Mineral composition variation in Boletales mushrooms-indication of soil properties and taxonomic influence.

The efficiency of element accumulation depends on numerous factors, where the physico-chemical characteristics of the soil seem to be very important, and the role of taxonomic rank in the accumulation of elements by mushrooms seems to be important. The aim of the study was to compare the mineral composition of 7 species belonging to Leccinum and Suillus genera, collected between 2019 and 2021 from localizations in the west-central part of Poland. The research aimed to indicate the role of selected soil parameters in stimulating/inhibiting the accumulation of elements by selected Boletales mushroom species and to answer the question about the role of species belonging to the genus as an indicator determining the specific mineral composition of fruiting bodies. Soil pH and other soil properties (granulometric composition, organic carbon, degree of organic matter decomposition) may significantly affect mushrooms' mineral composition. Mushroom species belonging to Leccinum genus exhibited the higher amount of essential major and trace elements than species of Suillus genus). It suggests that the affiliation of the studied mushroom species to a specific genus may affect their mineral composition, and the physicochemical properties of the soil may be responsible for the lack of a clear division in the efficiency of element(s) accumulation. Selected species contain high amounts of K, Cu, Fe, and Zn, while others, such as selected Suillus gravellei fruiting bodies, also contain As and Cd. The results described serve as an introduction to a broader scientific discussion and require many further studies to confirm the role of taxonomic ranks and the influence of soil characteristics on the accumulation of elements by fruiting bodies.

Results Following Stent-Graft Coverage of the Hypogastric Artery in the Management of Aortoiliac Aneurysms in Endovascular Aneurysm Repair.

<b><br>Aim:</b> The aim of our study was to assess the outcomes of stent-graft coverage of the hypogastric artery in the management of aortoiliac aneurysms with endovascular aneurysm repair (EVAR).</br> <b><br>Material and methods:</b> From January 2013 to March 2017, a total of 93 patients with aortoiliac aneurysms were treated with EVAR, which required occlusion of one or both of the hypogastric arteries. The patients of the Department of General, Vascular, Endocrine and Transplant Surgery were included in the study continuously and all procedures were elective.</br> <b><br>Results:</b> A total of 93 patients with aortoiliac aneurysms required a unilateral or bilateral procedure. Six patients were excluded from our study because they did not appear at their follow-up appointments. The study included 87 patients (80 men; mean age 71.9 (7.9) years, range 54-88), of which 30 had a unilateral procedure and 57 had a bilateral procedure. In 8 procedures (5.55%, n = 7) there was a type II endoleak that resolved during follow-up and required no surgical intervention. In 10 procedures (6.94%, n = 10) there was a type IB endoleak, with 8 procedures requiring surgical re-intervention in the form of an extension. In 12 procedures (8.33%, n = 9), the hypogastric artery thrombosed.</br> <b><br>Conclusion:</b> Coverage of the hypogastric artery by stent-graft has been proven to be a safe procedure, but there is still a risk of type II endoleak. Although 5.55% (n = 7) of the procedures in our study had a type II endoleak, none required surgical intervention.</br>.

Physiological and Morphological Implications of Using Composts with Different Compositions in the Production of Cucumber Seedlings.

