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Biomedical subjects

W Majewski

Publications and source records attributed to W Majewski.

At least 19 recordsLinked to original sources
PubMed2005

Experiences in kidney transplantation with duplicated ureters.

INTRODUCTION: The purpose of this study was to evaluate the complications of duplicated ureters in renal transplant recipients. METHODS: Between 1983 and 2004, 12 patients (median age 34 years) received renal transplants from donors with duplicated ureters. In four patients the ureter to bladder anastomoses were performed separately according to the method described by MacKinnon, including two cases transplanted with ureteral catheters because of narrow widths. In the following cases of eight duplicated ureters an anastomosis was performed between the distal part of each ureter to form a common ureteral ostium, which was connected to the urinary bladder. A ureteral catheter was used to the splint ureterovesical anastomosis. RESULTS: No graft loss to ureteral complications was observed. There was no ureteral necrosis in the postoperative period. No clinical symptoms of ureteral junction obstruction were revealed after removing the ureteral catheter. By ultrasound examination four patients showed a slight temporary pyelocaliectasis was observed and four patients developed temporary urinary fistulas. CONCLUSION: Our ureterocystoneostomy procedures with duplicated ureters were safe and useful in kidney transplantation.

Adult↗
PubMed2005

Serum magnesium, copper and zinc concentration changes in lower limb ischemia and postoperative treatment.

A prolonged state of ischemia of the lower limbs may affect the balance of some metal ion concentrations in blood. Ischemia of a critical degree, surgery and complicated postoperative periods invoke an inflammatory response, increased production of interleukin-6 (IL-6) and acute phase proteins (APhP) as a response to tissue destruction. The aim of the present study was to investigate the modification of Mg, Cu and Zn concentrations in the serum of patients with atherosclerosis obliterans (AO) before surgery and during the postoperative treatment, and the effect of chronic ischemia of the lower limbs on the relationship between the elements. The group studied consisted of 54 men with chronic ischemia of the lower limbs due to AO. The mean value of serum Mg concentration in men with AO was found to be significantly lower, and that of Cu to be higher, in comparison with the control group. In critical ischemia, the mean serum Cu concentration and the ratio Cu/Zn were found higher than in moderate ischemia. The postoperative treatment results in changes in Cu and Zn concentrations in the AO group that are inversely related to the levels before surgery.

Adult↗
PubMed2000

Diagnostic laparoscopy for the acute abdomen and trauma.

BACKGROUND: We set out to investigate the potential benefits of routine diagnostic laparoscopy (DL) in cases of acute abdomen. METHODS: A prospective study of 120 DL in acute abdominal cases was performed in comparison with 310 similar acute abdominal cases treated without DL. The diagnostic accuracy, hospital stay, therapeutic delay, and convalescence time were then evaluated. RESULTS: DL established the indications for intervention in 96% of cases, yielded a diagnosis in 90%, and changed the treatment in 14%. The sensitivity achieved was 99.3%, specificity was 83.3%, and accuracy was 88.6%. There were two false positives, one false negative, and three results insufficient to make a diagnosis. Morbidity was one (0.8%), and mortality was one (0.8%). Seventy-nine patients (66%) were managed by laparoscopy and 24 by open interventions. The hospital stay in DL groups was shorter (median, 5 days vs 6 days in controls, p<0.0003), as was the effective treatment time (median, 5 days vs 6 days, p<0.0012). The convalescence time was also shorter in DL groups (median, 14 days vs 14 days, p<0.04). Therapeutic delay occurred in 16% of the control group cases, doubling the morbidity rate, increasing mortality by 50%, and prolonging hospital stay (median, 9 days vs 6 days, p>0.3 (NS). CONCLUSIONS: DL in the acute abdomen is a safe and accurate procedure that enables laparoscopic interventions and helps avoid nontherapeutic surgery. DL and appropriate treatment reduces hospital stay, therapeutic delay, and convalescence time.

Abdomen, Acute↗
PubMed2000

Copper and zinc concentrations and the activities of ceruloplasmin and superoxide dismutase in atherosclerosis obliterans.

