MONITOROWANIE HODOWLI KOMÓRKOWYCH W CZASIE RZECZYWISTYM PRZY ZASTOSOWANIU NIKLOWYCH KONDENSATORÓW GRZEBIENIOWYCH

The aim of the study was to present a method for assessing the condition of cell culture by measuring the impedance of cells cultured in the presence of nickel. For this purpose, an impedance measurement technique using nickel comb capacitors was used. The capacitor electrodes were made using a thin film magnetron sputtering. In the experimental part, the culture of cells of mouse fibroblasts on the prepared substrate was performed. The cell culture lasted 43 hours and showed that the presented technique allows it to be used to analyze the effect of nickel on cells.Celem pracy było przedstawienie metody oceny stanu hodowli komórkowej poprzez pomiar impedancji komórek hodowanych w obecności niklu. W tym celu zastosowano technikę pomiaru impedancji z wykorzystaniem niklowych kondensatorów grzebieniowych. Cienkowarstwowe elektrody kondensatora wykonano metodą rozpylania magnetronowego. W części eksperymentalnej przeprowadzono hodowlę komórek mysich fibroblastów na przygotowanym podłożu. Hodowla komórkowa trwała 43 godziny i wykazała, że przedstawiona technika mogłaby być zastosowana do analizy wpływu niklu na komórki

Nonunion of ulnar diaphysis after Monteggia fracture of a right forearm in a 55-year-old patient - Are all methods effective? Case report

Fractures of the forearm make up about 10-14% of all fractures. Monteggia lesions account for 1-6% of the forearm fractures. The eponym “Monteggia fracture” is a term used for fracture of ulnar proximal shaft with concomitant dislocation of the radial head in the proximal radioulnar joint [1]. Its clinical symptoms are: pain, edema, local sensitivity, friction between bone fragments, deformation of the limb, loss of function in elbow joint and the forearm. Radiographs in AP and lateral views of the entire forearm, with wrist and elbow joint, are mandatory for successful diagnosis [2]. There are four types of fractures in the Bado classification system of the Monteggia lesion [3]. All Monteggia fractures in adults require surgical procedure of open reduction and internal fixation as a method of choice [4]. Delayed bone adhesion, nonunion, synostosis, instability of the radial head, nerve damage and restriction of movement are main complications of surgical intervention. We present a case of a 55-year-old patient with Monteggia fracture of a right forearm with a complication of a nonunion of the ulnar shaft, despite undergoing surgical procedure of open reduction and internal fixation. We describe consecutive methods of treatment that resulted in complete bone adhesion. Nonunion typically occurs due to technical mistakes in initial surgical intervention. Application of the correct reparative technique with autogenous bone graft and compression plates allows to fully heal nonunion of the bone

Early, posttraumatic, frontal instability of the knee joint deriving from injured medial collateral ligament, after total knee arthroplasty, complicated by wound dehiscence and Clostridium difficile infection in a 70-year-old patient

Gonarthrosis is a joint disease in which a balance between regenerative and degenerative processes of articular cartilage is impaired. Its main symptoms are: pain, swelling, rigidity, function restraint as well as articular deformation [1]. It is estimated that about 40% of the knee joint degeneration is a consequence of ageing of the body. 60% of remaining cases of gonarthrosis is a result of excessive strain, contusion and injury. Patients with advanced arthrosis are qualified for total arthroplasty of the knee. Medial collateral ligament (MCL) is responsible for the medial stability of the knee joint, it prevents from valgus deformity and restraints external rotation of tibia relative to the femur. Injury, most often distorting the knee, may lead to straining as well as complete rupture of the MCL [2,3]. We present a case of a 70-year-old patient with MCL injury that happened three weeks after total knee arthroplasty, complicated by wound dehiscence. Insufficiency of the medial collateral ligament in our patient had an effect in longer healing process and rehabilitation. Main treatment options are: revision surgery with use of constrained implants and injured medial collateral ligament reconstruction. Constrained implants may have reduced longevity in some patients through aseptic loosening. Our patient underwent a MCL reconstruction. Reconstruction of MCL without revision arthroplasty has good results for injured MCL after total arthroplasty of the knee

Pilon fracture of the tibia with severe complications in a 42-year-old patient – case report.

