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Is endoscopic therapy the treatment of choice in all patients with chronic pancreatitis?
Beata Jab？ońska
World Journal of Gastroenterology , 2013, DOI: 10.3748/wjg.v19.i1.12
Abstract: Chronic pancreatitis (CP) is a progressive inflammatory disease of the pancreas characterized by destruction of the pancreatic parenchyma with subsequent fibrosis that leads to pancreatic exocrine and endocrine insufficiency. Abdominal pain and local complications (bile duct or duodenal stenosis and pancreatic tumor) secondary to CP are indications for therapy. At the beginning, medical therapy is used. More invasive treatment is recommended for patients with pancreatic duct stones (PDS) and pancreatic obstruction in whom standard medical therapy is not sufficient. Recently, Clarke et al assessed the long-term effectiveness of endoscopic therapy (ET) in CP patients. The authors compared ET with medical treatment. They reported that ET was clinically successful in 50% of patients with symptomatic CP. In this commentary, current CP treatment, including indications for ET and surgery in CP patients, is discussed. Recommendations for endoscopic treatment of CP according to the European Society of Gastrointestinal Endoscopy Clinical Guidelines are reviewed. Different surgical methods used in the treatment of CP patients are also discussed. ET is the most useful in patients with large PDS, pancreatic duct obstruction and dilation. It should be the first-line option because it is less invasive than surgery. Surgery should be the first-line option in patients in whom ET has failed or in those with a pancreatic mass with suspicion of malignancy. ET is a very effective and less invasive procedure, but it cannot be recommended as the treatment of choice in all CP patients.
Biliary cysts: Etiology, diagnosis and management
Beata Jab？ońska
World Journal of Gastroenterology , 2012, DOI: 10.3748/wjg.v18.i35.4801
Abstract: Biliary cysts (BC) are rare dilatations of different parts of a biliary tract. They account for approximately 1% of all benign biliary diseases. BC occur the most frequently in Asian and female populations. They are an important problem for pediatricians, gastroenterologists, radiologists and surgeons. Clinical presentation and management depend on the BC type. Cholangiocarcinoma is the most serious and dangerous BC complication. The other complications associated with BC involve cholelithiasis and hepatolithiasis, cholangitis, acute and chronic pancreatitis, portal hypertension, liver fibrosis and secondary liver cirrhosis and spontaneous cyst perforation. Different BC classifications have been described in the literature. Todani classification dividing BC into five types is the most useful in clinical practice. The early diagnosis and proper treatment are very important, because BC are associated with a risk of carcinogenesis. A malignancy risk increases with the age. Radiological investigations (ultrasonography, computed tomography, endoscopic retrograde cholangiopancreatography and magnetic resonance cholangiopancreatography) play an important role in BC diagnostics. Currently, prenatal diagnosis using ultrasonography is possible. It allows to differentiate biliary disorders in fetals and to perform the early surgical treatment that improves results. In most patients, total cyst excision with Roux-Y hepaticojejunostomy is the treatment of choice. Surgical treatment of BC is associated with high success rate and low morbidity and mortality. The early treatment is associated with a lower number of complications. Patients following BC surgery require permanent and careful postoperative observation using laboratory and imaging investigations because of possibility of biliary anastomosis stricture and biliary cancer in tissue remnant.
Iatrogenic bile duct injuries: Etiology, diagnosis and management
Beata Jab？ońska, Pawe？ Lampe
World Journal of Gastroenterology , 2009,
Abstract: Iatrogenic bile duct injuries (IBDI) remain an important problem in gastrointestinal surgery. They are most frequently caused by laparoscopic cholecystectomy which is one of the commonest surgical procedures in the world. The early and proper diagnosis of IBDI is very important for surgeons and gastroenterologists, because unrecognized IBDI lead to serious complications such as biliary cirrhosis, hepatic failure and death. Laboratory and radiological investigations play an important role in the diagnosis of biliary injuries. There are many classifications of IBDI. The most popular and simple classification of IBDI is the Bismuth scale. Endoscopic techniques are recommended for initial treatment of IBDI. When endoscopic treatment is not effective, surgical management is considered. Different surgical reconstructions are performed in patients with IBDI. According to the literature, Roux-en-Y hepaticojejunostomy is the most frequent surgical reconstruction and recommended by most authors. In the opinion of some authors, a more physiological and equally effective type of reconstruction is end-to-end ductal anastomosis. Long term results are the most important in the assessment of the effectiveness of IBDI treatment. There are a few classifications for the long term results in patients treated for IBDI; the Terblanche scale, based on clinical biliary symptoms, is regarded as the most useful classification. Proper diagnosis and treatment of IBDI may avoid many serious complications and improve quality of life.
