Breast excision due to cancer negatively impacted the quality of sexual life for 71% of participants. Partnership relations after surgery remained unchanged for 67% of them. There was significant impact of surgery on the perception of one's own body.

The pathogenetic mechanism of nasal polyps remains unknown, although polyps seem to be an expression of chronic nasal inflammation of both allergic and nonallergic origin. The goal of our study was to compare the distribution mast cells and eosinophils (cells traditionally associated with allergic inflammation) in nasal polyps from well defined atopic and nonatopic patients, using advanced morphometric analysis system. Nasal polyps were removed during routine nasal polypectomy performed in 17 atopic and 19 nonatopic patients. Parrafin sections of nasal polyps were stained with haematoxilin/eosin, chromotrope R2 or toluidine blue, and light microscopy, assisted with computerized picture analysis system, was used to count the number of cells in the superficial and stromal layer of the mucosa. Regardless of the presence or absence of atopy, eosinophils were predominant cells in the polyps, and both eosinophils and mast cells were more abundant in the superficial layer than in the stromal layer of the mucosa. The density of eosinophils in both layers and mast cells in the stromal layer was similar in atopic and nonatopic patients. Only the density of mast cells in the superficial layer of the mucosa was slightly higher (p < 0.005 in atopic compared to nonatopic patients). In both groups of patients a significant correlation between the number of mast cells and eosinophils in the superficial layer of the polyp mucosa was found (r = 0.84; p < 0.001). Our study demonstrates that eosinophils and mast cells are abundant in nasal polyps from both atopic and nonatopic patients and that mast cells seem to be more superficially distributed in atopic compared to nonatopic patients.

Introduction. The aim of this study is to examine changes in the chosen morphological characteristics, motor conditioning, and coordination skills in physiotherapy undergraduates at a medical university in Bydgoszcz in the first decade of the millennium. We assume prevalence of a secular trend in values of morphological characteristics; however, characteristics of motor skills, particularly fitness levels, will remain relatively unchanged. Materials and Methods. The study included young people studying physiotherapy at the medical university of Bydgoszcz 2001-2010. Basic morphological features, including waist and hip circumferences, were measured, and BMI and WHR were calculated. The Cooper test and marching over a distance of two kilometers were employed to determine endurance; right and left spinning coordination was assessed by Starosta test. Calculated Mollison indicators were used in the evaluation of dimorphic differences in subsequent observation time. Statistics. Data are presented as mean with the standard deviation. Groupwise comparison was performed with Student’s t-test and linear relationships with Pearson’s r. Linear covariance models (ANCOVA) were built as theoretical models. Statistical significance was set at alfa=0.05. Based on the correlation between the data and the corresponding normal score used, the Shapiro-Wilk test is the best choice for testing the normality of data. Variables were excluded if they exceeded the tolerance level for multicollinearity. Analysis was performed with Statistica 10. Results. The study demonstrated a rising number of male students (from 13,3% to 39,2%, chi2=10,13; p=0,001) and a decrease in age of students overall but no significant changes (from 22,25±0,75 to 20,42±1,7; F=32,9; p<0,001) in their morphological characteristics and their dimorphic differences (average results for males: BMI, from 22,25±1,94 to 26,27±3,56; WHR index, from 0,78±0,06 to 0,85±0,06; average results for females: BMI, from 20,79±2,11 to 22,19±3,83; WHR index, from 0,7±0,04 to 0,75±0,15). An overall improvement in endurance was found; however, coordination, especially amongst women, had deteriorated (turn right, from 377,1±48,1 to 343,1±23,3; turn left, from 375,0±5,61 to 345,6±43,1). We observed multidirectional changes in the analyzed motor skills and most of them were statistically significant. Conclusions. Longitudinal study of physiotherapy students revealed no differences in morphological and dimorphic characteristics and multimodal changes in assessed motor skills, thus highlighting a need for further research into the identification of their causes. Moreover, a requirement for entry motor skills assessment and curriculum reorientation towards delivery of a broader scope of physical education was suggested.