Pilon type fractures of the distal tibia are among the most difficult injuries of the lower extremity. They occur due to the axial loading injury which drives the talus into the tibial plafond, mainly because of high energy traumas such as car accidents and falls, but may arise from low energy traumas also. Due to specific conditions in the area of the injury: where skin and subcutaneous tissue is delicate, soft tissues are usually severely damaged, it is crucial to choose the correct timing for surgical intervention. There are several surgical options regarding treatment of the pilon fractures, however treatment plan of pilon fractures has not yet been unified. Surgical methods include open reduction with internal fixation and external fixation. Main purpose of the treatment of pilon fractures are the preservation of length and restoration of the joint surfaces. Great risks for the successful treatment are skin and soft tissue infections, that occur quite commonly due to specific anatomy of the fractured area. Wound infection may have potentially catastrophic consequences. Here we present a case of our 42-year-old patient, with a pilon fracture of the tibia who suffered multiple complications due to obtained tauma as well as his concurrent diseases: diabetes, alcohol and nicotine abuse, also as a result of his lack of compliance with medical advice. Despite the complications that occurred, outcome of the overall treatment was satisfactory both to the patient as well as orthopedic team. This example shows that treatment method should be chosen wisely not only on the type of the fracture, but also with patient’s ability to comply with doctors’ recommendation

Nutritional Deficiencies in Radiotherapy-Treated Head and Neck Cancer Patients

Nutritional deficiencies (malnutrition, cachexia, sarcopenia, and unfavorable changes in the body composition) developing as a side effect of radiotherapy (RT) currently represents a significant but still inaccurately studied clinical problem in cancer patients. The incidence of malnutrition observed in head and neck cancer (HNC) patients in oncological radiology departments can reach 80%. The presence of malnutrition, sarcopenia, and cachexia is associated with an unfavorable prognosis of the disease, higher mortality, and deterioration of the quality of life. Therefore, it is necessary to identify patients with a high risk of both metabolic syndromes. However, the number of studies investigating potential predictive markers for the mentioned purposes is still significantly limited. This literature review summarizes the incidence of nutritional deficiencies in HNC patients prior to therapy and after the commencement of RT, and presents recent perspectives for the prediction of unfavorable nutritional changes developing as a result of applied RT

Rola adipokin w zespole metabolicznym, nadwadze i otyłości – praca przeglądowa

Otyłość typu wisceralnego i towarzyszący jej przewlekły stan zapalny to najpoważniejsze przyczyny chorób serca i naczyń, tak w Polsce jak i w innych krajach wysoko uprzemysłowionych. Trzewna tkanka tłuszczowa wykazuje znacznie zwiększoną aktywność metaboliczną i wydziela w tym stanie szereg substancji humoralnych oraz cytokin (adipokin), które inicjują, wzmacniają oraz przyspieszają rozwój wielu zaburzeń metabolicznych, wśród których wymienić należy głównie zaburzenia lipidowe, nieprawidłowe stężenie glukozy czy też nadciśnienie. Wszystkie wymienione zaburzenia w połączeniu z otyłością wisceralną tworzą zespół metaboliczny. W odpowiedzi na niestabilny poziom glukozy oraz podwyższone stężenie insuliny we krwi adipocyty wydzielają m.in. adipokiny (np. leptynę, adiponektynę, wisfatynę, rezystynę), które mogą przyczyniać się do nasilenia insulinooporności tkanek albo też przeciwnie, zwiększania tolerancji glukozy i insulinowrażliwości. Celem pracy jest zidentyfikowanie korelacji pomiędzy poziomem poszczególnych adipokin, a indukcją lub inhibicją schorzeń powiązanych z zespołem metabolicznym, otyłością wisceralną i nadwagą

Clinical Significance of TNFRSF1A36T/C Polymorphism in Cachectic Patients with Chronic Heart Failure

