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This paper discusses the failure of the over-chamber reinforced concrete ceiling of a cylindrical silo for storing extracted rapeseed meal. The failure resulted from the caving in of an arch formed in the chamber and the sliding down of the material column. Some factors contributing to the caking and arching of the cohesive materials stored in silos are identified. An analysis of the extraordinary loads during the autogenous or induced clearance of arches is made. Such loads are not taken into account by design standards. Attention was paid to the necessity of figuring these loads in the design (an own proposition was put forward); also, ways of preventing such impact or its limitation were pointed out. The direct cause and the indirect causes of the failure are determined. Design and utilization errors which contributed to the formation of the arch, the failure of the ceiling of silo and the compounding of the failure consequences are identified.

It is widely known that lateral-torsional buckling of a member under bending and warping restraints of its cross-sections in the steel structures are crucial for estimation of their safety and durability. Although engineering codes for steel and aluminum structures support the designer with the additional analytical expressions depending even on the boundary conditions and internal forces diagrams, one may apply alternatively the traditional Finite Element or Finite Difference Methods (FEM, FDM) to determine the so-called critical moment representing this phenomenon. The principal purpose of this work is to compare three different ways of determination of critical moment, also in the context of structural sensitivity analysis with respect to the structural element length. Sensitivity gradients are determined by the use of both analytical and the central finite difference scheme here and contrasted also for analytical, FEM as well as FDM approaches. Computational study is provided for the entire family of the steel I- and H - beams available for the practitioners in this area, and is a basis for further stochastic reliability analysis as well as durability prediction including possible corrosion progress.

Introduction: Colorectal cancer (CRC) is the most common cancer among patients, and its aetiology is still not precisely known. It is believed that 15–30% of colorectal cancers are genetically determined. P-glycoprotein (P-gp) encoded by the MDR1 gene in normal conditions plays an important role in the action of colon epithelial cells. However, the MDR1 polymorphism influences the P-gp expression and can weaken its effect against xenobiotics (procarcinogens) and increase the frequency of CRC. Aim: To evaluate the correlation between the MDR1 C3435T and G2677T/A polymorphisms and the risk of colorectal cancer. Material and methods: The study group with colorectal cancer included 47 women and 60 men while the control group consisted of 110 healthy patients. The diagnosis in patients suffering from CRC was confirmed by histopathological report. Genetic analysis was performed using PCR-RFLP method. Results: We showed only a correlation between the frequency of CT and TT genotypes of C3435T polymorphism and the risk of colorectal cancer in younger age. There was no correlation between the C3435T and G2677T/A polymorphisms of the MDR1 gene and other clinical parameters. Conclusions: Our findings suggest that T allele carriers of C3435T polymorphism have an increased risk of CRC. However, further studies are needed on a much larger number of patients and genes associated with metabolism and transport of xenobiotics including procarcinogens.

BACKGROUND This study analyzes the influence the of kidney donor hemostasis on the risk of complications in the kidney recipient after transplantation. MATERIAL AND METHODS We enrolled 38 deceased kidney donors, of whom 14 donors died from a physical injury and the others died from ischemic or bleeding central nervous system stroke. The donors were categorized into 2 subgroups. If the recipient's postoperative period proceeded smoothly, the kidney donor was assigned to the uncomplicated donors (UD) group. If the recipient's postoperative period was complicated, the donor was assigned to the complicated (CD) Group. The CD group of consisted of 9 donors who died from strokes or bleedings and 2 who died from physical injury. We examined the antithrombin (AT) protein C (PC), complexes of thrombin/antithrombin (TAT), fragments F1+2 of prothrombin (F1+2), plasminogen (Pl), complexes of plasmin/antiplasmin (PAP), and D-dimers (D-d). RESULTS In the CD group had decreased activity of AT, PC, and Pl and increased activity of F1+2, TAT, and D-d. The UD group had a higher level of PAP. The CD group had evidence of intensive blood coagulation, but the UD group had evidence of fibrinolysis. Fisher's exact test revealed an increased risk in recipients who received a kidney from the CD group. CONCLUSIONS The hemostasis of the kidney donors had a correlation with the occurrence of some complications in the kidney recipients, especially complications connected with activation of blood coagulation. It seems that the activation of fibrinolysis could be positive prognostic factor, but this requires further investigations.

