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Biomedical subjects

A Wysocki

Publications and source records attributed to A Wysocki.

At least 19 recordsLinked to original sources
PubMed2000

Perforated gastric ulcer.

BACKGROUND/AIMS: Reports about perforated gastric ulcer are scarce and thus it is difficult to settle for a uniform model of operative management. The purpose of the study was to review our experience with perforated gastric ulcer and evaluate the results of gastric resection vs. oversewing of the perforation. METHODS: Within 36 years 77 patients with peritonitis caused by histologically confirmed perforated gastric ulcer were operated. Furthermore, in another 7 microscopic examination revealed that perforation occurred within the gastric cancer. There were twice as many male as female patients. RESULTS: Recently, the overall postoperative mortality (20. 8%) tended to decrease markedly. 32 patients (mean age 49.9 years) were submitted to gastric resection and this procedure was associated with 2.9% mortality. All 3 subjects in whom vagotomy, pyloroplasty and wedge resection of the ulcer had been performed survived. In 40 patients (mean age 61.5 years) only a suture of the ulcer was performed. This procedure was associated with high mortality (1/3 of patients died). Selection criteria included poor general medical status, age, comorbidities, and substantial progression of the inflammatory process. CONCLUSION: Authors believe that emergency gastrectomy is a safe procedure; however, it might be performed without excessive operative risk in only half of the patients.

Adult↗
PubMed1999

Laparoscopic cholecystectomy and gallbladder cancer.

BACKGROUND: This study was designed to assess the treatment of patients in whom gallbladder cancer was diagnosed in the course of histological examination of their gallbladders, which were removed during laparoscopic cholecystectomy. METHODS: Six (0.29%) cancers were found among 2,017 patients who underwent laparoscopic cholecystectomy. Four of these cancers (0.22%) were in 1,831 gallbladders with normal walls, two (1.0%) were in 186 with thicker walls, and two (1.8%) were in 109 patients in whom conversion was necessary because of extensive inflammation and thickening of gallbladder wall. RESULTS: In two cases, the cancer did not cross the muscular layer. In one of them, no further treatment was undertaken. In the second case, liver resection and lymphadenectomy was performed. In the other four cases, dissemination was diagnosed during laparotomy, precluding radical treatment. CONCLUSIONS: Thickened and infiltrated gallbladder walls in patients without preoperative symptoms of cholecystitis should raise a suspicion of cancer. The surgeon should be prepared to perform a conversion, an intraoperative histological examination, and an appropriate radical operation, if necessary.

Aged↗
PubMed1999

[Seasonal periodicity of perforated peptic ulcers].

The aim of the study was to evaluate if the frequency of peptic ulcer perforation depends on the changes of seasons. The investigation was carried out in mountain region of Nowosadecki District. This complication of peptic ulcer disease appeared with constant time trend in the years 1991-95. Considering the whole five year period, the increasing number of new cases was observed on the turn of spring and summer (May, June, July) and in early autumn (September, October). Another pattern of seasonal periodicity is often observed in different regions of the world. Because of that, it may be assumed that not changes of seasons but different environmental factors (also weather changes) may influence the frequency of peptic ulcer perforation.

Duodenal Ulcer↗
PubMed1999

[Splenic abscess].

Splenic abscess consists a very rare pathology. There were less than 300 cases described in the literature in the last 10 years. We report a case of 68 year old women with the splenic abscess with a history of blunt trauma of the left side chest wall two years earlier. The diagnosis was confirmed by USG and CT. The patient underwent splenectomy. The post operative course was uneventful.

Abscess↗
PubMed1999

[Unusual complication in the course of acute pancreatitis].

Rare neurological complication in course of severe acute pancreatitis was described. A 38-year old woman developed Multiple Organ Dysfunction Syndrome ((MODS) and neurological complications such as transient encephalopathy and polineuropathy in a form of tetraplegy.

Acute Disease↗
PubMed1999

[Determination of blood cell count and spleen size in patients with liver cirrhosis submitted to endoscopic sclerotherapy for esophageal varices].

