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Biomedical subjects

M Barczyński

Publications and source records attributed to M Barczyński.

At least 37 records · Page 2Linked to original sources
PubMed1998

[Metastasis of kidney clear cell carcinoma to the thyroid cell in patients on renal replacement therapy].

The paper presents 2 cases of metastases of clear cell carcinoma of kidney into thyroid gland in patients on renal replacement therapy. In one patient after bilateral nephrectomy due to renal clear cell carcinoma (in 15 years time interval) and in second patient after left-side nephrectomy performed 16 years earlier and terminal right kidney insufficiency due to nephropathy with nephrotic syndrome for a year. In diagnosis essentials were: physical signs--palpable single node within the thyroid gland, earlier neoplastic anamnesis, cold node in scintigraphy, hypoechogenic node in ultrasonography of the thyroid gland, particularly with a rich vascular net within the node in power-doppler examination and, at last cytology of material from ultrasound-guided fine needle biopsy of the node. The diagnosis had been confirmed in intraoperative histopathological examination before the total thyroidectomy was performed.

Adenocarcinoma, Clear Cell↗
PubMed1998

[Intrathoracic goiter as a cause of superior vena cava syndrome].

Between 1984 and 1997 year 4985 patients underwent surgical treatment due to various thyroid gland diseases, among them were 28 (0.6%) patients with intrathoracic goitre, but only in one case (0.002%) the signs of superior vena cava syndrome (SVCS) were observed: oedema and lividity of the face, enlargement of jugular veins and superior limbs' veins. In addition the patient manifested subsequently growing dyspnoea, dysphagia and hoarseness. In diagnose essential were X-ray examination of the chest (widening of mediastinal shadow), X-ray examination of the trachea (dislocation and compression of the trachea), X-ray of esophagus with contrast (compression from the outside), ultrasonography of thyroid gland. Intraoperatively, after it was confirmed that the SVCS was caused by compression of the intrathoracic right lobe of thyroid gland, the oblong sternotomy was performed to provide the proper surgical access for subtotal thyroidectomy. The weight of resected tissues of thyroid gland was 1036 g. In histopathological examination the diagnosis of multinodular toxic goitre was confirmed.

Aged↗
PubMed1998

[Postoperative wound infections. IV. Flora and clinical course of postoperative wound infection].

Each wound infection may be coursed in few clinical manifestations and may concern either skin with subcutaneous tissue (superficial infection) or deeper layers-fascias, muscles (deep infection). The aim of this study was to evaluate the form of infection and its clinical course, and moreover, to find the specific flora of infected wounds. The material was 1527 surgically treated patients in the 3rd Surgical Department of the Collegium Medicum of the Jagiellonian University during one year. 66 patients with wounds of the head and 7 patients who died within first three days after surgery without wound infection signs were excluded from the study population. The healing of each wound was observed during the patient's hospitalisation and 30 days after discharge from hospital, and in orthopedic patients 6 months after discharge. The total number of 132 infected wounds was identified. The population of 1352 wounds healed without any complications was a control group. All the data were recorded in a Wound Infection Register Card and were collected in the computer database. The data were statistically analysed. Relationships between single factors and postoperative wound infection were evaluated using chi-square statistics and in the small number Fisher's exact probability test. Analysis of variance was used for continuous variables. Odds ratios and corresponding 95% confidence intervals were computed for all variables. Postoperative wound infection was found in 132 (8.9%) cases, including 76 (57.6%) in males and 56 (42.4%) in females. The average age was 50.9 years. The period of hospitalisation ranged from 3 to 119 days, with the mean of 31.9 days in comparison to 16.3 days in the control group.

Analysis of Variance↗
PubMed1998

[Postoperative wound infections. I. Population data and risk factors].

