Review of diagnostic methods for prostate cancer with consideration of MRI-TRUS fusion biopsy

Introduction and purpose of the study: Prostate cancer is one of the most common malignancies in the human population worldwide. The continuous development of imaging methods allows for its increased recognition. Conclusions have been drawn that MRI-TRUS (magnetic resonance imaging - transrectal ultrasonography) fusion biopsy is superior to other diagnostic methods. The aim of this study is to review the available studies and publications and determine which method of diagnosing prostate cancer is most effective. Materials and Evidence: We reviewed the literature available on PubMed and Google Scholar using the words "fusion biopsy"; "prostate diagnosis"; "prostate cancer"; "transrectal ultrasonography". Results: The diagnosis of prostate cancer is made possible by a range of tests such as transrectal palpation, measurement of prostate specific antigen, transrectal ultrasonography, needle biopsy and MRI. The combination of biopsy, MRI and transrectal ultrasonography has led to the development of fusion biopsy. It combines the high-resolution features of MRI and the real-time images provided by ultrasound. Conclusions: The higher cost of the test and the need for specialised equipment together with the advanced software required for fusion biopsy ultimately provides a statistically significant higher success rate for the diagnosis of prostate cancer. Mentioned the effects of this method, further development and dissemination is expected

Do anatomical aspects of great saphenous vein insufficiency determine the course of its operational treatment?

Background. Great saphenous vein insufficiency is the most common type of chronic vein insufficiency, and the most common treatment option is crossectomy with short stripping of the great saphenous vein (GSV) trunk. In our work, we confront this option with the anatomical range of GSV insufficiency revealed in preoperative duplex examination. Material and methods. In the presented publication, we analyze the anatomical range of great saphenous vein insufficiency in 157 patients (158 limbs) admitted to our ward for surgical treatment of the condition between 01.01.2005 and 10.01.2006. Results. We obtained the following rates of anatomical variants of GSV insufficiency: 1. isolated saphenofemoral junction (SFJ) insufficiency - 1%; 2. insufficiency in SFJ and thigh segment of GSV - 61%; 3. insufficiency in SFJ and thigh segment of GSV, isolated second insufficient crural segment - 9%; 4. insufficiency in SFJ and proximal thigh segment - 15%; 5. sufficient SFJ, insufficient proximal thigh segment - 5%; 6. sufficient SFJ, insufficient whole thigh segment - 8%; 7. sufficient SFJ, insufficient distal thigh segment - 1%. Conclusions. Our results confirm that short stripping of GSV is the treatment of choice in the majority of patients. On the other hand, we document a high rate of other anatomical variants of the condition. Using one routine procedure in all cases may consequently be an inadequate treatment. It also occurs that in 30% of cases, proper introduction of a stripper may be difficult.Wstęp. Najczęstszą postacią przewlekłej choroby żylnej kończyn dolnych jest niewydolność w układzie żyły odpiszczelowej, a najczęstszą opcję leczenia operacyjnego stanowi krosektomia z krótkim strippingiem jej pnia. W niniejszej pracy skonfrontowano to postępowanie z anatomicznym zakresem niewydolności żyły odpiszczelowej ustalonym w przedoperacyjnym badaniu ultrasonograficznym. Materiał i metody. W pracy przeanalizowano ustaloną w przedoperacyjnym badaniu ultrasonograficznym niewydolność pnia żyły odpiszczelowej w odniesieniu do jej anatomicznych odcinków u 157 pacjentów (158 kończyn), przyjętych na oddział autorów pracy w celu leczenia operacyjnego, w okresie 01.01.2005-10.01.2006. Wyniki. Odnotowano następujące wartości procentowe częstości występowania poszczególnych typów anatomicznych zakresu niewydolności w układzie żyły odpiszczelowej: 1 - izolowana niewydolność ujścia odpiszczelowo- udowego (SFJ) - 1%; 2 - niewydolność SFJ i pnia w całym odcinku udowym - 61%; 3 - niewydolność SFJ i pnia w odcinku udowym, izolowany drugi niewydolny odcinek na podudziu - 9%; 4 - niewydolność SFJ i pnia w proksymalnym odcinku udowym - 15%; 5 - ujście odpiszczelowo-udowego wydolne, niewydolność proksymalnego odcinka udowego - 5%; 6 - SFJ wydolne, niewydolność całego odcinka udowego - 8%; 7 - SFJ wydolne, niewydolność dystalnego odcinka udowego - 1%. Wnioski. Uzyskane wyniki z jednej strony potwierdzają zasadność wykonywania krótkiego strippingu żyły odpiszczelowej jako optymalnego rozwiązania u większości pacjentów, z drugiej dokumentują częste występowanie niewydolności wieloodcinkowej oraz innych wariantów anatomicznych schorzenia. Potwierdza się stanowisko, że stosowanie jednej, rutynowej procedury (krosektomia i krótki stripping) we wszystkich przypadkach choroby żylnej może być leczeniem nieadekwatnym do schorzenia. Z analizy powyższych danych wynika również, że w około 30% przypadków mogą wyniknąć trudności z takim wprowadzeniem strippera do pnia żyły odpiszczelowej, aby usunięty został właściwy jej odcinek

