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Neovascularization in the Region of Saphenofemoral Junction Following Babcock Excision of Great Saphenous Vein

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Mikusek W., Waniczek D., Arendt J., Buda K., Rudzki M.
Polish Journal of Surgery
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2009
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vol. 81
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issue 9
383-391
EN
Recurrent varicose veins are an important problem in the surgical practice. They can be caused by neovascularization. New venous anastomoses, formed at the site of primary surgical intervention, can result in venous reflux and then recurrence of the disease.The aim of the study was to investigate whether there is a neovascularization at the site of saphenofemoral junction and if so, how common it is, in patients undergoing surgical treatment for varicose veins of the lower limbs.Material and methods. The study enrolled 60 patients: 43 women and 17 men. In all study subjects the region of saphenofemoral junctions was dissected, visualized collateral vessels and great saphenous vein were ligated and cut; the latter was dissected using Babcock method. Ultrasound imaging of the saphenofemoral junction was performed twice: 30 days and 6 months after the surgical procedure. We sough vessels that persisted after the primary procedure as well as vessels formed in the process of neovascularization.Results. Thirty days after the surgical procedure, we did not find any blood vessels in the study group that would suggest that the process of neovascularization took place. In 10 (16.7%) patients we found collaterals left in the region of saphenofemoral junction. Six months after the surgical procedure, small newly formed venules were found in 17 (28.3%) patients in the region of previous surgical intervention. Certain neovascularization was found in 12 (20%) patients and probable neovascularization in 5 (8.3%) of the study group.Conclusions. Six months after the surgical procedure small, tortuous veins appeared at the site of saphenofemoral junction. Their formation is inevitable and occurs irrespectively of completeness of the primary surgical procedure. Throughout six months of follow-up we did not find any evidence to support the assumption that neovascularization could be the cause of recurrent varicose veins.
2
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Adult cutaneous diphtheria in Poland – a case report and literature overview

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Fick J., Bichalska-Lach M., Bichalski B., Rudzki M., Waniczek D.
Annales Academiae Medicae Silesiensis
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2023
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issue 77
146-150
EN
Corynebacterium diphtheriae (C. diphtheriae) is the primary pathogen causing diphtheria, which basically exists in two forms: nasopharyngeal and cutaneous. According to a commonly introduced vaccination programme against diphtheria, pertussis and tetanus (DPT), the incidence of diphtheria has significantly dropped around the world, in some areas disappearing almost completely. However nowadays, we observe the reappearance of diphtheria, especially the cutaneous form, even in countries with very high vaccination rates due to the increasing migration from countries with a lower level of vaccinated citizens. We present a case study of a Ukrainian immigrant diagnosed with cutaneous diphtheria to raise the awareness of the medical community about this returning disease, its cutaneous form and new medical challenges connected to it. It has been the first reported case of C. diphtheriae infection in Poland since 2005. We analysed the most recent articles available in PubMed and Google Scholar databases using criterion keywords such as: “diphtheria case”, “diphtheria case report”, “cutaneous diphtheria”. We selected the most suitable out of approximately 1,700 articles. The presented case report and analysis of scientific publications on cutaneous diphtheria show the importance of this form of the disease in the modern, post-vaccination era. We claim that the importance of vaccination, self-protection during contact with patients, and awareness of the risks of the medical environment are becoming even more important.
PL
Corynebacterium diphtheriae (C. diphtheriae) jest pierwotnym patogenem wywołującym błonicę, która zasadniczo występuje w dwóch postaciach: nosowo-gardłowej i skórnej. W związku z powszechnymi szczepieniami przeciwko błonicy, krztuścowi i tężcowi (diphtheria, pertussis and tetanus – DPT) częstość występowania błonicy na świecie znacząco zmalała, na niektórych obszarach zanikając niemal całkowicie. W dzisiejszych czasach ponownie obserwujemy przypadki błonicy, zwłaszcza postaci skórnej, nawet w krajach z wysokim wskaźnikiem wyszczepienia, w związku z nasilającą się migracją z krajów o niższym odsetku zaszczepionych obywateli. Prezentujemy studium przypadku ukraińskiego imigranta ze zdiagnozowaną błonicą skóry, by zwiększyć świadomość środowiska medycznego o tej powracającej chorobie, jej postaci skórnej oraz związanych z tym nowych wyzwaniach. To pierwszy zaraportowany przypadek zakażenia C. diphtheriae w Polsce od 2005 r. Przeanalizowano najnowsze artykuły dostępne w bazach PubMed i Google Scholar, używając jako kryterium następujących słów kluczowych: „błonica przypadek”, „błonica opis przypadku”, „błonica skóry”. Wybrano artykuły o najwyższej korelacji z ponad 1700 wyników wyszukiwania. Opis przypadku i analiza publikacji naukowych na temat błonicy skóry pokazują znaczenie tej postaci choro-by w nowej, poszczepiennej erze. Twierdzimy, że szczepienia, stosowanie ochrony osobistej podczas kontaktu z pacjentem oraz świadomość środowiska medycznego dotycząca możliwych zagrożeń stają się jeszcze bardziej istotne.
3
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Giant cell tumor of tendon sheath in the pediatric population – review

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Kopcik K., Koberling A., Koper J., Bichalska-Lach M., Rudzki M., Waniczek D.
European Journal of Translational and Clinical Medicine
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2023
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vol. 6
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issue 1
64-69
EN
Giant cell tumor of tendon sheath is a rare and benign so-fttissue tumor, which is even less common in the pediatric population. It may be connected with chromosomal translocations, oeftn the 1p11-13. Symptoms include pain, swelling, palpable mass or limited range of motion. Magnetic resonance is the diagnostic method of choice. Histopathological image obtained from biopsy should be also evaluated. The gold standard of treatment is total surgical resection of the tumor, as incomplete excision may result in recurrence. Physicians should also consider the future function of the aefcted joint or limb. Our aim was to review the available literature about GCTTS in the pediatric population. Kopcik K, Koberling A, Koper J, Bichalska-Lach M, Rudzki M, Waniczek D. Giant cell tumor of tendon sheath in the pediatric population - review. Eur J Transl Clin Med. 2023;6(1):64-69.
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The Usefulness of Preoperative Doppler Ultrasonographic Evaluation of Saphenofemoral Complex For Improving Lower Limb Varicose Veins Surgery

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Mikusek W., Arendt J., Waniczek D., Rudzki M., Buda K., Orkisz W.
Polish Journal of Surgery
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2008
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vol. 80
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issue 11
594-603
EN
The aim of the study was to determine whether detailed preoperative Doppler ultrasonographic examination of saphenofemoral complex can improve the results of the lower limb varicose veins surgery.Two groups of patients (30 people each) were operated due to lower limbs primary varicose veins caused by saphenous vein insufficiency. All patients had a routine duplex examination performed. Group B had additional ultrasound examination before the operation to evaluate the number, diameter, and localization of the tributary vessels in the area of saphenofemoral junction. 30 days after the operation, in both groups control duplex examination was performed to evaluate the sparingness of the surgical procedure. The control ultrasonography showed 8 and 2 tributary vessels overlooked in groups A and B, respectively. The differences were statistically significant. The conformity of the preoperative ultrasound and the scene found during the operation in group B was 83.3%. The chance of overlooking peripheral vessels in group A increased 5.1 times.Preoperative Doppler ultrasound estimates localization of tributary vessels within the saphenofemoral junction, which makes detecting vessels during the operation much easier. It allows to minimize the number of technical mistakes and improve the lower limb varicose veins surgery results.
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