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Jacek Waligóra and Bartłomiej Noszczyk

Proliferation and Ability for Epidermal Autoregeneration in Patients with Chronic Lower Leg Venous Ulcerations

The protein p63 plays a significant role in the development of animal epithelium. p63 is a regulator of differentiation, senescence and adhesion programs in numerous mature epithelial tissues. In patients with a healthy epidermis, p63 maintains cell progenitor potential — the ability for cellular division to occur using the delayed differentiation program. It is also responsible for the protecting the epithelial phenotype from depletion in migrating cells, thus resulting in invasion and infiltration after altering its endogenous expression.

The aim of the study was to compare the number of cells with p63 protein expression and the presence of Ki67 proliferation marker in the epidermis in patients with chronic venous ulcerations versus those with properly healing wounds.

Material and methods. Study materials were comprised of biopsy samples collected from healthy volunteers and patients treated for venous ulcerations. The specimens were subjected to immunohistochemical staining using available monoclonal antibodies and were analyzed with an imaging analysis program which evaluated the expression indices of both proteins in areas of intensified cellular division, i.e. wound edges.

Results. The number of cells displaying protein expression in patients with chronic venous ulcerations was significantly lower in comparison to the values observed in healthy volunteers. This was determined during the intermediary phase of wound healing, the most pronounced phase of cellular response to injury.

Conclusions. Decreased epidermal p63 expression in patients with venous ulcerations suggests insufficient protein production for the maintenance of autoregeneration and long-lasting division; both are required for the supplementation of migrating cells. The above-mentioned phenomenon suggests that there may be a role for p63 in regulation of the healing process and pathophysiology of chronic venous leg ulcerations.

Open access

Maciej Kielar, Maria Noszczyk, Jacek Waligóra, Andrzej Lewczuk and Wojciech Tur

Evaluation of Telangiectasia Treatment Results Using an Electro-Optical Synergy Method

ELOS technology uses a simultaneous activity of a semi-conductor laser light and bipolar current of high radiofrequency (RF). The laser energy is absorbed by hemoglobin in the dilated vessels through a selective photothermolysis. Energy of the radiofrequency current, conducted through the skin, heats the vessel up until it reaches the temperature which destroys it. This technology is the basis of safe and effective ablation of small vascular lesions up to 4 mm in diameter.

The aim of the study was evaluation of treatment results with application of a combined percutaneous technique using synergistic RF frequency activity and a diode laser.

Material and methods. One -hundred and fifty women ages 23 to 68 years (mean=41.1) qualified for the treatment. None of the patients had a history of deep venous insufficiency. Electro-optical synergy (ELOS) technology was used as a treatment approach. The time for the procedure ranged from 10 to 30 minutes (average=18 min.). Treatment results were evaluated after 30 days using both a four-point medical evaluation scale and a four-point subjective assessment-of-satisfaction scale. The degree of pain accompanying the procedure was also determined.

Results. In a medical evaluation, after all procedures were complete, 102 very good results were obtained (68%) and we did not succeed in 48 cases (32%). In a subjective evaluation, 120 (80%) very good or good and 25 (16.6%) unsatisfactory assessments were obtained. The results of the treatment were assessed as satisfactory by 5 patients (3.4%).

Conclusions. 1. The ELOS technique is an efficient and safe method of telangiectasia treatment. 2, The ELOS technique gives a high percentage of good and very good treatment results, both in medical evaluations and patients' subjective assessments.

Open access

Maciej Kielar, Katarzyna Raczek-Pakuła, Jacek Waligóra, Andrzej Lewczuk, Witold Woźniak and Izabela Taranta

Low Invasive Treatment of Breast Abscess in Lactating Women

The aim of the study was to present our own results of low-invasive treatment of breast abscess in lactating women.

Material and methods. 72 lactating women with severe mastitis were treated. In 22 cases abscess formations were observed, accompanied by local pain, tenderness, breast asymmetry and skin reddening. Ultrasonographic examinations confirmed the presence of typical image of an abscess, from 3.3 to 8.2 cm in diameter.

The proposed procedure consisted in abscess aspiration biopsy guided by ultrasonography. A soft 1.5mm latex catheter was inserted into the abscess, and antiseptic lavage was made to evacuate puss. Medical control was performed on the second, fourth and seventh days after the procedure. The drain was usually removed after four or seven days.

Results. In 21 cases the abscesses were healed without complications. During the treatment women fed their babies with the breast under treatment. No milk retention was noted, and there were no problems with breast-feeding.

All the women highly appreciated aesthetic effect of the treatment - three months later no visible scars or breast deformations were noted.

This treatment failed in one case, then we had to perform more aggressive surgical treatment: an incision and drainage performed under general anesthesia with farmacological suppression of lactation.

Conclusions. 1. Low invasive treatment of breast abscess in lactating women can lead to successful treatment without drug-induced blockade of lactation. 2. The results of treatment and visual effects are very good. 3. This method are comfortable for the patients, the suckling babies (there no significant problems during twelve days cure), and can reduce the cost of treatment