In memory of professor Czeslaw Nizankowski, Head of the Department of Anatomy, Wroclaw Medical University.

Professor Czeslaw Nizankowski was an academic teacher and researcher at several universities; head of the Department of Anatomy at Wroclaw Medical University (1966-1982); and head of the Department of Biological Sciences at the Wroclaw School of Physical Education (since 1972 University School of Physical Education in Wroclaw), as well as the chancellor there. He contributed greatly to the development of morphological sciences, supervising many doctoral and post-doctoral works. He dedicated considerable time to the preparation of anatomical specimens of lungs, hearts and organs of the gastrointestinal tract. At the Museum of Anatomy, there are over 100 specimens of lungs prepared using the forced air technique improved by Professor Nizankowski, along with specimens of the bronchial tree and vascular system prepared using a corrosive technique. Professor Nizankowski was an active member of scientific societies in Wroclaw and in other cities in Poland. For his accomplishments, he received a number of ministerial and state awards, including the Knight's Cross of the Order of Polonia Restituta, and was granted an honorary doctorate by Wroclaw Medical University.

Gender and age-dependent differences in body composition changes in response to cardiac rehabilitation exercise training in patients after coronary artery bypass grafting.

Cardiac rehabilitation (CR) is the standard procedure in persons after coronary artery bypass grafting (CABG). Its basic aim is to combat coronary heart disease (CHD) risk factors through physical activity and normalization of body mass. Many authors highlight the differences in response to training in CR as dependent on gender, age and occurrence of accompanying disease. The aim of this study is to assess the effectiveness of a three-week early CR in reference to changing body composition parameters in patients over 50 years of age. The study involved a random group of 65 patients (44 men and 21 women) between the ages of 50-76 (average: 62.6 ± 7.2) years with CHD following CABG. Anthropometric and body composition (bioelectrical impedance method) measurements were taken at the commencement of CR and after the training programme. After CR, body mass and body mass index were reduced in men < 65 and ≥ 65 years, and in women <65 years. A reduction % body fat and increase % fat free mass and % total body water was observed only in patients <65. years. Furthermore, in men < 65 years, an increase in % body cell mass was observed. In women ≥ 65 years, no statistically significant changes were observed in body fat indices and body composition features between initial and final study. Patients ≥ 65 years of age following surgery over a period of hospital cardiac rehabilitation do not experience the same significant improvement in body composition parameters associated with risk of CHD as middle-aged adults. Older women post-cardiac surgery are characterized by a higher disability index in relation to tolerance to physical stress in comparison with men of the same age and persons < 65 years of age.

Risk factors for carotid artery disease in patients scheduled for coronary artery bypass grafting.

BACKGROUND: Carotid artery disease is thought to be a risk factor for neurological complications after cardiac surgery. Routine ultrasonographic screening is still not performed in every patient scheduled for coronary artery bypass grafting (CABG). AIM: To assess factors which may facilitate the selection for elective carotid artery ultrasound examination in patients undergoing CABG. METHODS: 682 patients (mean age 63.2 +/- 8.7, range: 37-85 years) scheduled for CABG underwent preoperative duplex ultrasound examination of the carotid arteries. The following factors were collected and analysed: age, sex, LVEF, history of cerebrovascular accidents (stroke and/or TIA), myocardial infarction, and presence of hypertension, diabetes, unstable angina, chronic obstructive pulmonary disease, chronic kidney disease, left main stenosis > or = 50%, lower-extremity peripheral arterial disease, and obesity (BMI > 30 kg/m(2)). Logistic regression analysis was used to determine the risk factors for carotid artery stenosis. RESULTS: Internal or common carotid artery stenosis > or = 50% was detected in 123 (18%) patients. Bilateral stenosis occurred in 35 (5.1%) patients, of whom 29 (4.5%) presented at least a monolateral vessel diameter reduction of > or= 70%. History of cerebrovascular accidents, presence of lower-extremity peripheral arterial disease, and unstable angina were independent risk factors for at least monolateral vessel diameter reduction > or = 50%. Although older age was also an independent predictor (Exp(B) = 1.035, p < 0.05), the ROC curve analysis did not reveal an age threshold above which the probability of detecting carotid disease increases significantly with satisfying sensitivity and specificity. The predictors of bilateral stenosis (at least one of them > or = 70%) were a history of stroke, presence of left main disease, and lower-extremity peripheral arterial disease. CONCLUSIONS: Carotid disease is common in patients scheduled for CABG. Preoperative carotid artery ultrasound examination should be performed, regardless of age, in all patients with more advanced symptomatic atherosclerosis, such as a history of cerebrovascular accidents, presence of lower-extremity peripheral arterial disease, left main disease, or unstable angina.

Congenital heart defect with associated malformations in children.

BACKGROUND: Children with multisystem involvement including congenital heart defect (CHD) are a very salient problem. The purpose of this study was to evaluate the incidence of CHD associated with malformations of other systems and to assess the modalities of treatment and perioperative mortality among patients referred to the department of pediatric cardiac surgery. METHODS: The medical records of 1856 children were reviewed retrospectively from 1997 to 2002 to establish CHD and types of associated malformations. The connections between CHD and other lesions were investigated. Furthermore, the influence of patient and perioperative variables on mortality risk was scrutinized. Univariate and multivariate analyses were used. RESULTS: Eighty-four children (4.53%) had CHD and associated malformations. The malformations of digestive (35.7%), urinary (22.4%), and nervous (14.3%) systems were the most frequently observed associated defects. No relation was found between CHD and concomitant lesions. The results of multivariate logistic regression showed significant influence of patient age, primary cardiac procedure, and CHD type on mortality (ca 19%) in children with multiorgan lesions. CONCLUSIONS: The treatment of children with CHD and associated multiple lesions is connected with higher mortality risk. The following factors: younger age, urgency of surgical procedure, and primary surgical procedure had negative impact on patient's outcome. However, these risks in certain cases are inevitable. The cardiac procedure preceding the surgical operation may improve the overall effect of treatment because of circulatory stabilization, provided that the condition of the patient does not preclude any intervention at all.

[Lipid index (WL) in the blood serum of women undergoing surgery in the perimenopausal age]. / Wartosc wskaznika lipidowego w surowicy krwi kobiet poddanych operacjom ginekologicznym w okresie okolomenopauzalnym.

OBJECTIVES: In the blood serum from women divided into 4 groups (healthy women aged 24 and 45 years and patients after the gynaecological surgery with sparing or radical resection of uterus) the lipids index (WL) was determined. MATERIAL AND METHODS: The WL index expresses the correlations among the HDL, LDL, triglycerides and A1 and B apolipoproteins. In the perimenopausal period in women the decrease in the lipids index WL was observed comparing to the women at age of 25. RESULTS: During the diseases indicated the necessity of gynecological surgery in women in the perimenopausal period further decrease in the lipids index WL was noticed. Contrary to the sparing operation, surgical intervention with radical resection of uterus causes the following WL decrease observed in 3rd month after it. CONCLUSION: It may suggest that these differences have hormonal background.