In medicine spectacular progress can be observed at many stages, which sometimes requires the redefinition of already known anatomical structures. One of them is the transverse abdominal plane, which was the focus of anaesthetists. It was observed that anaesthetics introduced locally into this plane have similar power to a traditional epidural procedure or spinal anaesthesia. The concept of the transverse abdominal plane is a relatively new anatomical term which was introduced into clinical medicine by anaesthetists. Because of the potential performance of anaesthetic procedures through access to the transverse abdominal plane, there has been a growing interest not only expressed by anaesthetists, but also anatomists who wish to explore new anatomical aspects of this plane. It is generally believed that anatomical studies will provide more information on this plane, which can contribute to a wider spread of this procedure among anaesthetists.

Organ donors can be generally divided into two groups according to the cause of their death. The first group is composed of those who died because of physical injuries, especially road traffic injury, and the second group, those who died from central nervous system (CNS) stroke or bleeding. The aim of our work was to examine hemostatic processes among kidney donors.The 38 deceased kidney donors (KD) included 11 women and 27 men of overall average age of 37±12 years. The donor group of according to the cause of death, included 14 injured donors (ID) (41%) and 24 noninjured donors (ND) donors (59%). The control group consisted of 25 healthy volunteers matched for sex and age. We determined the following concentrations: antithrombin (AT), thrombin/antithrombin complexes (TAT), and prothrombin F1+2 fragments. The fibrinolytic parameter concentrations were: plasminogen (PL), plasmin/antiplasmin complexes (PAP), and D-dimers.Deceased kidney donors showed an increased plasma concentrations of TAT complexes (P.000001) and prothrombin fragments F1+2 (P.0000001); however, the protein C concentration was decreased (P.000001). The antithrombin activity was similar to the control group. The concentrations of PAP complexes and d-dimers were higher (both P.000001), but the level of PL lower among KD compared with controls (P.0000001). The higher of TAT, PAP complexes, d-dimers, and F1+2 concentrations as well and as lower plasminogen and PC concentrations were evidence for increased activation of blood coagulation and fibrinolysis in cadaveric KD. However, analysis compairing ID versus ND donors revealed increased concentrations of PAP complexes (P.05) and decreased amounts of TAT complexes (P.01) among ID subgroup. The positive predictive value (PPV) and negative (NPV) for PAP complexes were 75% and 68% and for TAT, 71% and 57%, respectively. On the basis of these observations, we concluded that an intensive activation of fibrinolytic process occurs among the ID. In contrast, ND show intensive activation of blood coagulation.

Background The etiopathogenesis of lymphoceles remains incompletely understood. The aim of our work was to analyze the perturbations of blood coagulation process for their possible impact on the etiology of lymphoceles. Additionally we performed an evaluation of the incidence and effectiveness of treatment methods for lymphoceles. Materials and methods During 2004 to 2010, we performed 242 kidney transplantations in 92 female and 150 male patients. The hemostatic parameters included concentrations of: antithrombin, plasminogen, thrombin/antithrombin complexes (TAT), prothrombin products F1+2 (F1+2), d-dimers, and plasmin/antiplasmin complexes. Results At 7 years follow-up 27 (11%) recipients had developed symptomatic lymphoceles, namely abdominal discomfort, a palpable mess in the lower abdomen, arterial hypertension, infection of the operative site with fever, lymphorrhoea with surgical wound dehiscence, decreased diurnal urine output with an elevated plasma creatinine, voiding problems of urgency and vesical tenesmus, and/or symptoms of deep vein thrombosis. We applied the following methods of treatment aspiration alone, percutaneous drainage, laparoscopic fenestration or open surgery. In two only patients did perform open surgery. Since 2008 we have not performed an aspiration alone because of high rate of recurrence (almost 100%) and abandoned open surgery in favor of a laparoscopic approach. Our minimally invasive surgery includes percutaneous drainage guided by ultrasound and a laparoscopic procedure with 100% effectiveness. The examined hemostatic parameters revealed decreased concentrations of TAT complexes and F1+2 in subjects with lymphocele showing positive predictive values of 33% and 41% respectively. The negative predictive values for TAT complexes and F1+2 were 14% and 10%, respectively, suggesting decreased blood coagulation activity among effected recipients. Altered blood coagulation processes may explain some aspects of the disturbances of postoperative obliteration of damaged lymphatic vessels and formation of pathological lymph collection afterward. Conclusions Perturbations of blood coagulation may be one cause for a lymphocele.

