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Mariusz Wojewoda


Awareness of mortality is one of the key aspects of human existence. Death goes beyond the boundary of knowledge, mortality. However, it is actually experienced by man as something inevitable. Death is a fact – the end of life, and the experience of mortality is one of the borderline situations. In the essay, the author puts forward the thesis that the experience of mortality has a significant impact on the human understanding of values. Attitudes towards death be it fear, resignation, indifference, fascination, mourning, sadness, despair after the loss of a loved one, or the desire for death, indicate the wealth of the world of value of axiological experience. The attitude of the person towards death, in some sense, is a test of our humanity, the principal value to which we refer most often. The author of the essay adopts the position of axiological relationalism (or axiological structurism), it implies that values are independent of the subject, they form a network of relational connections, but they are in a significant way connected with culture. The study of these connections: 1) with the world of people, 2) world of things, 3) internal relations that take place between values, allows us to get to know the complex structure of the world of values. In the article, the author analyzes in what sense mortality influences human understanding of values.

Open access

Sławomir Rudzki, Mariusz Matuszek, Andrzej Nowakowski, Beata Matuszek, Przemysław Matras and Katarzyna Wojewoda

Own Experience in Treatment of Autoimmune Goiter in the Last Decade

The aim of the study. The study was intended to be a retrospective analysis of clinical data concerning patients operated on for autoimmune goitre in the period 1998-2008, in the 1st Department of General and Transplant Surgery of the Medical University in Lublin.

Material and methods. 1157 patients were operated on for various goitre forms. This group included 134 patients with Graves' and Hashimoto's disease associated goitre, which accounted for 11% of all goitre patients undergoing the surgery. Major indications to surgical treatment of the Graves' disease included progressive exophthalmos, goitre with compression symptoms, hoarseness, and uncertain biopsy diagnoses. As regards Hashimoto's disease, goitre with compression symptoms or with tumour-like changes, and ambiguous biopsy diagnoses were the factors qualifying the patient for surgical treatment. Statistical analysis was conducted using STATISTICA 6.0 PL software, the chi2 test was performed, and the statistical significance was established at p<0.005.

Results. Graves' disease associated goitre was operated on in 72 patients, including 53 cases (39.5%) where infiltrative ophthalmopathy was also observed. Hashimoto's disease associated goitre was operated on in 62 patients. Early paralysis of the recurrent laryngeal nerve occurred in 10 (13.9%) patients operated on for Graves' disease, and in 5 (8.1%) patients operated on for Hashimoto's disease. As regards patients operated on for non-autoimmune goitre, early paralysis of the recurrent laryngeal nerve was observed in 29 (3%) cases. Post-surgical tetany was observed in 11.1% of Graves' disease patients, and in 8% of Hashimoto's disease patients. Finally, temporary post-surgical tetany was found in 2% of patients with non-autoimmune goitre.

Conclusions. The type of goitre being operated on has a significant impact on the incidence of early post-surgical complications. In general, the incidence of early post-surgical complications is higher in the case of patients operated on for autoimmune-type goitre, compared with patients with non-autoimmune goitre. Yet this method is both safe and efficient. Total thyroid removal should be the treatment applied in the case of progressive orbitopathy associated with Graves' disease.