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Background: during food provocation the mast cell degranulates causing the elevation of serum tryptase., Aim of Study: the aim of our work was to estimate if tryptase level is the efficient diagnostic marker in case of IgE dependent food allergy in children., Material and Methods: the studied group (group I) consisted of 100 children (age 3-5 yrs) with IgE dependent food allergy confirmed by positive case history and allergy tests. The children presented an allergic reaction to one of the 3 most common food allergens - milk, egg and wheat flour proteins. Control group (group II) consisted of 31 healthy children. The open food provocation was performed only in the group I. Tryptase level was estimated before and 120 minutes after the food provocation. The FluoroEnzymeImmunoAssay method (FEIA) was used to assess the tryptase levels., Results: baseline level of the tryptase in group I was significantly higher in comparison with group II. There was no significant difference between baseline level of the tryptase and level after the provocation. The decrease of the level of the tryptase after challenge was observed in 54% patients in group I. The increase of the tryptase level after the provocation was observed in 45% patients and in 1% patients the level of the tryptase was unchanged., Conclusions: 1. tryptase levels are not an effective marker in diagnostic of IgE dependent food allergy in children with allergic reaction to one or more food allergens, 2. patients with IgE dependent food allergy may have elevated level of tryptase with no clinical manifestation.

Introduction: Valsalva sinus aneurysms and fistulas (ASV; FSV) are rare aortic pathologies and present in only a few percent of patients with aorta and/or left arterial orifice disease. Etiology of ASV and FVS is congenital and acquired., Materials and Methods: 40 patients (pts) were operated on in the Department of Cardiovascular Surgery and Transplantology from 1978 to 2002 due to pathology of Valsalva sinus (< 1% of all operations in ECC). 18 pts were diagnosed with Valsalva sinus aneurysm and 22 with its fistula. Inflammatory etiology was confirmed in 22 pts (5%). Most common pathology was localized in the right and/or coronary lacking Valsalva sinus (30 pts-75%). FSV penetrated into the right atrium or ventricle in 20 pts (91%). Among accompanying pathologies aortic valve insufficiency was most frequently found. In 80% of pts with ASV aortic allografts were implanted. In 70% of pts with FSV, fistula was sutured with interrupted pledgeted mattress sutures. Accompanying anomalies were corrected simultaneously. Mechanical aortic valve was implanted in 9 pts., Results: 2 pts died in the early post-operative period and 3 in the follow up. Reoperation (with good results) was performed in 4 pts. At discharge all pts were in NYHA I/II except 1 pt in NYHA III. Objective estimation of patient's cardiopulmonary sufficiency did not differ from the subjective one. 24 pts performed normal life activities after operation. The echocardiography confirmed effectiveness of surgical treatment., Conclusion: 1. ASV and FSV require different surgical techniques. 2. Surgical treatment efficiently reduced symptoms. 3. Allografts were found very useful. 4. Accompanied anomalies should be treated simultaneously.

Introduction: In our department left ventricular aneurysmectomy was performed using only classic Cooley technique until 1989. Since then a modified technique was introduced: left ventricular geometry reconstruction modo Stoney simultaneously with the excision of scarred endocardium., Aim: Comparison of early clinical results after left ventricular aneurysmectomy using classic (Group A) and modified technique (Group B)., Material and Methods: Retrospective data analysis of early clinical outcome of patients (pts) operated from 1989 to 2000: classic technique 74 pts [63M (85.1%); 11F (14.9%); average age 52.26 +/- 10.35 years], modified technique 86 pts [74M (86%); 12F (14%); average age 55.83 +/- 9.3]., Results: No statistically significant differences between groups considering number of critically stenosed coronary arteries, left ventricular ejection fraction and left ventricular diameters were observed. Mean number of bypass grafts (gr. A 1.55, gr. B 1.69); aortic crossclamping time (gr. A 48.1 (24-77) +/- 12.9; gr. B 50.9 (0-91) +/- 16.1) were not significantly different between groups. In gr. A, 11 (14.8%) pts died: low output syndrome (LOS) 3 pts, LOS and ventricular dysrhythmias (VD) 5 pts, VD 3 pts. In gr. B 4 (4.6%) pts died: LOS 3 pts; LOS and VD 1 pt. Among other complications LOS and VD occurred significantly more frequently in gr. A. In both groups average postoperative ejection fraction increased; twice higher in gr. B than A., Conclusions: Modified technique: 1. Significantly decreases incidence of ventricular dysrhythmias in comparison to classic technique. 2. Significantly lowers incidence of low output syndrome and mortality rates in comparison to classic technique.

Between January 1991 and September 1997, in the Cardiovascular Surgery Department of the Institute of Cardiology of Jagiellonian University Medical School, 23 patients underwent emergency CABG due to acute myocardial ischaemia in result of failed PTCA. Over the same period of time invasive cardiologists performed 1883 PTCAs out of which 23 (1.2%) were emergency cardiosurgical procedures, and in 38 patients, stents were implanted in the damaged coronary arteries. The patients' age ranged from 37 to 67 years (median 52.2). In all patients good left ventricular function was preserved, median ejection fraction being 64%. Two patients required IABP to support left ventricular function. 1-4 bypass grafts were implanted (median 1.9 per patient). In one patient, internal mammary artery was collected and then implanted into anterior interventricular branch. The most common complication was myocardial infarction which occurred in 12 patients (52%). In ten patients low output was observed postoperatively. One operated patient (a female died (4.3%). The mean time of hospitalization was 11 days. Emergency myocardial revascularisation procedures performed after failed PTCA, bring higher risk of mortality and dangerous postoperative complications.

Studies were carried out on the evaluation of the condition of minerals in cows of a herd with reduced fertility, including 7 head of primiparae and 7 head of multiparae, in the period of interpregnancy. On the basis of analyses of fodder, blood serum and hair mineral disproportions were found which were manifested by excess calcium and deficiency of copper and phosphorus in the organism of the cows. This could be the reason of decreased fertility indices of the herd studied.