bluuebunny/crossref_metadata_2025 huggingface dataset:
Egea Jiménez, Carmen y Sánchez González, Diego (coords.) (2016). Ciudades amigables. Perspectivas, políticas, prácticas
Authors: Lardiés Bosque Raúl
Published: May 2018

Egea Jiménez, Carmen y Sánchez González, Diego (coords.) (2016)Ciudades amigables. Perspectivas, políticas, prácticasGranada: Editorial Comares, 264 p.ISBN 9788490453841
Infeasibility of endoscopic transmural drainage due to pancreatic pseudocyst wall calcifications - case report
Authors: Krajewski Andrzej , Lech Gustaw , Makiewicz Marcin , Kluciński Andrzej , Wojtasik Monika , Kozieł Sławomir , Słodkowski Maciej
Published: May 2018

Postinflammatory pancreatic pseudocysts are one of the most common complications of acute pancreatitis. In most cases, pseudocysts self-absorb in the course of treatment of pancreatitis. In some patients, pancreatic pseudocysts are symptomatic and cause pain, problems with gastrointestinal transit, and other complications. In such cases, drainage or resection should be performed. Among the invasive methods, mini invasive procedures like endoscopic transmural drainage through the wall of the stomach or duodenum play an important role. For endoscopic transmural drainage, it is necessary that the cyst wall adheres to the stomach or duodenum, making a visible impression. We present a very rare case of infeasibility of endoscopic drainage of a postinflammatory pancreatic pseudocyst, impressing the stomach, due to cyst wall calcifications. A 55-year-old man after acute pancreatitis presented with a 1-year history of epigastric pain and was admitted due to a postinflammatory pseudocyst in the body and tail of pancreas. On admission, blood tests, including CA 19-9 and CEA, were normal. An ultrasound examination revealed a 100-mm pseudocyst in the tail of pancreas, which was confirmed on CT and EUS. Acoustic shadowing caused by cyst wall calcifications made the cyst unavailable to ultrasound assessment and percutaneous drainage. Gastroscopy revealed an impression on the stomach wall from the outside. The patient was scheduled for endoscopic transmural drainage. After insufflation of the stomach, a large mass protruding from the wall was observed. The stomach mucosa was punctured with a cystotome needle knife, and the pancreatic cyst wall was reached. Due to cyst wall calcifications, endoscopic drainage of the cyst was unfeasible. Profuse submucosal bleeding at the puncture site was stopped by placing clips. The patient was scheduled for open surgery, and distal pancreatectomy with splenectomy was performed. The histopathological examination confirmed the initial diagnosis of postinflammatory pancreatic pseudocyst. Endoscopic transmural drainage is a highly effective procedure for treating postinflammatory pancreatic pseudocysts. In some patents, especially with large pseudocysts, pseudocysts with calcified walls, and cysts of primary origin, resection should be performed.
Surgical treatment of pancreatic cystic tumors
Authors: Jabłońska Beata , Braszczok Łukasz , Szczęsny-Karczewska Weronika , Dubiel-Braszczok Beata , Lampe Paweł
Published: May 2018

The aim of this study was to assess short-term outcomes of surgical treatment of pancreatic cystic tumors (PCTs). Material and methods: We retrospectively reviewed medical records of 46 patients (31 women and 15 men) who had undergone surgery for pancreatic cystic tumors in our department. Results: Pancreatic cystic tumors were located within the pancreatic head (21), body (11), tail (13), and whole pancreas (1). The following surgical procedures were performed: pancreatoduodenectomy (20), central pancreatectomy (9), distal pancreatectomy (3), distal pancreatectomy with splenectomy (3), distal extended pancreatectomy with splenectomy (2), total pancreatectomy (1), duodenum preserving pancreatic head resection (1), local tumor resection (4), and other procedures (2). Histopathological tumor types were as follows: serous cystadenoma (14), intraductal papillary mucinous adenoma (5), intraductal papillary mucinous carcinoma (5), solid pseudopapillary tumor (5), mucinous cystadenoma (5), mucinous cystadenoma with border malignancy (1), mucinous cystadenocarcinoma (2), adenocarcinoma (4), and other tumors (5). Early postoperative complications were observed in 14 (30.43%) patients. Reoperations were performed in 9 (19.56%) patients. The perioperative mortality rate was 6.52%. Conclusions: Serous cystadenoma was the most common pancreatic cystic tumor in the analyzed group. PCTs were most frequently located within the pancreatic head. Pancreatic resection was possible in most patients, and pancreatoduodenectomy was the most common pancreatic resection type.
Traumatic Transection of Pancreatic Neck in
Adults
Authors: Saydam Mehmet , Ersan Veysel , Kayaalp Cuneyt
Published: May 2018

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Career in vascular surgery – the medical student’s perspective
Authors: Grobelna Malwina K. , Stępak Hubert , Kołodziejczak Barbara , Dzieciuchowicz Łukasz , Oszkinis Grzegorz
Published: May 2018