Surgical Treatment of Pancreatic Neuroendocrine Tumours - Clinical Experience
Beata Jab ońska, Daria Dranka-Bojarowska, Hanna Palacz, Adam Lewiński, Pawe Lampe
Polish Journal of Surgery , 2011, DOI: 10.2478/v10035-011-0033-5
Abstract: The aim of the work was the clinical characteristics and analysis of preliminary results for surgical treatment of pancreatic neuroendocrine tumors (PNETs), based on own material. Material and methods. In the period from 2005 to 2009, in the Department of Gastrointestinal Surgery, Silesian Medical University in Katowice, there were 27 patients (15 males and 12 females) treated surgically for pancreatic neuroendocrine tumours, constituting 65.86% (27/41) of all gastroenteropancreatic neuroendocrine tumours. Prior to the surgery, the following diagnostic examinationswere performed: laboratory tests and imaging examinations (abdominal ultrasound and CT scan). The following tumour localisation was established: head of the pancreas - 14, body of the pancreas - 4, tail of the pancreas - 5, body and tail of the pancreas - 1, retroperitoneal space - 4. There were found 24 (88.89%) primary tumours and 3 (11.11%) recurrences. The following methods of surgical treatment were applied: pancreatoduodenectomy - 11, distal pancreatic resection with splenectomy - 6, middle segment resection with anastomosis between the pancreatic tail and jejunal loop: Roux-Y procedure - 1, pancreatic resection by Beger procedure - 1, pancreatic head and body resection with splenectomy - 1, tumour enucleation or local excision - 4, exploratory laparotomy with specimen collection - 3. Results. The mean hospitalisation period was 25 days (4-78 days). The mean procedure duration was 4.2 hours (1.15-9.15 hours). Early post-operative complications were observed in 10 patients (37.04%). The following early complications were observed: intra-abdominal abscess - 2, wound suppuration - 2, pancreatic fistula - 1, acute pancreatitis - 1, pancreaticojejunal anastomosis leak - 1, peritoneal cavity haemorrhage - 1, acute cholangitis - 1, adhesion obstruction - 1, subobstruction - 1, portal vein thrombosis - 1, sepsis - 1, fluid in pleural cavity - 1, acute heart failure - 1. There were performed 2 (7.41%) repeat surgeries: one due to adhesion obstruction and one due to peritoneal cavity haemorrhage. Death of 1 patient (3.71%) was recorded in the post-operative period due to acute heart failure. Conclusions. Pancreatic neuroendocrine tumours constituted the majority of gastroenteropancreatic neuroendocrine tumours in the analysed patient group. Most commonly, PNETs were localised in the head of the pancreas. In the presented material, the mortality rate does not exceed 4%, similarly as in other renowned centres.
The effects of lead level in the blood on social functioning in children with developmental disabilities [Wp yw poziomu o owiu we krwi na powstawanie utrudnień w funkcjonowaniu spo ecznym dzieci z zaburzeniami zachowania]
Szkup-Jab？ońska, Ma？gorzata,Karakiewicz, Beata,Grochans, El？bieta,Jurczak, Anna
Psychiatria Polska , 2011,
Abstract: Aim. The aim of the study was to assess the relationship between lead levels in children’s blood and the development of social disorders.Method. Lead levels were measured in every child’s blood test and following on from that the influence of this toxin on children’s behaviour was assessed. Manfred Cierpka questionnaire was used as the assessment tool examining children’s family relationships and Children’s Health Questionnaire Parent Form-28 was used to assess the subjects’ health profile.Results. The statistical analysis revealed a statistically significant relationship between lead concentration in the child’s blood and whether or not the child was able to meet social expectations (p=0.018), form affective relationships (p=0.046), its nervousness (p=0.024) and a generally lower assessment of his/her behavior in comparison with the peer group (p=0.024).Conclusions. Neurotoxic influence of lead on the developing child’s organism results in developmental disabilities in its behaviour. These dysfunctions can lead to disorders in the child’s social development and they can hinder its functioning. An increased concentration of metal toxins in the child’s blood can be responsible for difficulties in meeting social expectation, which in turn is connected with increased nervousness and disorders in forming relationships. Children facing these problems often receive negative marks for their behaviour in comparison with the peer group. Such difficulties can lead to the child’s social exclusion and predispose it to making antisocial or criminal decisions in the future.
