Vector bundles on real algebraic curves

We prove that any topological real line bundle on a compact real algebraic curve X is isomorphic to an algebraic line bundle. The result is then generalized to vector bundles of an arbitrary constant rank. As a consequence we prove that any continuous map from X into a real Grassmannian can be approximated by regular maps

Vector bundles on real algebraic curves

We prove that any topological real line bundle on a compact real algebraic curve X is isomorphic to an algebraic line bundle. The result is then generalized to vector bundles of an arbitrary constant rank. As a consequence we prove that any continuous map from X into a real Grassmannian can be approximated by regular maps

Does the type of a centre in which the resection of extensive tumours of the limbs and truck is performed, affect the patients’ survival?

Nowoczesna chirurgia rekonstrukcyjna opiera się na odpowiednim wykorzystaniu dostępnych metod rekonstrukcyjnych, w tym mikronaczyniowych. Zaplanowanie odpowiedniej operacji rekonstrukcyjnej daje możliwość wykonania maksymalnie szerokiej resekcji, co dodatkowo zwiększa radykalność zabiegu. Ostatnimi czasy zaznacza się tendencja do wykonywania rozległych resekcji nowotworów w ośrodkach nie dysponujących bogatym doświadczeniem w tego rodzaju procedurach. Istnieje obawa, że, z uwagi na brak możliwości wykonania jednoczasowej rekonstrukcji, zakres resekcji może być niewystarczający do uzyskania pełnej radykalności zabiegu. W oparciu o wyniki badań 71 chorych leczonych w Klinice Chirurgii Onkologicznej i Rekonstrukcyjnej w latach 2006 – 2017 z powodu rozległych zmian nowotworowych tułowia i kończyn wykazano, że chorzy leczeni pierwotnie (zabieg resekcyjny) poza Instytutem charakteryzowali się znacząco krótszym czasem przeżycia do wznowy. Powyższe wyniki stanowią głos potwierdzający zasadność przeprowadzania rozległych zabiegów resekcyjno – rekonstrukcyjnych w przypadku zaawansowanych zmian nowotworowych, w ośrodkach o bogatym doświadczeniu w tym zakresie

Adjuvant radiotherapy post microvascular reconstructive surgery (MRS) for patients with locally advanced head and neck cancer – when and how?

For many decades palliation (radiotherapy, chemotherapy or symptomatic treatment) was the only therapeutic solu­tion for locally very advanced head and neck cancer. In the mid 70s, H. Buncke carried out pioneering microvascular reconstructive surgery (MRS) as a radical treatment. Since that time, the MRS has been accepted around the world as a successful radical therapy, not only for head and neck (H&N) cancers. A part of the H&N cancers need however post­-MRS radiotherapy (RT). Based on the 20 year experience of the Institute of Oncology in Gliwice with MRS (about 2500 patients), D. Bula has defined local recurrence risk factors. Dutch studies convincingly documented the prognostic value of the estimated molecular profiles of the resected margins as additional risk factors. The use of conventional 2.0 Gy/ fraction post-MRS-RT result in a high risk of the inserted reconstructive flap necrosis or rejection. Therefore, a novel IMRT­-VMAT technique with 50 Gy given in 1.5–1.6 Gy/fraction has been designed which allows to almost eliminate the flap from the irradiated volume and therefore minimizes recurrence and/or flap rejection to almost zero. The present paper shows objectively selected a cluster of patients being the candidate to post-MRS safe and effective VMAT radiotherapy

Adjuvant radiotherapy post microvascular reconstructive surgery (MRS) for patients with locally advanced head and neck cancer – when and how?

For many decades palliation (radiotherapy, chemotherapy or symptomatic treatment) was the only therapeutic solu­tion for locally very advanced head and neck cancer. In the mid 70s, H. Buncke carried out pioneering microvascular reconstructive surgery (MRS) as a radical treatment. Since that time, the MRS has been accepted around the world as a successful radical therapy, not only for head and neck (H&N) cancers. A part of the H&N cancers need however post­-MRS radiotherapy (RT). Based on the 20 year experience of the Institute of Oncology in Gliwice with MRS (about 2500 patients), D. Bula has defined local recurrence risk factors. Dutch studies convincingly documented the prognostic value of the estimated molecular profiles of the resected margins as additional risk factors. The use of conventional 2.0 Gy/ fraction post-MRS-RT result in a high risk of the inserted reconstructive flap necrosis or rejection. Therefore, a novel IMRT­-VMAT technique with 50 Gy given in 1.5–1.6 Gy/fraction has been designed which allows to almost eliminate the flap from the irradiated volume and therefore minimizes recurrence and/or flap rejection to almost zero. The present paper shows objectively selected a cluster of patients being the candidate to post-MRS safe and effective VMAT radiotherapy

Cerebral stroke - preclinical diagnosis and in conditions of the hospital accident ward