Compost has a broad application in terms of the improvement of the soil properties. This research work was conducted to present the molecular implications of using compost obtained from different substrates to improve soil parameters for cucumber seedlings cultivation. In the experiment, the following compost mixtures were used: sewage sludge (80%) + sawdust (20%); sewage sludge (40%) + sawdust (10%) + biodegradable garden and park waste (50%); biodegradable garden and park waste (90%) + sawdust (10%); sewage sludge (80%) + sawdust (20%) + Eisenia fetida; sewage sludge (40%) + sawdust (10%) + biodegradable garden and park waste (50%) + Eisenia fetida; biodegradable garden and park waste (90%) + sawdust (10%) + Eisenia fetida. The final substrate compositions consisted of compost mixtures and deacidified peat(O) (pH 6.97; Corg content-55%, N content-2.3%), serving as a structural additive, in different mass ratios (mass %). The produced plants underwent biometric and physiological measurements as well as enzymatic analyses of stress markers. Based on the conducted studies, it has been found that the substrate productivity depends not only on the content of nutrient components but also on their structure, which is moderated by the proportion of peat in the substrate. The most effective and promising substrate for cucumber seedling production was variant 2 (I), which consisted of 25% compost from sewage sludge (40%) + sawdust (10%) + biodegradable garden and park waste (50%) and 75% deacidified peat. Despite the richness of the other substrates, inferior parameters of the produced seedlings were observed. The analysis of the enzymatic activity of stress markers showed that these substrates caused stress in the plants produced. The study's results showed that this stress was caused by the presence of Eisenia fetida, which damaged the developing root system of plants in the limited volume of substrate (production containers). The adverse influence of Eisenia fetida on the plants produced could possibly be eliminated by thermal treatment of the compost, although this could lead to significant changes in composition.

Selected Physicochemical, Thermal, and Rheological Properties of Barley Starch Depending on the Type of Soil and Fertilization with Ash from Biomass Combustion.

The following study analyzed the impact of fertilizing barley with fly ash from biomass combustion grown on two types of soil, Haplic Luvisol (HL) and Gleyic Chernozem (GC), on the properties of starch. The experiment was conducted in 2019 (A) and 2020 (B), and barley was fertilized with ash doses (D1-D6) differing in mineral content. In the tested barley starch samples, the amylose content, the clarity of the paste, and the content of selected minerals were determined. The thermodynamic characteristics of gelatinization and retrogradation were determined using the DSC method. Pasting characteristics, flow curves, and viscoelastic properties of starch pastes were performed. Starches differed in amylose content and paste clarity. The highest gelatinization and retrogradation enthalpy (ΔHG and ΔHR) values were recorded for samples GCD1A and HLD5B. None of the tested factors significantly affected the pasting temperature (PT), but they had a significant impact on the remaining parameters of the pasting characteristics. The average PT value of barley starches was 90.9 °C. However, GCD2A starch had the highest maximum viscosity and the highest rheological stability during heating. GCD2A paste was characterized by the highest apparent viscosity. It was shown that all pastes showed non-Newtonian flow and shear-thinning and had a predominance of elastic features over viscous ones. The resulting gels had the characteristics of weak gels. Ash from burning wood biomass is an innovative alternative to mineral fertilizers. It was shown that the use of such soil fertilization influenced the properties of barley starch.

Analysis of the Free Amino Acid Profile of Barley Grain from Organic Fertilisation with Ash from Biomass Combustion.

Fertilisation with ash from biomass combustion has a positive effect on the quality of nutrients in agrifood raw materials, improving their chemical composition and bioavailability. In the experiments carried out, the protein content and the profile of free amino acids in barley flour were examined from cultivation fertilised with biomass ash at various doses. Barley flour from Haplic Luvisol soil was characterised by a significantly higher (by 13.8% on average) total protein content compared to flour obtained from grains from Gleyic Chernozem soil. The highest protein content but a low content of free amino acids were found in the grains of plants fertilised with the mineral NPK (D1). An increase in the total pool of free amino acids in flour was observed, especially in the case of Haplic Luvisol soil. On average, after fertilising, significantly more ASP, ASN, GLU, GLY, ALA, and CYS were obtained in variant D4 (1.5 t·ha-1), and there were also significantly more TAU and GABA than in the control, up by 30.2% and 23%, respectively. A beneficial effect of fertilisation on the essential amino acid content in barley flour was found, but only up to the dose of D4, when it was significantly higher than in the control and under mineral fertilising (D1), up by 23.7% and 9.2%, respectively. High ash doses reduced the content of free amino acids in the tested barley flour. This study confirmed that using an alternative method of fertilising with plant biomass ash has a beneficial effect on protein quality and nutritional value.

