A calcified and cystic peripancreatic mass.
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Adult↗
Biomedical subjects
D Kaczmarek
Publications and source records attributed to D Kaczmarek.
[Management of traumatic retroperitoneal hematoma].
Traumatic retroperitoneal hematoma (RPH) may arise from injury to bony structures, major blood vessels, and intestinal or retroperitoneal viscera. To categorize the management of RPH, the retroperitoneum may be divided into three zones. Zone 1 (central) extends from the esophageal hiatus to the sacral promontory. Zone 2 (lateral) extends from the lateral diaphragm to the iliac crest. Zone 3 (pelvic) is confined to the retroperitoneal space of the pelvic bowl. For the traumatized patient with RPH, laparotomy is mandated by persistent hemodynamic instability despite intensive volume replacement. The judgment of whether and when to explore the retroperitoneal hematoma is guided by the mechanism of injury (blunt or penetrating) and the location of the RPH. RPH localized to the upper central area (Zone 1) after penetrating trauma implies injury to the great vessels and always requires urgent surgical exploration. RPH in other zones should be evaluated by CT and/or angiography; ongoing hemorrhage may respond to therapeutic embolization.
Hematoma↗
[Complicating neonatal Escherichia coli meningitis].
Neonatal Escherichia coli meningitis is a serious disease with high mortality and poor outcome. Ventriculitis, brain abscess and subdural empyema are frequent, with no homogeneous recommendations available for these complications. The case of a newborn infant who developed sepsis and meningitis caused by E. coli is presented. During intravenous treatment with ampicillin, cefotaxime and gentamycin in recommended doses, the patient developed severe subdural abscesses detected on MRI. After consequent antibiotic therapy over 2 months with fosfomycin, amikacin and meropenem the patient improved clinically and the abscesses regressed and disappeared without neurosurgical intervention. At the age of 6.5 months the infant is healthy and well developed. The conservative treatment of subdural abscesses complicating neonatal Escherichia coli meningitis without neurosurgical intervention is possible. The treatment of the individual case should be discussed between pediatrician and neurosurgeon.
Amikacin↗
[Port-site metastasis after laparoscopic resction of a duodenal stromal tumor].
Gastro-intestinal stromal tumors are rare and their evolution is dubious. This observation of port site metastasis after laparoscopic resection of a small duodenal stromal tumor would be, to our knowledge, the first case reported in the literature. Several direct and indirect mechanisms were supposed to be involved in the appearance of metastases after laparoscopic surgery, but the risk of dissemination remains badly evaluated on its frequency as well as on its mechanisms.
Aged↗
[Chondrosarcoma of the infratemporal fossa with intracranial extension. Case report and review of the literature].
Chondrosarcomas are rarely observed in the infratemporal fossa. We report a rare case with temporal extension into the middle cerebral fossa without meningoencephalic invasion. Surgical excision was followed by radiotherapy. The patient died 7 years later from another cause free of tumoral recurrence. We discuss the current understanding of cephalic chondrosarcomas involving the infratemporal fossa.
Adult↗
The actions of lovastatin on platelet function and platelet eicosanoid receptors in type II hypercholesterolaemia. A double-blind, placebo-controlled, prospective study.
We have studied the effects of 12 weeks of lovastatin (20 mg per day) on platelet function and thromboxane formation in 18 patients with type II hypercholesterolaemia in a double-blind, placebo-controlled, prospective study. Lovastatin significantly reduced total serum and LDL-cholesterol by 20% and 25% respectively. Washed platelets of lovastatin-treated patients had significantly reduced collagen-induced aggregation and thromboxane formation ex vivo. There was no change in ADP-induced platelet aggregation, but a significant increase in prostacyclin (iloprost)-stimulated platelet cyclic AMP concentrations in lovastatin-treated patients. This was associated with a significant increase in the number of prostacyclin receptors in platelet membranes prepared from lovastatin-treated patients. There was also an increase in platelet thromboxane receptors. There were no such changes in the placebo group. These data confirm our original observation of normalization of platelet function in hypercholesterolaemia by HMGCoA reductase inhibitors and suggest changes in platelet membrane composition at the megakaryocyte level as a possible site of action.
Adolescent↗
[Usefulness of determining the conduction of sensory nerve fibers in the diagnosis of vibration disease].
Thirty two metallurgical industry workers exposed to vibration (I group) and nine workers of the same industrial plant but unexposed to vibration (II group) underwent the following tests: electromyography--abductor dig. V, and abductor pollicis brevis, conductability of sensory fibers n. medianus and ulnaris, conductability of motoric fibers of n. ulnaris. In the third, control, group twenty five men had conductability norms determined. The results have been statistically analysed. Electromyography appeared more useful for the diagnosis of early symptoms of the vibration disease than for nerves conductability tests. The tests of sensory nerves conductability exhibit frequent deviations in the II group workers. Positive correlation was found between electromyography and nerves conductability findings.
Action Potentials↗
Material management: is it a profession or not?
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Certification↗