The paper presents the results of tests, numerical analyses and theoretical analyses of reinforced concrete beams loaded with a torsional moment as well as a shearing force and a bending moment, carried out in the Research Laboratory of the Institute of Building Engineering at Wroclaw University of Technology. The research focused on the load capacity and stiffness of such elements. Beams angular (in the shape of the inverted letter L) and rectangular in cross section were investigated. The tests were carried out in two series. In the first test series the elements were loaded with solely a torsional moment. In the second test series the beams were subjected to the combined load of a torsional moment, a shearing force and a bending moment. The behaviour of the beams with the different cross sectional shapes was compared. The experimental results and the ones yielded by numerical analyses were compared with theoretical and standard results.

Because of the properties of the material (concrete), computer simulations in the field of reinforced concrete structures are pose a challenge. As opposed to steel, concrete when subjected to compression exhibits nonlinearity right from the start. Moreover, it much quicker undergoes degradation under tension. All this poses difficulties for numerical analyses. Parameters needed to correctly model concrete under compound stress are described in this paper. The parameters are illustrated using the Concrete Damaged Plasticity model included in the ABAQUS software.

Objective Autosomal dominant polycystic kidney disease (ADPKD) is characterized by the presence of multiple cysts in both kidneys. Symptoms of the disease may arise either from the presence of cysts or from increasing loss of kidney function. First symptoms usually appear in the third decade of life: lumbar pain, urinary tract infections, arterial hypertension, or renal colic due to cyst rupture or coexistent nephrolithiasis. An early diagnosis, male gender, large kidneys by sonography, arterial hypertension, hematuria, and urinary tract infections are predictive factors of a faster progression of the disease. Our aim was to establish the indications for nephrectomy among symptomatic ADPKD patients before kidney transplantation and to assess the risks of posttransplantation complications among ADPKD patients without nephrectomy. Patients and Methods The observed group consisted of 183 patients with ADPKD among whom 50 (27.3%) underwent kidney transplantation during a 7-year observation period (2000–2007). Among those subjects were 3 groups: (I) nephrectomy preceding transplantation; (II) nephrectomy during kidney transplantation; and (III) without nephrectomy. Results Among group I before transplantation we observed: arterial hemorrhage, wound infections, and splenectomy 4 weeks after ADPKD nephrectomy; afterward we observed: urinary tract infections and contralateral cyst infection. Among group II we only observed 1 case of wound infection. Among group III we observed: ascending urinary tract infections, cyst infections, and cyst hemorrhage. Cyst hemorrhage and cyst infections led mainly to ADPKD kidney nephrectomy. During the observation time, 80.95% of grafts were functioning. Conclusions Unilateral nephrectomy is a well-founded preliminary surgical treatment before kidney transplantation. Bilateral nephrectomy before or during transplantation eliminates ADPKD complications and does not significantly increase general complications. The greatest numbers of complications and of graft losses were observed among the group without pretransplantation nephrectomy.

