The infection of a vascular prosthesis is potentially fatal, and its effective treatment still remains the greatest challenge for vascular surgeons. We present our initial experience using bovine pericardial vascular prostheses to replace infected aortoiliac vascular grafts. Six consecutive patients with infection of the graft were prospec-

The technique of 24-hour esophageal multichannel intraluminal impedance monitoring combined with pH-metry (MII-pH) is currently considered to be the golden standard in the diagnostics of gastroesophageal reflux disease (GERD). The technique allows for differentiation of gas and liquid reflux as well as detection of non-acid reflux, which cannot be detected with other techniques that are based only on measuring the pH of gastric contents.THE AIM OF THE STUDY was to assess the usefulness of MII-pH in the diagnostics and treatment of GERD and its complications. MATERIAL AND METHODS. A group of 213 patients referred to II Katedra i Klinika Chirurgii Ogólnej, Gastroenterologicznej i Nowotworów Układu Pokarmowego Uniwersytetu Medycznego w Lublinie [the Second Faculty and Clinic of General and Gastrointestinal Surgery and Gastrointestinal Oncology at Medical University of Lublin] due to persistent symptoms of GERD and 21 volunteers without any clinical evidence of GERD underwent esophageal monitoring via MII-pH. The results were correlated with those of upper gastrointestinal tract endoscopy. The data gathered during MII-pH and endoscopy as well as information from questionnaires were entered into an MS Excel spreadsheet and subsequently analyzed with STATISTICA PL software. RESULTS AND CONCLUSIONS. MII-pH proved to be considerably more useful than conventional pHmetry in recording acid reflux. The sensitivity of pH-metry based on the MII-pH technique was established at 74%. GERD-induced changes in the esophageal mucosa result in decreased impedance baseline. The presence and severity of inflammatory esophageal lesions was proven to be associated with acid reflux episodes and proximal reflux episodes. No direct relationship between the grade of GERD and the occurrence of non-acid reflux episodes was confirmed. Non-acid reflux episodes were shown to predispose to non-erosive reflux disease (NERD). The results of this study confirm that MIIpH is an essential technique in the diagnostics, as well as in assessment of the course of treatment and the severity of GERD.

the aim of the study was to assess angiogenesis markers -endostatin and endothelial growth factor (EGF) as markers of detection of gastric carcinoma. material and methods. The study involved 20 patients with colorectal cancer (10 women, 10 men) aged 35 -75 years, mean age = 55 years ± 11.2 who referred to the 2 nd Department of General Surgery, Medical University in Lublin between June 2008 and June 2009. The control group comprised 10 volunteers (6 women, 4 men) who underwent upper gastrointestinal (GI) endoscopy due to the reflux disease and in whom gastric cancer was not diagnosed. Results. The mean endostatin concentration in controls was 5.21 ng/mL ± 1.37. Mean concentrations in patients with gastric cancer were higher than those in controls -5.91 ng/mL ± 1.5. The difference was not statistically significant (p= 0.714). The EGF concentration in the control group was 28.19 pg/mL ± 12.94. EGF concentrations in patients with gastric cancer were higher compared to the control group -28.8 pg/mL ± 12.63. The difference was not statistically significant (p= 0.85). The mean concentration of endostatin before the operation was 5.91 ng/mL ± 1.5 and after surgery was 5.33 ng/mL ± 2.01, the difference was not statistically significant. conclusions. Blood endostatin and EGF quantitative determinations probably is not useful for detection of gastric carcinoma and effectiveness of treatment.

Słowa kluczowe: badanie ultrasonograficzne (USG) trzustki, nowe techniki w USG, różnicowanie zmian ogniskowych w trzustce. Key words: pancreas US evaluation, new techniques, focal lesion of the pancreas.Adres do korespondencji: dr hab. n. med. Grzegorz Ćwik, Klinika Chirurgii Ogólnej, Gastroenterologicznej i Nowotworów Układu Pokarmowego, SPSK 1, ul. Staszica 16, 20-081 Lublin, tel. +48 81 532 41 27, faks +48 81 532 88 10, e-mail: grzegorzcwik@poczta.fm Artykuł poglądowy/Review paper Streszczenie Ultrasonografia (USG) jest podstawową metodą diagnostyki obrazowej jamy brzusznej. Obecnie badanie to jest w stanie zastąpić wiele procedur z zakresu klasycznej rentgenodiagnostyki, takich jak tomografia komputerowa, badania naczyniowe czy rezonans magnetyczny. Jest jedyną uznaną nieinwazyjną, czyli bezpieczną, techniką obrazowania. W ostatnich kilku latach nastąpił znaczący postęp w diagnostyce USG jamy brzusznej -postęp technologii, pojawienie się najnowszych aparatów USG o olbrzymiej rozdzielczości, o nowoczesnych wielofunkcyjnych głowicach i oprogramowaniu pozwalającym na odczytanie obrazu w trzech, a nawet czterech wymiarach. Badanie USG ma obecnie znaczenie nie tylko diagnostyczne. Ultrasonografia zabiegowa pozwala na przeprowadzenie bezoperacyjnego drenażu zbiorników płynowych, ropni, torbieli zarówno w wątrobie, trzustce, jak i w całej jamie brzusznej. Współcześnie ważną rolę w diagnostyce górnego odcinka przewodu pokarmowego oraz narządów miąższowych nadbrzusza odgrywa endosonografia (endoskopowa ultrasonografia -EUS). W dalszym ciągu zwraca się uwagę na wartość badania metodą biopsji aspiracyjnej cienkoigłowej celowanej (BACC) przezskórnej i pod kontrolą EUS. Dopełnieniem diagnostyki obrazowej jest USG śródope-racyjna oraz laparoskopowa. AbstractUltrasonography (US) is one of the basic methods in abdominal organ diagnosis. This method can replace a lot of classic radiological examinations such as computed tomography, radiological vessel imaging and even magnetic resonance imaging. It is the only widely accepted and safe imaging method. For the last few years we have observed advancement in US evaluation of the abdomen. Technological progress to high resolution units with multifunctional heads and software enables imaging in 3D or 4D. Nowadays US is not only a diagnostic method. We can also do a lot of procedures such as a minimally invasive approach to pseudocysts, cysts and abscesses in the pancreas and liver and the rest of the abdominal cavity. Endosonography (EUS) plays a great role in the evaluation of pathological changes in the upper gut and epigastric region. BACC under US or EUS control is still very valuable. And finally we can use intraoperative US via laparotomy or laparoscopy.

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