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Biomedical subjects

R Król

Publications and source records attributed to R Król.

At least 19 recordsLinked to original sources
PubMed2003

Surgically treated early complications after kidney transplantation.

Early surgical complications after kidney transplantation (KTx) remain important clinical problems. The 35 patients in whom forty-six complications appeared within 1 month required surgical treatment. The causes were divided into four groups: bleeding and/or hematoma of the perigraft region (n = 22); urological complications (n = 9); simultaneous bleeding and/or hematoma and urological complications (n = 6); and others (n = 9). Among the 28 cases of hemorrhagic complication, the source of bleeding was not localized during the reoperation in 53.7% cases. Vascular anastomotic leakage was confirmed only in 7.1% of patients. The most common urological complications were stricture of (46.7% cases) and leakage at (26.7%) the vesicoureteral anastomosis. Within 3 months after KTx nephrectomy was performed in 27.5% of patients who had been previously operated for surgical complications compared to 4.6% patients without interventions. Among patients with a single reoperation the graft had to be removed in 20.0% compared with 44.4% for those with multiple reoperations. Localization of the bleeding source causing an early perigraft hematoma is not always possible. The most common early urological complication is a vesicoureteral stricture caused by edema. Surgical complications that appear within 1 month after KTx increase the risk of early graft loss.

Adolescent↗
PubMed2001

[Evaluation of methotrexate levels in biological fluids released from bone cement filling].

The authors present an analysis of methotrexate concentration in blood, urine and drainage liquid (both deep and superficial), as well as the results of biochemical analysis of blood and urine in a population of 42 patients treated surgically because of pathologic fractures of long bones. In 8 of the 42 patients chemotherapy was applied 14 days before the surgical procedure. Lithic lesions in the long bones were filled with cement with 2 g of methotrexate and further stabilisation was achieved by applying metal implants. The highest methotrexate concentrations were noted in deep drainage fluid and in blood. Methotrexate concentration reached its peak in body fluids 12-24 hours after the procedure, and fell to a minimum 48-72 hours post surgery. The lowest level of the drug compared to all body fluids was found to be in the blood. Only after 72 hours did it exceed the minimum required level of 0.05 umol/l. All biochemical markers in blood and urine except AspAT were found within normal range in all cases 72 hours post surgery. After 24-72 hours post-op a decrease in the number morphotic elements of blood was noted, particularly lymphocytes and thrombocytes.

Adult↗
PubMed2001

[Early results of high tibial osteotomy with the DERO system for osteoarthritis of the knee].

The authors present the surgical technique and early results after 14 wedge "minus" osteotomies and 5 wedge "plus" osteotomies performed in 16 (age ranging from 45 to 71 years) patients with osteoarthritis of the knee. Use of the DERO system for external stabilization of the knee allows early mobilization of the joint. According to the HSS scale in 15 cases (18 knees) a good result was achieved. Self-assessment of the results of treatment by the patients w\yielded good results in 12 cases and satisfactory in 3. All patients report greater ease of ambulation on flat terrain, across stairs, an increase in ROM and a decrease of pain symptoms. In one case a bad result was caused by infection of the surgical wound. In the observed group no infections, no reaction d\around the pins nor loosening of the bars was noted.

Aged↗
PubMed2001

[Management of early symptoms of acute septic hip in neonates and infants--conservative or surgical?].

The paper presents 41 cases of acute hip sepsis in 36 patients, age ranging from 5 to 66 days. 32 cases were treated at the Institute of Polish Mother Hospital and 4 at the Pediatric Surgery Department of the Medical School of Łódź. In 40% of the cases multifocal infections were noted. Septic arthritis was diagnosed basing on clinical symptoms, lab tests, ultrasound screening, X-rays and immunoglobulin scyntigraphy. Patients were divided into three groups according to treatment: group 1 was administered antibiotics and immobilization was applied (16 patients--19 hips), group 2 had a biopsy, was administered antibiotics and immobilization (5 patients--6 hips), group 3 had an arthrotomy performed, wound drainage, casting was applied and antibiotics were administered (15 patients--16 hips). Immobilization was maintained by means of a cast or Koszla's harness. Patients were qualified for surgery basing on ultrasound investigation. After completion of various modes of treatment patients were followed at the outpatient clinic of the orthopedic department. A complete assessment was performed 3-6 years after the first symptoms appeared. A full clinical examination (ROM assessment), X-ray investigations were performed. Hip dysfunction was assessed basing on X-ray images according to the Ho Choi classification. Conservative treatment seems to be sufficient in early stages of septic arthritis, with only minor morphological pathologies visible on ultrasound examination. Early arthrotomy seems to be the method of choice in septic arthritis treatment. Aspiration of the hip may not be possible due to solid consistency of pus.

