[Late results of surgical and conservative treatment for atheromatous ischemia of the lower limb in young patients]. / Odlegle wyniki leczenia operacyjnego i zachowawczego miazdzycowego niedokrwienia konczyn dolnych u mlodych chorych.

The study was carried out within a multicenter program. Hundred fifty four patients under 40 years were treated (73 conservatively, and 81 surgically) for the atheromatous ischemia of the lower limbs in 14 Departments of Vascular Surgery in Poland within 5 years. The results of the treatment were evaluated according to the site of atheromatous lesions, type of surgery, and mainly according to the progress in pathologic process expressed by the degree of limb ischemia. It was found that surgery performed in the II period of the disease produces the best results. Surgery produces positively better results than conservative treatment in patients with the II period of the disease whereas both surgical and conservative therapy are ineffective in the III and IV degrees of ischemia. Sympathectomy may be effective in the occlusion of crural arteries even of the IV degree ischemia. In case of the II degree ischemia better results are produced by the operation of aorto-iliaco-femoral segment (transplantation or thrombendarterectomy) than that involving distal segment (sympathectomy) whereas the results of conservative therapy are better in peripheral and iliaco-femoral occlusion than those in aortofemoral and multisegmental arterial occlusion. An opinion of several authors on the specificity of atheromatous ischemia of the lower limbs in young patients was not confirmed.

Intestinal and hepatic changes following superior mesenteric artery occlusion shock in dogs.

The protective role of the liver in haemorrhagic shock was strongly suggested. However, hepatic changes in other forms of shock has not been elucidate the purpose of present work were to investigate. The morphological and histochemical changes of the liver in SMAO shock were observed. In six mongrel dogs severe SMAO shock was produced by occlusion of superior mesenteric artery for 4 hours and experiment was terminated when agony of animals began. Six healthy dogs severed as control group. In SMAO shock the microscopic findings supposed severe necrotic changes in intestinal epithelium. Simultaneously distinct degenerative changes in hepatic cells with vacuolization of enzymic cytoplasm. The reaction to acid phosphatase was more intensive and partially diffuse. The staining reaction alkaline phosphatase, succinic dehydrogenase, and lactic dehydrogenase varied from strongly positive to negative. Different changes of p.a.S. reaction and protein and groups SH and groups NH were observed suggesting the damage hepatocytes. The results of this study suggest the severe disturbances in hepatic morphology and function following the SMAO shock. The pathogenesis of this changes is discussion.

Lysosomal hydrolases of dog kidney in superior mesenteric artery occlusion (SMAO) shock.

In 6 dogs with superior mesenteric artery occlusion (SMAO) shock and in 6 healthy animals the total and free activity of lysosomal hydrolases (acid phosphatase, betaglucuronidase and cathepsins) in the whole homogenate, the lysosomal enriched subfraction and the supernatant of kidneys were estimated. Statistically significant differences between the two groups were not observed. These results indicate that in SMAO shock, the stability of kidney lysosomes is well preserved during observed period.

[Ultrastructure of the new endothelium in polyester aortic prosthesis]. / Ultrastruktura nowej blony wewnetrznej poliestrowej protezy aorty.

The development of a new intima in polyester prostheses Dallon implanted into the abdominal part of dog's aorta was tested in the scanning and transmission electron microscope. It was proved that during the first month of the experiment morphoetic elements of blood appeared on the graft surface and later within 36 months smooth muscle cells, collagen fibres and small amounts of elasticin could be found. The process of endothelialization began in the 4 month and after 12 months the graft was totally covered by endothelium. The picture in the SEM especially in the central part differed from the picture of normal arterial endothelium.