UNLABELLED: Postoperative wound infection is one of the most essential problems in surgical department related to surgery. The occurrence of infection depends on different factors related to both, the patient and his disease, and treatment organisation as well. The aim of this study was to establish the postoperative wound infection rate and to assess the correlations between age, sex, wound contamination, time and mode of operation, type of anaesthesia, duration of preoperative hospitalisation, wound drainage and the season of the year and development of postoperative wound infections. Patients undergoing surgery in the 3rd Surgical Department of the Collegium Medicum of the Jagiellonian University during one year were prospectively investigated. From the study population, 66 patients with, wounds of the head and 7 patients who died within three days after surgery without wound infection signs were excluded. The healing of each wound was observed during the patient's hospitalisation and 30 days after discharge from hospital, and in orthopedic patients 6 months after discharge. The total number of 132 infected wounds was identified. The population of 1352 wounds healed without any complications was a control group. All the data were recorded in a Wound Infection Register Card and were collected in the computer database. The data were statistically analysed. Relations between single factor and postoperative wound infection were evaluated using chi2 statistics and in the small number Fisher's exact probability test. Analysis of variance for continuous variables was used. Odds ratios and corresponding 95% confidence intervals were computed for all variables. The overall wound infection rate was 8.9%. The mean hospitalisation time was 18 days and was doubled in the group with wound infection (p < 0.001). The mean age of the whole population was 48.1.77 (5.2%) patients died after surgery. The relationship between sex, duration and mode of operation, duration of preoperative stay in hospital, wound contamination, kind of wound drainage and postoperative wound infection rate was significant. CONCLUSIONS: 1. The time of hospitalisation was twice longer in the infected group of patients with infected wounds in comparison to the control group. 2. Male sex, longer preoperative stay in hospital, duration of operation longer than one hour, emergency mode of operation, contaminated and dirty infected operation in traditional wound classification system and open (passive) drainage were statistically significant factors which influenced occurrence of postoperative wound infection.

Adult↗
PubMed1998

[Postoperative wound infections. II. Risk factors related to surgery].

UNLABELLED: Postoperative wound infection is the most frequent complication of surgical treatment. The occurrence of infection depends on many factors, but the most important is bacterial contamination of wound according to the site of operation. The aim of this study was to establish wound infection rate and to determine the relationship between site of operation, wound contamination and the other surgery related factors and postoperative wound infection risk. The material was 1527 surgically treated patients in the 3rd Surgical Department of the Collegium Medicum of the Jagiellonian University during one year. From the study population were excluded 66 patients with wounds of the head and 7 patients who died within three days after surgery without wound infection signs. The healing of each wound was observed during the patient's hospitalisation and 30 days after discharge from hospital, and in orthopedic patients 6 months after discharge. The total number of 132 infected wounds was identified. The population of 1352 wounds healed without any complications was a control group. Data were recorded in a Wound Infection Register Card and were collected in the computer database. The data were statistically analysed. Relations between single factor and postoperative wound infection were evaluated using chi2 statistics and in the small group Fisher's exact probability test. Odds ratios and corresponding 95% confidence intervals were computed for all variables. The overall wound infection rate was 8.9%. The significant factors (p < 0.05) were gastrointestinal operation, reoperation, intraoperative X-ray examination, haematoma of the wound after operation, skeletal traction prior to surgery and implantation of prosthetic material in clean wounds. CONCLUSIONS: 1. Wound contamination, site of operation (GI tract), open drainage, reoperation, intraoperative X-ray examination and postoperative haematoma of the wound are statistically significant risk factors which influence postoperative wound infection rate. 2. Postoperative haematoma of wound is the most important local risk factor of wound infection after surgery.

Chi-Square Distribution↗
PubMed1998

[Neurilemmoma in the thyroid region].

In the paper we present the group of 3 patients with neurilemmoma. Patients were operated on because of simple nodular goiter transformed into the thyroid carcinoma. In all cases final diagnosis was based on postoperative paraffin-embedded tissues. In the authors' opinion modern imaging technics strictly allows to formulate the preoperative diagnosis. Total resection with special attention paid to the postoperative examination including ultrasound diagnostics improve survival.

Adult↗
PubMed1998

[Hodgkin's disease in the thyroid gland].

The paper presents one case with diagnosed the primary extra-nodular Hodgkin's disease in the thyroid gland. Patient was operated on. Hodgkin's disease was diagnosed postoperatively in the paraffin-embedded tissues. In authors' opinion progress in the imaging technics with fine-needle aspiration biopsy allows to formulate diagnosis, and treatment which includes chemo- and radiotherapy, improves survival.

Adult↗
PubMed1998

[Chromosome aberrations in patients with papillary thyroid cancer and other neoplasms].

