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Biomedical subjects

I Nawrot

Publications and source records attributed to I Nawrot.

9 recordsLinked to original sources
PubMed2000

Surgery for primary hyperparathyroidism.

OBJECTIVE: To define the role of surgery for organic primary hyperparathyroidism and to evaluate the diagnostic and operative methods applied. DESIGN: Retrospective, non-randomized, non-blinded evaluation. Case series. SETTING: Tertiary referral center. Department of Surgery. SUBJECTS AND METHODS: The report documents experience in surgical management at a single institution of 312 patients with primary (and 498 patients with secondary) hyperparathyroidism in a period from 1974 to 2000. Patient symptoms, clinical features, diagnostic and localization methods, operative management, and postoperative results were evaluated by retrospective medical record review with special attention to surgical management strategy. RESULTS: Of 321 patients with primary hyperparathyroidism 312 underwent 348 operations. There were 312 primary procedures and 36 multiple reoperations on 25 patients. The permanent success rate for primary (312) operations was achieved in 287 patients (92%). The permanent success rate for 36 secondary reoperations was achieved in 19 out of 25 reoperated patients (76%). The overall full recovery was obtained in 306 operated patients (98%). There were no postoperative emergency reoperations. There were 2 postoperative hospital deaths (0.6%) of patients with sustained hypercalcemic crisis after excision one cervical adenoma, but functioning second one in mediastinum.

Adolescent↗
PubMed1996

Cultured parathyroid cells allotransplantation without immunosuppression for treatment of intractable hypoparathyroidism.

Cultured, viable and functioning ABO compatible parathyroid cells were allografted in 18 nonimmunosuppressed patients with a postoperative hypoparathyroidism. Variable, but promising biochemical and clinical results were obtained. Clinical and biochemical observations have documented graft function up to 14 months. The mechanism of cessation of function of implanted cultured cell suspension remains unknown. Some parameters, suggest a rejection mechanism but other mechanisms can not be excluded. This suggests that some form of immune modulation may be necessary to improve further PT allograft survival in recipients off immunosuppressive therapy.

ABO Blood-Group System↗
PubMed1995

[Allotransplantation of the parathyroid in patients without immunosuppression].

Eighteen patients with postoperative insufficiency (after thyroid operations) have been treated with cultured, hormonally active, living and ABO the same group type parathyroid cells. Explants had been taken from 2 operated patients with secondary hyperparathyroidism. Hormonal activity of the transplanted parathyroid cells under the fascia of the brachio-radialis muscle has been confirmed by clinical, biochemical tests and the level of PTH in blood serum from the vein of non-grafted arm. Hormonal activity of the graft was variable but lasted up to 14 months.

Adult↗
PubMedDate not supplied

A solution to organ shortage: vascular reconstructions for pancreas transplantation.

Multiorgan harvesting (MOH) accounts for approximately 40% of all organ procurements in Poland. Simultaneous procurement of the pancreas and liver necessitates division of the vessels supplying both organs. Therefore, reconstruction of the pancreas vasculature is mandatory for proper function of the transplanted organ. The aim of this study was to present various methods of vascular reconstruction to prepare the pancreas for transplantation. Between January 1999 and April 2005, among 42 whole pancreas transplantations, 35 came from MOH necessitating arterial reconstruction. In 32 cases, the splenic artery (SA) and superior mesenteric artery (SMA) were sewn into a single trunk using the common iliac arterial bifurcation. Occasionally, the iliac Y-graft was unsuitable for vascular reconstruction due to atherosclerosis or iatrogenic injury. Therefore, the SA was anastomosed to the side of the SMA in two cases. In one case we utilized the brachiocephalic trunk bifurcation. Portal vein elongation employed an external iliac vein procured from the donor in all 35 cases. Good perfusion was achieved in all transplanted pancreata. During the early follow-up period, two venous and one arterial thromboses were noted. No negative effects of pancreatic vessel reconstruction were observed in postoperative graft function. Reconstruction of the pancreas vasculature did not affect the long-term function of the allograft while significantly increasing the available donor organ pool.

Humans↗
PubMedDate not supplied

Effect of surgical technique in subtotal and bilateral thyroidectomy on risk of postoperative parathyroid insufficiency development--our experience.

One of the postoperative complications after strumectomy is hypoparathyroidism. Therefore, the purpose of our study was to evaluate the effect of the surgical technique on the development of parathyroid gland insufficiency in our group of patients. Subtotal, bilateral strumectomies were performed according to Rothmund's suggestions. Randomized controlled trial was performed in two groups. In the first group of 19 patients, main trunk of the inferior thyroid artery was ligated and in the second one consisting of 18 patients, only the branches of this artery were ligated. Total calcium and PTH levels were evaluated pre- and postoperatively. Based on the biochemical and clinical data, no statistically significant differences in the development of postoperative hypoparathyroidism in relation to performed surgical techniques were observed.

Adult↗
PubMedDate not supplied

[Results of conservative treatment in patients with atheromatous obstruction of arteries in the leg].

Late results of the treatment of 107 patients with crural arteries occlusion (21 (20%) with isolated lesions and 86 (80%) with multisegmental lesions) were evaluated. Favourable result of the conservative treatment was achieved in 38% of patients with isolated lesions, no improvement in 38%, and worsening in one patient were noted during a 5-year follow up. Percentage in the group of patients with multisegmental lesions (including crural arteries) was 23%, 50%, and 27%, respectively. No patients with isolated lesions died during follow up period, whereas 11 (13%) patients with multisegmental lesions died.

Arterial Occlusive Diseases↗