10 research outputs found
Metallurgy study on swords from the Roman period burial ground in Czelin, West Pomeranian Voivodeship
Results of the metallurgy study on three, two-edged swords from a cremation
burial ground in Czelin, representing the Pompeii, Lachmirowice-Apa and VimoseIllerup types indicate a variability in the material used as well as in technique of their
production, and thus in the quality of the specimens. Two of them were made of
a single piece of metal with low (specimen of the Lachmirowice-Apa type) or
medium quality (specimen of the Pompeii type). A much higher level of craftsmanship is represented by the third sword of the Vimose-Illerup type, precisely
forged from several pieces of diverse, high-quality material, representing the socalled pattern welding techniqu
Combined total aortic arch replacement associated with aortic valve replacement and subtotal thyroidectomy
Własna modyfikacja leczenia operacyjnego przetok aortalno-dwunastniczych w porównaniu z innymi metodami operacyjnymi
Background. This paper is a comparison of surgical treatment of secondary
enteroaortal fistulas using own modification of surgical technique.
Material and methods methods. There were analysed 18 patients treated for
secondary enteroaortal fistulas as a complication of the vascular prosthesis implantation.
Patients were operated and the dracon prosthesis was changed to arterial homograft,
which is more resistant to infections or using subclavio-femoral bypasses. Removal
of intestinal fistula included resection of duodenum and gastroenterotomy or duodenorrhaphy.
The own modification of duodenal fistula provision relies on duodenorraphy and
protection of that area with pediculated flap of gastrocolic omentum conducted
retrocolically in retroperitonal space.
Results. The resection of duodenum was performed in 5 patients. In 9 patients
duodenorraphy with two layer suture was performed. In these cases transperitoneal
flap of omentum was fixed additionally in place of double layer suture of duodenum.
In 4 patients retroperitoneal retrocolical omentoplasty was performed, the penduculated
flap of gastrocolic omentum was conducted retrocolically and retroperitoneally.
The fistula in 15 patients resulted from dehiscence of upper part of anastomosis
of vascular prosthesis with aorta, in 2 cases decubitus ulcer evoked by graft
hanged into fistula, in 1 patient fistula was a result of prosthesis. In 1 patient
both mechanisms of fistula forming were observed. 6 patients died during the postoperative
period. No death was observed retrocolic omentoplasty.
Conclusion. Secondary enteroaortal fistula is the most serious complication
following infection of vascular prosthesis, with high risk of death rate regardless
of using different operative methods.Wstęp. W pracy przedstawiono porównanie (na podstawie materiału własnego)
własnej modyfikacji z innymi metodami leczenia operacyjnego wtórnej przetoki aortalno-jelitowej.
Materiał i metody. Analizie poddano 18 chorych leczonych z powodu wtórnej
przetoki aortalno-jelitowej, będącej powikłaniem infekcji po wszczepieniu protezy
naczyniowej. Chorych operowano, wymieniając protezę dakronową na homograft tętniczy,
protezę o zwiększonej oporności na zakażenie lub stosując przęsła podobojczykowo-udowe.
Likwidacja przetoki jelitowej obejmowała resekcję dwunastnicy z gastroenterostomią
lub zeszycie dwunastnicy. Własna modyfikacja zaopatrzenia przetoki dwunastnicy
polegała na zeszyciu jelita i zabezpieczeniu tego miejsca uszypułowanym płatem
sieci większej, przeprowadzonym zaokrężniczo, w przestrzeni zaotrzewnowej.
Wyniki. Resekcję dwunastnicy wykonano u 5 chorych. U 9 pacjentów dwunastnicę
zaopatrzono dwoma piętrami szwów z naszyciem sieci większej przeprowadzonej przez
jamę otrzewnową lub zabezpieczeniem tkankami przestrzeni zaotrzewnowej. U pozostałych
4 chorych wykonano pozaotrzewnową omentoplastykę zaokrężniczą - uszypułowany płat
sieci większej przeprowadzony zaokrężniczo, pozaotrzewnowo. U 15 chorych przetoka
powstała w wyniku rozejścia się górnego zespolenia protezy naczyniowej z aortą,
a u 2 osób - w wyniku odleżyny protezy. U 1 chorego obserwowano oba mechanizmy
powstawania przetoki. Nastąpiło 6 zgonów w okresie pooperacyjnym. Nie zanotowano
zgonów w przypadku zastosowania omentoplastyki zaokrężniczej.
