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Biomedical subjects

T Urbanek

Publications and source records attributed to T Urbanek.

9 recordsLinked to original sources
PubMed2004

Smooth muscle cell apoptosis in primary varicose veins.

OBJECTIVES: One of the important factors responsible for vessel wall remodelling is programmed cell death. In the paper the role of smooth muscle cell (SMC) apoptosis in primary varicose veins (PVV) is investigated. MATERIAL AND METHODS: Vein specimens were obtained from 40 patients with PVV. In each case proximal and distal (upper crural) great saphenous veins (GSV) were harvested. Morphometric computer assessed quantitative evaluation of SMCs, collagen and elastin content was carried out. Apoptotic cells were detected by TUNEL assay. The levels of p53, BAX, BCLl-2 and p21 mRNA expression were assessed by real time RT-QPCR and the presence of respective proteins in the vessel wall was confirmed by immunohistochemistry. RESULTS: In the proximal GSV segments a significant increase of p53, p21 and BCL-2 mRNA levels was found in PVV patients. In the distal segments BAX and BCL-2 expression levels were higher. Taking into account the patient age, elevated p53 mRNA expression level was noticed in the distal incompetent GSVs of young PVV patients. In this group a statistically significant increase in the apoptotic index (APIx) within the vein media was found which correlated positively with p53 mRNA expression level. There was no increase of the apoptotic activity in elderly patients that led to the structural changes increase. In proximal GSV segments, despite SMC amount reduction or presence of structural changes in perivalvular wall region, no increase of the APIx with was noticed. CONCLUSIONS: P53-related apoptosis is one of the regulatory mechanisms of vein wall homeostasis maintenance. During varicose vein development its activation is related to the early stages of the disease. In the further course, the down-regulation of the SMC apoptosis within the vein media leads to the structural changes increase. The reduction of the SMC population corresponding to an increase of p21 expression in proximal saphenous vein segments suggests that the cell cycle disturbances may lead to the 'weakness' of the proximal GSV wall. Valve injury is not the only factor leading to the varicose veins occurrence.

Adult↗
PubMed2002

The effect of prolonged ischaemia and cryopreservation on the cell viability of human aortic and femoral artery allografts.

The viability of the human arterial allograft cells depends on the time and method of vessel procurement and storage. In this study, an evaluation of the effect of the duration of 4 degrees C ischaemia and cryopreservation on human aortic and femoral artery allograft viability was performed. After the isolation of arterial wall cells, the identification of cultured cells was performed using mRNA analysis for estimation of smooth-muscle markers of differentiation: desmin and heavy-caldesmon. The viability of cells from the medial layer of the aortic wall ranged from 74 to 90% (61-79% for femoral arteries). Cold ischaemia time (from harvesting until the beginning of the preparation) is a statistically significant factor influencing smooth muscle cell viability. Smooth muscle cells represented the majority of live cell population.

Adolescent↗
PubMed2000

[Inflammatory abdominal aortic aneurysm].

The reported incidence of inflammatory abdominal aortic aneurysm (IAAA) is from 2% to 14% of patients with abdominal aortic aneurysm and the etiology of this disease is still discussed--according to the literature several pathogenic theories have been proposed. From 1992 to 1997 32 patients with IAAA were operated on. The patients were mostly symptomatic--abdominal pain was present in 68.75% cases, back pain in 31.25%, fever in 12.5% and weight loss in 6.25% of the operated patients. In all the patients ultrasound examination was performed, in 4 patients CT and in 3 cases urography. All the patients were operated on and characteristic signs of inflammatory abdominal aortic aneurysm like: thickened aortic wall, perianeurysmal infiltration or retroperitoneal fibrosis with involvement of retroperitoneal structures were found. In all cases surgery was performed using transperitoneal approach; in three cases intraoperatively contiguous abdominal organs were injured, which was connected with their involvement into periaortic inflammation. In 4 cases clamping of the aorta was done at the level of the diaphragmatic hiatus. 3 patients (9.37%) died (one patient with ruptured abdominal aortic aneurysm). Authors present diagnostic procedures and the differences in the surgical tactic, emphasizing the necessity of the surgical therapy in patients with inflammatory abdominal aortic aneurysm.

Adult↗
PubMed1999

[Eventration as a complication in general and vascular surgery].

