[Scintigraphic assessment of abnormal lymphatic function in edema of the lower limbs in patients with venous leg ulcers]. / Scyntygraficzna ocena zaburzen krazenia chlonki w obrzeku konczyn dolnych u chorych z owrzodzeniem zylnym goleni.

UNLABELLED: Venous ulceration of the legs is a complication of chronic venous insufficiency. Its pathogenesis together with the coexisting participation of insufficiency of the lymphatic system has not been fully explained. Clinical observations have shown that some of afflicted patients develop marked edema of the ulcerated extremity. The purpose of the studies performed with the use of lymphoscintigraphic radioisotopic method was the evaluation of the role of abnormal lymphatic function in the development of edema of the extremity. MATERIAL AND METHODS: The scintigraphic investigation with the use of human albumin labeled with 99mTc (Nanocoll) was performed in 43 patients with venous ulceration of one lower limb. A passage time of the colloid from the foot to the inguinal lymph nodes and its accumulation in the lymphatic system were evaluated. RESULTS: The mean passage time of the radiopharmaceutic from the foot to the groin of the ulcerated extremities was statistically significantly longer than that on the opposite side (20 min, SD 15 min 30 s vs. 12 min 30 s, SD 12 min 30 s; p < 0.001). The signs of obstruction of the lymphatic vessels were revealed in 16 out of 43 ulcerated extremities (37%) and in 4 out of 43 extremities without ulceration (9%; p < 0.005). CONCLUSIONS: 1. Lymphoscintigraphy has shown abnormal lymphatic function in patients with ulceration and edema of lower limb. 2. In the group of patient with venous lower leg ulcers a longer passage time of the lymph in the afflicted extremity was revealed. 3. In over 1/3 of the examined lower extremities with venous ulceration the signs of obstruction of the lymphatic vessels were found.

[Comparison of patients over 70 years old operated for hernia and cholecystolithiasis in the years 1990-1994 and 2001-2002]. / Porównanie chorych w wieku powyzej 70 lat operowanych w latach 1990-1994 oraz w latach 2001-2002 z powodu przepukliny i kamicy pecherzyka zólciowego.

UNLABELLED: THE AIM OF THE STUDY was assessment of this phenomenon as observed in the past period of 1990-2002 among patients from the surgical department. In the years 1990-1994 the percentage of persons over 70 years who had been operated upon rose from 14 to 25% with an average of 14.7%. MATERIAL AND METHOD: Patients operated for inquinal and femoral hernias and for cholecystolithiasis in the years 1990-1994 were assessed and compared with those operated in the years 2001-2002 with regard to the rate of postoperative complications. RESULTS: It was found that the total percentage of patients over 70 years old operated upon became reduced from 14.7 to 9.7% and that it even fell from 34 to 17% in persons past 80 treated for hernia. The marked improvement of the results of the treatment of cholecystolithiasis was attributed to the introduction of the laparoscopic method of operation. In the group of patients treated with the above method the percentage of persons over 80 years old also fell from 19.2 to 12.5%. CONCLUSION: This is proof that current demographic data do not always find their reflection among persons operated upon and that they do not bear aggravatingly upon the results of treatment.

[Laparoscopic cholecystectomy--the method of choice in the elderly]. / Cholecystektomia laparoskopowa metoda z wyboru u osób w wieku podeszlym.

The aim of the study was the comparison and assessment of the results of gallbladder excision performed with the classical and laparoscopic methods in persons after age of 70. A total of 242 patients with mean age of 76.1 years operated on in the years 1999-2002, were analysed. 150 of them were operated with the laparoscopic and 92 with the classical methods. The frequency of postoperative--surgical and general--complications and the presence of concomitant diseases associated with old age were compared. Laparoscopic procedures are distinguished for an almost six fold decrease in the percentage of complications (6 vs. 35%) loaded comparably with concomitant diseases. Patients operated with laparoscopic methods had suffered from cardiac infarctions twice as often in their past history (17 vs. 8%). The method of laparoscopic gallbladder excision proved to be beneficial also in persons of advanced age.

[Lymphoscintigraphy as a method of choice for the assessment of lymphatic oedema of the lower limbs]. / Limfoscyntygrafia jako metoda z wyboru dla oceny obrzeku limfatycznego konczyn dolnych.

Among various pathologic conditions characterized by swelling of the lower limbs, lymphatic oedema is that of more frequent occurrence. The oldest method used in the examination of the lymphatic system besides its clinical assessment is colour lymphography based on the application of methylene blue. A more accurate method was employment of iodic contrast media visualised on roentgenological plates. Nowadays disturbances of lymphatic drainage are almost exclusively examined by means of lymphoscintigraphy with the use of radioactive markers. The study discusses the technique of this examination as well as the criteria of the assessment of the results obtained.

[The influence of pentoxifylline on the course of experimental peritonitis]. / Wplyw pentoksyfiliny na przebieg doswiadczaneigo zapalenia otrzewnej.

The influence and relation between pentoxifylline (PTX) dose and time of administration and mortality rate of animals with experimental peritonitis (EP) were studied. Forty-five rats used in this study. Experimental peritonitis was elicited in study animals. All animals were divided onto 3 groups. The sorting was made according to drug dose and moment of administration. Group 1--the control one--consisted of non-treated animals with EP. Animals from group 2 received 50 mg of PTX per kg of body weight before cecal ligation and puncture (CLP). In group 3 PTX was administered in a dose of 250 mg/kg 8 hrs after CLP. The influence of PTX inactivating phosphodiestherase as a cyclooxigenas inhibitor on the behavior of C-reactive protein, II-11beta, TNFalph and its soluble sTNF-R type I p55 and type II p75 receptors' study animal serum concentrations was estimated. The influence of administered drugs on the course of EP was assessed by means of animal survival period and CRP serum concentration dynamics observation. Thirty-three percent of control group animals survived the experiment compared to 53.3% in group 2 and 46.6% in group 3. The study proved that PTX administration in animals with EP caused TNFa serum concentration decrease, however not changing the overall animal survival rate. On the contrary, cycloooxygenase inhibitors decrease arachidonic acid peroxidation product cytotoxicity in experimental peritonitis.

[Retrospective analysis of post-endoscopic retrograde cholangiopancreatography mortalities]. / Retrospektywna analiza zgonów po procedurach endoskopowej wstecznej cholangiopankreatografii.

Endoscopic retrograde cholangiopancreatography (ERCP) which belongs to routine investigations of the biliary tract may lead to a possible development of various complications terminating occasionally in death. The authors analyses the causes of death in 6 patients (1.06%) who died following ERCP procedures performed for various reasons. They were solely woman. Deaths were most often caused by acute pancreatitis (in 3 cases), perforation of the duodenum, hemorrhage from the carcinoma of the ampulla of Vater, and acute cholangitis. Emphasis was laid on the significance of accurate and purposeful indications for performing ERCP. It was pointed out that the ERCP equipment intended for being used only once has been utilized many times for economic reasons. It is of the highest importance that the ERCP procedures are carried out in well equipped and specialized centers by adequately trained and highly experienced endoscopists.