Clinical analysis of systemic and adipose tissue levels of selected hormones/adipokines and stromal-derived factor-1.

Recent studies demonstrated that selected hormones/adipokines may be involved into the regulation of bone metabolism and bone marrow-derived hematopoietic stem/progenitor cells (HSPCs) mobilization in humans. Interestingly, in obese individuals significantly higher numbers of spontaneously circulating stem cells are also observed. Therefore in this study we comprehensively examined plasma and AT (subcutaneous and visceral/omental) levels of hormones/adipokines involved in HSPCs mobilization in lean, overweight and obese individuals as well as verified their potential associations with concentrations of HSPCs chemoattractant, stromal-derived factor-1 (SDF-1). Blood and AT samples (35 subcutaneous and 35 omental) were obtained from individuals undergoing elective surgery. Plasma and AT-derived interstitial fluid levels of resistin, visfatin, osteocalcin and SDF-1 were measured using ELISA. In our study obese patients had almost significantly (P<0.06) higher plasma visfatin and resistin levels as well as lower osteocalcin concentrations (P<0.04) than lean individuals. Osteocalcin and resistin concentrations were strongly associated with levels of SDF-1 and metalloproteinases (MMP 2 and 9). AT levels of all examined substances were significantly lower than the corresponding levels in the plasma (in all cases at least P<0.05), and depot-specific differences in the concentrations of these factors were found only in terms of osteocalcin and SDF-1. In addition, subcutaneous and visceral/omental concentrations of osteocalcin and visfatin, but not of resistin, were associated with values of such parameters as age, body mass or adiposity indexes (BMI and BAI, respectively) and/or waist-to-hip ratio (WHR). In summary, our study showed that in obese individuals the biochemical constellation of adipokines/hormones involved in the process of HSPCs mobilization resembles this observed during pharmacological HSPCs mobilization. Moreover, our study offers further indirect translational evidence for existence of a biochemical cross-talk between bone and AT metabolism (so called - bone-fat- axis) in humans.

Preparation and bioactivity of novel multiblock thermoplastic elastomer/tricalcium phosphate composites.

There is a recognized need for improved treatment of osteoarthritis of the finger joints disease. Joint fusions are commonly used for treating the pain and potential deformity of arthritis. At severe deformity, artificial joint replacement is required. The most widely used are space-filler type joints made of high performance silicone rubber. One of the problems that occurs with these artificial replacements is that they can fail, because silicone elastomer used for their fabrication is relatively weak material and show to break apart and fragment. We have recently developed novel poly(aliphatic/aromatic-ester) (PED) material of sufficient mechanical properties and excellent flexibility. To enhance the bioactivity of these polymers (PED) and bone-bonding properties, PED/beta-TCP composites were prepared. The ceramic particles were homogeneously distributed during conventional blending and showed good adhesion to the polymer matrix. The thermal characteristics and mechanical properties of the composites were investigated as a function of beta-TCP content. The Youngs modulus and the yield strength of the composites increased with the increase in beta-TCP volume while the tensile strength and fracture strain decreased. In vitro investigations demonstrated an increase in cytocompatibility with increasing amount of beta-TCP up to 20 vol%.

Physical and mechanical behavior of electron-beam irradiated and ethylene oxide sterilized multiblock polyester.

The effect of two sterilization treatments (electron-beam radiation and ethylene oxide gas) on the structure and mechanical properties of a multiblock copolymer were investigated to establish the effects of the sterilizing procedures on potential biomedical material. The material was exposed for different radiation doses in order to find an optimum dose of electron-beam radiation. Characterization techniques employed include gel permeation chromatography, infrared spectroscopy, differential scanning calorimetry, dynamic mechanical thermal analysis and tensile testing. The optimal dose of radiation at which no change in structure and mechanical properties occurred was found as 25 kGy. Ethylene oxide gas treatment also did not affect the structure and properties of the polymer and it can be recommended as an alternative sterilization route for the studied polymer.

[Biocompatibility assessment of aqueous extracts from new multiblock poly(ester-ester) copolymer]. / Badania biologiczne wyciagów wodnych z nowego multiblokowego poli(estro-estro) kopolimeru.

In the Technical University of Szczecin, Department of Chemical Fibres and Physical Chemistry of Polymer there has been synthesised a new polymer based on butylene terephthalate--PBT and dimerized fatty acid--DFA. Five different polymers varying in mechanical properties depending on hard segments--PBT and soft segments--DFA composition were obtained. Assessment of biocompatibility of the new materials was conducted according to FDP. Prepared water extracts from polymers were applicated intravenously to mouse and intra-abdominaly to mice and guinea pigs. All animals survived spell of the experiment and no signs of physical degradation were noticed. Kidney, liver, spleen, heart and peritoneum specimens was taken and evaluated microscopically. There was no signs of toxic action of the extracts. Based on principles in FDP and the data from animal studies it is applicable that evaluated materials have no increased toxicity.