Effect of Soil Type and Application of Ecological Fertilizer Composed of Ash from Biomass Combustion on Selected Physicochemical, Thermal, and Rheological Properties of Potato Starch.

The aim of the study was to assess the effect of soil type and the application of fertilizer composed of ashes from biomass combustion to potatoes on selected physicochemical, rheological, and thermal properties of potato starches isolated by using the laboratory method. Potatoes were grown in Haplic Luvisol (HL) and Gleyic Chernozem (GC) soil and fertilized with different doses of biomass combustion ash (D1−D6) with different mineral contents. The thermodynamic characteristics of gelatinization and retrogradation were identified by DSC. The analyses of rheological properties included the determination of the gelatinization characteristics by using the RVA method, flow curves, and assessment of the viscoelastic properties of starch gels. It was found that the starches tested contained from 24.7 to 29.7 g/100 g d.m. amylose, and the clarity of 1% starch pastes ranged from 59% to 68%. The gelatinization characteristics that were determined showed statistically significant differences between the starches analyzed in terms of the tested factors. The value of maximum viscosity and final viscosity varied, respectively, in the range of 2017−2404 mPa·s and 2811−3112 mPa·s, respectively. The samples of the potato starches studied showed a non-Newtonian flow, shear thinning, and the phenomenon of thixotropy. After cooling, the starch gels showed different viscoelastic properties, all of which were weak gels (tan δ = G″/G' > 0.1).

Road traffic and abiotic parameters of underlying soils determine the mineral composition and nutritive value of the mushroom Macrolepiota procera (Scop.) Singer.

The effectiveness of accumulating mineral elements by wild-growing mushrooms depends mainly on species, their growth place, and the underlying soil's chemical characteristics. The aim of the study was to determine the effect of road traffic and the role of chemical characteristics of soil on the mineral composition of Macrolepiota procera fruit bodies growing in close proximity to a road and an adjacent forest during a four-year period. The concentrations of the majority elements (mainly Al, Cd, Co, Cr, Cu, Pb, Ti, and Zn) in the soil near the road were significantly higher than those in the forest soil, which was reflected in the fruit bodies which contained a higher amount of these elements. While the accumulation of heavy metals and other elements in the M. procera fruit bodies did not depend on the total soil organic carbon content, the degree of their decomposition determined by the C:N ratio and the individual fractions of organic carbon had a significant influence. Our studies show that soil properties are highly variable in the natural habitats of M. procera, which affects the efficiency of element accumulation. Macrolepiota procera fruit bodies growing in soil with similar chemical properties were characterized by different mineral compositions. Moreover, the obtained results indicate that the fruit bodies of edible M. procera, not only those close to roads but also at a greater distance, may contain significant amounts of toxic As and Cd, which could pose a health risk if consumed. Although most studies describing the mineral composition of M. procera fruit bodies have found no evidence to question the safety of their consumption, this species can effectively accumulate selected elements when growing immediately beside roads or in their close proximity.

Trees and shrubs from a post-industrial area high in calcium and trace elements: the potential of dendroremediation.

NOVELTY STATEMENT: That is probably the first study to date of trees and shrubs differing in age and growing on post-industrial soil contaminated with calcium (Ca) and selected toxic metals/metalloids. The obtained results show that an alkaline reaction (less than 9) of soil and an unusually high Ca concentration may help the studied tree species to adapt/survive in unfavorable habitat conditions (high concentration of toxic elements). The efficiency of phytoextraction of toxic elements was so high that, especially for forest animals (roe-deer) that consume, e.g., willow shoots, it could pose a serious threat to health and life, both for them and potentially for humans.

The Modification of Substrate in the Soilless Cultivation of Raspberries (Rubus Idaeus L.) as a Factor Stimulating the Biosynthesis of Selected Bioactive Compounds in Fruits.

