PubMed Health⌕ Search

Biomedical subjects

K Bielecki

Publications and source records attributed to K Bielecki.

At least 19 recordsLinked to original sources
PubMed2003

A prospective randomized trial of diltiazem and glyceryltrinitrate ointment in the treatment of chronic anal fissure.

OBJECTIVE: The aim of this study was to compare prospectively diltiazem with GTN ointment in the treatment of anal fissure. PATIENTS AND METHODS: Of 43 outpatients with chronic anal fissure, 22 patients were randomized to topical diltiazem (2%) ointment and 21 patients to glyceryltrinitrate (GTN) (0.5%) ointment twice daily for 8 weeks. During the course of treatment each patient was seen three times. Side-effects and healing were recorded. RESULTS: Healing occurred in 19 of 22 patients treated with diltiazem and 18 of 21 patients were cured with GTN (P = 0.95). Those who were treated with nitroglycerin ointment developed headache and dizziness developed after GTN in 33.3% of cases while no patient had any side-effects after diltiazem. CONCLUSIONS: Diltiazem and glyceryltrinitrate (GTN) were equally effective in healing anal fissure but the former resulted in fewer side-effects.

Administration, Topical↗
PubMed2002

Large bowel perforation: morbidity and mortality.

Perforations of large bowel are rare but severe complications, mainly of colorectal cancer and colonic diverticulitis. The choice of the surgical procedure is still debated. We retrospectively studied peritonitis caused by large bowel perforation to assess predictors of mortality and safety of primary resection and anastomosis. We investigated 59 patients with large bowel perforation treated surgically as emergency cases: 18 patients underwent primary resection and anastomosis, 36 had primary resection of the diseased part of bowel without anastomosis, and 5 patients had non-resective procedures. The severity of peritonitis was assessed using Hinchey's classification and the Mannheim peritonitis index (MPI). Overall mortality was 16.9%. MPI score was significantly lower for survivors vs. non-survivors, and for patients with resection and anastomosis vs. those who underwent resection without anastomosis (p<0.001). The mortality rate was 11.1% for primary resection with anastomosis, and 22.2% for primary resection without anastomosis. No patient with MPI less than 25 died, while 10 (38.5%) of the patients with MPI of 26-36 died. In conclusion, a radical aggressive approach is recommended for most patients with large bowel perforation. Mortality and morbidity are closely related to the extent of intraperitoneal infection and the incidence of postoperative complications is higher in patients with perforation due to non-malignant causes.

Adult↗
PubMed2001

[Surgical treatment of colonic diverticulitis--personal observations].

The aim of paper is presentation of our experience in surgical treatment of diverticular disease. In the period of 11 years we operated on 22 patients aged from 38 to 85 years because of complicated diverticulitis. We admitted to hospital 11 patients as emergency cases; operation was performed urgently in 9 of them due to symptoms and signs of acute peritonitis. The other patients were admitted to hospital because of stenosing inflammatory pericolic mass, pericolic abscess or at least two episodes of acute diverticulitis in the past. Resection of affected part of colon was performed in all patients. Primary anastomosis was performed in 13 patients, Hartmann's operation was performed in 8 patients and suture of caecum in site of resected diverticulum was performed in one patient. There was no mortality. Perioperative complications occurred in 31.8% of patients; anastomotic leak occurred in 1 (7.7%) of 13 patients with primary bowel anastomosis. Results were discussed on the base of recent literature.

Adult↗
PubMed2001

The membrane-disrupting activity of alpha-aminoalkanephosphonic acids and their derivatives.

The influence of a series of acyclic and cyclic aminophosphonates on the physicochemical properties of model (planar lipid membranes-BLM) and biological (erythrocytes-RBC) membranes was studied. The results obtained were compared with the results of physiological tests performed on the aquatic plant Spirodela oligorrhiza. It was found that the inhibition of plant growth by the compounds studied correlated, although not very highly, with the observed changes in the properties of membranes used. It was also found that both the biological activity of aminophosphonates and their efficiency at modifying the physicochemical parameters of membranes depended on their structural features.