Introduction Reperfusion is a crucial moment in kidney transplantation, connected with many metabolic changes that are the result of preservation and intraoperative course including ion movements, free radical generation, ATP and other adenylate depletion. During reperfusion we observed increased metabolic acidosis, which may be the result of accumulation of lactic acid due to anaerobic metabolism, with a simultaneous expiratory pCO2 growth as respiratory compensation. The study’s purpose was to examine acid-base balance dynamics during 30 minutes of reperfusion of the transplanted kidney and its influence on renal function based on observations of the 1-year creatinine values. Materials and methods The examined group consisted of 76 recipients: 44 men, 32 women. Measurements by gasometric analysis and expiratory pCO2 in each patient were performed nine times during reperfusion. In the postoperative period we analyzed donor-related factors including: gender, age, number of HLA matches weight and height, as well as recipient-related factors including: gender, age, basic immunosuppression, creatinine level at hospital discharge and at 5 to 24 months of follow-up. Statistical significance was analyzed using repeated-measures analysis of variance followed by Tukey post hoc test as well as Mann-Whitney U and Spearman’s correlation tests. Results The analysis showed correlations between reperfusion, acidosis, respiratory pCO2 compensation, early graft loss, patient death, donor and recipient gender, renal function, donor age, and histocompatibility. Conclusions At the beginning of reperfusion there is increasing metabolic acidosis with simultaneous expiratory pCO2 as compensation. A greater relative increase in expiratory air pCO2 was correlated with a higher incidence of early graft loss. The higher intensity of metabolic acidosis correlated with worse renal function at 6 months after transplantation. Elderly donor age and fewer HLA-matched antigens correlated with greater intensity of metabolic acidosis during 30 minutes of kidney reperfusion.

In this paper we present experimental investigations of carbon nanotubes deposited on highly orientated pyrolytical graphite using scanning tunneling microscopy and scanning tunneling spectroscopy. The aforementioned methods apart from detailed topographic data provided us with information about local density of state. We also show the I−V and dI/dV characteristics, which display the metallic and semiconducting characters of investigated carbon nanotubes. All measurements were taken in the air and at room temperature.

Introduction Many factors affect long-term results in kidney transplantation including histologic damage as a independent predictor, such as chronic allograft/nephropathy in protocol biopsies and age-dependent lesions. Histopathologic findings correlate with the incidence of delayed graft function, renal function, and allograft survival, allowing a rather precise prediction of graft outcome. Materials and Methods We analyzed 92 renal thick needle preimplantation and 29 postexplantation biopsies. Biopsies were preserved in 4% formalin and immersed in paraffin. Optimal biopsies contained at least 10 glomeruli and at least 2 cross-sections of arteries. We analyzed tubulitis, intensity of acute tubular necrosis, inflammatory infiltration, glomerulonephritis, arterial hyalinization, arteritis, fibrosis, tubular atrophy, arterial intimal fibrosis, increase of mesangial matrix, and percentage of glomerulosclerosis. During the postoperative course we analyzed patients condition, exigency of postoperative dialysis, urine output, as well as serum concentrations of creatinine, urea, uric acid, and ions. During a 1-year observation period, we analyzed living recipients, graft loss, death with a functioning graft, incidence of nephropathy (CAN), and acute rejection episodes (ARE). Results We observed a significant correlation between immediate graft function (IGF) and lack of ATN in the pre-0 biopsy. We observed no correlation between renal function and arterial hyalinization and fibrosis, inflammatory infiltration, tubular atrophy. In the postoperative period, we observed a significant correlation between IGF and lack of interstitial fibrosis with significantly lower levels of creatinine, urea, and potassium and higher urine output early after transplantation. IGF and better function of the right kidney was correlated with shorter time to reach a creatinine level of 2 mg%. In the postoperative periods, we also observed a difference between renal function depending on gender. The presence of acute tubular necrosis, arterial fibrosis, lack of inflammatory infiltration in the pre-0 biopsy correlated with worse late renal function. Among explantation biopsies 65.5% showed signs of CAN, and 37.93%, histologic marks of ARE.