Raspberry fruits are a valuable source of bioactive compounds. The study used the modification of the substrate (coconut fibre), consisting of the use of various organic and mineral additives, in the soilless cultivation of raspberries. The additives influenced the biosynthesis of bioactive compounds in the raspberry fruits by modifying the sorption properties and the abundance of the substrate. The influence of the additives on the content of polyphenols was determined as well as their profile (UPLC-MS), antioxidant potential (ABTS), vitamin C content, and the activity of selected enzymes that are markers of stress and resistance to abiotic factors. In the study, a significant effect of these additives was observed on the biosynthesis of polyphenols in raspberry fruit. The highest increase in the content of these compounds in relation to the control sample (substrate-100% coconut fibre), namely 37.7%, was recorded in the case of fruit produced on coconut substrate enriched with sheep wool. These fruits were also characterised by a significantly different profile of these compounds. These changes were caused by readily available ammonium nitrogen and free amino acids in the decomposition of proteins contained in the sheep wool. This was confirmed by the recorded content of chlorophyll SPAD in the plant leaves and the activity of selected enzymes, which proves a low level of stress and good condition of the plants.

Short-Term Effect of Fly Ash from Biomass Combustion on Spring Rape Plants Growth, Nutrient, and Trace Elements Accumulation, and Soil Properties.

The short-term impact of biomass combustion fly ashes (BAs) fertilization on the spring rape growth, essential and trace elements accumulation in seeds, and selected soil and soil solution properties were analyzed in a pot experiment study. The pot experiment was carried out in the growing season (April-August) during the year 2018. The effect of BAs on the dry matter content in spring rape plants and the relative content of chlorophyll in leaves (SPAD) was analyzed. In addition, the effect of BAs on the accumulation of essential and trace elements in the seeds of this plant was analyzed. The impact of BAs on the basic physicochemical properties of soils was also assessed. Additionally, the solubility of compounds contained in BAs was monitored on the basis of the analysis of the changes in the physicochemical properties of soil solution during the experiment period. The present study demonstrated a positive effect of BAs fertilization on plant growth and development and improvement of soil physicochemical properties. A change has been achieved in the soil reaction class from a slightly acidic (control, NPK) to neutral (D1-D6), with the highest increase in pH induced by the highest ash dose of 3 mg ha-1 (D6). It was shown that BAs contributed to a significant increase in the content of macroelements than trace elements in the analyzed soil. In turn, the accumulation of these elements in plant seeds exhibited an inverse relationship, which was mainly influenced by the soil pH and the content of N, Ca, Mg, K, and Na in the soil, as indicated by the correlation coefficients. The highest contents of Fe, Mn, Zn, Cu, Cr, and Ni were detected in the seeds of plants fertilized with BAs at a dose of 2.0 Mg ha-1 (D4), and their respective values were 263, 363, 107, 51, 1835, and 137% higher than in the control. The Ca, Mg, S, and Na compounds introduced with BAs exhibited high solubility, as evidenced by the higher concentration of Ca2+, Mg2+, Na+, and SO42- ions in the soil solutions and the dynamic changes in pH and EC observed during the experiment. The lowest solubility after the application of BAs was exhibited by N and P. The conducted PCA analysis to a large extent explained the variability between the applied fertilization and the factors analyzed in the experiment. Despite the positive impact of ashes, attention should be paid to the potential risks associated with their use. The use of higher doses of BAs may result in excessive alkalization and salinity of soils and may enhance the accumulation of trace elements in plants. These aspects should therefore be closely monitored, especially in the case of a long-term application of these wastes, in order to avoid serious environmental problems.

The Possibility of Using Paulownia elongata S. Y. Hu × Paulownia fortunei Hybrid for Phytoextraction of Toxic Elements from Post-Industrial Wastes with Biochar.

