Full-text resources of PSJD and other databases are now available in the new Library of Science.
Visit https://bibliotekanauki.pl
Preferences help
Polish version English version Language
enabled [disable] Abstract
Number of results

Results found: 8

Number of results on page
first rewind previous Page / 1 next fast forward last

Search results

help Sort By:

help Limit search:
first rewind previous Page / 1 next fast forward last
1
Content available remote

Evaluation of Intraabdominal Presure changes after large Abdominal hernia Surgeries

100%
Pukacki F., Zieliński M., Grzeszczak M.
Polish Journal of Surgery
|
2010
|
vol. 82
|
issue 5
259-266
EN
Occurrence of systemic complications after a large abdominal hernia operation depends on the increase of intraabdominal pressure (IAP). It is thus essential to device a preoperative method to predict IAP level changes in perioperative period.The aim of the study was evaluation of our own mathematical calculation of hernial sac volume in prognosis of intraabdominal pressure changes after abdominal wall reconstruction.Material and methods. Between January 2006 and November 2007 32 patients were operated because of a large abdominal hernia. Secondary hernias made up 68.8%, whereas primary hernias 31.3%. Mean patients' age was 67.5 years. Using our own method of mathematical calculation of hernial sac volume, the patients were divided into groups according to hernia size. Intraabdominal pressure values and their influence on respiratory, circulatory and excretory systems have been analyzed. The operation was conducted under intratracheal anesthesia. The abdominal wall plasty was carried out using a polypropylene mesh that has been placed in the prefascial retromuscular space.Results. No perioperative deaths were observed. The highest mean IAP increase occurred after hernial ring closure, whereas the highest mean abdominal perfusion pressure (APP) drop was observed in the first 24 hours after the operation. There was observed a positive correlation between hernial sac volume (HSV) and IAP values and a negative one between HSV and APP value. There was observed a decrease of diuresis, saturation, blood pressure and an increase of urea and creatinine in the first 24 hours after the operation.Conclusions. A non-invasive hernial sac volume measurement helps to predict postoperative IAP growth and thus development of general complications. Pressure-free operations seem to be safe in terms of preventing post-operative intraabdominal pressure growth.
2
Content available remote

The Usefulness of Topical Negative Pressure (TNP) As a Supporting Method for the Surgical Treatment of Venous Ulcers with the use of Middle-Split Thickness Skin Graft

76%
Zieliński M., Pukacki F., Oszkinis G., Gabriel M., Waliszewski K., Majewski W.
Polish Journal of Surgery
|
2008
|
vol. 80
|
issue 3
124-131
EN
The most effective method of treatment for venous ulcers resistant to conservative therapy is operation.The surgical procedure consists of resection of the entire ulceration followed by perforated middle-split thickness skin graft transplant. Postoperative treatment requires both long term elevation of the patient's leg and frequent dressing changing.The aim of the study was to assesses the effectiveness of TNP as a method supporting surgical treatment.Material and methods. From 2004 to 2006 in the Poznań Clinic of General and Vascular Surgery of Medical University, 25 patients (16 women and 9 men) were treated for venous ulcers resistant to conservative treatment. The patients' ages varied from 50 to 82 years (average: 69), and the time of ulceration presence ranged from 6 months to 6 years (average: 2 years and 5 months). Patients were divided into two groups: all patients in group I (n=14) underwent surgical treatment with the use of middle split thickness skin grafting, whereas all patients in group II (n=11) underwent surgical treatment with support of TNP - VAC® Subsequent parameters, including the time of hospitalization, time and effectiveness of skin graft healing, and patient's subjective comfort of the therapy, were analyzed.Results. The average hospitalization time was significantly shorter in group II than group I (18 vs 24 days, p<0.0005). The average healing time in group II was significantly shorter than that in group I (31 vs 42 days, p<0.00002). Additional skin grafting was necessary in four cases from group I but none from group II. Subjective therapy comfort was higher among patients from group II than group I.Conclusions. TNP is a useful method supporting the surgical treatment of venous ulcers that are resistant to conservative treatment.
3
Content available remote

Endovascular Treatment of Symptomatic Stenosis of the Brachiocephalic Trunk

76%
Juszkat R., Pukacki F., Wachal K., Oszkinis G., Staniszewski R., Zieliński M., Majewski W.
Polish Journal of Surgery
|
2007
|
vol. 79
|
issue 1
12-18
EN
The aim of the study was to present our own endovascular treatment results in cases of patients suffering from symptomatic stenosis of the brachiocephalic trunk.Material and methods. During the period between March 2000 and October 2004, 14 patients underwent angioplasty accompanied by stent implantation. The above-mentioned procedure was performed, due to critical, symptomatic stenosis of the brachiocephalic trunk. The patients were diagnosed and placed into different procedural groups based on the physical examination and radiological imaging examinations (Doppler ultrasound and DSA). The immediate and long-term results were evaluated with the physical examination and Doppler ultrasound examination performed at 3-, 6- and 12-months after the procedure.Results. In every patient, the immediate results were positive. Intraoperative DSA angiography confirmed that the artery was dilated. Preoperative clinical symptoms of cerebral and collateral circulation insufficiency in the upper extremity were limited (5/14) or totally regressed (9/14) during the postoperative period. During the intra- and postoperative period, none of the following complications were found: upper extremity arterial embolism, acute arterial thrombosis, dissection or rupture of the brachiocephalic trunk wall, or death. Patients were discharged 2 or 3 days following the procedure. Follow-up examinations confirmed proper blood flow in the brachiocephalic trunk and increased flow in the right vertebral artery. No symptoms of restenosis were found in the area of stent implantation and the stent was not dislocated.Conclusions. Angioplasty accompanied by stent implantation is a safe and efficient treatment method in the case of patients suffering from symptomatic stenosis of the brachiocephalic trunk, particularly in patients with significant operative risk. The hypothesis was confirmed by both perioperative observations and immediate, as well as, long-term patency results.
4
Content available remote