Introduction Reperfusion is a crucial moment in kidney transplantation. Resumption of blood flow is associated with many metabolic changes, which result from the kidney’s initial condition and preservation. These biochemical alterations including the acid–base balance are the part of ischemia–reperfusion injury. The study’s purpose was to examine acid–base balance during the first 30 minutes after reperfusion of the transplanted kidney. Materials and Methods The 30 recipients (13 men, 17 women) averaged ages of 46 ± 14 years. Measurements performed nine times (at 0, 1, 3, 5, 10, 15, 20, 25, and 30 minutes after unclamping renal vessels) included: gas analysis, expiratory P co 2 , tidal volume, and respiratory rate. The evaluation of the temporary acid–base balance was performed on the basis of common parameters: pH, P co 2 , [HCO 3 − ], and base excess (BE). The patients were under general anesthesia with stable external conditions of O 2 saturation, heart rate, blood pressure, and temperature. Blood samples were analyzed using Corning 278 and 248 blood gas analyzer; vital parameters were recorded using Ohmeda 5250 RGM and Drager Sulla 909V/Julian apparatus. Results The analysis showed increasing metabolic acidosis with coexisting increase in blood P co 2 , changes that were most intense in the first minute of reperfusion. Decreasing mean pH index did not exceed physiologic limits, but the final mean values of [HCO 3 − ] and BE were in most of cases below the limit. Increased expiratory air P co 2 was most intense in the first 3 minutes reaching a maximum at about 15 minutes. Conclusions The beginning of reperfusion was the cause of increasing metabolic acidosis, which was partially compensated by blood buffers. Simultaneous increase in expiratory P co 2 , corresponding to the dynamics of acidosis, indicated the existence of respiratory compensation. Sudden increase in acidosis parameters may be the result of lactate accumulation during kidney ischemia. The decreased [HCO 3 − ] may indicate postreperfusion kidney injury, which must be the subject of further research.

An attempt at standardization of the diagnostic laparoscopy (DL) procedure during laparoscopic cholecystectomy (LC) was undertaken by establishing a simple pattern and checking its applicability in 100 consecutive LCs. DL was performed following the reversed number 5 pattern, starting from the right upper quadrant and moving to the left upper quadrant, left flank, back to the right flank along the transverse colon, down to the pelvis, along the sigmoid to the left flank, and back to the right upper quadrant inspecting small bowel. DL was incomplete in 11 patients. Inspection lasted 6-12 minutes (operation time increase, 14%). Abnormalities were discovered in 38% of patients, diagnosis elucidated in 8%, intervention undertaken in 11%, and control or further treatment proposed in 33%, without morbidity and mortality. The reversed 5 pattern of diagnostic laparoscopy is feasible and safe. It can be routinely done during LC in the general hospital setting. Standardization of diagnostic laparoscopy during laparoscopic cholecystectomy seems necessary for early disclosure of visible disorders and for medicolegal purposes.

Electrical and luminescent properties of ZnS:Mn,Cu,Cl thin films were investigated. Combined both studies: scanning tunneling microscopy and scanning tunneling spectroscopy were made. The current and differential conductance versus applied voltage were measured for the ZnS:Mn,Cu,Cl thin films. Additionally, the spectral and kinetic properties of the electroluminescent cells based on the ZnS:Mn,Cu,Cl thin films were measured. The maximum of the electroluminescence lies at 586 nm. The electroluminescence was excited by rectangular wave voltage pulses with pulse length from 1 μs to 1 ms. It was shown that time dependence of the electroluminescence is well explained assuming energy transfer between monomolecular centres.

This paper presents the outcome of research into the effects of ambient temperature changes on structured-light three-dimensional (3D) scanners. The tests were conducted in a thermal chamber and consisted of a comparison of the 3D measurement of a special reference unit (made of a carbon composite) performed at different temperatures, with measurements performed at the calibration temperature. A contact measuring arm with temperature compensation was used as a reference. Based on the results of these experiments, we propose a method that allows us to extend the existing scanner calibration method by using a temperature-correction procedure that is based on linear and nonlinear mathematical models. An exemplary application of this procedure has shown that the range of temperatures in which scanner accuracy is within declared limits can be increased 11-fold.

