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Biomedical subjects

T Zajaczkowski

Publications and source records attributed to T Zajaczkowski.

At least 19 recordsLinked to original sources

[Joseph Dietl (1804-1878). Reformer of medicine and his contributions to urology].

Two centuries have now passed since the birth of Joseph Dietl, whose uncommon ability, industry, inexhaustible energy, dogged perseverance, and courage contributed to the development of medical science in Europe. He also contributed to reform of the educational system, and to bringing order to the badly neglected city of Cracow. He belonged to the so-called New Vienna School of Medicine. Dietl, chief physician at the Wieden Hospital in Vienna since 1941, had voiced his disbelief in the existing therapy in such strong terms that it was recorded in the history of medicine as the program of therapeutic nihilism. Dietl demonstrated experimentally in Vienna and Cracow that bloodletting in pneumonia is not indicated, since it does not promote recovery and is indeed harmful, raising mortality rates three times compared to those patients who had received dietary treatment only. He eliminated bloodletting in pneumonia therapy. Dietl was the first to investigate and classify Galician and Silesian therapeutic springs as well as work out detailed prescriptions for spa treatments. He understood that treatment in a health resort could not be limited to balneotherapy, and he indicated that climatotherapy and physiotherapy should also play a role. Dietl described the crisis attributable to a kink in the renal vessels or ureter when the kidney dropped. It was also Dietl who gave a description of the floating kidney problem and of kidney partial incarceration, a condition still known as Dietl's crisis. He recommended conservative therapy for these cases.

Clinical Medicine↗

[The development of the municipal hospital in Stettin (since 1945 Szczecin). The development of the Department of Urology in Stettin (part 2) - Prof. Alfons Wojewski (1912-1992)].

The end of World War II created a new political situation in Europe. Stettin and the Western Pomeranian region became part of Poland. During the war, the municipal hospital and other hospitals in Stettin were almost completely destroyed. In spite of the great difficulties, the Polish authorities set up health services for the city of Szczecin and the entire province. In 1948, the Pomeranian Academy of Medicine (PAM) was created, which to this day plays an important role in the health care provided in the entire Pomeranian territory. In 1955, a 30-bed urological ward was opened in Pommerensdorf forming part of the Second Surgical Clinic of the PAM. The head doctor of the new ward was Dr. Alfons Wojewski, a surgeon and urologist from Gdansk (Danzig). Seven years after coming into existence, the urological ward was transformed into an independent Urological Clinic with 62 beds in 1955. Professor Wojewski organized the clinic right from the start, quickly raising it to the level of a modern scientific, teaching, and service facility. The authors describe biographical details of Prof. Alfons Wojewski.

History, 20th Century↗

[Development of the Stettin municipal hospital. The beginnings of urology in Stettin (1.)].

The growth of the city's population, rapid advances in medical science, the increasing understanding of the importance of hygiene and, finally, the demand for health care led to the erection of a modern 353-bed municipal hospital complex at Pommerensdorf, Apfelallee, which was officially opened in 1879. From the very beginning of its existence, the municipal hospital was constantly in the process of extension and rebuilding. A hospital base was set up and new departments and clinics were opened. In 1937, the number of the hospital beds had increased to 1,004. The official existence of an independent urology department with 30 beds, first headed by Dr. Felix Hagen (1880-1962), dates back to March 1919. The aim of this new department was to carry out examinations and differential diagnoses, together with the department of internal medicine, for those patients from the urological surgery sector including evaluation for surgery. Surgical urology was the responsibility of the surgery department. The remaining cases requiring urological experience, such as those involving transurethral intervention, diseases of the bladder and urinary tract infection, were treated in the new urology department. As an auxiliary department, de facto dependent on the departments of surgery and internal medicine, urology could not develop properly and survive. In October 1935, the position of the head of the urological department was terminated, and urology was incorporated into the department of surgery. During the Second World War, between 1939 and 1945, as during the World War 1, a field hospital was set up in the municipal hospital at Pommerensdorf in Stettin.

