Renal vascularization anomalies in the Polish population.

The aim of the study was to determine the incidence of renal venous system congenital anomalies in the Polish population. MATERIAL AND METHOD: Vascular kidney samples were investigated by means of preparations and X-ray contrasting. The study the group comprised 281 male and 269 female specimens. RESULTS: Congenital anomalies were diagnosed in 186 patients (33 8% of all cases), and they were more frequent in men than in women, albeit that difference was non-significant. The following anomalies were most commonly observed: multiple venous variations on the right side (20.4%), retroaortic course of the left renal vein (4.2%), and circumaortic venous ring of the left renal vein (3.8%). Other anomalies were diagnosed in 1%-2% of cases. CONCLUSIONS: Awareness and preoperative assessment of the venous system before abdominal aortic surgery, isolated collection of renal venous blood samples, and urological or kidney transplantation procedures is essential.

Research on genesis of adipocytic metaplasia in uterine fibroids.

The genesis of lipoleiomyoma has not been explained yet. Immunohistochemical examinations were performed on 17 lipoleiomyomas in women aged 43-82 (mean age: 51 ±9 years). Four types of myomas were distinguished: 1) pure leiomyoma, 2) fibroleiomyoma, 3) hyalinizing leiomyoma, 4) strongly hyalinized myoma, along with three degrees of progression of adipocytic metaplasia: 1) up to 25% of lipocytes, 2) up to 50% of lipocytes, and 3) over 50% of lipocytes in the analyzed sample, along with three degrees of progression of adipocytic metaplasia: 1) up to 25% of lipocytes, 2) up to 50% of lipocytes, and 3) over 50% of lipocytes in the analyzed sample. A positive correlation was found between the age of women and rate of development of metaplasia (r = 0.51, p = 0.035) as well as with activity of the estrogen receptor in the primary tumor (r = 0.53, p = 0.03). New mucous perivascular tissue was reported among 11.8% of patients and on this basis lipocytes were formed. The appearance of subendothelial granular cells of large blood vessels with a positive reaction for smooth muscle actin (SMA) and CD68 was reported in 17.7%. Results of immunohistochemical research seem to confirm that lipocytes de novo come from the primal pluripotent cells of the tumor stroma and not from the fatty degeneration of myocytes.

Investigations into human tracheal cartilage osseocalcineus metaplasia III. ventro-dorsal measurement of the thickness of human tracheal cartilages.

The aim of the study was to verify the hypothesis that osseocalcineus metaplasia present in the tracheal cartilage is conditioned by its thickness. The study group comprised 78 male tracheas (age ranging between 19 and 84 years, mean = 56.5 years ±12.6 years), and 69 female tracheas (age ranging between 18 and 90 years, mean = 65.3 ±14 years). Tracheal transverse segments (every 4 cm) were collected for histopathological examinations from organs fixed in 10% formalin solution. Typical paraffin specimens, 5 µm thick, were measured in the horizontal position using the ocular micrometer (10 : 100 Zeiss) and Semiplan 3.2/0.10 objective. Differences between mean patient group and subgroup values were statistically verified. P = 0.05 was considered as statistically significant. Osseocalcineus metaplasia occurred 2.5-fold more often in male patients, in spite of the higher mean age of female patients (p < 0.001). The average male cartilage thickness was 50.32 ±7.94 × 10⁻² cm, while that of female patients was 38.44 ±4.44 × 10⁻² cm (p < 0.001). The average height of male patients (168.63 ±27.14 cm) was significantly higher in comparison to female patients (157.2 ±5.78 cm) (p < 0.001). The thickness of tracheal cartilages in men was significantly greater in metaplastic tracheas than in tracheas without metaplasia, as well as in changed cartilages as compared to unchanged ones in the same trachea. Considering both genders, the thickness of tracheal cartilages positively correlated with patient age (men: +0.44; p < 0.001; women: +0.293; p < 0.014), whereas height did not correlate with cartilage thickness.

Investigations into human tracheal cartilage osseocalcineus metaplasia IV. Morphokinesis of tracheal cartilage retrograde lesions during the process of aging.

We determined the frequency of occurrence and dynamism of the mentioned retrograde lesions. The investigated material comprised 371 cartilages collected from 95 male tracheas (mean age: 56 ± 13 years), and 279 cartilages collected from 70 female tracheas (mean age: 65.3 ± 14 years) during the process of aging. The dynamism proved non-homogenous with a visible gender difference. The empirical regression curves often crossed each other. Some of the presented curves in female patients were observed beginning two decades after that of male patients, and at lower levels. Thus, it seems hard to conclude that some processes considering tracheal cartilage morphokinesis always precede others.

Investigations into human tracheal cartilage osseocalcineus metaplasia II. Histopathological examination of tracheal cartilages.

Different opinions in the literature about changes in tracheal cartilages were the basis for investigations concerning the types of morphological changes occurring in ageing tracheal cartilages. 5 micron thick specimens stained with haematoxylin-eosin and in selected cases using von Kossa method of 371 cartilages taken from 95 male (mean age 56.6 +/-13.4 years) and 279 cartilages from 70 female patients (mean age 64.9 +/-16 years) (p < 0.001) were the investigated material. The analysis demonstrated statistically significant cartilage type differences between men and women (p < 0.001). Chondrolysis and asbestoids were observed in 11.9% of male and 2.9% of female patients. Calcium deposits were seen in 13.2% of male and 9.7% of female patients, while cartilage ossification in 20.5% and 3.6%, respectively. The coexistence of calcium deposits and osseous metaplasia was observed in 8.6% of male and 3.9% of female patients.