The aim of the study was to evaluate the influence of reduced vascular resistance following calcium channel blocker verapamil administration on kidney function at 3 months after transplantation. A group of 48 kidneys received 100 μg verapamil by injection directly into renal artery before starting perfusion. The control group included 48 paired kidneys without verapamil addition. Calcium channel blocker therapy with verapamil greatly decreased renal vascular resistance but it did not affect graft function. Administration of calcium channel blockers improved kidney function in the early period after transplantation. A better-functioning graft seems to be based more on metabolic than hemodynamic effects.

Introduction Infections are one of the most common complications after organ transplantation. Viral infections such as hepatitis type B (HBV) and C (HCV) or cytomegalovirus (CMV) infections are among the most serious ones. A high frequency of HBV and HCV infections has been recognized in kidney recipients. Viral infections play a special role in graft recipients because of clinical symptoms influencing graft function and recipient survival. Immunosuppressive treatment to decrease immunological reactions after organ transplantation may increase the risk of viral infections. The aim of this study was to evaluate the impact of the presence of HBs antigen and HCV and CMV antibodies on patient and graft survivals. Material and methods Two hundred one enrolled kidney transplantation patients (96 women and 105 men) were treated with the same immunosuppressive regimen. Age, sex, and viral state (HBs antigen, anti-HCV and anti-CMV antibodies) were evaluated in every patient. Statistical analysis was performed with the Gompertz model, Kaplan-Meier curves and Cox proportional hazard tests. Results The presence of HBs antigen was detected in 161 patients (20.4%), HCV antibodies in 61 recipients (30.3%); and CMV antibodies in 12 patients (5.9%). Eighty-seven recipients (43.4%) were seronegative. Average recipient age was 38.5 years. Conclusion Time of graft function was independent of the presence of HBs antigen or HCV or CMV antibodies.

Cold ischemia time (CIT) and graft reperfusion events are important nonimmunological factors that influence kidney graft function. The optimal temperature for the organs during CIT ranges from 4 degrees C to 8 degrees C. However, preservation of the designated temperature is usually not controlled during standard storage procedures. Aspects of initial graft reperfusion are usually assessed indirectly. Better evaluation of the effectiveness of the early blood supply may improve the surgical outcome. The aim of the study was to monitor the temperature during CIT in the kidney and surrounding area and subsequently to assess graft reperfusion using thermography. Temperature values of the area surrounding the kidney were registered during 8 organ procurements. We observed that the area surrounding the kidney displayed the optimal temperature range only during the first 5 minutes of CIT; later the temperature oscillated between 1 degrees C and 3.5 degrees C. The study proved that the temperature of the preservation fluid is frequently below prescribed. Analysis of the thermograms of 40 transplanted kidneys with the use of a thermovision camera ThermaCAM SC500 showed usefulness of this method to assess reperfusion and blood distribution in the transplanted kidney.

Transplantation is the best treatment for end-stage renal diseases. For transplantologists, it is most important to know the factors that worsen graft survival prognosis. The aim of the study was to investigate factors predictive of graft loss and shortened graft survival. We retrospectively reviewed 442 renal transplant patients between 1990 and 1995 in two Szczecin units, all of whom received a triple-drug immunosuppressive regimen. One hundred thirty patients showed graft disorders such as delayed graft function or primary nonfunction. The occurrence of these disorders was examined as a function of donor and recipient age and sex, cause of ESRD, HLA compatibility, ABO and Rh compatibility, cold ischemia time, warm ischemia time, antileukocyte antibody level (PRA), and period of dialysis therapy before transplantation. The study showed that a high maximal PRA level, incompatibility for ABO group, and a longer warm ischemia time increase the probability of early graft function disorders.

