Two-Axial Measurement of the Angular Microdeflection of a Laser Beam Using One Single-Axis Sensor.

The majority of current methods for measuring the angular deflection of a laser beam enable measurement only in one selected plane. However, there are tasks in which measurements of laser beam deflections in 3D are required. In this paper, we present a way of enabling two-axial measurements of the deflection of a beam based on a single-axis sensor. The key idea is to direct a laser beam, alternately, into one of two arms of a measurement system. In the first arm, the beam is transmitted directly to the angular sensor, while in the second, the beam is directed to the sensor via a special optical element that rotates the plane of the beam deflection; in other words, this element changes the deflection in the horizontal plane into a deflection in the vertical plane, and vice versa. To alternate the path of the beam, a variable phase retarder and a polarising beamsplitter are used. The proposed technique was experimentally verified, and the results confirm its effectiveness.

Interference method for ultra-precision measurement and compensation of laser beam angular deflection.

A new interferometric method for ultra-precise measurement of laser-beam angular deflection is proposed. The angular tilt of a measuring device in relation to the beam axis also can be measured. The method is based on interference fringe period analysis in the selected plane of measurement. The theoretical basis and experimental verification of the method are presented. It is shown that by using the proposed technique, it is possible to measure the laser beam angular deflection or instability with ultrahigh resolution reaching single nanoradians. The proposed method allows the measurement and further compensation of laser beam deflections in a very compact design.

The influence of social support from the family on health related-quality of life in persons with a colostomy.

PURPOSE: We evaluated the influence of social support on health-related quality of life (HRQOL) in persons with a colostomy, taking into account time since surgery. SUBJECTS AND SETTINGS: The study was conducted in 8 cities in Poland. The sample comprised 128 patients with a colostomy; their mean age was 66.24 years. Forty-five percent of participants had lived with a colostomy for more than 5 years, and 16% had a colostomy for less than 1 year. INSTRUMENTS: The questionnaire used in the study included 76 questions divided into 3 parts. The first part comprised 8 questions that queried demographic characteristics. Parts 2 and 3 included 2 validated scales assessing HRQOL and social support, respectively. Health-related quality of life was assessed using the Functional Assessment of Cancer Therapy-Colorectal instrument. Social support received was assessed using the Berlin Social Support Scale. In the case of both scales, the respondents were asked to assess their status during the last 7 days. METHODS: The study was conducted by an interviewer during monthly meetings of colostomy support groups as well as during hospitalization. The respondents gave their verbal answers to questions read by the interviewer or completed the questionnaires by themselves. After the questionnaire was completed, the interviewer verified completeness of answers. The outcome time elapsed since surgery was categorized as 3 subgroups: (1) respondents having a colostomy 1 year or less, (2) respondents having colostomy for more than 1 or up to 5 years, and (3) respondents having colostomy more than 5 years. RESULTS: Analysis revealed a statistically significant relationship between level of social support and HRQOL among persons with a colostomy (R = 0.361, P = .000029). Moreover, we observed that the time elapsed since colostomy surgery influenced this relationship. Level of social support and HRQOL were not significantly related in persons living with a colostomy ≤1 year (R = 0.155, P = .525). The correlation was significant in persons with a colostomy for more than 1 to but less than 5 years (R = 0.329, P = .02), and in individuals living with a colostomy for more than 5 years (R = 0.482, P = .0001). CONCLUSIONS: Persons with permanent colostomies and the higher level of social support from family reported higher HRQOL than did persons with lower levels of social support. Time elapsed since colostomy surgery exerts a positive effect on this relationship; the longer the patients live with a colostomy, the greater the influence of social support.

Nutritional Status and the Outcomes of Endoscopic Stenting in Benign and Malignant Diseases of Esophagus.

