The image of Japan in Ni d’Ève, ni d’Adam of Amélie Nothomb. Critical essay

The goal of this paper is to present the place of Japan in "Ni d’Ève, ni d’Adam" of Amélie Nothomb. The paper is focused on the experiences and observations of Nothomb about Japanese mentality, civilisation, culture and the clash of cultures which writer lived through during her stay in Japan. The analysis of her images of this Eastern country leads to show an ambiguous and subjective portrait of Japan, sometimes surprisingly stereotypical, where the admiration for Japan turns easily into a disappointment and the incomprehension of Japanese principles and mentality.The goal of this paper is to present the place of Japan in "Ni d’Ève, ni d’Adam" of Amélie Nothomb. The paper is focused on the experiences and observations of Nothomb about Japanese mentality, civilisation, culture and the clash of cultures which writer lived through during her stay in Japan. The analysis of her images of this Eastern country leads to show an ambiguous and subjective portrait of Japan, sometimes surprisingly stereotypical, where the admiration for Japan turns easily into a disappointment and the incomprehension of Japanese principles and mentality

The influence of atrioventricular and atrioventricular nodal re-entrant tachycardia on left ventricular systolic and diastolic function

Background: Incessant tachycardia may result in left ventricular (LV) systolic dysfunction. Little is known about the influence of atrioventricular tachycardia (AVRT) and atrioventricular nodal re-entrant tachycardia (AVNRT) on LV systolic and diastolic function. The aim of the study was to assess LV systolic and diastolic function and factors affecting LV systolic and diastolic performance in patients with AVRT and AVNRT. Material: The study group included 90 patients (40 male, 50 female, mean age 40 &#177; 12 years) with symptomatic narrow-QRS tachycardia. After an invasive electrophysiology study (EPS) had been performed, these were divided into two groups: one (AVNRT) of 25 patients with AVNRT and the other (WPW) of 65 patients with AVRT. The control group consisted of 50 healthy volunteers (23 male, 27 female, mean age 39 &#177; 13 years). In all three groups transthoracic echocardiography was performed in order to assess LV systolic and diastolic function. Results: LV fractional shortening (FS) (WPW: 32 &#177; 6%, AVNRT: 36 &#177; 4%, p < 0.005) and ejection fraction (EF) (WPW: 54 &#177; 7%, AVNRT: 55 &#177; 5%, p < 0.001) were significantly decreased in the study groups compared to the control group (FS: 40 &#177; 5%, EF: 62 &#177; 4%). FS was significantly increased in the AVNRT compared to the WPW patients (p < 0.005). LV diastolic dysfunction was found in 20 (80%) of the AVNRT and 55 (83%) of the WPW group and in none of the patients from the control group. A positive correlation was found between diastolic dysfunction and the scale of recurrence of AVRT (R = 0.67, p < 0.05) and AVNRT (R = 0.52, p < 0.05). Conclusions: AVNRT and AVRT may lead to development of LV systolic and diastolic dysfunction. LV diastolic dysfunction is related to the frequency of AVRT or AVNRT recurrence. (Cardiol J 2007; 14: 160-166

