Przemysław Pyda - Academia.edu (original) (raw)

Papers by Przemysław Pyda

Research paper thumbnail of Rare occurrence of the liver metastases at the HBsAg positive patients operated due to colorectal cancer

Contemporary Oncology/Współczesna Onkologia, Jul 14, 2003

W przebiegu choroby nowotworowej jelita grubego u ok. 15-40 proc. operowanych chorych stwierdza s... more W przebiegu choroby nowotworowej jelita grubego u ok. 15-40 proc. operowanych chorych stwierdza siê wystêpowanie przerzutów odleg³ych, najczêoeciej w w¹trobie. Obecnooeae guzów przerzutowych w w¹trobie jest jednym z istotnych parametrów prognostycznych, czêsto decyduj¹cym o mo¿liwooeci wykonania zabiegu radykalnego. Postêpowaniem z wyboru w przypadku guzów przerzutowych, okreoelanych jako operacyjne, pozostaje chirurgiczna resekcja zmian. Inne metody, tzn. chemioterapia, embolizacja têtnic w¹trobowych, podawanie doguzowo alkoholu b¹dŸ innych aktywnych biologicznie substancji, charakteryzuj¹ siê zdecydowanie ni¿szym odsetkiem prze¿yae 5-letnich.

Research paper thumbnail of Initial experience with endoscopic ultrasound-guided gallbladder drainage

Wideochirurgia I Inne Techniki Maloinwazyjne, 2019

Introduction: Patients with acute cholecystitis who are unsuitable for cholecystectomy undergo co... more Introduction: Patients with acute cholecystitis who are unsuitable for cholecystectomy undergo conservative treatment or percutaneous transhepatic gallbladder drainage. As these two methods are not always successful, further treatment options are needed. One increasingly popular method is endoscopic ultrasound-guided gallbladder drainage (EUSGBD), whereby stents are placed so as to create a permanent fistula connecting the gallbladder to the stomach or the duodenal bulb, thus enabling drainage of its contents to the gastrointestinal tract. Aim: To present our early experience with EUSGBD for the treatment of cholecystitis in patients who are not suitable for cholecystectomy. Material and methods: The procedure was performed in 5 patients with acute cholecystitis. Two patients also had symptoms of biliary obstruction due to pancreatic head cancer. An ultrasound endoscope was used to create a fistula between the gallbladder and the stomach or between the gallbladder and the duodenal bulb, in which a self-expandable metallic stent (SEMS) was placed. Results: All procedures were performed with no perioperative complications. In all patients, the clinical symptoms of cholecystitis subsided within 3-15 days. In those patients who also showed symptoms of biliary obstruction, these symptoms subsided within 3-6 days following the procedure. Conclusions: The EUSGBD seems to be an effective and safe treatment for acute cholecystitis in patients unsuitable for cholecystectomy. It can also be used to treat jaundice caused by obstruction of the common bile duct, when no other methods can be used. The method is particularly promising in cases of concurrent acute cholecystitis and common bile duct obstruction.

Research paper thumbnail of Chlorinated pesticides levels in human adipose tissue in the district of Poznań

Journal of Environmental Science and Health . Part A: Environmental Science and Engineering, 1986

... All the ana-lyzed samples oontained beta-BHC, Lindane, HCB, pp'-DDE and DDT isomers.... more ... All the ana-lyzed samples oontained beta-BHC, Lindane, HCB, pp'-DDE and DDT isomers. Copyright © 1986 by Marcel Dekker, Inc. 0360-1266/86/2101-0005S3.50/0 5 ... Res. 28:106, 1982. 9. Polishuk, ZV, Vassermann, D., Vassermann, M., Cucos, S., and Ron, M., Environm. ...

Research paper thumbnail of Lymphoproliferative Disease After Liver Transplantation: Primary Biliary Localization

Transplantation Proceedings, 1998

Research paper thumbnail of Long-Term Use of Probiotics<i>Lactobacillus</i>and<i>Bifidobacterium</i>Has a Prophylactic Effect on the Occurrence and Severity of Pouchitis: A Randomized Prospective Study

BioMed Research International, 2014

The aim of the study was to assess the impact of the long-term use of the composite probiotics in... more The aim of the study was to assess the impact of the long-term use of the composite probiotics in patients after restorative proctocolectomy. Method. Forty-three patients (20 females and 23 males, aged 21 to 68 years) after restorative proctocolectomy were included in the study. After randomization patients were divided into placebo group and treatment group with oral intake of probiotic containing Lactobacillus acidophilus, Lactobacillus delbrueckii subsp. bulgaricus, and Bifidobacterium bifidus. Patients were investigated during initial visit and during final visit after 9 months. All patients were subjected to standard clinical and endoscopic examination with microscopic study of the specimens. Concentrations of calprotectin and pyruvate kinase isoenzyme M2-PK were determined in all cases. Results. The average severity of pouchitis and the number of patients with pouchitis significantly decrease after 9 months of the probiotic taking. The concentrations of calprotectin and pyruvate kinase isoenzyme M2-PK significantly decreased after the therapy. Conclusions. Nine months of the probiotic treatment (Lactobacillus acidophilus, Lactobacillus delbrueckii subsp. bulgaricus, and Bifidobacterium bifidus) reduced the number of patients with pouchitis, decreased the PDAI score, and also decreased the fecal pyruvate kinase and calprotectin. The long-term probiotics use is safe and well accepted and can be an effective method of the pouchitis prevention.

