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A case of comminuted pelvic fracture with marked displacement of the fragments complicated by extensive genitourinary injury is presented. Pelvic ring was reconstructed and stabilized with Hammer external fixator; the fracture united without complications.

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Carcinoma of the gallbladder has always been associated with dismal prognosis. In this study we present single institution experience in surgical treatment for gallbladder cancer obtained during last five years. Even with recent improvement in diagnostic imaging modalities gallbladder malignancies are still diagnosed too late. The choice of operative procedure for a treatment of gallbladder carcinoma still remained the open question. Carcinoma of the gallbladder is not very common disease in Europe, but some how more common in Poland. According to the National Register, based on a study from 1991, 1863 cases of death from the gallbladder carcinomas were registered [13]. At the same time 2015 new cancer cases were diagnosed and registered. These gave us a crude rate of new cases in 1991 as follows: 2.7/100,000 man and 7.7/100,000 female. Those were even higher for some voivodeships in 1988, for example: Lódz (M = 3.95/100,000, F = 10.58/100,000) and Warsaw (M = 3.15/100,000, F = 7.59/100,000). Carcinoma of the gallbladder has always been associated with dismal prognosis. This was essentially the result of the slow and asymptomatic growth of the neoplasm that infiltrates the surrounding structures, such as the portal vein, hepatic artery and liver parenchyma, making a curative surgical treatment almost impossible. So there is a general impression that no progress has been made during last 20 years in the treatment for carcinoma of the gallbladder [2, 7, 9, 12]. However, in last years, we have observed improvements in diagnostic, surgical and intensive care techniques that allowed to offer a wider range of surgical and non-surgical options to our patients [1, 3, 4, 6, 8].(ABSTRACT TRUNCATED AT 250 WORDS)

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Three short-course regimens, all comprising isoniazide (H), rifampicine (R), streptomycine (S) and pyrazinamide (Z), are compared in a randomized prospective cooperative clinical trial. The drugs are given daily in a 3-month regimen (3-HRSZ), twice a week in a 6-month regimen (6-HRSZ2), and in a further two-phase 6-month regimen the 4 drugs are administered 3 times a week for the first 3 months followed by the administration of HSZ twice a week (without R) for further 3 months (3-HRSZ3/3-HSZ2). The number of patients admitted to study is 80, 144 and 139 respectively. The 3-month regimen has been stopped because of a high rate of relapses. 17 p.c. of the patients admitted have to be excluded from analysis for various reasons, out of these 5.8 p.c. because of adverse reactions. Two thirds of the patients had heavily positive sputum cultures at the start. 300 patients completed therapy. At the end of therapy cultures were negative in 94 p.c., 100 p.c. and 99 p.c. respectively. The rate of bacteriological relapses is 19 p.c. in 3-HRSZ, 9 p.c. in 3-HRSZ3/3-HSZ2 and 3 p.c. in 6-HRSZ2, during a follow-up period of 3-4 years after completing therapy. The acceptability was good in all treatment groups. Adverse reactions like "flu" were rarely observed. Increased blood urea was common but in general without clinical symptoms. Elevation of ALAT and ASAT was relatively frequent but mostly transient and without clinical importance. The results served as basis for the new "Recommendation for Treatment of Tuberculosis" and are interpreted with regard to practical consequences and possibilities for further rationalisation of treatment.

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The purpose of this study was to examine muscle plasmalemma which is implicated as the site responsible for the appearance of malignant hyperthermia in human and susceptible strains of animals. In pigs with malignant hyperthermia (MH) the activity of Na+/K+, Mg2+-ATPase, p-nitrophenylphosphatase and Mg2+-ATPase fell significantly during anaesthesia. In the control group the contrary occurred. In both the groups tested there was a marginal rise in the levels of sialic acid. The levels of cholesterol and lysoderivatives were abnormal before the provoking agents were administered but they changed significantly after onset of the MH syndrome. Anaesthesia reduced the phospholipids level in both tested animal groups. Before and after the provoking agents an impoverishment in the polypeptide pattern in the range between 80,000 and 30,000 daltons of mol. wt. in MH susceptible animals occurred. It is postulated that in MH the macromolecular disorganization of the muscle plasma membranes means that defence mechanisms maintaining cell gradients do not work in the presence of provoking agents.

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During a period of 5 months 44 patients with acute carbon monoxide poisoning were treated with hyperbaric oxygen. In 80% of cases very good results were obtained. Analizing the causes of death the following factors were considered: the duration of exposure to carbon monoxide, the age of patients and the degree of unconsciousness at the time of hospital admission. The patients stayed in a hyperbaric chamber for 90 min. on the average. The mean pressure of 100% oxygen was 2.5 ATA. When lower pressures were applied the time necessary for elimination of the same amount of carbon monoxide from the organism was slightly prolonged, nevertheless, the use of lower pressures is recommended, since it reduced the risk of toxic effects on oxygen.

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