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The present research project attempts to forecast future value of sales revenue for public company which operates in sector "restaurants and mobile food service activities" (i.e. in class 56.10 according to the NACE classification). Financial projection is prepared for a next year (it means 2012). Author try to estimate company's financial condition using fundamental analysis and analyzing its financial statements. Furthermore author using "steady state model" to predict future sales revenue., Niniejszy projekt badawczy ma na celu sporządzenie prognozy przyszłej wartość przychodów ze sprzedaży w spółce akcyjnej, która działa w branży "restauracje i ruchome placówki gastronomiczne" (czyli w klasie 56.10 według klasyfikacji NACE). Prognoza finansowa jest przygotowana dla następnego roku (to znaczy 2012). Autor próbuje ocenić kondycję finansową firmy za pomocą analizy fundamentalnej i badania sprawozdań finansowych. Ponadto autor korzystając z metody "modelowania w stałych warunkach" stara się przewidzieć przyszłą wielkość sprzedaży.

The present research project attempts to forecast future value of sales revenue for public company which operates in sector "restaurants and mobile food service activities" (i.e. in class 56.10 according to the NACE classification). Financial projection is prepared for a next year (it means 2012). Author try to estimate company's financial condition using fundamental analysis and analyzing its financial statements. Furthermore author using "steady state model" to predict future sales revenue., Niniejszy projekt badawczy ma na celu sporządzenie prognozy przyszłej wartość przychodów ze sprzedaży w spółce akcyjnej, która działa w branży "restauracje i ruchome placówki gastronomiczne" (czyli w klasie 56.10 według klasyfikacji NACE). Prognoza finansowa jest przygotowana dla następnego roku (to znaczy 2012). Autor próbuje ocenić kondycję finansową firmy za pomocą analizy fundamentalnej i badania sprawozdań finansowych. Ponadto autor korzystając z metody "modelowania w stałych warunkach" stara się przewidzieć przyszłą wielkość sprzedaży.

Celem pracy jest analiza sytuacji finansowej spółki w oparciu o indeks kondycji finansowej określający m.in. stabilność finansową spółki, na przestrzeni sześciu kolejnych lat obejmujących okres od 2007 do 2012 roku. Ponadto zostanie przedstawiony schemat tworzenia indeksu PHI wraz z interpretacją wyników. Obliczeń dokonano w oparciu o pracę John'a Zietlow'a pt. "A Financial Health Index for Achieving Financial Sustainability", w której zostały zaprezentowane wykorzystane wskaźniki m.in. płynności, wypłacalności czy finansowej elastyczności spółki. Analiza zostanie przeprowadzona na przykładzie przedsiębiorstwa z branży 35 EKD zajmującego się wytwarzaniem, przesyłaniem, dystrybucją i handlem energią elektryczną. The aim of the study is to analyze the financial situation of the company based on the A Financial Health Index, inter alia, financial stability of the company, over the next six years, covering the period from 2007 to 2012. In addition, will be presented to the index creation scheme PHI along with the interpretation of the results. The calculations were based on the work of John Zietlow "A Financial Health Index for Achieving Financial Sustainability", in which they were presented, among others, the indicators used liquidity, solvency and financial flexibility of the company. The analysis will be carried out on the example of companies from the 35 NACE involved in the generation, transmission, distribution and trading in electricity. Note: Downloadable document is in Polish.

In this study, the authors focused on the calculation and analysis of indicators to assess the financial condition of the selected companies and public benefit entities. The data used in the calculations are taken from the financial statements published by the selected units. The paper necessary calculations ultimately give a PHI measure, W niniejszej pracy, autorzy skoncentrowali się na wyliczeniu oraz analizie wskaźników umożliwiających ocenę kondycji finansowej wybranych przedsiębiorstw oraz jednostki pożytku publicznego. Dane wykorzystywane podczas wyliczeń zaczerpnięto ze sprawozdań finansowych publikowanych przez wybrane jednostki. W pracy dokonano niezbędnych obliczeń docelowo uzyskując miarę PHI Zietlowa.

