Search results

1

Ultrasound measurement of the gallbladder wall thickness in the assessment of the risk of conversion from elective laparoscopic cholecystectomy to open surgery — Olkusz county experience

100%

Kania D.

Polish Journal of Surgery

|

2016

|

vol. 88(6)

587-607

EN

The aim of the study was to assess the risk of intraoperative difficulties, conversion and biliaryintestinal fistula during laparoscopic cholecystectomy on the basis of an ultrasound-measured gallbladder wall thickness. Material and methods. A prospective study was conducted in 50 patients undergoing laparoscopic cholecystectomy for chronic gallstone-induced cholecystitis. To calculate the relationships between categorical variables, a chi-square (χ2 ) independence test was used, and the results were interpreted for the significance threshold of α = 0.05. Results. The relationship between the gall-bladder wall thickness and the occurrence of intraoperative difficulties in the analysed set is deterministic (AUC = 1), and the wall thickness of ≥ 5 mm allows to predict their occurrence as soon as at the stage of diagnostic evaluation (p < 0.001). In addition, the ultrasound-measured GB wall thickness is a good predictor of conversion (AUC = 0.976; 95% CI 0.444–0.975; p < 0.001) and biliary-intestinal fistula (AUC = 0.935; 95% CI 0.121–0.738; p = 0.001). Conclusions. The results allow prediction of technically difficult laparoscopic cholecystectomies in patients with CCh, and selection of the right surgical team helps to reduce the number of conversions and possible complications. In addition, bearing in mind the above results in everyday practice should facilitate planning and increase effectiveness in the operating room.

2

Personalization of structural PDB files

100%

Woźniak T., Adamiak R.

Acta Biochimica Polonica

|

2013

|

vol. 60

|

issue 4

591-593

EN

PDB format is most commonly applied by various programs to define three-dimensional structure of biomolecules. However, the programs often use different versions of the format. Thus far, no comprehensive solution for unifying the PDB formats has been developed. Here we present an open-source, Python-based tool called PDBinout for processing and conversion of various versions of PDB file format for biostructural applications. Moreover, PDBinout allows to create one's own PDB versions. PDBinout is freely available under the LGPL licence at http://pdbinout.ibch.poznan.pl

3

Factors Influencing Frequency of Conversion During Laparoscopic Cholecystectomy

100%

Skonieczny B., Pytka M., Stefaniak T., Skonieczny W., Grzybowski Z., Śledziński Z.

Polish Journal of Surgery

|

2008

|

vol. 80

|

issue 2

62-68

EN

The aim of the study was to evaluate factors influencing the frequency of conversion during laparoscopic cholecystectomy; to observe dynamic trends concerning frequency of classic versus laparoscopic cholecystectomies; and to evaluate correlations between the experience of a surgeon and conversion incidence.Material and methods. A retrospective study was performed, reviewing the records of 3337 patients operated on for gallbladder stones from January 2000 to December 2005 in three hospitals in the Pomeranian Region of Poland: Department of General, Endocrine and Transplant Surgery, Medical University of Gdańsk; Department of Surgery, 110th Military Hospital in Elbląg and Department of Surgery, Hospital in Słupsk.The main issues evaluated were: dynamic changes in frequency of laparoscopic versus classic cholecystectomies; frequency of conversions, reasons for conversion; correlation between experience of a surgeon and conversion incidence; and demographic data.Results. Out of 3337 patients, there were 2390 (71.62%) females and 947 (28.3%) males. For these patients, 1493 procedures (45.2%) were performed as classical, 1804 (54.06%) as laparoscopic, and 176 (9.7%) as converted from laparoscopy to open procedure. Sex distribution in the laparoscopic group was 1352:452 (F:M 74.9%:25.05%) and in the converted group was 107:69 (60.8%:39.2%).The main problems relating to conversion during laparoscopic cholecystectomy were: adhesions - 108 (61.36%), gall-bladder perforations - 8 (4.5%), tumors - 10 (5.6%), technical problems - 28 (15.9%), hemostasis problems - 11 (6.25%), unrecognizable anatomical structures - 24 (13.6%), complications of ‘e fundo’ cholecystectomy - 24 (13.6%) and equipment problems - 4 (2.27%).It was also observed that SHO's and surgeons with greater experience are performing more conversions during laparoscopic procedures.Conclusions. Laparoscopic cholecystectomy is a safe procedure recommended as a gold standard for gallbladder stone treatment. Frequency of this procedure is rising in centers in the Pomeranian region.The highest incidence of conversions is associated with adhesions after previous open operations.Consultants perform earlier conversion due to greater experience and better estimation of risk factors.