Animals↗
PubMed2000

Physiological activity of some organophosphorus compounds and their effects on the physico-chemical properties of model membranes.

The effect of the newly synthesized phosphonic compound dibutyl 2-octylamino-2-propanephosphonate (DBOP) on the growth of the aquatic plant Spirodela oligorrhiza and stability of red blood cells (RBC) and planar lipid membranes (BLM) was studied to determine its physiological activity and, if possible, correlate this activity to compound-induced changes in the mechanical properties of the model membranes. The measure of the phytotoxicity was the DBOP concentration causing 50% plant growth retardation, while measures of stability of model membranes were 100% hemolysis of RBC and a critical concentration of DBOP causing BLM destruction in no more that 3 min. These data were compared with those for dibutyl 1-butylamino-1-cyclohexanephosphonate (DBBC) and diethyl 9-butylamino-9-fluorenephosphonate (DEBF) known for their physiological activities. Both DBBC and DEBF influenced Spirodela growth significantly less than DBOP Destabilization of the model membrane caused by DBBC and DBOP was similar whereas DEBF exerted a weak influence on RBC and BLM stability. The results indicate that the physiological activities of DBOP and DEBF are not limited to the lipid phase of biological membranes and may involve also disturbance of metabolic processes.

Animals↗
PubMed2000

Trauma care for the year 2000.

Trauma is a third killer of modern european and world societies. Everywhere in Europe there is the great necessity of having an efficient emergency prehospital and hospital trauma care organization which will reduce mortality and invalidity of the trauma critical patients. Three objectives are the most important: 1) defining of the lines guide (e.g. ALTS) 2) continuous education and training of education the medical and paramedical operators (doctors, nurses, technicians, paramedics) 3) applying the method on organization and structural base. According to statements of Council of Europe, European College of Surgeons, E.A.E.S., it has been affirmed "In addition to General Surgery training for the surgeons should require a complementary training in Emergency Surgery either" concurrently or consecutively. As a first suggestion; the idea is to create centers of excellence fully equipped with all modern facilities and well trained medical staff. Those centers should be spread over the Europe and available round tho clock. Those centers should be supervised by a trained Emergency Surgeons with the indispensable aids and cooperation of anesthesiologist. The other very important factor is optimalization of patients transport towards the suitable trauma care center. Emergency Surgical Training should be established on three levels namely; 1) within the undergraduate medical curriculum 2) complementary training in emergency surgery during the general surgery specialization 3) additional theoretical and practical training for emergency nurses. There are many cultural and organizational differences among the "old and new" European Countries. The most important and special objective is the evolution of a correct and equal education in training care in order to improve our situation.

Curriculum↗
PubMed1998

[Necrotizing dermatitis, infections of soft tissue and deep fascia: classification and treatment].

Nectrotizing fasciitis is a mixed infection of skin and subcutaneous tissue with a characteristic clinical and pathological appearance. Necrotizing soft tissue infections, caused by aerobic, anaerobic and mixed bacterial flora are an increasing problem in medical and surgical practice. The apparently wide variety of these infections is systematized. Etiology and bacteriology are discussed, as the role of surgery, antibiotics and hyperbaric chamber in the treatment of the infections. Early and radical surgical excision of all affected tissue is the treatment of choice. Adjuvant hyperbaric oxygen appears to be important in refractory progressive bacterial gangrene. A combination of hyperbaric oxygen, surgical treatment and antibiotics gives the lowest mortality and morbidity in gas gangrene compared with other treatment modifications. Extensive clinical experience shows the efficacy of these treatment protocols.

Anti-Bacterial Agents↗
PubMed1997

[Anastomosis of ducts and intestines in non-neoplastic bile duct stricture].

