Search results

1

Scrotal imaging

100%

Studniarek M., Skrobisz-Balandowska K., Modzelewska E.

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issue 62

245-258

EN

Pathological lesions within the scrotum are relatively rare in imaging except for ultrasonography. The diseases presented in the paper are usually found in men at the age of 15–45, i.e. men of reproductive age, and therefore they are worth attention. Scrotal ultrasound in infertile individuals should be conducted on a routine basis owing to the fact that pathological scrotal lesions are frequently detected in this population. Malignant testicular cancers are the most common neoplasms in men at the age of 20–40. Ultrasound imaging is the method of choice characterized by the sensitivity of nearly 100% in the differentiation between intratesticular and extratesticular lesions. In the case of doubtful lesions that are not classified for intra-operative verifi cation, nuclear magnetic resonance is applied. Computed tomography, however, is performed to monitor the progression of a neoplastic disease, in pelvic trauma with scrotal injury as well as in rare cases of scrotal hernias involving the ureters or a fragment of the urinary bladder.

PL

Patologiczne zmiany w obrębie worka mosznowego są stosunkowo rzadko spotykane w badaniach obrazowych, z wyjątkiem ultrasonografii. Prezentowane choroby dotyczą najczęściej grupy mężczyzn w przedziale wiekowym 15–45 lat, czyli w wieku rozrodczym, dlatego zasługują na szczególną uwagę. U niepłodnych mężczyzn badanie ultrasonograficzne moszny powinno być wykonywane rutynowo, ponieważ w tej populacji częstość wykrywania zmian patologicznych w mosznie jest bardzo wysoka. Nowotwory złośliwe jąder należą do najczęstszych nowotworów występujących u mężczyzn w wieku 20–40 lat. Metodą diagnostyczną z wyboru jest badanie ultrasonograficzne, którego czułość w różnicowaniu zmian wewnątrzjądrowych i zewnątrzjądrowych wynosi prawie 100%. W diagnostyce niejednoznacznych zmian, niekwalifikujących się do weryfikacji operacyjnej, stosowany jest magnetyczny rezonans jądrowy. Tomografię komputerową natomiast wykorzystuje się w monitorowaniu zaawansowania choroby nowotworowej, w stanach pourazowych miednicy z udziałem urazu moszny oraz w rzadkich przypadkach przepuklin mosznowych zawierających moczowody lub fragment pęcherza moczowego.

2

Complex Interventional Treatment of Extensive Consequences of Necrotizing Pancreatitis - Case Report

88%

Jagielski M., Smoczyński M., Studniarek M., Śledziński Z., Adrych K.

Polish Journal of Surgery

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2015

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vol. 87

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issue 1

39-42

EN

The paper presents description of the effective treatment of patients with extensive consequences of necrotizing pancreatitis. The strategy of treatment was to extend access to necrotic areas („step-up approach”). Applied endoscopic transmural access (transgastric), percutaneous access (transperitoneal) and surgical access. The cooperation endoscopist, surgeon and interventional radiologist gave very beneficial clinical effects in patients with extensive complications of acute pancreatitis.

3

Percutaneus Thermoablation in Patients with Primary and Secondary Liver Cancer - Early Results

76%

Zadrożny D., Śledziński Z., Studniarek M., Dobrowolski S., Gorycki T., Adamonis W., Bury K.

Polish Journal of Surgery

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2008

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vol. 80

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issue 8

387-393

EN

Liver is common place where the cancer occurs primary as well as secondary. Liver resection as a potentially healing method can be performed only in about 20% of patients. Prognosis in group of patients treated non-invasively is bad. Using high frequency thermal ablation which damages the neoplastic tissue in liver may lead to prolongation of life expectancy.The aim of the study was to assess the early results of using the high frequency thermal ablation in patients with primary or secondary cancer.Material and methods. During years of 2001-2007 371 patients underwent the 520 procedures of percutaneous RF thermal ablation under US control. Mean age of patients was 62.47 (19-85 ± 11.63). 175 women and 196 men were treated using this method.Results. There were 10 early complications after thermal ablation (1.92% of procedures, 2.7% of patients). Two of them ended fatal (0.38% of procedures, 0.54% of patients). In seven cases absces formation were observed, one of them was the cause of death due to Clostridium perfingens infection. Cholerrhagia from damaged bile duct in cirrhotic liver caused the peritonitis and subsequent death of patient. Two patients suffered from sub-capsular hematoma of liver. 14 patients also suffered from long lasting pain (more than 14 days).Conclusions. Percutaneous thermal ablation in primary or secondary liver tumors is safe and efficient procedure. Long term follow up will give the knowledge about the real value of the procedure.