BACKGROUND: Endoscopic stenting (ES) is a widely known method for palliative dysphagia treatment in esophageal strictures. Esophageal cancer is often associated with advanced malnutrition, which may increase the risk of complications of the procedure. The aim of this study was to evaluate complication rates and the impact of nutritional status on the outcomes of ES. PATIENTS AND METHODS: A single-center retrospective study was conducted at Copernicus Hospital in Gdansk, Poland. Adult patients who underwent endoscopic stenting between February 2014 and December 2018 were included. The influence of patient characteristics (age, sex, indications for esophageal stenting, and location of stenosis) and nutritional status (BMI, NRS 2002, GLIM, and dysphagia score) on complication rates and survival were analyzed. RESULTS: Eighty-one patients (69% men) were enrolled in the study. In 69%, the indication for ES was malignancy (mainly esophageal cancer). The median dysphagia score significantly decreased from 2.8 to 0.6 after the procedure (p < 0.001). Complications were observed in 27% (n = 22) of the patients. Early complications were bleeding (2.5%), stent unexpansion (2.5%), and stent migration during the procedure (3.7%). There were no early fatal complications of the procedure. Late complications included: stent migration (6.2%), tissue overgrowth (6.2%), food impaction (2.2%), fistula formation (3.7%), bleeding (3.7%), and stent malposition (1.2%). A total of 76% of the participants scored ≥ 3 points in nutritional screening (NRS2002) and 70% were diagnosed with severe malnutrition (GLIM -stage 2). A stent diameter of < 2.2 cm compared with ≥ 2.2 was associated with a higher rate of migrations (15.5% vs. 2.5%). The median survival time in the malignant group was 90 days. Histopathological diagnosis and patients' nutritional status (BMI, NRS 2002, GLIM, and dysphagia score) had no significant effect on complication rates and survival after esophageal stent insertion. CONCLUSIONS: Endoscopic stenting is a relatively safe procedure for the palliative treatment of esophageal strictures. Severe malnutrition, although common, does not affect the outcomes of the procedure.

Surgical morphology of the pancreatic isthmus.

BACKGROUND: Pancreatic isthmus method anastomosis following pancreatic resection is an important factor of postoperative fistula formation. While the anatomy and vascular supply of the pancreatic head have been studied in detail, little is known about the morphology of the pancreatic isthmus. The authors determine the anatomy and morphology of the pancreatic isthmus. METHODS: 99 consecutive cadaveric pancreatic specimens were taken during standard autopsy. Organs were transected at the isthmus and pancreatograms and microscopic specimens of the transection plane were analyzed. RESULTS: The mean size of the Wirsung duct at the isthmus was 2.89 mm (+/-0.87 mm, from 1.4 to 6 mm). The main pancreatic duct was located approximately in the middle of the pancreatic cross-section plane in almost all specimens. The total number of second-degree pancreatic ducts visible on pancreatograms within the isthmus was 1.77 (+/-1.00, from 0 to 4) and 1.83 (+/-1.4, from 0 to 5) on microscopic analysis. CONCLUSIONS: The presence of second-degree pancreatic ducts at the transection site might favor the use of a pancreaticoenteric anastomosis with stump invagination to reduce the risk of anastomotic leakage. and IAP.

Diagnostic imaging of the diabetic foot.

Diabetic foot syndrome is a significant complication of diabetes. Diagnostic imaging is a crucial factor determining surgical decision and extent of surgical intervention. At present the gold standard is MRI scanning, whilst the role of bone scanning is decreasing, although in some cases it brings valuable information. In particular, in early stages of osteitis and Charcot neuro-osteoarthropathy, radionuclide imaging may be superior to MRI. Additionally, a significant contribution of inflammation-targeted scintigraphy should be noted. Probably the role of PET scanning will grow, although its high cost and low availability may be a limiting factor. In every case, vascular status should be determined, at least with Doppler ultrasound, with following conventional angiography or MR angiography.

Interference sensor for ultra-precision measurement of laser beam angular deflection.

