Mandibular inferior cortex width may serve as a prognostic osteoporosis index in Polish patients.

BACKGROUND: Panoramic radiographs are increasingly considered as a screening tool in the search for osteopaenia and osteoporosis. No information on normal ranges of radiographic parameters of the inferior cortex (IC) in Polish population has been found in literature; therefore, the objective of the study was to determine normal ranges of mandibular inferior cortex width on panoramic radiographs and to examine the influence of gender and age on these parameters. MATERIAL AND METHODS: The material consisted of 877 digital panoramic radiographs taken of patients aged 20 to 95 years (mean 48.69 years), including 467 females and 410 males. Mandibular inferior cortex width at the mental foramina was estimated, and the obtained results were subjected to statistical analysis. RESULTS: It was found that IC and mental index (MI) values in the studied group of Polish patients depended on age. As far as gender is considered, IC and MI were higher in males. When age and gender were discussed simultaneously, the highest values of IC and MI were observed in age group 30-39 years in both genders, followed by a gradual decrease with age, but this decrease was more pronounced in females. CONCLUSIONS: The elaborated norms of panoramic radiomorphometric parameters in Polish patients may serve as a source of comparison for radiological and clinical applications.

Influence of selected factors on survival after liver retransplantation.

OBJECTIVE: The aim of this study was to examine the survival of adult liver retransplant recipients depending on selected factors: time from the primary transplantation, cold ischemia time, indications for retransplantation, patient age and United Network for Organ Sharing (UNOS) status. PATIENTS AND METHODS: Between December 1989 and March 2011, we performed 43 orthotopic liver retransplantations (re-OLTs) among patients aged 20-62 years including 24 women and 19 men. The cold ischemia time was 250-820 minutes. UNOS status before re-OLT: UNOS 1 (n=19; 44%) UNOS 2A (n=15; 35%), and UNOS 2B (n=4; 9%). The time from OLT to re-OLT was 1-2, 146 days. The indications for re-OLT were arterial thrombosis (n=14; 33%), anastomotic biliary complication (n=3; 7%), recurrence of the original disease (n=9; 21%), hepatic vein thrombosis (n=1; 2%), primary nonfunction (PNF) dysfunction (n=2; [5%] /6 [14%]), de novo hepatitis C cirrhosis (n=2; 5%) and other etiologies (n=6; 14%). RESULTS: The 6-year survival among the primary OLT group was 80% compared with 58% among the re-OLT group (P=.0001). One-year survivals in the re-OLT group according to UNOS status 1, 2A, and 2B were 47%, 60%, and 75%, respectively (P=.475). There was a low negative correlation between survival time and time between OLT and re-OLT. There was a low positive correlation between survival time and cold ischemia time. There was a low negative correlation between survival time and patient age. CONCLUSIONS: There was a significant difference in survival between OLT and re-OLT. There was a correlation between survival time and time to re-OLTx; a shorter time corresponded to longer survival. There was a poor correlation between survival time and patient age. UNOS status before re-OLT and indication for re-OLTx influenced survival.

Treatment of early hepatic artery thrombosis after liver transplantation.

INTRODUCTION: Early hepatic artery thrombosis remains one of the major causes of graft failure and mortality in liver transplant recipients. It is the most frequent severe vascular complication after orthotopic liver transplantation (OLT) accounting for >50% of all arterial complications. Most patients need to be considered for urgent liver retransplantation. MATERIALS AND METHODS: Among 911 OLTs in 862 from 1989 to 2011, we observed 23 cases (2.6%) of acute early hepatic artery thrombosis. Seventeen patients were qualified immediately for liver retransplantation, and 6 underwent endovascular therapies, including intra-arterial heparin infusion or percutaneous transluminal angioplasty with stent placement. RESULTS: Among patients who were assigned to early liver retransplantation, 11/17 survived with 3 succumbling due to postoperative complications, including 1 portal vein thrombosis, and 3 succumbling on the waiting list. All patients who underwent endovascular therapy survived with an excellent result obtained in 1 who underwent treatment<24 hours after arterial thrombosis. In 2 patients we achieved a satisfactory result not requiring retransplantation, but 3 patients assigned to endovascular treatment>24 hours after arterial thrombosis needed to be reassigned to liver retransplantation because of poor results of endovascular treatment. CONCLUSIONS: Endovascular treatment efforts should be made to rescue liver grafts through urgent revascularization depending on the patient's condition and the interventional expertise at the transplant center, reserving the option of retransplantation for graft failure or severe dysfunction.

Panoramic radiomorphometric parameters in Polish patients.

Panoramic radiographs are frequently applied in dental radiodiagnostics and might serve as a tool for identification of a subject's bone mass. Only in a few publications can data on men, younger subjects and larger groups of patients be found. No such data are available for the Polish population; therefore, the aim of the study was to determine normal ranges of panoramic radiomorphometric parameters and examine the influence of gender and age on them. The material consisted of 877 digital panoramic radiographs taken in patients aged 20 to 95 years (mean 48.69 years), including 467 females and 410 males. Panoramic parameters such as mandibular height (H) and distance between inferior margin of mental foramen and inferior mandibular cortex (h), which are used for calculation of panoramic radiomorphometric indices, were estimated and the obtained results were subjected to statistical analysis. Gender influenced H and h, while it was found that H was age-dependent and h values were similar in all age groups. When age and gender were discussed simultaneously, the highest values of H were observed in the age group 30-39 years in both genders, followed by a gradual decrease with age. However, in females this decrease was more intense than in males. The elaborated norms of panoramic radiomorphometric parameters and indices in the Polish patients may serve as a source of comparison for radiological and clinical applications.

