Clinical, biochemical and hormonal characteristics of 84 patients with incidentally found adrenal tumor (incidentaloma)

In this study we have analyzed 84 patients (58 women, 26 men, mean age 57 +/- 1.1 year) hospitalized in the Department of Nephrology, Endocrinology and Metabolic Diseases of the Medical University of Silesia in Katowice from 01.01.1999 to 30.04.2003 because of incidentally discovered adrenal tumors (incidentaloma). The diameter of the tumors ranged from 8 to 86 mm (mean size 35.4 +/- 1.8 mm). Unilateral tumors were found in 74 patients and bilateral ones in 10 patients. In all patients circadian rhythm of plasma cortisol concentration and urinary cortisol excretion were measured. In 73 patients with a history of hypertension plasma renin activity was estimated in basal conditions and after stimulation by sodium restriction and upright position. Aldosteronemia and urinary metoxycatecholamines excretion were also determined. 45 patients with tumors >4 cm and/or with suspicion of malignancy or hormonal hypersecretion were qualified for surgical treatment. Thirty two patients out of the selected 45 have been operated so far. In two patients histopathological examination confirmed malignancy (adrenocortical carcinoma in one patient and metastatic cancer in the other one). The remaining 30 patients were operated because of size of the adrenal mass (16 patients) or biochemical suspicion of pheochromocytoma (12 patients, 5 of them with the mass size >4 cm) or primary aldosteronism (2 patients). The histological examination confirmed Conn syndrome in two patients and pheochromocytoma in one patient.     

Atrial fibrillation in patients after coronary artery bypass grafting: the role of autonomic nervous system

In 42 patients the 24-hour ECG was performed before and on the fifth day after the elective coronary artery bypass grafting. In general 34 bouts of atrial fibrillation occurred in 14 patients. According to frequency analysis of the HRV 23 (67.6%) of these paroxysms were found sympathetically driven, 6 (17.6%) vagally driven and 5 (14.7%) undefined. The predominating role of adrenergic activation in the initiation of the bouts of atrial fibrillation in this group of patients suggests the need to use adequate doses of beta-adrenolytic agents during the perioperative period of ischaemic heart disease treatment.     

Oral contraceptives use and weight gain in women with a Central European life-style.

OBJECTIVES: The aim of the study was to check and present data on the relation between combined oral contraceptives (COC) use and body weight in young women living in Poland. METHODS: Observational study on the group of young women on COC and the control group of young women who never used COC. Candidates for study (145 women) and control (218 women) groups were recruited in selected gynecological clinics in Poland during the period of 1-31 January 2002 (with the use of randomization). RESULTS: Both groups (study and control) were almost identical in age, anthropometric characteristics, number of pregnancies and deliveries. On the basis of this investigation it was found that there was no relation between use of COC and weight gain. Observed (in both groups) weight gain in young women was most probably related rather to time-passing (patients were getting older). The higher risk for overweight and obesity was found in the group of young women who had already had problems with overweight in their childhood. and in the group of women with high weight gain during the first pregnancy. CONCLUSION: COC use is not associated with weight gain in young women with a Central European life-style.     

Effectiveness of neuroendoscopic procedures in the treatment of complex compartmentalized hydrocephalus in children

OBJECTIVE: The main object of the work is to assess the suitability of neuroendoscopic techniques for the treatment of complex compartmentalized hydrocephalus. METHODS: For this purpose the authors compared two groups of children treated in the Research Institute of the Polish Mother's Memorial Hospital from March 1997 to January 2002. The first group of 47 children, treated using neuroendoscopic procedures, was compared with the second, which comprised 80 children treated conventionally by complicated shunt implantations. RESULTS: The children treated neuroendoscopically needed on average 1.7660 procedures during the entire therapy, and 1.0232 operations a year. The same parameters in the conventionally-treated group were as follows: the total number of procedures was 7.050, and the rate of reoperation was 3.949 procedures a year. The proportion of patients who suffered from complications connected with operative treatment and who had a bad outcome was higher in the conventionally-treated group than in the neuroendoscopic one.     

A comparison of blood and Fluosol-DA for cardiopulmonary bypass

Fluosol-DA was compared to blood as a pump prime for total cardiopulmonary bypass in the pig animal model. Nineteen pigs weighing between 14 and 22 kg were studied, nine with blood and ten with Fluosol. Metabolic and hemodynamic measurements were determined before, during and after 60 minute bypass to establish the adequacy of Fluosol to sustain perfusion as compared to blood. The measurements and subsequent calculations included blood gases, arterial and mixed venous oxygen content, oxygen extraction and consumption, cardiac output, systemic and pulmonary vascular resistance and arterial, venous, pulmonary artery and left atrial pressures. The result showed a significant decrease in hematocrit during bypass in the Fluosol group as compared to blood perfusion (20 vs. 30%). While the arterial oxygen content fell from control levels with Fluosol during bypass, in the blood prime group, oxygen content remained at pre-control levels. Whole body oxygen consumption decreased during bypass, in both groups equally, but this decrease did not lead to acidosis and was stable during recovery. Oxygen and carbon dioxide transport were adequately maintained during bypass in both Fluosol and blood groups. Systemic pressures remained stable during bypass and were lower, but stable, during recovery. Pulmonary vascular resistance was elevated in both groups during recovery which probably explains a concomitantly decreased cardiac output. There was a 40% mortality in both experimental groups secondary to postpump pulmonary hypertension. It is concluded that Fluosol is a satisfactory oxygen carrying agent to be used instead of blood during cardiopulmonary bypass, and in the pig model both blood and Fluosol were associated with a high incidence of pulmonary hypertension.