Is serum protein electrophoresis useful in separating the "high risk group" in patients with colonic polyps?

BACKGROUND: Adenomas have the highest potential or clinical value from among colonic polyps of developing into adenocarcinoma. The aims of this paper are: to establish criteria to identify the high risk group of patients in a group of patients with colonic polyps, to work out a simple scheme for follow-up care after endoscopic polypectomy, and to establish indications for surgery. The usefulness of determination of electrophoresis of serum proteins has been specially analysed to detect early development of malignant growths in patients with colonic polyps regarding alfa-1/alfa-2 and alfa/beta. 67 cases - 21 women, 46 men were tested. Follow-up endoscopy with the electrophoresis was performed after 6 weeks, 6 and 12 months after polypectomy. 97 polyps were resected with endoscopy in 67 patients. 38 patients (39.17%), those constituting the high risk group, were selected. Included were all polyps with grade II and III of cellular differentiation. CONCLUSIONS: 1) alfa-1/alfa-2 and alfa/beta is a helpful test in identifying the high risk group among patients with colonic polyps and it can be used as a screening test, 2) the determination of beta-2-macroglobuline is not useful in the diagnosis of this group of patients, 3) the electrophoresis of proteins should be the first test to perform on patients with colonic polyps. The relation of electrophoresis to endoscopic polypectomy aids evaluations of patients specially predisposed to malignant.

[Osseous metaplasia in rectal cancer in a 69-year-old man]. / Metaplazja kostna w raku gruczolowym odbytnicy u 69-letniego mezczyzny.

The first case of osseous metaplasia in rectal cancer is described. The authors present the diagnostic evaluation based on the transrectal ultrasound examination, determination of neoplastic markers, pathological examination, treatment, and follow-up in a 69-year-old man.

[Chronic anal fissure--conservative or surgical treatment?]. / Przewlekla szczelina odbytu--leczenie zachowawcze czy operacyjne?

Chronic anal fissure is one of the most common anus diseases. The main ailments reported by the sick are: stubborn pain connected with defecation and bleeding. Etiopathogenesis of this disease has not been exactly explained yet. The most important factors are anodermal blood flow disturbances and excessive cramp of internal anal sphincter (IAS). Lateral sphincterotomy is the main way of treatment. However, a very dangerous complication as a stool incontinence may occur. As far as a pharmacological treatment is concerned, nitric oxide donors, calcium channel antagonist and botulinum toxin have been used. In some patients threatened with stool incontinence botulinum toxin may be used as an alternative way of treatment right after surgical treatment. Other ways of conservative treatment seem to be less effective due to the side effects and the frequency of repeating doses. The view on the etiopathogenesis of anal fissure, the ways of surgical treatment and the mechanism of activity of drugs used in the conservative treatment are presented in this paper.

[Insulinoma exclusively localized during intraoperative ultrasonography]. / Insulinoma zlokalizowany wylacznie podczas ultrasonografii sródoperacyjnej.

The case of the patient surgically treated for diagnosed pancreatic insulinoma is reported. Pancreatic insulinomas are the most often diagnosed hormonally active tumors of pancreas. They are small in size, localized evenly in the head, body or tail of pancreas. Their precise location is not easy. This case confirms that the preoperative localization of the tumor is very difficult and preoperative image tests often fail. The performance of intraoperative ultrasonography (IOUS) led to the visualization of the tumor and the curative surgery.

[Instillagel in prevention of postoperative urinary tract infection--randomized trial]. / Instillagel w profilaktyce pooperacyjnych zakazen ukladu moczowego. Badanie randomizowane.

UNLABELLED: The progress of operative technique, introduction of new drugs, modernizing of medical equipment are the cause of long and complicated operations. For that reason, the number of patients, who need the catheterization of the urinary bladder is increasing. The use of the vesical catheter over 5 days is the cause of the urinary tract infection (bacterial and mycotic), the bacteraemia and the extension of the time of recovery. The aim of the study was the estimation of the usefulness of the preparation Instillagel used at the time of the urinary bladder catheterization in the patients before an operation, in aspect of frequency of urinary tract infection. Between January and December 2000, 59 patients were selected for the study. The patients were divided into two groups. In the first group, the preparation Instillagel was used at the time of the catheterization. In the control group 2% Lignocainum hydrochloricum was used at the time of the catheterization. The study was prospective and randomized. The usefulness of the preparation Insillagel was estimated through the comparison of frequency of the urinary tract infection in both groups. The catheterization of the urinary bladder was performed according to aseptic principle. The difference between number and age of the patients in both groups was not statistically significant (p = 0.8538). The time of the keeping of the vesical catheter was similar in both groups (p = 0.576635). The urinary tract infection estimated on the basis of clinical symptoms and laboratory findings was diagnosed in 13 patients (5 patients in the first group, and 8 patients in the control group). The frequency of urinary tract infection was not statistically significant in both groups. CONCLUSIONS: The urinary tract infection is frequent complication in patients with catheter in the urinary bladder, before operation. The frequency of urinary tract infection was not statistically significant in both groups. The discomfort and pain occurred with the same frequency in both groups.