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Introduction: The early results of treatment of gallbladder cancer have not been improved for many years. Satisfying results can only be achieved in the very early stage of the disease. Therefore the search for the factors allowing early diagnosis is still in progress. One of those seem to be gallbladder polyps. Only some of them are adenomas and cancers. Performing cholecystectomy in every patient with polyp can lead to serious complications even if the surgery is performed with the laparoscopic technique. That is why it is vital to indicate the group of patients in which the risk of malignant transformation is justified. Aim of study: The aim of the paper was creating the algorithms of patients with gallbladder polyps. Material and methods: There were 77 patients with gallbladder polyps among the group of 8373 patients who underwent laparoscopic cholecystectomy. Gallbladder cancer was diagnosed in 41 cases. All the groups were analyzed with regards to age, sex, size of polyps and histopathological diagnosis. Results: All polyps were small with 6 mm size in diameter (standard deviation -SD=3.2). Histopathology did not reveal either the presence of cancer or adenoma in any of the gallbladders. Cholesterol and inflammatory polyps were the most commonly found. In 70 patients (90%) among 77 with polyps the only complaint was some pain in the right subcostal region. The mean age in the polyp group was 51.2 years (SD=12.8); 53.7 years (SD=13.9) in the group of stone cholecystitis and 67 years (SD=12.6) in the group with gallbladder cancer. The patients from the last mentioned group were older than all the rest of the patients (p=0.001). Other groups did not differ statistically by a significant amount. The group of 77 patients with polyps consisted of 40 women (52%) and 37 men (48%). There were 35 female (85.4%) and 6 male (14.6%) patients in the group of 41 cases with cancer and 6632 female (80.3%) and 1623 male (19.7%) patients in the group with stone cholecystitis. In the group of patients with polyps the percentage of men was higher than in any other group (p=0.01). Conclusions: The patients over 60 years of age with single polyps greater than 10 mm in diameter should be operated. Additional indications are abdominal pain and the suspicion of adenoma or cancer on ultrasound examination. Small polyps measuring less than 10 mm in diameter can be monitored with the ultrasound every 6 months. Cholesterol polyps did not show to be precursors of gallbladder stones, but the group of patients with these diseases presents multiple similarities, which require further research. [ABSTRACT FROM AUTHOR]

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Background. Atherosclerotic lower limb ischemia is the most important cause of intermittent claudication. Patients with intermittent claudication are at relatively low risk of limb loss. Therefore the predominant therapeutic approach in this group of patients is conservative treatment. The objective of this study was a comparison of bencyclane versus pentoxifilline effects on the clinical picture (pain free walking distance and maximum walking distance) and selected parameters of oxidative stress including blood level of nitric oxide (NO) and total antioxidant status of the plasma in patients with chronic lower limb ischaemia (Fontaine lib). Material and methods. Adult patients (60 subjects) with claudication distance shorter than 200 m (Fontaine IIb) were divided into three groups: I. 20 patients administered bencyclane 200 mg i.v for 7 days followed by 2 x 200 mg orally for 21 days; II. 20 patients administered pentoxifilline 300 mg i.v. for 7 days followed by 2 x 600 mg orally for 21 days; III. 20 patients administered placebo i.v. for 7 days fallowed by 2 x 1 tablet orally for 21 days In all patients walking distance until first pain, maximum walking distance and ankle brachial index (ABI) were measured. In all patients blood samples were taken on days 0, 7, 14 and 28 of the treatment and blood levels of nitric oxide (NO) and plasma total ontioxidant status (TAS) were measured. Results. Statistically significant increase in pain-free waling distance i.e. 127 ± 37.95 m in patients administered bencyclane (p < 0.001) and 125.29 ± 41.10 m in patients administered pentoxifilline (p < 0.001) was observed Total antioxidant status (TAS) of the plasma and blood levels of nitric oxide also increased in patients treated with bencyclane and pentoxifilline (p < 0.05) Conclusions. The administration of bencyclane and pentoxifilline is an effective therapeutic approach for patients with Fontaine II b chronic limb ischaemia No significant differences were found in efficacy of the two active treatments in the study. [ABSTRACT FROM AUTHOR]

Copyright of Acta Angiologica is the property of VM Medica-VM Group (Via Medica) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background. More and more data indicate that the increase of production of free radicals by the endothelium with simultaneously decreasing synthesis and/or increasing nitric oxide (NO) degradation is the basis of changes in atheromatous vessel structure and reactivity. It is suggested that the administration of L-arginine to patients with NO deficiency is the rational method both of increasing NO production by the endothelium and decreasing the free radical release. In the last year it has been proven that this therapeutic procedure could be successful in portents with atherosclerotic ischaemia of lower extremities. The aim of this study was the estimation of the influence of 28 day L-arginine oral supplementation on intermittent claudication in patients with peripheral arterial occlusive disease. Material and methods. The authors studied 48 patients (25 men/23 women) with peripheral arterial disease -- Fontaine II. They were randomly divided into two groups: group 1 - 24 patients receiving L-arginine 3 x 4 g/day and group II - 24 patients receiving placebo 3 x 4 g/day. During the study patients were under strict clinical observation, the aim of which was to evaluate drug tolerance and to observe possible adverse effects of L-arginine used in therapy. During the study at 0 h, after 3 h, and on the 7th, 14th, and 28th days subjective and objective examinations were conducted with evaluation of pain-free distance and total walking distance. Results. After L-arginine treatment clinical improvement was observed in all patients, such as elongation of pain free walking distance (from 80 m at the beginning to 438 m at the end) and total walking distance (from 158 m to 687 m), while there was no clinical improvement in patients with placebo. Conclusions, In patients with peripheral arterial occlusive disease Fontaine stage II oral supplementation of L-arginine results in elongation of pain free and total walking distance. [ABSTRACT FROM AUTHOR]

Open repair of thoracoabdominal aortic aneurysm is connected with high mortality and morbidity. On the other hand, endovascular treatment of thoraco-abdominal aneurysms, which started 10 years ago, reduced perioperative mortality and morbidity. However, it results in a high level of late complications. It seems that an interesting solution to the problem is a hybrid procedure, which allows late complications to be reduced with acceptable levels of operative mortality and morbidity. This case report presents the use of a hybrid procedure in treatment of symptomatic thoraco-abdominal aneurysm in a patient with prior abdominal aortic reconstruction. In the first stage the patient underwent open revascularization of visceral vessels of the aorta. One week later a thoraco-abdominal stent-graft was implanted. The perioperative and postoperative period was uncomplicated. Two months after the second intervention the patient returned to work. Control imaging conducted 30 and 90 days after the procedure confirmed patency of all revascularized vessels and did not reveal any graft-related complications. The hybrid procedure seems to be an interesting alternative for open and endovascular repair of thoraco-abdominal aneurysms because it combines the advantages of open and endovascular repair. It also gives an opportunity to perform the procedure within a reasonable period of time from diagnosis of symptomatic thoraco-abdominal aneurysm.

In a 37 year-old woman with Takayasu's arteriopathy angiography revealed occlusion of right coronary artery (RCA), brachiocephalic trunk and left carotid artery (LCA), as well as aortic regurgitation. She underwent a complex cardiovascular surgery consisting of aortic valve implantation, RCA grafting and implantation of vascular bifurcated graft anastomosed between ascending aorta and brachiocephalic trunk and LCA. The multi-slice computed tomography performed two weeks after the operation revealed preserved grafts patency.