[An attempt to restore protective sensation after a greater omentum flap coverage due to circular soft tissue defect in the hand]. / Próba odtworzenia czucia ochronnego po pierwotnym pokryciu oskalpowanych okreznie rak i palców platem z sieci wiekszej.

The paper presents method of restoration of protective sensation after major hand injuries primarily treated with great omental flap. Existing methods have been modified on assumption that free end of transplanted sural nerve might act as sensation receptor. Two patients were operated on. Several months after surgery patients reported paresthesiae at skin compression. Function improvement is seemingly indicated by objects less frequently falling of out of the hand.

[The advanced stomach cancer]. / Zaawansowany rak zoladka.

In the years 1993 to 1997, 106 patients with gastric carcinoma were treated. The age of patients ranged from 24 to 90 years. There were 73 males and 33 females. Variant advancement of gastric carcinoma was diagnosed in the patients: 29 had III grade and 77 IV grade according to TNM. The following resections of the stomach were performed: total in 38 (46%), subtotal or partial 45 (54%). While the remaining 23 patients had other operative procedures. The resection rate increased from 13% to 54%. Chemotherapy was also used. 53 patients died. The authors conclude that the increase in surgical radicalness and application of aggressive chemotherapy are the methods improving the results in gastric carcinoma.

[Minor blunt abdominal trauma can be dangerous]. / Niebezpieczenstwa pozornie blahych zamknietych urazów jamy brzusznej.

Four cases with apparently mild abdominal trauma were presented. Finally, all but one were operated. On laparotomy ruptured spleen was found in two patients, the third had hematoma of the ileal mesentery. The fourth patient with subcapsular kidney hematoma was treated conservatively. All patients had initially denied any abdominal trauma. Sonography seems to be the most reliable and non-invasive investigation in making the diagnosis.

[Stab wound of the chest with penetration into abdominal cavity]. / Rana kluta klatki piersiowej drazaca do jamy brzusznej.

The case of the 33 year old woman with stab wound of the chest with penetration into abdominal cavity was presented. Due to injury mechanism the diagnostic thoracotomy was recommended. The operation confirmed the lung, diaphragm, spleen and kidney lesion. It was very interesting that patient with dangerous lesion of important organs had no clinical and radiological indications for emergency operation before.

[Assessment of tissue responsiveness after implantation of a new block copolymer into rat tissue]. / Badanie odpowiedzi tkankowej po wszczepieniu nowego kopoliestru blokowego do tkanek szczura.

The report describes tissue response an implantation of new block copolymer and compares with tissue response after presently used in medicine polymer implants. Implants shaped as 15 x 3 mm cylinders were placed subcutaneously on the abdomen and into muscles of both tight of Wistar rats. After 3, 7 and 14 days was taken tissue specimens with implants and kidneys to gross and light microscope examination. During the experiment there was not toxic signs considering rat's appearance and behaviour. Microscopic examination shows no difference between tissue response to presently in medicine used implants and new polymers.

[Free and pedicled omental flaps. Harvesting and transplanting]. / Technika wykonania wolnych i uszypulowanych platów z sieci wiekszej.

The paper describes technique of harvesting and transplanting of great omentum. The flap is a useful alternative to other flaps particularly in large tissue defects within upper extremity. Depending on general patient's condition and local vascular status at acceptor site the flap can be transplanted as a free or pedicled one. In the latter case immobilization of the extremity is required for two weeks until the pedicle can be divided. Plastic properties of the flap are underlined; postoperative management is also presented.

The influence of new polyester block copolymer on morphology of hepatocytes of rats liver.

The liver is a complex organ with metabolic, excretory, and defence functions, so the effect of toxic polymers is often find in disorganisation of hepatic structure and may induce cell damage. In this study it is estimated the influence of recently synthesised multiblock copolymers based on poly/butylene terepthalate) and a dimerized fatty acid. The films of polymers were implanted intra-abdominally in 45 rats of Wistar breed covering the right lobe of liver. The specimens of liver were collected in 1, 3 and 6 day of experiment in order to be evaluated under microscope. The morphology of lobules, size and shape of hepatocytes, size and shape of nuclei's of hepatocytes, any infiltration of plasma cell were taken into account during examination. There have been no difference in morphology between specimens of liver from rats with implanted polymer and control group which could implicate their toxicity.

