The impairment of wound healing process is correlated with abnormalities of TNF-alpha production by peritoneal exudate cells in obstructive jaundiced rats.

The wound healing process and production of tumour necrosis factor alpha (TNF-alpha) by peritoneal cells of 7-day and 14-day obstructive jaundice (OJ) and sham-operated rats were investigated. In the study the skin wound breaking strength was measured. In addition such histological and biochemical parameters as fibroblast and endothelial cell proliferation, inflammatory cell infiltration and hydroxyproline content were evaluated in polyurethane sponge discs implanted subcutaneously into rats. TNF-alpha production by peritoneal exudate cells (PEC), both spontaneous and lipopolysaccharide (LPS)-induced was determined by a bioassay. In OJ rats the process of both early as well as late phase of healing was impaired. The breaking strength of skin wound was decreased, the fibroblast and endothelial cell proliferation and collagen deposition, as well as hydroxyproline content were diminished. In 7 day OJ the numbers of inflammatory cells in the implants were lowered with a subsequent slight increase on day 14 of OJ. The spontaneous and LPS induced TNF-alpha production by PEC were significantly higher in 7 day OJ as compared with sham-operated controls. On day 14 of OJ the LPS-induced TNF-alpha level was, in contrast, much lower and did not differ much from the spontaneous TNF-alpha production. We conclude that the impairment of wound healing in OJ results from disturbances in functioning of the immune system caused by systemic endotoxaemia.

[Pancreatoduodenectomy by Whipple's method--a method of dealing with the pancreatic stump]. / Pankreatoduodenektomia sposobem Whipple'a--sposób zaopatrzenia przewodu trzustkowego.

Different methods of pancreatic stump management are possible to perform after pancreaticoduodenectomy. The group of 24 patients after pancreaticoduodenectomy with pancreaticojejunostomy, pancreaticogastrostomy and occlusion of the pancreatic duct by Neopren or Ethiblock were analysed. According to the literature and own results pancreatogastrostomy or occlusion of the pancreatic duct seems to be the safer procedure, but sometimes the choice is made intraoperatively.