The relationships among concentrations of copper and zinc, the oxidase activity of ceruloplasmin (Cp) in serum, and Cu,Zn-SOD (superoxide dismutase) activity in erythrocytes were investigated in men with atherosclerosis obliterans (AO) and a control group. The oxidase activity of Cp was measured with o-dianisidine dihydrochloride as a substrate, and Cu,Zn-SOD activity in erythrocytes by using the RANSOD kit. The lipid profile and uric acid concentration were determined in AO and control groups. The results showed higher copper and zinc concentrations in serum in the AO group (20.0+/-3.5 and 18.0+/-3.2 micromol/L, respectively) in comparison with the control group (15.6+/-2.3 and 14.7+/-1.9 micromol/L). The Cp activity in serum was higher in the AO group (174.2+/-61.8 U/L) than in the control group (93.7+/-33.9 U/L), and a significant difference was found in the activity of Cu,Zn-SOD in erythrocytes (2389+/-1396 and 1245+/-365 U/g Hb, respectively) between both groups. The activity of Cu,Zn-SOD was positively correlated with copper in the control group (r=0.73), but not in AO, and negatively with uric acid concentration (r= -0.63) in the AO group. The oxidase activity of Cp was correlated with copper, but not zinc, in AO and control groups (r> or =0.65). Negative correlation coefficients were calculated for uric acid and copper and zinc concentrations in the AO group (-r > or = 0.61). Increased copper concentrations and oxidase activity of Cp in serum in AO and the activity of Cu,Zn-SOD in erythrocytes could result from atherosclerotic disease, accompanied by chronic ischemia of a lower limb. These results suggest also that relationship between copper concentration and Cu,Zn-SOD activity in erythrocytes found in the serum of healthy subjects may be disturbed in pathologic conditions.

Adult↗
PubMed2000

Sutureless intraluminal graft for repair of high abdominal aortic aneurysm.

The aim of our study was experimental and clinical assessment of bifurcated grafts with ring on its main branch made of the same polyester as the prosthesis. This type of prosthesis facilitates quick anastomosis with the aorta through tying the aortic wall on the ring using a polyester tape. Experimental studies carried out on 18 pigs demonstrated good healing up of such a graft. The prosthesis was used for surgery in 8 patients with abdominal aneurysm which required clamping the aorta above renal arteries. The prosthesis was found to facilitate and accelerate making the proximal anastomosis, diminish the amount of blood loss, and reduces the time of the surgery, especially the time necessary for clamping the aorta above renal arteries which prevents renal ischaemia.

Aged↗
PubMed1999

Video-assisted gastrostomy: a modification.

Surgical centers that treat esophageal cancer need to create a simple and easy method to feed patients who suffer from complete occlusion of the upper alimentary tract. The purpose of this work is to present our own modification of a laparoscopic feeding gastrostomy, which is based on our own experience and previously published methods. Our system requires only two trocars and can be done under general or local anesthesia. It consists of exteriorizing a stomach fragment through a 12-mm opening in the skin under video control. The newly created gastrostomy forms a channel in the abdominal wall that is long narrow and enough to allow a 24-F catheter to be inserted without serious leakage. The method was applied satisfactorily to 11 patients, with a mean observation time of 3.5 months. It offers the patient an ongoing nutrition gastrostomy for early use. After 3 weeks, the gastrostomy can be used on a temporary basis by inserting the catheter during the feeding time and afterward withdrawing it with the gauze pad still attached. We have found this procedure to be a simple, easy, and cost-effective alternative to supplying nutrition to patients with complete upper alimentary tract stenosis. Moreover, it is superior to previously described methods.

Enteral Nutrition↗
PubMed1999

Activities of copper,zinc-superoxide dismutase in erythrocytes and ceruloplasmin in serum in chronic ischemia of lower limbs.

Cu,Zn-superoxide dismutase is an endogenous scavanger of superoxide radicals (O(2)(*-)) which also induce the synthesis of this enzyme. Ceruloplasmin is an antioxidant and acute-phase reactant. Changes in the synthesis of both enzymes are related to the metabolism of copper and zinc. Concentrations of copper and zinc were previously found to be increased in the serum and arterial wall of atherosclerotic subjects. The aim of this study was to investigate the Cu,Zn-superoxide dismutase activity in erythrocytes and ceruloplasmin activity in serum, and to measure serum concentrations of copper, zinc, and malonyldialdehyde in patients with moderate and critical chronic ischemia of the lower limbs. A group of 26 patients with chronic arterial occlusion of the lower limbs was divided into two groups depending on the degree of ischemia: moderate and critical. Cu,Zn-superoxide dismutase activity in erythrocytes was measured using the RANSOD kit, the serum ceruloplasmin oxidase activity was determined with o-dianisidine as a substrate. Copper and zinc concentrations in serum were determined by atomic absorption spectrometry. There was an increase in the ceruloplasmin activity and serum copper concentration in critical ischemia (194.4+/-51.94 U/l and 23.5+/-4.2 micromol/l, respectively) compared with moderate ischemia (139.1+/-34.9 U/l and 18.5+/-2.0 micromol/l, respectively). The Cu,Zn-superoxide dismutase activity in erythrocytes was higher in moderate ischemia (2,657+/-1,564 U/g hemoglobin) than in controls (1,205+/- 353 U/g hemoglobin), but not different from critical ischemia. There was a negative correlation for Cu,Zn-superoxide dismutase and ceruloplasmin (r=-0.60, P</=0.05) in critical ischemia.