4

Reasons for Conversion of Laparoscopic Cholecystectomy - Evaluation of Risk Factors

100%

Ciesielczyk B., Cwaliński J., Janusz P.

Polish Journal of Surgery

|

2008

|

vol. 80

|

issue 4

202-208

EN

Laparoscopic cholecystectomy is one of the most frequently performed surgical procedures. In spite of the progress in diagnostic methods and surgical techniques, some operations have to be converted into the laparotomy.The aim of the study was to analyse the reasons and determine predictive factors for conversion.Material and methods. The study was comprised of 765 patients were operated on with the laparoscopic procedure due to cholelithiasis in Franciszek Raszeia Hospital in Poznań from 1 January 1996 to 31 January 2007. Conversion was performed in 106 cases. Retrospective researches were based on descriptions of operations and case records. Statistical comparisons were performed by means of Mann-Withney, t-Student and Fisher tests (p<0.05).Results. The percentage of conversion was 13.85%. The following reasons for conversion were observed: uncertain anatomy 25.47%, dense adhesions 25.47%, inaccessible gall-bladder 9.43%, bleedings 9.43%, inflammatory-purulent lesions of the gallbladder 12.26%, lost gallstones 3.77%, bile leakage 3.77%, failed pneumoperitoneum 2.83%, suspicion of cancer 1.88%, anaesthetic difficulties 1.88, choledocholithiasis 1.88%, equipment failure 1.88%. The statistically significant risk factors for conversion were the following: operations performed by less experienced surgeons (p<0.0001), BMI≧30 (p<0.0001), results above the norm - AspAT (p=0.0288), AlAT (p=0.0013), bilirubin (p<0.0001), WBC (p<0.0001) and ultrasound results - thickened gallbladder wall (p<0.0001), gall-bladder bigger than 10 cm (p=0.0762), hyperechogenic bile (p=0.0003). Conversions were performed more often in the case of men (p=0.0001), people aged over 50 years (p=0.0001) and illness duration over 5 years (p=0.0007). Early postoperative complications occurred in 7 cases (0.91%). Late postoperative complications occurred in three patients (0.39%).Conclusions. A preoperative analysis of risk factors enables selection of a group of patients with higher probability of conversion during the laparoscopic cholecystectomy. A higher number of conversions decreases the number of complications after a laparoscopic cholecystectomy.

5

Measurement and Analysis of Partial Discharge using an Ultra-High Frequency Sensor for Gas Insulated Structures

88%

Wang G., Kil G.-S.

Metrology and Measurement Systems

|

2017

|

vol. 24

|

issue 3

6

Intraoperative Difficulties and the Reasons for Conversion in Patients Treated with Laparoscopic Colorectal Tumors

88%

Tarnowski W., Uryszek M., Grous A., Dib N.

Polish Journal of Surgery

|

2012

|

vol. 84

|

issue 7

352-357

EN

The aim of the study was an evaluation of conversion causes and intraoperative difficulties in patients treated with laparoscopic surgery due to colorectal tumours on the basis of authors' own material.Material and methods. in the period 2009-2012 160 patients were operated on because of large bowel cancer, 79 women and 81 men. Average age of patients was 66 years. The conversion was recognized as desuflation of peritoneal cavity, trocars removal and making laparotomy.Results. The conversion was made in 22 cases (13,7%). More in men (16.1%) than in women. The conversion was made twice as likely in T3 and T4 tumors than in T1 and T2.Conclusions. The main cause of conversion in laparoscopic operations of colorectal cancer is local tumor progression.