Liver regeneration in 120 consecutive living-related liver donors.

BACKGROUND: Living-related liver transplantation for pediatric patients has become an acceptable, low-risk treatment option. The aim of this study was to assess the extent of donor liver regeneration. MATERIALS AND METHODS: Between October 1999 and January 2008, 120 living-related donors provided 109 grafts consisting of segments II and III and 11 grafts consisting of segments II, III, and IV. Volumetric assessment of the donor liver and selected segments was performed using computed tomography. After procurement every graft was weighed. At 7 and 30 days, as well as 12 months after the operation the donor liver remnant was evaluated for differences in volume. RESULTS: A significant correlation was observed between the liver graft mass and its volume as assessed by computed tomography (r = 0.781; P < .05). Twelve months after procurement, the average regeneration index was significantly higher among donors of segments II, III, and IV (144 +/- 23%) versus donors of segments II and III (114 +/- 15%; P < .05). CONCLUSION: Liver regeneration after procurement of selected liver segments from living donors is a consistent finding. Computed tomography is an accurate imaging modality to track changes in liver volume. This study showed a positive correlation between the size of the liver graft and the regeneration of the liver remnant in the donor.

Clinical significance of lymphocytes hepatocyte growth factor mRNA expression in patients after liver transplantation.

UNLABELLED: Hepatocyte growth factor (HGF) plays a key role in the regulation of liver regeneration after hepatocyte damage. Changes in HGF gene expression reflect the status of the regeneration process. AIM: The aim of this study was to ascertain the clinical significance of the expression of HGF among liver transplant patients. METHODS: Expression of the mRNA of HGF among peripheral blood lymphocytes were measured prior to as well as at 1, 2, 6, and 10 days after liver transplantation in a group of 30 liver recipients. RESULTS: In first 24 hours after reperfusion, the patients with compromised graft function (group 1) showed persistently higher HGF gene expression after reperfusion compared with patients displaying well-functioning grafts (group 0; P = .0189). Between postoperative days 1 and 10, there was a rapid decrease in gene expression among group 0 compared with group 1 (P = .0155). The significant decrease observed in the both groups reached a certain plateau after 48 hours postoperatively. There was no statistical difference in aminotransaminase levels over the days after liver transplantation. The decreased mRNA HGF expression in lymphocytes preceded the decrease in aminotransferase levels. CONCLUSIONS: HGF was more sensitive to predict early graft function than prothrombin time, aspartate aminotransferase, and alanine aminotransferase levels. The determination of HGF expression level in lymphocytes after liver transplantation may yield valuable information for evaluation of early graft function.

Excess male mortality at the productive age in Poland at the end of the 20th century.

In the last decades of the 20th century there was observed a continuous increase in mortality rates of men at the productive age, which still causes enormous economic and social problems. Thus the aim of the paper is the analysis of the causes of excess death rates in men at the productive age in Poland. There were gathered demographic data collected by the Main Statistical Office (GUS) concerning Polish society as well as available epidemiological data related to the state of health of male population in Poland. The mortality rates referring to Polish males were analysed in several age groups. It was observed that the main causes of excess male mortality in Poland were cardiovascular diseases, neoplasms as well as trauma and accidents, which is consistent with the trends in the whole population. The mortality rates from ischaemic heart disease and pulmonary cancer have doubled in the years 1970-1990. However, in the last years of the 20th century there is perceived a decreasing trend in mortality of men at the productive age. The maintenance of this trend will be very profitable for the Polish society in the new millennium.

The influence of prophylactic vaccination on epidemic situation of infectious diseases illustrated by the epidemiology of measles in Poland in the years 1968-1998.

There were gathered demographic data collected by the Main Statistical Office (GUS) concerning Polish society. There were analysed the incidence, morbidity and mortality rates as well as the number of cases and number of deaths from measles in Poland in the years 1968-1998. It was stated that the introduction of prophylactic vaccinations against infectious diseases totally changed the epidemiologic situation. It was also stated that measles is a good example of the influence of prophylactic vaccinations on the course of disease. The measles vaccinations caused the elimination of periodicity of the disease, increase in the interepidemic periods, decrease in incidence rates and nearly eliminated morbidity from this disease. There is a chance of eradication of measles in Poland provided that mandatory vaccination periods are strictly kept and 99% of children at the age of two years are vaccinated.

Demographic structure of patients taking dental X-rays in the Lublin region.

Intraoral radiograms are the most often taken X-ray pictures in humans and the dose of radiation necessary for such radiogram is very low. However, there exists a considerable anxiousness in Polish society towards Roentgen radiation making patients avoid dental X-rays even when these are indispensable in dental treatment. The aim of the study was the evaluation of demographic structure of patients taking intraoral radiograms. The material consisted of 1,014 adults undergoing dental treatment, who had intraoral radiograms taken in the Department of Dental and Maxillofacial Radiology in 2000. After the informed consent the patients filled an anonymous questionnaire of standardised interview. The collected records were analyzed statistically and data such as age, sex, education, place of residence, employment and income were considered. The demographic structure of population of patients who had intraoral radiograms taken in the course of dental treatment differs considerably from the structure of the general population. These differences were marked especially when taking into account the level of education, employment and place of residence of the studied patients. Inhabitants of rural communities, people with lower level of education as well as older patients avoid taking dental radiograms irrationally fearing ionizing radiation. The economic factor is also important and influences the structure of patients in the domain of employment and income.