A new interference sensor for ultra-precise measurement of laser beam angular deflection is proposed. The angular tilt of the measuring device, in relation to the beam axis, can also be measured. The theoretical basis of the angle evaluation presented is based upon analyzing the fringe period, as well as the suggested optical setup and design of the device. Calculating algorithms for the evaluation of the beam angle change, the influence of the fringe phase on angle measurement, and the metrological feasibilities are also detailed herein. The main source of measurement errors is explored, and the influence of the sensor's positioning procedure in relation to the laser beam on the repeatability of the processing function is statistically analyzed. The results show that the sensor resolution reaches 25 nrad with an accuracy better than 1% in the measuring range 350 µrad. Finally, the potential applications of the interference sensor are described.

Laser beam angular stabilization system based on a compact interferometer and a precise double-wedge deflector.

To increase the laser beam pointing stability required for precise interferometric measurements, we designed an active laser beam angular stabilization system. We used two recently proposed techniques: an interferometric measurement method of laser beam angular deflection which allows compact sensor design and a double wedge-prism beam deflector for precise laser beam steering. Our system provides long-term angular stabilization independently in the horizontal and the vertical planes, providing a hundredfold reduction of the output beam deviations. First, we describe the compact sensor setup with a new measurement algorithm prepared specifically for our stabilization system. Then, the system is introduced, and experimental evaluation is described. The test results show a good performance for the proposed design. We reached a reduction in beam angular deviations amplitude down to 100 nrad/h (in terms of double standard deviation of beam fluctuations).

Double wedge prism based beam deflector for precise laser beam steering.

Aiming to increase laser beam pointing stability required in interferometric measurements, we designed a laser beam deflector intended for active laser beam stabilization systems. The design is based on two wedge-prisms: the deflecting wedge driven by a tilting piezo-platform and the fixed wedge to compensate initial beam deflection. Our design allows linear beam steering, independently in the horizontal or vertical direction, with resolution of less than 1 µrad in a range of more than 100 µrad, and no initial deflection of the beam. Moreover, the ratio of the output beam deflection angle and the wedge tilt angle is less than 0.1; therefore, the noise influence is significantly reduced in comparison to standard mirror-based deflectors. The theoretical analyses support the designing process and can serve as a guide to wedge-prism selection. The experimental results are in agreement with theory and confirm the advantages of the presented double wedge system.

Desmoid tumor of the mesentery in a patient after restorative proctocolectomy as a result of familial adenomatous polyposis - case reports.

Desmoid (desmoid tumor) is a cytologically benign fibrous tumor that originates from musculoskeletal structures of the entire body [1]. The term "desmoid", first introduced by Muller in 1838, derives from the Greek word desmos, which means tendinous [2]. The etiopathogenesis of desmoid is not fully understood, most reports of publications regarding its treatment are based on individual case reports. The prognosis is good, and healing is achieved mainly through surgical excision of the lesion. The aim of the paper is to present a case of a 33-year-old woman with diagnosed familial polyposis in the colon, who has been identified with mesenteric desmoid.ic desmoid.

Pancreatic cancer - summary of the session of 6th International Pancreatic Days in Gdynia 27-30 October 2016.

The session participants were Prof. Caroline Verbeke (CV) from The Department of Pathology Oslo University and Prof. Marcus Wolfgang Büchler (WMB) from the Department of General, Visceral and Transplantation Surgery at the University Hospital Heidelberg. The participants had to assume the problem of the surgical treatment of pancreatic cancer with the reflection to radicality.

Pancreatic cross-section: an elliptical model.