Utility of Measurements of Abdominal Perfusion Pressure as a Measure of Isovolemic Status and Intestinal Perfusion in Patients with Ruptured Aortic Aneurysm

76%
Bieda K., Pukacki F., Zieliński M., Sobczyński P., Oszkinis G., Hartman-Sobczyńska R., Majewski W.
Polish Journal of Surgery
|
2011
|
vol. 83
|
issue 8
443-448
EN
Ruptured abdominal aorta aneurysm of ten results in intraabdominal hypertension (IAH). When IAH exceeds 20 mm Hg, intestinal ischemia can result that is a common cause of severe postoperative complications, including death.The aim of the study was to evaluate utility of measurement of abdominal perfusion pressure (APP) to estimate intestinal perfusion and isovolemic status in patients undergoing surgical treatment for ruptured abdominal aorta aneurysm.Material and methods. A group of 40 patients of either sex, aged 47 - 93 years (average age 70 ± 10) was treated at an Intensive Care Unit after surgical reconstruction of abdominal aorta due to ruptured aortic aneurysm. The study was prospective. The following were measured: parameters of intraabdominal pressure (intraabdominal pressure - IAP, abdominal perfusion pressure - APP); parameters of intestinal perfusion - tonometric (intramucosal gastric carbon dioxide partial pressure PgCO2, intramucosal-arterial difference in carbon dioxide partial pressure - Pg-aCO2); hemodynamic parameters (mean arterial pressure - MAP, central venous pressure - CVP).Results. A statistically significant correlation was demonstrated between parameters of visceral perfusion and abdominal perfusion pressure. Pearson correlation coefficient for APP/PgCO2 and APP/Pg-aCO2 was negative and was - 0.4664 and - 0.3498, respectively.Conclusions. Abdominal perfusion pressure is an useful parameter in the evaluation of intestinal perfusion in IAH patients after surgical treatment of ruptured aortic aneurysm. MAP reflects current physiological body reserves at a critical stage of the disease, informing about possibility to provide visceral perfusion and indirectly, about adequacy of fluid replacement therapy. In intraabdominal hypertension, CVP is falsely elevated, making it of low utility in the evaluation of volemic status and intestinal perfusion.
5
Content available remote

Changes in Transmission of Lower Limbs Nerves After Varicose Veins Operations with Saphenous Vein Stripping

64%
Oszkinis G., Jaworucka-Kaczorowska A., Huber J., Kaczorowski P., Wiertel-Krawczuk A., Pukacki F., Zieliński M., Snoch M., Majewski W.
Polish Journal of Surgery
|
2008
|
vol. 80
|
issue 8
404-412
EN
The injury of the lower limb nerves is a very frequent complication after the varicose veins surgical treatment. The stripping of the great saphenous vein can cause the lesion of saphenous nerve and other lower limb nervesThe aim of the study was to establish the relationship between the percentage of the nerve injuries at the long stripping of great saphenous vein and to estimate the impact of this surgical treatment on the quality of patient's life.Material and methods. The neurophysiological examinations which included 80 patients were performed four times- before the operation, 2 weeks, 3 and 6 months after the operation. The following neurophysiological examinations were used: the sensory conduction velocity studies (SCV), the intensity of current-stimulus duration curves (IC-SD) and the von Frey filaments examination, the electroneurography (ENG, M-wave studies) and electromyography (EMG). The questionnaire to estimate the quality of life among the patients after the varicose veins operations was also conducted.Results. 30 patients (36%) were found to be injured with the saphenous nerve. These disorders persisted among 17 patients (21.25%) 3 months and among 11 patients (13.75%) 6 moths after the operation. In 38 patient (47.5%) 2 weeks after the operation, 24 of patients (30%) 3 months after the operation and in 15 patients (18.75%) 6 months after the operation showed the abnormalities which were usually located near the medial ankle. The paraesthesia which occured among 32 patients (40%) did not worsen the quality of life and only one patient wouldn't agree to repeated operation. In 6 patients (7.5%) there was found hyperaesthesia which had the significantly bad impact on patient's life and 5 of them (83.33%) wouldn't agree to such an operation once again. There were also observed the temporary disorders of the tibial nerve (7 patients - 8.75%) and the peroneal nerve (17 patients - 21.25%).Conclusions. The varicose veins operations have the significantly bad influence on the saphenous nerve transmission and can cause a transient injury of the tibial and peroneal nerves. The sensory disorders usually concern the region of the medial ankle. The operation doesn't significantly worsen the patient's quality of life but the sort of sensory disorders has the influence on patient's estimation.
6
Content available remote