Aim To evaluate the endocrinological and ophthalmological results of the tuberculum sellae meningioma surgery. MATRRIAL and METHODS: A total of 18 patients diagnosed with tuberculum sellae meningioma received surgical treatment at Neurosurgery Clinic at Military Medical Institute in Warsaw from January 2010 to July 2012. This analyzed group of patients included 15 females and 3 males at a mean age of 50.5 years (ranging from 30 to 73; SD ± 13.4). In the pre-operative and post-operative periods, all patients underwent magnetic resonance imaging of the head according to a uniform protocol, eye examinations with assessment of visual acuity and field of vision, as well as endocrine tests to evaluate the hypothalamic-pituitary axis (including urine specific gravity and osmolality as well as blood cortisol, TSH, fT3, and fT4 levels). All patients underwent surgical treatment of the tumor via unilateral subfrontal craniotomy, achieving macroscopically complete tumor removal (Simpson grade II resection). Results The use of the unilateral subfrontal approach helped improve vision in 88% of the treated patients. Endocrine tests revealed no hypothalamic-pituitary axis dysfunction. The most commonly diagnosed meningiomas of the area were meningothelial (77%) and transitional (12%) meningiomas. Conclusion Surgical treatment of tuberculum sellae meningiomas via the unilateral subfrontal approach is a safe technique with no significant complications. Visual improvement was observed in 88% of the patients who had received this treatment. There were no hormonal disturbances in patients operated via the subfrontal approach either prior to or after the procedure, which suggests that surgical treatment of tuberculum sellae meningiomas has no effect on pituitary endocrine function.

In the paper authors described a method of CBN grinding wheel cutting ability evaluation and research results achieved with this method during grinding process. Research results, which allowed for verification of the method (e.g. measurements of grinding force components, surface roughness and waviness parameters and stress level in surface layer) were also presented.

Most cases of periaqueductal tumours were found in children and adolescents, so treatment modalities in adults are not evaluated yet. A case of 40 years old woman with tectal and periaqueductal protoplasmatic astrocytoma grade II with history of headache and episodes of syncope is described. MRI showed triventricular hydrocephalus. After a shunt procedure she was doing well for about 15 months. Then she became somnolent, disoriented, and Parinaud syndrome appeared. The solid tumour was resected microsurgically in one stage. A part of it was removed via the supracerebellar infratentorial approach and tectal plate incision. The remainder of the tumour was removed through the fourth ventricle and the aqueduct which was filled by tumour mass. Postoperatively bilateral ptosis, vertical gaze palsy, slight horizontal gaze limitation and pupilloplegia were the main neurological sequelae. They all almost completely resolved within a year. The patient is doing well two and half years after the surgery. MRI showed patency of the aqueduct and no residual tumour. The authors suggest, that direct surgical attempt at total tumour removal should be considered in cases of periaqueductal and tectal gliomas. They also believe it is the first described case, in whom this type of tumour was totally removed by a combined transtectal and transaqueductal route.

Background There are several endovenous methods to ablate the saphenous vein, all of which require tumescent anesthesia. This report was designed to evaluate the efficacy of a tumescent-free technique using mechanochemical ablation (MOCA). Methods This was a prospective observational multicenter report on the efficacy of MOCA in selected patients with lower extremity chronic venous disease. Demographic information, clinical and procedural data were collected on a customized database. The distribution and extent of venous reflux and the closure rate of the treated veins were assessed with duplex ultrasound. Pain was evaluated during the procedure and postoperatively using an analog scale. The presence and severity of complications were recorded. Patient improvement was assessed by clinical-etiology-anatomy-pathophysiology (CEAP) class and venous clinical severity score (VCSS). Results There were 126 patients that were included at baseline, 81% females, with a mean age of 65.5 ± 14 years. The average BMI was 30.5 ± 6. The mean diameter of the great saphenous vein in the upper thigh was 7.3 mm and the mean treatment length was 38 cm. Adjunctive treatment of the varicosities was performed in 11% of patients during the procedure. Closure rates were 100% at one week, 98% at three months, and 94% at six months. Post-procedure complications included hematoma 1%, ecchymosis 9%, and thrombophlebitis 10%. There were no cases of venous thromboembolism. There was significant improvement in VCSS ( p Conclusion MOCA of the saphenous veins has the advantage of endovenous ablation without tumescent anesthesia, making it an almost pain-free procedure. High occlusion rates with significant clinical improvement can be achieved with this method at short term.

