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In the Department of General Surgery of Medical University 11 patients with hydatid cysts of liver were operated. Ultrasonography and computer tomography allowed to define exact localization, size and contents of the cysts, what made possible planning of operating procedure. In 2 cases nonanatomic resection of liver parenchyma was performed, in 2 ones with coexisting stornach neoplasm just excision of the frontal wall of the cyst and emptying of the interior. In all the other cases the cysts were removed with surrounding liver tissue. Late results of surgical treatment with albendazol therapy are good. Diagnosis of echinococcic desease should be precised, considering with possibility of coexisting foci in other organs.
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Liver cysts taken from 9 patients, operated on in the Medical Academy Clinic in 2000, have been examined. Cyst layers, their thickness and content have been analysed. We have searched for the cestoid scolexes and rostellar hooks. In 6 patients Echinococcus granulosus larvae have been found. In 4 cases there have been protoscolexes discovered, however with some signs of degeneration of the larva. In one case dead larva has been diagnosed on the basis of the presence of single hooks and in one patient one larva alive with unchanged structures has been revealed. Profound parasitological examination is a good supplement to the examination of the histopathological slides, especially in the case of degenerating larvae, when the tissues of the parasite lose their contact with the connective tissue layer of the host. Separated layer fragments, as well as protoscolexes and rostellar hooks need not be exposed to histological cutting.
The purpose of this Work was to analyse results of serologie examinations and complaints reported by patients who were operated on echinococcal liver cysts. The analysis was conducted on patients who were qualified to surgical removal of echionococcal liver cysts. Persons who were analysed answered the questionaires and 11 of them send sera for serologie examination. The questionaires consisted of questions about time since operation, complaints before and after operation abdomen pains, distensions, vomits, exanthema, weakness, headaches). Results showed that patient were from 1 to 6 years after operation. Among 11 who send sera 18% results were negative (2 and 6 years after operation) and 82% was positive. Analysis of 15 questionnaires showed that majority of patients still had the complaints that were present before operation.
Role of E. granulosus-specific IgG antibody avidity in evaluation of a natural history of the parasite cysts in the liver, duration of infection and immunogenic cysts activity was studied. Thirty-one patients with liver cysts suspected of echinococcosis were examined; E. Granulosus infection was finally confirmed by a fine needle aspiration biopsy or surgery in 29 cases (93.5%) and two non-parasitic simple cysts in the liver were diagnosed. E. granulosus-specific IgG antibody was found in 21 patients (67.7%). High IgG avidity values were observed in 14 patients with liver cysts in a degcneration stage confirmed by imaging techniques. Low IgG avidity values were mostly detected in children with hypoechogenic echinococcal cysts being in a recent stage of infection. Determination of anti-E. Granulosus immunoglobulin G antibody avidity is a very usefull diagnostic tool for a determination of parasitic cysts activity and their developmental age.
Cystic and alveolar echinococcosis, parasitic diseases, caused in humans by the larval stage of tapeworm Echinococcus granulosus and E. multilocularis are rare diseases in Poland. We have diagnosed 71 patients with cystic echinococcosis and 10 patients with alveolar echinococcosis during last 12 years. Echinococcosis still create significant diagnostic difficulties, particularly alveolar one. Progress and actually available radiological imaging techniques, which can be applied in the cystic and alveolar echinococcosis diagnostics, are presented. Ultrasound appearance, CT, MRI images are described. Own experience with Proton Magnetic Resonans Spectroscopy in two patients with recurrent alveolar echinococcosis are presented.
The occurrence of parasites in wild boars in the Olsztyn province has been analysed. It was found that trichinellosis in the period from 1975 to 1990 occurred in 191 animals (0.229%), lung worms in 6442 (7.72%), hadatidosis in 3463 (4.5%), cysticercosis in 12 (0.014%) and liver fluke in 7 (0.008%). There was observed a distinet increase of T. spiralis extensiveness. A marked number of trichinellosis was noted especially in 1985 and 1990 (0.421% and 0.452% respectively). Liver fluke and cysticercosis appeared only three times: liver fluke in 1979, 1988 and 1990 (extensiveness from 0.02% to 0.05%) and cysticercosis in 1978, 1987 and 1990 (from 0.02% to 0.14%). Hadatidosis and roundworms were found every year: extensiveness of hadatidosis fluctuated from 4.15% to 7.72% and roundworms from 4.24% to 12.82%.
The occurrence of parasites in slaughter animals between 1980—1991 in the Olsztyn province was analysed. Out of 2 231633 slaughter pigs trichinellosis was found in 20 animals (0.0009%), hydatidosis in 9037 (4.047%), cysticercosis in 80 (0.0036%) and liver fluke in 27 (0.0012%). In cattle (221 971 animals) cysticercosis was recorded in 8042 (3.62%), liver fluke in 62 662 (28.23%) and hydatidosis in 41 (0.018%). Of 15 369 examined sheep liver fluke was observed in 1460 animals (9.5%) and hydatidosis in 106 (0.69%). The post mortem examinations pointed to a significant extensiveness of parasitic invasions, particularly liver fluke in cattle and sheep (28.33% and 9.5% respectively), cysticercosis in cattle (3.62%) and hydatidosis in pigs (4.04%).
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