7

BENEFIT, CHAMPS i ETOMS: porównanie wyników leczenia interferonem beta chorych na klinicznie izolowane zespoły sugerujące stwardnienie rozsiane

75%

Cendrowski W.

Aktualności Neurologiczne

|

2006

|

vol. 6

|

issue 3

195-199

EN

The 2-year outcomes of three non-parallel, prospective, placebo-controlled studies (BENEFIT, CHAMPS, ETOMS) have shown that IFN beta-lb s.c. (Betaferon®), IFN beta-la i.m. (Avonex®) and IFN beta-la s.c. (RebiP) similarly prevented conversion of clinically isolated syndromes (CIS) into clinically definite multiple sclerosis (CDMS). Smaller proportions of CIS patients in the Betaferon®, Avonex® and RebiP groups converted to CDMS as compared with fractions in the placebo groups (28%, 21%, 34% vs. 45%, 35%, 45%); p from 0.047 to 0.00007. The mean number of days to CDMS development was prolonged by three products of IFN beta (363, 375, 569 days), but not by placebo (255, 309, 252 days); p between <0.05 and 0.00007. The mean or median number of new T2-related brain lesions was more strongly reduced in all studies by the verum than by placebo (1.0 vs. 2.0,2.1 vs. 5.0,2.0 vs. 3.0); the differences were significant. The mean or median number of new, enhancing lesions was also significantly reduced in the BENEFIT and in the CHAMPS studies, but not in the

PL

Dwuletnie wyniki trzech nierównoległych, prospektywnych, kontrolowanych przez placebo badań (BENEFIT, CHAMPS, ETOMS) dowiodły, że IFN beta-lb s.c. (Betaferon®), IFNbeta-la i.m. (Avonex®) i IFN beta-la s.c. (Rebif®) w podobnym stopniu zapobiegły konwersji klinicznie izolowanych zespołów (KIZ) w klinicznie pewne stwardnienie rozsiane (KP SR). Mniejsze proporcje chorych z KIZ w grupach Betaferon u®, Avonexu® i Rebifu® przekształciły się w KP SR w porównaniu z frakcją w grupach placebo (28%, 21%, 34% vs 45%, 35%, 45%); p od 0,047 do 0,00007. Średnia liczba dni do wystąpienia KP SR została wydłużona przez trzy produkty IFN beta (363, 375, 569 dni), lecz nie przez placebo (255, 309, 252 dni); p między <0,05 i 0,00007. Verum silniej niż placebo zmniejszyło średnią lub medianę liczby nowych, T2-zależnych uszkodzeń mózgu (1,0 vs 2,0; 2,1 vs 5,0; 2,0 vs 3,0); p = różnice istotne. Średnia lub mediana wzmacniających się po kontraście uszkodzeń również uległa istotnej redukcji w BENEFIT, CHAMPS, ale nie w ETOMS. Pośrednie porównanie dowiodło, że trzy produkty IFN beta częściowo zapobiegły lub opóźniły konwersję KIZ w KP SR i zahamowały ewolucję nowych uszkodzeń mózgu na obrazach rezonansu magnetycznego.

8

Impact of vascular diseases on the progression of mild cognitive impairment to Alzheimer’s disease

63%

Nesteruk M., Nesteruk T., Styczyńska M., Barcikowska M.

Aktualności Neurologiczne

|

2015

|

vol. 15

|

issue 1

18-21

EN

Introduction: Mild cognitive impairment does not meet the criteria for the diagnosis of dementia, but reaching this diagnosis raises concern about the future state of a patient due to the possibility of the conversion to Alzheimer’s disease. Although the aetiology of Alzheimer’s disease is neurodegenerative, the impact of vascular diseases is also taken into consideration. The aim of this study was to assess the impact of vascular diseases in patients diagnosed with mild cognitive impairment on the conversion to Alzheimer’s disease. Material and methods: In each of 101 patients with a diagnosis of mild cognitive impairment, a detailed medical history was taken, taking into account: hypertension, ischaemic heart disease, arrhythmias, myocardial infarction, stroke, diabetes as well as thyroid diseases, head injuries, alcohol abuse, smoking, exposure to toxic substances, surgery under general anaesthesia and the family character of dementia. Clinical follow-ups were scheduled after 6, 12 and 24 months. Results: Amongst 101 patients with mild cognitive impairment, 17 (16.8%) converted to Alzheimer’s disease within two years of observation. The analysis of the distribution of independence tests showed that the conversion is significant for two variables: ischaemic heart disease and myocardial infarction.

