Differentiation of vertical limit of forest at the Babia Góra Mt., the Western Carpathian Mountains

The work contains quantitative analysis of differentiation of altitudinal position and sinuosity of two lines determining the course of forest limit, i.e. timberline and treeline within Babia Góra Mt. (1725 m a.s.l.) homoclinal flysch ridge (the Western Carpathians). The course of the empiric timberline was delimited basing on aerial photographs with details from spatial data of Aerial Laser Scanning conducted in 2012. On the N slope, the course of timberline is exclusively conditioned by natural factors, whereas on the S slope this line was shifted downwards as a result of sheep and cattle grazing (however it has shown progression for the last 80 years). In the course of theoretical treeline conditioned by macrotopography and local climate, the mass-elevation effect is visible, and on the N slope, additionally, a sub-summit downward shift (the Diablak effect) occurs. The sequence of natural factors, according to their positive or negative influence on timberline and treeline courses was determined

Purple glove syndrome

Introduction: Purple glove syndrome is an atypical and adverse reaction to intravenous phenytoin, which is characterized by oedema, pain and a dark purple-bluish discolouration, typically located on an upper extremity. The clinical manifestation of this syndrome occurs in three stages: appearance, progression and resolution of symptoms. PGS develops up to 12 hours after administration of intravenous phenytoin and it disappears in a few weeks or months. Objective: The aim of this article is to summarize the current state of knowledge about purple glove syndrome: the pathophysiology, risk factors, the diagnosis and the current treatment. Brief descriptions of the state of knowledge: Despite many years PGS is still unexplained phenomenon. It is claimed that vascular tearing, micro-extravasation, alkaline pH of the solution or unidentified procoagulant mechanism can cause tissue impairment. The treatment depends on a limb elevation, physiotherapy, intravenous heparin administration, pain control, nitroglycerine application and a nerve blocks. To prevent PGS it is recommended to use oral phenytoin whenever possible, slow infusion rate of phenytoin less than 25mg/min, large cannula (20G or larger) in a large calibre vein and suitable, small doses. What is important fosphenytoin, a pro-drug of phenytoin, can also cause PGS, even though it was thought to be a safe drug, and a purple glove syndrome induced by fosphenytoin has never been described before. Summary: Despite the existence of many clinical trials, long term observations and scientific speculations, PGS can still be challenging for clinicians. There is a need for further scientific research to explain this phenomenon and to increase the awareness of this problem in general medical practice

Management of lower limb ischaemia associated with the use of intra-aortic balloon pumps during cardiac surgery

Objective:To audit the lower limb vascular complications associated with the use of an intraaortic balloon pump (IABP) on a cardiothoracic unit over a 12 month period.Design:Retrospective analysis.Setting:Regional university cardiothoracic unit.Patients:Fifty four IABPs inserted into 51 patients.Results:Seventeen patients (33%) died from cardiogenic shock in the immediate postoperative period. Of the remaining 34 patients (37 IABPs), lower limb vascular complications occurred in nine patients (26%) who underwent 11 IABP insertions (30%). Vascular complications included groin haematomas (n = 2 insertions), compartment syndrome (n = 2 insertions), femoral artery trauma (n = 7 insertions).Conclusions:Prompt management by peripheral vascular surgeons resulted in limb salvage in 10 legs and only one death from a pulmonary embolus

