[The lateral extraperitoneal access in surgery of the adrenal glands]. / Ocena dostepu bocznego zaotrzewnowego w chirurgii guzów nadnerczy.

This study aimed at evaluating lateral extraperitoneal access to adrenals in 233 patients (103 patients with pheochromocytoma, 101 with Conn syndrome, 11 with Cushing syndrome and 18 patients with hormonally inactive tumours) who underwent surgery in our department within 1981-1998. The age of patients ranged from 10 to 84 years. Biochemical tests have been performed and hormones assayed in all of them prior to surgery, and the localization of tumours has been established by means of the abdominal cavity ultrasound examination and CT scans. Two hundred thirty five tumours have been excised. The mean duration of surgery was 91 minutes and the mean time of postoperative hospital stay--5 days. Postoperative complications have been noted in 4.7% of the operated patients but in the group with pheochromocytoma their incidence increased to 8.7%. In 13.7% of cases an accidental opening of pleural cavity was noted. The majority of cases has had drain left in pleural cavity whereas the remaining patients have had pleurae sewn. There were two hospital deaths in the group of pheochromocytoma, i.e. in 0.85% of all patients. These results and complications were analysed in a discussion. It seems that this kind of surgical access to adrenals can be successfully used in most unilateral adrenal pathologies and in cases of extra-adrenal tumours localized along abdominal aorta. Patients with pheochromocytoma are still in increased surgical risk.

[Simple vs bifurcated graft operations in patients with abdominal aortic aneurysm]. / Proteza prosta vs proteza rozwidlona w operacjach tetniaków aorty brzusznej.

We analysed 148 patients treated surgically from 1992-1997 because of abdominal aortic aneurysm (AAA). All patients were divided into two groups: group I--118 (79.7%) patients operated with the implantation of the straight graft and group II--30(20.3%) with the bifurcated graft. The aim of the study was to analyse early (30 days after operation) complications in both groups. The mortality rate was 8.5% for group I and 26.7% for group II. The mortality was also analysed according to AAA symptoms (asymptomatic, symptomatic and ruptured). The death rate in asymptomatic patients from group I was 1.1% versus 13.3% in group II. In symptomatic patients the difference was not statistically significant--20% in group I versus 22.2% in group II. The mortality rate in patients with ruptured AAA was 50% for group I and 66.7% for group II. The early morbidity rate was significantly higher in the second group(p < 0.05) although coexisting diseases were similar for both groups. According to our material we conclude, that operation of AAA should be finished in abdomen if there is only technical possibility. It is especially important for patients with ruptured AAA.

[Complication risk after abdominal aortic aneurysm operations]. / Ryzyko powiklan pooperacyjnych tetniaków aorty brzusznej.

Between 1992-1997 185 patients were treated in our Department because of abdominal aortic aneurysm (AAA). The aim of the study was the evaluation of frequency of hospital mortality (30 days) in patients treated because of AAA. One hundred forty eight (80%) patients were operated on and 37 (20%) were treated classically. The surgical group of 148 patients were divided into three parts: group I: 106 patients with asymptomatic AAA, group II: 24 patients with symptomatic AAA and group III: 18 patients with ruptured AAA. Straight graft was performed in 118 patients (79.7%) with hospital mortality rate 8.5% and bifurcated graft implanted in 30 patients with mortality rate 26.7%. Analysis of our material allowed to find that hospital mortality was in group I: 2.8%, group II: 20.8% and in group III: 55.6%. The main cause of deaths in patients from groups I and II was myocardial infarction and hypovolemic shock in group III. The most common postoperative general complications were cardiac and pulmonary and were significantly more often in group III (p < .05). Other not significantly registered postoperative complications as renal insufficiency were also more common in patients from group III. Analysis of our material revealed that patients with abdominal aortic aneurysm should be operated selectively, when aneurysm diameter reaches 50 mm, and optimal method is straight graft which allows to reduce to minimum postoperative complications.

[The epidemic of typhus in the Polish Army in the USSR (1941-1942)]. / Epidemia duru plamistego w Armii Polskiej w ZSRR (1941-1942).

Using the archival documents from the Sikorski Institute in London the author presented the course of the epidemic. The first cases of typhus appeared at the time of the organizing of the army in the region of Tockoje. The epidemic however broke out a bit later when the army moved to the South of the USSR. The climax of this epidemic took place in February of 1942. Altogether 7346 were taken ill with the disease and 1290 people died. After the first wave of the evacuation to Teheran there were also many civilians taken ill by this disease. The names of the doctors who died as the result of their work at the time of the epidemic were mentioned in the same article.

[Short history of Polish and German relations in field on the history of medicine]. / Krótka historia zwiazków polsko-niemieckich w dziedzinie historii medycyny.

The beginnings of regular contacts between historians of medicine from Germany goes back to 1977. The initiators of them were: from German side Prof. Georg Harig, from Polish side Prof. Tadeusz Brzezinski. Since then 4 conferences have taken place: two in German, and two in Poland. Another flow of contacts there became a cooperation on the grounds of Société Internationale d'Historie de la Médecine. It has brougt the fruits of contacts mainly between Szczecin centre and Professors Hans Schadewaldt and Heinz Goerke, and also between other Polish and German Departments of Medical History. The idea of revival of the conferences was born at the Congress of Medical History in Glasgow and a present conference is the fruit of it.

[Reception of the Roentgen's discovery in Poland at the turn of XIX and XX century]. / Recepcja odkrycia Roentgena w Polsce na przelomie XIX i XX wieku.

Press information about the Roentgen's discovery were published in Poland in January, 1896, and the first scientific sessions devoted to this discovery took place on 7th February the same year. Though all scientific circles were interested in it, a radiology in Warsaw was developing the most intensely. It has happened mainly due to activity of Mikolaj Brunner, who can be recognized as the first Polish radiologist. In the article there are presented opinions and controversies about roentgen rays in different Polish circles at the turn of XIX and XX century, expressed in Polish publications in Poland and abroad.

[About relations between physician and patient in Polish medical historiography]. / O relacjach lekarz-pacjent w polskiej historiografii medycznej.

Presenting the history of medicine as interdisciplinary science, the author is trying to delimitate the competences of representatives of different sciences involved in it. As the main stream of the history of medicine he is recognizing the history of medical thought, in which a leading parf falls to a physician.

[The epidemiological status of Polish Army in the USSR at the time of its dislocation to the south and Iran]. / Sytuacja epidemiologiczna Armii Polskiej w ZSRR w okresie przemieszczania na poludnie ZSRR i do Iranu.

On the basis of the archives from Sikorski Institute in London the epidemiological status during the stay of the Polish Army in the area of Buzuluk in Kazachstan and in Iran is presented. Both malnutrition and poor conditions resulted in cases of typhoid fever and typhus. The danger from the above appeared epidemics of infant contagious diseases. The epidemiological status had been one of the reasons of hastening the evacuation to Iran. This took place in two stages. In Iran the most serious problem was malaria. Hard work of the medical service and improved conditions allowed to control the situation.