BACKGROUND: Pancreatic surgery has developed over the last 60 years. A pancreaticoduodenectomy of the pancreatic head and duodenal papilla is the most common procedure. The most popular pancreatic cross-section site of a pancreaticoduodenectomy is the isthmus of the gland. The pancreatic isthmus anatomical configuration is still being considered. STUDY DESIGN: The authors propose a new parametric descriptive system of pancreatic cross-section based on an elliptical model. RESULTS: The pancreatic cross-section was evaluated as a geometric ellipse and the location of the pancreatic duct was based on coordinates. When analyzing the cross-section plane of the pancreatic isthmus, the mean size of the pancreatic isthmus cross-section was 10.46+/-2.34 mm in width (mean+/-SD) and 25.55+/-4.56 mm in length. The mean vertical/horizontal distance ratio was 0.42+/-0.12. The mean size of the main pancreatic duct was 1.02x2.46 mm. The mean distribution coordinates of the main pancreatic duct were: X 51.23; Y 50.60. CONCLUSIONS: A proportional model of pancreatic isthmus cross-section analysis is easy and effective, and could become a valuable tool in future anatomical studies. The system described allows us to analyze data acquired from several investigators.

Social, demographic and clinical characteristics of patients suffering from peripheral vascular disease treated surgically compared to patients treated with endovascular angioplasty.

INTRODUCTION: Atherosclerosis is the most common cause of chronic lower limb ischaemia. Many factors that have a crucial influence on the development of the disease, its course and prognosis have been identified. The risk factors seem to be subject to interventions due to their susceptibility to changes. It is important to increase the engagement of doctors and nurses performing the screening oriented on risk factors, medical consultation regarding giving up smoking, changing the diet and undertaking physical activity. Therefore, knowledge of the patients' health situation allows introduction of optimal treatment in this group of patients. MATERIAL AND METHODS: The study group consisted of 119 patients with peripheral artery atherosclerosis, who underwent surgical and endovascular repair. The diagnostic survey method was used in this study. The socio-demographic and clinical data were collected using an originally developed questionnaire. The statistical analysis was performed using the data analysis software system Statistica, version 10.0, by StatSoft Inc. (2011) and an Excel spreadsheet. The statistical significance was set at p < 0.05 for all calculations. RESULTS: There were statistically significant differences between the analysed groups with regard to severity of ischaemia (p = 0.0001), intermittent claudication (p = 0.0001), rest pain (p = 0.0001), ulceration (p = 0.0031), smoking (p = 0.0075) and comorbidities (percutaneous coronary interventions p = 0.0299; ischaemic stroke p = 0.0235). CONCLUSIONS: There are significantly more patients with more advanced disease and ex-smokers in the surgically treated group. There are significantly more patients with a history of ischaemic stroke, surgical coronary interventions and current smokers in the endovascular group.

Interference comparator for laser diode wavelength and wavelength instability measurement.

Method and construction of a setup, which allows measuring the wavelength and wavelength instability of the light emitted by a laser diode (or a laser light source with a limited time coherence in general), is presented. The system is based on Twyman-Green interferometer configuration. Proportions of phases of the tested and reference laser's interference fringe obtained for a set optical path difference are a measure of the unknown wavelength. Optical path difference in interferometer is stabilized. The interferometric comparison is performed in vacuum chamber. The techniques of accurate fringe phase measurements are proposed. The obtained relative standard uncertainty of wavelength evaluation in the tested setup is about 2.5 ⋅ 10(-8). Uncertainty of wavelength instability measurement is an order of magnitude better. Measurement range of the current setup is from 500 nm to 650 nm. The proposed technique allows high accuracy wavelength measurement of middle or low coherence sources of light. In case of the enlarged and complex frequency distribution of the laser, the evaluated wavelength can act as the length master in interferometer for displacement measurement.

Management of acute pancreatitis (AP) - Polish Pancreatic Club recommendations.

The presented recommendations concern the current management of acute pancreatitis. The recommendations relate to the diagnostics and treatment of early and late phases of acute pancreatitis and complications of the disease taking into consideration surgical and endoscopic methods. All the recommendations were subjected to voting by the members of the Working Group of the Polish Pancreatic Club, who evaluated them every single time on a five-point scale, where A means full acceptance, B means acceptance with a certain reservation, C means acceptance with a serious reservation, D means rejection with a certain reservation and E means full rejection. The results of the vote, together with commentary, are provided for each recommendation.