Introduction: One of the main factors contributing to the development of nutritional deficits in chronic heart failure (CHF) patients is the systemic inflammatory process. Progressing inflammatory response leads to exacerbation of the disease and could develop into cardiac cachexia (CC), characterized by involuntary weight loss followed by muscle wasting. The aim of this study was to assess the relationship between rs767455 (36 T/C) of the TNFRSF1A and the occurrence of nutritional disorders in CHF patients with cachexia. Materials and Methods: We enrolled 142 CHF individuals who underwent cardiac and nutritional screening in order to assess cardiac performance and nutritional status. The relationship between TNFRSF1A rs767455 genotypes and patients’ features was investigated. Results: A greater distribution of the TT genotype among cachectic patients in contrast to non-cachectic individuals was found (TT frequencies of 62.9% and 37.1%, respectively; p = 0.013). We noted a significantly lower albumin concentration (p = 0.039) and higher C-reactive protein (CRP) levels (p = 0.019) in patients with the TT genotype. Regarding cardiac parameters, CHF individuals bearing the TT genotype demonstrated a significant reduction in ejection fraction (EF) (p = 0.033) in contrast to other genotype carriers; moreover, they had a significantly higher concentration of N-terminal prohormone of brain natriuretic peptide (NT-proBNP) in the blood (p = 0.018). We also noted a lower frequency of TT genotype carriers among individuals qualified as grades I or II of the New York Heart Association (NYHA) (p = 0.006). The multivariable analysis selected the TT genotype as an unfavorable factor related to a higher chance of cachexia in CHF patients (Odds ratio (OR) = 2.56; p = 0.036). Conclusions: The rs767455TT genotype of TNFRSF1A can be considered as an unfavorable factor related to a higher risk of cachexia in CHF patients

Otyłość chorobą XXI wieku. Najważniejsze czynniki ryzyka – praca przeglądowa

Otyłość jest powszechnie uznawana za wieloczynnikową, przewlekłą chorobę, której występowanie wzrasta w ostatnich latach w zastraszającym tempie. Na podstawie badań Światowej Organizacji Zdrowia (WHO) w 2008 roku 1,4 miliarda osób dorosłych posiadało nadwagę. Spośród tych osób, ponad 200 milionów mężczyzn i ponad 300 milionów kobiet to ludzie otyli. W 2011 roku ponad 40 milionów dzieci powyżej piątego roku życia miało nadwagę. Otyłość wiąże się ze zwiększonym ryzykiem występowania wielu chorób, takich jak choroby serca, nadciśnienie, hiperlipidemia, cukrzyca typu 2 i niektóre nowotwory. Wysoka częstotliwość występowania nadwagi i otyłości wśród dzieci i dorosłych jest przede wszystkim wynikiem indywidualnych zachowań i czynników środowiskowych prowadzących do nadmiernego dostarczania kalorii i nieodpowiedniej ilości aktywności fizycznej. Otyłość jest zazwyczaj wynikiem kombinacji różnych czynników ryzyka, takich jak uwarunkowania genetyczne, brak aktywności fizycznej, dieta, wiek, problemy zdrowotne, przyjmowane leki, czy zmęczenie. Celami pracy jest przedstawienie aktualnej wiedzy na temat tendencji zachorowalności na otyłość oraz przeanalizowanie czynników ryzyka wpływających na występowanie tej choroby

Capacitance of Membrane As a Prognostic Indicator of Survival in Head and Neck Cancer.

Evaluation of prognostic value of capacitance of membrane (Cm), parameter measured by bioelectrical impedance (BIA) as an alternative to known clinical factors in patients with Head and Neck Cancer (HNC).A cohort of 75 stage IIIB and IV HNC patients treated in Department of Otolaryngology, Head and Neck Surgery, Medical University of Lublin, Poland were prospectively evaluated. Cm measurements were performed in all patients using a bioelectrical impedance analyzer that was set on a frequency of 50 kHz. Results of Cm measurements were presented in nF. Survival differences were estimated using Kaplan-Meier method.Significantly higher Cm median was noted in well-nourished(n = 45) compared to malnourished (n = 30) patients (1.41 vs 1.01 respectively; p = 0.0009). Established in ROC curves analysis cut-off value (0.743) was characterized by 98% specificity and 37% sensitivity in the detection of malnutrition. Median overall survival (mOS) in the cohort was 32months. At the time of analysis deaths were recorded in 47 cases (62.7%). In patients who had Cm below the level of 0.743 risk of OS shortening was significantly higher than in other patients (12.1 and 43.4 months respectively; HR = 8.47, 95%CI: 2.91-24.66; χ2 = 15.38, p = 0.0001).Cm is a strong, independent prognostic factor in head and neck cancer