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EN
Introduction: Total hip arthroplasty already has a permanent place among surgical procedures dealing with osteoarthritis, as well as traumatic injuries of the femoral neck. In recent years, there has been an increased interest in metaphyseal-fitting and short-stem endoprostheses, which bring new challenges regarding operating technique and rehabilitation care. The aim of this study was to evaluate functional results of total hip arthroplasty using the following endoprostheses: short-stem, metaphyseal-fitting, and cementless with a standard stem. Research Project: Retrospective study. Materials and methods: The research material covers the period between 1993 and 2014 and includes 180 patients operated on due to hip osteoarthritis using total hip arthroplasty. In 96 patients (53.4%) cementless endoprosthesis with a standard ABG-1 stem was used, in 62 patients (34.4%) the Proxima metaphyseal prosthesis was implanted, in 14 patients (7.7%) the BTS short-stem endoprosthesis was used, and in 8 patients (4.4%) TL short-stem endoprosthesis was used. Each patient was evaluated several times using the Harris Hip Score. Results: Functional results obtained in individual groups of patients who underwent surgery are comparable and consistent, without pronounced differences. Conclusions: Functional results obtained in analysed total hip arthroplasties were excellent and good in the majority of patients, both in the early and late observation periods. They are comparable with results of total hip arthroplasties with standard stem endoprosthesis. Patients operated on using the described methods do not require a different rehabilitation programme with different biomechanical or clinical characteristics when compared to patients with standard stem endoprostheses.
PL
Wstęp: Aloplastyki całkowite stawu biodrowego z pewnością zajmują już trwałe miejsce w praktyce operacyjnej choroby zwyrodnieniowej, a także uszkodzeń urazowych szyjki kości udowej. Na przestrzeni ostatnich kilkunastu lat coraz większą uwagę skupiają na sobie tzw. endoprotezy przynasadowe i krótkotrzpieniowe, które niosą ze sobą nowe wyzwania operacyjne i rehabilitacyjne. Celem pracy była ocena wyników czynnościowych aloplastyki całkowitej stawów biodrowych z wykorzystaniem endoprotez krótkotrzpieniowych, przynasadowych oraz niecementowanych z trzpieniem standardowym.Projekt badań: Badanie retrospektywne.Materiał badań: Materiał badań pochodzi z lat 1993-2014 i obejmuje 180 operowanych z powodu zwyrodnienia stawów biodrowych metodą aloplastyki całkowitej, w tym 96 endoprotezą niecementowaną z trzpieniem standardowym typu ABG-1, co stanowi 53,4%, 62 endoprotezą przynasadową typu Proxima, co daje 34,4%, 14 endoprotezą krótkotrzpieniową typu BTS, czyli 7,7% oraz 8 endoprotezą z krótkim trzpieniem typu TL, co stanowi 4,4%.Metoda badań: Kilkukrotnie wykonywany test czynnościowy Harrisa.Wyniki badań: Uzyskane wyniki czynnościowe w poszczególnych grupach operowanych są porównywalne i zbieżne, bez wyraźnych różnic.Wnioski: Analizowane aloplastyki całkowite stawów biodrowych u większości operowanych, zarówno w obserwacji wczesnej, jak i odległej, skutkują bardzo dobrymi i dobrymi wynikami czynnościowymi oraz są porównywalne z wynikami aloplastyk całkowitych endoprotezami z trzpieniem standardowym. Operowani analizowanymi metodami nie wymagają odmiennych programu rehabilitacji o odrębnej charakterystyce biomechanicznej i klinicznej.
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EN
Primary adenocarcinoma of the vermiform appendix is a rare clinical condition. It usually presents as an acute abdominal process or as a mass in the right lower quadrant. The gross pathologic and microscopic characteristics of this disease are the same as for colon carcinoma and carry a serious prognosis. We report a case of a 64-year old male patient presenting symptoms of acute appendicitis. The patient underwent laparoscopic appendectomy that revealed a severely inflamed appendix. Histopathological examination has shown that it was a poorly differentiated, high grade adenocarcinoma invading the periappendicular fat. According to the histopathological findings, a right hemicolectomy was further advised and performed. Right hemicolectomy is the generally recommended method of treatment for invasive adenocarcinoma of the appendix
EN
Gall-stone disease constitutes a serious clinical problem and is the most frequent cause of elective cholecystectomies. There are many etiopatogenic factors however; lithogenic bile and its stasis due to gall-bladder hypomotility seem to be the most important. In recent years discovery of pacemaker function of Interstitial Cells of Cajal changed our understanding of smooth muscle physiology and helped to disclose many gastrointestinal motility disorders. The aim of the study was identification and quantification of interstitial Cajal-like cells (ICLCs) in gall-bladder muscle wall from patients with cholelithiasis and in gall-stone-free controls, as well as determination of the relationship between the number of ICLCs and Cholesterol Saturation Index (CSI) of bile in both analyzed groups. Material and methods. 20 patients operated for symptomatic cholelithiasis were enrolled into the study group. The control group consisted of 20 patients operated for pancreatic head tumors, with no pre- and intraoperative signs of gall-stones. Identification of ICLCs in the gall-bladder was performed by means of double immunofluorescence technique with anti c-Kit and anti-mast cell tryptase antibodies. Quantitative analysis was carried out under fluorescence microscopy conjoined with image analysis software. Bile samples were used for calculation of CSI. Results. ICLCs were detected within gall-bladder muscle wall. Number of ICLCs was statistically significantly lower in patients from the study group as compared to control. The study also revealed statistically significantly higher CSI in the study group. Conclusions. The quantity of ICLCs is diminished in the gall-bladder from patients with cholelithiasis and there is negative correlation between the number of ICLCs and CSI of bile. Regarding the role of ICCs in regulation of GI tract motility, it appears that reduction in their number may be important etiopatogenic factor of cholelithiasis.
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