Aim: Under the supervision of the Department of General and Vascular Surgery of Poznan University of Medical Sciences, a questionnaire was distributed online or as a paper version to medical students (MSs) in order to better understand the attitudes towards surgery as a specialty and to determine the reasons why students do and do not choose vascular surgery as their career path. Materials and methods: The questionnaire was distributed online or as a paper version to MSs in the 3rd, 5th, and 6th year of the PUMS 6-year M.D. program. It provided the data on the year of study, grade point average (GPA), sex, age, respondent’s specialty choice, 33 questions with responses on a 1-5 Likert scale (1 was the least important reason and 5 was the most important reason), and 2 questions with socres between 0 and 4. A total of 136 Polish MSs of PUMS completed the survey. Results: For MSs who choose vascular surgery as their career path, “endovascular capabilities of vascular surgery” and “higher income possibilities than a general surgeon” were the most important reasons. The “poor availability of work in other places than the vascular surgery department of your choice, few such clinics in the region” was the most important reason not to choose vascular surgery. A role of gender was also noted - 13% of male MSs classified gender as an “important factor”, in contrast to 60% of female MSs. Conclusions: The findings of this study might help to develop better strategies to attract future trainees to surgical specialties, particularly vascular surgery, and improve work environment.
Effects of bariatric surgery on cardiovascular risk factors among morbidly obese patients
Authors: Major Piotr , Kowalczuk Aleksandra , Wysocki Michał , Osadnik Sonia , Pędziwiatr Michał , Głuszewska Anna , Pisarska Magdalena , Małczak Piotr , Lasek Anna , Kisielewski Michał , Budzyński Andrzej
Published: May 2018

Aim of the study: The aim of this study was to evaluate the influence of laparoscopic sleeve gastrectomy and laparoscopic
Roux-en-Y gastric by-pass on risk factors of cardiovascular diseases.
Material and methods: We analyzed prospectively collected data of patients operated for morbid obesity who were
qualified for laparoscopic sleeve gastrectomy (LSG) or laparoscopic Roux-en-Y gastric by-pass (LRYGB). Risk factors for
wyłączecardiovascular
diseases were assessed with the SCORE scale and both full and hard Framingham cardiovascular risk
scores (FCRs). The data were collected on admission and one year after the procedures. We enrolled 264 patients (119
females, 116 males, 40.2±9.9 years old), of whom 117 underwent LRYGB and 118 LSG, respectively.
Results: Preoperatively, 12% of patients were in the high-risk category of the SCORE scale, 65% were in the moderate
risk category, and 24% were in the low-risk category. The median score of the SCORE scale was 1 (1-2). Lipid-based
full FCR was 34.5% (24%-68%) and the hard FCR was 17.5% (10%-52%), while the respective BMI-based FCRs were
59% (31%-84%) and 37% (15%-67%). One year after the procedures, the mean %EBMIL (62.88%±20.02%) and %EWL
(53.18%±15.87) were comparable between both procedures. Hypertension treatment was not necessary in 33 patients
after LSG and in 55 after LRYGB. Diabetes mellitus remitted in 9 and 29 patients, respectively. Both procedures significantly
reduced high and moderate risk prevalence in the SCORE scale in favor of the low risk category. Surgical interventions
resulted in significant reductions of FCRs 1 year after surgery ( p<0.001).
Conclusions: Both LSG and LRYGB lead to a significant and comparable body mass reduction. Both procedures significantly
decrease of the risk of cardiovascular diseases, based on SCORE and Framingham scales.
Anastomotic leaks in gastrointestinal surgery and their prevention
Authors: Banasiewicz Tomasz , Dziki Adam , Lampe Paweł , Lorenc Zbigniew , Szczepkowski Marek , Zieliński Jacek , Wallner Grzegorz
Published: May 2018

Anastomotic leak in the gastrointestinal tract is one of the most important complications of resection. They are the main cause of reoperation, their occurrence worsens the prognosis of the patient, increasing the proportion of direct mortality, as well as being a significant risk factor for recurrence of cancer. The risk of leaks within the gastrointestinal tract is greatly varied, depending on the location and extent of the resection, but also on patient, disease or a surgical procedure, including surgeon. To determine the potential risk of leakage can be significant for introduction some prophylactic actions. Some of them have the character of general recommendations, as proper nutrition of the patient in the perioperative period, while another part is directly connected to the surgical procedure. The second group includes protective stoma, the use of tissue glues, insertion transrectal drain for rectal anastomosis decompression, the use of stents or the use of collagen matrix coated with fibrinogen and thrombin. Important to reduce the proportion of leaks can be more precise and targeted prophylactic recommendations, based on the individualized determination of risk factors leaks. Further research for this purpose are necessary for this purpose, the big hope can be associated with data obtained through mobile applications.
Mucinous cystadenoma of the appendix – case report
Authors: Janczak Dariusz , Szponder Mateusz , Janczak Dawid , Leśniak Michał , Ziomek Agnieszka , Chabowski Mariusz
Published: May 2018

Tumors of the appendix are extremely rare and constitute about 0.4% of all tumors of the gastrointestinal tract. The most common benign neoplasm is mucinous cystadenoma, which can be found in 0.6% of all excised appendices and it rarely produces any symptoms. We present the case of a female patient who underwent surgery in the Department of Surgery due to suspicion of an appendicular abscess. On the postoperative pathology study, the diagnosis of a tumor of the appendix (mucinous cystadenoma) was made. Mucinous cystadenoma is rarely included in the differential diagnosis of a non-specific abdominal pain accompanied by non-characteristic laboratory test results and imaging studies. There are no unequivocal guidelines and algorithms of managing this disease. Long-term prognosis is good in the case of a benign tumor.
The usefulness of D-dimer in diagnosis and prediction of venous thromboembolism in patients with abdominal malignancy
Authors: Kwietniak Marcin , Al-Amawi Tariq , Błaszkowski Tomasz , Sulżyc-Bielicka Violetta , Kładny Józef
Published: May 2018

