Complicated peptic ulcer disease — still a major challenge for surgery. A case report

Choroba wrzodowa żołądka i dwunastnicy jest ciągle częstą chorobą przewodu pokarmowego. Rozwój farmakologii, w szczególności inhibitorów pompy protonowej, a także eradykacja Helicobacter pylori, zmniejszyły znacznie liczbę powikłań choroby wrzodowej (takich jak krwawienia czy perforacje), wymagających natychmiastowej interwencji chirurgicznej. Praca przedstawia przypadek pacjenta z chorobą wrzodową o bardzo ciężkim przebiegu. Chronologicznie przedstawiono kilkuletnią historię pacjenta, dowodząc, że choroba wrzodowa pozostaje wielkim wyzwaniem dla chirurgii.Peptic ulcer disease continues to be a common condition of the alimentary system. The development of pharmacology, particularly proton pomp inhibitors, as well as the eradication of Helicobacter pylori has significantly reduced the number of complications associated with peptic ulcer disease (such as haemorrhages or perforations), which require immediate surgical intervention. The paper presents the case of a patient with a very severe course of the disease. It provides a chronological overview of the patient’s entire medical history over the past several years, demonstrating that peptic ulcer is still a major challenge for surgery

Characteristics of the indoor propagation channel in 1.9 GHz band, Journal of Telecommunications and Information Technology, 2001, nr 4

This paper presents results of propagation mea- surements carried out in the frequency range 1.8-2.0 GHz inside a building, using network analyser. Wideband properties of the channel, described through mean delay and delay spread, and a narrowband local statistics of the received power have been presented. For each transmitter and receiver antennas location two propagation cases have been considered, line of sight (LOS) and obstructed line of sight (NLOS) – the direct path component was attenuated by radio absorbing mat near the receiver

Immunohistochemical assessment of mitochondrial superoxide dismutase (MnSOD) in colorectal premalignant and malignant lesions

Introduction: It is generally accepted that mitochondria are a primary source of intracellular reactive oxygen species (ROS). Under physiological circumstances they are permanently formed as by-products of aerobic metabolism in the mitochondria. To counter the harmful effect of ROS, cells possess an antioxidant defence system to detoxify ROS and avert them from accumulation at high concentrations. Mitochondria-located manganese superoxide dismutase (MnSOD, SOD2) successfully converts superoxide to the less reactive hydrogen peroxide (H2O2). To the best of our knowledge, there are no available data regarding immunohistochemical expression of MnSOD in colorectal neoplastic tissues. Aim: To investigate the immunohistochemical expression status of MnSOD in colorectal premalignant and malignant lesions. Material and methods: This study was performed on resected specimens obtained from 126 patients who had undergone surgical resection for primary sporadic colorectal cancer, and from 114 patients who had undergone colonoscopy at the Municipal Hospital in Jaworzno (Poland). Paraffin-embedded, 4-mu m-thick tissue sections were stained for rabbit polyclonal anti SOD2 antibody obtained from GeneTex (clone TF9-10-H10 from America Diagnostica). Results: Results of our study demonstrated that the development of colorectal cancer is connected with increased expression of MnSOD both in adenoma and adenocarcinoma stages. Samples of adenocarcinoma with G(2) and G(3) grade showed significantly higher levels of immunohistochemical expression of this antioxidant enzyme. Moreover, patients with the presence of lymphovascular invasion and higher degree of regional lymph node status have been also characterised by higher levels of MnSOD expression. The samples of adenoma have been characterised by higher levels of MnSOD expression in comparison to normal mucosa as well. Interestingly, there was no significant correlation between expression and histological type of adenoma. Conclusions: Development of colorectal cancer is connected with increased expression of MnSOD both in adenoma and adenocarcinoma stages. Keyword

Europejska polityka bezpieczeństwa i integracji

Praca recenzowana / peer-reviewed pape

Czy w 50 lat po opublikowaniu Skala Barthel jest wciąż przydatna?

Minęło 50 lat, kiedy to w lutym 1965 r. Florence Mahoney i Dorothea Barthel opublikowały artykuł zatytułowany Functional evaluation: the Barthel Index. Od tej pory skala Barthel, występująca również jako Basic ADL Index (BI), Barthel Score i Maryland Disability Index, należy do najbardziej znanych skal ADL (czynności życia codziennego, ang. Activities of Daily Living) i wciąż jest popularna. Ta prosta skala wykorzystywana jest ciągle przez przedstawicieli zawodów medycznych do wielu celów, w tym oceny wyników leczenia, rehabilitacji, prognozowania, oceny samodzielności, oszacowania potrzeb co do opieki i do celów orzecznictwa. Na podstawie przeglądu piśmiennictwa i własnego doświadczenia w artykule tym przedstawiono zalety i wady skali Barthel, jej przydatność i miejsce wśród innych skal, oceniających czynności życia codziennego.It has been 50 years since, in February 1965, Florence Mahoney and Dorothea Barthel published an article entitled “Functional evaluation: the Barthel Index”. Since then, the Barthel scale, also known as the Basic ADL Index (BI), Barthel Score and Maryland Disability Index, is one of the most well-known ADL scales (Activities of Daily Living) and is still popular. This simple scale is still used by the representatives of a number of medical workers for many purposes, including the assessment of the results of treatment, rehabilitation, prognosis, assessment of self-reliance, assessment of needs for care and for determining the degree of disabilities. Based on a review of the literature and our own experience, this article presents the advantages and disadvantages of the Barthel Index, including its usefulness and place among other scales assessing the activities of daily living

