The heterotopic pancreas, which is usually described as an untypical presence of pancreatic tissue without any anatomic or vascular continuity with the pancreas, is relatively rare. Clinical manifestations may include bleeding, inflammation, pain and obstruction; however, in most cases it remains silent and is diagnosed during autopsy. Here, we report a case of ectopic pancreatic lesion located in the gastric cardia. The patient was a 73-year-old woman who had a history (over four months) of chronic epigastric pain accompanied by heartburn. Esophagogastroduodenoscopy revealed inflammatory changes throughout the stomach and lower esophagus, as well as a flat polypoid mass with benign features located in the gastric cardia, approx. 10 mm below the "Z" line, measuring approx. 7 mm in diameter. Endoscopic biopsy forceps were used to remove the lesion. Histological examination of the lesion revealed the presence of heterotopic pancreatic tissue in the gastric mucosa. On the basis of the presented case, we suggest that pancreatic ectopia should be a part of differential diagnosis, not only when dealing with submucosal gastric lesions, but also with those that are small, flat and/or untypically located.

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IntroductionFailure to perform surgical repair of varicocele before puberty is among the common causes of male infertility. The purpose of this study was to evaluate the testicular volume and fertility potential in men after laparoscopic varicocelectomy conducted in adolescence due to varicocele and concomitant testicular hypotrophy.Material and methodsFrom 1996 through 2011, eighty–two adolescents were operated on for unilateral primary varicocele with testicular hypotrophy. Sixty–eight patients were subject to the current analysis. The age of the patients was 13 to 17 years (mean 15.3 years). Clinical diagnosis was established on the basis of andrologic examination and ultrasonography with an assessment of testicular size and varicocele severity. Laparoscopic surgical repair was performed by a transperitoneal approach with division of testicular vein only.ResultsAn increase in left testicular volume when compared with the contralateral testis was found in 25 (78.1%) young men with clinical grade 2 varicocele (p = 0.02) and in 32 (88.8%) subjects with grade 3 abnormality (p = 0.04). An increase in left testicular volume was found in 46 (85.1%) of 54 patients with unilateral varicocele and in 12 (85.7%) of 14 subjects operated on for bilateral disease. A left testicular volume increase was comparable independent of the use of uni– or bilateral repair. Fifty–eight (85.2%) of our 68 patients had normozoospermia.ConclusionsLaparoscopic varicocele repair resulted in a significant increase of hypotrophic testicular volume in 83.8% of our subjects.

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Results. The group of 36 patients (19 women and 17 men); mean age of 47 years with a range of 16-74 years) was examined. The mean length of time for the examination was 22 h 47 min, the shortest one lasting 18 h 36 min; brakes were caused by battery failure. 1509 episodes of reflux were confirmed by impedance channels. Only 538 (35.65%) of these reflux episodes were acidic or weakly acidic and 971 (64.35%) were non-acidic. There was one patient without acid reflux episodes during examination and only 12 non-acidic episodes. The proximal extend, defined as 15 cm above the LES, achieved 616 reflux episodes (40.82%). None of the patients had abnormal physical clearing times; 5 had extended chemical clearing times (13.8%) in recumbent positions. Summary. This paper is not a statistical evaluation of a MII-pH study and is only a report of our first experiences with this new diagnostic method. Objective evaluation of symptom correlation to reflux in MII and the chemical character of the refluxate gives a much more precise qualification to the best type of treatment. In cases of non-acidic reflux, MII-pH testing hastens decision making about surgery.

An analysis in 53 patients with kidney cancer has been conducted, a group on which kidney sparing operations have been performed. 25 women and 28 men have been examined at the age of 53.7 in the postoperative period of 7 divided by 130 months. The average observation time without any recurrences or metastases was 48.8 months. 5.7% local and 1.9% remote decease related recurrences have been found. The stage of clinical progression and the degree of histological malignancy are factors determining the five-year survival being 98.0%, while without any recurrences or metastases being 88.4%.

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1. The original quality of life questionnaire meets the requirements for the tools evaluating quality of life in gastroesophageal reflux disease. 2. The usefulness of questionnaire was confirmed in a group of 10,623 patients with gastroesophageal reflux disease in the Polish population. 3. The questionnaire equals the international tests, while its advantages are the ease of completion and high level of perception.