Specific problems of nursing patients suffering from Mayer-Rokitansky-Küster-Hauser syndrome

W pracy przedstawiono opis przypadku chorej z zespołem Mayera-Rokitansky'ego-Küstera-Hausera. Scharakteryzowano czynniki etiologiczne, obraz kliniczny, diagnostykę i metody leczenia. Szczególną uwagę zwrócono na specyficzne problemy pielęgnacyjne osób z tym zespołem.Introduction. This paper presents a case description of a woman suffering from Mayer-Rokitansky-Küster-Hauser Syndrome. The etiological factors, the clinical presentation as well as the diagnostics and methods of treatment were scrutinized in this paper. Special attention was devoted to specific problems of nursing patients suffering from that syndrome

The topographical anatomy of the round window and related structures for the purpose of cochlear implant surgery

The treatment of total deafness using a cochlear implant has now become a routine medical procedure. The tendency to expand the audiological indications for cochlear stimulation and to preserve the remnants of hearing has brought new problems. The authors have studied the topographical anatomy of the internal structures of the ear in the area where cochleostomy is usually performed and an implant electrode inserted. Ten human temporal bones were obtained from cadavers and prepared in a formalin stain. After dissection of the bone in the area of round and oval windows, the following diameters were measured using a microscope with a scale: the transverse diameters of the cochlear and vestibular scalae at the level of the centre of the round window and 0.5 mm anteriorly to the round window, the distance between the windows and the distances from the end of the spiral lamina to the centre of the round window and to its anterior margin. The width of the cochlear scala at the level of the round window was 1.23 mm, and 0.5 mm anteriorly to the round window membrane it was 1.24 mm. The corresponding diameters for the vestibular scala are 1.34 and 1.27 mm. The distances from the end of the spiral lamina to the centre of the round window and to its anterior margin are 1.26 and 2.06 respectively. The authors noted that the two methods of electrode insertion show a difference of 2 mm in the length of the stimulated spiral lamina. The average total length of the unstimulated lamina is 2.06 and 4.06 in the two situations respectively

Modern Solutions in Selected Tourist Facilities in Rural Areas of North-Eastern Poland

The aim of the publication is to present modern solutions introduced in selected specialised tourist facilities in the North-Eastern Poland. Description of facilities was based on the following criteria: [Boguszewicz-Kreft 2015] modernity, diversity, prestige and quality. To achieve this, the author applied a monographic method, field research – participant observation, and interview. The field research was performed during study and educational visits in 2014-2015, while interviews – in 2016. Description of modern solutions covers 6 facilities located in rural areas with the following prevailing functions: health protection, education and sport, preservation of tradition, specialised functions. On the basis of gathered data, it was possible to assess the quantity and popularity of modern solutions in selected facilities in rural areas

The initial zones of the atrioventricular node: really neglected anatomical features of potential clinical significance?

The constant evolution of medical knowledge and accompanying development of diagnostic and treatment possibilities for arrhythmias and conduction disturbances has reawakened interest in the structure and function of the conduction system of the human heart, especially in the region of the atrioventricular (AV) junction and within the junction itself. Of the large number of studies dealing with the AV junction few focus on the initial zones of the AV node. These were described for the first time by Tawara in 1906. Similarly, Anderson et al. distinguished two origins of the AV node, the left one running towards the basis of the mitral valve and the right one leading towards the tricuspid valve. The differences in length and scale could be the result of the adoption of different reference points. The study was carried out on the material of 50 human hearts, of both sexes and ranging in age from 22 to 93, which were fixed in 10% formalin and 98% ethanol solution. The tissue obtained was fixed in the 10% formalin solution and, after being sunk in the paraffin, was cut into layers of about 10 μm thick. According to the age of the hearts, every 10th or 6th section was stained by the Masson-Goldner method. The preparations were examined under a LEICA 2000 and BIOLAR 2 microscope at magnifications of 2× to 400×. Each of the 50 examined hearts contained the atrioventricular node and its initial parts. We observed that the initial zone of the AV node is created by an assembly of cells typical for a conduction system that can create three groups that are initially independent of each other and are always arranged around the AV nodal artery. In all the hearts examined we found at least two initial parts of the node: the superior and inferior. These two groups were present in 45 hearts (90%). In the last 5 cases (10%) there was also a middle group. No cases were found either with a single initial group or without any initial groups. In the sections examined the superior group appeared to be first in 27 hearts (54%), while in 23 cases (46%) the inferior group was first. The length of each group was measured from its first appearance to its first direct contact with the second part. The length of the superior part varied from 0.15 to 2.91 mm (mean 0.90 ± 0.6 mm), the inferior from 0.11 to 2.41 mm (mean 0.88 ± 0.6 mm) and the middle from 0.67 to 2.21 mm (mean 1.04 ± 0.7 mm). As mentioned above, in all 50 hearts there was a direct connection between the atrial muscle and the upper origin of AV node. Furthermore, in all sections (100%) the same part of the interatrial septal muscle was connected to the compact part of the node. Additionally, in 3 cases (6%) we were able to observe direct connections between the muscle fibres running from the fasciculus limbicus inferior to the initial zone of the AV node: in 2 cases (4%) with the superior group and in 1 case (2%) with the inferior group. In 8% of the material the atrial muscle of the supra-orificial zone made direct contact with the superior initial group and the compact zone of the node and in 10% there was contact between the suborificial muscle and the inferior group and the compact part of the node. This configuration was not observed in relation to the middle and inferior groups

Natural radioactivity content in groundwater of Mt. Etna’s eastern flank and gamma background of surrounding rocks

Waters of Mt. Etna are the main source of drinking water for the local population and are also distributed in municipal supply systems to neighbouring areas. Radioactivity in underground waters and surrounding rocks from the eastern flank of Mt. Etna was investigated on the basis of 9 water and 8 rock samples from 12 localities altogether. Three samples were from water drainage galleries and six from water wells. All water intakes are used for consumption. Activity concentration of uranium isotopes 234,238U, radium isotopes 226,228Ra and radon 222Rn were determined with the use different nuclear spectrometry techniques. The determination of uranium isotopes was carried out with the use of alpha spectrometry. The measurements of radium and radon activity concentration in water were performed with the use of a liquid scintillation technique. Additionally, rocks surrounding the intakes were examined with gamma spectrometry. All water samples showed uranium concentration above Minimum Detectable Activity (MDA), with the highest total uranium (234U + 238U) activity concentration equal to 149.2±6 mBq/L. Conversely, all samples showed radium isotopes activity concentrations below MDA. Radon activity concentration was within the range from 2.91±0.36 to 21.21±1.10 Bq/L, hence these waters can be classified as low-radon waters. Gamma natural background of the rocks surrounding the water sampling sites was found on the same levels as other volcanic rocks of Italy