Health-related quality of life after the surgical treatment of obesity.

The aim of the study is to answer the question: what is the range and character of changes within health-related quality of life (HRQL) in obese patients who have undergone surgical treatment (VBG - vertical banded gastroplasty or RYGBP - Roux-en-Y gastric bypass) in the period of three and six months after operation? Three groups of patients participated in the study: G I (n=33; BMI 49.90 +/- 6.74 kg/m(2)) - tested prior to the operation, G II (n=17; BMI 34.26 +/- 5.28 kg/m(2)) - tested six months after the operation, and G III (n=11) - examined prior to the operation (BMI 45.72 +/- 5.27 kg/m(2)) as well as three months after the operation (BMI 36.10 +/- 4.60 kg/m(2)). The Nottingham Health Profile (NHP) questionnaire was used as an indicator of HRQL. Surgical treatment of obesity resulted in significant positive changes in relation to the basic dimensions of NHP: energy, pain, physical mobility and in the influence of the current health state on selected spheres of life: paid employment, jobs around the house, social life, sex life, interests and hobbies, holidays. Significant changes in HRQL resulting from bariatric surgery occur in a relatively short period of time and are related not only to physical but also to social functioning.

[Changes in secretion of cholecystokinin after cholecystectomy and the effect of these changes on biliary reflux and the state of the gastric mucosa]. / Zmiany w wydzielaniu cholecystokininy po cholecystektomii oraz wplyw tych zmian na wystepowanie refluksu zólciowego i stan blony sluzowej zoladka.

Cholecystokinin's role in regulations of gallbladder and gastric function was well documented. After cholecystectomy a secretion of cholecystokinin may be changed and observed symptoms are able to create a new clinical picture including biliary gastric reflux. In the study was noticed that in 12 patients after cholecystectomy the cholecystokinin secretion was increased in comparison to the period before operation. Observed increased levels of the enzyme were not in connection with biliary gastric reflux.

[Sigmoid-vesical fistula as a consequence of sigmoid tumor]. / Przetoka esiczo-pecherzowa w nastepstwie raka esicy.

Because of unusual rarity of neoplastic sigmoid-vesical fistula in young patients the case of 43 years old woman, in whom the fistula was the consequence of sigmoid adenocarcinoma infiltration of urinary bladder, was presented. The patient was treated radically by resection of the sigmoid and partial resection of the urinary bladder within healthy tissue. After operation the patient was exposed to radiotherapy, after which chemotherapy followed (6 courses of 5-day chemotherapy with fluorouracil and calcium folinate). 18 months after operation, 16 months after radiotherapy and 14 after chemotherapy patient's general condition was good and control laboratory tests did not indicate the relapse of the neoplasm.

Normal human immune peritoneal cells: subpopulations and functional characteristics.

Normal human peritoneal cells collected during elective laparatomy from patients with gallbladder stones without clinically detectable inflammatory changes were characterized phenotypically with immunocytochemical method and flow cytometry, with special attention paid to the presence of memory cells. The responsiveness of normal PCs to mitogen and, specifically, the role of peritoneal macrophages in this process was studied. The peritoneal cells consisted of 45% of monocytes/ macrophages (CD68+), as many as CD2+ T lymphocytes, 8% CD57+ NK and K 2% CD22+ B, cells. The CD4/CD8 ratio was 0.4. The peritoneal cells did not express interleukin-2 (CD25+) and transferrin receptors (CD71+) on their surface. Approximately 49% of the peritoneal cells were class II MHC antigen positive cells. Two per cent of S100+ dendritic cells were found. Flow cytometric two-colour analysis revealed that the majority of peritoneal CD4+ (92.4%) and CD8+ (73.1%) lymphocytes, while only 50.2% of CD4+ and 30.1% CD8+ peripheral blood cells expressed simultaneously the CD45R0 (UCHL1) molecule, which is characteristic to the memory/effector T-cell subpopulation. Peritoneal T lymphocytes responded to the mitogens less than peripheral blood lymphocytes of the same individual. Supplementation of cell culture with anti-macrophage (anti-CD68) and anti-HLA-DR MoAb brought about a dose-dependent decrease of proliferative peritoneal cell response to ConA. The authors conclude that human peritoneal cell population comprises a high proportion of T lymphocytes and macrophages capable of presenting antigens to peritoneal lymphocytes. High prevalence of memory lymphocytes points to the preparedness of these cells to react with invading antigens most likely of gut bacterial origin.

Experimental assessment of canine pancreatic segment function.

The purpose of the study was to examine the variability of pancreatic arterial vascularization and to evaluate a vascular model of canine pancreatic segment for transplantation, providing preservation of normal endocrine and exocrine functions. The study included the assessment of pancreatic segment function on the basis of glycemia and post mortem corrosion-casts dissection.

[A system for continuous monitoring of hospital infections]. / System stalego monitorowania zakazen szpitalnych.

The authors of the paper present the system designed for constant monitoring of the nosocomial infections. The system is based on the following data: 1. The chart on which the nosocomial infections are registered; the chart, added to the case record of every patient in the hospital, is prepared by a nurse in the admission quarters and it is homogenously filled in by the doctor when patient is discharged from the hospital. 2. Computer processing of the information included in the chart on which nosocomial infections are registered, with the use of IBM computer and a special prepared on the data base for DOS system.

