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ABSTRACT: Liposarcoma constitutes a heterogeneous group of tumors which rarely arise from the retroperitoneal area. They are the single most common tumor in all sarcoma of the retroperitoneum space. Surgery plays a dominant role in the treatment of retroperitoneal liposarcoma. The histologic subtype and margin of resection are prognostic for survival in primary tumors. Local recurrences are the most frequent cause of failure of the surgery. We report the case of a patient with massive recurrences ofretroperitoneal liposarcoma. A 45 year-old male had low-grade liposarcoma of the retroperitoneum which recurred 6 times within 10 years. The next retroperitoneal recurrence tumor excised weighted 25 kg in total. Seven months after resection the patient feels well. We conclude that aggressive surgery in recurrent tumors can produce prolonged survival in patients with low-grade retroperitoneal liposarcoma.
Wiadomości lekarskie (Warsaw, Poland: 1960) 02/2006; 59(7-8):577-9.
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ABSTRACT: Cerebral metastases from colorectal cancer are uncommon. They are usually a late manifestation of the neoplasmatic disease. The symptoms aren't always typical. We report the case of 52-year-old woman in whom the first manifestation of the disease was metastasis to brain.
Wiadomości lekarskie (Warsaw, Poland: 1960) 02/2006; 59(5-6):422-3.
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ABSTRACT: Obesity is associated with many comorbid pathologies that lead to increased morbidity and increased mortality. Hemorheological changes in obesity are currently investigated as one of the risk factors for many comorbid pathologies. It has been found that erythrocyte hyperaggregation and a decrease in erythrocyte filterability have also been well documented in obesity patients. The aim of this study is to present preliminary results of the influence of weight reduction after vertical banded gastroplasty (VBG) on aggregation of red cells and red blood cells deformability. We studied seven patients who underwent VBG, median age 46 years (range 35-52), median BMI 52.1 kg/m(2) (range 36.6-66). Blood rheology changes and selected biochemical parameters were examinated before and 6 months after VBG. Erythrocyte elongation and red blood cells (RBC) aggregation were measured using the Laser-assisted Optical Rotational Cell Analyser (LORCA). The RBC aggregation index was significantly decreased, while the aggregation half-time (t(1/2)) significantly elongated after surgery. The syllectogram amplitude did not change. No differences in RBC deformability were observed in the postoperative period. Conclusion: We could conclude that among morbidly obese patients six months after VBG some beneficial changes of erythrocyte rheological parameters are observed. Further studies are necessary to confirm our preliminary results.
Clinical hemorheology and microcirculation 02/2006; 34(4):499-506. · 3.40 Impact Factor
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ABSTRACT: Intragastric band migration is a potential complication of adjustable gastric banding. A 39-year-old morbidly obese female underwent laparoscopic adjustable gastric banding. After uneventful postoperative follow-up of 4 years, she had slow, steady failure of the restrictive effect, associated with regain of weight. Intragastric band migration was confirmed on GI series, and the patient was admitted to the hospital for revision. The patient presented no symptoms of acute abdomen. Intraoperatively, a huge intra-abdominal abscess was discovered in the epigastric area. The stomach with the band and tubing were involved in the inflammatory process. Labtobacillus acidofilus was found to be the causative organism. Removal of the gastric band with simultaneous resectional gastric bypass was performed. The recovery proceeded with no complications. Intragastric band migration can cause intra-abdominal abscess; thus, we believe that every case of band migration should be treated without delay to avoid further complications.
Obesity Surgery 02/2006; 16(1):102-4. · 3.29 Impact Factor
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ABSTRACT: Many scoring systems have been applied for the grading and staging of non-alcoholic fatty liver disease (NAFLD). There is no consensus according to semiquantitative scales for the assessment of steatosis, inflammatory grading, and fibrosis staging in NAFLD.
We analysed 24 consecutive patients who underwent bariatric surgery. The grading for steatosis was estimated according to the systems proposed by Brunt and by Dixon. Brunt's scale and Scheuer's scale modified by Gabriel were used for inflammatory activity and fibrosis staging. Additionally, types of NAFLD disease were diagnosed according to Matteoni's classification.