Pituitary apoplexy (PA) is a rare, potentially life-threatening medical condition due to acute ischaemia or haemorrhage of the pituitary gland. The main clinical features are: abrupt onset of severe headache, nausea, vomiting, deteriorating level of consciousness, visual impairment and/or endocrine deficiency. Correct and prompt diagnosis is essential for effective therapy, but there are no randomised studies or strict recommendations defining treatment modalities. We present the case of a 59 year-old woman with pituitary tumour apoplexy, presenting with severe headache, vomiting and visual field deterioration. The patient was treated conservatively because of her refusal of surgery and was followed-up for five years. In the course of treatment, recovery of the visual field defects, as well as right sixth cranial nerve paresis, was observed. Repeated magnetic resonance imaging (MRI) revealed regression of the tumour without signs of its re-growth. We discuss therapeutic modalities with particular emphasis on morbidity and review the literature relating to the management of pituitary tumour apoplexy.

Meningiomas are very common neurosurgical problem. Their histological appearance, different size and localization, adherence to vital neural and vascular structures or extensive peritumoral brain edema (PTBE), especially in deep seated tumors, may lead to severe, life-threatening complications. We report a case of tuberculum sellae meningioma (TSM). A 48-year old female presented with 7-month history of blurred vision and progressive visual impairment. Intracranial tumor was confirmed by magnetic resonance imaging (MRI). After ophtalmological and endocrinological evaluation, the patient underwent surgical removal of the tumor. She immediately recovered from her visual disturbances and no tumor recurrences were seen during follow-up. Pathological diagnosis showed a meningioma of the secretory subtype (MS). We discuss the role of immunohistochemical staining in the diagnosis and the role of different factors in the PTBE formation. Selection of surgical route to the TSM is discussed, as well. Review of the literature is presented.

W niniejszej pracy, autorzy skoncentrowali sie na wyliczeniu oraz analizie wskaźnikow umozliwiających ocene kondycji finansowej wybranych przedsiebiorstw oraz jednostki pozytku publicznego. Dane wykorzystywane podczas wyliczen zaczerpnieto ze sprawozdan finansowych publikowanych przez wybrane jednostki. W pracy dokonano niezbednych obliczen docelowo uzyskując miare PHI Zietlowa. In this study, the authors focused on the calculation and analysis of indicators to assess the financial condition of the selected companies and public benefit entities. The data used in the calculations are taken from the financial statements published by the selected units. The paper necessary calculations ultimately give a measure of PHI.

The present research project attempts to forecast future value of sales revenue for public company which operates in sector "restaurants and mobile food service activities" (i.e. in class 56.10 according to the NACE classification). Financial projection is prepared for a next year (it means 2012). Author try to estimate company's financial condition using fundamental analysis and analyzing its financial statements. Furthermore author using "steady state model" to predict future sales revenue.

Niniejszy projekt badawczy ma na celu sporządzenie prognozy przyszlej wartośc przychodow ze sprzedazy w spolce akcyjnej, ktora dziala w branzy "restauracje i ruchome placowki gastronomiczne" (czyli w klasie 56.10 wedlug klasyfikacji NACE). Prognoza finansowa jest przygotowana dla nastepnego roku (to znaczy 2012). Autor probuje ocenic kondycje finansową firmy za pomocą analizy fundamentalnej i badania sprawozdan finansowych. Ponadto autor korzystając z metody "modelowania w stalych warunkach" stara sie przewidziec przyszlą wielkośc sprzedazy.The present research project attempts to forecast future value of sales revenue for public company which operates in sector "restaurants and mobile food service activities" (i.e. in class 56.10 according to the NACE classification). Financial projection is prepared for a next year (it means 2012). Author try to estimate company's financial condition using fundamental analysis and analyzing its financial statements. Furthermore author using "steady state model" to predict future sales revenue.

Niniejszy projekt badawczy ma na celu przedstawienie strategii zarządzania środkami pieniężnymi w spółce akcyjnej, która działa w branży "restauracje i ruchome placówki gastronomiczne" (czyli w klasie 56.10 według klasyfikacji NACE). Raport przedstawia budżet gotówki i wpływ struktury kapitału na wartość firmy. Ponadto prezentuje propozycję metody zarządzania należnościami i zapasami. The present research project attempts to propose cash management strategy for public company which operates in sector "restaurants and mobile food service activities" (i.e. in class 56.10 according to the NACE classification). The report presents the cash budget and the impact of capital structure on the value of the company. In addition, the report presents a proposal for management methods of receivables and inventories.