Cancer is essentially a genetic disease resulting from congenital or acquired alterations in some cells of the patient. Such changes may occur in particular oncogens and are responsible for the tumour phenotype of the affected population of cells. In contrast, unaltered tumour-suppressor genes are responsible for suppressing the neoplastic phenotype, and their inactivation by deletion or mutation permits cancerous development in the affected cells. The genetic model of carcinogenesis is based on the idea mutations at the DNA level, what creates a functional imbalance between the oncogenes and the tumour-suppressor genes, resulting in uncontrolled clonal proliferation. The ret/PTC oncogene is unique to papillary thyroid cancer. The paper presents a correlation analysis between chromosomal changes in papillary thyroid cancer and abnormalities of chromosomes in patients with breast cancer and chronic lymphocytic leukemia.

Breast Neoplasms↗
PubMed1997

[Evaluation of autonomic nervous system function with heart rate variability analysis in patients with hyperthyroidism and during euthyroidism after pharmacologic and surgical treatment].

The aim of the present study was both to estimate autonomic nervous system (ANS) function in patients with hyperthyroidism by the heart rate variability (HRV) analysis and to evaluate the impact of pharmacological and surgical treatment on the ANS function. Analysis of the HRV underwent 10 female patients in course of thyreotoxicosis and after reaching full clinical and biochemical euthyroidism, after pharmacological therapy and in month after surgical treatment. The 10 minutes records at rest, in horizontal position were evaluated. The HRV parameters like mean of the heart rate, mean of RR intervals, standard deviation of all normal RR intervals (SDNN), range of the heart rate variability, low frequency (LF), high frequency (HF) components of the heart rate power spectral density and LF/HF ratio were assessed. The results were compared to those obtained from 10 age-, sex-, and body mass index-matched control subjects. The statistical significance (p < 0.05) was found in reduction of range of RR intervals, in increase of LF/HF ratio and in decrease of SDNN in hyperthyroidism in comparison to the control group (151.6/346.8 ms; 2.4/0.74; 24.4/57.2 ms2). In course of pharmacological euthyroidism there were statistically significant (p < 0.05) increase of range of RR intervals, reduction of LF/HF ratio and increase of SDNN in comparison to hyperthyroidism (270/151.6 ms; 0.995/2.4; 39/24.4 ms2). In euthyroidism after surgical treatment all the above parameters kept the similar levels as in pharmacological euthyroidism (no statistical significance for p < 0.05). On the base of the outcomes it was considered that in hyperthyroid patients there is advantage of sympathetic part of ANS over parasympathetic one which is due to sharp reduction of parasympathetic system activity. Pharmacological therapy with thyreostatics normalises balance of ANS to the level of the control group and after surgical treatment the balance keeps the same. Moreover, in the estimation of ANS as important as LF/HF ratio is the mean range of RR intervals.

Adult↗
PubMed1997

[Metastasis of clear cell carcinoma of the kidney to the thyroid gland].

We preset three patients operated on at our hospital with diagnosed metastasis clear cell carcinoma of the kidney to the thyroid gland 5, 6, and 9 years after nefrectomy. Patients were operated on because of nodular goiter and metastases were diagnosed intraoperatively (frozen section) at two cases and postoperatively in the remaining care (diagnosis made by pathologist-microscopic examination). A radical thyroidectomy was employed without chemio- or radiotherapy which is now recommended as a method of treatment of clear cell carcinoma metastasis.

Adenocarcinoma, Clear Cell↗
PubMed1997

[Primary malignant lymphoma of the thyroid gland--diagnosis and treatment tactics].

The paper presents clinical signs, diagnosis, treatment and therapeutic results in the group of 10 patients with at primary malignant lymphoma of the thyroid gland. There were presented up to date methods of diagnosis and treatment with includes chemio- and radiotherapy. In authors opinion progress in imaging technics cyto- and histopathology, and potentiality of complex treatment allows us to avoid from surgery in most cases of malignant lymphoma of the thyroid.

Adult↗
PubMed1997

[Surgical treatment of secondary hyperparathyroidism in patients treated with renal replacement].