Recurrence of hepaticojejunal anastomotic stricture should be regarded as an operative risk, particularly in the case of patients with type III and IV stricture according to Bismuth classification. This complication should be taken into account, especially in the first five postoperative years. Since in some cases, biliary stricture has an insidious course with nebulous clinical symptoms. It becomes evident at the stage of advanced degenerative lesions in the liver. Success of the next surgical intervention is dependent to a great extent on whether reoperation is performed on patients with existing fibrotic and cirrhotic lesions in the liver. Considering the time of postoperative follow-up, patients with benign biliary stricture constitute a ++non-uniform group. Under such circumstances, the results can be standardised with the statistically approved Cutler-Ederer method. Prospective observations and rapid determination of indications for the next surgical intervention led to a permanent recovery rate of 92%, although single surgery brought permanent improvement in only 72-75% of the operated patients.

Cholestasis↗
PubMed1996

Normal human immune peritoneal cells: subpopulations and functional characteristics.

Normal human peritoneal cells collected during elective laparatomy from patients with gallbladder stones without clinically detectable inflammatory changes were characterized phenotypically with immunocytochemical method and flow cytometry, with special attention paid to the presence of memory cells. The responsiveness of normal PCs to mitogen and, specifically, the role of peritoneal macrophages in this process was studied. The peritoneal cells consisted of 45% of monocytes/ macrophages (CD68+), as many as CD2+ T lymphocytes, 8% CD57+ NK and K 2% CD22+ B, cells. The CD4/CD8 ratio was 0.4. The peritoneal cells did not express interleukin-2 (CD25+) and transferrin receptors (CD71+) on their surface. Approximately 49% of the peritoneal cells were class II MHC antigen positive cells. Two per cent of S100+ dendritic cells were found. Flow cytometric two-colour analysis revealed that the majority of peritoneal CD4+ (92.4%) and CD8+ (73.1%) lymphocytes, while only 50.2% of CD4+ and 30.1% CD8+ peripheral blood cells expressed simultaneously the CD45R0 (UCHL1) molecule, which is characteristic to the memory/effector T-cell subpopulation. Peritoneal T lymphocytes responded to the mitogens less than peripheral blood lymphocytes of the same individual. Supplementation of cell culture with anti-macrophage (anti-CD68) and anti-HLA-DR MoAb brought about a dose-dependent decrease of proliferative peritoneal cell response to ConA. The authors conclude that human peritoneal cell population comprises a high proportion of T lymphocytes and macrophages capable of presenting antigens to peritoneal lymphocytes. High prevalence of memory lymphocytes points to the preparedness of these cells to react with invading antigens most likely of gut bacterial origin.

Adult↗
PubMed1995

Hartmann procedure: place in surgery and what after?

The results of 65 consecutive cases of Hartmann's procedure carried out between 1982/1993 inclusive, were reviewed. There were 41 emergency procedures including 27 cases with complicated carcinoma and 24 elective procedures including 20 with carcinoma, 3 with diverticular disease and one with perirectal haemangioma. Postoperative complications occurred in 25 (38.5%) patients, including 13 (19%) with wound infection. Seven patients had to be reoperated because of intraperitoneal abscess (3 cases) or wound dehiscence (4 cases). There were five (7.7%) postoperative deaths. The mean hospital stay of operation survivors was 16 days (range 8-54). Intestinal continuity has been reestablished in 13 (81.2%) of 16 survivors in the benign disease group and in 4.5% of patients of the malignant group. The mean time to of restoration of continuity was 240 days (range 40-630) after the primary procedure. No one died after these procedures. In five (31.2%) patients postoperative complications were observed: anastomotic leak (2 cases) and wound infection (3 cases). All complications were treated conservatively.

Adolescent↗
PubMed1995

Influence of proximal end diverting colostomy on the healing of left-sided colonic anastomosis: an experimental study in rats.

The purpose of this study was to evaluate the healing of an experimental left-sided colonic anastomosis in rats protected by an end diverting proimal colostomy. The anastomoses were studied by radiological and biochemical examination and breaking strength was estimated. The results were compared with a non-operated group and with a group of rats having a non-defunctional anastomosis constructed in the same manner. In animals with an end diverting colostomy, anastomotic protein levels and enzymic activity were lower than in those with a colostomy, and the development of anastomotic strength was delayed compared with those not defunctioned.