AdmissionThe cerebral stroke is a direct distress of the health and the life. The patient with the suspicion of stroke requires urgent intervention irrespective of the course of manifestations and their degree of the intensity. During the help at the preclinical stage an evaluation of practical parameters and registering direction and dynamics of changes are most important in this respect. As part of dealing on the Hospital accident ward with the sick person with the stated cerebral stroke one should verify and implement changes in applied curing by team members medical lifeguards.Purpose of researchAnalysis of diagnostic and therapeutic standards is a purpose of the work applied with patients with the cerebral stroke at the preclinical stage and as part of the care on the Hospital accident ward. Materials and methodsInformation taken from medical documentation of course of the process of diagnostics and curing 130 patients with the diagnosed cerebral stroke at medical institutions in the province constitutes research material Lublin. Analysis of medical documentation covered years 2013 up to 2016.DiscussionThe most frequent object manifestations stated at patients from the examined group: giddiness, headache, disequilibrium, nausea and/or the vomiting, the dysphagia, visual disturbances, pareses and hypoesthesias. According to analysis results and with literature at sick persons with the cerebral stroke a computed axial tomography and a magnetic resonance, as well as additional examinations are made examinations leading the way.ConclusionsAccording to the analysis of the results amongst early complications they observed: cerebral oedema, widen/ing moving the arrangement of the cellular brain, the secondary ischaemia of the haemorrhagic stroke. All described disorders of the awareness were diagnosed in the early phase of the cerebral stroke i.e. 4-5 hours from the beginning of the riot of any neurological warning signals

Transradial approach for carotid artery stenting in a patient with severe peripheral arterial disease

We present a case of a 73-year-old man with critical bilateral internal carotid artery stenosis, recent right hemisphere stroke and severe peripheral artery disease in whom right internal carotid artery stenting (RICA-CAS) was performed successfully via a right transradial approach

Transradial approach for vertebral artery stenting

Introductuion: Symptomatic severe vertebral artery (VA) stenosis may be treated safely with stent supported angioplasty via femoral access. There is limited clinical data on transradial approach for VA angioplasty in case of peripheral artery disease. Aim: To evaluate the safety and efficacy of transradial angioplasty of symptomatic VA stenosis. Material and methods: Fifteen patients (age 66 ±7.4 years, 73% men, with VA > 80% stenosis, 11 right-side, all symptomatic from posterior circulation (history of stroke, TIA, or chronic ischaemia symptoms)) with peripheral artery disease (PAD) or unsuccessful attempt via femoral approach were scheduled for VA angioplasty by radial access. Clinical and duplex ultrasound (DUS) follow-up were performed before discharge and 1, 12, and 24 months after VA angioplasty. Results: The technical success rate was 100%. In all cases VA angioplasty was performed with the use of single balloon-mounted stent (9 bare metal stents, 6 drug-eluting stents). The mean NASCET VA stenosis was reduced from 85.3% to 5.3% (p < 0.001). No periprocedural death, stroke, myocardial infarction, or transient ischaemic attack occurred. During 24-months follow-up, in 12 of 15 patients chronic ischaemia symptoms release was observed, and no new acute ischaemic neurological symptoms were diagnosed in all patients. One patient died 20 months after intervention from unknown causes. There was one symptomatic borderline VA in-stent stenosis 12 months after angioplasty. Conclusions: Transradial VA stenting may be a very effective and safe procedure, and it may constitute an alternative to the femoral approach in patients with symptomatic VA stenosis

Mesh-covered (Roadsaver) stent as a new treatment modality for symptomatic or high-risk carotid stenosis

Introduction: Prevention of periprocedural stroke has a crucial role in carotid artery stenting (CAS) procedures. Aim: To assess retrospectively 30-day safety and effectiveness of 41 procedures of internal and common carotid artery stenting using the Roadsaver double nitinol layer micromesh stent in 40 non-consecutive patients with symptomatic or high-risk carotid artery stenosis. Material and methods: The patients were men (n = 31) and women (n = 9); mean age was 67.8 ±7.9 years. Femoral access was used in 39 cases, whereas radial access was used in 2. Proximal (n = 27) or distal (n = 14) embolic neuroprotection was used. Results: The Roadsaver stents (nominal diameter 7, 8 or 9 mm, length 25 or 30 mm) were implanted successfully in all cases. One minor stroke occurred after common carotid artery intubation with a guiding catheter (before stent deployment) and one transient postprocedural ischemic attack (TIA) of the ipsilateral cerebral hemisphere was observed. Internal/common carotid artery stenosis severity was evaluated by duplex Doppler. Maximal peak systolic velocity (PSV) before CAS was in the range: 2.0–7.0 m/s, mean: 3.9 ±1.0 m/s, at 24–48 h after stenting mean PSV was 1.1 ±0.4 m/s (p < 0.05), and at 30 days 1.1 ±0.3 m/s (p < 0.05). Maximal end-diastolic velocity (EDV) was 0.85–3.5 m/s, mean 1.4 ±0.5 m/s, at 24–48 h after stenting mean EDV was 0.3 ±0.1 m/s (p < 0.05), and at 30 days 0.4 ±0.1 m/s (p < 0.05). No restenosis or thrombosis was observed. Angiographic stenosis decreased from 82.9 ±9.1% (range: 61–97%) to 19.3 ±7.3% (range: 0–34%) (p < 0.05). Conclusions: The CAS using the Roadsaver stent seems to be safe and effective. Further studies involving larger patient populations and longer follow-up are needed