66 research outputs found
Difficult-to-treat asthma and dysphagia in an adult patient with aberrant right subclavian artery
Prof. Maria Jaczynowska – wybitna badaczka świata starożytnego
Professor Maria Jaczynowska – the eminent historian of Ancient World (Summary) The article is a profile of Professor Maria Jaczynowska (1928–2008), one of the most outstanding Polish historians of Antiquity. It includes an outline of the personal and academic life of the Professor and a more in-depth analysis of her achievements in the field of epigraphic research. It also presents her as an author of academic textbooks, which were very popular with students for many decades. Professor Jaczynowska, who graduated from the University of Warsaw, was associated with the Nicolaus Copernicus University in Toruń for most of her professional life. It was here that she built, from the ground up, the Department of Ancient History in the Institute of History and Archival Sciences. Her research interests were varied and included such problems as the social history of the Roman Republic and the early Empire, organisations gathering Roman youths, and Roman religions. Many of her articles were published in the most prestigious European history magazines. Les associations de la jeunesse romaine sous le Haut-Empire (1978), Le culte de l’Hercule romain au temps du Haut-Empire,ANRW II 17. 1 (1981), and Religie świata rzymskiego (1987, 1990) are among her most quoted works. The article was written for the sixth anniversary of Professor Jaczynowska’s death
Current practice of care for adolescent and adult patients after Fontan surgery in Poland: Heart transplantation
Patient out of control: diagnostic and treatment dilemmas in Loeys-Dietz syndrome
Zespół Loeysa-Dietza (LDS) opisany po raz pierwszy w 2005 roku jest wrodzoną wieloukładową chorobą tkanki łącznej o agresywnym przebiegu. Najczęstsze są objawy naczyniowe, takie jak rozległe tętniaki i rozwarstwienia tętnic w młodym wieku. Diagnoza stawiana jest na podstawie wyników badań molekularnych i tomografii komputerowej, jednak nadal nie istnieją specyficzne kryteria diagnostyczne. Podobieństwo objawów klinicznych do innych zaburzeń tkanki łącznej skutkuje zbyt małą rozpoznawalnością LDS. Praca przedstawia historię 20-miesięcznego chłopca przyjętego do naszej kliniki z powodu niewydolności krążenia. Przeprowadzone badania wykazały poszerzenie aorty wstępującej i niedomykalność zastawki aortalnej, z powodu których podjęto decyzje o wymianie aorty wstępującej i zastawki aortalnej. 7 lat po zabiegu stan zdrowia chłopca uległ znacznemu pogorszeniu. W angiografii tomografii komputerowej rozpoznano masywnego tętniaka łuku aorty (8 cm), liczne tętniaki aorty piersiowej i stwierdzono krętość naczyń. Na podstawie charakterystycznego obrazu klinicznego rozpoznano LDS. Ze względu na mnogość tętniaków pacjent został zdyskwalifikowany z dalszego leczenia operacyjnego. LDS charakteryzuje się agresywnym przebiegiem naczyniowym. U tych chorych kluczowe znaczenie mają wczesna diagnostyka, profilaktyczna operacja aorty i leczenie farmakologiczne dające jedyną możliwość przedłużenia życia.Loeys-Dietz syndrome (LDS) first identified in 2005 is an aggressive congenital disorder of connective tissue characterized by multisystemic involvement (hypertelorism, and bifid/broad uvula or cleft palate). The most common features are vascular manifestations such as widespread arterial aneurysms and dissection in a young age. The diagnosis is confirmed by a molecular test and Computed Tomography but no specific diagnostic criteria exist. The similarity of clinical manifestations to other connective tissue disorders may be associated with poor recognition of LDS. The patient is a 20-month-old boy who was admitted to our clinic presenting circulatory failure. Tests revealed dilated ascending aorta and aortic valve regurgitation, because of which ascending aorta and aortic valve replacement was performed. 7 years later his health state deteriorated significantly. Computed tomography angiography revealed massive aneurysm of the aortic arch (8 cm), multiple thoracic aortic aneurysms and vascular tortuosity. Based on significant clinical image LDS was diagnosed. Due to multiplicity of aneurysms the patient was disqualified for any further surgical treatment. LDS is characterized by an aggressive vascular course. Early diagnosis, prophylactic surgery of the aorta and pharmacological treatment are recommended in these patients as the only possibility to prolong their lives
Immediate and long-term outcomes of percutaneous transcatheter pulmonary valve implantation
Background: Transcutaneous pulmonary valve replacement (TPVR) has become an alternative to heart surgery for patients after previous right ventricular outflow tract (RVOT) or pulmonary artery (PA) surgical interventions. The objective was to present immediate and long-term outcomes of trans¬cutaneous pulmonary valve replacement.
Methods: Between 06/2009 and 06/2016, 46 patients underwent TPVR. Initial diagnoses included tetralogy of Fallot, common arterial trunk, transposition of great arteries post Rastelli correction, left ventricle outflow obstruction after Ross operation, pulmonary atresia, and isolated dysplastic pulmonary valve stenosis. Thirty eight (78%) patients had previously implanted conduits in the pulmonary position, the rest had either RVOT patch reconstruction (n = 6; 13%) or biological valve implantation (n = 2; 4%). They presented primarily with pulmonary stenosis (n = 18; 39%) or regurgitation (n = 28; 60%).
Results: All procedures were successful — 44 Melody and 2 Edwards-Sapien valves were implanted. Before each procedure exclusion of potential coronary compression and RVOT prestenting was performed. Significant RVOT systolic gradient reduction (from 35.3 ± 19.5 to 13.5 ± 7.1 mm Hg; p < 0.001) and decrease of right to left ventricle systolic pressure ratio from 0.58 ± 0.18 to mean 0.37 ± 0.1 (p < 0.001) was achieved. Also, in every patient PA-RVOT competence was restored, with minor in¬competence in only a few patients. Post procedure follow-up ranged from 2 to 86 (mean 35.2) months. Follow-up fluoroscopy or chest X-ray revealed 6 stent fractures (2 stent defragmentation — with only 1 significant valve stenosis).
Conclusions: Transcutaneous pulmonary valve replacement is a safe procedure with encouraging results, it also enables deferring surgical reintervention in the majority of patients
Blood flow rate estimation in optic disc capillaries and vessels using Doppler optical coherence tomography with 3D fast phase unwrapping
The retinal volumetric flow rate contains useful information not only for ophthalmology but also for the diagnosis of common civilization diseases such as diabetes, Alzheimer's disease, or cerebrovascular diseases. Non-invasive optical methods for quantitative flow assessment, such as Doppler optical coherence tomography (OCT), have certain limitations. One is the phase wrapping that makes simultaneous calculations of the flow in all human retinal vessels impossible due to a very large span of flow velocities. We demonstrate that three-dimensional Doppler OCT combined with three-dimensional four Fourier transform fast phase unwrapping (3D 4FT FPU) allows for the calculation of the volumetric blood flow rate in real-time by the implementation of the algorithms in a graphics processing unit (GPU). The additive character of the flow at the furcations is proven using a microfluidic device with controlled flow rates as well as in the retinal veins bifurcations imaged in the optic disc area of five healthy volunteers. We show values of blood flow rates calculated for retinal capillaries and vessels with diameters in the range of 12-150 µm. The potential of quantitative measurement of retinal blood flow volume includes noninvasive detection of carotid artery stenosis or occlusion, measuring vascular reactivity and evaluation of vessel wall stiffness
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