Acute acalculous cholecystitis in patients with severe general condition - a report of four cases

Ostre niekamicze zapalenie pęcherzyka żółciowego (AAC, acute acalculous cholecystitis), potencjalnie śmiertelne powikłanie u pacjentów w ciężkim stanie ogólnym, pozostaje nierozwiązanym problemem klinicznym. Nie istnieje w pełni wiarygodna diagnostyka, nie wypracowano również powszechnie uznanych standardów leczenia. W dostępnej literaturze nie ma ani jednej metaanalizy dotyczącej AAC. W niniejszym artykule przedstawiono cztery przypadki AAC u pacjentów leczonych w szpitalu w Sanoku. Chirurgia Polska 2010, 12, 1, 43-50Acute acalculous cholecystitis (AAC), a potentially fatal complication in patients in a severe general condition remains an unsolved clinical problem. Neither reliable diagnostic procedures for this condition, nor commonly agreed treatment standards have been set. In the available literature there is not even one metaanalysis of AAC. In our study we present four patients treated in our hospital for this condition. Polish Surgery 2010, 12, 1, 43-5

Structure and Function of Enterocyte in Intrauterine Growth Retarded Pig Neonates

The intestine of intrauterine growth retarded (IUGR) neonates showed different morphology compared to neonates born with normal body weight (NBW). The aim of the present study was to investigate the ultrastructure and proteomic profile of the gut epithelium in IUGR pig neonates with special attention to the digestive and absorptive function. Intestine tissue samples were investigated in 7-day-old IUGR and NBW littermate piglets using histometry, immunofluorescence, scanning electron microscopy (SEM), and mass spectrometry analysis. IUGR piglets have shown reduced mucosa and muscularis thickness and an enhanced number of foetal type enterocytes (FTE). SEM studies have shown the lack of the characteristic large-size vacuole in IUGR’s enterocytes. Delayed removal of FTE in IUGR neonates was probably due to the inhibited apoptosis in the apical part of villi and increased apoptosis and reduced mitosis in the crypt region. In the expression of proteins in the intestinal mucosa such as hexokinase I, histones, and prelamin A/C, carbamoyl phosphate was reduced in IUGR neonates. Finally, IUGR intestines showed higher expression of HSPA9 and HSPA5 as apoptosis markers. The data indicate modifications of gut mucosa in IUGRs that may result in slower gut mucosa maturation and reduced utilisation of nutrient as compared to NBW pig neonates

Risk factors for postoperative infectious complications after RIRS treatment of kidney and ureteral stones

Abstract Introduction and aim of the study: Urolithiasis is a disease involving the formation of deposits in the lumen of the urinary tract. The continued development of minimally invasive treatment methods allows for more effective treatment with greater operator comfort and less risk to the patient. It has been concluded that retrograde intrarenal surgery (RIRS) is superior to other therapeutic methods in many respects. The aim of this study is to review the available studies and publications and to identify potential complications following treatment of kidney and ureteral stones by RIRS, with a particular focus on infectious complications and their risk factors.   Method and materials: We reviewed the literature available on PubMed and Google Scholar, using the words 'urolithiasis'; 'urolithiasis treatment'; 'retrograde intrarenal surgery'; 'infectious complications of retrograde intrarenal surgery'.   Results: Among the risk factors associated with infectious complications after RIRS, long duration of surgery, recent positive urine culture, urinary tract infections or antibiotic use, purulent urine, urinary nitrites, obstructed access through the ureter, struvite stones, co-morbidities play a special role.   Conclusions: Among the complications of surgical treatment of nephrolithiasis and ureteral stones by RIRS, infectious complications are of particular concern. In view of the knowledge of their risk factors, preventive measures should include limiting the duration of surgery, possible antibiotic therapy and considering the use of a larger diameter UAS. This is especially true for patients with abnormal urine results, struvite stones, a history of urinary tract infection or predisposing comorbidities.   Key words: Urolithiasis; Kidney Calculi; Retrograde Intrarenal Surgery; Urolithiasis infection