The aim: of the study was to evaluate the usefulness of D-dimer evaluation in the diagnosis and prediction of venous thromboembolism
(VTE) of lower extremities in patients operated on for abdominal tumors depending on the chosen cut-off point for this parameter.
Material and methods: We included 150 patients operated on for abdominal cancer in our department between October 2014 and June
2016. In these patients, concentration of D-dimer was determined, medical histories were taken, and physical examinations were performed.
Ultrasound exams of the veins of the lower limbs were performed three times in every patient in order to confirm or exclude VTE.
Results: When a standard cut-off point (500 ng/ml) was used, in 46% of cancer patients D-dimer values were elevated despite
the lack of VTE. We did not detect any influence of cancer stage on the value of D-dimer. However, if cut-off point was 1440 ng/ml,
which has been suggested in the literature, only 14% of patients were false positive. When the upper cut-off value for D-dimer
was raised, the effect of cancer stage on the value of this parameter could be seen.
Conclusion: The concentration of D-dimer is often elevated in patients with active cancer, but is not a sufficient criterion for diagnosis
of VTE. The concentration of D-dimer before surgery does not determine the risk of postoperative thromboembolic complications.
This is undoubtedly related to the widespread use of effective thromboprophylaxis. According to the literature, ultrasound is
the optimum method for detection of VTE in surgically treated cancer patients. The effect of cancer stage on the value of D-dimer is
revealed only when the cut-off point in this group is 1440 ng/ml, instead of 500 ng/ml which is used for the general population.
Inhibition of PERK-dependent pro-adaptive signaling pathway as a promising approach for cancer treatment
Authors: Rozpędek Wioletta , Pytel Dariusz , Dziki Łukasz , Nowak Alicja , Dziki Adam , Diehl J. Alan , Majsterek Ireneusz
Published: May 2018

Endoplasmic Reticulum (ER) is an organelle that is vital for cell growth and maintenance of homeostasis. Recent studies
have reported that numerous human diseases, including cancer, are strictly connected to disruption of ER homeostasis. In
order to counteract adverse intracellular conditions, cancer cells induce protein kinase R (PKR)-like endoplasmic reticulum kinase
(PERK)-dependent, pro-adaptive unfolded protein response (UPR) signaling branches. If ER stress is severe or prolonged,
pro-adaptive signaling networks are insufficient, resulting in apoptotic cell death of cancer cells.
The main aim: of the study was to evaluate the biological activity of a small-molecule PERK inhibitor GSK2606414 in two cancer
cell lines - human neuroblastoma (SH-SY5Y) and human colorectal adenocarcinoma (HT-29) cell lines. We analyzed the level of
phosphorylation of the eukaryotic initiation factor 2 (eIF2), which is the main substrate of PERK and a subsequent activator of
UPR, which under long-term ER stress may evoke apoptotic death of cancer cells.
Material and methods: In the study, we utilized commercially available cell lines of human colorectal adenocarcinoma HT-29 and
human neuroblastoma SH-SY5Y. Cells were exposed to the tested PERK-dependent signaling inhibitor GSK2606414 in suitable
culture media with addition of thapsigargin (500 nM) to induce ER stress. To identify the protein, Western blot with specific antibodies
was used. Detection of immune complexes was performed using chemiluminescence.
Results: We found a complete inhibition of p-eIF2α expression due to the GSK2606414 inhibitor in both cell lines, SH-SY5Y and HT-29.
Conclusions: Currently available cancer treatments are insufficient and cause various side effects. It has been assumed that utilization of
small-molecule inhibitors of the PERK-dependent signaling pathway, like GSK2606414, may switch the pro-adaptive branch of UPR to
its pro-apoptotic branch. It is believed that the tested inhibitor GSK2606414 may become a promising treatment for many cancer types.
Incidental diagnosis of the tall-cell variant of the papillary microcarcinoma of the thyroid gland requires completion lymphadenectomy: case report
Authors: Bartella I. , Meyer F. , Frauenschläger K. , Reschke K. , Wallbaum Th. , Buth B. , Bruns C. , Chiapponi C.
Published: May 2018

Papillary thyroid carcinoma is the most common neoplasm of the thyroid gland which is usually associated with a very good prognosis.
The aim of this case report is to present the disease course of a rare tumor of the thyroid gland, which is worthwhile due to its extraordinary appearance and specific management.
A 46-year-old patient presented with a pronounced right-sided, but bilateral, multinodular goiter, with a volume of approximately 80 mL, as assessed on ultrasonography. Surgical removal was indicated as scintigraphy showed a 4-cm cold nodule that almost completely took up the right thyroid lobe. Because of the micronodular texture of the left thyroid lobe, complete thyroidectomy was performed according to well-established guidelines.
Histopathological investigation of the specimen revealed a follicular adenoma without any malignancy in the right thyroid lobe and the tall-cell variant of the papillary thyroid microcarcinoma in the left lobe, with a capsular invasion and diameter of 0.6 cm.
Because this rare tumor subtype is known for its aggressive behavior, and there was capsular invasion, low-grade differentiation, and an increased risk for lymphatic metastases, completion lymphadenectomy of the central compartments was performed after an interdisciplinary board decision. On histopathology, there were 30 tumor-free lymph nodes; final TNM classification was as follows: pT3 pN0 [0/30] L0 V0 Pn0 R0). The postoperative course was uneventful, and surgery was followed by radioiodine therapy. Six months after the surgery, clinical follow-up did revealed any sign of recurrence.
The tall-cell variant is a rare and aggressive subtype of the papillary thyroid carcinoma, and it is characterized by poor 5-year survival and high recurrence rate. According to our understanding and based on current literature, this disease requires an aggressive surgical treatment and a close follow-up, as recommended by the current guidelines.
Comparative Analysis of Immediate Postoperative Complications Following Total Gastrectomy
Authors: Stancu S. M. , Popescu B. A.
Published: May 2018