Acute Disease↗
PubMed2000

[Morphology of a lithic lesion of the bone treated with cement filling with the addition of methotrexate].

The results of histopathologic examination of a lithic bony lesion and of the surrounding soft tissues obtained from a metastatic site from 2 patients are presented. Both patients had been previously treated surgically with a 40 g bone cement filling with 2 g of methotrexate. Revision surgical intervention was necessary because of loss of stability at the fracture site in a 68 year old female after with a metastasis from breast cancer after 8 weeks and in a 72 year old male with metastasis from cancer of the prostate after 10 weeks. During revision surgery the metal plates and the cement were removed. Tissues samples from the fracture site were taken for histopathologic examination. Fibrosis of connective tissue and haemosiderin accumulation were noted in the soft tissues surrounding the fractures site. Where there was direct contact between the bone cement and bone, necrosis of bone trabeculae and granuloma like bodies were noted. Revision surgery 10 weeks after the first procedure revealed more advanced bony necrosis. No cancerous tissue was observed in any of the cases.

Adult↗
PubMed1998

[Use of bone cements with added methotrexate for stabilization of pathologic fractures and filling of long bone defects in cases of neoplasm metastasis].

Preliminary results of surgical treatment in 24 patients with pathologic fractures or metastatic long bone defects impending fracture are presented. Fourteen females and 10 males aged 36-72 years with femoral (18 cases), tibial (4 cases) or humeral (2 cases) involvement were followed-up for 6-48 months. In 12 patients the pain ceased or decreased, 3 patients occasionally required non narcotic analgesics, in 9 cases the pain continued. All patients with lower extremity involvement were able to ambulate with an aid of walking sticks, 2 patients with humeral fracture resumed activities of daily living. Nine patients with multiple metastases to the lungs and spine died on average 15 months after surgery. The longest survival rate was found in patients with kidney cancer-19 months, ovary cancer-17 months and breast cancer 15 months. No postoperative complications were found. In 2 patients fracture fixation lost their stability after 8 and 10 weeks due to excessive weight bearing.

Activities of Daily Living↗
PubMed1998

[The effect of treatment method for tibial fracture on tibial bone mineral density].

Bone mineral density (BMD) has been measured above malleolar fracture site and within femoral neck in 17 patients treated conservatively and in 17 patients treated surgically. The BMD was taken 3 months after injury. BMD at the fracture site decreased in patients treated conservatively by 20 +/- 3% and by 17 +/- 4% in those operated on. BMD within the femoral neck of the extremity involved decreased by 5% regardless of the mode of treatment. The results achieved indicate no significant difference in BMD in both groups of patients.

Adult↗
PubMed1997

[The role of intracellular activation of enzymes in pathogenesis of acute pancreatitis--literature review].

Pathophysiology of acute pancreatitis (AP) is not full clear to present-day. Current review shows an importance of experimental models of AP with observations of intracellular changes during early stages of disease. One of the actual opinion suggest that abnormality in intracellular transport, secretion with intracellular activation of enzyme protein plays an important role in evolution of AP. These events further start cascade reactions and lead to autodigestion of pancreas.

Acute Disease↗
PubMed1997

[Surgical treatment for complicated clavicle fracture].

A review of 78 patients (43 males, 25 females), aged 17-62, operated on for complicated fracture of the clavicle served to present indications and surgical techniques for this treatment. The use of a metal plate allows for stable fixation of the fracture, thus further management of patients with concomitant thoracic, pulmonary, or spinal injuries does not require plaster cast immobilization. Inaccurate fracture fixation with compression screw as being unstable necessitates plaster cast immobilization. Coexisting shoulder dislocation has been primarily managed surgically.

Adolescent↗
PubMed1997

[Surgical treatment of different forms of renovascular hypertension].

24 patients with renovascular hypertension were operated from 1995 to 1997. Patients were divided into three groups: group I-atherosclerotic stricture of renal arteries with or without aorta stenosis (13), group II-fibromuscular dysplasia (8), group III-stricture of vascular anastomosis after renal transplantation (5). All patients were disqualified from PTA. Operations of reanastomosis of renal arteries to aorta or prosthesis and TEA dominated in group I, the operation of choice in groups II and III was plastic procedure with patch or venous graft. Authors conclude that surgical treatment of renovascular hypertension is an efficient method of treatment in case of disqualification from PTA and the way of reconstruction should be dependent on the reason of renovascular hypertension.