4

Diabetic foot syndrome: Charcot arthropathy or osteomyelitis? Part I: Clinical picture and radiography

76%

Konarzewska A., Korzon-Burakowska A., Rzepecka-Wejs L., Sudoł-Szopińska I., Szurowska E., Studniarek M.

Journal of Ultrasonography

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2018

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vol. 18

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issue 72

42-49

EN

One of significant challenges faced by diabetologists, surgeons and orthopedists who care for patients with diabetic foot syndrome is early diagnosis and differentiation of bone structure abnormalities typical of these patients, i.e. osteitis and Charcot arthropathy. In addition to clinical examination, the patient’s medical history and laboratory tests, imaging plays a significant role. The evaluation usually begins with conventional radiographs. In the case of osteomyelitis, radiography shows osteopenia, lytic lesions, cortical destruction, periosteal reactions as well as, in the chronic phase, osteosclerosis and sequestra. Neurogenic arthropathy, however, presents an image resembling rapidly progressing osteoarthritis combined with aseptic necrosis or inflammation. The image includes: bone destruction with subluxations and dislocations as well as pathological fractures that lead to the presence of bone debris, osteopenia and, in the later phase, osteosclerosis, joint space narrowing, periosteal reactions, grotesque osteophytes and bone ankylosis. In the case of an unfavorable course of the disease and improper or delayed treatment, progression of these changes may lead to significant foot deformity that might resemble a “bag of bones”. Unfortunately, radiography is non-specific and frequently does not warrant an unambiguous diagnosis, particularly in the initial phase preceding bone destruction. For these reasons, alternative imaging methods, such as magnetic resonance tomography, scintigraphy, computed tomography and ultrasonography, are also indicated.

PL

Jednym z istotnych problemów, z jakimi borykają się diabetolodzy, chirurdzy i ortopedzi zajmujący się leczeniem pacjentów z zespołem stopy cukrzycowej, jest możliwie wczesne rozpoznanie oraz zróżnicowanie zmian w strukturach kostnych typowych dla tej grupy chorych – zapalenia kości i neuroosteoartropatii Charcota. W procesie diagnostycznym obok badania podmiotowego, przedmiotowego i wyników badań laboratoryjnych istotną rolę odgrywa diagnostyka obrazowa. Metodą pierwszego rzutu jest klasyczna radiografia. W przypadku zapalenia kości na radiogramach można stwierdzić: obszary rozrzedzenia struktury kostnej, przerwanie zarysów warstwy korowej, odczyny okostnowe, a w fazie przewlekłej również zagęszczenie utkania kostnego i obecność martwaków. W przebiegu neuroosteoartropatii Charcota rozwija się natomiast obraz przypominający szybko postępujące zmiany zwyrodnieniowe, połączone z martwicą aseptyczną lub zmianami zapalnymi, na który składają się: destrukcja kostna z podwichnięciami i zwichnięciami oraz patologicznymi złamaniami prowadzącymi do pojawienia się licznych fragmentów kostnych, rozrzedzenie struktury kostnej, a w fazie późniejszej sklerotyzacja, zwężenie szpar stawowych oraz powstawanie odczynów okostnowych, groteskowych osteofitów, jak również ankyloza kostna. Przy niekorzystnym przebiegu i niewłaściwym leczeniu progresja zmian może doprowadzić do nasilonego zniekształcenia stopy i powstania tzw. rumowiska kostnego. Niestety obraz radiologiczny bywa nieswoisty i niejednokrotnie nie pozwala na postawienie jednoznacznego rozpoznania, zwłaszcza w fazie początkowej, zanim dojdzie do destrukcji kostnej. Z tego względu w niejednoznacznych przypadkach wskazane jest wykorzystanie również innych metod diagnostyki obrazowej, takich jak tomografia rezonansu magnetycznego, badania scyntygraficzne, tomografia komputerowa i ultrasonografia. Artykuł w wersji polskojęzycznej jest dostępny na stronie http://jultrason.pl/index.php/issues/volume-18-no-72

5

Panoramic radiograph – a useful tool to assess the difficulty in extraction of third molars

64%

Adamska P., Adamski Ł. J., Musiał D., Tylek K., Studniarek M., Wychowański P., Kaczoruk-Wieremczuk M., Pyrzowska D., Jereczek-Fossa B. A., Starzyńska A.