Introduction: Total gastrectomy (TG), despite disrupting the continuity of the alimentary tract and accounting for significant postoperative complications, is the procedure of choice for curative resection of gastric carcinoma. The objectives of this study were to report the rate of postoperative complications following TG, to analyze adverse postoperative outcomes, and to determine the safer technique between Roux –en-Y Esophagojejunostomy and Omega Braun TG. Materials and Methods: A retrospective, observational study was conducted among patients diagnosed with gastric carcinoma who underwent TG between January 1st, 2010 and December 31st, 2012 in the Surgery Department of the Bucharest Clinical Emergency Hospital. Descriptive and analytical statistical analysis with parametric and non-parametric tests was carried out using GraphPad, with statistical significance set at p <0.05. Results: Seventy-seven patients, aged 37-91 years (average age 64.1 ± 11.59 years), were enrolled in this study. A total of 84 immediate postoperative complications were encountered in 35 patients (47.5%), classified into local (n=21, 25%) and general complications (n=63, 75%). Reoperation was necessary in five cases (6.2%), all after Roux-en-Y end-side esophagojejunostomy. Two deaths (n=2, 2.5%), one after Roux-en-Y and one after Omega-Braun TG, were reported. Discussion: The Roux-en-Y technique had the higher number of complications, both local and general. Omega-Braun TG was associated with a lower number of local complications; however, it was associated with life-threatening complications including hemodynamic instability and multisystem organ failure. A statistically significant correlation between manual anastomosis and mortality was observed. Conclusion: The study deemed Roux-en-Y Esophagojejunostomy the overall safer procedure. A statistically significant correlation between manual anostomosis and mortality was observed. Total Gastrectomy is a complex procedure with numerous potential complications which calls for an improved surgical technique to reduce postoperative risk.
Oesophageal perforation – therapeutic and diagnostics challenge. Retrospective, single-center case report analysis (2009–2015)
Authors: Misiak Piotr , Jabłoński Sławomir , Piskorz Łukasz , Dorożała Lechosław , Terlecki Artur , Wcisło Szymon
Published: May 2018

Background: Esophageal perforation is a life-threatening condition of a complex etiology. No clear guidelines are available regarding the management of this condition. In this study, we review publications related to esophageal perforation, and analyze patients treated for this condition at our Department of Thoracic, General and Oncological Surgery. Objective: The objective of the study was to retrospectively assess and analyze management methods for esophageal perforations of different etiologies. All patients were treated in the Department of Thoracic, General and Oncological Surgery in years 2009-2015. Patients with perforations resulting from post-operational leaks within surgical anastomoses were excluded from the study. Material, methods, results: The analysis involved a total of 16 cases of esophageal ruptures. All cases were treated in years 2009-2015. Patients with perforations resulting from postoperative leaks within surgical anastomoses following elective surgeries for either oncological or non-oncological causes were excluded. The most common reason for esophageal rupture was iatrogenic injury (7 cases, 44%). Other causes included Boerhaave syndrome (5 cases, 31.2%), blunt trauma (2 cases, 12.5%), abscess perforation (1 case, 6.2%), and ulcer perforation (1 case, 6.2%). Ten patients underwent surgery, and the rest underwent esophageal prosthesis placement, of whom 2 cases required drainage of the mediastinum and pleural cavity. The mortality rate in the study group was 9/16 cases (56.2%). Conclusions: Esophageal perforation poses a significant interdisciplinary challenge regarding diagnostic workup, selection of treatment methods, and management of potential postoperative complications. This retrospective study was conducted in a single center. Although the analyzed period was long, we found only 16 cases. In spite of a variety of etiologies present, we found several statistically significant results of potential clinical value. 1. Most perforations that are not diagnosed within 48 hours affected the lower part of the esophagus and presented with unclear symptoms and imaging findings 2. Delaying diagnosis and treatment beyond 24 hours was associated with a higher mortality rate.
Buttressing hepaticojejunostomy's with hepatic round ligament flap may be beneficial
Authors: Banerjee Jayant Kumar , Bharathi Ramanathan Saranga , Rao Pankaj Purushotam
Published: May 2018

Background: Bile leaks and anastomotic strictures are important complications of hepaticojejunostomy (HJ). Evidence suggests that the use of hepatic round ligament (HRL) to buttress HJ may be beneficial. This study evaluates the feasibility of this approach. Methods: HJs performed over 2 years (Jun 2014- May 2016), with HRL reinforcement, were analyzed. Operative outcomes measured included technical difficulty, blood loss, time necessary for flap harvest, and reinforcement of HJ. The postoperative outcomes measured were the presence of bile leak and anastomotic stricture. Results: Forty-one patients (27 M: 14 F), aged 2-79 years, median age of61 years, underwent HJ with HRL buttress; 27 for periampullary/ head of the pancreas carcinoma; 4 for choledochal cysts; 4 for chronic pancreatitis; 3 for gallbladder carcinoma; 3 for benign biliary stricture. The time for harvesting HRL flaps and buttressing HJ was <10 minutes. No blood was lost during harvesting the flaps. One patient (2.5 %) had grade A leak following radical cholecystectomy, and structures were not observed during a median follow-up of 18 months (6 months to 2years). Conclusion: HRL-based buttressing of HJ can reduce the bile leak and/or stricture rate.
The Impact of Obesity on the Perioperative, Clinicopathologic, and Oncologic Outcomes of Robot Assisted Total Mesorectal Excision for Rectal Cancer
Authors: Pai Ajit , Alsabhan Fahad , Park John J. , Melich George , Sulo Suela , Marecik Slawomir J.
Published: May 2018