Natural and Chemically Modified Post-Mining Clays—Structural and Surface Properties and Preliminary Tests on Copper Sorption
Andriy V. Kityk,Beata Jab？ońska,Mark Busch,Patrick Huber
Minerals | An Open Access Journal from MDPI , 2019, DOI: https://doi.org/10.3390/min9110704
Abstract: The structural and surface properties of natural and modified Pliocene clays from lignite mining are investigated in the paper. Chemical modifications are made using hydrofluoric acid (HF), sulfuric acid (H 2SO 4), hydrochloric acid (HCl), nitric acid (HNO 3), sodium hydroxide (NaOH), and hydrogen peroxide (H 2O 2), at a concentration of 1 mol/dm 3. Scanning electron microscopy is used to detect the morphology of the samples. Nitrogen adsorption isotherms were recorded to determine the specific surface area (SSA), mesoporosity, microporosity, and fractal dimensions. The raw clay has an SSA of 66 m 2/g. The most promising changes in the structural properties are caused by modifications with HF or H 2SO 4 (e.g., the SSA increased by about 60%). In addition, the raw and modified clays are used in preliminary tests with Cu(II) sorption, which were performed in batch static method at initial Cu(II) concentrations of 25, 50, 80, 100, 200, 300, and 500 mg/dm 3 in 1% aqueous suspensions of the clayey material. The maximum sorption of Cu(II) on the raw material was 15 mg/g. The structural changes after the modifications roughly reflect the capabilities of the adsorbents for Cu(II) adsorption. The modifications with HF and H 2SO 4 bring a similar improvement in Cu(II) adsorption, which is around 20–25% greater than for the raw material. The structural properties of investigated clays and their adsorptive capabilities indicate they could be used as low-cost adsorbents (e.g., for industrial water pretreatment). View Full-Tex
Distal Pancreatectomy - OWN Experience
Marek Olakowski, Beata Jab ońska, ukasz Braszczok, Andrzej Lekstan, Pawe Bednarek, Agnieszka Bratek, Anna Bocheńska, Pawe Lampe
Polish Journal of Surgery , 2012, DOI: 10.2478/v10035-012-0050-z
Abstract: The aim of the study was the retrospective analysis of early results after distal pancreatectomy (DP). Material and methods. During the period between January, 2000 and December, 2010 distal pancreatectomy was performed in 73 patients, including 32 (43.83%) male, and 41 (56.16%) female patients. Average patient age amounted to 53.92 ± 14.37 years. Surgery was performed by means of laparoscopy or the classical method. Results. The mean duration of the procedure amounted to 179.79 ± 59.90 minutes. Fifty-nine (80.82%) patients were subject to splenectomy. After the resection the pancreatic stump was hand-sewn in 69 patients. Pancreatoenterostomy was performed in 4 (5.47%) patients. Early postoperative complications occurred in 11 (15%) patients. Reoperation was required in two (2.7 %) patients. The postoperative mortality rate amounted to 2.7%. The average hospitalization period after surgery amounted to 12.72 ± 9.8 (1- 66) days. Conclusions. Distal pancreatectomy performed in a center experienced in pancreatic surgery is a safe procedure characterized by a low rate of complications and mortality.
When the prefixes meet the suffixes
Patrycja Jab？ońska
Nordlyd : Troms？ University Working Papers on Language & Linguistics / Institutt for Spr？k og Litteratur, Universitetet i Troms？ , 2004,
Abstract: This paper explores the different interpretations the prefix po- in Polish gets depending on what kind of stem it attaches to. Thus, I show that the distinction between high and low suffixing verbalizers correlates with a distinction within the prefixal domain, namely the type of verbalizer influences the interpretation that po- is assigned, as well as being responsible for the restriction on po- attachment.1 I argue for four different structural positions into which a prefix can be inserted. The system bears on the way Aspectual proper- ties are decided in the course of the derivation, with three different aspectual levels (Asp1P relevant for most of the prefixes, Asp2P i.e. Secondary Imperfective (henceforth, SI), and Asp3P relevant for po- exclusively) contributing information which can be overridden on higher levels.
Remarks on Haar meager sets and Haar null sets in spaces of sequences
Eliza Jab？ońska
Mathematics , 2014,
Abstract: In the paper we will show how to construct a Haar meager set (consequently meager) which is not Haar null, and conversely, a meager Haar null set which is not Haar meager in spaces of sequences: $l_p$ with $p\geq1$, $c_0$ or $c$. It refers to the paper \cite{Darji}.
Some analogies between Haar meager sets and Haar null sets in abelian Polish groups
Eliza Jab？ońska
Mathematics , 2014,
Abstract: In the paper we would like to pay attention to some analogies between Haar meager sets and Haar null sets. Among others, we will show that $0\in \inn (A-A)$ for each Borel set $A$, which is not Haar meager in an abelian Polish group. Moreover, we will give an example of a Borel non-Haar meager set $A\subset c_0$ such that $\inn (A+A)=\emptyset$. Finally, we will define $D$-measurability as a topological analog of Christensen measurability, and apply our generalization of Piccard's theorem to prove that each $D$-measurable homomorphism is continuous. Our results refer to the papers \cite{Ch}, \cite{Darji} and \cite{FS}.
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