The paper describes the possibility of using high-efficiency motors to fans mill drives. Criteria for economic analysis of replacing standard motors by energy-saving ones are quoted. The results of this analysis are presented. Mathematical models of induction motors for dynamic tests are briefly described. Simulation and measurement results of start-up for standard and energy-saving motors used in fans mill drives are given. Advisability of such a replacement is presented in the paper conclusion‥

The aim of this paper is an attempt of the simulation of the electromechanical systems with the use of the programming tools included in the modern graphical packages or graphical extensions to the programming languages. The advantage of such approach lies in possibility of the simultaneous high quality visualization of the currently obtained results. The possibilities of new graphical packages enable making calculations on the Web platform - it is new and very interesting idea. The proposed solutions can be used both to the educational and presentation tasks.

Allergic asthma is a chronic inflammatory disease in which interleukin-18 (IL-18) plays an important role. However, there are controversial reports on IL-18 promoter polymorphism as an independent marker of asthma susceptibility. The aim of the present study was to examine the IL-18 promoter polymorphism in patients with allergic asthma. Two hundred and thirty-one patients with allergic asthma from a Polish population diagnosed according to the National Heart, Lung, and Blood Institute (NHLBI)/WHO guidelines were examined. An allele-specific polymerase chain reaction was used to analyse polymorphisms at positions -137 and -607 in the promoter region of the IL-18 gene. Neither in the -607 C>A nor in the -137 G>C promoter polymorphism were there any differences observed between the total group of asthmatic patients and the controls in the frequencies of genotypes, alleles, diplotypes or haplotypes. In patients with severe asthma, the -607 CC and -137 GG genotypes were observed significantly more frequently (P = 0.03 for both), whereas in patients with mild and moderate asthma, the -137 CC genotype was more prevalent than in the former group. The strongest difference between mild to moderate and severe asthma was observed in -137 allele frequencies (P = 0.006). The results of the present study suggest that the -137 G allele and the C-G/C-G diplotype seem to be involved in the pathogenesis of the severe form of asthma.

Background. The most frequent genetic disease of the kidneys occurring in 1 of 1000 inhabitants is autosomal-dominant polycystic kidney disease (ADPKD). Growing renal cysts compress the kidney resulting in damage to parenchyma and functional disorders. Around 10% of these patients are dialyzed due to terminal renal insufficiency. With the advent of laparoscopic techniques, the idea of laparoscopic excision of cysts seemed a tempting alternative to nephrectomy. We assed the preliminary results of laparoscopic treatment of polycystic kidneys compared with open nephrectomy for patients with ADPKD. Materials and methods. Thirty ADPKD patients were treated between 2000 and 2004. Eleven procedures in five men and six women of mean age 51 years included laparoscopic cyst excisions. In the remaining 19 patients (six men and 13 women) of mean age 54 years, nephrectomy was done. Indications for surgery included pain due to compression by large cysts and cyst contamination. Patients after nephrectomy were prepared for renal transplantation when necessary. Results. Laparoscopic polycyst removal produced better effects than nephrectomy. Mean operative time was significantly shorter (86 minutes for cyst removal vs 108 minutes for nephrectomy; P

Introduction The purpose of this study was to evaluate the complications of duplicated ureters in renal transplant recipients. Methods Between 1983 and 2004, 12 patients (median age 34 years) received renal transplants from donors with duplicated ureters. In four patients the ureter to bladder anastomoses were performed separately according to the method described by MacKinnon, including two cases transplanted with ureteral catheters because of narrow widths. In the following cases of eight duplicated ureters an anastomosis was performed between the distal part of each ureter to form a common ureteral ostium, which was connected to the urinary bladder. A ureteral catheter was used to the splint ureterovesical anastomosis. Results No graft loss to ureteral complications was observed. There was no ureteral necrosis in the postoperative period. No clinical symptoms of ureteral junction obstruction were revealed after removing the ureteral catheter. By ultrasound examination four patients showed a slight temporary pyelocaliectasis was observed and four patients developed temporary urinary fistulas. Conclusion Our ureterocystoneostomy procedures with duplicated ureters were safe and useful in kidney transplantation.