Purpose: To analyze the feasibility and outcomes of robotic rectal cancer surgery in obese patients. Methods: From 2005 to 2012, 101 consecutive rectal cancers operated robotically were enrolled in a prospective database. Patients were stratified into obese (BMI ≥ 30 kg/m2) and non-obese (BMI < 30 kg/m2) groups. Operative, perioperative parameters, and pathologic outcomes were compared. Data were analyzed using SPSS 22.0, while statistical significance was defined as a p value ≤ .05. Results: There were 33 obese patients (mean BMI 33.8 kg/m2). Patients were comparable regarding gender, T stage, and type of operation. Operative time and blood loss were higher in the obese group; only operative time was statistically significant. The conversion rate, length of stay, and anastomotic leak rates were similar. Circumferential margin positivity and lymph node yield were comparable. Disease free and overall survivals at 3 years were 75.8% versus 80.9% and 84.8% versus 92.6%, respectively for obese and non-obese subgroups. Conclusions: Robotic surgery for curative treatment of rectal cancer in the obese is safe and feasible. BMI does not influence conversion rates, length of stay, postoperative complications, and quality of the specimen or survival when the robotic platform is used.
Diagnosis and treatment of gastroesophageal reflux disease complicated by Barrett’s esophagus
Authors: Stasyshyn Andriy
Published: May 2018

The aim of the study was to evaluate the effectiveness of a diagnostic and therapeutic algorithm for gastroesophageal reflux disease complicated by Barrett’s esophagus in 46 patients. Materials and methods. A diagnostic and therapeutic algorithm for complicated GERD was developed. To describe the changes in the esophagus with reflux esophagitis, the Los Angeles classification was used. Intestinal metaplasia of the epithelium in the lower third of the esophagus was assessed using videoendoscopy, chromoscopy, and biopsy. Quality of life was assessed with the Gastro-Intestinal Quality of Life Index. The used methods were modeling, clinical, analytical, comparative, standardized, and questionnaire-based. Results and their discussion. Among the complications of GERD, Barrett’s esophagus was diagnosed in 9 (19.6 %), peptic ulcer in the esophagus in 10 (21.7 %), peptic stricture of the esophagus in 4 (8.7 %), esophageal-gastric bleeding in 23 (50.0 %), including Malory-Weiss syndrome in 18, and erosive ulcerous bleeding in 5 people. Hiatal hernia was diagnosed in 171 (87.7 %) patients (sliding in 157 (91.8%), paraesophageal hernia in 2 (1.2%), and mixed hernia in 12 (7.0%) cases). One hundred ninety-five patients underwent laparoscopic surgery. Nissen fundoplication was conducted in 176 (90.2%) patients, Toupet fundoplication in 14 (7.2%), and Dor fundoplication in 5 (2.6%). It was established that the use of the diagnostic and treatment algorithm promoted systematization and objectification of changes in complicated GERD, contributed to early diagnosis, helped in choosing treatment, and improved quality of life. Conclusions: Argon coagulation and use of PPIs for 8-12 weeks before surgery led to the regeneration of the mucous membrane in the esophagus. The developed diagnostic and therapeutic algorithm facilitated systematization and objectification of changes in complicated GERD, contributed to early diagnosis, helped in choosing treatment, and improved quality of life.
Patient with metastatic breast cancer presenting as acute cholecystitis with one-year survival on hormonotherapy
Authors: Zamkowski Mateusz , Kąkol Michał , Makarewicz Wojciech , Ropel Jerzy , Bobowicz Maciej
Published: May 2018

Breast cancer has high metastatic potential with distant metastases involving mainly lungs, liver and bones. Less frequently it gives distant spread to other organs. Herein we would like to present a very rare case of an acute cholecystitis which turned out to be a metastatic breast cancer in previously healthy woman. A female patient, 64-years old, presented to the emergency department with symptoms of biliary colic and acute abdomen. During the emergency cholecystectomy, we diagnosed the gallbladder empyema with thickened wall. There were also multiple metastatic nodules in the peritoneal cavity and an excessive amount of free fluid. The emergency physicians diagnosing female patient with the acute abdominal symptoms and a breast cancer history might suspect malignant spread into abdominal organs including gallbladder. On the other hand, acute cholecystitis symptoms might be the first symptoms of metastatic process in the gallbladder from the unknown primary source, which may be breast.
An association of the MCP-1 and CCR2 single nucleotide polymorphisms with colorectal cancer prevalence
Authors: Walczak Anna , Przybyłowska-Sygut Karolina , Sygut Andrzej , Cieślak Adrianna , Mik Michał , Dziki Łukasz , Dziki Adam , Majsterek Ireneusz
Published: May 2018

The aim of the study: We evaluated the connection between the presence of the -2518 A/G MCP-1 as well as 190 G/A CCR2 polymorphic variants and colorectal cancer (CRC) occurrence. Material and methods: Study group consisted of subjects with different stages of CRC as well as healthy controls. Genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Results: W observed an association between the colorectal cancer and the GG genotype of the -2518 A/G MCP-1 single nucleotide polymorphism. No statistically significant correlation was found between CRC and the 190 G/A CCR2 polymorphism. Conclusion: The results of this study support the hypothesis that polymorphism in the MCP-1 gene may contribute to the etiology of colorectal cancer.
Internal hernia following laparoscopic colorectal surgery: single center experience
Authors: Svraka Melina , Wilhelmsen Michał , Bulut Orhan
Published: May 2018