Parkes Weber Syndrome

Introduction: Parkes Weber Syndrome (PWS) is a traditional eponymous denomination of a certain type of angiodysplasia. It is a congenital vascular disease which consists of capillary malformation (CM), venous malformation (VM), lymphatic malformation (LM), congenital arteriovenous malformation (AVM) and multiple arteriovenous fistulas (AVFs). There is a soft-tissue and skeletal hypertrophy of the affected extremity (usually a lower extremity). Moreover the affected limb is warmer and longer than the other side. Objective: The aim of this article is to summarize the current state of knowledge about Parkes Weber Syndrome: the pathophysiology, genetic inheritance, the main symptoms, the diagnosis especially differential diagnosis and the current treatment. Brief descriptions of the state of knowledge: Despite many years, physicians still have difficulties with diagnosing PWS correctly. Although the aetiology is unknown, it is claimed that PWS is caused by mutations of the RASA1, gene located on chromosome 5q13.1, which are inherited in an autosomal dominant manner. This gene is responsible for mediating cellular growth, differentiation and proliferation. No efficacious pharmacological treatment has been found. Nowadays Tranexamic Acid, Sirolimus, Everolimus and Miconazole are used in medical practice. The most frequently utilized invasive treatment methods are amputation, surgical AVM resection and occasionally stent-graft implantation. Furthermore it is thought that embolization, alone or combined with surgical resection leads to clinical improvement. Summary: Despite the existence of many clinical trials, long term observations and scientific speculations, PWS can still be challenging for clinicians. There is a need for further scientific, molecular and genetic research to diagnose this phenomenon correctly, because despite fact, that its symptoms are similar to other syndromes or entities, therapeutic strategies differ significantly. It is important to increase the awareness of inheritance in an autosomal dominant manner in generation of patients with PWS

Comprehensive study of the mountainous lake sediments in relation to natural and anthropogenic processes and time (Mały Staw Lake, Poland)

The Sudety Mts. form a chain of mountains in the South of Poland and during the last 200 years were subjected to strong industrial and agricultural pressure. The records of these human-induced changes are stored in natural archives like lake sediments. For the comprehensive study, three sediment cores taken from Mały Staw Lake (Sudety Mts.) were analyzed for the concentration of K, Na, Mn, Fe, Cu, Mg, Zn, Cd, Cr, Ni, Pb and radioactivity of 137Cs and 210Pb. As a result of the studies, the bathymetry map was developed and the sources of solid material supplied to the lake were identified. The geochronology studies of the cores were performed using 210Pb method, to evaluate model of time changes in the sediment. Radioactivity of 210Pbuns (determined indirectly by 210Po) ranged from 1051 ± 64 to 12 ± 8 Bq kg−1. The 137Cs radioactivity was determined directly by gamma spectrometry and varied from525 ± 37Bq kg−1 for top layers to 9.80 ± 5.40 Bq kg−1 for the bottom of the core. Two characteristic peaks of 137Cs radioactivity related to the global fallouts after nuclear weapons testing and the Chernobyl accident were observed and used to confirm210Pb dating method. Chemometrics analysis of the chosen metal’s concentrations combined with sample dating showed distinct imprint of human activity on the studied area

Randomized comparison of ultrasonic aspiration versus conventional electrocautery for dissection of the human internal thoracic artery

AbstractThe most common technique currently employed to harvest the internal thoracic artery for coronary artery bypass grafting is conventional electrocautery. This study compared an alternative method, electrocautery with an ultrasonic aspirator, for harvesting the internal thoracic artery. Patients were randomly assigned to one of six experimental groups (conventional electrocautery, ultrasonic aspirator at settings of 60%, 80%, and 100% power output, and ultrasonic aspirator in 100% CAVI-Pulse modes 1 and 3). Ring segments of internal thoracic artery were studied in an organ bath. Contraction responses were elicited with 123 mmol/L potassium physiologic salt solution, KPSS, KPSS solution containing noradrenaline, and a cumulative noradrenaline dose-contraction curve. Relaxation studies were performed with the vasodilators acetylcholine, bradykinin, and sodium nitroprusside. Forty percent of the electrocauterized vessels were traumatized or damaged and failed to respond to contractile stimuli, whereas only 10% of the vessels in ultrasonic aspirator groups 60%, 80%, and 100% failed to respond. All vessels in the group harvested by ultrasonic aspirator in 100% CAVI-Pulse mode 1 responded, whereas 20% of the vessels in the group harvested by ultrasonic aspirator in 100% CAVI-Pulse mode 3 failed to respond. All settings of electrocautery with an ultrasonic aspirator produced a greater contractile response to KPSS and noradrenaline. Acetylcholine and sodium nitroprusside produced similar relaxations in all groups, but the bradykinin responses were significantly improved in all groups undergoing 100% electrocautery with an ultrasonic aspirator. These results suggest that 100% electrocautery with an ultrasonic aspirator, particularly in 100% CAVI-Pulse mode 1, resulted in less damage and trauma than conventional electrocautery during harvesting of the internal thoracic artery. (J T HORAC CARDIOVASC SURG 1996;111:1194-9