[The use of radial artery for the revascularization of the amputated thumb]. / Wykorzystanie tetnicy promieniowej wskaziciela do rewaskularyzacji amputowanego kciuka.

We present one of several methods for revascularization of the replanted thumb. Index radial artery is prepared, transposed and anastomosed to pollicis princeps artery. Twenty-seven patients aged 12-67 operated between 1991 and 1997 due to total or subtotal thumb amputation were included in this study. The method was used in 6 of them. In 21 patients different methods were applied to restore thumb arterial circulation. Venous grafts were used in 5 cases, end to end anastomosis of the artery in 16 cases. Thumb necrosis occurred in 2 cases in the venous grafts group and in 5 cases in end to end group. All thumbs revascularized with index radial artery healed successfully. The method requires only one microanastomosis and the risk of thrombosis is relatively small. The method should be recommended in cases of large arterial defects as an alternative for venous grafting.

[The traumatic amputation of the forearm complicated by pneumocephalus]. / Amputacja urazowa przedramienia powiklana odma Sródczaszkowa.

The case of 37-year old man is reported who had traumatic amputation of the right forearm together with brachial plexus and cervical roots and third right rib fracture without pneumothorax. Due to a large damage of the limb replantation was dropped and only surgical elaboration of the wound was made. A few hours after the operation, dyspnoe and headache appeared. New x-ray picture showed right pneumothorax and pneumocephalus with continuing air shadow in cervical vertebral canal. In our opinion the air from pleura might go through cervical intramuscular space to the holes in dura after avulsed roots causing pneumocephalus.

[The use of the ulnar artery in hand replantation]. / Wykorzystanie tetnicy lokciowej w replantacji reki.

A method for restoring arterial circulation at replantation of the metacarpus with reversed ulnar artery is presented. It was employed in 31 years old patient who underwent replantation of the metacarpus with index, middle and ring finger. The little one was abandoned due to the vast damage. Great defect made end-to-end anastomosis not feasible. Reversed ulnar artery bypass served to restore arterial circulation without need for shortening of the metacarpals. Numerous presentations stressing arterial bypass advantages provoked our attempt to use this method. After half a year good functional and cosmetic result has been achieved.

[Transplantation of the greater omentum and complication]. / Przeszczepy sieci wiekszej i powiklania.

A series of 13 patients (12 males, 1 female, aged 5-57) operated between 1990 and 1997 is presented. In 12 cases the greater omentum was used to cover tissue defect within upper extremity, in 1 case--lower extremity. Complications at donor site and within extremity were assessed in two groups (group I--5 cases of free omentum graft, group II--8 cases of pedicled omentum graft). Two acceptor site complications (flap necrosis and osteomyelitis) and no donor site complications were observed in group I. In group II 2 similar donor site complications occurred but 5 patients from this group complained of strong abdominal pain due to excessively short pedicle of the graft and 1 case of abdominal hernia occurred. The complications have been analyzed, means for prevention discussed.

[Various possibilities for taking advantage of the Chinese flap in reconstruction of post-traumatic soft tissue defects in the upper extremity]. / Rózne mozliwosci wykorzystania plata chinskiego w rekonstrukcjach pourazowych ubytków tkanek w obrebie konczyny górnej.

A forearm flap based on radial artery (Chinese Flap) is one of the most often used flaps in reconstruction of posttraumatic tissue defects within upper extremity. It may be used as free flap or pediculated one. Long vascular pedicle allows easy transposition of the flap within upper extremity. Microsurgical techniques do not have to be employed. Flap anatomy enables one stage reconstruction of majority of posttraumatic defects both during acute or planned operations. The material includes 10 patients. Satisfactory functional results have been achieved in all cases.

[Post-traumatic painful ulnar nerve compression syndrome treated by wrapping the nerve with the vein: preliminary report]. / Pourazowy zespól bólowy nerwu lokciowego leczony przez otulenie nerwu zyla: doniesienie wstepne.

Three cases of post-traumatic painful ulnar nerve compression syndrome are presented. Previous treatment both conservative and surgical (neurolysis) proved unsatisfactory. The method described-wrapping of the nerve with the saphenous vein graft in the area of scarification-gave satisfactory outcome in 2 of 3 operated patients (significant resolution of pain and improvement of sensation) in one year follow-up. In one patient surgery failed. The method presented might be considered in refractory cases of painful nerve compression syndrome due to its entrapment within scarred tissue after injury or previous surgery.