Deep Vein Thrombosis of the Left Lower Limb in a 12 Year-Old Female Child with Ulcerative Colitis - Case Report.

BACKGROUND: Inflammatory bowel disease includes ulcerative colitis and Crohn's disease. CASE REPORT: This case report presents a patient with ulcerative colitis, with thrombotic complication of the left common iliac vein that occurred at the age of 11, two years after diagnosis. After a year of anticoagulation and compression therapy, although exacerbations of underlying disease occurred in the first 6 months of treatment, there was no recurrence of deep venous thrombosis, partial recanalization within affected venous system has been achieved and the patient is remission of ulcerative colitis for the last six months. CONCLUSIONS: In children, thromboembolic complications occur about 7 times less often than in adults, but increases in the case of hospitalized children. In children with IBD this complication can occur independently og disease activity even in patients with any other risk factors.

[Stem and progenitor cells in biostructure of blood vessel walls]. / Komórki macierzyste i progenitorowe w biostrukturze scian naczyn krwionosnych.

Development of vascular and hematopoietic systems during organogenesis occurs at the same time. During vasculogenesis, a small part of cells does not undergo complete differentiation but stays on this level, "anchored" in tissue structures described as stem cell niches. The presence of blood vessels within tissue stem cell niches is typical and led to identification of niches and ensures that they are functioning. The three-layer biostructure of vessel walls for artery and vein, tunica: intima, media and adventitia, for a long time was defined as a mechanical barrier between vessel light and the local tissue environment. Recent findings from vascular biology studies indicate that vessel walls are dynamic biostructures, which are equipped with stem and progenitor cells, described as vascular wall-resident stem cells/progenitor cells (VW-SC/PC). Distinct zones for vessel wall harbor heterogeneous subpopulations of VW-SC/PC, which are described as "subendothelial or vasculogenic zones". Recent evidence from in vitro and in vivo studies show that prenatal activity of stem and progenitor cells is not only limited to organogenesis but also exists in postnatal life, where it is responsible for vessel wall homeostasis, remodeling and regeneration. It is believed that VW-SC/PC could be engaged in progression of vascular disorders and development of neointima. We would like to summarize current knowledge about mesenchymal and progenitor stem cell phenotype with special attention to distribution and biological properties of VW-SC/PC in biostructures of intima, media and adventitia niches. It is postulated that in the near future, niches for VW-SC/PC could be a good source of stem and progenitor cells, especially in the context of vessel tissue bioengineering as a new alternative to traditional revascularization therapies.

[Usage of hydrophilic catheters and guidewires in endovascular surgery]. / Zastosowanie prowadników i cewników hydrofilnych w chirurgii endowaskularnej.

AIM OF STUDY: The aim of this study was to evaluate the effectiveness of hydrophilic catheters and guidewires during endovascular overcoming long stenoses or occlusions of the superficial femoral and popliteal artery. MATERIAL AND METHODS: Based on 142 procedures rated the functionality of the equipment of the hydrophilic coating. The operations were performed in the years 2010-2012 in the Department of Vascular, General and Transplantation, Medical University in Wroclaw. Procedures related to recanalization or enlargement of the superficial femoral artery. Patients were divided into groups according to the Consensus TASC II depending on the length change. Each patient was assessed ankle-brachial ratio (ABI), claudication distance measured and constructed with double ultrasound imaging (USG-DD). In doubtful cases an additional study was performed with contrast computed tomography (angio-CT). The procedure was performed at the Laboratory of angiography using a angiograph Siemens Artis Zee Ceiling. Every time the contrlateral access was made, and as the first step the angiography was performed to verify type of changes in the arteries RESULTS: . A significant benefit of using hydrophilic guidewires and catheters in patients with long stenoses or occlusions. In case of long and calcified changes, hydrophilic catheters was the only option because it gave good support for hydrophilic guidewire. CONCLUSIONS: The changes in the type C and D according to the criteria for TASC II, an essential tool to achieve a positive treatment effect is the use of hydrophilic catheters and guidewires.

Diagnosis and treatment of pelvic congestion syndrome: Single-centre experiences.