Contemporary Indications and own Results of Surgical Treatment of occlusions of the initial section of the Left subclavian artery

64%
Pukacki F., Zieliński M., Oszkinis G., Juszkat R., Gabriel M., Słowiński M., Zapalski S., Majewski W.
Polish Journal of Surgery
|
2010
|
vol. 82
|
issue 5
272-278
EN
Symptomatic occlusion of the initial section of the subclavian artery, resistant to intravascular treatment, is an indication for a surgery as it exacerbates the verterbrobasilar insufficiency and creates the risk of peripheral embolism. Reconstructive surgery fixes the reversed blood flow in the vertebral artery, alleviates neurological and limb ischemia symptoms.The aim of the study was to retrospectively evaluate the results of surgical treatment of the occlusion of the initial section of the subclavian artery using transposition or subclavian-carotid by-pass with a PTFE.Material and methods. Retrospective analysis covered 55 patients operated on between June 1996 and August 2008 for occlusion of the left subclavian artery. 39 patients underwent a subclavian artery transposition (SCT) and the remaining 16 had a subclavian-carotid by-pass (SCB) using a PTFE. Indications for surgery included ischeamic symptoms in the upper limb and impaired vertebrobasilar circulation. Clinical symptoms occurred in the following order: vertebrobasilar insufficiency and upper limb ischemia (62%), upper limb ischemia symptoms (22%), vertebrobasilar insufficiency (16%).Results. There were no early deaths (by day 30). Ischemia was lifted in 100% of the patients operated using transposition and in 93% of those with a by-pass. In the perioperative period, one patient had a bypass thrombosis, and 2 patients had a transitional brain ischemia. These incidents affected patients who underwent subclavian-carotid by-pass. In the late postoperative period, 12 patients (21.81%) died due to cardiological complications and 7 patients (12.72%) for other causes, and none of them was related to the primary surgery. All patients with transposition have maintained the primary patency, with average follow-up period of 73 months (23-138). In the group with a by-pass, occlusion occurred in 3 patients in the first follow-up month. These incidents had no effect on survival rates. For the remaining 14/16 patients from the SCB group the average primary patency was 63.4 (8-104) months.Conclusions. Subclavian-carotid transposition is a safe and effective method of upper limb revascularization. It is technically more difficult than the by-pass but ensures a better short-term and long-term result.
7
Content available remote

Negative Pressure therapy in the treatment of wounds - review of literature data and multicenter experience

64%
Banasiewicz T., Malinger S., Zieliński M., Mańkowski B., Ratajczak A., Borejsza-Wysocki M., Majewski W., Słowiński K., Drews M.
Polish Journal of Surgery
|
2010
|
vol. 82
|
issue 7
435-446
8
Publication available in full text mode
Content available

Peripheral regulatory T cells and anti-inflammatory cytokines in children with juvenile idiopathic arthritis

64%
Sznurkowska K., Boćkowska M., Zieliński M., Plata-Nazar K., Trzonkowski P., Liberek A., Kamińska B., Szlagatys-Sidorkiewicz A.
|
EN
Background: Juvenile idiopathic arthritis (JIA) is a chronic, heterogenous inflammatory disease of unclear pathogenesis. JIA is hypothesized to be linked to a defective immune regulation. Anti-inflammatory cytokines belong to the best known regulatory factors. T-regulatory cells are a crucial cellular component of immune tolerance. One of their functions is synthesis of interleukin 10 (IL-10) and transforming growth factor beta1 (TGF-β1). The aim of this study was to determine the proportion of T-regulatory cells (CD4+CD25highFOXP3+) in peripheral blood, and serum levels of TGF-β1 and IL-10 in patients with JIA. Methods: The study included 25 patients with newly diagnosed JIA: oligoarthritis (n=17) and polyarthritis (n=8). The control group was comprised of 17 healthy children. CD4+CD25highFOXP3+ T cells in peripheral blood were quantified by means of three-color flow cytometry. Serum concentrations of TGF-β1 and IL-10 were estimated with ELISA. Results: The proportion of peripheral CD4+CD25highFOXP3+ cells in patients with JIA was significantly higher than in the controls (p=0.04). The two groups did not differ significantly in terms of their TGF-β1 and IL-10 concentrations. Conclusions: At the time of diagnosis, children with JIA presented with an elevated proportion of T-regulatory cells (CD4+CD25highFOXP3+) in peripheral blood. Anti-inflammatory cytokines, IL-10 and TGF-β1, are not upregulated in the serum of patients with JIA, and therefore should not be considered as biomarkers of this condition.
first rewind previous Page / 1 next fast forward last
JavaScript is turned off in your web browser. Turn it on to take full advantage of this site, then refresh the page.