Celem pracy jest analiza sytuacji finansowej spolki w oparciu o indeks kondycji finansowej określający m.in. stabilnośc finansową spolki, na przestrzeni sześciu kolejnych lat obejmujących okres od 2007 do 2012 roku. Ponadto zostanie przedstawiony schemat tworzenia indeksu PHI wraz z interpretacją wynikow. Obliczen dokonano w oparciu o prace John'a Zietlow'a pt. "A Financial Health Index for Achieving Financial Sustainability", w ktorej zostaly zaprezentowane wykorzystane wskaźniki m.in. plynności, wyplacalności czy finansowej elastyczności spolki. Analiza zostanie przeprowadzona na przykladzie przedsiebiorstwa z branzy 35 EKD zajmującego sie wytwarzaniem, przesylaniem, dystrybucją i handlem energią elektryczną. The aim of the study is to analyze the financial situation of the company based on the A Financial Health Index, inter alia, financial stability of the company, over the next six years, covering the period from 2007 to 2012. In addition, will be presented to the index creation scheme PHI along with the interpretation of the results. The calculations were based on the work of John Zietlow "A Financial Health Index for Achieving Financial Sustainability", in which they were presented, among others, the indicators used liquidity, solvency and financial flexibility of the company. The analysis will be carried out on the example of companies from the 35 NACE involved in the generation, transmission, distribution and trading in electricity.

The surgical treatment of obesity reaches the 50th of last century. The first operations were based on significant shortening of digestive tract and were associated with many metabolic disturbances. The growing epidemic of obesity was the most decisive factor for the development of bariatric surgery. Because of its high efficacy (80%) comparing to the conservative treatment (5%), bariatric surgery today is the only effective therapy for morbid obesity. Surgical procedures can be categorized as restrictive, restrictive-malabsorptive, malabsorptive and others. The restrictive operations limit gastric volume. There are Vertical Banded Gastroplasty (VBG), Adjustable Gastric Banding (AGB) and Sleeve Resections (SR). The restrictive-malabsorptive are based on the creation of small gastric pouch or the resection of 4/5 of stomach and the shortening of common digestive tract. There are Gastric bypass (GB), and Biliopancreatic divertion with duodenal switch (BPD-DS). The malabsorptive procedure (Biliopancreatic divertion--BPD) are based on resection of 2/3 of stomach and significant shortening of digestive tract. The appearance of new bariatric operation such as SR changed the pattern of treating obesity with BMI50 kg/m2. The two or three stage treatment of obesity minimizes the perioperative risk for patients. Although the great development of bariatric surgery there is no golden standard. The choice of procedure should be done by surgeon and patient together.

This year it has been 90 years since the first hiatal hernia repair was performed (Soresi, 1919). Nowadays surgeons' approach to operational treatment has changed as a result of development of more precise imaging techniques, better understanding of physiology and pathology of gastroesophageal reflux disease (GERD), invention of effective medicines and alternative endoscopic procedures. Complications and discomfort in patients during a follow-up resulted in evolution of surgical methods. Close co-operation between surgeons and gastroenterologists and interchange of experiences among surgeons have allowed establishing general algorithm for therapeutic and preoperational management. It seems crucial for further defining of surgical management of hiatal hernia and reflux disease to have at least basic knowledge on previous medical views on GERD. Another reason for taking the subject is epidemiology, oncological prophylaxis and quality of life improvement in patients with reflux disease. It has been proven that the most effective way of operational treatment of GERD is creating with the liberated gastric fundus a full "floppy" wrap around the lower esophagus. The procedure is completed with narrowing of esophageal hiatus. In cases of impaired esophageal motor activity the partial (180 degrees) posterior fundoplication is widely used. In hiatal hernias, particularly of type II or paraesophageal hernias, the diaphragmatic defect can be repaired with surrounding tissues or, when large, with a synthetic mesh.

Gastroesophageal reflux disease (GERD) has been a serious health and social problem. Population based survey revealed that around 40 per cent of the whole population reported monthly GERD related symptoms. When not treated properly GERD can lead to severe complications such as Barrett's oesophagus (BE) and adenocarcinoma as a consequence. Various methods can be useful in diagnosis of GERD but only gastroscopy is a widespread investigation that enables to establish the diagnosis of reflux disease. The symptoms of reflux disease can be effectively treated by drugs, surgical procedures remain the way of curing the cause of gastroesophageal reflux. Nowadays the laparoscopic fundoplication is a standard in operative treatment of the ailment.was to evaluate of GERD treatment with laparoscopic "floppy" Nissen fundoplication (LFN).A group of 41 patients who underwent LNF were recruited for the study. All qualified patients underwent pre and post-surgical upper GI endoscopy and were requested to answer the questions in a GERD-related quality of life questionnaire. The main group of patients was divided into two subgroups--those with concomitant hiatal hernia and those without hernia. The outcomes of treatment were then compared between the subgroups.After the procedure the endoscopic improvement of reflux oesophagitis and better symptoms self-assessment were found.Laparoscopic "floppy" Nissen fundoplication is an effective method of treatment of erosive oesophagitis and its symptoms.