Wnioski. Wtórna przetoka aortalno-dwunastnicza jest najcięższym powikłaniem
infekcji protezy naczyniowej, obarczonym dużą śmiertelnością pomimo stosowania
różnych metod leczenia operacyjnego. Zdaniem autorów wprowadzenie pozaotrzewnowej
omentoplastyki zaokrężniczej jest praktyczną modyfikacją zaopatrzenia przetoki
aortalno-dwunastniczej
The results of metallurgical testing swords from the cemetery of the Przeworsk culture in Opatów, site 1
The results of metallurgical testing swords from the cemetery of the Przeworsk culture in Opatów, site 1
Affordable single-family housing. From the traditions of the Warsaw School of Architecture
Sirtuin 1 and Sirtuin 2 Plasma Concentrations in Patients with Ascending Aortic Dissection and Ascending Aortic Aneurysm
Abstract Background Previous studies explored multifactorial interactions and sirtuin expression in the aortic cells of laboratory rodents and humans. Human studies were limited due to the availability of biological material exclusively in the advanced stage of the disease. The role of sirtuins in aortic pathology has not been explained extensively therefore the aim of the study was to assess the plasma concentrations of human sirtuin 1 (SIRT1) and human sirtuin 2 (SIRT2) in patients with ascending aortic dissection and ascending aortic aneurysm. Material and methods The study group included 43 adults (34 males and 9 females) aged 44–92 years with ascending aortic dissection (n = 10) or with ascending aortic aneurysm (n = 33). The SIRT1 and SIRT2 plasma concentrations in patients’ blood samples were determined, and the differences between groups were observed (p = 0.02 for SIRT1, p = 0.04 for SIRT2). Results Levels of both SIRT1 and SIRT2 were lower in patients with ascending aortic dissection (SIRT1: median = 6.5 ng/mL; SIRT2: median = 5.7 ng/mL) than in patients with ascending aortic aneurysm (SIRT1: median = 9.2 ng/mL; SIRT2: median = 7.8 ng/mL). The SIRT1 and SIRT2 cut-off levels differentiating both groups of patients were 6.7 ng/mL and 3.2 ng/mL, respectively. Conclusions The patients with ascending aortic dissection had lower plasma concentrations of SIRT1 and SIRT2 than the patients with ascending aortic aneurysm. Calculated cut-off values for both enzymes may be helpful in laboratory differentiation of ascending aortic dissection from ascending aortic aneurysm
The Direct Anterior Approach to Primary Total Hip Replacement: Radiological Analysis in Comparison to Other Approaches
Total hip arthroplasty (THA) is currently considered the most effective treatment for end-stage hip osteoarthritis (OA). The surgery can be performed via a number of different approaches, including direct anterior (DAA; Smith–Petersen; Hueter), anterolateral (ALA; Watson–Jones), direct lateral (LA; Bauer), posterior (PA; Kocher–Langenbeck), and posterolateral (PLA). There is still a dispute over the optimal technique. The aim of this systematic review was to assess how different surgical approaches toward a THA influence the prosthesis elements’ positioning. We conducted a literature search of Scopus, ScienceDirect, PubMed, Embase, and The Cochrane Library. We evaluated studies in terms of the first author’s name, country, publication year, type of surgical approach being compared to the direct anterior approach, any significant differences at baseline, sample size, and radiographic analysis. A subanalysis of each approach in comparison to the DAA revealed differences in terms of all analyzed implant positioning radiographic parameters. There is still an insufficient number of randomized controlled studies that include radiological analyses comparing THRs (total hip replacements) performed using DAA with other approaches. Implant placement is a crucial step during a THR and surgeons must be aware that the approach they use might impact their judgment on angles and spaces inside the joint and thus alter the implant positioning
Analysis of biomechanical gait parameters in patients after total hip replacement operated via anterolateral approach depending on size of the femoral head implant : retrospective matched-cohort study
INTRODUCTION: Total hip replacement (THR) is considered one of the most effective medical procedures in treatment of osteoarthritis. Since its introduction, there has been a worldwide debate over proper implant selection in terms of size, bearing type and shape. Following study was designed to assess the importance of femoral head size in long-term follow-up. MATERIALS AND METHODS: A cohort of 30 patients with primary end stage osteoarthritis who underwent total hip replacement was analysed retrospectively. A homogenous group was chosen with no major differences in BMI. Patients’ gait parameters were measured in a biomechanics laboratory using the 3D BTS Smart system. WOMAC and VAS questionnaires were used to assess patient reported outcome. RESULTS: The subgroup with larger implant head size had several outcomes significantly superior to the subgroup with standard head size and non-inferior to healthy hips. Following variables were measured during this study: time of support phase, time of swing phase, double support time, walking hip extension angle. CONCLUSIONS: Use of larger sized femoral heads during THR gives better results in terms of gait pattern. Since restoring the gait pattern is one of the aspects of rehabilitation and returning to daily activities it seems to be an important observation