European Journal of Translational and Clinical Medicine

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2020

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vol. 3

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issue 2

44-52

EN

Introduction: Third molars (TMs) are the most frequently impacted teeth due to the frequent lack of space in the dental arch resulting in their malposition or inability to erupt. Partially erupted TMs that cause recurrent inflammatory conditions must be removed. The aim of this study was to assess TM position on panoramic radiographs. Materials and methods: We evaluated 200 panoramic radiographs of patients 18-72 years of age. Teeth were assessed in terms of the presence of dental follicle, cervix/root ratio and root development stage. Maxillary TMs were assessed using the Archer and Pell and Gregory classifications, whereas the mandibular ones according to Pell and Gregory, Winter, IAN and Pederson classifications. Results: 622 TMs were assessed. In the maxilla, the most common type was A-positioned, vertically angulated TM with completely formed root/roots. In the mandible, the most common type was A1-positio- ned, mesioangular TM with completely formed root/roots and without enlarged follicle. According to Pederson’s index, 59.44% TMs were moderately difficult to extract. Most roots were in contact with inferior alveolar nerve. Conclusions: The use of the classifications mentioned above is helpful in assessment of the surgery difficulty level. In the long term this allows to increase the predictability of the procedure and minimize the intra- and post-operative complications.

6

Regional resting state perfusion variability and delayed cerebrovascular uniform reactivity in subjects with chronic carotid artery stenosis

64%

Szarmach A., Kaszubowski M., Sabisz A., Frydrychowski A., Halena G., Piskunowicz M., Dzierzanowski J., Studniarek M., Szurowska E., Winklewski P.

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2018

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vol. 65

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issue 1

151-162

EN

The aim of this study was to assess regional perfusion at baseline and regional cerebrovascular resistance (CVR) to delayed acetazolamide challenge in subjects with chronic carotid artery stenosis. Sixteen patients (ten males) aged 70.94±7.71 with carotid artery stenosis ≥ 90% on the ipsilateral side and ≤ 50% on the contralateral side were enrolled into the study. In all patients, two computed tomography perfusion examinations were carried out; the first was performed before acetazolamide administration and the second 60 minutes after injection. The differences between mean values were examined by paired two-sample t-test and alternative nonparametric Wilcoxon's test. Normality assumption was examined using W Shapiro-Wilk test. The lowest resting-state cerebral blood flow (CBF) was observed in white matter (ipsilateral side: 18.4±6.2; contralateral side: 19.3±6.6) and brainstem (ipsilateral side: 27.8±8.5; contralateral side: 29.1±10.8). Grey matter (cerebral cortex) resting state CBF was below the normal value for subjects of this age: frontal lobe - ipsilateral side: 30.4±7.0, contralateral side: 33.7±7.1; parietal lobe - ipsilateral side: 36.4±11.3, contralateral side: 42.7±9.9; temporal lobe - ipsilateral side: 32.5±8.6, contralateral side: 39.4±10.8; occipital lobe - ipsilateral side: 24.0±6.0, contralateral side: 26.4±6.6). The highest resting state CBF was observed in the insula (ipsilateral side: 49.2±17.4; contralateral side: 55.3±18.4). A relatively high resting state CBF was also recorded in the thalamus (ipsilateral side: 39.7±16.9; contralateral side: 41.7±14.1) and cerebellum (ipsilateral side: 41.4±12.2; contralateral side: 38.1±11.3). The highest CVR was observed in temporal lobe cortex (ipsilateral side: +27.1%; contralateral side: +26.1%) and cerebellum (ipsilateral side: +27.0%; contralateral side: +34.6%). The lowest CVR was recorded in brain stem (ipsilateral side: +20.2%; contralateral side: +22.2%) and white matter (ipsilateral side: +18.1%; contralateral side: +18.3%). All CBF values were provided in milliliters of blood per minute per 100 g of brain tissue (ml/100g/min). Resting state circulation in subjects with carotid artery stenosis is low in all analysed structures with the exception of insula and cerebellum. Acetazolamide challenge yields relatively uniform response in both hemispheres in the investigated population. Grey matter is more reactive to acetazolamide challenge than white matter or brainstem.

7

Polish guidelines for treatment of patients with parastomal hernia

52%

Śmietański M., Bury K., Matyja A., Dziki A., Wallner G., Studniarek M., Fridiger J., Szczepkowski M., Świerblewski M., Wróblewski T., Tarnowski W., Solecki R., Mitura K.

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vol. 85

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issue 3

152-180