Treatment of iatrogenic iliac artery rupture during endovascular surgery

Recently a growing number of endovascular operations are associated with an increased number of iatrogenic vascular injuries. The aim of the study is to analyse the treatment of iliac artery damage during angioplasty. Method. In the period 2002&#8211;2009, 328 patients underwent endovascular surgery of iliac artery stenosis, 219 men and 109 women aged from 47 to 85 years. Qualified patients displayed IIB, III, and IV stage of ischaemia by Fontaine. The collected information concerned details of the performed procedures, possible complications and ways of solving problems. Results. In 132 cases, endovascular surgery consisted of extension of the iliac artery using a stent, while in 196 no stent was applied. Iatrogenic injury to the iliac artery during the angioplasty occurred in six patients. In four cases, there was damage to the common iliac artery, and in the next two patients to the external iliac artery. In four cases, there was damage to the artery during endovascular expansion, and in two cases after stent implantation. In four cases, the damage to the artery was treated by an endovascular method, in two patients a stent was implanted, in one patient a stent-graft was introduced, and in one case a spillage was sealed using a balloon. Two patients underwent classic surgery due to symptoms of hypovolaemic shock caused by bleeding into the retroperitoneal space; in one case arterial damage was sutured, and in the second patient an aortal-femoral bypass graft was implanted. Of the patients supplied by an intravascular method, in one case, because of the very large retroperitoneal haematoma and the compression symptoms associated with it, surgical drainage was necessary. In the remaining cases, the postoperative course passed without complications. Among the patients who underwent classic surgery there was one case of deep vein thrombosis. All patients achieved satisfactory haemodynamic and clinical effects. There were no deaths. Conclusions. 1. Each instance of iatrogenic iliac artery injury during endovascular surgery requires an individual approach. 2. An attempt to repair damage by an intravascular method is the treatment of choice in haemodynamically stable patients. 3. In cases of large retroperitoneal bleeding, patients require immediate conversion to classical surgery. Acta Angiol 2011; 17, 2: 150&#8211;157Wstęp. Rosnąca ostatnio liczba operacji wewnątrznaczyniowych wiąże się również ze zwiększoną liczbą jatrogennych uszkodzeń naczyń. Celem pracy jest analiza sposobu postępowania przy uszkodzeniach tętnic biodrowych w czasie angioplastyki. Materiał i metoda. W latach 2002&#8211;2009 operowano wewnątrznaczyniowo 328 chorych ze zwężeniami tętnic biodrowych, w tym 219 mężczyzn i 109 kobiet w wieku 47&#8211;85 lat. Do operacji kwalifikowano chorych w IIB, III i IV stadium niedokrwienia według klasyfikacji Fontaine&#8217;a. Zbierano informacje na temat szczegółów przeprowadzonych zabiegów, ewentualnych powikłań i sposobów rozwiązywania problemów. Wyniki. W 132 przypadkach wykonano poszerzenie wewnątrznaczyniowe tętnicy biodrowej ze stentem, zaś w 196 bez stentu. Do jatrogennego urazu tętnic biodrowych w miejscu przeprowadzanej angioplastyki doszło u 6 chorych. W 4 przypadkach stwierdzono uszkodzenie tętnicy biodrowej wspólnej, w kolejnych 2 &#8212; tętnicy biodrowej zewnętrznej. U 4 chorych do uszkodzenia tętnicy doszło podczas wewnątrznaczyniowego poszerzenia, zaś w 2 przypadkach po wszczepieniu stentu. U 4 chorych uszkodzenie tętnicy leczono metodą wewnątrznaczyniową, u 2 osób implantowano stent, u 1 pacjenta &#8212; stentgraft, zaś w 1 przypadku uszczelniono wyciek za pomocą balonu. Dwóch chorych ze względu na objawy wstrząsu hipowolemicznego spowodowanego krwawieniem do przestrzeni zaotrzewnowej operowano klasycznie, w jednym przypadku zszyto uszkodzenie tętnicy, zaś u drugiego chorego wszczepiono pomost aortalno-udowy. Spośród chorych zaopatrzonych metodą wewnątrznaczyniową w jednym przypadku ze względu na bardzo dużego krwiaka zaotrzewnowego i objawy uciskowe z nim związane konieczne było przeprowadzenie jego chirurgicznego drenażu. U pozostałych przebieg pooperacyjny upłynął bez powikłań. Wśród operowanych klasycznie u 1 chorego stwierdzono zakrzepicę żył głębokich. U wszystkich pacjentów uzyskano zadowalający efekt hemodynamiczny i kliniczny. Nie zanotowano zgonów. Wnioski. 1. Każdy przypadek jatrogennego urazu tętnicy biodrowej podczas operacji wewnątrznaczyniowej wymaga indywidualnego podejścia. 2. Próba wewnątrznaczyniowej naprawy uszkodzenia jest postępowaniem z wyboru u chorych w stanie stabilnym hemodynamicznie. 3. W przypadku dużych krwawień do przestrzeni zaotrzewnowej konieczne jest natychmiastowe przeprowadzenie operacji klasycznej. Acta Angiol 2011; 17, 2: 150&#8211;15

Implementation of distance technologies in Euro-Asian universities during the COVID-19 pandemic

The authors of the chapter Implementation of distance technologies in Euro- Asian universities during the COVID-19 pandemic are Sergey Kokhan, Ariunsanaa Byambaa, Elena Romanova, Batbaatar Gunchin and Witold Kowalski. The aim of the study is to conduct a comparative analysis of the organization of the transition to the distance education (DE) during the coronavirus period in the universities of Mongolia and Russia and to identify problems that need to be addressed by the administration of universities and academic teaching staff. The study object are students of the Mongolian National University of Medical Sciences (MNUMS, Mongolia) and Trans-Baikal State University (TBSU, Russia). The main research method was questioning. The total number of respondents was 271 people. The research carried out at the universities in Mongolia and Russia showed a certain difference in approaches to solving alternative problems which were connected with the transition to DE and the identification of problems among students of the two countries. In the period of pandemic, the transition from the traditional system to DE was the only correct way to save education all over the world. Nevertheless, the emergency transition showed both its positive aspects and the problems of the system. It is possible to solve these problems but they can only be solved with the interaction of all interested sides, starting with state level, the administration of universities, the teaching staff, and ending with student youth, the consumers of DE.Collection name: LIBRARY "PEDAGOGICAL THEORY AND PRACTICE" 5

Wpływ nawrotnego częstoskurczu przedsionkowo-komorowego i przedsionkowo-komorowego węzłowego na funkcję skurczową i rozkurczową lewej komory