Incorporation of the sphenoid sinuses' septum / septa in the carotid canal : evaluation before the fess

The purpose of the research was to define the frequency prevalence of the incorporation of sphenoid sinuses’ septum / septa in the carotid canal of the adult population. Materials and Methods: 296 computed tomography (CT) scans of the patients (147 females, 149 males), who did not present any pathology in the sphenoid sinuses, were evaluated in this retrospective analysis. Spiral CT scanner - Siemens Somatom Sensation 16 - was used to glean the medical images. Standard procedure applied in the option Siemens CARE Dose 4D. No contrast medium was administered. Multiplans reconstruction (MPR) tool was used in order to obtain frontal and sagittal planes from the transverse planes previously received. Results: Bilateral incorporation of the main septum (MS) in the carotid canal was not present in any of the patients, whereas unilateral incorporation was noticed in 21.96% of the patients (17.68% females, 26.17% males). On the right side it occurred in 11.82% of cases (10.88% females, 12.75% males), and on the left side in 10.14% of cases (6.8% females, 13.42% males). Bilateral incorporation of the additional septum (AS) was found in 8.45% of the patients (4.08% females, 12.75% males), whereas unilateral incorporation was noted in 28.37% of the patients. It was seen on the right side in 11.82% of cases (12.93% females, 10.74% males), and on the left side in 16.55% cases (15.65% females, 17.45% males). The most common variant was the incorporation of only one of the septa (either the MS or the AS) in the wall of the carotid canal unilaterally. Such situation took place in 30.07% of the patients (29.25% females, 30.87% males). Incorporation of two septa on the same side was noticed in 4.39% of cases (4.08% females, 4.7% males), and incorporation of three septa in 0.34% of cases (0.7% males). Conclusions: The anatomy of the paranasal sinuses is varied to a great extent, hence performing a CT scan is crucial before the scheduled surgery, as it may lessen the unforeseeable surgical complications, that may result from the high prevalence of variants in the sinuses

The occipital-vertebral anastomosis revisited

Background: The goal of the study was to provide relevant data about the location and prevalence of the OA-VA anastomosis in patients without visible occlusive disease, as well as to thoroughly discuss the clinical significance of these anastomotic channels. Furthermore, the morphometric properties of the OA and its branches were also analyzed. Materials and methods: A retrospective study was carried out to indicate anatomical variations, their prevalence, and morphometrical data on the OA and its branches. The study was performed on 55  randomly selected computed tomography angiographies (CTA) of the head and neck region. Each CTA result was analyzed bilaterally. Thus, 110 results were originally assessed. Results: The OA median maximal diameter was demonstrated at 4.85 mm (LQ: 4.11; UQ: 5.53) and the median maximal diameter of VA at 3.60 mm (LQ: 2.79; UQ: 4.38). The distances between OA and its branches were also measured giving a median result of 21.73, 30.29, 60.84, 34.88, 18.02, 55.16 mm for the LSCMB, USCMB, MeB, MaB, and DB respectively. The median distance between OA and its first anastomosis was set to be 51.15 mm (LQ: 37.20; UQ: 60.10). Moreover, a set of additional measurements was carried out in order to create a 3-dimensional anatomical heat-map of the occurrence of the OA-VA anastomosis. Conclusions: Knowledge about the anatomy of the OA-VA anastomosis might be of immense importance to avoid potentially fatal complications during embolization of the OA and its branches

Enantioselective Dynamic Process Reduction of α- and β-Tetralone and Stereoinversion of Resulting Alcohols in a Selected Strain Culture

α-Tetralone and β-tetralone were subjected to biotransformation by 14 fungal strains. Enantiomeric purity of the products depended on the reaction time. 3-Day transformation of α-tetralone in Absidia cylindrospora culture gave S-(+)-1,2,3,4-tetrahydro-1-naftol of 92 % ee, whereas longer biotransformation time resulted in decrease of ee value. 3-Day transformation of β-tetralone by the same strain gave predominantly S-(−)-1,2,3,4-tetrahydro-2-naftol, whereas after 9 days of the reaction, the R-enantiomer with 85 % ee was isolated. Transformation of β-tetralone by Chaetomium sp. KCh 6651 gave pure (S)-(−)-1,2,3,4-tetrahydro-2-naftol in high yield at the concentration of 1 g/l. In this process, a non-selective carbonyl reduction was observed, followed by a selective oxidation of the R-alcohol