Research paper thumbnail of Palliative treatment of the liver metastatic tumours – usefulness of the intratumoral injection of the TNF-α

Contemporary Oncology/Współczesna Onkologia, Jul 25, 2003

Chorzy z przerzutami do w¹troby stano-wi¹ znaczny odsetek pacjentów z nowotworem w obrêbie przewo... more Chorzy z przerzutami do w¹troby stano-wi¹ znaczny odsetek pacjentów z nowotworem w obrêbie przewodu pokarmowego. Szacuje siê, i¿ u 40-50 proc. chorych z nowotworem jelita grubego wystêpuj¹ w ró¿nym stopniu zaawansowania guzy przerzutowe do w¹troby [1, 2]. W wiêkszooeci przypadków u tych chorych wykonuje siê jedynie zabiegi paliatywne. Jedn¹ z metod stosowanych w przypadkach nieoperacyjnych przerzutów do w¹troby jest ostrzykiwanie ognisk nowotworowych. Najczêoeciej stosowanym oerodkiem jest alkohol etylowy [3, 4]. Prowadzi siê równie¿ badania nad wykorzystaniem cytokin i innych biologicznie czynnych substancji [5, 6, 7, 8]. TNF-α (ang. tumor necrosing factorczynnik martwicy nowotworów) jest cytoki-n¹ syntetyzowan¹ przez aktywowane makrofagi (monocyty), zbudowan¹ ze 157 aminokwasów. Wydzielanie TNF-α wystêpuje w odpowiedzi na lipopolisacharydy, inne czynniki pochodzenia wirusowego lub bakteryjnego. Czynnikiem stymuluj¹cym wydzielanie tej cytokiny jest równie¿ obecnooeae komórek nowotworowych.

Research paper thumbnail of A comparison of the oxidative stress response in single-incision laparoscopic versus multi-trocar laparoscopic totally extraperitoneal inguinal hernia repair

Videosurgery and Other Miniinvasive Techniques

Introduction: Surgical treatment is always associated with tissue damage and the subsequent devel... more Introduction: Surgical treatment is always associated with tissue damage and the subsequent development of oxidative stress. Aim: To compare the oxidative stress response in patients treated operatively for inguinal hernia with multi-trocar laparoscopic totally extraperitoneal technique (TEP) or single-incision laparoscopic totally extraperitoneal technique (TEP-SI). Material and methods: A randomized group of 34 patients with one-sided inguinal hernia was enrolled in the study. Seventeen patients were treated with a standard TEP method (group 1) and the other 17 patients were treated with the TEP-SI technique (group 2). Thiobarbituric acid reactive substances (TBARS) and total antioxidant status (TAS) as the oxidative stress markers were measured before surgery (0), 1 day (1) and 4 days (2) after surgery. Results: A decrease in TAS on the first day after surgery was observed in both groups. Sustained reduction on the fourth day after surgery was observed in group 1, whereas in group 2 an increase followed. A statistically significant difference was observed in TAS (2 : 0) ratio with a meaningful decrease in group 1. TBARS concentration was elevated one day after surgery in both groups. It remained at an elevated level on the fourth day after surgery in group 1, while it decreased in group 2. The duration of surgery was higher in group 2 (mean: 57.5 min) than in group 1 (mean: 50.0 min) (p = 0.0286). Conclusions: Oxidative stress levels are lower in patients treated operatively by TEP-SI technique than by TEP. TEP-SI may be considered as a less invasive technique associated with less tissue injury.

Research paper thumbnail of Postoperative negative-pressure drainage through a PEG tube can prevent pancreatic fistula after pancreatoduodenectomy

Hepatobiliary & Pancreatic Diseases International

Research paper thumbnail of Applying NPWT to bleeding open wounds after forefoot amputation in diabetic foot patients - a case report

Negative Pressure Wound Therapy Journal

NPWT is increasingly used in patients with diabetic foot. The protocol for performing NPWT is sub... more NPWT is increasingly used in patients with diabetic foot. The protocol for performing NPWT is subject to debate. Main concerns regard the type of suction to use (continuous, intermittent, or variable), the wound-packing material, or the exact pressure to apply. Typically, an optimum pressure range of –80 to –125 mmHg is indicated. Following bone resection in diabetic foot patients, the surgical wound is left open, which often entails bleeding from the resection site. In these cases, the start of NPWT was typically delayed by 24–48 hours – during that time a pressure dressing was applied – and NPWT was only started once bleeding had ceased. In order to initiate NPWT as soon as possible, we decided to start it at a higher negative pressure than usual, i.e. –180 mmHg, expecting that this would stop the bleeding. Only then would we reduce the negative pressure. This paper presents the course of NPWT with high negative pressure values after an amputation in 2 diabetic foot patients. In b...

Research paper thumbnail of Selective resection of the bone with preservation of soft tissues (“empty toe technique”) combined with negative pressure wound therapy for treatment of osteomyelitis of the great toe - a case report

Negative Pressure Wound Therapy Journal

Diabetic foot ulceration (DFU) is a serious complication of diabetes mellitus, and one that is di... more Diabetic foot ulceration (DFU) is a serious complication of diabetes mellitus, and one that is difficult to treat. In many cases of DFU, chronic osteomyelitis occurs in the foot. The present paper describes the course of treatment for chronic osteomyelitis of the great toe with metatarsophalangeal arthritis using selective resection of the bone preserving the soft tissues (the “empty toe technique”). Following the procedure, to promote surgical wound healing, negative pressure wound therapy was administered for 7 days, with a constant pressure of –120 mmHg. The presented method was found to be effective in treating osteomyelitis in a patient with DFU, partially preserving the function and completely preserving the shape of the treated toe.

Research paper thumbnail of Initial experience with endoscopic sleeve gastroplasty in Poland

Polski przeglad chirurgiczny, Jan 13, 2018

Obesity is becoming one of the major public health problems. Bariatric procedures are considered ... more Obesity is becoming one of the major public health problems. Bariatric procedures are considered the most effective methods of treating this condition but they are costly and entail a high risk of complications. Thus, there is a need to look for better bariatric treatment solutions. One of the newest, highly promising bariatric methods is endoscopic sleeve gastroplasty (ESG), which is comparably effective to other bariatric procedures in terms of weight loss but at the same time it is much less invasive. Eight obese patients underwent ESG. Under general anaesthesia, an endoscope was inserted into the stomach, where a row of 4-5 running stitches was placed (from the pyloric part towards the GE junction). Each of the stitches was cinched tight, which resulted in gastric lumen reduction comparable to that achieved with laparoscopic sleeve gastrectomy. The procedures were performed without any severe peri-operative complications. The only adverse event was a minor haemorrhage in one of ...