A laboratory-scale study on the anaerobic treatment of selected pulp mill streams was carried out in a collaboration between the Research Institute for Environmental Protection and Designing Office of Water and Waste Disposal. Anaerobic treatment of effluents from acid hydrolysis of wood from sulfate cellulose production, and effluents from the sulfite cellulose fibers washing was investigated. The results indicated 80% COD removal and the average methane generation was found to be 340 Ncm3/gCOD removed in case of highly polluted (COD = 63 kgO2/m3) acid hydrolysis effluents. The waste from cellulose washing contained, beside sugars, alsorefractory compounds, such as high-molecular-mass lignin derivatives, resins and tannins. According to that, only 20-30% COD removal was obtained and the methane generation was 270-360 Ncm3/g COD removed.

The evolution of surgery of no neoplastic diseases of the gastroesophageal junction, particularly gastroesophageal reflux disease (GERD), is an unquestionable factor for further analysis of indications for treatment and treatment results. Full-symptomatic GERD with coexisting sliding hiatal hernia is an indication for surgical treatment for a long time. The question is when to operate functional disorders of the esophagus and lower esophageal sphincter (LES) and what the results of the treatment are. Aim of study was to analyze results of surgical treatment of patients with GERD on the background of functional disorders and patients with sliding and mixed hiatal hernia.This study retrospectively analyzed the data of 49 patients operated in Department of General, Oncological and Thoracic Surgery. Patients were divided into two groups. First group: patients with symptomatic GERD with confirmed 24 hour pH monitoring night-time and after-meal acid refluxes--23 subjects. Second group: patients with symptomatic GERD with type I and III hiatal hernia proven by gastroscopy, radiological tests and intraoperative examinations--26 subjects. There was no sign of decreased esophageal propulsive function among examined patients. For surgical intervention from the first group were qualified patients after ineffective conservative management. All patients underwent Nissen procedure--laparoscopy, hernioplasty and floppy fundoplication, and agreed on follow-up evaluation after 3, and some after 6 and 12 months which included case history, gastroscopy and 24 hour pH monitoring.Operative management resulted in withdrawal of suffered subjective symptoms and remission of lesions in lower part of esophagus. 10% of the patients had LES motor activity dysfunction not qualified for surgical consultation. There was no case of recurrence of hiatal hernia.Patients suffering from LES functional disorders and type I and III hiatal hernia can be effectively treated with surgical management.

Transsphenoidal microsurgery (TSS) is the method of choice for resection of most pituitary tumors. Postoperative cerebrospinal fluid rhinorrhea is one of the most frequent complications of TSS. Its incidence ranges from 1.3 to 9.6%. Failure to close a cerebrospinal fistula can result in life-threatening complications e. g. meningitis or tension pneumocephalus. Therefore sellar closure has to be done properly certainly and has to be watertight. The aim of the study was to evaluate the results of reconstruction of the skull base after TSS with autologous material (fascia lata and fat or muscle).Our operative experience of reconstruction of the sellar floor during transsphenoidal surgery is described. We report the well known method of the sellar closure using autologous tissue (fascia lata and fat or muscle). We did not use other materials e.g., fibrin glue, titanium mesh etc. This technique has been performed in 316 patients.The postoperative cerebrospinal fluid leakage occurred in 7 patients. Four of them underwent early reoperation. Three others were treated successfully with lumbar drainage. In another patient, a cerebrospinal fistula occurred during chronic pharmacotherapy of the giant PRL-secreting adenoma. Transsphenoidal reconstruction of the skull base according to the described method was performed in that case. Lethal meningitis occurred in one patient in our group.In our opinion the described method of reconstruction of the sellar floor is easy, safe and very effective.

