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Comparative analysis was done between a group of 193 patients operated on for mechanical bowel obstruction at the end of the XIX century (prof. A Obalifiński's clinical material), and a group of 207 patients with the same condition operated on between 1.01.1999 - 31.12.2003 (own clinical material). Both groups were operated on at the same surgical institution. A hundred years ago, and at present mechanical bowel obstruction has been appearing (depending on a patient's sex), in the 1:1 relationship. In both analysed periods two third of the patients developed small bowel obstruction, and one third large bowel obstruction. At the end of the XIX century mean age of the operated patient was 41 years. It was equal to the mean survival time span for the general population at that time. The patients operated on at present were about 25 years older. However their mean age is significantly lower compared with the actual mean survival time span for the general population observed now in Poland. In small bowel the main cause of obstruction has still been an incarcerated abdominal hernia (increase from 30.7% up to 55%), followed by intraperitoneal adhesions (increase from 29.5% up to 34.5%). However their etiology has changed, recently all of them are postoperative adhesions. At the end of the XX century we observed significant drop (from 16.8% to 2.7%) in strangulation of the small bowel mesentery as a cause of obstruction. In case of large bowel during the last century there was a definitive change in frequency of different etiological factors causing obstruction. In the XIX century 72% of them was caused by mesentery strangulation of sigma or cecum. whereas at present over 80% of them is caused by cancer. We presented Prof. A. Obaliński's and his associates scientific output, as they were genuine precursors of mechanical bowel obstruction surgery in Poland.

From 1.07.1994 to 30.06.2001 in the 2-nd Department of Surgery and Department of Nephrology Collegium Medicum Jagiellonian University, in 274 patients with terminal renal failure 341 vascular access for hemo-dialysis have been performed. Acute insufficiency in functioning arteriovenous fistulas occurred in 93 patients. In six of them, an attempt of thrombectomy was done. In 56 patients (group I) we carried out the new fistula on the same vascular level. In the remaining 31 cases (group II) we were forced to perform the procedure at a higher level. To compare late results in both groups of patients the method of Life Table Analysis was used. Cummulated index of patency (Pk) in the time interval 10-12 months in two groups was 0.67. In the time interval 49-54 month in group I, Pk dropped to 0.38, in group II was 0.57. The study we carried out indicates that creation of vascular access on arterialized vessels, being profitable in many aspects, does not provide such long efficient functioning as those created on the new, higher level.

Presented is a case of pheochromocytoma with an ectopic or extrarenal localisation in a 47 year old female farmer. The patient was admitted to the 1st Chair and Clinic of Internal Disease, Jagiellonian University Collegium Medicum due to a three year history of hypertension. The bouts of hypertension were characterised by sudden increases of blood pressure to 250/150 mmHg, which occurred after physical exertion but particularly during the night. On physical examination no abnormalities were detected. Laboratory analysis revealed no changes apart from mild hyperglycemia. 24 hour vanillymandelic acid excretion was normal on two successive accounts, but on a third analysis was raised. Fundus examination revealed bilateral hypertensive and diabetic angiopathy. Abdominal ultrasound revealed a tumor in the region of the pancreas with an echogenicity similar to that of the liver. Abdominal CT scan revealed normal suprarenal glands bilaterally. A smooth walled tumor of 55 mm diameter was visualized below the head of the pancreas. Its structure was not uniform with degenerating features. The tumor adhered to the descending and transverse part of duodenum, compressing the vena cava inferior and was in close proximity to the abdominal aorta. After surgical consultation the patient was transferred to the II Clinic of General Surgery Jagiellonian University Collegium Medicum where after pretreatment with alpha and beta blockers, ACE inhibitors, diuretics and Insulin CHOS the patient underwent surgery. Posterior to the duodenum, inferior to the head of the pancreas, between the aorta and vena cava inferior was a polycystic tumor of 80 mm diameter, which was evacuated in its entirety. Histopathology revealed a paraganglioma with an appearance of pheochromocytoma. On a three month follow up visit the patient was without symptoms. Her blood pressure and glycemia were normal despite being without treatment.