Aged↗
PubMed1999

Oxidase activity of ceruloplasmin and concentrations of copper and zinc in serum in chronic arterial occlusion of the lower limbs.

The presence of ischaemic tissue excites an inflammatory reaction and synthesis of acute phase proteins (APhPs). Ceruloplasmin (Cp) protein binds 90% of the copper in plasma and it is one of the positive APhPs, and its concentration increases in infection, inflammation or necrosis. The study presents the relationship of the oxidase activity of Cp and concentrations of Cu and Zn in serum of men with different degrees of ischaemia of the lower limbs. The subjects were 32 men with chronic arterial occlusion (AO) of the lower limbs. The oxidase activity of Cp was measured in serum with o-dianisidine as a substrate. Concentrations of Cu and Zn were determined by using atomic absorption spectrometry. The mean activity of Cp in serum in AO (173 +/- 69.2 U/l) was higher as compared with the control group (123.7 +/- 28.6 U/l), and in men with critical ischaemia (> or = 194.8 U/l) than in men with a moderate level of ischaemia (109.3 +/- 31.6 U/l). The mean concentrations of Cu and Zn in serum were found to be higher in AO (22.2 +/- 4.2 and 19.1 +/- 6.9 mumol/l, respectively) than in the control group (16.3 +/- 1.8 and 15.2 +/- 2.3 mumol/l), and in men with critical ischaemia (> or = 22.2 and 19.1 mumol/l) than in men with a moderate level of ischaemia (18.5 +/- 3.3 and 14.5 +/- 4.3 mumol/l). Significant positive correlation coefficients were calculated for the activities of Cp and concentrations of Cu in the control group (r = 0.86) and the AO group (r = 0.76), and low, but significant, correlations for Cp and Zn in the AO group (r = 0.66). The increase in the oxidase activity of Cp and concentration of Cu in serum in ischaemia is caused by the acute phase response. The relationship of Zn concentration and Cp activity in ischaemia is indirect and needs further study.

Adult↗
PubMed1998

Serum glycerol ester hydrolase activity is related to zinc and copper concentrations in atherosclerosis obliterans and aneurysm.

Although the body status of zinc and copper in cardiovascular disease (CVD) has been shown to be important little is known about the effect of these trace element alterations on lipolytic enzyme activities in atherosclerosis human subjects. The aim of the present study was to evaluate the multiple relationships between lipase (GEH = glycerol ester hydrolase, EC 3.1.1.3) activity, zinc, copper and lipid concentrations in serum and the arterial wall of men with atherosclerosis obliterans (AO) and abdominal aortic aneurysm (AA). The mean concentrations of zinc and copper in serum were found to be higher in AO in comparison to AA. Low but significant correlation coefficients for zinc and lipase catalytic activity (r > or = 0.64) and lipase metabolic activity GEH/TAG (r > or = 0.67) were calculated in serum in AA. Multiple correlation coefficients (R) for three variables GEH-Zn-Cu were found to be significant for both AO and AA (R > or = 0.45 and 0.68, respectively) in serum but not in the arterial wall. Multiple relations for GEH/TAG-HDL-C (LDLC)-Zn(Cu) were found to be significant (R > or = 0.63) in serum in AA. The results indicate the influence of zinc and copper on the activity of lipase and lipid concentrations and suggest that the multiple relations may provide a better understanding of the role these elements play in atherosclerosis than relations between 2 substances.

Aged↗
PubMed1997

Relationship of calcium, magnesium, zinc and copper concentrations in the arterial wall and serum in atherosclerosis obliterans and aneurysm.