Each of the 24 patients with bleeding oesophageal varices related to the liver cirrhosis was submitted to 3-12 endoscopic sclerotherapies. During one year of follow-up blood cell counts including erythrocytes, white blood cell, neutorophiles and platelets, the size of spleen on ultrasound were assessed. After a year we noticed marked, statistically significant decline in white blood cells, neutrophiles and platelets counts. The size of the spleen remained unchanged. We may conclude that repeated sclerotherapy of oesophageal varices does not contribute to the rise in blood pressure within the portal system while decrease in blood cells count might be attributed to deterioration of the liver function.

Blood Cell Count↗
PubMed1999

[Neuromas of the extrahepatic bile ducts].

Authors collected three cases of neuromas situated in the wall of extrahepatic bile ducts, which occluded lumen and caused jaundice. In two cases without any evidence of previous surgery or cholelithiasis, neuroma was localized in ductus choledochus. After excision of ductus choledochus and cholecystectomy, we performed hepaticojejunostomy Roux--en Y. In the last patient, 7 years after cholecystectomy, neuroma localized in hepatic duct was treated by T-tube. In all patients with mechanical jaundice, before operation we had never correctly diagnosed this very rare cause of obstruction of extrahepatic bile ducts.

Adult↗
PubMed1998

[Splenomegaly and plasma lipids].

UNLABELLED: Lipid metabolism is influenced by several factors, among them the spleen is supposed to play some spleen. It has been noticed that in the asplenia the level of the triglycerides is raised. On the other hand the patients with myeloproliferative process and splenomegaly have lower level of serum lipids compared with the general population. The aim of this clinical study was to estimate the level of: total cholesterol (TC), HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C), and triglycerides (TG), in group I which consisted of 17 patients with splenomegaly, which had developed during portal hypertension caused by liver cirrhosis, and group II 7 patients with splenomegaly caused by myeloproliferative disease. These patients were compared with the control group III of 25 patients without evidences of metabolism disturbances or splenomegaly. There were no statistically significant differences of the mean values of: TC, HDL-C, LDL-C, and TG between groups I and II. The levels of all serum lipids were lower in the patients with splenomegaly (groups I, II) irrespective of causal factor, compared with the control group III. CONCLUSION: The changes in the serum lipids in the patients with splenomegaly indicate the potential role which the spleen can play the spleen in the lipid metabolism.

Adult↗
PubMed1998

[Sclerotherapy of single non-parasitic liver cyst].

Single, non-parasitic liver cysts, usually asymptomatic, accidental finding during ultrasound examination require treatment only if they attain larger diameter and upper right quadrant symptoms could not be explained by other pathology. Treatment options include surgical enucleation, open or laparoscopic unroofing or percutaneous emptying usually associated with injection of sclerotising agent. From May 1995 to June 1997 10 patients with single, symptomatic, non-parasitic cysts of the liver were treated at the 2nd Department of General Surgery, Collegium Medicum of Jagiellonian University. Ultrasound and gastroscopy excluded other pathology of upper GI tract that might be responsible for the symptoms. Under ultrasound guidance samples of cysts content were collected for cytology, bilirubin concentration and bacteriology. Injection of the contrast medium revealed no contact of the cyst's cavity with the biliary tree. 5 patients were excluded from the protocol due to leakage of contrast in to fee peritoneal cavity. Other 5 were submitted to sclerotherapy by injection of 95% ethanol after introduction of fine drain into the cyst's cavity under ultrasound guidance; in two patients procedure was performed once, in two twice and in one tree times. In 4 patients complete or nearly complete resolution of symptoms was achieved, in one with big cyst treatment failed. We observed no complication. Owing to satisfying results we may conclude that this minimally invasive method might be attempted before more aggressive treatment would be employed.

Adult↗
PubMed1998

[The effect of surgical trauma on the level of plasma iron].

