Swedish adjustable gastric band (SAGB) implanted laparoscopically in the treatment of morbid obesity--the first experience in Poland.

Surgical treatment of morbid obesity is a recognized method of proceedings in patients who did not obtain any positive results in conservative therapy. In October and November 1998 laparoscopic implantation of the SAGB was performed among ten morbid obesity patients with mean BMI of 41.9 +/- 3.6 kg/m2. It was the first experience in Poland. In this group we observed also non-insulin dependent diabetes mellitus in five, hyperlipidemia in eight and hypertension in three patients. In this series, there was no mortality and no perioperative morbidity. The mean operation time was 158 +/- 51 min. The mean hospital stay was four days after the operation. Median BMI reduction after four months was 4.7 +/- 1.6 kg/m2. Parallel to the reduction in body weight, there occurred a significant reduction in plasma concentration of glucose (111.0 +/- 38.5 vs. 90.2 +/- 20.8 p < 0.01), total cholesterol (223.8 +/- 42.0 vs. 192.7 +/- 21.3 p < 0.005), and LDL-cholesterol (140.4 +/- 34.0 vs. 121.7 +/- 25.2 p < 0.01). Hypertension was still observed only in one patient. Nowadays laparoscopic gastric banding represents the least invasive surgical treatment of morbid obesity. In our series laparoscopic implantation of SAGB seems to be an effective surgical method for the treatment of obesity. Substantial reduction in body weight was associated with improvement in metabolic control. Absence of mortality and morbidity is one of the main aims in bariatric surgery which was achieved in our study. The results of the present, first in Poland, preliminary study confirm previous observations that gastric banding is an effective treatment of obesity.

[Rare foreign body in the lumen of the small intestine]. / Niezwykle rzadkie cialo obce w swietle jelita cienkiego.

The pathologic conditions caused by forgotten surgical gauze give rise to many different clinical pictures and are very hazardous for the patient. Such patient are seldom reported in the medical literature, mainly due to legal implications. That's why authors describe a case of surgical gauze forgotten after gynecologist procedure. The interval between the causative operation and the admission in our hospital was 7 months. The tentative diagnosis was jejunal tumor. Definitive diagnosis was made intraoperatively, we find surgical gauze 25 cm x 30 cm of diameter in jejunum with jejuno-jejunal fistula which protect patient against ileus.

[Anatomical correction of transposition of the great arteries in 7 newborn infants]. / Korekcja anatomiczna przelozenia wielkich pni tetniczych u siedmiu noworodków.

In the presented article, the course and results of anatomical correction of transposition of great arteries (TGA) in 7 neonates (2 females and 5 males) with mean body mass of 3250 g and 2 to 5 days old (mean 3 days) are reviewed. Surgery was performed in moderate hypothermia. St. Thomas cold cardioplegia was used. Mean aortic clamping time was 70 min (55-115), and the time of extracorporeal circulation was 165 min (117-210). Low cardiac output in all patients in the postoperative period required prolonged mechanical ventilation and positive inotropic drugs. Out of 7 patients operated, two died (29%). The cause of death in both cases was myocardial ischemia of right ventricle. The other 5 patients were discharged after healing of operational wound. In the control echocardiographic examination performed 3 to 12 months postoperatively, apart from one case of moderate pulmonary artery stenosis, no other haemodynamically significant complications were noted.

[Cardiogenic shock. Surgical reperfusion and myocardial revascularization]. / Wstrzas kardiogenny. Chirurgiczna reperfuzja i rewaskularyzacja miesnia sercowego.

Emergency coronary bypass for cardiogenic shock has been associated with a high operative mortality. From February 1986 through October 1989, 40 patients with acute myocardial infarction were operated. Ten pts (25%) were in shock despite intensive treatment (intra-aortic balloon pump in 4, catecholamines in 10). Seven pts. required cardiopulmonary resuscitation before operations. After operations 66% of the patients required catecholamine support and 60% were treated with intra-aortic balloon pump. There were three (30%) hospital deaths (one in the operating room due to acute cardiac failure). Follow-up (100%),(mean 26 months) revealed one late death--39 months after operations. In functional class I were 2 patients, II--one, and III--two pts. One pt is in group IV (transplant candidate). Myocardial infarction complicated by cardiogenic shock can produce a mortality rate in excess of 85%. Contemporary medical management has had little effect on mortality, hence effective surgical therapy has evolved for this lesion.

[A nomogram of vestibular pendular stimulation in guinea pigs]. / Nomogram pobudzenia wahadlowego narzadów przedsionkowych u swinki morskiej.

Vestibular pendular test was performed in 20 guinea pigs of various sexes and weights 250-300 g. The total sum of deviations on the right and on the left was 105-164. According to the standard deviation we have accepted the minimal norm 94 and maximal 183. Taking into consideration this norm we have elaborated the nomogram for the quantitative reaction to pendular excitation. There were 6 positions from 0.7 to 1.2 deviations for sec. and total sum from 94 to 183. The results in guinea pigs were in contrast with those in men. The guinea pig vestibular organ is more susceptible for high-rate excitation (17-12 degrees/sec2) and of minor susceptibility in lower rate of acceleration (12-0 degrees/sec2).

[Recording of electric evoked responses from the distal field of the vestibular part of the VIII nerve. Preliminary report]. / Rejestracja elektrycznych odpowiedzi wywolanych z odleglego pola w czesci przedsionkowej nerwu VIII. Doniesienie wstepne.

The authors described the results of distant field registration of evoked responses from the vestibular part of acoustic nerve. The investigations were carried out as a preliminary pilot study and were successful in obtaining the repeatable responses in guinea pigs. The detailed informations about the stimulation, reception and average technique equipment were enumerated. The variant proposition of the extraction of side motor disturbances was done.

Recording of electrical-evoked responses from a remote field in the vestibular part of the eighth nerve. A preliminary technical report.

The paper discusses the results of the author's own studies concerning the recording of electrical responses evoked from a remote field in the vestibular part of the eighth nerve. The studies are of experimental nature and they were carried out repetitively in guinea pigs. Particular attention is paid to an apparatus specially designed and constructed, permitting to obtain stimulation of adequate quality of vestibular organs, and to receive and average short (up to 10 ms) evoked vestibular potentials. Different variants of elimination of bioelectrical muscular disturbances and of the auditory pathway are proposed.

[Dosimetric evaluation of noise and results of the audiometric examination of a selected group of workers in the refinery-petrochemical industry]. / Ocena dozymetryczna halasu i wyniki badan audiometrycznych w wybranej grupie pracowników przemyslu rafineryjno-petrochemicznego.

Sonometric and dosimetric measurements of noise at a dozen workplaces of three divisions in a refinery-petrochemical plant have been made. The equivalent level allowable with a view to hearing protection was found to be exceeded by 1-3 dBA at some workplaces. The tonal audiometric test was used to determine threshold levels for 250-8000 Hz frequencies in 122 workers. The present acoustic conditions at the test workplaces do not pose a risk of a significant hearing loss. Only a slight high-frequency hearing loss which might result from noise exposure was diagnosed. Not a single case of occupational hearing impairment conformable with the mandatory diagnostic and certificatory rules was reported.