Between January 1990 and July 1997, in 15 maintenance dialyzed patients and in 3 patients after renal transplantation manifesting hyperparathyroidisms surgical treatment was performed. The diagnosis was based both on the estimation of serum PTH level, total and ionised calcium, phosphates, alkaline phosphatase and imaging procedures: ultrasonography and 99-mTc subtraction scintigraphy. Indications to surgical treatment included ailments like generalized prurigo, bone and joint pains and muscular weakness with no response to pharmacological treatment. The commonly used procedure was subtotal parathyroidectomy (94%), its extent, however, was in each case determined during surgery, depending on the quantity and size of parathyroid glands found. In all cases the immediate intraoperative histopathological examination of the resected tissues was performed. In 10 patients resection of the thyroid gland tissues was carried out because of goiter (56%), among them in 1 case occult papillar carcinoma was found in histopathological examination. In the postoperative period 4 patients (22%) manifested transient hypocalcemia with good response to pharmacological treatment. Good results of surgical treatment reflected by both ailment relief and normalization of serum PTH and phosphates were obtained in 16 patients (89%). In 2 patients (11%) the ailments subsided but did not completely disappear. Surgical treatment of secondary hyperparathyroidism by subtotal parathyroidectomy is efficacious and entails a low risk of complications.

Adolescent↗
PubMed1996

[Treatment of goiter in adolescents in surgical practice--personal observations].

Fifty one patients 12-19 years old were operated on because of different thyroid diseases (1.7% of total amount 3029 patients after surgical treatment). There was no post-operative complication (except of 2 cases of temporary vocal cord paresis). Late results of surgical treatment in adolescents were not significantly different then in other groups. Presence of the symptoms of clinical or subclinical hypothyreosis or rarely recurrence of thyrotoxicosis in patients with toxic nodular goitre after surgical treatment, however, makes the treatment worst, particularly important in this age group. Suppression therapy of thyroid hormones was administrated in all patients with simple nodular goitre and with thyroid cancer. All patients were followed up in our outpatient clinic. During the follow-up from 6 months to 10 years no recurrence of goitre or thyroid cancer was observed.

Adolescent↗
PubMed1995

[Wrong diagnoses of acute appendicitis in women].

In the years 1988 through 1992, 434 patients with acute appendicitis were operated at Third Department of Surgery, Medical Academy, in Kraków. The group included 201 females aged 14 to 90 years of life. In 159 women the diagnosis of acute appendicitis was confirmed, whereas 42 patients were subjected to surgical procedures due to other than appendicitis conditions located within the abdominal cavity. Surgeries prompted by symptoms suggesting appendicitis were most often performed in women with gynecological diseases. Only in several cases laparotomies were performed for other reasons. Wrong diagnoses were most often noted in women below 20 years of life and in the group between 40 and 60 years of life. The introduction of routine ultrasound examinations into the diagnostic management of acute peritonitis and diseases of the reproductive system might result in decrease of the number of diagnostic errors in acute appendicitis in women. An emergency procedure performed when the diagnosis is unclear is recommended rather than prolonged observation. The latter often results in delayed diagnosis of acute appendicitis when diffuse peritonitis develops.

Adolescent↗
PubMed1994

[Modern possibilities of preventing postoperative goiter recurrence].

The authors present an analysis of the material of 84 patients operated on in the years 1979-1992 for non-malignant recurrent goitre. The method of management and treatment results are presented. The schema of management is also described in prevention of goitre recurrences, involving correctly performed operation, periodical control examination, and routine postoperative administration of thyroid preparations. The use of hormonal prophylaxis (L-Thyroxin) in suppressive doses, under TSH control seems to have a significant influence on the reduction of the number of recurrences.

Aged↗
PubMed1994

[Risk factors and surgical tactics in differentiated thyroid cancer].

Differentiated thyroid cancer presents various, frequently astonishing outcomes, not only to the patients but sometimes to physicians as well. The dynamics of progress of the neoplasm is calculating depending on the type of tumor, that is to say microscopic findings, ways of spreading and other prognostic factors, such as: age, sex, grade of histologic malignancy and the advancement of the disease. The authors of this paper try to assess the purposefulness of individual choice of surgical procedure, according to analysis of risk factors (AMES, AGES). Therefore, the surgeon should decide about the extent of the procedure depending on those factors.

Adenocarcinoma↗
PubMed1993

[Mortality in acute appendicitis. (Risk yesterday and today)].

An analysis is presented of deaths of patients operated on in the III Department of Surgery, Medical Academy in Cracow, for acute appendicitis (AA). In the years 1980-1988 962 patients were operated on with preliminary diagnosis of AA which was confirmed intraoperatively in 749 cases. In the group of patients with AA confirmed intraoperatively 14 patients died (1.9%). The most frequent postoperative complications and, at the same time, the most important cause of death were purulent complications. In the paper a detailed analysis is presented of all cases of AA leading to death. It is stressed that advanced age and extensiveness of inflammatory changes are significant factors of high risk of death.

Adolescent↗