Prosthesis-patient mismatch after transcatheter aortic valve implantation with the Medtronic-Corevalve bioprosthesis

Aims: Prosthesis-patient mismatch (P-PM) is an important determinant of morbidity and mortality following open aortic valve replacement. The aims of this study were to report its incidence and determinants following transcatheter aortic valve implantation (TAVI) with the Corevalve bioprosthesis, which have—thus far—not been described. Methods and results: Patients with severe calcific aortic stenosis received TAVI with the Corevalve bioprosthesis via transfemoral route. Following TAVI, moderate P-PM was defined as indexed aortic valve effective orifice area (AVAi) ≤0.85 cm2/m2 and severe P-PM as AVAi ≤0.65 cm2/m2. Clinical, echocardiographic, and procedural factors relating to P-PM were studied. Optimal device position was defined on fluoroscopy as final position of the proximal aspect of the Corevalve stent frame 5–10 mm below the native aortic annulus. Between January 2007 and January 2009, 50 consecutive patients underwent TAVI in a single centre with the Corevalve bioprosthesis. Mean age was 82.8 years (SD 5.9; 70–93) and 48% were male. P-PM occurred in 16 of 50 cases (32%). Optimal position was achieved in 50% of cases. P-PM was unrelated to age, annulus size, LVOT size, Corevalve size, aortic angulation, ejection fraction, and sex. It was inversely correlated to optimal position (Spearman rho r = −0.34, P = 0.015). Those with optimal positioning had a 16% incidence of P-PM relative to 48% of those with suboptimal positioning (Pearson χ2P = 0.015). Conclusion: The incidence of P-PM following TAVI with the Corevalve bioprosthesis is compared favourably with that seen after AVR with conventional open stented bioprostheses and its occurrence is influenced by device positioning

Application of timberline morphometric analysis for detecting snow avalanche paths : a case study of the Tatra Mountains

The upper forest limit is principally controlled by climate factors, mainly temperature but locally also other factors, such as snow avalanches, debris flows, and wind throw. Therefore, the timberline course may be use as a proxy of these drivers. The aim of the study was to employ the morphometric features of the upper forest limit for remote detection of avalanche paths. We introduced the Morphometric Avalanche Index (MAI), which combine simple parameters such as: Perimeter Development, Altitudinal Difference, Elongation Ratio, Area, and the existence forest patches. This tool was tested in four valleys in the Tatra Mountains, wherein 103 known avalanche paths. The employment of MAI resulted in remote identification of 90% of avalanche paths existing and acknowledged in this region. Additionally 28 avalanche paths that had not been previously indicated as such were detected

Rapid river bed recovery after the in-channel mining : the case of Vistula River, Poland

The effects of in-channel wet-pit mining is nowadays widely discussed in terms of negative influence of the created pits on the river ecosystem and fluvial processes. The pits induce an alteration of natural flow or sediment transport. This paper describes the post-mining channel recovery observed in a relatively short time in a gravelly sand bed lowland river. The study was based on repeated bathymetry of the channel and grain size analyses of bed material taken from the mining area and its surrounding upstream and downstream pit. We also use calculations of possible bedload sediment movement in the studied river reach. We noticed that the excavation pit exceeded the maximum depth of 8.8 m in 2014 and, immediately after the end of mining, the bedload started to infill the pit. The bathymetric measurements in 2019 indicated that the process of pit infill was completed after five years, though the former pit is refilled with material finer than the natural bedload observed in the discussed river reach, and consists mainly of sand. The studied process of pit infilling runs continuously, even during the annual average water stages