Research paper thumbnail of Tissue expression of β-catenin and E- and N-cadherins in chronic hepatitis C and hepatocellular carcinoma

Archives of Medical Science, 2017

Introduction: The role of the Wnt/β-catenin signalling pathway in HCV-associated hepatocellular c... more Introduction: The role of the Wnt/β-catenin signalling pathway in HCV-associated hepatocellular carcinogenesis is still unknown. Material and methods: This study aimed to perform quantitative analysis of immuno-and hybridocytochemical expression of β-catenin, E-cadherin and N-cadherin and HCV proteins (C, NS3, NS5A) in long-term (≥ 20 years) chronic hepatitis C (CH-C) (n = 54), hepatocellular carcinoma (HCC) (n = 61) and control liver (n = 8). Results: Typical membranous expression of β-catenin in the control liver was significantly higher than in the CH-C and HCC groups. The mean β-catenin tissue expression in CH-C was similar to the control group, and significantly higher than that of HCC. E-cadherin expression was lower in CH-C than in the control and HCC. In HCC expression of both β-catenin and E-cadherin was significantly lower in comparison to controls. Positive correlations were found between β-catenin and E-cadherin (in CH-C and HCC), β-catenin and N-cadherin (HCC), and E-and N-cadherin expression (HCC). The altered liver expression of β-catenin, E and/or N-cadherin did not correlate with any clinicopathological characteristics in the examined groups. In CH-C a positive correlation was demonstrated between NS5A and β-catenin, and between all HCV proteins (C, NS3, NS5A) and E-cadherin expression. Conclusions: Alterations in cellular locations of β-catenin and E-cadherin in CH-C and HCC pointed to structural disturbances in intercellular junctions in the livers and presence of the transcriptionally inactive form of β-catenin. The reduced expression of E-cadherin in long-lasting CH-C may represent an early indicator of the epithelial-mesenchymal transition. The most important role in modulation of the Wnt/β-catenin pathway in vivo is probably played by the NS5A viral protein.

Research paper thumbnail of Partial thyroidectomy under local anaesthesia—the analysis of 49 subsequent cases

Langenbeck's Archives of Surgery, 2008

Background and aims Partial thyroidectomy under local anaesthesia was performed in 49 subsequent ... more Background and aims Partial thyroidectomy under local anaesthesia was performed in 49 subsequent individuals in the Central African Republic. Because of the shortage of medical resources, all patients with goitre were scheduled for an operation under local anaesthesia. Materials and methods There were no inclusion or exclusion criteria applied for patient selection for the procedure. Before the operation, patients had received an oral sedation and antibiotic. For infiltration anaesthesia, 1% lignocaine was used. Results Subtotal bilateral thyroidectomy was performed in 37 patients; 12 patients underwent lobectomy or partial lobectomy of the affected portion of the gland. There were no intraoperative complications in any of the patients. The mean time of the procedure averaged 127 min. There were no postoperative complications noticed in the reported group, and this includes also complications related to laryngeal nerve injury. General condition of the operated on patients allowed for full self-dependency within 4 to 6 h postoperatively. Patients remained under medical surveillance for mean 3 days, and cutaneous stitches were removed on the first postoperative day. General condition of all patients on the day of discharge from hospital was good. Conclusion Surgery for goitre under local anaesthesia may be a safe alternative where general anaesthesia is not available or contraindicated for medical reasons.

Research paper thumbnail of Initial Experience with Endoscopic Ultrasound Guided Tru-Cut Biopsy for Known Or Suspected Benign Liver Disease

Gastrointestinal Endoscopy, 2008

Since its introduction in early 1990s, endoscopic ultrasound (EUS) has become integral to the dia... more Since its introduction in early 1990s, endoscopic ultrasound (EUS) has become integral to the diagnosis and staging of various luminal, extraluminal gastrointestinal (GI) and certain non-GI lesions. There is no data on EUS experience in Bangladesh. The aim of this paper is to evaluate the initial recent experience and clinical impact of EUS. All EUS procedures data were recorded prospectively from July 2013 to December 2014. These included patients' demographics, referral details, provisional diagnosis, management plan before and after EUS & indications of procedures. EUS-FNA data recorded included details regarding site, number of passes and histological diagnosis. Two hundred & four EUS procedures were carried out over one and half years. Male female ratio was 1.4:1, mean age was 46.4±20 years. Of these procedures 148 (72.5%) were referrals from physicians and 56 (27.5%) were from surgeons. Most common indications were pancreatobiliary pathologies, esophageal & gastric pathologies. Pancreatobiliary lesions (n=165, 80.9%) included patients with (A) Benign pathologies: Microliths in Gall baldder (n=6), Gall stones (n=12), Biliary ascarrisis (n=22), Choledocholithiasis (n=42), Acute Pancreatitis (n=9), Chronic Pancreatitis (n=15), Pancreatic pseudocysts(n=4) (B) Malignant Pathologies : GB Carcinoma(n=4), Cholangiocarcinoma (n=29), Capancreas (n=9), Periampullary carcinoma (n=12).Esophageal lesion was 9.3% (n = 19) of total procedures. Forty seven percent (n=9) of EUS procedures on esophagus were for staging of esophageal malignancy, 10. 5% (n=2) for restaging or recurrence after chemoradiation and 21% (n=4) for submucosal lesions. Fifteen EUS procedures were carried out for gastric lesions, 07 were for staging of gastric carcinoma, 04 were for assessment of submucosal lesions (e.g. GIST, lipoma or external compression), 02 for assessment of polyps and 02 for gastric ulcers.In clinical impact & outcome study, changes in diagnosis, management, avoidance of investigations and usefulness of EUS were evaluated. Diagnosis was changed in 34.4% (64/186) & management was changed in 45%(92/204). Additional investigation was avoided in 57.8% (118/204). This is the first report of Bangladesh experience of EUS to date. EUS is safe, accurate, cost effective & very useful tool for diagnosis and management of G.I. disorders.

