[Unique massive recurrence liposarcoma of the retroperitoneum].

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.

[Metastasis to brain from rectal cancer as the first manifestation of neoplasmatic disease].

Cerebral metastases from colorectal cancer are uncommon. They are usually a late manifestation of the neoplasmatic disease. The symptoms aren't always typical.

Rheological properties of erythrocytes in patients suffering from morbid obesity. Examination with LORCA device.

Unlabelled: 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.

Intra-abdominal abscess in the course of intragastric migration of an adjustable gastric band: a potentially life-threatening complication.

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.

Results of revisional operation following vertical banded gastroplasty performed due to morbid obesity--comparison between restoration of vertical banded gastroplasty and conversion of gastric bypass up to three years.

The aim of this study was to analyse incidence and efficacy of revisional surgery for failed vertical banded gastroplasty among 458 patients who underwent primary surgery between 1993 and 2003. Staple line disruption was diagnosed in 29 patients and was an indication for restoration of gastroplasty in 10 cases and a conversion to Roux-en-Y gastric bypass in 19 patients. In two cases of outlet stenosis the band was exchanged to enlarge the collar.

Biliopancreatic diversion in Poland.

Biliopancreatic diversion (BPD) is a bariatric operation of proved efficacy especially in patients with metabolic comorbidities. The aim was to assess the results of BPD in relation to weight loss and coexisting lipid and glucose metabolism disturbances in the Polish population. Between October 2001 and December 2003 57 morbidly obese patients (24 male and 33 female) underwent BPD.

The nasal airway evaluation in morbid obesity.

The aim of the present study was to evaluate objectively the nasal patency in the obese patients. A total of 18 morbidly obese patients were recruited for the study. All of them were surgically treated because of morbid obesity using Bilo-Pancreatic Diversion (BPD) or Laparoscopic Gastric Banding (LGB) methods.

The progress in bariatric surgery.

Morbid obesity, caused by fat tissue accumulation, is a serial multi-factorial chronic disease, with rapidly increasing prevalence in most countries in the world including Poland. Conservative treatment of morbid obesity is almost always unsatisfactory and that is why several surgical methods have been developed. There are four kind of methods: malabsorbtive procedures; restrictive procedures; malabsorbtive/restrictive procedures and experimental procedures.

The comparison of scoring scales for liver biopsy assessment in morbidly obese patients undergoing bariatric surgery.

Background: 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.

Methods: We analysed 24 consecutive patients who underwent bariatric surgery.

[Tracheal injury during transhiatal esophagectomy treated conservatively].

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.

[Obesity and surgery].

Obesity is a life-long, progressive, life-threatening, genetically related, costly, multifactorial disease manifested by excessive fat storage. It is often accompanied by multiple comorbidities including mainly hypertension, diabetes, hyperlipidemia, hypoventilation, obstructive sleep apnea, degenerative arthritis and psychosocial impairment which influence the patients quality of life and ultimately limit their life expectancy. Conservative treatment of morbid and extreme obesity including diet, physical activity, behaviour modifications or pharmacotherapy is not effective in achieving a medically significant long-term weight loss.

[Assessment of plasma lipid profile oxysterols and vitamin E concentration in morbidity obese patients with coexisting arterial hypertension and non-insulin dependent diabetes mellitus].

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.

[Plasma oxysterols and vitamin E concentrations and lipid profile in morbidly obese women].

Morbid obesity (BMI > or = 40 kg/m2) is accompanied by lipid disturbances which may be involved in the increased incidence of atherosclerosis, arterial hypertension and non-insulin-dependent diabetes mellitus. The aim of the study was to assess concentrations of total cholesterol (TC), HDL-cholesterol, LDL-cholesterol, triglycerides (TG), products of cholesterol peroxidation--oxysterols, and the major lipophilic antioxidant--vitamin E, in morbidly obese women without coexisting diseases. The study was performed in 11 morbidly obese women (BMI 42.

Swedish adjustable gastric band (SAGB) implanted laparoscopically in the treatment of morbid obesity--the first experience in Poland.

Surgical treatment of morbid obesity is a recognized method of proceedings in patients who did not obtain any positive results in conservative therapy. In October and November 1998 laparoscopic implantation of the SAGB was performed among ten morbid obesity patients with mean BMI of 41.9 +/- 3.

ASSESSMENT OF BETA-ENDORPHIN AND MELATONIN CIRCADIAN RHYTHMS IN NORMOTENSIVE OBESE WOMEN OF REPRODUCTIVE AGE.

We have evaluated the relationship between beta-endorphin (beta-EP) and melatonin (MEL) secretion as determined at 3 h intervals over a 24 h period in 27 normotensive obese women of different phenotypes (12 showing gynoid-type and 15 showing android-type of adipose tissue distribution) as well as in 12 healthy volunteers with normal body weight, aged 30 to 40 years. A considerable increase of mean 24 h beta-EP secretion (mainly due to elevated afternoon and evening levels) and total absence of beta-EP circadian rhythm were observed in all obese patients. Mean 24 h MEL concentrations were markedly higher (mainly due to increased daytime levels) in all obese patients while the disturbances of MEL secretion in the form of acrophase shift and (or) suppression of its rhythmicity were observed especially in obese women with android phenotype.

Assessment of bone metabolism in obese women.