Changes in copper concentration in the arterial wall are important because of cross-linkage formation in collagen and elastin. The breakdown of the elastic layer is characteristic for aneurysm and is affected by the abnormalities in copper metabolism. This study was undertaken to evaluate Ca, Mg, Zn and Cu concentrations and their relationships in the arterial wall, serum and calcified plaque in atherosclerosis obliterans (AO) and abdominal aortic aneurysm (AA). Samples of the aorta wall were obtained at the endarterectomy in AO and the vascular reconstruction in AA. Elements were determined by means of atomic absorption spectrometry. Serum concentrations of Zn and Cu were higher and that of Ca lower in AO as compared to AA and the controls. Arterial concentrations of Zn, Cu and Mg were higher in AO as compared to AA. The ratios of element concentrations in serum (Ca/Mg, Ca/Zn and Mg/Cu) were higher in serum in AA than in AO. Positive correlations were calculated for Ca and Mg (r > or = 0.74), Ca and Zn (r > or = 0.73), Mg and Zn (r > or = 0.90) in the arterial wall in AO and AA. Low but significant correlation was calculated for Cu concentrations between serum and the arterial wall in AA (r = 0.43). Concentrations of Ca, Mg, Zn and Cu were higher in plaque than in the surrounding tissue. The results indicate differences in arterial and serum concentrations of Ca, Mg, Zn and Cu between AO and AA and the accumulation of these elements in the plaque rather than in the surrounding vascular tissue.

Adult↗
PubMed1997

[Diagnostic and therapeutic value of laparoscopy in acute abdomen].

The purpose of this work is to evaluate the degree of applicability of the diagnostic laparoscopy (DL) and therapeutic laparoscopy in the acute abdomen and trauma patients. The material of 109 cases of DL performed since 1983 has been evaluated retrospectively. 22 patients were operated by laparoscopy. The patients were assessed in the following groups: I-suspected acute appendicitis, II-acute abdomen of uncertain ethology, III-abdominal trauma. In the first group 60 patients were diagnosed, 13 of them were operated by laparoscopy, 28 by open access, 15 avoided the unnecessary laparotomy. In the second group 30 patients were diagnosed, 6 of them were operated by laparoscopy, 8 open interventions were noted, 16 avoided the non-therapeutic laparotomy. In the third group 19 patients were diagnosed, 13 underwent laparotomy, 6 avoided the unnecessary intervention. There has been one death, not associated with DL (acute bowel ischemia), morbidity was 1% (one case of bleeding from the mesenterial artery, treated by conversion to laparotomy), one DL was considered as falsely negative, one not sufficient to establish the diagnosis. Basing on our experience in DL as a diagnostic tool we can confirm the accuracy of the method in 99.08% with only 1% of morbidity. 20.1% of patients were operated by laparoscopy, without complications. In conclusions the authors consider the DL allows to establish a prompt and accurate diagnosis in the acute abdomen and trauma without a therapeutic delay and unnecessary hospital observation. The fault of the method and morbidity rate is acceptable. The treatment by the same laparoscopic access offers to these patients another benefit, the more the experience is increasing.

Abdomen, Acute↗
PubMed1997

Clinical and morphological aspects of Buerger's disease.

BACKGROUND: Thirty-five patients with TAO and 35 with ASO have been studied. To determine differences between these two arterial diseases, we used clinical criteria, arteriographic and morphological methods. The peripheral (below the bifurcation of the popliteal artery) angiographic changes were found in TAO with 94% sensitivity, 94% specificity and with 96% of positive predictive value. Other clinical diagnostic criteria for differential diagnosis had a lower value (they had high sensitivity and low specificity or low sensitivity and high specificity). RESULTS: The histologic studies confirmed the clinical diagnoses of Buerger's disease in 92,9% cases. The pathologic findings in TAO and ASO were different. CONCLUSIONS: Our investigations proved that the characteristics of Buerger's disease include the development of changes not only in small and medium size arteries or veins, but also in microcirculation.

Adult↗
PubMed1996

[Preoperative autotransfusion and hemodilution and its value in reconstructive vascular surgery].

Autotransfusion and haemodilution are the most safe and well known methods of blood protection in patients planned for vascular operations. During reconstructive vascular surgery autotransfusion with hypovolemic or normovolemic haemodilution were used. In the I group of patients hypovolemic haemodilution was done. In the II group of patients vascular bed was filed up with Ringer solution or with 6% solution of hydroxyethyl starch. The type of haemodilution and its influence on haemodynamics were estimated. Investigations were done by echocardiograph: ATL ULTRAMARK 8. It was concluded that the most effective are autotransfusion and normovolemic haemodilution with filing up vascular bed with Ringer solution.