UNLABELLED: The serum iron level drops in many diseases and after bone fractures or elective surgical operations. The aim of this study was to determine if the degree of stress hypoferremia depends on severity of the operation. Serum iron concentration and TIBC was measured during two weeks in 37 patients. The first group consisted of 29 patients operated for ingunal hernia or cholelithiasis. It was laparoscopic cholecystectomy or classical or laparoscopic hernia repair. These types of operations were considered as mild surgical stress. The second group consisted of 8 patients with colon cancer, who had segmental colon resection. This operation was considered as severe surgical stress. The patients with colon cancer had significantly lower preoperative serum iron level. After operations, profound but temporal drop in serum iron concentration was observed in both groups of patients. TIBC drops but not so significantly. The diagrams illustrating changes of iron concentration after operations looked similar in both groups. CONCLUSION: The changes of iron concentration after abdominal operations are independent of the severity of surgical stress.

Adolescent↗
PubMed1998

[Primary peritoneal mesothelioma--report of two cases].

We report two cases of primary peritoneal mesothelioma. In both of them contact with asbestos was negative. In the first case the patient was hospitalized in another hospital five years earlier. The performed USG and CT of the abdomen revealed the tumor near the spleen. But then the patient was not operated. In the second case the symptoms lasted for several months. In both cases the tumors were nonoperative because of the advanced malignant process.

Abdomen↗
PubMed1998

[Mortality in perforated duodenal ulcer in 35 years of experience].

UNLABELLED: The analysis of mortality rate during 35 years was the purpose of this paper. 572 person with diffuse peritonitis due to perforated duodenal ulcer were operated on in a period of years 1962-1996. Most patients were treated definitively (most frequent operation was the truncal vagotomy with pyloroplasty, then vagotomy and antrectomy, and exceptionally--gastric resection). Only in case of elderly patients, with coexisting serious diseases and advanced purulent peritonitis, or very young patients without previous digestive complains--the surgery was limited to a simple closure or only pyloroplasty (107 = 18.7%). 62 person died after the operation, that means that a general mortality rate was 10.9%. In vagotomy pyloroplasty group, the mortality rate was 2.9%, and after vagotomy with antrectomy or resection, the mortality rate reached 3.4%. In a group of patients younger than 50, 0.6% died. Above this age (people in their 50s and 60s), around 15.0%, and in the oldest group 45.2% died after the surgery. The last group (56 cases), the operation was limited to a simple closure or pyloroplasty; among these patients--30 died. A relative risk of death in men cases was higher than in women. IN CONCLUSION: the age of a patient, rather than a type of surgery, influences the mortality rate in a perforated duodenal ulcer.

Adult↗
PubMed1997

Mineralocorticoid receptors in the rabbit iris-ciliary body.

To demonstrate the presence of mineralocorticoid receptors, specifically aldosterone receptors, iris-ciliary body cytosol from New Zealand albino rabbits was incubated with increasing amounts (0.5-20.0 nM) of radiolabeled aldosterone in the presence and absence of a 100-fold excess of aldosterone. A glucocorticoid receptor blocker, RU-28362, was employed when various steroids were allowed to compete with aldosterone for binding sites on the aldosterone receptor. Aldosterone bound to two classes of receptor proteins. Scatchard analysis of the data indicated one component to bind aldosterone with high affinity (Kd = 2.2 x 10-9 M) and low capacity (Bmax = 32 fmol/mg protein). If the concentration of aldosterone is increased, it also binds to a second component, but with a lower affinity (Kd = 9.8 x 10-9 M) and greater capacity (Bmax = 64 fmol/mg protein).

Aldosterone↗
PubMed1997

[Incidence and causes of upper gastrointestinal hemorrhage].

The incidence rate of the upper gastrointestinal haemorrhage in Nowy Sacz region in years 1991-1995 was 43.5/100 thousand/year among men and 20.1/100 thousand/year among women. The most common causes of bleeding among male were: duodenal ulcer, gastric ulcer and haemorrhagic gastritis. Among female gastric ulcer was more frequent than duodenal ulcer. In the whole group of haemorrhage, the average age of men was lower than the age of women. In similar, in the bleeding duodenal ulcer, gastric ulcer, haemorrhagic gastritis and gastric cancer groups--male were significantly younger.