OBJECTIVE: To evaluate the bone metabolism in obese women by the estimation of selected markers of bone formation. METHODS: The concentration of plasma parathyroid hormone (PTH) and selected markers of bone formation [osteocalcin (BGP) in plasma, carboxyterminal propeptide of type I procollagen (PICP) and alkaline phosphatase (AP) activity in blood serum] and bone resorption [cross-linked carboxyterminal telopeptide of type I collagen (ICTP) in blood serum and urinary excretion of calcium (Ca)] in 18 extremely obese women (BMI>40 kg/m2) with android phenotype (WHR>0.8) and in 20 healthy women with normal body weight.

Circadian variations of androstenedione, dehydroepiandrosterone sulfate and free testosterone in obese women with menstrual disturbances.

OBJECTIVE: To assess the 24 h profile of androgenemia related to the androgens of both the ovarian and adrenal origin in obese women with menstrual disturbances. METHODS: The association of body mass and body fat distribution with circadian variations of selected androgens of ovarian and adrenal origin was examined in 16 obese women with menstrual disturbances (BMI between 38 and 51 kg/m2; WHR between 0.80 and 0.

[Contemporary methods of treatment of morbid obesity].

Surgical treatment of morbid obesity appears to be more cost-effective than medical treatment. Moreover many medical treatments fail in the long term especially in cases with BMI > 40 kg/m2. That's why surgical treatment was introduced.

[A case of ectopic breast tissue located in the axilla].

Authors have presented a very rare case of young woman favourable surgically treated for morphologically correct breast tissue in the unilateral axilla. They have paid the peculiar attention to possibility of ectopically placed breast tissue malignancy of every that case.

Assessment of the relationship between collagen metabolism and selected hormonal factors in extremely obese women before and after jejunoileostomy.

The majority of obese persons have hyperinsulinemia and disturbances in the secretion of melatonin, catecholamines and pituitary, thyroid, adrenal and gonadal hormones. These hormones play an important role in the regulation of collagen metabolism either by acting directly or by influencing IGF-I production. This study aimed at ascertaining whether, and to what degree, the changes in the concentration of hormones listed above as well as in the concentration of sex hormone-binding globulin (SHBG) and insulin-like growth factor-I (IGF-I) affect the metabolism of collagen as evaluated indirectly from the measurement of propeptides of type I (PICP) and type III procollagen (PIIINP) in blood serum and hydroxyproline in urine.

[The role of Shouldice's operation in treating inguinal hernia].

Clinical estimation of Shouldice procedure in the surgical treatment of inguinal hernia was performed in the group of 95 patients (102 operations) treated in the Second Department of General and Vascular Surgery Clinic at Zabrze between 1994 and 1996. Their ages ranged from 18 to 78 years with an average 53.6.

[Causes of peri-operative mortality in patients with esophageal cancer treated surgically (personal material)].

99 surgical procedures of thoracic part of esophagus resections were performed between 1985 and 1995. All thoracotomies were right-sided and alimentary canal continuity were substituted with a stomach (or with a small intestine or a colon in only a few cases) transposed inside a thorax cavity. Almost all cases there were planoepitheliale cancers.

Assessment of relationship between hypothalamo-pituitary dysfunction and peripheral endocrine function in normotensive and hypertensive obese men.

The relationship between hypothalamo-pituitary function and various hormonal factors (insulin, cortisol, thyroid hormones, sex steroid hormones, SHBG, IGF-I) was investigated in 34 obese men (16 normotensive and 18 hypertensive) and 15 healthy male volunteers aged 35 to 50 years. Hyperinsulinaemia in obese men was associated with altered hypothalamo-pituitary function as indicated by impaired GH, PRL and cortisol secretion in response to insulin induced hypoglycaemia. On the other hand, hyperinsulinaemia and disorders in GH, PRL and cortisol release were associated with lower levels of reverse triiodothyronine, gonadotropins, testosterone, 17-corticoids and SHBG and higher levels of triiodothyronine, estradiol, 17-hydroxycorticoids and IGF-I.

Association of body mass and body fat distribution with serum melatonin levels in obese women either non-operated or after jejunoileostomy.

The association of body mass index (BMI) and body fat distribution (as measured by waist-to-hip circumference ratio; WHR) with serum melatonin (MEL) levels determined at 02 and 14 h were examined in 22 non-operated obese women and 21 obese women who underwent jejunoileostomy for morbid obesity 2 to 6 years earlier as well as in 20 gender and age-matched healthy controls with normal body weight. All non-operated obese women either with moderate or morbid obesity had significantly higher MEL concentration at 14 h compared with controls, whereas the amount of MEL secreted at 02 h was elevated only in morbidly obese women. The mean differences between serum MEL levels at 14 h and 02 h (delta MEL) was reduced in morbidly obese women - it may be due to desynchronisation of its circadian rhythmicity.

Effect operative weight reduction on Hypothalamo-Pituitary, -adrenal and -ovarian axes function in obese women with menstrual disturbances.

The aim of the study was to evaluate insulin (Ins), pituitary hormones (GH, PRL, LH, FSH), sex hormone-binding globulin (SHBG) and insulin-like growth factor-I (IGF-I) under basal conditions as well as the changes in GH, PRL and F levels after insulin-induced hypoglycemia in 21 obese women before and one year after jejunoileostomy as well as in 20 healthy female volunteers with normal body weight (aged 27 to 36 years). Before surgery all obese women had irregular menstrual cycles. In 14/21 non-operated morbidly obese women and after operative weight reduction (jejunoileostomy), the GH, PRL and F response to insulin-induced hypoglycemia was lower than that in non-obese healthy controls.