which approximately 50% originate from the carotid body [4]. The carotid body was first described by von Haller in 1743 [5]. It mainly regulates pH, pO 2 and pCO 2 levels in the blood by registering changes in those parameters and transmitting them though the glossopharyngeal nerve Paragangliomas, also known as chemodectomas or carotid body tumors, are rare neuroendocrine tumors. They represent about 0.03% of all neoplasms and appear more frequently in women than men (1. Objectives. The aim of the study was to carry out an epidemiological and clinical analysis of paraganglioma patients diagnosed and treated at the authors' clinics between 1985 and 2014. Material and Methods. The medical data of 47 patients were analyzed. All the patients were qualified for surgery. In 43 cases (88%), simple resection of the tumor was performed, including 11 cases (22%) that additionally required vascular suturing, and 5 (10%) that required reconstruction of the internal carotid artery. Carotid vessel repair was performed by shortening the internal carotid artery in 3 cases (6%), using a saphenous vein graft in 2 cases (4%), and by creating an anastomosis between the external carotid artery and the distal portion of the internal carotid artery in one case (2%). Results. In 40 cases (82%), the course of treatment was uneventful. Three patients (6%) were reoperated because of symptoms of cerebral stroke. Palsy of the hypoglossal nerve occurred in 3 cases (6%), and facial nerve palsy in 2 patients (4%). Six patients (12%) developed postoperative hematomas in the wound. In all the cases, histopathological examinations confirmed carotid paraganglioma. Conclusions. Cooperation with an otolaryngologist and vascular surgeon during surgery is recommended due to frequent damage to carotid vessels by carotid paragangliomas. Detection of the tumor in the early stages improves surgical treatment outcomes and reduces the number of complications. Regular postoperative check-ups are necessary due to possible occurrences of multiple tumors (Adv Clin Exp Med 2016, 25, 6, 1173-1177).

The study presented a case of a patient with a glomus tumor of the stomach, a mesenchymal neoplasm manifesting with upper gastrointestinal bleeding (Forrest IB). The patient was operated twice. First, he underwent elective laparotomy, during which Billroth I (Rydygier's method) gastric resection was performed. This his was followed by Billroth II resection with Braun's anastomosis. Histopathological examination revealed glomus tumor tissue. Literature data on the glomus tumor of the stomach are presented.

Purpose of Review Head and neck tumors (HNC) rank sixth among cancers worldwide. Due to their late diagnosis and poor prognosis, they are a clinical challenge. However, recent years have seen a dynamic development of science on the microbiome. The aim of the study is to discuss the role of the microbiome in HNC, the impact of the microbiome on oncogenesis, the course of the disease, as well as on treatment, and its toxicity. Recent Findings The microbiome’s influence on oncogenesis, the course of the disease, and the effectiveness of oncological treatment have been confirmed in cancers of the colon, pancreas, lungs, and prostate. There is no solid literature on HNC. Many studies indicate disruption of the oral microbiome and periodontal disease as potential cancer risk factors. Disruption of the microbiome increases radiotherapy’s toxicity, intensifying radiation reactions. Summary The microbiome plays an important role in cancer. It is a new target in research into new therapies. It may also be a prognostic marker of cancer development. Changes in the composition of the microbiome modulate the effectiveness of oncological treatment. More research is needed on the microbiome and its effects on HNC.

