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Treatment of Ultra Long-Gap Esophageal Atresia. Own Experience based on Combined Foker and Kimura Technique

100%
Sroka M., Czauderna P., Landowski P.
Polish Journal of Surgery
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2009
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vol. 81
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issue 3
129-134
EN
The aim of the study. Authors present their own experience in the treatment of ultra long-gap esophageal atresia using combined Kimura's and Foker's methods, while the latter one to our best knowledge has been used for the first time in Poland.Material and methods. Multi-stage process of treatment was used in four patients. In three of them, in case of previous spit fistula presence, Foker's and Kimura's methods were simultaneously applied. In one of the patients without the spit fistula, only Foker's method was used.Results. Only patients, who completed treatment were discussed: in two of them esophageal anastomosis was achieved, however in one case delayed perforation of esophagus occurred during an attempt of intrathoracic correction of the huge hiatal hernia.Conclusions. In the authors' opinion Foker's method, eventually in combination with Kimura's technique (in cases of previous spit fistula), seems to be a promising option for the treatment of ultra longgap esophageal atresia. It allows to save the patients' own esophagus, and in case of the treatment failure it does not preclude the future use of other methods of esophageal substitution.
2
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Evaluation of clinical usefulness of serum neopterin determination in children with bacterial infections

76%
Plata-Nazar K., Luczak G., Liberek A., Dudzinska-Gehrmann J., Sznurkowska K., Landowski P., Kaminska B.
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2015
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vol. 62
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issue 1
133-137
EN
Neopterin (NPT) (6-D-erythro-trihydroxypropyl pteridin) is one of the indicators of the immune system activity. Elevated neopterin concentration occurs in diseases mostly involving stimulation of cellular immunity. The determination of neopterin concentration, usually in blood serum and urine but also in many other bodily fluids, has already been applied in many areas of medicine, such as transfusiology, transplantology, oncology, infectious diseases and autoimmunological diseases. Objective. The aim of this work is to evaluate clinical usefulness of serum neopterin determination in children with urinary tract infections of confirmed bacterial etiology. Material. The study involved 56 children with bacterial urinary tract infections - patients of the Clinic of Paediatrics, Paediatric Gastroenterology, Hepatology & Paediatric Nutrition of Medical University of Gdańsk in the years 2012-2013. The control group included 105 healthy children. Results. The values of NPT concentration in blood serum obtained in the group of children with urinary tract infections did not significantly differ from the values obtained in the control group. Conclusions. The determination of neopterin concentration in children with bacterial urinary tract infections is not a clinically useful parameter.
3
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Diagnosis and treatment difficulties in 18-year-old male patient with hereditary hemochromatosis, chronic hepatitis B, Gilbert syndrome and ulcerative colitis

76%
Sikorska K., Liberek A., Romanowski T., Szlagatys-Sidorkiewicz A., Landowski P., Bielawski K.
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EN
Among possible causes of chronic hepatitis in adolescents most common are infections, autoimmune disorders and metabolic diseases. Thus, diagnostic procedures should be multidirectional. This study reports diagnosis and treatment difficulties in an 18-year-old male patient with hereditary hemochromatosis (HH), ulcerative colitis (UC), chronic hepatitis B (CHB) and Gilbert syndrome. The presented case illustrates problems in diagnostics related to the presence of numerous disease conditions in one patient. It should be taken into consideration that these diseases coexisting in one patient can mutually affect their symptoms creating specific diagnostic difficulties.
4
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Helicobacter pylori increases expression of proapoptotic markers Fas and FasL on CD4 lymphocytes in children

64%
Kotłowska-Kmieć A., Bąkowska A., Szarszewski A., Kamińska B., Łuczak G., Radys W., Landowski P., Brodzicki J., Korzon M., Liberek A.
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EN
The pathomechanism of Helicobacter pylori action upon gastric mucosa and its role in the pathogenesis of gastritis have not been fully elucidated. The aim of this study was to evaluate the most prevalent lymphocyte subpopulations of the gastric mucosa in gastritis in children, as well as to evaluate the expression of Fas and Fas ligand receptors (FasL), periapoptotic markers of gastric mucosa lymphocytes before and after H. pylori eradication. Forty nine patients aged 6 to 17 years, investigated due to chronic abdominal pain, were studied. The obtained tissue samples were analysed by immunohistochemistry. Different lymphocyte subsets were quantified on the basis of surface antigen expression (CD3, CD4, CD8, CD20), secreted cytokines (IL-4, IL-6, IFNγ) and Fas and FasL proteins in the gastric mucosa. B and T helper lymphocytes were found to play a major role in the inflammatory infiltration in the gastric mucosa in children during H. pylori infection. Their expression was found to decrease after eradication. The enhanced expression of Fas receptor on lymphocytes before treatment and a decrease of this expression after eradication of H. pylori were shown. It was demonstrated that there is a correlation between CD4 and Fas receptor expression that may induce apoptosis of the helper lymphocytes in infected children.
5
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Comparison of fecal pyruvate kinase isoform M2 and calprotectin in assessment of pediatric inflammatory bowel disease severity and activity

52%
Czub E., Nowak J., Szaflarska-Poplawska A., Grzybowska-Chlebowczyk U., Landowski P., Moczko J., Adamczak D., Mankowski P., Banasiewicz T., Plawski A., Walkowiak J.
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2014
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vol. 61
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issue 1
99-102
EN
Aims: Accurate assessment of inflammatory bowel disease (IBD) activity is the cornerstone of effective therapy. Fecal M2 isoform of pyruvate kinase (M2-PK) and fecal calprotectin (FC) are noninvasive markers of mucosal inflammation in IBD. The aim of this study was to compare performance of M2-PK and FC in assessment of pediatric ulcerative colitis (UC) and Crohn's disease (CD) severity and activity. Materials and methods: 121 patients with IBD, including 75 with UC and 46 with CD were recruited. Control group consisted of 35 healthy children (HS). Patients were assigned to groups depending on disease severity and activity. M2-PK and calprotectin concentration were determined in stool samples using ELISA. Areas under receiver operating characteristic curves (AUC) for FC and M2-PK with cut-off level at which M2-PK specificity was matching FC specificity were calculated and compared. Results: Performance of M2-PK at identifying patients with IBD, UC and CD among HS was inferior to FC. The differences in AUC were respectively: -0.10 (95% confidence interval [CI] [-0.13-(-0.06)], p<0.0001), -0.14 (95% CI [-0.19-(-0.09)], p<0.0001) and -0.03 (95% CI [-0.05-(-0.001)], p<0.02). M2-PK was inferior to FC in discriminating patients with mild UC from those with HS (AUC difference -0.23, 95% CI [-0.31-(-0.15)], p<0.0001). Conclusions: FC reflects pediatric IBD severity and activity better than M2-PK. This difference is particularly pronounced when identifying patients with mild UC and UC in remission.
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