Catholicism↗

[Treatment of primary therapy refractory choriocarcinoma using the EMA-CO protocol].

This is a report on a 33 year old patient with a metastatic gestational choriocarcinoma. The patient was hospitalized with the picture of a spontaneous left kidney rupture and nephrectomy was performed. Under primary mono-dose methotrexate chemotherapy, the patient showed rapidly progressive metastases in both lungs, liver, right kidney and soft tissue. With the use of multiple-chemotherapy, according to the EMA-CO scheme, we observed complete remission. To date, there has been no indication of any tumour recurrence.

Adult↗

Rhabdomyolysis and myoglobinuria associated with violent exercise and alcohol abuse: report of two cases.

Two cases of acute rhabdomyolysis with myoglobinuria and high levels of serum enzyme are presented. The first patient developed acute renal insufficiency in the context of a binge and heavy alcohol drinking lasting several days. He was treated with haemodialysis for three weeks, and survived. The second patient developed rhabdomyolysis and heavy myoglobinuria after playing squash vigorously. Forced mannitol-alkaline diuresis therapy for prophylaxis against hyperkalaemia and metabolic acidosis was performed. He did not develop renal failure. The clinical features, pathology and treatment of rhabdomyolysis and myoglobinuria are summarized.

Acute Kidney Injury↗

[Hypertension and nephroptosis].

Renal diseases have been recognized as both a cause and a consequence of hypertension. Orthostatic renal hypertension is caused by ischemia resulting from elongation, twisting and angulation of renal vessels when a hypermobile kidney is present. Recent observation of a 22-year-old woman in whom orthostatic renal hypertension was cured by nephropexy prompted this report. Clinical manifestations, diagnosis and therapy of this condition are also discussed.

Adult↗

[Granulomatous orchitis].

Five cases of granulomatous orchitis are reported and the literature is reviewed. The clinical features, pathology and treatment of this rare disease are discussed. In four cases the clinical features were chronic, while one patient had an acute course. The average age of the five patients was 31 years. In all cases we found only one testes was affected. In two cases the affected testis was removed, and in the remaining three cases only partial orchiectomy was performed.

Adult↗

[Spontaneous kidney rupture].

Two cases of spontaneous rupture of the kidney are reported and the literature is reviewed. The clinical and pathological features of this uncommon disease and its treatment are discussed. In the first case the cause of retroperitoneal bleeding was a renal carcinoma, while in the second it was the result of renal metastases from gestational trophoblastic disease. The most common symptoms are an acute onset of flank or abdominal pain, macroscopic hematuria and a drop in the hemoglobin level. Resistance or a mass can be palpated. Ultrasound and radiological examinations allow visualization of a tumor or hematoma and mostly reveal the etiology of hemorrhage. An exploratory operation is necessary for diagnosis, and primary nephrectomy should be seriously considered.

Adult↗

Experiences in treating cancer of the bladder.

Experience in the treatment of urinary bladder cancer based upon observation of 306 cases has been presented. Two hundred and thirteen patients were treated surgically by performing in 151 cases partial cystectomy and in 62 cases total cystectomy. Conservative treatment was applied in 75 patients. In the authors' opinion the best method of treating bladder cancer is its radical excision. A simple and easy method of implantation of the ureters into the rectum is described.

Adult↗

Malignant tumours of the renal pelvis.

A review of the clinical data of 22 patients with malignant tumours of the renal pelvis, accounting for 10% of the total patient material of renal tumours, is presented. The earliest manifestation was prevalently haematuria, less often pain. In two thirds of the cases the diagnosis was established on radiological evidence and in one third the process remained undetected until surgical exposure of the kidney. The diagnostic difficulties involved by tumours of the renal pelvis and the value of the diagnostic methods are discussed. Nephroureterectomy with excision of a cuff of bladder was carried out in 15, nephrectomy in 5 cases. Three of the 22 patients have survived five years. Early diagnosis followed by total nephroureterectomy without delay may bring some improvement in the poor prognosis of these tumours.

Adult↗