Megaesophagus is the end-stage of achalasia cardiae. It is the result of peristaltic disorders and slow decompensation of the muscular layer of the esophagus. The aim of this article is to detail the diagnostic criteria and surgical management of megaesophagus. Criteria were acute bending of esophagus axis; lack of esophagus peristalsis, and no response to stimulation in the manometric test; and Los Angeles C/D esophagitis in the endoscopic examination. Between 1991 and 2004 seven patients (5 females, 2 males; age, 51-67 years; average age, 59 +/- 8 years) were treated. A bypass made from the pedunculated part of the jejunum connecting the part of esophagus above the narrowing with the praepyloric part of the stomach was made. Access was by an abdominal approach. A jejunum bypass was made in six patients with megaesophagus. A transhiatal esophageal resection was carried out, and in the second stage a supplementary esophagus was made from the right half of the colon on the ileocolic vessels in one patient who had experienced two earlier unsuccessful operations. Symptoms of dysphagia, recurrent inflammation of the respiratory tract, and pain subsided in all patients. Complications were not reported in the postoperative period. All patients survived. Subsequent radiographic and endoscopic examination showed very good outcome. The jejunum bypass gave very good results in the surgical treatment of megaesophagus.

IntroductionProstaglandin-2 (PGE-2), one of the products of cyclooxygenase-2 (COX-2) induced catalysis, may play a critical role in the carcinogenesis of esophageal squamous cell carcinoma (ESCC). We investigated the efficacy of using serum PGE-2 concentration as a biomarker for this cancer type.Material and methodsProstaglandin-2 levels were analyzed in the serum of 65 ESCC patients and in 47 healthy individuals. The concentrations of cyclooxygenase-2 (COX-2) were measured in tumor tissues and normal tissues obtained from 31 surgically treated ESCC patients.ResultsSerum PGE-2 concentration was significantly higher in ESCC patients than in control patients (p = 0.004), especially in the early stages (I + II) of cancer (p < 0.0001). We observed significant inverse relationships between serum PGE-2 levels and: tumor stage, primary tumor progression, lymph and distant metastasis. The COX-2 concentration was significantly elevated in tumors as compared to normal tissues (p = 0.008). A significant correlation between serum PGE-2 and tumor COX-2 was observed (rho = 0.46, p = 0.009). However, ROC analysis showed that serum PGE-2 may be a weak prognostic factor for ESCC.ConclusionsOur results suggest that an elevated concentration of serum PGE-2 in the early stages of cancer may possibly be associated with tumor initiation and cancer development in ESCC. The exact role of these findings in early detection of this highly lethal cancer requires further research.

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The purpose of this retrospective study is to show that transcervical diverticulectomy (TD) in treatment of Zenker diverticulum (ZD) can still be a first choice procedure in selected patients and in experienced hands its safety might be compared to the minimally invasive endoscopic diverticulostomy.The study cohort consisted of 44 patients (18 male, 26 female) operated for (ZD). All the patients underwent open diverticulectomy. The decision to choose open surgical repair depended on surgical risk, age of the patient, size of the diverticular septum (the distance between the top of the diverticulum and its bottom on barium study), and patient's preference.Mean age of patients was 64.6 ± 11.9 years; range: 26 to 88 years. A total of 36.4% out of them finished 70 years. Postoperative mortality was nil. Two major complications (4.5%) requiring surgical intervention occurred: leak and hematoma.Data were analyzed by t test for independent samples using Statistica 12.5 software. P value <0.05 was considered statistically significant.Surgical treatment of patients with ZD should be individualized. Large Zenker diverticula with the septum longer than 6 cm should preferably be resected through an open approach because it is not possible to remove the septum completely during one-step endoscopic procedure and diverticulostomy creates a weak and large common cavity in the esophagus. Surgical repair is effective for all sizes of diverticula, but its most serious complications such as leakage or laryngeal nerve injury should be considered, especially in elderly patients with comorbidities. However, age alone should not be the main criterion if choosing the treatment option.

BackgroundThe optimal therapeutic schedule in patients with achalasia is still under discussion. The aim of this study was to review our institution’s experience with myotomy and dilation in patients with achalasia.Material/MethodsClinical data were available for 59 patients who had ever had myotomy (n=38), dilation (n=21), or both procedures (n=8) between 2000 and 2007. Patients were followed prospectively with objective (a barium esophagogram) and subjective (a simple survey that scored dysphagia and overall patient satisfaction with the procedure) diagnostic tools. In the group of patients after pneumatic dilatations, frequency of interventions was higher (1, 2) than in the myotomy group (0, 2) at 2-year follow-up. Patients after myotomy with recurrence of dysphagia were treated with dilations.ResultsMean time of dysphagia occurrence was similar in both groups (10 months). The statistically significant differences in treatment outcomes in both groups were in favor of myotomy during 2-year follow-up.ConclusionsThe data indicates that both methods of treatment might be useful in dysphagia control, but better results are obtained after myotomy. Repeat interventions are more frequent after endoscopic dilation. One method of treatment does not exclude the other. A short period of symptom relief after myotomy may suggest the myotomy was incomplete.