Intrasellar arachnoid cyst (IAC) is a very rare pathological lesion occurring in 5 of 1000 autopsy cases, and constitutes 9% of all arachnoid cysts. As a space-occupying mass, IAC may cause headaches, visual disturbances, hypopituitarism, precocious puberty, and the "bobble-head doll" syndrome. The pathogenesis of IAC remains controversial. Magnetic resonance imaging (MRI) is the neurodiagnostic tool of choice to evaluate IAC. The authors presented a 38 year-old woman suffering from severe chronic headaches, dysmenorrhea, and visual disturbance. MRI revealed an intrasellar cystic lesion that had compressed the optic chiasma. Preoperative endocrinological assessment revealed hyperprolactinemia and hypogonadotropic hypogonadism. The patient underwent transsphenoidal surgery. The cyst membrane was opened and clear, serous fluid was evacuated. The postoperative course was complicated by CSF leakage, which was corrected by an autologous fat graft placement. Visual field defects improved immediately after surgery but a transient panhypopituitarism and diabetes insipidus occurred. Postoperative MRI revealed no recurrence of the lesion during the four-year follow-up.

Invasive pituitary adenomas with extension to the cavernous sinus are rare and comprise 6-10% of all pituitary tumors. Their effective surgical treatment is very difficult. Cavernous sinus invasion increases the morbidity and mortality associated with surgical procedures. Prolonged medical treatment and radiotherapy are an alternative to the surgery.Efficiency of the extended transnasal transsphenoidal approach in the treatment of the invasive pituitary adenomas with extension to the cavernous sinus.During the past two years (from January 2000 to December 2001) authors carried out 24 surgical operation in the medial compartment of the cavernous sinus (extended transnasal transsphenoidal approach). Our experience is based on the analysis of 24 patients (19 patients with GH-secreting tumors and 5 patients with ACTH-secreting adenomas--2 with Cushing disease and 3 with Nelson's syndrome) with invasive macroadenomas expanding to the cavernous sinus. Mean age was 46.21 years (range 28-68, SD +/-9.54 years) in our group. Mean serum GH level was 43.95 microg/l (range 9-170 microg/l, SD +/-39.68 microg/l) and mean serum ACTH level in the group of Nelson's syndrome was 1180 pg/ml (range 790-1780 pg/ml, SD +/-527.35 pg/ml). Parasellar extension of the tumor was measured according to Knosp's scale. There were 16 patients in stage III and 9 patients in stage IV.Total surgical removal of invasive GH-secreting adenoma (according cure criteria: basal serum GH level below 2.5 microg/l, OGTT1 microg/l, normal sex and age-related IGF-I level) we achieved in 6 patients. Basal serum GH level was below 5 microg/l (postoperative mean serum IGF-I level was significantly lower but abnormal) in the next five patients. Remission (normalization of 24-hour urine-free cortisol (UFC) and its metabolites) was achieved in one patient with Cushing disease. Out of 3 patients with Nelson's syndrome two were cured. Their postoperative serum ACTH level was below 80 pg/ml. There were no mortality and no deterioration of cranial and optic nerves. CSF leakage occurred in one patient and was treated surgically. Deterioration of pituitary function and diabetes insipidus occurred in one patient.Extended transnasal transsphenoidal approach is the safe surgical procedure in the treatment of invasive GH or ACTH-secreting pituitary adenomas. The overall morbidity rate of this surgical intervention is rare. We suppose the extended transnasal transsphenoidal approach is an alternative for prolonged medical treatment and radiotherapy.

Advances of minimally invasive surgery caused return to operative treatment of gastroesophageal reflux disease (GERD). Authors present advantages and faults of laparoscopic treatment of gastroesophageal reflux disease (in literature and own experience).

The advent of laparoscopic colorectal surgery evoked discussion on its advantages and limitations. Although application of laparoscopy in the management of benign colorectal diseases has been widely accepted, its use for treatment of malignancies is still controversial. Many reports suggest that laparoscopic operations provide similar oncological radicality as open procedures, with less operative trauma, shorter hospital stay and low complication rate. In the hands of well-trained surgeon laparoscopic colorectal surgery seems to be attractive operative modality. Authors present own experience with laparoscopic colorectal surgery.