Research paper thumbnail of Primary sclerosing cholangitis at the patients operated due to ulcerative colitis

Digestive and Liver Disease, 2000

Background: Intestinal epifhelial cells (JEC) are generated by stem cells in the crypt base and r... more Background: Intestinal epifhelial cells (JEC) are generated by stem cells in the crypt base and reach the huninaJ surface afier only 3-5 days. The IEC life cycle is terminated as IEC loose aachoragc and shed into the lumen. The aim of [his study is to enhance our understanding of the molecular mechanisms underlying Lhe elimination of IEC. Methods: Detachment-induced apoptosis (DICD) was initiated by loss of cell-anchorage in ax viva isolated normal human KC. Studies on cytochrome c release and the activation of caspases

Research paper thumbnail of Partial thyroidectomy under local anaesthesia—the analysis of 49 subsequent cases

Langenbecks Archives of Surgery, 2008

Background and aims Partial thyroidectomy under local anaesthesia was performed in 49 subsequent... more Background and aims Partial thyroidectomy under local anaesthesia was performed in 49 subsequent individuals in the Central African Republic. Because of the shortage of medical resources, all patients with goitre were scheduled for an operation under local anaesthesia. Materials and methods There were no inclusion or exclusion criteria applied for patient selection for the procedure. Before the operation, patients had received an

Research paper thumbnail of Unsuspected femoral hernias diagnosed during endoscopic inguinal hernia repair

Advances in Clinical and Experimental Medicine

Research paper thumbnail of Evaluation of the laparoscopic cholecystectomy on patients with simple and complicated cholecystolithiasis

World Journal of Surgery, 1992

Laparoscopic eholecystectomy is now a well described method for the eatment of cholelithiasis. Th... more Laparoscopic eholecystectomy is now a well described method for the eatment of cholelithiasis. The purpose of this paper is to define its Implementation, limits, risks and indications. Following a prospective raethod, the results of this treatment were compared in 187 patients with simple cholelithiasis and 75 patients with complicated cholelithiasis. Cbolecystectomy was performed with a straight optic introduced through the paraumbilical region, and coupled with video camera. Two, 3, or 4 Other trocars were inserted and placed as required by anatomic conditions. In the group with simple cholelithiasis, laparoscopic cholecystectomy was performed in 99% of the patients while in the group with COmplicated cholelithiasis the procedure was achieved in 75% of the Patients. Immediate laparotomy was done in 1% and 25% of cases respectively in both groups. No interventional mortality occurred. Post-Operative eom,qicatian s have been accentahle (1 6% and 2 7%), with no late . ~. v r • • t COmphcations reported. Our study shows that laparascopic cholecyseetomy is feasible in the majority of cases of complicated cholelithiasis and that the main advantages of this method were retained.

Research paper thumbnail of Local Anesthesia in Thyroid Surgery - Own Experience and Literature Review

Polish Journal of Surgery, 2011

The local anesthesia in thyroid surgery is rarely used, only in selected patients. Majority of ce... more The local anesthesia in thyroid surgery is rarely used, only in selected patients. Majority of centers performing thyroid surgery with local anesthesia have possibility to convert to the general anesthesia. The aim of the study was to present our experiences with partial thyroidectomy under local anesthesia performed in 49 consecutive subjects in the Central African Republic (bilateral subtotal strumectomy, total resection of the one lobe, subtotal resection of the one lobe). All admitted patients with clinically significant goiter were accepted for surgical treatment. For infiltration anesthesia 1% lignocaine was used. Because of the shortage of medical resources, potential conversion to the general anesthesia was impossible. Before the operation patients had received an oral sedation and antibiotic. In 16 patients general anesthesia was used, in other 33 it was impossible. Subtotal bilateral thyroidectomy was performed in 37 patients, 12 patients underwent lobectomy or partial lobectomy of the affected portion of the gland. There were no intraoperative and postoperative complications noticed in the reported group, including complications related to laryngeal nerve injury. The mean duration of the procedure was 127 minutes and mean medical follow-up was 3 days. General condition of all patients on the day of discharge from hospital was good. Surgery for goiter under local anesthesia may be a safe alternative where general anesthesia is not available or contraindicated for medical reasons. The infiltration anesthesia is simple to perform and reduces the number of complications potentially occurred at the C2-C4 neck plexus block.

Research paper thumbnail of Insulin-like growth factor-1 mRNA isoforms and insulin-like growth factor-1 receptor mRNA expression in chronic hepatitis C

World journal of gastroenterology : WJG, Jan 7, 2015

To evaluate the expression of different insulin-like growth factor (IGF)-1 mRNA isoforms and IGF-... more To evaluate the expression of different insulin-like growth factor (IGF)-1 mRNA isoforms and IGF-1 receptor (IGF-1R) mRNA in hepatitis C virus (HCV)-infected livers. Thirty-four liver biopsy specimens from chronic hepatitis C (CH-C) patients were obtained before anti-viral therapy. Inflammatory activity (grading) and advancement of fibrosis (staging) were evaluated using a modified point scale of METAVIR. The samples were analyzed using quantitative real-time PCR technique. From fragments of liver biopsies and control liver that were divided and ground in liquid nitrogen, RNA was isolated using RNeasy Fibrous Tissue Mini Kit according to the manufacturer's instruction. Expression levels of IGF-1 mRNA isoforms (IGF-1A, IGF-1B, IGF-1C, P1, and P2) and IGF-1R mRNA were determined through normalization of copy numbers in samples as related to reference genes: glyceraldehyde-3-phosphate dehydrogenase and hydroxymethylbilane synthase. Results on liver expression of the IGF-1 mRNA isof...

