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Open access

Michał Stanisławski, Leszek Gruszecki and Jacek Pawlak

Case of A 46-Year-Old Woman With Cecum Adenocarcinoma Metastasis to The Right Pectoralis Major Muscle and Skin

The authors present the case of a 46-year-old patient with colon adenocarcinoma and metastases to the right pectoralis major muscle and to the skin. We present the diagnostics and therapy performed on the patient, who was hospitalized from July to October 2006.

Open access

Michał Stanisławski, Stanisław Fabisiewicz and Jacek Pawlak

Use of Modified Animal Collagen Implant (Permacol) for Plastic Surgery of Recurrent Parastomal Hernia

The authors present the usage of new on the Polish market reconstructive material (Permacol) used for plastic surgery of recurrent parastomal hernia. Material and methodology presented below seem to be a valuable alternative for currently recognized methods used in the treatment of parastomal hernias. European and American experience confirms that further studies in Polish centers should be conducted.

Open access

Cezary Rykała, Jacek Bartosiewicz, Jacek Pawlak, Agnieszka Nawrocka-Kunecka and Aleksandra Omulecka

Abstract

Most patients with obstructive jaundice caused by an etiology other than choledocholithiasis are at risk of adenocarcinoma development. Other types of tumors are less common, although more benign. The presented study described management in case of liver hilar tumors with special regards to common hepatic duct carcinoids

Open access

Katarzyna Grygiel, Jacek Szmidt, Magdalena Jeleńska and Katarzyna Pawlak

Surgical Treatment of Hyperinsulinism During the Course of Pancreatic Cancer (Insulinoma) - One Center Experience

Endogenic hyperinsulinism is mainly caused by neuroendocrine tumors (insulinomas) which autonomously secrete insulin. Because the symptoms are often aspecific, a considerably delay in diagnosis occurs. The treatment consists of operative removal of the tumor from the pancreas, preceded by pre-operative localization. In this article we describe our experience with surgical removal of insulinomas

Material and methods. We retrospectively analyzed all patients with insulinoma which were treated in our center. Definitive diagnosis was made using a 72-hours glucoses fasting test. We describe the symptoms, localization techniques and the outcomes after surgery.

Results. Between January 2002 and May 2011, 45 patients (35.6% men and 64.4% female) were treated in our center. The most prevalent symptoms were altered consciousness and general malaise. The combination of CT-scan and endoscopic ultrasound had the highest (90%) sensitivity to localize tumors pre-operatively. During surgery, in 40 patients (89%) the tumor could be removed by enucleation. In the other five patients partial pancreas resection was required. In 22 patients (49%) we used intra-operative insulin level measurements to confirm complete tumor resection. Within the first month after surgery, two patients (4.4%) developed acute pancreatitis, four patients (8.8%) developed a pancreatic fistula. One patient died of multi-organ-failure. All patients were free from symptoms of hyperinsulinism after the surgery and after a median follow-up of 4.5 years.

Conclusions. Based on the experience with 45 patients, surgical removal, aided by pre-operative localization with CT and endoscopic ultrasonography, is an effective and safe treatment for insulinomas.

Open access

Monika Romanowska, Tomasz Okniński and Jacek Pawlak

Open access

Tomasz Goryń, Monika Meszka and Jacek Pawlak

Abstract

The study presented two cases of synchronous occurrence of colon and appendiceal adenocarcinoma. Both patients required surgical intervention, due to acute peritonitis during the course of acute appendicitis. In case of one patient we performed abdominal CT confirming the presence of sigmoid cancer. The patient was subjected to appendectomy and Hartmann’s operation. The second patient underwent an appendectomy, and colonoscopy performed two months later revealed the presence of rectal adenocarcinoma. The patient was subjected to low anterior rectal resection. The histopathological results considering both patients revealed the presence of synchronous colon and appendiceal adenocarcinoma.

Open access

Tomasz Goryń, Cezary Rykała and Jacek Pawlak

Open access

Jacek Pawlak, Marcin Błaszczyk, Helena Hercman and Šárka Matoušková

Abstract

Recent research shows that the last interglacial climate was more unstable in comparison to Holocene. Lack of suitable dating techniques and precisely defined absolute age benchmarks is one from main problems for present LIG studies. Therefore many of LIG chronologies base on indirect dating techniques like record alignment strategies. In this context, speleothems are valuable paleoclimate archives because of their capability to be dated by U-series method. In Europe LIG speleothem records are known mostly from western and central part of the continent. In this paper we present a 1,650 mm long stalagmite (ocz-6) from Bulgarian Cave Orlova Chuka. The ocz-6 stalagmite records the period of time ca. 129–112 ka. Ocz-6 stalagmite was analyzed in terms of stable isotopic composition of calcite and trace elements content. All analyzed geochemical proxies point to dynamic changes in the environment during the Last Interglacial time. At the time of interglacial development (129–126.5 ka), ocz-6 records shows systematic change in proportion of moisture delivered from Atlantic source and other sources. The beginning of last interglacial optimum is connected with a rapid change to more humid and warm conditions. During interglacial demise local climate become more dependent from regional settings.

Open access

Halina Pawlak-Kruczek, Michał Ostrycharczyk, Marcin Baranowski, Michał Czerep and Jacek Zgóra

The aim of the paper is a comparative study of co-firing high shares of wooden and agro-biomass with hard coal under oxy-fuel and air conditions in the laboratory scale reactor for pulverised fuels. The investigations of co-combustion behaviour NOx and SO2 emission and burnout were carried out for selected blends. Detailed investigations were concentrated on determining the effect of dosing oxygen method into the burner on NOx emission. The paper presents the results of co-firing blends with 20 and 50% share of biomass by mass in air and oxy-combustion condition. Biomass oxy-cofiring integrated with CCS (CO2 capture) technology could be a carbon negative technology. The reduction of NOx emissions in the conditions of oxy-co-firing is dependent on the concentration of oxygen in the primary stream of oxidiser. A significant reduction of NOx was achieved in the case of low oxygen concentration in the primary stream for each investigated blends. Co-firing of biomass with coal in an oxygen enriched atmosphere enhances combustion behaviour, lowers fuel burnout and as a result increases of the boiler efficiency.

Open access

Jakub Kulesza, Monika Meszka, Cezary Rykała and Jacek Pawlak

Abstract

The paper presents a rare case of a patient with adenocarcinoma of the small intestine who reported to the hospital due to non-specific gastrointestinal symptoms. Following diagnostic examinations, the patient underwent a surgery. The post-operative period proceeded with no complications. The case presented below confirms the usefulness of imaging examinations (abdominal CT) when pathologies within the small intestine are suspected. An accurate interpretation of the result was an indication for a surgical intervention, but the final diagnosis is still established on the basis of the histopathological examination