Rare variations of hepatic arteries in association with variable origin of gastroduodenal artery found in multidetector computed tomography angiography.

Three rare anatomical variations were found during study on hepatic arterial vascularisation in multidetector computed tomography angiography. In the first described variation the common hepatic artery (CHA) arises from the celiac trunk (CTr) and supplies right hepatic lobe. The left lobe of the liver is supplied by aberrant left hepatic artery originating as a common trunk with the left gastric artery and the splenic artery. This variation may correspond to the type 2 in Michels' classification coexisting with one of three possible patterns of the CTr division (when the CHA is the first branch of the CTr and the gastrosplenic trunk is the second one). The second variation corresponds to the very early bifurcation of the CHA arising from the CTr. Both, the right and left hepatic arteries originate separately from the CTr. The gastroduodenal artery (GDA) originates from the left hepatic artery. It may be regarded as the variation of most common type 1 according to Michels. In the third case the CHA gives raise to the GDA and terminates as the right hepatic artery supplying the right lobe of the liver only. The proper hepatic artery is missing and the left hepatic artery arises from the GDA. This variation does not correspond to any types of Michels' classification.

CD56(NCAM) antigen in glandular epithelium of human thyroid: light microscopic and ultrastructural study.

CD56 antigen, an isoform of the neural cell adhesion molecule (NCAM) was previously found by us in human thyroid by APAAP immunohistochemistry in light microscopy on frozen tissue sections. In the current study, it was attempted to trace the antigen in question using another light microscopic immunohistochemical procedure and to validate the results at the ultrastructural level. For light microscopy, cryostat sections of 12 surgical samples of human thyroid were subjected to ABC (preformed avidin-biotin-peroxidase complex) method. For immunoelectron microscopy, immunoperoxidase reaction was carried out on prefixed, small thyroid tissue blocks. Following preliminary inspection of semithin sections, ultrathin sections were examined in the transmission electron microscope. ABC reaction revealed distinct specific CD56 staining of thyrocyte cell membranes. The staining was weak or absent in thyroid papillary carcinoma cells. The results were confirmed in semithin sections by indirect immunoperoxidase. The latter reaction in ultrathin sections at the ultrastructural level has shown that specific reaction product was confined to free and lateral surfaces of thyroid follicular cells. Endothelial cell membranes of thyroid capillary vessels were totally devoid of the reaction product. The reaction was weakly positive in thyroid follicular and papilllary carcinomas but absent from medullary carcinoma.

[Reconstructive surgery of bile ducts from personal material]. / Operacje naprawcze dróg zólciowych w materiale wlasnym.

In the years 1976-1996, 112 patients were treated surgically for the biliary tract injuries, 156 operations were performed upon them. The long term outcome was assessed in 85 patients along with the effectiveness of different surgical techniques. The best results (86.2%) were achieved when the repair was performed immediately on detecting the lesion, the results were less encouraging for the secondary repair. Perioperative mortality was 8.8%.

Total thyroidectomy in the treatment of Basedow's ophthalmopathy.

Four patients in the age 42-63 (3 females and 1 male) with Basedow's disease and hyperthyroidism were investigated. Visual changes were classified to the IV group of American Thyreologic Society's classification. A total thyroidectomy was performed when status of euthyreosis has been obtained. Check examinations were carried out 6, 12 and 18 months after surgery. It has been confirmed that total thyroidectomy performed in patients with thyroid ophthalmopathy leads to reduction of infiltrative changes in the orbit. However, this can be stated not earlier than 12 months after surgery.

Congenital chest deformities.

The authors discuss 334 patients operated upon for congenital deformities of the chest. The clinical manifestations, radiological and electrocardiographic investigations and spirometric measurements as well as postoperative complications are described. The results of follow-up examinations in a part of this material are reported.

Recurrent goiter.

The authors report on 134 patients operated upon in the years 1950 through 1973 for recurrent goiter at the Department I of General Surgery, Institute of Surgery, Medical Academy in Poznan. The causes of recurrence, manifestations, indications for operation and the types of operations, postoperative complications and results of follow-up examinations are discussed.

Histoenzymatic studies on the adaptation of villi of the small intestine segment left after extensive enterotomy.

After extensive resection of the small intestine in rats, histochemical reactions of selected enzymes were studied during seven weeks to one year in the remaining segment. The rise of activity of the hydrolytic, oxidative and proteolytic enzymes in enterocytes of elongated intestinal villi indicates enhanced active transport and adaptation.