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The use of radial arteries as an arterial bypass conduit is an invasive procedure which is becoming popular among various medical centres. The greatest risk associated with harvesting the radial artery is ischaemia of the soft tissues of the hand. In this study we dissected 200 hands derived from 100 formalin-fixed cadavers in order to identify arterial patterns that will allow safe removal of the radial artery for use in bypass procedures. A complete superficial palmar arch (SPA) was found in 90% of the cases and divided into 5 types, while the remaining 10% possessed an incomplete palmar arch. Types of SPA are designated by the letter S. In type S-I (40%), the SPA is formed by anastomosis of the superficial volar branch of the radial artery to the ulnar artery. Type S-II (35%) is formed entirely of the ulnar artery. Type S-III (15%) is formed by anastomosis of the ulnar and median arteries. Type S-IV (6%) is formed by anastomosis of the ulnar, radial, and median arteries and Type S-V (4%) is formed by a branch of the deep palmar arch (DPA) communicating with the SPA.DPA was identified in all specimens and classified into three types, all designated by the letter D. Type D-I (60%) is formed by anastomosis of the deep volar branch of the radial artery and the inferior deep branch of the ulnar branch. Type D-II (30%) is formed by anastomosis of the deep volar branch of the radial artery and the superior deep branch of the ulnar artery. Type D-III (10%) is formed by anastomosis of the deep volar branch of the radial artery with both deep branches of the ulnar artery. This data could provide an important source of information for vascular surgeons harvesting radial arteries.
To confirm the sensitivity of the polymerase chain reaction (PCR) technique (versus blood cultures) and to gain a better understanding of the incidence of true- and false-positive results when using this technique, one hundred randomly chosen patients treated operationally because of valve defects were examined. In our studies we found that PCR techniques using universal primers complementary to the bacterial 16S rDNA showed promise as being more sensitive than conventional blood culture (BC) techniques. From the time that a blood culture is positive, conventional methods of culture and antibiotic susceptibility testing require at least 64 h for the detection of infection or colonization. Rapid identification of bacteria from blood using PCR technique accelerates the microbiological diagnosis.
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Outlined history of the development of the world and Polish cardiac surgery

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It was the dream of humanity to perform surgery on an open non-beating heart. Scientific and medical discoveries five thousand years ago in China, partially adopted by the Western civilization, laid, through ancient Egypt, Mesopotamia, Greece, Rome and, later on in the Renaissance, the foundations for the development of empirical medicine. The 19th and the 20th centures shoved dynamic scientific and technical development in various fields including medicine and surgery whose importance grew with the necessity to help the patients wounded in the wars. A break-through event in the development of surgery was overcoming of pain and discovery of reasons of infections and the control thereof, and, in the case of cardiology and cardiac surgery, the discoveries in physiology of circulation and the diagnostics of cardiovascular system diseases. This review contains a brief description of medical science in the past centuries, emphasizing the most important discoveries. A focus has been placed on the contribution of general surgery and thoracic surgery to the development of Polish and World cardiac surgery. The I Congress of the Polish Surgeons was held in 1889 in the Austria occupied territory of Cracow, which celebrated its one hundredth anniversary. The main obstacles in the development of clinical cardiac surgery included intratracheal general anesthesia, antisepsis and aseptics, hypothermia, oxygenators, extracorporeal circulation, transfusions, blood clotting and thromboses and cardioplegia. The spectacular heart and aorta surgical operations performed for the first time in the world and in Poland as well as the names of cardiac surgeons employed by the important cardiac surgery centers in Poland have been mentioned. The Department of Heart, Vascular and Transplantology Surgery of Cracow, the role and the share of Fundacja Rozwoju Kardiochirurgii COR AEGRUM in Cracow (COR AEGRUM Foundation for the Development of Cardiac Surgery in Cracow) in the construction of the new facilities for the Department of Cardiac Surgery of Cracow consecrated on June 9, 1997 by pope John Paul II, have been discussed. The contribution of the Club of Polish Cardiac Surgeons to the integration of surgical community and to development of the Polish cardiac surgery has been emphasized. In summary, it has been outlined that the contemporary standards of the Polish cardiac surgery do not differ from cardiac and vascular surgery and transplantology in developed countries.
The influence of ischemia on purine nucleotide and their catabolite concentration in human myocardium was investigated during surgery of acquired and congenital heart defects. This was compared with the influence of ischemia on rat heart. Concentrations of adenine and guanine nucleotides and their catabolites were measured in the extracts of heart biopsies taken at the onset of ischemia and at the time of reperfusion. The content of myocardial ATP in human heart decreased from the initial value of 223 ± 1.1 to 14.6 ±1.5 nmol/mg protein and total adenine nucleotide pool decreased from 34.2 ± 1.8 to 27.6 ± 1.5 nmol/mg protein during the operation. Significant increases in myocardial concentrations of purine catabolites were also observed with the most prominent rise in inosine from below 0.5 at the onset of the ischemia to 3.0 ± 0.5 nmol/mg protein at the time of reperfusion. A positive correlation was demonstrated between the concentration of purine catabolites in the heart at the end of ischemia with the decrease of both ATP and the total nucleotide pool. An interesting metabolic specificity of the ischemic human heart appeared to be only a small accumulation of inosine monophospahate (IMP). The increase of IMP in the rat heart after ischemia was several-fold higher.
The tendon of Todaro, found in the right atrium of the heart, has considerable clinical importance in the fields of both cardiac surgery and invasive cardiology. The goal of this study was to examine the occurrence and degree of development of the tendon of Todaro in humans. Research was conducted on material consisting of 160 human hearts of both sexes from the age of 14 Hbd to 87 years of age. Classical anatomical methods were used and histological sections were prepared from 100 hearts of various age groups stained with Masson’s method in Goldner’s modification. The tendon of Todaro occurred in all examined hearts. In foetal hearts, in the area typical of the course of the tendon of Todaro, a very well-developed, white structure was observed, convexed into the lumen of the atrium. Histologically, this was young fibrous tissue with a characteristically large number of fibroblasts. Evenly in infants and newborns, a visible convex structure was also observed extending into the lumen of the right atrium, however, to a lesser degree than in foetuses. In the group of hearts of young adults, it was also possible to follow the course of the tendon of Todaro macroscopically. However, the older the heart was, the less the convex was visible, and in older adults it was completely invisible. In histological sections, it was observed that with ageing the number of connective tissue cells decreased, and fibres forming the lining increased. In the hearts of older adults the tendon of Todaro formed very small ribbons of connective tissue. Histologically, only small numbers of cellular elements were noticed. In the adult heart the examined tendon was located the deepest and did not connect to the endocardium. We can conclude that the tendon of Todaro is a stable structure, occurring in all examined hearts even when it is not macroscopically visible. Due to the morphological changes that affect the tendon of Todaro in human ontogenesis, for the cardiac surgeon, its relevance as an important topographical structure in the hearts of older adults is minimal.
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