Adult↗
PubMed1995

[Calcium, magnesium, copper and zinc in blood serum in men with femoral atherosclerosis].

Calcium, magnesium, copper and zinc were determined in serum in men with femoral atherosclerosis. Also total cholesterol, HDL- and LDL-cholesterol were estimated. Subjects in control group were in the same range of age. The present study compares two methods of preparing serum for the flame atomic absorption spectrometry. In the first method (I), serum was diluted by the demineralized water. In the second method (II), serum protein was precipitated by trichloracetic acid (TCA). We found that the first method (I) was simpler and more precise than the other. The optimal proportions of serum and water amounted to 1 + 62 for calcium and magnesium and the coefficient of variation (C.V.) was 2.8%. For copper and zinc, the optimal dilution was 1 + 3 (C.V. = 1%). Total cholesterol was significantly higher (p < 0.05) and HDL-cholesterol was lower (p < 0.05) in subjects with femoral atherosclerosis as compared with controls. There was no difference in LDL-cholesterol. Subjects with femoral atherosclerosis had significantly higher level of all micro- and macroelements determined, then those of the control group (p < 0.05). However, higher serum copper does not necessary mean higher copper body status. It is possible that higher serum copper in femoral atherosclerosis reflects the transfer of copper from the tissue to the ceruloplasmin, as an acute phase reaction. On the other hand, the differences in serum magnesium, calcium, copper and zinc concentrations, may indicate the possible involvement of these elements in the disorder of total and HDL-cholesterol in femoral atherosclerosis.

Adult↗
PubMed1995

The value of quantitative bacteriological investigations in the monitoring of treatment of ischaemic ulcerations of lower legs.

The quantitative and qualitative bacteriological investigations of 63 patients were done on ischaemic ulcerations before reconstructive vascular surgery and at 7 day intervals after the operation. Among the isolated bacteria the most common were Gram positive (62.9%), especially Staphylococcus aureus. Amputations due to non-healing ulcers were performed on 8 patients, who had ankle brachial index (ABI) lower than 0.47. In 55 patients with ABI higher than 0.47 (with the exception of one case) free skin grafts were applied to reduce the time of the ulcers healing. Primary healing of ulcers covered with free-skin grafts was achieved in 44 out of 55 patients (80%). In 11 patients, were free-skin grafts had failed, ulcerations were healed following the repetition of the free-skin grafts. The healing results of skin grafts statistically were significantly better in the group where the number of bacteria in 1 cm2 of ulceration was lower than 50.000. The severity of infections in ulcers makes the healing process of skin grafts impossible. Quantitative bacteriology additionally helps in objective evaluation of granulating tissue and facilitates choice of proper skin grafting time. This study has shown the usefulness of quantitative bacteriology for the determination of the severity of infections in ulcers.

Adult↗
PubMed1995

[Characterization of bacteriophage nontypable patterns of S. aureus strains].

Out of 195 strains of S. aureus isolated from in and outpatients. 43 were proven not to be lysed by the chosen set of bacteriophages. Of these nontypeable strains 14 were isolated from blood cultures and septic wounds of patients from Poznań University Hospital. 29 strains were derived from the anterior nares or throat swabs of outpatients, who were treated for chronic pharyngitis in the children's clinic in Poznań. S. aureus was identified using standard bacteriological method. Sensitivity tests to antibiotics were performed using the ATB computer system (bioMérieux). Beta lactamase production was examined using the iodometric method. The intracellular esterases of S. aureus were separated by polyacrylamid gel electrophoresis and stained with Fast Blue using alpha-naphtyhl acetate, beta-naphthyl propionate and indoxyl acetate as substrates. A much higher percentage of S. aureus strains isolated from specimens obtained from the hospital patients showed the ability to produce beta-lactamase than the strains cultured from outpatients. The esterase patterns of S. aureus are helpful in differentiating bacteriophage nontypeable strains.

Adolescent↗
PubMed1994

[Infection as a risk factor in biliary system surgery].

Infection of the biliary system in which one of the signs is the presence of bacteria in bile is connected with an increase of incidence of postoperative complications especially in elderly people. Therefore, early diagnosis of infections and their prophylaxis and treatment are an important aspect of surgical management which is particularly significant in view of large number of patients with acute and chronic cholangitis. Proper selection of the operation time and the use of antibiotic therapy with adequate utilization of even broader spectrum of antibiotics may be of decisive importance for effective treatment.

Aged↗