Although internal hernias are rare complications of laparoscopic colorectal surgery, they can lead to serious outcomes and are associated with a high mortality of up 20 %. Aim of the study: The aim of this study was to describe our experience regarding internal herniation following laparoscopic colorectal surgery. Materials and methods: From 2009 to 2015, more than 1,093 laparoscopic colorectal procedures were performed, and 6 patients developed internal herniation. Data were obtained from patients’ charts and reviewed retrospectively. Perioperative course and outcomes were analyzed. Results: All patients were previously operated due to colorectal cancer. Two patients presented with ischemia at laparotomy, and 2 had endoscopic examinations before surgery. One patient was diagnosed with cancer on screening colonoscopy. One patient died after laparotomy. Conclusion: Internal herniation that develops following laparoscopic colorectal surgery may be associated with a high mortality. More efforts should be made to identify risk factors of internal herniation, as this could indicate which patients would benefit from closure of mesenteric defects during laparoscopic colorectal surgery.
Results of home parenteral nutrition in patients with severe inflammatory bowel disease – an alternative for surgery of malnourished patients
Authors: Turkot Maryla , Sobocki Jacek
Published: May 2018

Introduction: In the world, the inflammatory bowel disease affects an increasing number of younger and younger patients, and in some of them parenteral nutrition is an alternative to high-risk surgical intervention due to advancement of the disease and malnutrition. Aim: The aim of the study was to assess the results of home parenteral nutrition in patients with severe bowel inflammatory disease, in whom surgical treatment is associated with high risk of complications. Materials and methods: A retrospective analysis was conducted on 46 patients, who received home parenteral nutrition instead of another surgical intervention. The inclusion criteria included home parenteral nutrition and diagnosis of Crohn’s disease or ulcerative colitis. Results: Mean number of complications requiring hospital admission per patient was 1.76, the BMI increased by 4.3 on average [kg/m2]. During parenteral nutrition, the percentage of patients, in whom anti-inflammatory or immunosuppressant drugs were completely discontinued, was 17.4%. In the whole group, at least one immunosuppressive drug was discontinued in onefifth of patients. Mean albumin level increased by 2.4 g/L, lymphocyte count dropped by 474 lymphocytes/mm3, and leukocyte count increased by 747.6/mm3. The patients described their condition as good in 87%, and 7.4% of patients were able to work. Conclusions: Home parenteral nutrition positively affects patient’s general condition by increasing BMI and normalizing biochemical test results. The results indicate the need to consider this method as an alternative to surgical intervention in severe bowel inflammatory disease with high perioperative risk, which could reduce the complication rate.
Stoppa method – forgotten surgery
Authors: Ratajczak Andrzej , Lange-Ratajczak Małgorzata , Zastawna Kinga
Published: May 2018

Stoppa method – forgotten surgery
Association between clinical stage of oral cancer and expression of immunohistochemical markers
Authors: Świątkowski Wojciech , Rahnama Mansur , Tomaszewski Tomasz , Bigas Mariola , Świątkowska Agnieszka , Łobacz Michał , Wallner Jan
Published: May 2018

Aim: The aim of this study is to demonstrate the possible correlation between the expression of examined protein markers - p53, EGFR, PCNA, p44/42 in the mass of the tumor and the clinical stage of disease. Material: 48 patients of the Department and Clinic of Oral and Maxillofacial Surgery, Lublin diagnosed with oral cancer. The control group consisted of 10 patients diagnosed with leukoplakia lesions in the oral cavity. The methods: Immunohistochemical analysis using the detection system DAKO K5007 Cat - Dako REAL ™ Detection System, Peroxidase DAB +, Rabbit / Mouse. Results: Based upon the statistical results, significant correlation between p53 protein and tumor staging; however, a correlation between the level of expression of EGFR, p44/42, PCNA and staging was not likewise revealed. Conclusions: Looking for oral squamous cell carcinoma markers remains an actual issue. Identification of specific markers of oral cancer could be used in screening the population, determining prognosis and response to treatment.
Impact of the Ser326Cys polymorphism of the OGG1 gene on the level of oxidative DNA damage in patients with colorectal cancer
Authors: Kabzinski Jacek , Walczak Anna , Dziki Adam , Mik Michał , Majsterek Ireneusz
Published: May 2018

As a result of reactive oxygen species operation, cell damage occurs in both cellular organelles and molecules, including DNA.
Oxidative damage within the genetic material can lead to accumulation of mutations and consequently to cancer transformation.
OGG1 glycosylase, a component of the Base Excision Repair (BER) system, is one of the enzymes that prevents excessive
accumulation of 8-oxoguanine (8-oxG), the most common compound formed by oxidative DNA damage. In case of
structural changes of OGG1 resulting from polymorphic variants, we can observe a significant increase in the concentration of
8-oxG. Linking individual polymorphisms to DNA repair systems with increased risk of colorectal cancer will allow patients to
be classified as high risk and included in a prophylactic program.
The aim of the study was to determine the level of oxidative DNA damage and to analyze the distribution of Ser326Cys polymorphism
of the OGG1 gene in a group of patients with colorectal cancer and in a control group in the Polish population.
Material and methodology. DNA was isolated from the blood of 174 patients with colorectal cancer. The control group consisted
of 176 healthy individuals. The level of oxidative damage was determined by analyzing the amount of 8-oxguanine using
the HT 8-oxo-dG ELISA II Kit. Genotyping was performed via the TaqMan method.
Results. The obtained results indicate that Ser326Cys polymorphism of the OGG1 gene increases the risk of RJG and is associated
with significantly increased levels of 8-oxoguanine.
Conclusions. Based on the results obtained, we conclude that Ser326Cys polymorphism of the OGG1 gene may modulate the
risk of colorectal cancer by increasing the level of oxidative DNA damage.
Initial experience with endoscopic sleeve gastroplasty in Poland
Authors: Sowier Aleksander , Pyda Przemysław , Borucka Anna-Maria , Sowier Sebastian , Białecki Jacek , Kapturzak Joanna , Wójtowicz Stanisław
Published: May 2018