Research paper thumbnail of Rare occurrence of the liver metastases at the HBsAg positive patients operated due to colorectal cancer

Contemporary Oncology/Współczesna Onkologia, Jul 14, 2003

W przebiegu choroby nowotworowej jelita grubego u ok. 15-40 proc. operowanych chorych stwierdza s... more W przebiegu choroby nowotworowej jelita grubego u ok. 15-40 proc. operowanych chorych stwierdza siê wystêpowanie przerzutów odleg³ych, najczêoeciej w w¹trobie. Obecnooeae guzów przerzutowych w w¹trobie jest jednym z istotnych parametrów prognostycznych, czêsto decyduj¹cym o mo¿liwooeci wykonania zabiegu radykalnego. Postêpowaniem z wyboru w przypadku guzów przerzutowych, okreoelanych jako operacyjne, pozostaje chirurgiczna resekcja zmian. Inne metody, tzn. chemioterapia, embolizacja têtnic w¹trobowych, podawanie doguzowo alkoholu b¹dŸ innych aktywnych biologicznie substancji, charakteryzuj¹ siê zdecydowanie ni¿szym odsetkiem prze¿yae 5-letnich.

Research paper thumbnail of Initial experience with endoscopic ultrasound-guided gallbladder drainage

Wideochirurgia I Inne Techniki Maloinwazyjne, 2019

Introduction: Patients with acute cholecystitis who are unsuitable for cholecystectomy undergo co... more Introduction: Patients with acute cholecystitis who are unsuitable for cholecystectomy undergo conservative treatment or percutaneous transhepatic gallbladder drainage. As these two methods are not always successful, further treatment options are needed. One increasingly popular method is endoscopic ultrasound-guided gallbladder drainage (EUSGBD), whereby stents are placed so as to create a permanent fistula connecting the gallbladder to the stomach or the duodenal bulb, thus enabling drainage of its contents to the gastrointestinal tract. Aim: To present our early experience with EUSGBD for the treatment of cholecystitis in patients who are not suitable for cholecystectomy. Material and methods: The procedure was performed in 5 patients with acute cholecystitis. Two patients also had symptoms of biliary obstruction due to pancreatic head cancer. An ultrasound endoscope was used to create a fistula between the gallbladder and the stomach or between the gallbladder and the duodenal bulb, in which a self-expandable metallic stent (SEMS) was placed. Results: All procedures were performed with no perioperative complications. In all patients, the clinical symptoms of cholecystitis subsided within 3-15 days. In those patients who also showed symptoms of biliary obstruction, these symptoms subsided within 3-6 days following the procedure. Conclusions: The EUSGBD seems to be an effective and safe treatment for acute cholecystitis in patients unsuitable for cholecystectomy. It can also be used to treat jaundice caused by obstruction of the common bile duct, when no other methods can be used. The method is particularly promising in cases of concurrent acute cholecystitis and common bile duct obstruction.

Research paper thumbnail of Chlorinated pesticides levels in human adipose tissue in the district of Poznań

Journal of Environmental Science and Health . Part A: Environmental Science and Engineering, 1986

... All the ana-lyzed samples oontained beta-BHC, Lindane, HCB, pp&#x27;-DDE and DDT isomers.... more ... All the ana-lyzed samples oontained beta-BHC, Lindane, HCB, pp&#x27;-DDE and DDT isomers. Copyright © 1986 by Marcel Dekker, Inc. 0360-1266/86/2101-0005S3.50/0 5 ... Res. 28:106, 1982. 9. Polishuk, ZV, Vassermann, D., Vassermann, M., Cucos, S., and Ron, M., Environm. ...

Research paper thumbnail of Lymphoproliferative Disease After Liver Transplantation: Primary Biliary Localization

Transplantation Proceedings, 1998

Research paper thumbnail of Long-Term Use of Probiotics<i>Lactobacillus</i>and<i>Bifidobacterium</i>Has a Prophylactic Effect on the Occurrence and Severity of Pouchitis: A Randomized Prospective Study

BioMed Research International, 2014

The aim of the study was to assess the impact of the long-term use of the composite probiotics in... more The aim of the study was to assess the impact of the long-term use of the composite probiotics in patients after restorative proctocolectomy. Method. Forty-three patients (20 females and 23 males, aged 21 to 68 years) after restorative proctocolectomy were included in the study. After randomization patients were divided into placebo group and treatment group with oral intake of probiotic containing Lactobacillus acidophilus, Lactobacillus delbrueckii subsp. bulgaricus, and Bifidobacterium bifidus. Patients were investigated during initial visit and during final visit after 9 months. All patients were subjected to standard clinical and endoscopic examination with microscopic study of the specimens. Concentrations of calprotectin and pyruvate kinase isoenzyme M2-PK were determined in all cases. Results. The average severity of pouchitis and the number of patients with pouchitis significantly decrease after 9 months of the probiotic taking. The concentrations of calprotectin and pyruvate kinase isoenzyme M2-PK significantly decreased after the therapy. Conclusions. Nine months of the probiotic treatment (Lactobacillus acidophilus, Lactobacillus delbrueckii subsp. bulgaricus, and Bifidobacterium bifidus) reduced the number of patients with pouchitis, decreased the PDAI score, and also decreased the fecal pyruvate kinase and calprotectin. The long-term probiotics use is safe and well accepted and can be an effective method of the pouchitis prevention.