Eventration is a serious complication in the abdominal surgery. Despite the surgical suture technique improvement the frequency of this complication is still increasing. In the paper the cases of the patients operated for the diseases requiring laparotomy from November 1991 to December 1997 were retrospectively analysed. There were 4030 laparotomies done because of vascular or other surgical diseases. In 23 cases eventrations were postoperatively observed (0.57%). Mean age was 58.7 years. 11 patients were qualified for the emergency surgery (6 patients with acute abdominal diseases and 5 with vascular diseases). 12 patients were operated electively (6 patients--general surgery, 5--vascular reasons). Among 23 patients with eventrations--16 patients were qualified for the relaparotomy with abdominal cavity suture. In 7 cases because of bad general condition of the patient only the skin suture above the eventration in the intensive care station was performed and abdomen was wrapped with the bandage. There were 8 deaths: 2 patients (8.7%) after skin suture and 6 patients (26.1%) after reoperation. Respiratory or respiratory and circulatory insufficiency was observed in 13 patients (56.5%). In 60.8% of cases (14 patients) wound infection was recognized and in 3 cases sepsis occurred in the postoperative period. The disease that was the reason for the surgery did not play a significant part in the eventration occurrence frequency. The condition of the patient before the surgery was the most important prognostic factor of the eventration. In patients with bad condition it is more convenient to perform the suture of the skin above the abdominal viscera first and later the reoperation.

Adult↗
PubMed1998

[The infection of the vascular prosthesis treated by the human cryopreserved allograft implantation: a case report].

75 years old patient was admitted to the Department with infection of the previously implanted bifurcated aorto-bifemoral by-pass. Periprosthetic retroperitoneal abdominal abscess in the US--colour doppler examination was recognized. Unilateral femoral pulse was present--the patient after femoral amputation of the right leg. In the first step of the treatment, the drainage of the periprosthetic abscess was performed. Because of poor results of the local and pharmacological treatment and bleeding from the prosthesis, in the next step, human cryopreserved aorto--femoral allograft was implanted "in situ". Simultaneously, bifurcated prosthesis was evacuated. In the postoperative period, healing of the inquinal wounds was excellent. There were no problems connected with peripheral circulation. The patient was discharged from the hospital on the 24th post-operative day in the good local and general condition. Homograft is an efficient and promising alternative for the treatment of severe vascular prosthesis infections.

Abdominal Abscess↗
PubMed1997

[Analysis of mortality risk factors in patients with ruptured abdominal aortic aneurysm].

The purpose of the study was to estimate which factors could have effect on successful outcome of surgery in patients operated on for ruptured abdominal aortic aneurysm (RAAA). The analysis referred to 66 patients operated upon from 1992 to 1995. The specification of all factors which could bring the influence on the successful result of the surgical treatment, was done. The statistical analysis was taken using the Yule-Kendall test and according to it for each factor the risk coefficient Q (from 0.8 to 1.0) was suggested. The group of factors conditioning in each case the failure of surgical procedure was noticed. There were differences in mortality after surgical treatment of RAAA -from 41.2% to 83.3%, mean 63.6%. The mortality of 100% was ascertained in patients with Q above 3.5. The correlation between number of patients with expected risk factors and increasing mortality rate was done. This method is useful for explaining divergences in results of surgical treatment in patients with RAAA and may be helpful for qualification of patients for surgical procedure.

Aged↗
PubMed1997

[Second look in abdominal surgery].

The paper presents authors experience and indications for an elective relaparotomy performed as the second-look laparotomy after primary operation. 12 patients with vascular or surgical diseases were operated on for: abdominal neoplastic tumors (2 patients), elective abdominal aneurysm (2 patients), ruptured abdominal aneurysm (2), abdominal aneurysm ruptured into the inferior caval vein (1), ruptured aneurysm of the iliac artery (1), abdominal aortic coarctation with visceral arteries abnormality (1), thrombosis of the superior mesenteric artery (1) and peritonitis because of intestinal ischaemia and necrosis (2 patients). In all cases an elective relaparotomy was done on the 1st or 2nd postoperative day. 5 patients died, in 4 cases complications found during second look relaparotomy required surgical treatment (2 of this patients died, two other were successfully treated). The authors discuss indications and advantages of elective second-look laparotomy in abdominal surgery according to the anticipated risk factors and patients condition.

Abdomen↗