BACKGROUND: One of the underestimated causes of chronic pelvic pain (CPP) in women may be pelvic congestion syndrome (PCS) that is defined as the presence of varicose of ovarian and pelvic veins associated with chronic pain in the region of the pelvis. This pain is present longer than 6 months and intensifies with prolonged standing, coitus and menstruation. The disease constitutes a diagnostic as well as therapeutic problem, thus posing a challenge for the clinician. Transcatheter ovarian vein embolization might be a safe and effective option for PCS treatment. OBJECTIVES: The objective of this study was to evaluate the efficacy of ovarian vein embolization ovarian as a method of the PCS treatment. MATERIAL AND METHODS: Between 2002-2012, 11 embolization procedures were performed in 10 women (age range: 34-43; median age 39) with the diagnosis of PCS. One patient underwent embolization procedure twice. In 1 case the combined therapy of endovascular embolization and surgical phlebectomy of vulvar varices was performed. RESULTS: There were no major intrainterventional complications. In all the patients (100%) a significant improvement in the clinical status was noted. The procedure improved the quality of life in the patients. Three women (30%) had a mild recurrence of the symptoms at mid-term follow-up. Among 8 women who had complained of dyspareunia prior to embolization 6 patients reported complete pain relief, in other 2 cases the pain subsided partially. There was a significant decrease in the severity of symptoms associated with hemorrhoids. CONCLUSIONS: We consider embolization of insufficient ovarian veins an effective and safe way of treatment in a well-selected group of patients with PCS.

[Head and neck paraganglioma--neoplasm of nervous origin]. / Przyzwojaki glowy i szyi--nowotwory pochodzenia nerwowego.

The authors of the present paper demonstrate the head and neck paraganglioma, discuss its location, clinical picture, diagnostics and treatment. Paragangliomas are relatively rarely occurring tumors, stemming from the autonomic nervous system. Initially asymptomatic, they do not present any characteristic clinical picture during the further development. Not large size of the tumor contributes to the late diagnosis which is most regrettable due to its potential malignancy (10%). Diagnostic and therapeutic problems cause it's medication reasonable only in specialist centers. Perioperative mortality is estimated at 5 to 13%. Postoperative neurological lesions in a form of the cranial carebro-vascular failure occur in 8 to 20% of cases. A contemporary advanced angiosurgical and anesthesiologic technology allow reducing a postoperative mortality to 5% and neurological complications by 10%. During the previous years many centers carried a preoperative embolization of a tumor during angiographies. An alternative to the large tumor vessels obliteration may be a radium therapy, although several reports confirm its low radiosensitivity.

[A value of compression therapy prophylaxis following surgery in patients suffering from chronic venous insufficiency]. / Wartosc pooperacyjnej profilaktyki kompresoterapia u chorych na przewlekla niewydolnosc zylna konczyn dolnych.

The varices of the lower limbs and its complications are very common Surgical procedure which consists of ligatur of the venous tranks or stripping of them, ligation of perforating veins are basic methods of the treatment. After surgery, veins compression prevents secondary bleeding and above all, the development or recurrence of thrombosis The purpose of this study was the assessment of graduated compression stockings in prophylaxis of varicose vein disease recurrency. The study included 120 patients who underwent phlebectomy due to varicose veins. The period of follow up lasts 3 years and has been carried out in two groups. The first one was agreed to use compression therapy following surgery. The second group did not get any physical support to their legs. Compression class I and II: calf, thigh, panty medical stockings and were used. The first group of 60 patients (102 legs) wearing medical stockings following surgery have no either subjective or objective signs of venous insufficiency in long period of time after surgery. Statistical analysis pointed out marked significance between both groups of patients p < 0.001.

[Bilateral chemodectoma--a case report]. / Przypadek obustronnego guza klebka szyjnego.

Chemodectoma is exceptionally rarely tumor comes from the parasympathetic part of nervous system. Cases description first of all concern multiple, single tumors localized on the neck, occasionally somewhere else. Tumors expansion in internal carotid vein aperture or in ear provoke serious complications from cranial nerves paralysis to cerebellum lesion. In this paper authors present a case of bilateral chemodectoma. Surgical treatment has required--not only simple tumor excision but also internal carotid artery reimplantation.