Adult↗
PubMed1996

Effect of Mycobacterium tuberculosis and its components on macrophages and the release of matrix metalloproteinases.

BACKGROUND: Pulmonary tuberculosis is associated with caseating necrosis, parenchymal lung destruction, and cavity formation. It was hypothesised that tuberculous lung destruction is mediated, at least in part, by the participation of matrix metalloproteinases released by mononuclear phagocytes. METHODS: Cells of the myelomonocytic leukaemia cell line THP-1 were incubated with lipoarabinomannan (LAM), the major antigenic cell wall component, and with Mycobacterium tuberculosis and analysed by Northern blot analysis. Two patients with active cavitary tuberculosis also underwent bronchoalveolar lavage and the cells were analysed by Northern blotting. RESULTS: Incubation of THP-1 cells with LAM resulted in the stimulated release of matrix metalloproteinase-9 (MMP-9), a 92 kDa gelatinase, by 24 hours in a dose-dependent fashion. In addition, Northern analysis revealed that LAM upregulated the gene for MMP-9 by 24 hours, but not the gene for the 72 kDa gelatinase MMP-2. Heat killed M tuberculosis H37Ra also upregulated the MMP-9 gene. Bronchoalveolar lavage of the two patients with active cavitary tuberculosis showed striking upregulation of the MMP-9 gene compared with a normal control using Northern analysis. LAM also upregulated the type I interstitial collagenase (MMP-1) gene by 24 hours in both THP-1 cells and peripheral blood monocytes. CONCLUSIONS: These data suggest that M tuberculosis and its major cell antigenic component, LAM, stimulate the release of MMP-9 and upregulate the expression of genes for MMP-1 and MMP-9. It is possible that M tuberculosis and its components contribute directly to cavity formation by their ability to stimulate macrophages to release matrix metallo-proteinases that digest collagens I-IV, and indirectly by stimulating the release of the cytokines interleukin 1 beta and tumour necrosis factor alpha that induce fibroblasts to amplify the release of matrix metalloproteinases.

Antigens, Bacterial↗
PubMed1996

[Retroperitoneal desmoid tumor].

We present a rare localisation of desmoid tumor in retroperitoneal space. Although it is very unusual to perform radical operation in similar settings in this patient we were able to resect whole tumor with a spleen and pancreas tail which makes the case particularly interesting.

Adult↗
PubMed1992

Degradation of fibronectin and vitronectin in chronic wound fluid: analysis by cell blotting, immunoblotting, and cell adhesion assays.

We used a combination of cell blotting, immunoblotting, and cell adhesion assays to analyze fibronectin and vitronectin in wound fluid from acute and chronic wounds. Acute wound fluid (e.g., suction blister fluid, mastectomy fluid) contained intact fibronectin and vitronectin as major cell adhesion proteins. In marked contrast, chronic wound fluid samples from three of 11 patients with venous stasis ulcers showed complete degradation of vitronectin and degradation of fibronectin into small molecular mass polypeptides less than 125 kDa. Three of these polypeptides--54, 93, and 125 kDa--were biologically active in promoting cell attachment and were recognized by monoclonal antibodies that bind fibronectin near the arg-gly-asp (RGD) domain. In wound fluid samples from the other eight of 11 patients, only slight degradation of vitronectin and fibronectin occurred, which resulted in a mixture of mostly intact molecules along with large fragments. Intact fibronectin in chronic wound fluid samples contained the ED-A domain, which showed that fibronectin synthesis occurred locally in the wound bed. Wound fluid containing extensively degraded vitronectin and fibronectin reversibly inhibited cell adhesion, and excess fetal bovine serum, but not purified fibronectin, neutralized the inhibitory effect. We suggest that protease activity in some chronic wounds may cause degradation of adhesion proteins and prevent cell adhesion necessary for normal wound closure.

Animals↗