[Growth Guidance System in Treatment of Early Onset Scoliosis]. / Systémy usmernovaného rustu v lécbe raných detských skolióz.

PURPOSE OF THE STUDY The Growth Guidance System (GGS) represent a relatively new alternative to the traditional growing systems used for the treatment of early onset scoliosis. Ranking among the main aims of this surgical treatment is a three-dimensional correction of the deformity, maintenance of spinal growth and postponement of the necessity of final treatment by spondylodesis. MATERIAL AND METHODS Our study retrospectively evaluates the results of surgical correction in a group of 35 patients treated by GGS technique. The group consisted of patients with idiopathic, neuromuscular and syndromic spine deformity with the average age of 8 years and 2 months at the time of the surgery. The time of the follow-up is 3 years and 5 months on average. We evaluated the correction of the curve itself, the growth of the spine measured in the thoracic and lumbar part separately, and the growth of the trunk as a whole in the mentioned range on X-ray pictures. RESULTS The average correction of the scoliotic curve was 67%, from 75 preoperative degrees to 20 postoperative degrees. After the first operation 11% elongation of the trunk (from 321 mm to 356 mm) was reached, the thoracic spine was elongated by 10% (from 196 to 217 mm) and the lumbar spine was elongated by 11% (from 125 to 139 mm). The elongation of the trunk by 16% (from 322 to 375 mm) was observed in the cohort of patients with two years postoperative follow-up (21 patients). The total protraction of the trunk by 21% (from 318 to 386 mm) was reached in patients treated by definitive fusion (7 patients). DISCUSSION There is a very low number of studies analysing the long-term clinical results with the use of GGS. The first pilot results indicate that it is a technique allowing to achieve at least comparable results in correction of frontal plane compared with the distraction type of instrumentations. A negative aspect of this method is the abrasion of metal followed by metallosis. The new types of fixation screws enable more effective sliding of rods, maintenance of continuity of body grow by the shifting of rods as well as lower abrasion of the instrumentation. CONCLUSIONS The main advantage of GGS is the limited continuous growth of the spine, partial three-dimensional correction of the deformity, minimisation of inevitable reoperations under general anaesthesia and the possibility to quit a brace. Key words: growth guided system, early onset scoliosis, distraction, spinal growth, spondylodesis.

[Social consequences of breast cancer in women suffering from the disease]. / Rozpoznanie raka sutka u kobiet--implikacje psycho-spoleczne.

The opinion poll was carried out among 350 patients suffering from the breast cancer who had been treated in 1995 in the Autonomous Public Oncological Health Centre in Lublin. Out of this group 155 women filled in their questionnaires correctly and the data included in them underwent the statistic analysis whose aim was to determine the consequences of the breast cancer detection for women and their families as well as to evaluate the influence of the disease on the social situation of the subjects. The average age of the subjects was 56.7 and the largest group consisted of women at the age of 60 to 88 (41.9%). In the majority of cases (85.2%) the detection took place by means of self-examination, 88.4% of the women primarily underwent surgical treatment, the remaining 11.6% had no chance for radical treatment. Metastases were recorded in 13.5% of the cases in the period of 5 years after the application of treatment. The neoplasm triggered serious outcomes in the mental sphere of the women's lives. Feelings of fear (56.8%) and sadness (56.1%) were dominating. The sense of low self-esteem occurred in 19.4% of the subjects. In 41.9% of the women increased irritability and nervous excitability were observed which resulted in a more frequent usage of the tranquilizers (by 32.3% of them). The disease caused changes also in the economical and professional spheres of the women's lives. 57.4% of the women claimed that their family income had become lower which was the result of their retirement and ceasing their professional careers in 49% of the cases. Only 16.1% of the women did not observe any impact of the disease on their professional work. The changes which appeared in their lives in connection with the disease created the need for support and help from the side of the medical staff (47.1%) as well as the need for contacts and exchange of experience with women in a similar situation (40%). At the same time only a small percentage of women (16.8%) had an access to the Amazons' clubs and wanted to benefit from their aid.

[The possibilities of operative treatment of residual and recurrent congenital clubfoot]. / Mozliwosci leczenia operacyjnego resztkowej i nawrotowej, wrodzonej stopy konsko-szpotawej.

The paper presents 14 different surgical procedures recommended in literature for the correction of singular deformed elements of congenital clubfeet. Basing on clinical material collected from patients treated during the last five years, the authors introduce the application of the presented procedures for the correction of residual and recurrent deformities occurring in congenital clubfeet. Basing on their own experience, knowledge and available publications the authors attempt to assess the indications for each particular procedure and their mutual connections, which depend on: the kind and extend of the deformity, its location and the age of the child.