The potential of the Paulownia hybrid for the uptake and transport of 67 elements along with the physiological response of plants cultivated in highly contaminated post-industrial wastes (flotation tailings-FT, and mining sludge-MS) was investigated. Biochar (BR) was added to substrates to limit metal mobility and facilitate plant survival. Paulownia could effectively uptake and translocate B, Ca, K, P, Rb, Re and Ta. Despite severe growth retardation, chlorophyll biosynthesis was not depleted, while an increased carotenoid content was noted for plants cultivated in waste materials. In Paulownia leaves and roots hydroxybenzoic acids (C6-C1) were dominant phenolics, and hydroxycinnamic acids/phenylpropanoids (C6-C3) and flavonoids (C6-C3-C6) were also detected. Plant cultivation in wastes resulted in quantitative changes in the phenolic fraction, and a significant drop or total inhibition of particular phenolics. Cultivation in waste materials resulted in increased biosynthesis of malic and succinic acids in the roots of FT-cultivated plants, and malic and acetic acids in the case of MS/BR substrate. The obtained results indicate that the addition of biochar can support the adaptation of Paulownia seedlings growing on MS, however, in order to limit unfavorable changes in the plant, an optimal addition of waste is necessary.

Toxicological risks and nutritional value of wild edible mushroom species -a half-century monitoring study.

The content of major- and trace elements in wild-growing mushrooms has been subject to numerous studies, but the data on long-term trends in this regard are scarce. The aim of research was to determine the content of 34 elements in four edible mushroom species Boletus edulis, Imleria badia, Leccinum scabrum and Macrolepiota procera, and associated soil collected from Polish forests between 1974 and 2019. As initially hypothesized, the element concentration in the studied soil revealed an increasing trend and was positively correlated with their levels found in fruit bodies. Bioconcentrafion Factor values exceeding 1 were documented for all mushroom species for K, P, Ag, Cd, Cu, Hg, and Zn. When compared to the Adequate Intakes, all the mushroom species were found to be a good dietary source of K, P, and Zn (range of 6260-8690, 6260-8690 and 97-135 mg kg-1 dry weight (dw), respectively), and B. edulis and I. badia a moderate source of Fe (mean 71.5 and 76.5 mg kg-1 dw, respectively), B. edulis of Mn and Mo (mean 20.0 and 0.42 mg kg-1 dw, respectively), while L. scabrum and M. procera a source of Cu. Consumption of the studied mushrooms would not lead to significant exposure to Al, As, Cr, or Ni. Considering that wild mushrooms will continue to be collected in Poland, one should bear in mind that they are a limited source of minerals in the human diet while their frequent, regular consumption, associated with exposure to selected toxic elements, should not be recommended.

Possible sources of rare earth elements near different classes of road in Poland and their phytoextraction to herbaceous plant species.

The growing use of rare earth elements (REE) in industry determines their increased transport to the environment. The higher concentration of this group of elements in soils near roads may also suggest that traffic plays a significant role in their distribution. The aim of this study was to examine the content of REEs in selected consumables (car parts, asphalt) and environmental samples (plants, soils) in order to estimate the extent to which these elements derive from traffic and also to analyze their phytoextraction from soil by selected herbaceous plants species. Research materials were car parts (5 brake pads, 10 new tires - summer and winter), 20 samples of asphalt and road dust settled on its surface; soil, and 7 plants species growing at a distance of 1 m from the edge of the 5 roads located in the Wielkopolska Voivodeship, Poland. The content of REEs in the collected samples was determined using inductively coupled plasma optical emission spectrometer. The content of REEs in asphalt and brake pads was similar and significantly higher than in tires. According to the mass of particular stripped materials, the main source of these elements was asphalt. The amount of REEs released from tires to the environment was found to be much lower than REEs released from asphalt but generally higher than from brake pads. The content of REEs in the soil was found to increase in accordance with traffic intensity, but chemical composition of soil was the main determinant of the uptake these elements, mainly via the root systems of plants. The obtained results suggest that densely vegetated roadsides and verges could be an effective strategy for decontamination of soils polluted with REEs, although the most effective remedy would involve significant changes in the production technologies of automotive parts and asphalt that would limit the emission of elements to environment.

Multiannual monitoring (1974-2019) of rare earth elements in wild growing edible mushroom species in Polish forests.