Introduction: Obesity is becoming one of the major public health problems. Bariatric procedures are considered the most effective methods of treating this condition but they are costly and entail a high risk of complications. Thus, there is a need to look for better bariatric treatment solutions. One of the newest, highly promising bariatric methods is endoscopic sleeve gastroplasty (ESG), which is comparably effective to other bariatric procedures in terms of weight loss but at the same time it is much less invasive. Materials and methods: Eight obese patients underwent ESG. Under general anaesthesia, an endoscope was inserted into the stomach, where a row of 4-5 running stitches was placed (from the pyloric part towards the GE junction). Each of the stitches was cinched tight, which resulted in gastric lumen reduction comparable to that achieved with laparoscopic sleeve gastrectomy. Results: The procedures were performed without any severe peri-operative complications. The only adverse event was a minor haemorrhage in one of the patients, which did not require any surgical intervention. After the surgery, the patients reported a substantial weight loss. Mean %TBWL was 8.6%, 15.4% and 19.6% at 1, 2 and 3 months, respectively. Conclusions: Minimally invasive and highly effective in body weight reduction, endoscopic sleeve gastroplasty is a promising method of treating obesity. The procedure requires appropriate tools and equipment. The method guarantees gastric volume reduction comparable to that achieved with sleeve resection. The initial results confirm that the effectiveness of the surgery in terms of body weight loss is similar to that seen in other forms of bariatric treatment. Discussion: Compared to laparoscopic sleeve gastrectomy, endoscopic sleeve gastroplasty is substantially less invasive. Also, it requires shorter procedure time and shorter hospital stay. Data from other medical centres demonstrate somewhat lower dynamics of total body weight loss but these results need to be verified in a long-term follow-up.
Endoscopic treatment of extensive walled-off pancreatic necrosis with the use of single transluminal gateway transcystic multiple drainage (SGTMD)
Authors: Jagielski Mateusz , Smoczyński Marian , Adrych Krystian
Published: May 2018

The paper presents a description of the course of severe acute necrotizing pancreatitis as well as endoscopic treatment of an
extensive infected walled-off pancreatic necrosis (WOPN), being the consequence of acute pancreatitis. The basic strategy of
interventional treatment was to extend access to necrotic areas with use of single transluminal gateway transcystic multiple
drainage (SGTMD). Endoscopic transmural access (transgastric) was applied. Endoscopic necrosectomy under fluoroscopic
guidance was repeated nine times during active transluminal drainage. Endotherapy with use of SGTMD, as well as endoscopic
necrosectomy became a successful and safe technique of treatment. Moreover, the paper proved the efficiency of endotherapy
in the treatment of complete pancreatic duct disruption in the course of acute necrotizing pancreatitis.
DocGenealogy – Visualizing the doctoral advisors and mentors genealogic tree
Authors: Fernandes David Paiva , Carvalho Elizabeth Simão
Published: May 2018

DocGenealogy is a data mining project that allows the visualization and exploration of the doctoral advisement/mentoring relationship through an interactive graph chart. Wikipedia is known for its informal collaborative nature, based on a somewhat loose and non-structural way of producing information, and one of its strengths is, in fact, the openness to all sorts of collaborations. DocGenealogy uses the Wikipedia available data on doctoral advisement and mentoring to find out and track the existing relationships between advisors or mentors and their students. The data mining process starting point is always some well-known scientist. This process continues until finding all the ultimate reputed co-related advisors and mentors, and builds iteratively the relationship graph. Besides this, DocGenealogy also visually shows how people are distributed by alma mater and field of knowledge. The main objective of the work is to evaluate the effectiveness of the graph-oriented techniques in the interpretation of data from Wilipedia infoboxes.
Aplicação de Técnicas de Inteligência Analítica em Repositórios de Software
Authors: Rodrigues Bruno Rafael de Oliveira , Parreiras Fernando Silva
Published: May 2018

A inteligência analítica na Engenharia de Software permite analisar os dados contidos nos diversos repositórios com a finalidade de apresentar decisões fundamentadas aos engenheiros de software. Com a intenção de promover a utilização da inteligência analítica na Engenharia de Software, este artigo responde a questão: é possível utilizar a inteligência analítica para descobrir quais arquivos de código fonte do sistema têm sido alterados e quais os motivos de suas alterações? Por meio das técnicas de modelo de tópicos e regra de associação, foi realizado um estudo com o repositório de código fonte de um sistema de software livre, o Jenkins, e desenvolvido um protótipo de um sistema a partir dessas técnicas. Com o auxilio de um grupo focal formado por profissionais da área de desenvolvimento de sistemas, foi possível avaliar o protótipo desenvolvido. Apura-se que o método apresentado, neste trabalho, permite identificar quais arquivos do sistema estão sendo alterados e a justificativa para essa modificação, facilitando o mapeamento dos arquivos do sistema por assunto, o planejamento de refatorações, builds e o entendimento da estabilidade e evolução do software.
Iniciativas sobre patrimônio geológico e temas correlatos no Quadrilátero Ferrífero, MG / Initiatives on geological heritage and related topics in Quadrilatero Ferrifero, MG
Authors: Castro Paulo de Tarso Amorim , Ruchkys Úrsula De Azevedo
Published: May 2018