Research paper thumbnail of Palliative treatment of the liver metastatic tumours – usefulness of the intratumoral injection of the TNF-α

Contemporary Oncology/Współczesna Onkologia, Jul 25, 2003

Chorzy z przerzutami do w¹troby stano-wi¹ znaczny odsetek pacjentów z nowotworem w obrêbie przewo... more Chorzy z przerzutami do w¹troby stano-wi¹ znaczny odsetek pacjentów z nowotworem w obrêbie przewodu pokarmowego. Szacuje siê, i¿ u 40-50 proc. chorych z nowotworem jelita grubego wystêpuj¹ w ró¿nym stopniu zaawansowania guzy przerzutowe do w¹troby [1, 2]. W wiêkszooeci przypadków u tych chorych wykonuje siê jedynie zabiegi paliatywne. Jedn¹ z metod stosowanych w przypadkach nieoperacyjnych przerzutów do w¹troby jest ostrzykiwanie ognisk nowotworowych. Najczêoeciej stosowanym oerodkiem jest alkohol etylowy [3, 4]. Prowadzi siê równie¿ badania nad wykorzystaniem cytokin i innych biologicznie czynnych substancji [5, 6, 7, 8]. TNF-α (ang. tumor necrosing factorczynnik martwicy nowotworów) jest cytoki-n¹ syntetyzowan¹ przez aktywowane makrofagi (monocyty), zbudowan¹ ze 157 aminokwasów. Wydzielanie TNF-α wystêpuje w odpowiedzi na lipopolisacharydy, inne czynniki pochodzenia wirusowego lub bakteryjnego. Czynnikiem stymuluj¹cym wydzielanie tej cytokiny jest równie¿ obecnooeae komórek nowotworowych.

Research paper thumbnail of A comparison of the oxidative stress response in single-incision laparoscopic versus multi-trocar laparoscopic totally extraperitoneal inguinal hernia repair

Videosurgery and Other Miniinvasive Techniques

Introduction: Surgical treatment is always associated with tissue damage and the subsequent devel... more Introduction: Surgical treatment is always associated with tissue damage and the subsequent development of oxidative stress. Aim: To compare the oxidative stress response in patients treated operatively for inguinal hernia with multi-trocar laparoscopic totally extraperitoneal technique (TEP) or single-incision laparoscopic totally extraperitoneal technique (TEP-SI). Material and methods: A randomized group of 34 patients with one-sided inguinal hernia was enrolled in the study. Seventeen patients were treated with a standard TEP method (group 1) and the other 17 patients were treated with the TEP-SI technique (group 2). Thiobarbituric acid reactive substances (TBARS) and total antioxidant status (TAS) as the oxidative stress markers were measured before surgery (0), 1 day (1) and 4 days (2) after surgery. Results: A decrease in TAS on the first day after surgery was observed in both groups. Sustained reduction on the fourth day after surgery was observed in group 1, whereas in group 2 an increase followed. A statistically significant difference was observed in TAS (2 : 0) ratio with a meaningful decrease in group 1. TBARS concentration was elevated one day after surgery in both groups. It remained at an elevated level on the fourth day after surgery in group 1, while it decreased in group 2. The duration of surgery was higher in group 2 (mean: 57.5 min) than in group 1 (mean: 50.0 min) (p = 0.0286). Conclusions: Oxidative stress levels are lower in patients treated operatively by TEP-SI technique than by TEP. TEP-SI may be considered as a less invasive technique associated with less tissue injury.

Research paper thumbnail of Postoperative negative-pressure drainage through a PEG tube can prevent pancreatic fistula after pancreatoduodenectomy

Hepatobiliary & Pancreatic Diseases International

Research paper thumbnail of Applying NPWT to bleeding open wounds after forefoot amputation in diabetic foot patients - a case report

Negative Pressure Wound Therapy Journal

NPWT is increasingly used in patients with diabetic foot. The protocol for performing NPWT is sub... more NPWT is increasingly used in patients with diabetic foot. The protocol for performing NPWT is subject to debate. Main concerns regard the type of suction to use (continuous, intermittent, or variable), the wound-packing material, or the exact pressure to apply. Typically, an optimum pressure range of –80 to –125 mmHg is indicated. Following bone resection in diabetic foot patients, the surgical wound is left open, which often entails bleeding from the resection site. In these cases, the start of NPWT was typically delayed by 24–48 hours – during that time a pressure dressing was applied – and NPWT was only started once bleeding had ceased. In order to initiate NPWT as soon as possible, we decided to start it at a higher negative pressure than usual, i.e. –180 mmHg, expecting that this would stop the bleeding. Only then would we reduce the negative pressure. This paper presents the course of NPWT with high negative pressure values after an amputation in 2 diabetic foot patients. In b...

Research paper thumbnail of Selective resection of the bone with preservation of soft tissues (“empty toe technique”) combined with negative pressure wound therapy for treatment of osteomyelitis of the great toe - a case report

Negative Pressure Wound Therapy Journal

Diabetic foot ulceration (DFU) is a serious complication of diabetes mellitus, and one that is di... more Diabetic foot ulceration (DFU) is a serious complication of diabetes mellitus, and one that is difficult to treat. In many cases of DFU, chronic osteomyelitis occurs in the foot. The present paper describes the course of treatment for chronic osteomyelitis of the great toe with metatarsophalangeal arthritis using selective resection of the bone preserving the soft tissues (the “empty toe technique”). Following the procedure, to promote surgical wound healing, negative pressure wound therapy was administered for 7 days, with a constant pressure of –120 mmHg. The presented method was found to be effective in treating osteomyelitis in a patient with DFU, partially preserving the function and completely preserving the shape of the treated toe.

Research paper thumbnail of Initial experience with endoscopic sleeve gastroplasty in Poland

Polski przeglad chirurgiczny, Jan 13, 2018

Obesity is becoming one of the major public health problems. Bariatric procedures are considered ... more Obesity is becoming one of the major public health problems. Bariatric procedures are considered the most effective methods of treating this condition but they are costly and entail a high risk of complications. Thus, there is a need to look for better bariatric treatment solutions. One of the newest, highly promising bariatric methods is endoscopic sleeve gastroplasty (ESG), which is comparably effective to other bariatric procedures in terms of weight loss but at the same time it is much less invasive. Eight obese patients underwent ESG. Under general anaesthesia, an endoscope was inserted into the stomach, where a row of 4-5 running stitches was placed (from the pyloric part towards the GE junction). Each of the stitches was cinched tight, which resulted in gastric lumen reduction comparable to that achieved with laparoscopic sleeve gastrectomy. The procedures were performed without any severe peri-operative complications. The only adverse event was a minor haemorrhage in one of ...