A superior vena cava (SVC) aneurysm is an extremely rare case of vascular malformation in the chest cavity. This is a report of a case of a 57-year-old woman with a saccular SVC aneurysm which was 8 cm wide. The chest computed tomography (CT) scan confirmed a giant 75 mm × 79 mm × 81 mm mass containing the contrast medium from SVC, constricting the right lung parenchyma, narrowing the right innominate vein, in contact with the anterolateral chest cavity wall, and adjoining the superior mediastinum.Under general anesthesia and employing the median sternotomy approach, using a cardiopulmonary bypass (CPB), the venous aneurysm was successfully resected. The postoperative period was uneventful. Radical surgical resection using a sternotomy and a CPB is recommended. and was entirely constricting the right upper lobe of the lung. After the mass was dissected from the right phrenic nerve and the surrounding tissue, we used a vascular clamp to exclude the neck of the aneurism. The mass was detached; the neck of the aneurysm was continuously sutured and strengthened with teflon felt patches (Figure 2).A histopathological examination was conducted and this confirmed that the mass which had been removed was a part of a venous blood vessel. A control CT scan and chest X-ray was done after surgery ( Figure 3). Because of an uneventful postoperative period, the patient was discharged on the 5th day after the procedure. DiscussionA vein aneurysm is an extremely rare phenomenon in medicine. In 1963, Abbot and Leight introduced a classification of aneurysms and divided them into four groups (congenital, acquired, pseudo-aneurysm, and arteriovenous aneurysm) (2). The fusiform aneurysm constitutes the vast majority. In our case we are presenting a saccular aneurysm, which has only been described in literature a few times. Such aneurysms are usually asymptomatic and are usually diagnosed accidentally in routine chest X-rays. Detailed diagnostics include a CT scan or magnetic resonance imaging (MRI). Aneurysms might be congenital, or caused by inflammation or by the degeneration of the vascular wall, but in most cases their cause is unknown (3). They might be solitary or they may coexist with cystic hygromas and angiomas. In asymptomatic patients where the diameter of the aneurysm is less than 40 mm, we might proceed conservatively, using anti-plaque therapy and periodic scans (4). Aneurysms which are larger, growing, symptomatic or containing thrombus require radical surgical treatment (3,5,6). Part of the thrombus forming the sack of the aneurysm can break away and cause pulmonary embolism or lung infarct which may lead to the patient's death (7,8). Particular caution is required in this circumstances. Thanks to CPB, our patient was protected from pulmonary embolism and lung infarct. The use of CPB should be considered not only when the thrombus formation is detected, but also in the case of calcification in the wall of the aneurysm (5). In our opinion, the type of surgical approach presented here gives better insight ...

Background. One of the underestimated causes of chronic pelvic pain (CPP) in women may be pelvic congestion syndrome (PCS) that is defined as the presence of varicose of ovarian and pelvic veins associated with chronic pain in the region of the pelvis. This pain is present longer than 6 months and intensifies with prolonged standing, coitus and menstruation. The disease constitutes a diagnostic as well as therapeutic problem, thus posing a challenge for the clinician. Transcatheter ovarian vein embolization might be a safe and effective option for PCS treatment. Objectives. The objective of this study was to evaluate the efficacy of ovarian vein embolization ovarian as a method of the PCS treatment. Material and methods. Between 2002-2012, 11 embolization procedures were performed in 10 women (age range: 34-43; median age 39) with the diagnosis of PCS. One patient underwent embolization procedure twice. In 1 case the combined therapy of endovascular embolization and surgical phlebectomy of vulvar varices was performed. Results. There were no major intrainterventional complications. In all the patients (100%) a significant improvement in the clinical status was noted. The procedure improved the quality of life in the patients. Three women (30%) had a mild recurrence of the symptoms at mid-term follow-up. Among 8 women who had complained of dyspareunia prior to embolization 6 patients reported complete pain relief, in other 2 cases the pain subsided partially. There was a significant decrease in the severity of symptoms associated with hemorrhoids. Conclusions. We consider embolization of insufficient ovarian veins an effective and safe way of treatment in a well-selected group of patients with PCS.

This case report presents the diagnostic and treatment procedures of stone removal from the kidney of a 67-year-old donor, the transplantation of the kidney to a 65-year-old recipient, and the postoperative course until the end of hospitalization. Computed tomography performed before collecting the organ showed a staghorn stone in the renal pelvis and lower calyces in the right donor kidney. The stones were removed ex-vivo using a rigid ureteroscope and a holmium laser prior to transplantation. Then the organ was transplanted to the left iliac fossa of a 65-year-old man with end-stage renal failure. The authors think there is a possibility of increasing the kidney pool, by using organs containing large calculi. In such cases stones should be removed before the operation and the patient should be monitored regularly, especially in the first months after the transplant.

Carotid endarterectomy is equally effective as CAS in stroke prevention, but is associated with a higher incidence of cranial nerve palsy, access site hematoma and other non-stroke complications. Symptomatic patients had a higher incidence of stroke, regardless of the treatment method.

Acute respiratory syndrome, associated with coronavirus 2 (SARS-CoV-2), is the most important medical and epidemic problem of today. The biggest challenge is to find an effective treatment and to reduce the need for hospitalisation. In the article, the patients with mild to moderate coronavirus disease 2019 (COVID-19) treated with doxycycline with significant improvement have been discussed. Doxycycline is a known antibiotic, but also an anti-inflammatory and immunomodulatory drug, so it seems to be ideal for the treatment of COVID-19. Doxycycline, as an easily available and low-cost medication, should be considered as a COVID-19 therapy in all patients in the first days of the symptoms of a SARS-CoV-2 infection. Due to its immunomodulatory, anti-inflammatory, cardioprotective and antiviral effects, it seems to be an ideal drug for patients with mild, moderate and severe disease. A large multicentre study is needed to evaluate the effects of this medication.