Steatosis was observed in 88% and steatohepatitis in 54% of patients. We observed portal, periportal and pericellular fibrosis. Neither bridging fibrosis nor cirrhosis were found. Extent of steatosis estimated according to Dixon and Brunt's scales was positively associated with appearance of steatohepatitis. The comparison of Dixon's and Brunt's scales according to grade of steatosis demonstrated a statistically significant difference. Inflammatory activity grades and fibrosis stages assessed according to Scheuer and Brunt scales differ significantly. Inflammatory activity evaluated with the Brunt scale was associated with the extent of steatosis and occurrence of steatohepatitis.
Non-advanced forms of liver fibrosis do not appear to be dependent on steatosis and inflammatory grade in NAFLD. It is necessary to find the precise estimation of extent of steatosis especially occupying less than 1/3 or 1/4 of the lobule area. Brunt's scale seems to be more useful for the estimation of liver biopsy in NAFLD. It is essential to create a consensus for evaluation of steatosis and necroinflammatory grading and fibrosis staging in NAFLD.
Obesity Surgery 11/2005; 15(9):1309-14. · 3.29 Impact Factor
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ABSTRACT: Damage of trachea or main bronchi occurs rarely during esophagectomy, but when it happens the prognosis is unfavorable. There are no unambiguous guidelines for treatment in such cases. It is considered, that the tracheal injury can be managed by primary closure. Conservative treatment of tracheal injury with the mechanical ventilation is, according to current opinions, ineffective. We report the case of tracheal injury during transhiatal esophagectomy performed due to postscald stenosis. The injury was not operated because of too large laceration of the posterior wall, difficult surgical access and the scarring of surrounding tissues. Membranous tracheal tear was filled with endotracheal tube cuff. The mechanical ventilation was applied till the time of complete recovery, when the tear was healed.
Wiadomości lekarskie (Warsaw, Poland: 1960) 02/2004; 57(3-4):180-2.
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ABSTRACT: Morbid obesity (BMI > or = 40 kg/m2) is accompanied by lipid disturbances which may be involved in the increased incidence of arterial hypertension and non-insulin dependent diabetes mellitus. The aim of the study was to assess plasma concentrations of total cholesterol (TC), HDL-cholesterol, LDL-cholesterol, triglycerides (TG) and two parameters of oxidation stress--vitamin E and oxysterols, in morbidly obese patients with coexisting arterial hypertension and non-insulin dependent diabetes mellitus. Studies were performed in 37 morbidly obese patients divided into three groups: group I--without coexisting diseases, group II--with arterial hypertension, and group III--with arterial hypertension and non-insulin dependent diabetes mellitus. In all groups there was an increase in TG concentration, a decrease in HDL-cholesterol level, and normal values of TC and LDL-cholesterol. The concentrations of 7-hydroxycholesterols (7-OH) in group II (602.65 +/- 264.46 ng/ml) and group III (570.94 +/- 210.59 ng/ml) were significantly higher compared to that in group I (336.09 +/- 220.74 ng/ml). There were no differences between groups in concentrations of 7-ketocholesterols (7-K), TC, HDL-cholesterol, LDL-cholesterol, TG, vitamin E and vitamin E/(TC + TG) ratio. In all groups TC concentration correlated positively with TG concentration, and negatively with vitamin E/(TC + TG) ratio. Moreover, the positive correlation between TG and HDL-cholesterol concentrations, and negative correlation between plasma vitamin E and 7-K concentrations were demonstrated. In conclusion, although the study demonstrates similar disturbances in lipid profile and oxidation stress parameters in all groups, with significant differences in 7-OH only, the role of cholesterol oxidation products in pathogenesis of arterial hypertension and non-insulin dependent diabetes mellitus in morbidly obese patients cannot be excluded.
Polskie archiwum medycyny wewnȩtrznej 02/2002; 107(2):141-7. · 1.37 Impact Factor
