Marek Rokicki

Liver regeneration in rats after complete and partial occlusion of the portal blood influx

The role of portal blood influx in liver regeneration was studied in rats. Partial hepatectomy with removal of 45% of the liver mass was performed after end-to-side portacaval shunt (PCS) leading to complete diversion of portal blood from the liver, or after side-to-side PCS causing partial portal blood deprivation. Liver resection was limited to 45% to avoid the high mortality rate in rats with vascular anastomoses and 70% hepatectomy, but it did not change the pattern of liver regeneration. The total RNA and DNA content, the rate of DNA synthesis and the number of hepatocyte mitoses in regenerating liver were measured in comparison to sham-operated controls. Complete occlusion of the portal blood influx did not block hepatoproliferative response, but caused a significant decrease and delay of regeneration. Partial preservation of portal flow in rats with side-to-side PCS markedly improved liver regeneration in comparison to end-to-side PCS, but the process was slower than in the control group.

The role and importance of club cells (Clara cells) in the pathogenesis of some respiratory diseases

The report presents the cellular structure of the respiratory system as well as the history of club cells (Clara cells), their ultrastructure, and location in the airways and human organs. The authors discuss the biochemical structure of proteins secreted by these cells and their importance for the integrity and regeneration of the airway epithelium. Their role as progenitor cells for the airway epithelium and their involvement in the biotransformation of toxic xenobiotics introduced into the lungs during breathing is emphasized. This is followed by a discussion of the clinical aspects associated with club cells, demonstrating that tracking the serum concentration of club cell-secreted proteins is helpful in the diagnosis of a number of lung tissue diseases. Finally, suggestions are provided regarding the possible use of proteins secreted by club cells in the treatment of serious respiratory conditions.

The Original Experimental Model in Rats to Study Gastric Banding Surgery

BackgroundA new bariatric surgical experimental model in rats for aspects of investigation was created.MethodsIn 121 male Wistar rats with body mass 250–270 g, the original gastric banding (GB) operation was performed. Sixty days after the surgical procedure, we measured body mass and upper part of the alimentary tract patency (radiography with contrast medium).ResultsOne hundred twenty one rats were operated on. In the study group, the mortality was 0%. A complication (incisional hernia) was found in only three cases. The average weight of the rat in the GB group on the 60th day after the surgery was 355.0 ± 4.12 g, and that in the sham-operation group was 394.0 ± 4.80 g (t test, t = 6,073, p < 0.001). The daily weight gain in sham-operated rats was 2.23 ± 0.07 g, whereas in the GB group, it was 1.60 ± 0.07 g (p < 0.02). Complete inhibition of weight gain was not observed.ConclusionThe rat model of GB surgery that we created is easy to perform, repeatable, long-lasting, relatively cheap, and can be used in various experimental trials of diverse aspects of surgery in the field of obesity.

Malignant mesothelioma as a difficult interdisciplinary problem

The authors of the present report review the etiology and clinical symptoms of malignant pleural mesothelioma (MPM) as well as diagnostic techniques (both radiological and biomarkers) used for its detection. Subsequently, they present methods of multimodal treatment (surgery, chemotherapy, and radiotherapy) recommended by the International Mesothelioma Interest Group (IMIG). Finally, they discuss complications and long-term results associated with these methods of MPM treatment.

Is it possible to standardize the treatment of primary spontaneous pneumothorax? Part 2: surgical methods of treatment

The present report provides a detailed description of the surgical methods for primary spontaneous pneumothorax (PSP) treatment, from open surgery (thoracotomy) to minimally invasive procedures (video-assisted thoracoscopic surgery – VATS). It describes the methods of preventing pneumothorax recurrence, including partial or complete resection of the parietal pleura and chemical pleurodesis with VATS. The pros and cons of each method are presented. The paper also discusses new techniques for diagnosing pneumothorax, such as fluorescein-enhanced autofluorescence thoracoscopy (FEAT) and infrared thoracoscopy. Finally, the authors propose their own algorithm for the treatment of PSP.

Boerhaave`s Syndrome – over 290 yrs of surgical experiencesIs it possible to return this condition?

Spontaneous perforation of the esophagus (Boerhaave syndrome) is a rare disease that poses a serious surgical challenge. The analysis of literature concerning the Boerhaave syndrome reveled cases of recurrent spontaneous perforation of the esophagus. The incidental nature of this condition calls for more accurate assessment of all such cases. The authors made a detailed evaluation of the data obtained from eight reports of recurrent Boerhaave syndrome. The data is presented as a summary table comparing the clinical course and outcomes of patients with the primary Boerhaave syndrome as well as recurrent Boerhaave syndrome.

What do we know about Tietze’s syndrome?

Tietze’s syndrome is a benign, self-limiting arthropathy, without purulent character. The disease most often involves articulations: sternocostal, sternoclavicular, or costochondral joints. The characteristic symptoms are tenderness, pain and edema involving one of the aforementioned joints on one side. Diagnosis of Tietze’s syndrome is based on physical examination (increase of palpation tenderness in the affected joint), laboratory tests (increase of inflammatory parameters) and imaging studies (USG, MRI). Differential diagnosis of Tietze’s syndrome is based on exclusion of costal cartilage inflammation, coronary syndrome and inflammatory changes in the lung and pleura. Most commonly the treatment is conservative, in resistant cases surgical.

New aspects in the diagnosis and treatment of primary spontaneous pneumothorax

This paper provides a recapitulation of the position of the British Thoracic Society and the American College of Chest Physicians based on a review of the literature concerning the current methods of diagnosing and treating primary spontaneous pneumothorax (PSP). The previously developed guidelines were re-evaluated in 2015 by a task force of the European Respiratory Society (ERS). They are intended to be used by surgeons as well as emergency and pulmonary ward physicians, and they apply largely to emergency procedures. In recent years, the effectiveness of minimally invasive methods (punctures, drainage) in combination with talc pleurodesis for the initial therapy of PSP has been recognized. The efficacy of thoracoscopy (VATS) for the treatment of this disease has been proven by the development of minimally invasive surgical techniques in thoracic surgery. This paper also discusses the efficacy of the surgical methods available.

Is it possible to standardize the treatment of primary spontaneous pneumothorax? Part 1: etiology, symptoms, diagnostics, minimally invasive treatment

The authors of this report present the history of primary spontaneous pneumothorax (PSP) treatment, its etiology, clinical symptoms, and diagnostic methodology. Further, they discuss minimally invasive methods of treating PSP such as thoracentesis and chemical pleurodesis. They discuss the pros and cons of each method, emphasizing that, according to the international recommendations, they should be used as the first line of treatment for PSP.

A rare case of duodenal ulcer perforation accompanied by Boerhaave syndrome

Esophageal perforation is the fastest progressing and the most life-threatening disruption of gastrointestinal tract continuity. It must be regarded as an emergency condition that requires early diagnosis as well as very aggressive and rapid implementation of treatment in order to avoid serious complications and death. Methods of treatment for spontaneous esophageal perforation continue to be a matter of controversy. However, all authors emphasize that ultimate success depends largely on the time taken to establish the diagnosis. The authors of this study describe a rare case of duodenal ulcer perforation accompanied by Boerhaave syndrome.