Use of polypropylene prostheses for strangulated inguinal and incisional hernias.

We used monofilament polypropylene prostheses in 20 emergency operations for strangulated hernias. Sixteen of the operated patients had groin hernias (five of them recurrent), two had incisional and one had a Spigel's type hernia. Intestinal resection was performed because of bowel wall necrosis in one of the patients. During the postoperative period, we observed only one minor complication (a seroma formation). During the follow-up, no recurrence was observed. In our opinion, the use of monofilament polypropylene mesh in emergency hernia operations is safe, simple and effective.

[Thyroid crisis diagnosed on the basis of anatomic-pathologic examination]. / Przelom tarczycowy rozpoznany na podstawie badania anatomopatologicznego.

Graves-Basedow disease is the most common cause of hyperthyroidism. Rhabdomyolysis is occasionally associated with metabolic coma or severe electrolyte disturbances. We describe rhabdomyolysis accompany ing thyroid crisis. A 48-years old man admitted with hypovolemic shock developed rhabdomyolysis, congestive heart failure, hepatic failure and renal failure and then died. It is interesting that correct diagnosis was done on the basis of microscopic examination of specimens of the thyroid gland.

[Single non-parasitic liver cysts]. / Pojedyncze niepasozytnicze torbiele watroby.

Solitary non-parasitic cysts of the liver (NPHC) are rare. The incidence of NPHC on autopsy is 0.2% to 0.5% and on imaging from 2.5 to 4.6% of the population. They are more common in females than males. Congenital cysts can be solitary, multiple or involve the whole liver which is referred to as polycystic liver disease (PCLD). Post-traumatic, neoplastic and echinococceal cysts are acquired lesions. Imaging procedures (USS, CT, MRI) are essential in diagnosis of hepatic cysts. Further diagnostic procedures include cytological, bacteriological and biochemical analysis of cystic fluid. Cystography can exclude communication of the cyst with the ductal system. Serologic tests are used in hydatid disease and serum tumour markers (CEA, CA 19-9) are measured to aid in differential diagnosis of suspected neoplastic cysts. Various therapeutic methods are used in the treatment of solitary non-parasitic hepatic cysts. The simplest is percutaneous obliteration with, for example ethyl alcohol. Fenestration (deroofing) with excision of the cyst wall is increasingly more often performed laparoscopically. Conventional open deroofing is used exceptionally, mainly in complicated cases.

[Changing views in the 20-th century regarding acute appendicitis]. / Jak w XX wieku zmienialy sie poglady na ostre zapalenie wyrostka robaczkowego.

In 1886 Reginald H. Fitz described the pathology of acute appendicitis suggested surgical treatment. 10 years later, during VII-th the Congress of Polish Surgeons in Cracow, Maksymilian Rutkowski was the first in Poland to present the results of that kind of treatment. Operations performed for that frequently, not seldom fatal disease-were not accepted from the beginning through the world. In Poland as well at the beginning of the 20-th century, indications for appendectomy were discussed. In 1920 previous views regarding the necessity for surgical treatment in acute and chronic cases changed. These changes were supported by the observation that in some cases involving pain in the right, pain remains even after appendectomy were the vermiform appendix was found to be unaffected and it was also found that adhesion of ileus can be a dangerous late complications. It might appear that today's knowledge relating to this disease is fully established. Close observation found successful results as shown by in decreasing mortality. Within 100 years in the Massachusetts General Hospital mortality feel from 40% to 0.8% to Fitzs between patients who had undergone appendectomy accompany high percentage failed preoperative diagnosis. Today at the beginning of the 21-st century with the availability of MRI, CT, videosurgery and organs transplant it is difficult to imagine that the cause of such a common disease is still unknown and that in almost 1/4 of the operations performed on patients do not confirm the preoperative diagnosis.

[Determination of blood cell count and spleen size in patients with liver cirrhosis submitted to endoscopic sclerotherapy for esophageal varices]. / Upostaciowane elementy krwi i wielkosc sledziony u chorych na marskosc watroby, poddanych endoskopowej sklerotyzacji zylaków przelyku.

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.

[Sclerotherapy of single non-parasitic liver cyst]. / Leczenie obliteracyjne pojedynczych niepasozytniczych torbieli watroby.

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.

Smooth endoplasmic membranes rich fraction isolated from liver cells of streptozotocin diabetic rats.

It was found that yield of isolation of the fraction enriched with rat liver smooth endoplasmic membrane was higher in diabetic rats group, than in the control group. It was also shown that the level of glucose-6-phosphatase activity varied in the investigated fraction isolated from two groups of animals. These differences were statistically significant.

Glycine and serine rich peptides isolated from rat liver preparations enriched with smooth endoplasmic membranes.

Three electrochromatographic homogeneous peptides belonging to acidic, basic and neutral electrophoretic glycopeptide fractions isolated from rat liver preparations enriched with smooth endoplasmic membranes contain a very high level of glycine and serine and only a slight level of phenylalanine but do not contain tyrosine. Their amino acid compositions differ chiefly in the contents of basic and acidic amino acids.