Research paper thumbnail of Tissue expression of β-catenin and E- and N-cadherins in chronic hepatitis C and hepatocellular carcinoma

Archives of Medical Science, 2017

Introduction: The role of the Wnt/β-catenin signalling pathway in HCV-associated hepatocellular c... more Introduction: The role of the Wnt/β-catenin signalling pathway in HCV-associated hepatocellular carcinogenesis is still unknown. Material and methods: This study aimed to perform quantitative analysis of immuno-and hybridocytochemical expression of β-catenin, E-cadherin and N-cadherin and HCV proteins (C, NS3, NS5A) in long-term (≥ 20 years) chronic hepatitis C (CH-C) (n = 54), hepatocellular carcinoma (HCC) (n = 61) and control liver (n = 8). Results: Typical membranous expression of β-catenin in the control liver was significantly higher than in the CH-C and HCC groups. The mean β-catenin tissue expression in CH-C was similar to the control group, and significantly higher than that of HCC. E-cadherin expression was lower in CH-C than in the control and HCC. In HCC expression of both β-catenin and E-cadherin was significantly lower in comparison to controls. Positive correlations were found between β-catenin and E-cadherin (in CH-C and HCC), β-catenin and N-cadherin (HCC), and E-and N-cadherin expression (HCC). The altered liver expression of β-catenin, E and/or N-cadherin did not correlate with any clinicopathological characteristics in the examined groups. In CH-C a positive correlation was demonstrated between NS5A and β-catenin, and between all HCV proteins (C, NS3, NS5A) and E-cadherin expression. Conclusions: Alterations in cellular locations of β-catenin and E-cadherin in CH-C and HCC pointed to structural disturbances in intercellular junctions in the livers and presence of the transcriptionally inactive form of β-catenin. The reduced expression of E-cadherin in long-lasting CH-C may represent an early indicator of the epithelial-mesenchymal transition. The most important role in modulation of the Wnt/β-catenin pathway in vivo is probably played by the NS5A viral protein.

Research paper thumbnail of Partial thyroidectomy under local anaesthesia—the analysis of 49 subsequent cases

Langenbeck's Archives of Surgery, 2008

Background and aims Partial thyroidectomy under local anaesthesia was performed in 49 subsequent ... more Background and aims Partial thyroidectomy under local anaesthesia was performed in 49 subsequent individuals in the Central African Republic. Because of the shortage of medical resources, all patients with goitre were scheduled for an operation under local anaesthesia. Materials and methods There were no inclusion or exclusion criteria applied for patient selection for the procedure. Before the operation, patients had received an oral sedation and antibiotic. For infiltration anaesthesia, 1% lignocaine was used. Results Subtotal bilateral thyroidectomy was performed in 37 patients; 12 patients underwent lobectomy or partial lobectomy of the affected portion of the gland. There were no intraoperative complications in any of the patients. The mean time of the procedure averaged 127 min. There were no postoperative complications noticed in the reported group, and this includes also complications related to laryngeal nerve injury. General condition of the operated on patients allowed for full self-dependency within 4 to 6 h postoperatively. Patients remained under medical surveillance for mean 3 days, and cutaneous stitches were removed on the first postoperative day. General condition of all patients on the day of discharge from hospital was good. Conclusion Surgery for goitre under local anaesthesia may be a safe alternative where general anaesthesia is not available or contraindicated for medical reasons.

Research paper thumbnail of Initial Experience with Endoscopic Ultrasound Guided Tru-Cut Biopsy for Known Or Suspected Benign Liver Disease

Gastrointestinal Endoscopy, 2008

Since its introduction in early 1990s, endoscopic ultrasound (EUS) has become integral to the dia... more Since its introduction in early 1990s, endoscopic ultrasound (EUS) has become integral to the diagnosis and staging of various luminal, extraluminal gastrointestinal (GI) and certain non-GI lesions. There is no data on EUS experience in Bangladesh. The aim of this paper is to evaluate the initial recent experience and clinical impact of EUS. All EUS procedures data were recorded prospectively from July 2013 to December 2014. These included patients' demographics, referral details, provisional diagnosis, management plan before and after EUS & indications of procedures. EUS-FNA data recorded included details regarding site, number of passes and histological diagnosis. Two hundred & four EUS procedures were carried out over one and half years. Male female ratio was 1.4:1, mean age was 46.4±20 years. Of these procedures 148 (72.5%) were referrals from physicians and 56 (27.5%) were from surgeons. Most common indications were pancreatobiliary pathologies, esophageal & gastric pathologies. Pancreatobiliary lesions (n=165, 80.9%) included patients with (A) Benign pathologies: Microliths in Gall baldder (n=6), Gall stones (n=12), Biliary ascarrisis (n=22), Choledocholithiasis (n=42), Acute Pancreatitis (n=9), Chronic Pancreatitis (n=15), Pancreatic pseudocysts(n=4) (B) Malignant Pathologies : GB Carcinoma(n=4), Cholangiocarcinoma (n=29), Capancreas (n=9), Periampullary carcinoma (n=12).Esophageal lesion was 9.3% (n = 19) of total procedures. Forty seven percent (n=9) of EUS procedures on esophagus were for staging of esophageal malignancy, 10. 5% (n=2) for restaging or recurrence after chemoradiation and 21% (n=4) for submucosal lesions. Fifteen EUS procedures were carried out for gastric lesions, 07 were for staging of gastric carcinoma, 04 were for assessment of submucosal lesions (e.g. GIST, lipoma or external compression), 02 for assessment of polyps and 02 for gastric ulcers.In clinical impact & outcome study, changes in diagnosis, management, avoidance of investigations and usefulness of EUS were evaluated. Diagnosis was changed in 34.4% (64/186) & management was changed in 45%(92/204). Additional investigation was avoided in 57.8% (118/204). This is the first report of Bangladesh experience of EUS to date. EUS is safe, accurate, cost effective & very useful tool for diagnosis and management of G.I. disorders.