PL

Wstęp: Łagodne zaburzenia poznawcze nie spełniają kryteriów rozpoznania zespołu otępiennego, jednakże ustalenie tego rozpoznania wzbudza obawę o przyszły stan pacjenta, w związku z zagrożeniem konwersją do choroby Alzheimera. Mimo etiologii zwyrodnieniowej choroby Alzheimera brany pod uwagę jest również wpływ chorób naczyniowych na rozwój tej choroby. Celem pracy była ocena wpływu obciążenia chorobami naczyniowymi u pacjentów ze zdiagnozowanymi łagodnymi zaburzeniami poznawczymi na konwersję do choroby Alzheimera. Materiał i metody: U 101 pacjentów z rozpoznaniem łagodnych zaburzeń poznawczych przeprowadzono szczegółowy wywiad chorobowy, uwzględniający: nadciśnienie tętnicze, chorobę niedokrwienną serca, zaburzenia rytmu serca, zawał serca, udar mózgu, cukrzycę, a ponadto choroby tarczycy, urazy głowy, nadużywanie alkoholu, nikotynizm, kontakt z substancjami toksycznymi, operacje w znieczuleniu ogólnym i rodzinność otępienia. Zaplanowano wizyty kliniczne po 6, 12, 24 miesiącach. Wyniki: Spośród 101 pacjentów z rozpoznaniem łagodnych zaburzeń poznawczych u 17 osób (16,8%) stwierdzono konwersję do choroby Alzheimera w ciągu 2 lat obserwacji. Analiza testów niezależności rozkładów wykazała, że konwersja jest istotna dla dwóch zmiennych: choroby niedokrwiennej serca oraz zawału serca w wywiadzie.

9

Znaczenie ultrasonografii przy wyborze metody leczenia ostrego zapalenia pęcherzyka żółciowego

63%

Ćwik G., Wyroślak-Najs J., Skoczylas T., Wallner G.

Journal of Ultrasonography

|

2013

|

vol. 13

|

issue 54

282-292

EN

Surgical removal of the gallbladder is indicated in nearly all cases of complicated acute cholecystitis. In the 1990s, laparoscopic cholecystectomy became the method of choice in the treatment of cholecystolithiasis. Due to a large inflammatory reaction in the course of acute inflammation, a laparoscopic procedure is conducted in technically difficult conditions and entails the risk of complications. The aim of this paper was: 1) to analyze ultrasound images in acute cholecystitis; 2) to specify the most common causes of conversion from the laparoscopic method to open laparotomy; 3) to determine the degree to which the necessity for such a conversion may be predicted with the help of ultrasound examinations. Material and methods: In 1993–2011, in the Second Department and Clinic of General, Gastroenterological and Oncological Surgery of the Medical University in Lublin, 5,596 cholecystectomies were performed including 4,105 laparoscopic procedures that constituted 73.4% of all cholecystectomies. Five hundred and forty-two patients (13.2%) were qualified for laparoscopic procedure despite manifesting typical symptoms of acute cholecystitis in ultrasound examination, which comprise: thickening of the gallbladder wall of > 3 mm, inflammatory infiltration in the Calot’s triangle region, gallbladder filled with stagnated or purulent contents and mural or intramural effusion. Results: In the group of operated patients, the conversion was necessary in 130 patients, i.e. in 24% of cases in comparison with 3.8% of patients with uncomplicated cholecystolithiasis (without the signs of inflammation). The conversion most frequently occurred when the assessment of the anatomical structures of the Calot’s triangle was rendered more difficult due to local inflammatory process, mural effusion and thickening of the gallbladder wall of >5 mm. The remaining changes occurred more rarely. Conclusions: Based on imaging scans, the most common causes of conversion included inflammatory infiltration in the Calot’s triangle region, mural effusion and wall thickening to > 5 mm. The classical cholecystectomy in acute cholecystitis should be performed in patients with three major local complications detected on ultrasound examination and in those, who manifest acute clinical symptoms.