Anastomosis, Surgical↗
PubMed1994

Repeated reconstruction for recurrent benign bile duct stricture.

Since 1965, 101 operations for benign bile duct stricture have been performed, including 51 Roux-en-Y end-to-side hepaticojejunostomies. Complete follow-up to a mean of 12.5 years has been achieved. Nine patients required reoperation for stricture; the total cumulative late patency rate was 90 per cent, including successful repair. Seven of the nine patients who underwent a second operation had a favourable outcome. Early hepaticojejunostomy is a satisfactory treatment for recurrent biliary stricture.

Adult↗
PubMed1994

Effect of 5-fluorouracil on secretion and synthesis of pancreatic digestive enzymes: studies in isolated pancreatic acini and perfused pancreas derived from normal rats and from rats with acute necrotizing pancreatitis.

5-Fluorouracil (5-FU) has been claimed to have beneficial effects in human pancreatitis because of its ability to inhibit protein synthesis and secretion. However, the effect of 5-FU has not been studied in the pancreas of animals in more detail and the data in human pancreatitis are mostly derived from uncontrolled studies. Thus, we studied potential short-term effects of 5-FU on protein synthesis and secretion in isolated pancreatic acini from normal rats and from rats with sodium taurocholate-induced pancreatitis. Furthermore, we used the isolated perfused pancreas, damaged by taurocholate, to study whether arterial perfusion with 5-FU has any beneficial effects. When pancreatic acini were incubated with various concentrations of 5-FU, CCK-8-stimulated amylase secretion was not altered. Furthermore, 5-FU had no short-term effects on protein synthesis. Protein synthesis and secretion was already markedly depressed in isolated pancreatic acini derived from rats with sodium taurocholate-induced pancreatitis. 5-FU did not further decrease protein synthesis or secretion. Retrograde injection of sodium taurocholate in the main pancreatic duct of the isolated perfused pancreas resulted in a steep increase of amylase and lipase in the portal effluate. Arterial perfusion with 5-FU had no influence on enzyme release into the portal blood. We may conclude that our data, derived from experimental pancreatitis in rats, do not encourage investigation of the effect of 5-FU, an anticancer drug with possibly toxic side effects, in human pancreatitis.

Acute Disease↗
PubMed1991

Assessment of noninvasive intra-anal electromyography to evaluate sphincter function.

Assessment of anal function is now regarded as an important aspect of the proctologic examination in assessment of patients with disordered defecation. Conventional electromyography is invasive and often not repeatable because of patient discomfort. Noninvasive surface intra-anal EMG was evaluated as a method of assessing sphincter function in 76 subjects. A significant correlation was found between intra-anal EMG and anal manometry at rest and during a maximum squeeze effort (P less than 0.01). Intra-anal EMG was found to be reproducible when evaluated by 2 independent observers (P less than 0.05) and may prove a reliable portable noninvasive method of assessing sphincter function.

Anal Canal↗
PubMed1990

Poliovirus type 1 enters the human host through intestinal M cells.

It was demonstrated by electron microscopy that after in vitro incubation of human Peyer's patches with poliovirus type 1, either Sabin or Mahoney strain, poliovirus particles adhere specifically to and are endocytosed by intestinal epithelial M cells. These findings suggest that M cells in humans are the site of poliovirus penetration of the intestinal epithelial barrier.

Adult↗
PubMed1989

[Two-step removal of Kehr's drain from the common bile duct].

The removal of Kehr's drain from the common bile duct is not an indifferent procedure. In about 5% of cases complications develop, as described. Two-step removal of T drain prevents accumulation of bile around the defect in the common bile duct and development of such complications as massive escape of bile, septic complications, biliary peritonitis. In a group of 167 patients with T drain in whom the drain was removed in one step, three cases of serious complications developed, and in the group of 120 patients with two-step removal of T drain no complications were noted.

Common Bile Duct↗