Wstęp: Przewlekła tachykardia może prowadzi&#230; do zaburzeń funkcji skurczowej lewej komory (LV). Niewiele jest doniesień na temat wpływu nawrotnego częstoskurczu przedsionkowo-komorowego (AVRT) i przedsionkowo-komorowego węzłowego (AVNRT) na czynność skurczową i rozkurczową LV. Celem pracy była ocena występowania zaburzeń funkcji skurczowej i rozkurczowej LV oraz czynników wpływających na dysfunkcję skurczową i rozkurczową LV u chorych z AVRT i AVNRT. Materiał: Analizie prospektywnej poddano 90 chorych (40 M, 50 K, średni wiek 40 &#177; 12 lat) z objawowym częstoskurczem z wąskimi zespołami QRS, u których w inwazyjnym badaniu elektrofizjologicznym stwierdzono rozszczepienie łącza przedsionkowo-komorowego i stymulowano AVNRT (grupa AVNRT, n = 25) oraz zespół preekscytacji i stymulowano AVRT (grupa WPW, n = 65). Grupę kontrolną stanowiło 50 zdrowych ochotników (23 M, 27 K, średni wiek 39 &#177; 13 lat). W grupach badanych i kontrolnej wykonano przezklatkowe badanie echokardiograficzne z oceną parametrów funkcji skurczowej i rozkurczowej LV. Wyniki: W grupach badanych stwierdzono istotnie niższe wartości frakcji skracania (FS) (WPW 32 &#177; 6%, AVNRT 36 &#177; 4%, p < 0,005) i frakcji wyrzutowej (EF) (WPW 54 &#177; 7%, AVNRT 55 &#177; 5%, p < 0,001) w porównaniu z grupą kontrolną (FS 40 &#177; 5%, EF 62 &#177; 4%) oraz istotnie niższą FS u chorych z WPW niż AVNRT (p < 0,005). Zaburzenia funkcji rozkurczowej LV stwierdzono u 20 (80%) chorych z AVNRT i u 55 (83%) pacjentów z WPW. Skala często&#339;ci powtarzania epizodów częstoskurczu dodatnio korelowała ze stopniem dysfunkcji rozkurczowej w obu grupach badanych (AVRT: R = 0,67, AVRT: R = 0,52; p < 0,05). Wnioski: AVNRT i AVRT prowadzą do rozwoju zaburzeń funkcji skurczowej i rozkurczowej lewej komory. Im częściej występują epizody AVRT lub AVNRT, tym większy jest stopień zaburzeń czynności rozkurczowej lewej komory. (Folia Cardiologica Excerpta 2007; 2: 113-119

Influence of percutaneous pulmonary valve implantation on exercise capacity: Which group of patients benefits most from the intervention?

Background: The aim of the study was to evaluate the role of cardiopulmonary exercise testing (CPET) parameters in assessing exercise capacity improvement after percutaneous pulmonary valve implantation (PPVI). Additionally, it aimed to determine if there are any baseline characteristics influencing that change. Methods and results: The study comprised 32 patients (mean age 26 ± 9); 53% males; diagnosis: tetralogy of Fallot (n = 18), pulmonary atresia (n = 6), Ross procedure (n = 4), other (transposition of great arteries, pulmonary stenosis, double outlet right ventricle, common arterial trunk type II — n = 4) who underwent successful PPVI due to right ventricular out­flow tract dysfunction (predominant pulmonary regurgitation — n = 17, predominant pulmo­nary stenosis — n = 15). Treadmill CPET was performed before and a year after PPVI along with clinical evaluation, cardiac magnetic resonance and transthoracic echocardiography. Twelve months post successful PPVI (pulmonary valve competence restoration and pulmonary gradient reduction from 58.8 ± 47.1 to 26.6 ± 10.8 mm Hg) there was a significant decrease in the ventilatory equivalent for CO2 at peak exercise (EQCO2) (25.3 ± 3.3 to 24.3 ± 3.0, p = 0.04) and oxygen consumption at peak exercise (pVO2) (20.4 ± 5.0 to 22.6 ± 5.3 mL/kg/min, p = 0.04). Improved EQCO2 correlated with an increase in right and left ventricular ejection fraction (respectively R = –0.57, p = 0.002; R = –0.56, p = 0.002). In this study, no baseline factors that might affect improvement in exercise function were found. Conclusions: Successful PPVI leads to an improvement in exercise capacity and hemodynamic response to exercise. The correlation between the improvement in EQCO2 or peak VO2 and baseline characteristics was too weak to reliably identify the group of patients that will benefit from the procedur

Analiza metod diagnostycznych wycieku z brodawki sutkowej u pacjentek poddanych leczeniu operacyjnemu

Background: Spontaneous, one-ductal nipple discharge can be a symptom of intraductal breast hyperplasia. The aim of this study was to assess nipple discharge diagnostic methods and the established diagnostictherapeutic rules in these cases. Material/Methods: 81 women (18-79 years old) were examined at the RCO in Bydgoszcz. Each patient underwent a clinical medical examination, USG, mammography (for patients > 35 years old), galactography, and cytological examination o f nipple discharge. We analyzed the results o f these methods and compared them with histopathological results of operated patients. Results: In 20 of the 81 cases, breast changes were palpable. These could be visualized in 39/81 cases using USG and in 12/73 using mammography. Using galactography, we had diagnostic results in 78/81 cases, the most common symptom being a "filling” defect.. We found 54 papilloma intraductale and 4 carcinoma cases. Conclusions: Galactography is an indispensable diagnostic method in nipple discharge. The main cause of nipple discharge is papilloma