To evaluate efficiency of the transcranial epidural approach in the treatment of invasive GH- or ACTH-secreting pituitary adenomas with extension to the cavernous sinus.During the past two years (from January 2000 to December 2001) 14 patients with invasive GH- or ACTH-secreting pituitary adenomas extending to the cavernous sinus were operated on using the transcranial epidural approach. Our experience is based on an analysis of 12 patients with GH-secreting tumors and 2 patients with ACTH-secreting adenomas. The patients' mean age was 45.36 years (range 28-66, SD +/- 10.26 years). Parasellar extension of the tumor was measured using the Knosp scale--in all the cases there was an extension to the cavernous sinus, in stage III (4 patients) or stage IV (10 patients).In none of the cases a total surgical removal of the invasive GH-secreting adenoma was attained (according the following cure criteria: basal serum GH level below 2.5 micrograms/l, OGTT1 microgram/l, normal sex- and age-related IGF-I level). In four patients the surgery resulted in a reduction of the basal serum GH level to below 5 micrograms/l (their postoperative mean serum IGF-I level was 530 micrograms/l--significantly lower, but still abnormal, p0.05). In a single case of a female patient the basal serum GH level was below 10 micrograms/l, while in other 7 patients the GH level remained above 10 micrograms/l. Remission (normalization of 24-hour urine-free cortisol (UFC) and its metabolites) was achieved in one patient with the Cushing disease. There were no complications involving case fatality. A transient deterioration of the third cranial nerve function observed in one patient disappeared within 3 months from the surgery. There was no deterioration of pituitary function and no cases of diabetes insipidus in our group.Transcranial epidural approach is an alternative to radiotherapy and/or prolonged medication in the treatment of invasive GH- or ACTH-secreting pituitary adenomas.

Microsurgical transsphenoidal approach has been for decades an established standard surgical treatment of pituitary adenomas. Actually it offers a safe and rapid midline access to the sellar region with a minimal risk of injury to vascular vessels, the optic chiasm or nerves and the brain. Major limitations of this approach are due to the narrow and deep operating field, with the related possible complications of the pituitary insufficiency and the cerebrospinal fluid rhinorrhea. In this paper the authors present their own experience with transsphenoidal surgery they performed in over 1500 cases during the past 28 years. The history and evolution of the microsurgery are described, including the operative technique, indications and counter-indications, as well as relative advantages and disadvantages of the transsphenoidal approach. Moreover, current modifications of the neurosurgical technique (extended transsphenoidal approaches) and their application in the treatment of non-glandular perichiasmatic tumors are outlined and discussed.

Pharmacological treatment of craniocerebral injuries (CCI) to a large extent involves correction of metabolic disturbances resulting from primary and secondary mechanisms of trauma. Choline alphoscerate (CA), a substrate of phosphatydylocholine and a carrier of choline, plays a major role in phospholipidic transformation of the neuronal cell wall.To goal of the study was to evaluate the risk and efficacy of early CA treatment in patients with CCI.Twenty three CCI patients were treated with CA in the years 2001-2002. In 8 cases an acute subdural haematoma with multiple hemorrhagic foci was diagnosed. Six patients were diagnosed with cerebral contusion with multiple hemorrhagic foci, while 9 patients suffered from concussion of the brain. The patients' condition was assessed at admission using the adult trauma score (ATS)--11 patients scored 8 points on the ATS, 4 patients scored 9, and 8 patients scored 11 points.The inclusion criterion was the patient's clinical status at admission in the range 8-11 ATS points. CA was administered according to the following schedule: 1.0 g/d i.m. for 14 days, then 0.8 g/d orally for the next 28 days. AC (Gliatilin) produced by Italfarmaco was used in the study. The cost of this CA treatment was estimated by the producer at PLN 424.After three months of the treatment an improvement was noted in 96% of the patients. Fourteen patients were independent and professionally active, another five were independent, but did not work, while three patients required permanent care. One patient died because of pneumonia. No complications due to the CA treatment were observed in the group studied.Early treatment with CA is safe and as a component of complex pharmacotherapy has a beneficial effect on the treatment outcome in CCI patients.

The paper presents a case of a Jehovah's Witness, 64-year-old woman harboring multiple meningiomas in the right cerebral hemisphere. As the first stage of her treatment endovascular embolization of the tumor vascular bed was performed. Through the middle cerebral artery Ivalon particles and acrylic glue were injected. Four days later the patient underwent craniotomy and four intracranial meningiomas were removed. Intraoperative blood loss was minimal and the patient was discharged with no neurological sequelae and without anemia. The authors emphasize benefits that endovascular embolization may bring, especially as regards improvement of neurosurgical treatment safety in Jehovah's Witnesses.