapid tumour dissemination in peritoneal cavity after laparoscopic cholecystectomy is probably a consequence of laparoscopic technique.

Aged↗

PubMed2000

[Gallbladder cancer in the age of laparoscopic surgery].

In routine post operative microscopic test of unsuspected of cancer gallbladder--before or during laparoscopic cholecystectomy--cancer is recognized in 0.5% to 1%. Bad prognosis is mainly connected with how far advanced the cancer is. It seems that laparoscopic technic it is a disadvantage itself as it conduces to dissemination of cancer in peritoneal cavity and also in cicatrix. Our experience so far proofs that repeatedly during the second traditional operation--even up to several days after laparoscopy--dissemination of cancer is found in peritoneum. Today's views regarding treatment of not advanced cancer considerable are based on experience when the traditional operations were used to remove gallbladder. Further more--it permitted to accept that just cholecystectomy is sufficient in cases when cancer infiltration has not gone beyond mucous membrane. In cases of more advanced cancer extensive operations may prolong life. Due to that observation in cases of gallbladder with cancer infiltration beyond mucous membrane and removed in laparoscopic way an extensive operation is carried out later and it is taking in adherent liver parenchyma and lymphatic tissue in hepato-duodenal ligament or if necessary main biliary tract. Extensive operations are being carried out till microscopic routine test has been performed and few days after laparoscopic cholecystectomy. Some other solution rely during laparoscopic operation--on treating respective with thicken wall gallbladder as a suspected of cancer and microscopic test is carried out intraoperatively. It conditions accomplishment of extensive operation. It must be emphasise that laparoscopic technique encourages dissemination of cancer. From different point of view switching from laparoscopic to traditional cholecystectomy with 1% risk of cancer in thicken wall gallbladder against remaining will be deprived of benefits of laparoscopic operation. Still this quite complicated problem remains open to discussions, research and it needs some time yet before solution will be found.

Cholecystectomy↗

PubMed2000

[Surgical treatment of neoplastic obstruction of the left colon--economic and medical aspects].

Left-sided obstructing resectable colonic cancer is treated by one-stage resection-anastomosis or resection without anastomosis (the Hartmann operation). Morbidity and mortality rates after the first and the second procedure performed in our Department were similar, therefore we analyzed the duration of the operation, hospital stay, cost of the operation, and yearly cost of management. In one-stage operation, the operating time was longer and the costs higher than in the Hartmann procedure. One-stage procedure stay in surgical department was shorter, quality of life higher, and finally, year expenses--cheaper.

Aged↗

PubMed2000

[Changing views in the 20-th century regarding acute appendicitis].

In 1886 Reginald H. Fitz described the pathology of acute appendicitis suggested surgical treatment. 10 years later, during VII-th the Congress of Polish Surgeons in Cracow, Maksymilian Rutkowski was the first in Poland to present the results of that kind of treatment. Operations performed for that frequently, not seldom fatal disease-were not accepted from the beginning through the world. In Poland as well at the beginning of the 20-th century, indications for appendectomy were discussed. In 1920 previous views regarding the necessity for surgical treatment in acute and chronic cases changed. These changes were supported by the observation that in some cases involving pain in the right, pain remains even after appendectomy were the vermiform appendix was found to be unaffected and it was also found that adhesion of ileus can be a dangerous late complications. It might appear that today's knowledge relating to this disease is fully established. Close observation found successful results as shown by in decreasing mortality. Within 100 years in the Massachusetts General Hospital mortality feel from 40% to 0.8% to Fitzs between patients who had undergone appendectomy accompany high percentage failed preoperative diagnosis. Today at the beginning of the 21-st century with the availability of MRI, CT, videosurgery and organs transplant it is difficult to imagine that the cause of such a common disease is still unknown and that in almost 1/4 of the operations performed on patients do not confirm the preoperative diagnosis.

Appendicitis↗

PubMed2000

Does the laparoscopic cholecystectomy accelerate the intraperitoneal dissemination of previously unrecognized gallbladder cancer.

BACKGROUND: Many observations suggest that early intraperitoneal dissemination and port site metastasis occur after laparoscopic cholecystectomy in previously unrecognized gallbladder cancer. MATERIAL AND METHODS: In the years 1992-1999 nine patients after laparoscopic cholecystectomy, were operated on because of previously unsuspected gallbladder cancer following standard postoperative microscopic examination. All gallbladders with markedly thickened wall were removed from abdominal cavity in protective bag. In three cases tumor infiltrated muscular layer (T1b), and in six serosa (T3). All patients 12 to 65 days after cholecystectomy were operated in order to extended operational margins. RESULTS: In four cases (three T1, one T3) during the second operation 3 cm width of the liver parenchyma surrounding the gallbladder bed was resected, along the dissection of the lymphatic of the hepatoduodenal ligament. In these four patients no neoplastic infiltration was found on microscopic examination. All four patients are alive with no signs of recurrence within 3, 5, 17 and 40 months after cholecystectomy. In five persons (all T3), at the second operation, we found intraperitoneal carcinomatosis, and operation was limited to only explorative laparotomy. Four of these five patients died 3, 4, 10 and 11 months after cholecystectomy. One patient is alive 22 months after operation; in this case microscopic examination did not confirm the macroscopic intraoperative diagnosis. CONCLUSION: Laparoscopic cholecystectomy probably accelerates intraperitoneal dissemination in previously unrecognized gallbladder cancer, especially in stage T3 patients and contemporary standard precautions are inadequate.

Aged↗

PubMed1999

Laparoscopic cholecystectomy and gallbladder cancer.

BACKGROUND: This study was designed to assess the treatment of patients in whom gallbladder cancer was diagnosed in the course of histological examination of their gallbladders, which were removed during laparoscopic cholecystectomy. METHODS: Six (0.29%) cancers were found among 2,017 patients who underwent laparoscopic cholecystectomy. Four of these cancers (0.22%) were in 1,831 gallbladders with normal walls, two (1.0%) were in 186 with thicker walls, and two (1.8%) were in 109 patients in whom conversion was necessary because of extensive inflammation and thickening of gallbladder wall. RESULTS: In two cases, the cancer did not cross the muscular layer. In one of them, no further treatment was undertaken. In the second case, liver resection and lymphadenectomy was performed. In the other four cases, dissemination was diagnosed during laparotomy, precluding radical treatment. CONCLUSIONS: Thickened and infiltrated gallbladder walls in patients without preoperative symptoms of cholecystitis should raise a suspicion of cancer. The surgeon should be prepared to perform a conversion, an intraoperative histological examination, and an appropriate radical operation, if necessary.

Aged↗

PubMed1999

[Seasonal periodicity of perforated peptic ulcers].

The aim of the study was to evaluate if the frequency of peptic ulcer perforation depends on the changes of seasons. The investigation was carried out in mountain region of Nowosadecki District. This complication of peptic ulcer disease appeared with constant time trend in the years 1991-95. Considering the whole five year period, the increasing number of new cases was observed on the turn of spring and summer (May, June, July) and in early autumn (September, October). Another pattern of seasonal periodicity is often observed in different regions of the world. Because of that, it may be assumed that not changes of seasons but different environmental factors (also weather changes) may influence the frequency of peptic ulcer perforation.

Duodenal Ulcer↗

PubMed1999

[Splenic abscess].

Splenic abscess consists a very rare pathology. There were less than 300 cases described in the literature in the last 10 years. We report a case of 68 year old women with the splenic abscess with a history of blunt trauma of the left side chest wall two years earlier. The diagnosis was confirmed by USG and CT. The patient underwent splenectomy. The post operative course was uneventful.

Abscess↗