Research paper thumbnail of Primary sclerosing cholangitis at the patients operated due to ulcerative colitis

Digestive and Liver Disease, 2000

Background: Intestinal epifhelial cells (JEC) are generated by stem cells in the crypt base and r... more Background: Intestinal epifhelial cells (JEC) are generated by stem cells in the crypt base and reach the huninaJ surface afier only 3-5 days. The IEC life cycle is terminated as IEC loose aachoragc and shed into the lumen. The aim of [his study is to enhance our understanding of the molecular mechanisms underlying Lhe elimination of IEC. Methods: Detachment-induced apoptosis (DICD) was initiated by loss of cell-anchorage in ax viva isolated normal human KC. Studies on cytochrome c release and the activation of caspases

Research paper thumbnail of Partial thyroidectomy under local anaesthesia—the analysis of 49 subsequent cases

Langenbecks Archives of Surgery, 2008

Background and aims Partial thyroidectomy under local anaesthesia was performed in 49 subsequent... more Background and aims Partial thyroidectomy under local anaesthesia was performed in 49 subsequent individuals in the Central African Republic. Because of the shortage of medical resources, all patients with goitre were scheduled for an operation under local anaesthesia. Materials and methods There were no inclusion or exclusion criteria applied for patient selection for the procedure. Before the operation, patients had received an

Research paper thumbnail of Unsuspected femoral hernias diagnosed during endoscopic inguinal hernia repair

Advances in Clinical and Experimental Medicine

Research paper thumbnail of Evaluation of the laparoscopic cholecystectomy on patients with simple and complicated cholecystolithiasis

World Journal of Surgery, 1992

Laparoscopic eholecystectomy is now a well described method for the eatment of cholelithiasis. Th... more Laparoscopic eholecystectomy is now a well described method for the eatment of cholelithiasis. The purpose of this paper is to define its Implementation, limits, risks and indications. Following a prospective raethod, the results of this treatment were compared in 187 patients with simple cholelithiasis and 75 patients with complicated cholelithiasis. Cbolecystectomy was performed with a straight optic introduced through the paraumbilical region, and coupled with video camera. Two, 3, or 4 Other trocars were inserted and placed as required by anatomic conditions. In the group with simple cholelithiasis, laparoscopic cholecystectomy was performed in 99% of the patients while in the group with COmplicated cholelithiasis the procedure was achieved in 75% of the Patients. Immediate laparotomy was done in 1% and 25% of cases respectively in both groups. No interventional mortality occurred. Post-Operative eom,qicatian s have been accentahle (1 6% and 2 7%), with no late . ~. v r • • t COmphcations reported. Our study shows that laparascopic cholecyseetomy is feasible in the majority of cases of complicated cholelithiasis and that the main advantages of this method were retained.

Research paper thumbnail of Local Anesthesia in Thyroid Surgery - Own Experience and Literature Review

Polish Journal of Surgery, 2011

The local anesthesia in thyroid surgery is rarely used, only in selected patients. Majority of ce... more The local anesthesia in thyroid surgery is rarely used, only in selected patients. Majority of centers performing thyroid surgery with local anesthesia have possibility to convert to the general anesthesia. The aim of the study was to present our experiences with partial thyroidectomy under local anesthesia performed in 49 consecutive subjects in the Central African Republic (bilateral subtotal strumectomy, total resection of the one lobe, subtotal resection of the one lobe). All admitted patients with clinically significant goiter were accepted for surgical treatment. For infiltration anesthesia 1% lignocaine was used. Because of the shortage of medical resources, potential conversion to the general anesthesia was impossible. Before the operation patients had received an oral sedation and antibiotic. In 16 patients general anesthesia was used, in other 33 it was impossible. Subtotal bilateral thyroidectomy was performed in 37 patients, 12 patients underwent lobectomy or partial lobectomy of the affected portion of the gland. There were no intraoperative and postoperative complications noticed in the reported group, including complications related to laryngeal nerve injury. The mean duration of the procedure was 127 minutes and mean medical follow-up was 3 days. General condition of all patients on the day of discharge from hospital was good. Surgery for goiter under local anesthesia may be a safe alternative where general anesthesia is not available or contraindicated for medical reasons. The infiltration anesthesia is simple to perform and reduces the number of complications potentially occurred at the C2-C4 neck plexus block.

Research paper thumbnail of Insulin-like growth factor-1 mRNA isoforms and insulin-like growth factor-1 receptor mRNA expression in chronic hepatitis C

World journal of gastroenterology : WJG, Jan 7, 2015

To evaluate the expression of different insulin-like growth factor (IGF)-1 mRNA isoforms and IGF-... more To evaluate the expression of different insulin-like growth factor (IGF)-1 mRNA isoforms and IGF-1 receptor (IGF-1R) mRNA in hepatitis C virus (HCV)-infected livers. Thirty-four liver biopsy specimens from chronic hepatitis C (CH-C) patients were obtained before anti-viral therapy. Inflammatory activity (grading) and advancement of fibrosis (staging) were evaluated using a modified point scale of METAVIR. The samples were analyzed using quantitative real-time PCR technique. From fragments of liver biopsies and control liver that were divided and ground in liquid nitrogen, RNA was isolated using RNeasy Fibrous Tissue Mini Kit according to the manufacturer's instruction. Expression levels of IGF-1 mRNA isoforms (IGF-1A, IGF-1B, IGF-1C, P1, and P2) and IGF-1R mRNA were determined through normalization of copy numbers in samples as related to reference genes: glyceraldehyde-3-phosphate dehydrogenase and hydroxymethylbilane synthase. Results on liver expression of the IGF-1 mRNA isof...