Normal human immune peritoneal cells: phenotypic characteristics.

Normal human peritoneal cells (PC) collected from patients with calculous cholecystitis without clinically detectable inflammatory changes were characterized morphologically, histochemically and phenotypically by means of monoclonal antibodies. The PC consisted of 45% of monocytes/macrophages (M718 + cells). Thirty-five per cent of PC were esterase-positive and 23% acid phosphatase positive. Forty-five per cent of PC adhered to glass surface. In the lymphocyte population, 2% of CD22 B lymphocytes (M738 +) and 42% CD2 T lymphocytes (M720+) were found. CD4/CD8 ratio was 0.4. There were 8% of Leu7 + cells. The PC did not reveal interleukin 2 (OKT26a +) and transferrin receptors (OKT9 +) on their surface. No blast cells were detected in the PC suspension. Approximately 49% of the PC expressed Ia antigens (OKIa1 +). Two per cent of S100 positive dendritic cells (Z311 +) were found. Peritoneal fluid contained 9% of granulocytes, mostly neutrophils. Two per cent of PC were free mesothelial cells (M717 +). We conclude that human peritoneal cavity contains a cell population significantly differing from that which is present in peripheral blood, which strongly suggests a non-random cell accumulation in the peritoneum. Lack of any activated cells indicates that under normal conditions the peritoneum lavage fluid contains a steady-state population. We conclude that the normal peritoneal fluid cells represent a heterogeneous population capable of reacting to various antigens entering the cavity from the gut.

Study of the arterial blood supply of the pancreas harvested for transplantation.

Blood supply of the pancreas was studied on 42 latex corrosion casts and 22 arteriograms. The study confirmed variability of the arteries of the pancreas especially the dorsal pancreatic artery.

The radiological examination of the pancreas harvested for transplantation.

The radiological examination of the pancreatic arterial blood supply was performed to show the presence of the arterial variability. 40 arteriograms of pancreatic vessels were made. The research confirmed the subsistence of the arterial variability concerning the dorsal pancreatic artery in particular. The importance of the previous arteriography in donor, before harvesting the pancreatic graft, was unterlined.

Myocardial revascularization by CO2 laser.

An original method of myocardial revascularization using CO2 laser has been studied in a pig model with acute myocardial infarction. Transparietal channels were created by myocardial vaporization, using a CO2 laser beam. A comparative evaluation was made against a control group using as parameters survival rate, ECG changes, anatomopathologic findings, and angiographic studies. With the exception of favorable changes in the ECG there was no other evidence of improved regional perfusion. No evidence of long-term patency of the transmyocardial channels could be demonstrated by angiographic and histologic studies.

New fiber for ligament and tendon prosthesis.

A new material has been used as tendon and ligament prosthesis on animals. The long-term clinical results obtained after ACL and Achilles tendon replacement suggest an adequate tolerance and a function of the prosthesis.

Effect of methylated prostaglandin E2 analogue on insulin secretion in man.

Previous studies of the effect of E series prostaglandins /PGs/ on insulin secretion gave conflicting results in animals and little information in man. This study was designed to determine the effect of methylated PGE2 analogue /15/S/- 15-methyl PGE2 methyl ester/, given orally, intraduodenally or intravenously, on insulin secretion, both under basal conditions and in response to intraduodenal or intravenous administration of glucose in 22 male volunteers. Methylated PGE2 kept basal serum insulin level unchanged, but significantly reduced insulin response by 15 +/- 6 microunits/ml to intravenous glucose pulse injection /0.1 g/kg/ or by 45 +/- 11 microunits/ml to intraduodenal glucose infusion /0.5 g/kg-hr/. Blood glucose level was unaffected in tests with intraduodenal methylated PGE2, but in tests with intravenous administration it was significantly reduced. These studies demonstrate that methylated PGE2 analogue given orally, intraduodenally or intravenously results in a potent suppression of insulin response to glucose challenge.

Effect of somatostatin on meal-induced gastric secretion in duodenal ulcer patients.

The effect of somatostatin, a growth hormone releasing-inhibiting hormone (GH-RIH) on basal and meal-, pentagastrin-, or histamine-stimulated gastric acid and pepsin secretion was studied in six duodenal ulcer patients. Intravenous GH-RIH infused in graded doses ranging from 0.62 to 5.0 microgram/kg/hr produced a dose-related inhibition of pentagastrin-induced acid secretion reaching about 15% of control level at the dose of 5.0 microgram/kg/hr. Acid inhibition was paralleled by a decrease in the pepsin output and accompanied by a dose-dependent reduction in serum growth hormone and insulin levels measured by radioimmunoassay. GH-RIH used in a single dose of 2.5 microgram/kg/hr produced about 85% inhibition of acid secretion induced by a meal (measured by intragastric titration) accompanied by a significant decrease in serum gastrin and insulin levels. The effect of GH-RIH on histamine-stimulated secretion was very modest and observed only after stopping the GH-RIH infusion. Thus GH-RIH suppressed acid and pepsin secretion induced by pentagastrin and a meal, and this effect was accompanied by a suppression of serum growth hormone and gastrin levels which may contribute to the inhibition of gastric secretion observed.