PL

Operacyjne usunięcie pęcherzyka żółciowego jest wskazane praktycznie we wszystkich przypadkach powikłanego, ostrego zapalenia pęcherzyka żółciowego. W latach dziewięćdziesiątych metodą z wyboru w leczeniu objawowej kamicy pęcherzyka żółciowego stała się cholecystektomia laparoskopowa. Z uwagi na duży odczyn zapalny w przebiegu ostrego stanu zapalnego zabieg laparoskopowy jest przeprowadzany w trudnych technicznie warunkach i wiąże się z ryzykiem wystąpienia powikłań. Celem pracy były: 1) analiza obrazów ultrasonograficznych przypadków ostrego zapalenia pęcherzyka żółciowego; 2) ustalenie najczęstszych przyczyn konwersji z metody laparoskopowej do otwartej laparotomii; 3) określenie, w jakim stopniu za pomocą badania ultrasonograficznego można przewidzieć potrzebę konwersji. Materiał i metoda: W latach 1993–2011 w II Klinice i Katedrze Chirurgii Ogólnej, Gastroenterologicznej i Nowotworów Układu Pokarmowego UM w Lublinie wykonano 5596 cholecystektomii, w tym 4105 zabiegów laparoskopowych, co stanowiło 73,4% wszystkich przeprowadzonych cholecystektomii. Pomimo typowych objawów ostrego zapalenia pęcherzyka w badaniu ultrasonograficznym, do których zaliczamy pogrubienie ściany pęcherzyka > 3 mm, naciek zapalny okolicy trójkąta Calota, wypełnienie pęcherzyka treścią zastoinową lub ropną, wysięk śródścienny lub przyścienny, 542 chorych (13,2%) zakwalifikowano do leczenia metodą laparoskopową. Wyniki: W grupie pacjentów operowanych konwersja była konieczna u 130 osób – w 24% przypadków w porównaniu z 3,8% chorych z niepowikłaną kamicą pęcherzyka żółciowego (bez cech zapalnych). Konwersji dokonywano najczęściej w przypadkach utrudnionej oceny struktur anatomicznych trójkąta Calota, wynikającej z miejscowego stanu zapalnego, wysięku przyściennego oraz pogrubienia ściany >5 mm. Pozostałe zmiany występowały rzadziej. Wnioski: Do najczęstszych przyczyn konwersji w badaniach obrazowych należały: zapalny naciek okolicy trójkąta Calota, wysięk przyścienny i pogrubienie ściany > 5 mm. Do cholecystektomii klasycznej w ostrym zapaleniu pęcherzyka żółciowego powinni być kwalifikowani pacjenci, u których w badaniu ultrasonograficznym stwierdza się trzy główne powikłania miejscowe oraz u których występują ostre objawy kliniczne.

Refine search results

Ultrasound measurement of the gallbladder wall thickness in the assessment of the risk of conversion from elective laparoscopic cholecystectomy to open surgery — Olkusz county experience

Personalization of structural PDB files

Factors Influencing Frequency of Conversion During Laparoscopic Cholecystectomy

Reasons for Conversion of Laparoscopic Cholecystectomy - Evaluation of Risk Factors

Measurement and Analysis of Partial Discharge using an Ultra-High Frequency Sensor for Gas Insulated Structures

Intraoperative Difficulties and the Reasons for Conversion in Patients Treated with Laparoscopic Colorectal Tumors

BENEFIT, CHAMPS i ETOMS: porównanie wyników leczenia interferonem beta chorych na klinicznie izolowane zespoły sugerujące stwardnienie rozsiane

Impact of vascular diseases on the progression of mild cognitive impairment to Alzheimer’s disease

Znaczenie ultrasonografii przy wyborze metody leczenia ostrego zapalenia pęcherzyka żółciowego