[Treprostinil therapy for distal chronic thromboembolic pulmonary hypertension]. / Obwodowa postac przewleklego zakrzepowo-zatorowego nadcisnienia plucnego. Trudnosci diagnostyczne, nowe mozliwosci terapeutyczne.

We present a case of a 77-year-old female with distal chronic thromboembolic pulmonary hypertension. Diagnostic and therapeutic difficulties are discussed. Clinical and haemodynamic benefits resulting from treprostinil therapy added to continuous anticoagulation are shown.

The pathomorphology of Bartholin's gland. Analysis of surgical data.

Medline data did not reveal any statistical approach to Bartholin's gland pathomorphological lesions, especially when the social aspect was considered. Objectives. To complete knowledge and data according to this subject on the basis of own surgical material analysis. Microscopic examinations of histopathological 5 microm thick specimens stained with hematoxylin-eosin and in selected cases with histochemical and immunohistochemical methods on 104 Bartholin's glands taken from 103 female patients in age of 39.4 +/- 9.6. Retention cysts, suppurating lesions (abscesses), extrauterine endometriosis and neoplasms were separated from obtained samples. Localization of lesions, the patients' age and education status were determined. P < 0.05 was considered as statistically significant. Retention cysts were observed in 84.6% of cases, abscesses in 10.6%, extrauterine endometriosis in 2% and neoplasms in nearly 3% of patients. In 54.1% of cases the lesion was localized on the left side, in 45.9% on the right. 17.2% of female patients presented with university education, 29.9% with elementary education, while 52.9% with secondary education. The average age of operated patients amounted to 33 +/- 9.8 years in case of university education, being significantly lower as compared to the average age of secondary (40.5 +/- 7 years) and elementary (42.4 +/- 12 years) education (p < 0.01 and p < 0.02 respectively). 47.7% of retention cysts demonstrated various degrees of inflammatory infiltration. However, the anatomical variability of the ductal and glandular epithelium was higher in cases of non-inflammatory cysts. Considering three Bartholin's gland neoplasms, two were diagnosed as adenocarcinomas and one as a fibromyoma. All of them were observed in female patients with a rare blood type (twice Rh-minus and once AB Rh-plus). There was no significant relationship between the type of pathomorfological lesions and age of operated patients, in spite of the fact that the lowest mean age was observed in woman with endometriosis while the highest in those with neoplasms. The pathology of Bartholin's gland mostly concerns female patients with secondary education. However, early diagnosis is associated with patients with university education. Thus, further investigations considering the statistical analysis of Bartholin's gland neoplasms in order to determine the possible relationship between blood type antigens and neoplasm development are required.

[Normal coronary angiogram in patient with diagnosis of acute coronary syndrome with ST segment elevation. Was it possible to recognise acute pulmonary embolism earlier?]. / Prawidlowy wynik koronarografii u pacjenta z rozpoznaniem ostrego zespolu wiencowego z uniesieniem ST zakwalifikowanego do przezskórnej interwencji wiencowej. Czy mozna bylo wczesniej rozpoznac ostra zatorowosc plucna?

A case of a 48 year old male scheduled for early invasive treatment of acute coronary syndrome with ST segment elevation is presented. Clinical suspicion of acute pulmonary embolism was undertaken because of normal coronary angiogram and was confirmed by pulmonary angiography. Differential diagnosis based on medical history, electrocardiogram and laboratory findings was discussed.

Liposarcoma of the uterine corpus coexisting with preinvasive cervical cancer--a case report.

Case report of isolated liposarcoma of the uterine corpus coexisting with preinvasive cervix cancer in 71-year-old woman, who 41 years ago underwent the enucleation of the uterine corpus myomas. In tumor histogenesis the malignant transformation of fat cells, which might have been previously transferred to myometrium, was taken into consideration. The 8 year long follow-up revealed neither recurrence nor metastases.

[Cardiac tamponade due to angiosarcoma--was surgical treatment necessary? A case report]. / Tamponada serca wywolana miesakiem naczyniowym--czy nalezalo wykonac zabieg kardiochirurgiczny?

We present a case of a 49-year-old patient with cardiac tamponade due to haemopericardium. The decision to perform surgery, although controversial, allowed to diagnose cardiac angiosarcoma with metastases to pericardium, vena cava superior and pulmonary trunk. Consequently, chemotherapy was instituted and was initially effective, however, the patient died 12 months later due to the progression of the disease.

Double cancer of the gallbladder--a case report.

The study presented the coexistence of papillary adenocarcinoma and microcellular neuroendocrine carcinoma of the gallbladder in a 56-year old female patient without cholelithiasis and developmental anomalies of the biliary-pancreatic ducts. Considering the material obtained by the authors (94 cases), the above-mentioned was diagnosed in 1,06% of gallbladder carcinomas. The authors analyzed literature data and considered pathogenetic factors, responsible for development of two gallbladder carcinomas.

[Some aspects of gallbladder carcinogenesis]. / Wybrane aspekty kancerogenezy pecherzyka zóltciowego.

Gallbladder carcinoma is an uncommon but highly malignant tumor with a poor survival rate. The coincidence of gallstones, especially those with a diameter over 3 cm and gallbladder carcinoma is well established. Anomalous junction of pancreaticobiliary ducts (AJPBD) is an additional risk factor for gallbladder malignancy. Those conditions followed by chronic inflammation lead to many molecular disturbances in the cell cycle of the gallbladder mucosa and make the tumorigenesis possible.