There is a growing demand for rare earth elements (REEs) due to their use in modern technologies, and this may result in their emission to the environment. This is the first long-term study to monitor the content of REEs in four edible mushroom species. Over 21,900 samples of fruit bodies (sporocarps) of Boletus edulis, Imleria badia, Leccinum scabrum and Macrolepiota procera and their underlying soils, collected between 1974 and 2019 from 42 forest sites in Poland were examined in an attempt to understand the time evolution of the presence of REEs in the environment. In general, I. badia and B. edulis displayed a greater total content of REEs on mg per kg basis than L. scabrum and M. procera. A gradual increase in REEs in the studied mushrooms as well as associated forest soil samples was observed over the monitored period. Both levels were also highly correlated. Regardless of the considered period, human consumption of these mushrooms would not contribute significantly to dietary exposure to REEs. Wild growing mushroom species studied over a long time period may be a good bioindicator of REE migration to the environment.

Assessment of genome stability in various breeds of cattle.

Chromosomal instability is a type of genome instability involving changes in genetic information at the chromosomal level. The basic tests used to identify this form of instability are sister chromatid exchange (SCE) tests and identification of fragile sites (FS). SCE is the process by which sister chromatids become fragmented as a result of DNA strand breakage and reassembly, followed by exchange of these fragments. FS can be observed in the form of breaks, gaps or constrictions on chromosomes, which often result from multiple nucleotide repeats in DNA that are difficult to replicate. The research material was the peripheral blood of ten breeds of cattle raised in Poland, including four native breeds covered by a genetic resources conservation programme, i.e. Polish Red, Polish Red-and-White, White-Backed, and Polish Black-and-White, as well as Polish Holstein-Friesian, Simmental, Montbéliarde, Jersey, Limousine and Danish Red. Two tests were performed on chromosomes obtained from in vitro cultures: SCE and FS. The average frequency of SCE was 5.08 ± 1.31, while the incidence of FS was 3.45 ± 0.94. Differences in the incidence of SCE and FS were observed between breeds. The least damage was observed in the Polish Red and White-Backed breeds, and the most in Polish Holstein-Friesians. The most damage was observed in the interstitial part of the chromosomes. Age was shown to significantly affect the incidence of SCE and FS. Younger cows showed less damage than older ones (SCE: 4.84 ± 1.25; 5.34 ± 1.24; FS: 3.10 ± 0.88, 3.80 ± 0.92).

Differences of Acer platanoides L. and Tilia cordata Mill. Response patterns/survival strategies during cultivation in extremely polluted mining sludge - A pot trial.

The study aimed to evaluate the physiological mechanisms underlying differences in metals and metalloid uptake and tolerance of two tree species cultivated in mining waste material. Two-year old Acer platanoides L. and Tilia cordata Mill. were cultivated in mining sludge characterized by high pH, salinity and an extremely high concentration of As. Both species were able to develop leaves from leafless seedlings, however, their total biomass was greatly reduced in comparison to control plants, following the severe disturbances in chlorophyll content. Phytoextraction abilities were observed for T. cordata for Ba, Nb, Rb and Se, and phytostabilisation was stated for Pd, Ru, Sc and Sm for both species, Ba and Nd for A. platonoides and Be for T. cordata only. Metal exclusion was observed for the majority of detected elements indicating an intense limitation of metal transport to photosynthetic tissue. A diversified uptake of elements was accompanied by a species-specific pattern of physiological reaction during the cultivation in sludge. Organic ligands (glutatnione and low-molecular-weight organic acids) were suppressed in A. platanoides, and enhanced biosynthesis of phenolic compounds was observed for both species, being more pronounced in T. cordata. Despite its higher accumulation of key metabolites for plant reaction to oxidative stress, such as phenolic acids, flavonoids and organic ligands, T. cordata exhibited relatively lower tolerance to sludge, probably due to the increased uptake and translocation rate of toxic metal/loids to aerial organs and/or restricted accumulation of salicylic acid which is known to play a decisive role in mechanisms of plant tolerance.