Anastomosis, Surgical↗
PubMed1997

[Primary retroperitoneal tumors--course, diagnosis and treatment results].

36 patients with primary retroperitoneal tumors (PRT) were studied. In 15 cases (41.7%) tumours were found incidentally. Ultrasound examination seems to be the golden standard for finding asymptomatic retroperitoneal neoplasms. High percentage of malignancy (72.2%-26 cases), mesenchymal texture of tumors and late detection of the disease caused by its occult clinical course are the frequent reasons of inoperability (11 patients-30.5%).

Diagnostic Imaging↗
PubMed1997

[Atypical recipient and longterm results of kidney transplantation].

In their study authors compared the results of renal transplantations in a group of 51 patients with relative contraindications to a remaining group of 413 patients. Congenital anomalies or previously performed operations of urinary tract, previous renal transplantations, laparotomies, peritoneal dialysis, extreme atherosclerosis of the aorta and iliac arteries were regarded as relative contraindications. Results of the treatment do not differ considerably in both groups of patients what confirms the necessity of renal transplantations in difficult recipients.

Contraindications↗
PubMed1996

[Reconstruction of the acetabular roof in cemented total hip replacement].

Acetabular roof reconstruction technique for primary cemented THR according to Zuk is presented in a series of 48 patients. No screws or bone bolts were used for cancellous graf fixation. In 30 patients the graft was sufficiently remodeled within 10-12 months, in 16 cases it lasted 1.5-2 years. Longer remodeling time depended on the size of acetabular defect, coexisting conditions and postoperative complications. In 2 cases an autolysis of the graft occurred; one patient underwent prolonged corticosteroid therapy before, the other one was exposed extensively to chemical substances prior to surgery. Aseptic loosening of the acetabular component followed.

Acetabulum↗
PubMed1996

[Early results of treatment for a comminuted articular fracture of the calcaneus using a "DERO" fixator].

The method of treatment for comminuted articular fracture of the calcaneus with the use of a "Deroo" fixator is presented. A "Deroo" eliminates the need for the cast, allows for an early active foot mobilization in the first post-operative day, prevents muscular atrophy. Crosby and Fitzgibbons classification served to assess clinical and radiological results; in 5 cases they were rated excellent, in 10 good, in 5 fair and in 7 cases results were poor.

Adult↗
PubMed1996

A comparison of the clinical usefulness of CA 19-9 and CA 50 in the diagnosis and monitoring of gastrointestinal cancers.

We compared serum levels of CA 19-9 and CA 50 in 108 patients with malignant neoplasms of the stomach, pancreas, liver, and colon with the serum levels in 60 patients with benign gastrointestinal diseases, and 10 healthy subjects. Increased serum levels of CA 19-9 and CA 50 were found in 51.8 and 62% of the cancer patients, respectively. The results of CA 19-9 and CA 50 assays in the nonneoplastic group showed less specificity. False positive results were noted in 11.7% of CA 19-9 tests and in 31.6% of CA 50 tests. We concluded that in gastrointestinal cancer, the CA 19-9 test should be performed initially. CA 50 determination can be useful, but the lower specificity of the test should be taken into consideration. CA 50 should be recommended only for postoperative monitoring, especially in patients with normal CA 19-9 serum levels.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1995

[Isolated stem fracture in total hip replacement].

Clinical, mechanical and metallographic assessment of the isolated fatigue fracture of the Weller stem has been presented. Excessive body weight, too short a stem for the length of the femur and material defects contributed to the failure.

Aged↗
PubMed1993

[Tissue morphology at the site of fusion after osteotomy of the proximal end of the femur in children].

The preliminary results of histomorphologic examination of tissue harvested at the site of bone plate junction, screw and plate-blade holes as well as from the fascia and muscle around the fusion site. The samples were taken at the time of the plate removal. A cartilage resembling growth plate, callus and bony trabeculae were found in preparations examined, what may indicate proliferation around the plate. Focal necrosis implies tissue destruction. Tawny deposits positively reacting to iron detectors and inflammatory infiltration were common findings. This may prove formulation of biologically active metallic albumins.

Adolescent↗