Kidney transplantation has become therapy of choice for patients with end-stage renal failure. However, many factors may cause graft rejection or delayed graft function, both of which decrease the prognosis for graft survival. For transplantologists the most important endeavor is to eliminate factors responsible for shortening graft function and to find those predictive of immediate graft function. The aim of the study was to investigate which factors influence early graft function. We retrospectively reviewed 442 renal transplant patients performed between 1990 and 1995 in two Szezecin units. All patients received an identical immunosuppressive drug schedule. Three hundred twelve patients who displayed immediate graft function were included in the study group to analyze donor and recipient age and sex, etiology of ESRD, HLA compatibility AB0 and Rh compatibility cold ischemia time, warm ischemia time, antileukocytes antibodies (PRA), and period of dialysis therapy before transplantation. We observed statistical significance for HLA and AB0 compatibility, younger donor age, and shorter cold ischemia time as the most important factors predictive of early graft function and an improved prognosis for graft survival.

Brittle layered materials and structures are used in many fields of engineering. The long-term behaviour of these materials and structures depend not only on service conditions but also material properties of layered components. The sensitivity analysis introduces a new aspect into optimisation of layered materials and structures against fatigue failure with respect to components' material properties. Numerical sensitivity analysis of the fatigue life is performed here using the Finite Element Method (FEM) program and adopting such design parameters as Young's moduli and the Poisson's ratios of composite constituents as well as the interface friction coefficient.

Objectives Postoperative adaptation of urinary bladder is a process involving all patients after kidney transplantation that is facilitated by improve surgical techniques and new perioperative protocols. Methods The study enrolled 102 kidney transplant recipients whose transplantations were performed between 2000 and 2002. The function of urinary bladder was examined: on the day of operation and 2, 4, 8, 12, 16, and 24 weeks following operation. Patients were assessed with respect to bladder adaptation in relation to the period of dialysis. Results In patients undergoing dialysis up to 24 months, the maximum speed of flow increased from the 2nd week postoperation and regained normal values after 12 weeks. Volume of micturition, cystometric volume, and compliance regained proper values after 24 weeks of observation. Conclusion The findings confirm that adaptation of the bladder is faster among patients who have had dialysis for longer than 12 months. The most useful, economical, and noninvasive assessment of bladder function was obtained with uroflowmetry in combination with daily bladder diary.

BackgroundThe role of FAST in diagnostic protocols has been adopted in most major trauma centers in well-developed countries. This procedure has become the initial diagnostic way in blunt abdominal trauma patients. However there are researches which show FAST is not reliable triage tool in patients with pelvic fracture.ObjectivesTo evaluate the usefulness of Focused Assessment with Sonography for Trauma in diagnostic of blunt abdominal trauma patients and to bring attention to patients with pelvic fracture who should receive additional tests for the presence of peritoneal fluid.MethodsAn analysis of high-quality evidence resources was performed, limited to the articles published since 2005 year.Results99 articles were found during the search, of which 23 were accurate. 16 articles were based on original research.ConclusionFocused Assessment with Sonography for Trauma plays a key role in the investigation of blunt abdominal trauma and should be used in all emergency departments. FAST-negative patients can remain under observation except major pelvic injury patients. The evaluation of peritoneal fluid in this group has low sensitivity.

Patients (n = 45) with psoriasis vulgaris were studied for natural killer (NK) cell activity and antibody-dependent cell cytotoxicity (ADCC) of their peripheral blood mononuclear cells against K-562 and L1210 target cells, respectively. Simultaneously, the studies were performed on the adherence to human endothelium of polymorphonuclear leukocytes (PMN) from various forms of the disease. Mean values of NK-cell activity in psoriasis vulgaris, as a whole, and mean values of ADCC in male patients were significantly lower than in a group of healthy controls. This decrease was most pronounced in patients with the active form of the disease, in whom in vitro PMN adherence to human endothelium was found to be increased. Neutrophils from both patients with active psoriasis and healthy individuals were capable of reducing NK-cell activity of normal human mononuclear cells.