Aggression and arrogance phenomenon among school youth as a health risk factor for teachers.

Arrogance and aggressive behaviour occur more and more often in our lives. Especially at school there are observed negative attitudes of school youth. The aim of the study was to estimate the occurrence of aggressive behaviour among school youth towards teachers. Research based on questionnaires was carried out among 156 teachers (63.5% women and 36.5% men), aged 23-60 (mean 40 +/- 8.9) with time of employment ranking from 1-35 years (mean 14 +/- 9.2), working at vocational, technical and secondary schools as well as in the last classes of primary schools. Generally, aggressive behaviour more often occurs among school youth. It mainly includes verbal aggression, disrespectful attitude towards a teacher and refusal to follow his instructions. Other kinds of aggressive behaviour were observed rarely. More than half of the investigated persons did not feel distress at school, some of them only a little. The majority of subjects noticed the growing problem of negative behaviour among school youth during the last few years. Especially women defined their job as stressful and associated stress level with psychosomatic disorders (most often the increasing nervous stress and headache) they suffered from. Therefore, some teachers had to use tranquillizers to reduce stress level at work.

[Knowledge and competence of primary care physicians in diagnosis and treatment of nervous system diseases]. / Wiedza i umiejetnosci lekarzy podstawowej opieki zdrowotnej w zakresie diagnozowania i leczenia chorób ukladu nerwowego.

The diagnosis and treatment of neurological diseases in primary health care requires not only the specialistic knowledge but also easy access to the diagnostic and rehabilitation procedures and co-operation with neurologist. The aim of this study was to specify the quality of diagnosis and treatment of the neurological diseases in primary health care. The knowledge and practical skills of physicians working in the primary health care were analysed paralell to their possibilities of the diagnostics and rehabilitation of the patients suffering from neurological disturbances. Furthermore the quality of the co-operation with specialised neurologist was assessed. The research was carried on in 1999 using anonymous inquiry in the group of 151 primary health care (p.h.c.) physicians participating in the teaching courses in the Institute of Agricultural Medicine in Lublin. The research proved that patients with disturbances of the nervous system were frequently admitted to the primary health care outpatient departments. Among the diseases the low back pain, headaches and dizziness dominated. Most of the p.h.c. physicians used to examine patients by themselves but were sceptical about their skills. They tried to diagnose the neurological problems according to their abilities. The final effect was satisfactory, however neurological diseases treated by p.h.c. physicians were limited to the low back pain, headache, zoster and the febrile seizures. Only small percentage of patients was treated properly and in accordance with new trends in neurological art. Also the co-operation between primary health care physician and neurologist was not satisfactory.

The evaluation of the first period of the health service reform.

The aim of the study was to give preliminary estimation of functioning of the health service after the introduction of the reform on the basis of the opinions of the patients who used the services of the public health institutions.

[Ultrastructure of epithelial cells of rat seminal vesicles in the period of functional transformation and puberty]. / Ultrastruktura komórek nablonkowych pecherzyków nasiennych szczurów w okresie przeksztalcen czynnosciowych i dojrzewania plciowego.

It was found that the ultrastructure of the epithelial cells of the rat seminal vesicles changes during the period of puberty. The changes consist in formation of the cell organelles that participate in the production of secretion and in differentiation of the epithelial cells into the secretory and basal cells. The complementary biochemical studies indicate the close relationship between the formation of the typical ultrastructure of the secretory glandular cells of seminal vesicles and the presence of fructose in the secretion of these glandular cells.

[Ultrastructural studies and neutrophil myeloperoxidase determination in rats with acute 2,4-dichlorphenoxyacetic acid poisoning]. / Badania ultrastrukturalne oraz badania mieloperoksydazy granulocytów obojetnochlonnych szczura w ostrym zatruciu kwasem 2,4-dwuchlorofenoksyoctowym.

The aim of the work was to study changes in the ultrastructure and activity of different developing forms of cells in the neutrophil series in rat bone marrow during acute poisoning with 2,4-dichlorphenoxyacetic acid. The results of the study enabled determination of the influence of this herbicide on the process of granulogenesis in the neutrophils to be achieved. Disturbances of granulogenesis appeared in some cells of the experimental group II (160 mg of 2,4-D-acid/kg of body weight) and in most cells in the experimental group III (400 mg of 2,4-D-acid/kg). The disturbances manifested themselves mainly as a decrease in the number of primary and secondary granules in different developing forms of the neutrophil series. This decrease was associated with appearance of numerous cytoplasmic vacuoles. The results show that primary granules participate in phagocytosis.