Large diaphragmatic hernia subject to successful reconstruction – case report

The study presented a case of a large left-sided diaphragmatic hernia treated by means of successful phrenic reconstruction. The above-mentioned are very challenging considering general surgery, although reluctantly supplied in General Surgery Department

The application of Nordic walking in the treatment hypertension and obesity

Background. Increasing physical activity is a widely recognized method of prevention and treatment of hypertension and obesity. Objectives . The aim of the following study was to assess the results of application of Nordic walking in the treatment of patients with hypertension and obesity. Material and methods . Participating in the study were 30 overweight or obese men with hypertension, undergoing pharmacological treatment, randomly assigned to one of the two study groups. The first group performed Nordic walking training for 4 weeks. The second group underwent pharmacological treatment only. The value of blood pressure measured with a 24-hour AMBP monitoring device, exercise tolerance based on the duration and value of the metabolic equivalent during the exercise test, body mass and BMI value, as well as total cholesterol, LDL, HDL and triglyceride values, were measured before and after the study. Results . The results of the study demonstrated the fact that the application of Nordic walking over the course of 4 weeks did not cause significant changes as far as the value of blood pressure. However, the training led to increased exercise tolerance, a reduced body mass and BMI value, as well as lowered triglyceride and total cholesterol levels. There were no cases of discontinuation of the training due to unwanted effects or symptoms. Conclusions . The 4-week period of Nordic walking training did not result in the lowering of blood pressure in patients with hypertension. However, Nordic walking training did result in improved exercise tolerance, decreased body mass, as well as reduced metabolic risk factors for cardiovascular disease

Identification of Sliding Hiatus Hernia by High-Resolution Manometry and Upper Gastrointestinal Endoscopy in Patients with Gastro-Oesophageal Reflux Disease

Background/Aim: The aim of this study was to compare high-resolution manometry (HRM) and upper gastrointestinal (GI) endoscopy as diagnostic utilities in detecting a sliding hiatus hernia in patients with gastro-oesophageal reflux disease (GORD) symptoms. Material and Methods: For both diagnostic modalities, the data obtained from 31 patients (20 females; mean age 48.2) who qualified for Nissen fundoplication were analysed using oesophageal pressure topography in line with the Chicago Classification. Confirmation of hiatus hernia during the surgery was considered the gold standard. HRM protocol involved 10 consecutive boluses of 10 mL of water. Results: Sliding hiatus hernia was confirmed intraoperatively in 29 out of 31 patients. In 14 patients, hiatus hernia was detected in HRM, while 19 patients were found to have hiatus hernia by upper GI endoscopy before surgery. No false positive results were obtained in HRM, while 15 false negative results were shown. In upper GI endoscopy, false positive data were observed in 1 patient, while false negative results were found in 10 patients. Thus, the sensitivity of HRM in detecting hiatus hernia was 48% (95%CIs: 29–67%), and sensitivity of upper GI endoscopy was 66% (95%CIs: 46–82%). It was not possible to assess the specificity of HRM or upper GI endoscopy because only 2 of 31 patients had no hiatus hernia during fundoplication (gold standard). False negative results (sensitivity) were not significantly different between compared diagnostic modalities HRM and upper GI endoscopy (52% vs. 34%, respectively, p = 0.29). Conclusions: Due to poor sensitivity, both modalities, i.e., HRM and upper GI endoscopy, are not reliable tools to diagnose sliding hiatus hernia in patients with GORD symptoms

Przegląd wchłanianych nici chirurgicznych stosowanych w chirurgii ogólnej – dobór obecnie istniejących materiałów oraz optymalizacja doboru

Artykuł cytowany również: Gierek M., Kuśnierz K., Lampe P., Ochała G., Kurek J., Hekner B., Merkel K., Majewski J.; Absorbable sutures in general surgery – review, available materials, and optimum choices;Pol Przegl Chir 2018; 90 (2): 34-37 https://ppch.pl/resources/html/article/details?id=186966Sutures are the most versatile materials used in surgery. Despite recent technological advances and availability of novel materials such as tissue cements, it appears that surgical sutures will continue to be used for many years to come. The objective of this study was to provide an overview of the most common absorbable sutures used in general surgery. The appropriate suture choice for a particular procedure is of key importance for the success of that procedure