Applying the posterior fasciocutaneous thigh flap in bed sores treatment]

The paper presents the possibilities of applying the posterior thigh flap in the treatment of ischial pressure sores. Between 2000 and 2004 the flap was used in three cases treated in the Orthopaedics and Traumatology Department of the Medical Universtity in Bialystok. The indications, contraindications, operative technique and advantages of the posterior thigh flap are described. In all three cases the ischial bed sores healed well without recurrences. The posterior fasciocutaneous pedicled flap is a good method of treatment for not too extensive bed sores in the ischial region.This flap can be applied in recurrences found after primary bed sore treatment with another method. However the fasciocutaneous flap has a limited range of transposition as compared with cutaneous flaps.     

Nephron Sparing Surgery for De Novo Renal Cell Carcinoma in an Allograft Kidney: A Case Report

De novo renal cell carcinoma in a renal allograft is rare and has special implications in renal transplant recipients. We describe a patient with a renal allograft who developed a de novo renal cell carcinoma in the functioning renal allograft 258 months after transplantation. The patient underwent enucleation of the tumor because preoperative MRI showed it was well-encapsulated. A DNA banding study showed that the tumor originated from the donor. Indications for conservative renal surgery in renal cell carcinoma have been increasing. Accordingly, 1 option in the treatment of de novo renal cell carcinoma in a functioning renal allograft is enucleation as a method of nephron sparing surgery.     

Synthesis and local anesthetic and circulatory actions of aminoesters and hydroxyamine monoterpene derivatives.

Esters of N,N-diethylaminoacetic acid and hydroxyamines, obtained from structurally different natural monoterpenes, were pharmacologically examined. It was proved that salts of the obtained compounds had local anesthetic properties in infiltration anesthesia, compounds 9, 6 and 8 having been more potent than lidocaine. Compounds 7-9 slightly increased the arrhythmogenic dose, and compound 12 - the lethal dose of strophanthin. All the examined compounds transiently decreased the arterial blood pressure and displayed a cardiopressive activity.     

Value of autologous chondrocyte transplantation in experimental cartilage defects reconstruction. Part II: Microscopic analysis of reconstructed cartilage structural integrity and surface regularity]

Experimental and clinical tests proved that cultured, autologous chondrocytes retain their properties and have ability to reconstruct hyaline-like cartilage, which represents chemical composition and biomechanical characteristics similar to normal hyaline cartilage. The aim of this part of the study was microscopic evaluation of repair tissue structural integrity and surface regularity after autologous chondrocyte transplantation. MATERIAL AND METHODS: Repair of partial thickness cartilage defect (ICRS III(o) grade) on distal femur joint surface was evaluated (25 adolescent rabbits). Procedures were performed in two groups: I--autologous chondrocyte transplantation under periosteal flap, II--periosteal graft. Chondrocytes were isolated from the cartilage specimens by enzymatic digestion and cultured in vitro. The follow-up periods were established at 4, 8, 12 weeks. Repair tissue was evaluated microscopically according to modified O'Driscoll scale. RESULTS: In group I, 4 weeks after the procedure surface of the reconstructed tissue was irregular. 8- and 12-week observation found the surface regular and plain, and repair tissue exhibited complete structural integrity. In group II, in all follow-up periods regenerate surface was irregular, there was many fissures and cracks in graft tissue, and in several cases--regenerate disintegration. CONCLUSION: Obtained results indicate, that hyaline-like cartilage reconstructed after autologous chondrocyte transplantation was characterized by regular, plain surface and complete structural integrity.     

Evaluation of the visual system in people having extended contact with fluorine

Presented are the results of examination of 75 men, workers of the Chemical Works in Police, in whom in the scheme of complex clinical examinations detailed ophthalmological examinations have been carried out. The period of a professional contact with fluor amounted 6-15 years. The examined persons showed a variety of changes; the most important were opacities of the lens capsule, attenuation of the retinal arteries and a pathological record of the ERG.     

Advanced systemic sclerosis complicated by pulmonary hypertension and complete atrioventricular block: a case report.

BACKGROUND: Systemic sclerosis (SSc) is a connective tissue disorder of unknown etiology characterized by fibrosis of the skin and visceral organs, in which the heart is frequently (40-70% of patients) and severely involved. Pulmonary hypertension affects 10-15% of patients with SSc and is one of the most important complications adversely influencing their survival. CASE REPORT: The case report presents a 59-year-old male patient with advanced systemic sclerosis whose initial examination revealed pulmonary hypertension, rhythm and atrioventricular conduction disturbances, and elevated level of NT-proBNP. After six months the patient deteriorated; an increase in NT-proBNP level and progression of pulmonary hypertension were observed. CONCLUSIONS: The described case is followed by a discussion of cardiovascular involvement in systemic sclerosis and emphasizes that heart involvement in SSc may have very serious clinical implications.