Neutrophil engagement and septic challenge in acute experimental pancreatitis in rats.

AIM: To investigate the influence of neutrophil adhesion molecule blockade with monoclonal antibody (MoAb CD11b) and E. coli lipopolysaccharide (LPS) administration on experimental acute pancreatitis (AP). METHODS: AP was induced by four ip injections of cerulein (Cn) at 1-h intervals. MoAb CD 11b and LPS were administered at the beginning of the experiment. RESULTS: The neutrophil count and chemiluminescence were diminished at the beginning of AP. The oxidative stress parameters were found within the pancreatic gland. MoAb CD 11b used for AP resulted in a significant reduction of pancreatic infiltration and pancreatitis oxidative stress parameters. Serum interleukin-6 (IL-6) was not detected in AP animals, whereas high serum IL-6 concentration was noted only in animals receiving LPS. CONCLUSION: Neutrophils are involved in pancreatic damage in the early stage of AP. Neutrophil infiltration reduction protects the pancreatic gland from destruction during AP. LPS does not change the early course of Cn pancreatitis in rats.

A case of traumatic rupture of the pancreas. Combined surgical and endoscopic management.

Traumatic rupture of the pancreas is a rare and difficult diagnostic and therapeutic problem. The authors present a case of traumatic rupture of the pancreas (grade IV on AAST scale) where concurrent endoscopic and surgical management was used.

Multifocal Extra-Adrenal Paraganglioma - Case Report.

Paraganglioma is a rare neoplasm originating from extra-adrenal pheochromocytes of the sympathetic and parasympathetic nervous system. It is usually benign and the treatment method of choice is a complete resection of the tumour. The authors present a case of 66-year-old female patient with a multifocal benign retroperitoneal paraganglioma, which was completely removed during surgery.

Heparin improves organ microcirculatory disturbances in caerulein-induced acute pancreatitis in rats.

AIM: Microcirculatory disturbances are important early pathophysiological events in various organs during acute pancreatitis. The aim of the study was to evaluate changes in microperfusion of the pancreas, liver, kidney, stomach, colon, skeletal muscle, and to investigate the influence of heparin on the organ microcirculation in caerulein-induced experimental acute pancreatitis. METHODS: Acute pancreatitis was induced by 4 intraperitoneal injections of caerulein (Cn) (15 microg/kg). The organ microcirculation was measured by laser Doppler flowmetry. Serum interleukin 6 and hematocrit levels were analysed. RESULTS: Acute pancreatitis resulted in a significant drop of microperfusion in all examined organs. Heparin administration (2 x 2.5 mg/kg) improved the microcirculation in pancreas (36.9 +/- 4% vs 75.9 +/- 10%), liver (56.6 +/- 6% vs 75.2 +/- 16%), kidney (45.1 +/- 6% vs 79.3 +/- 5%), stomach (65.2 +/- 8% vs 78.1 +/- 19%), colon (69.8 +/- 6% vs 102.5 +/- 19%), and skeletal muscle (59.2 +/- 6% vs 77.9 +/- 13%). Heparin treatment lowered IL-6 (359.0 +/- 66 U/mL vs 288.5 +/- 58 U/mL) and hematocrit level (53 +/- 4% vs 46 +/- 3%). CONCLUSION: Heparin administration has a positive influence on organ microcirculatory disturbances accompanying experimental Cn-induced acute pancreatitis.

Method improvement: released cecal ligation-septic shock model.

A new released cecal ligation (RCL) technique of septic shock induction in rats is presented. It is relatively not complicated, fast, not expensive, and it mimics the human pathology. Presented procedure seems to be a useful alternative for the cecal ligation alone or cecal ligation and puncture to induce experimental septic shock in small laboratory animals.