Phytoextraction of arsenic forms in selected tree species growing in As-polluted mining sludge.

The aim of this study was to determine the phytoextraction of inorganic (As(III), As(V)) and organic arsenic (Asorg) forms in six tree species: Acer platanoides, Acer pseudoplatanus, Betula pendula, Quercus robur, Tilia cordata and Ulmus laevis. Plants were grown in a pot experiment using As-polluted mining sludge for 90 days. Arsenic (Astotal) was accumulated mainly in the roots of all six tree species, which were generally thinner, shorter and/or black after the experiment. The highest concentration of As(III) and As(V) was determined in the roots of A. pseudoplatanus and A. platanoides (174 and 420 mg kg-1, respectively). High concentrations of As(III) were also recorded in the shoots of B. pendula (11.9 mg kg-1) and As(V) in the aerial parts of U. laevis and A. pseudoplatanus (77.4 and 70.1 mg kg-1). With some exceptions, the dominant form in the tree organs was Asorg, present in mining sludge in low concentration. This form has a decisive influence on As phytoextraction by young tree seedlings even though its BCF value was the only one lower than 1. The obtained results highlight the important role of speciation studies in assessing the response of plants growing in heavily polluted mining sludge.

Adrenal cysts - optimal laparoscopic treatment.

INTRODUCTION: Adrenal cysts develop in up to about 0.2% of the overall population. They may account for up to 11% of all pathologies of adrenal glands. AIM: Is laparoscopic resection of adrenal cysts a method for the treatment of these pathologies? MATERIAL AND METHODS: In the years 2010-2017, a total of 27 patients underwent surgery due to adrenal cysts; those included 18 (66.7%) women and 9 (33.3%) men aged 29 to 84 years (mean age: 42.7). Cyst diameter ranged from 55 to 130 mm. After exclusion of hormonal hyperactivity, parasitic cysts, or, to the best possible extent, cancer lesions, patients were qualified for adrenal-sparing laparoscopic surgery. RESULTS: All patients were subjected to laparoscopic surgery. Cystic wall resection was performed in 15 (55.6%) patients while adrenalectomy was performed in the remaining 12 (44.4%) patients. The decision regarding the extent of the surgery was made intraoperatively. Histopathological assessment revealed pathological adrenal lesions in as few as 3 (11.1%) patients, with the rest of the study population, i.e. 24 (88.9%), presenting with normal adrenal tissue. CONCLUSIONS: Laparoscopic resection of adrenal cysts appears to be recommendable as a method for the treatment of these pathologies. It is simpler than adrenalectomy and associated with low risk of any pathological lesion remaining within the adrenal gland following careful intraoperative assessment by an experienced surgeon.

Adrenal Incidentaloma - Diagnostic and Treating Problem - Own Experience.

INTRODUCTION: Incidentaloma is defined as an tumor diagnosed accidentally using imaging studies performed due to other indications. The aim of this paper was to describe the diagnostic and treatment problems experienced by patients with adrenal incidentaloma in a clinical practice. MATERIAL AND METHODS: In years 2009-2012 there were 33(16,5%) adrenal tumors diagnosed incidentally out of 200 cases treated due to adrenal pathology. The group consisted of 54 patients aged 27-77. In 15(45,5%) patients the diagnosis was made based on ultrasound examination, while in 18(54,5%) the tumor was visualized in CT/MRI. RESULTS: Only after the diagnostics was finalized, in which in all cases no signs of hormonal activity were detected, 26(78,8%) patients were qualified for the surgery. In 7(21,2%) cases no indications for such a management were found. The latter group was followed-up and in all patients the indications for the surgery arose due to enlargement of the tumor or/and the existence of hormonal activity. Our observations suggest that the incident finding of adrenal tumor is an indication of long-term observation. The analysis of our material shows that all patients observed needed surgical treatment. CONCLUSIONS: The small adrenal tumors under follow-up have a tendency to enlarge and acquire hormonal activity. Long-term observation significantly increases the costs of treatment in that group, which eventually results in surgical management.