O presente artigo faz uma breve reconstituição histórica de como o patrimônio geológico e temas correlatos tem sido incorporado em ações e pesquisas na região do Quadrilátero Ferrífero, com seus objetivos e resultados. Mostra como essas temáticas ganham a arena regional e influenciam no desenvolvimento e crescimento de dissertações e teses. Discute aspectos importantes para a continuidade da promoção da conservação do patrimônio geológico no contexto de uma das mais importantes províncias minerais do mundo.Palavras–Chave: Geopatrimônio, Quadrilátero Ferrífero, Produção CientíficaAbstract This article makes a brief historical reconstitution of how geological heritage and related themes have been incorporated into actions and research in the Quadrilatero Ferrifero region, with its objectives and results. It shows how these themes gain the regional arena and influence the development and growth of dissertations and thesis. It discusses important aspects for the continuity of the promotion of conservation of the geological heritage in the context of one of the most important mineral provinces of the world.Keywords: Geoheritage, Quadrilatero Ferrifero, scientific production
Creativity, Human and Transhuman
Authors: Cruz Eduardo R. ,   Philosophy Documentation Center
Published: May 2018

Transhumanists, like other elites in modernity, place great value on human creativity, and advances in human enhancement and AI form the basis of their proposals for boosting it. However, there are problems with this perspective, due to the unique ways in which humans have evolved, procreated and socialized. I first describe how creativity is related to past evolution and developmental aspects in children, stressing pretend play and the ambivalent character of creativity. Then, I outline proposals for enhancing creativity, be it in embodied humans on the way to a superior species, in AI-related beings (virtual reality, robotics), or even in any degree of mixture in human-machine interaction. In the final section, I describe intrinsic limits to these proposals, such as the absence of a good understanding of human psychology by the proponents of enhancement; the lack of interest in the subjective side of creativity (for one’s own sake); delayed maturation and the ambivalence of pretend play in childhood; and the contrariness typical of new human generations. As for the enhancement of creativity, it is argued that creativity in its social context may be the victim of its own past success. On the other hand, an asymmetry between virtual beings and children is described—the latter can behave in a nasty way, it is part of their growth and creativity, whereas the former are not supposed to cause any harm to human beings. In sum, despite impressive progress in several scientific and technological interventions in creativity, philosophical questions emerge that place many constraints on transhumanist dreams of endless creativity.
La reconstrucción de las causas de muerte por el método MODICOD en el análisis demográfico-sanitario. De la CIE-9 a la CIE-10 a un nivel de cuarto dígito
Authors: Faus-Bertomeu Aina , Gómez-Redondo Rosa
Published: May 2018

A pesar del conocimiento acumulado sobre mortalidad y longevidad se hace imprescindible conocer con mayor profundidad la cuarta fase de la Transición Epidemiológica en la que se encuentra España, como otros países de su entorno, para anticipar la emergencia de un nuevo escalón en la Transición Sanitaria así como su impacto social en los años venideros. Para ello, se precisa del análisis de datos de mortalidad por  causas de muerte con el objeto de seguir su evolución y cambios. No obstante la codificación de las causas de muerte se interrumpe con las sucesivas revisiones a la Clasificación Internacional de Enfermedades (CIE). Por ello, se utiliza la metodología de la reconstrucción de causas de muerte propuesta por France Meslé y Jacques Vallin (1988, 1996), de aplicación en la comunidad científica de los países que forman parte de la red internacional Mortality, Divergence and Causes of Death (MODICOD) y en la que las autoras participan en representación de España. El presente trabajo describe las fases de dicho protocolo y lo ejemplifica con los datos de causas de muerte españolas para el periodo 1980- 2012, reconstruyendo las series entre la CIE-9 y la CIE-10. Los resultados obtenidos garantizan el seguimiento de 6.902 rúbricas de causas de muerte continuas y homogeneizadas que por primera vez se establece a nivel de desagregación del cuarto dígito de la CIE-10 configurándose como un instrumento metodológico en el análisis demográfico-epidemiológico.Despite the accumulated knowledge about mortality and longevity, it is essential to know in the depth of the fourth phase of the Epidemiological Transition in which Spain, like other neighboring countries, is in to anticipate a new step in the Health Transition as well as its impact in the coming years. In this context, the analysis of the data of the causes of death is necessary in order to follow its evolution and changes. However, the codification of causes of death is interrupted by the successive revisions to the International Classification of Diseases and Related Health Problems (ICD). For this reason, the methodology of the reconstruction of causes of death proposed by France Meslé and Jacques Vallin (1988, 1996) is used and applied in the countries that are part of the international network Mortality, Divergence and Causes of Death (MODICOD) and in which the authors participate in representation of Spain. The present work describes the phases of this protocol and exemplifies it with the date of Spanish causes of death for the period 1980 to 2015, reconstructing series between ICD-9 and ICD-10. The results obtained ensuring the monitoring of 6,902 rubrics of continuous and homogenized causes of death at a fourth digit level of the ICD-10, which for the first time is established at a level of the fourth digit of the ICD-10, that are configured as a demographic-epidemiological methodological instrument.