The course of the cystic artery during laparoscopic cholecystectomy.

Proper recognition of the particular structures that form the triangle of Calot is essential for the proper and safe performance of laparoscopic cholecystectomy. Proper recognition, ligation, and cut of the cystic duct and cystic artery with branches (dorsal and ventral) remain an integral condition for the removal of the gallbladder. Calot's triangle, as an orientation structure, determines the most common location of the cystic artery. The triangle of Calot is one of the most variable regions of the abdomen in terms of anatomy. The aim of this study was to evaluate how important for surgery is the detailed anatomical recognition of the main branches of the cystic artery in Calot's triangle during laparoscopic cholecystectomy. Relations of the main branches of the cystic artery were evaluated in 88 patients that underwent laparoscopic cholecystectomy at the Department of General Surgery of the District Specialistic Hospital of Lublin. The anatomical relations of cystic duct and artery were classified into typical and variant types. Significantly more frequently variants of cystic artery were observed in women. However, the time of the procedure was not significantly related with the type of cystic artery.

Spiegelian hernia - - anatomy, diagnosing and imaging difficulties-report of 2 cases.

Spiegelian hernias account for less than 1% of all hernias diagnosed in the adult population. The most important factors in the proper diagnostic process are detailed physical examination combined with imaging procedures. Two cases of Spiegelian hernias are presented. The anatomical background of the pathology, as well as diagnostic procedures and surgical treatment, is discussed.

[Uncomplicated course of pregnancy after previous ligation of both internal iliac arteries and left ovarian artery]. / Ciaza o prawidlowym przebiegu, po wykonanym uprzednio podwiazaniu tetnic biodrowych wewnetrznych i tetnicy jajnikowej lewej.

The described case is the mature pregnancy in a patient with previously ligated both internal iliac arteries and the left ovarian artery due to the haemorrhage complicating the last delivery. The course of the pregnancy was uncomplicated. The results of the CTG tracings, USG of the fetus and Doppler measurements of the blood flow in the umbilical artery have not revealed any abnormalities. The pregnancy was terminated by elective cesarean section. A healthy baby weighing 2970 g was born.

[Long term observation of patients after bilateral ligation of internal iliac arteries]. / Odlegle obserwacje pacjentek po obustronnym podwiazaniu tetnic biodrowych wewnetrznych.

Internal iliac arteries ligation is procedure useful intraoperative haemorrhage control. It was reported as simple and without severe early side effects. The aim of this study is to assess the distant side effects of this procedure. Study group consists of 66 hysterectomized patients. Among them 23 had internal iliac arteries ligation (group I) and 43 hysterectomy without this procedure (group II). The ten month to 2.5 years follow-up does not revealed any differences in complaints of patients from both groups. Thus, internal iliac arteries ligation appeared to have no side effects also in distant observation.

[Abdominal actinomycosis imitating non-operable stage of cancer]. / Promienica brzuszna imitujaca nieoperacyjne stadium raka.

In a 44-year-old woman on the basis of short hospital medical observation and gynaecological consultations, malignancy of reproductive organs was preliminarily diagnosed. During the operation the gynaecological-surgical team confirmed the presence of generalized neoplastic process in the abdominal cavity. In the obtained surgical specimens actinomycosis was diagnosed by histological examination. Longterm antibiotic therapy caused an improvement of the patient's condition, increase of body weight, improvement of blood morphologic picture, regression of tumour-like changes in the liver. The case reminds the necessity of taking into account actinomycotic infection in the differential diagnosis of conditions suggesting a neoplastic process in the abdominal cavity.

Angiogenic activity and neovascularization in adenocarcinoma of endometrium.

Angiogenic activity of adenocarcinoma of endometrium was evaluated by qualitative and quantitative assays that measure vessel growth in chorioallantoic membrane (CAM) of chick embryo and incorporation of [3H] thymidine to DNA of CAM, respectively. In addition, histological specimens of adenocarcinoma with the vascular system filled with contrasting medium, were examined for the presence of neovascularization. Both qualitative and quantitative assays on CAM indicated that adenocarcinoma of endometrium possessed angiogenic activity. Histological analysis suggested that neovascularization took place during development of adenocarcinoma. It is therefore possible that neovascularization in this tumor is stimulated by its angiogenic activity.

Angiogenesis: quantitative assessment by the chick chorioallantoic membrane assay.

The aim of the present work was to improve quantitative assessment of angiogenesis by chick chorioallantoic membrane (CAM) assay based on measurement of DNA synthesis. Following incubation of [3H]thymidine (3H-T) with CAM in vivo, incorporation of 3H-T to DNA fraction was expressed as percent of total 3H-T present in the initial homogenate of CAM, regardless of CAM weight and full recovery of applied radioactivity. The assay required simple, partial isolation of DNA to remove traces of free or unspecifically bound 3H-T. These modifications gave a reproducible assay with adequate precision (10-20%). DNA content of CAM did not change between 10-15 days of embryo development and growth of CAM was completed on day 11. 10 to 12-day old CAMs were used for evaluation of the assay. Using a qualitative approach (visual scoring), tissues of several tumors were implanted on CAM. Extracts of tumors that produced the highest score stimulated DNA synthesis in CAM. A similar effect was induced by EGF while cytostatics inhibited DNA synthesis in CAM. Since stimulation of angiogenesis is not a cell type-specific phenomenon, the assay in the present modification should aid the studies on angiogenic factors. With the help of this assay the angiogenic activity of adenocarcinoma of human endometrium was described.