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Biomedical subjects

B Nowak

Publications and source records attributed to B Nowak.

At least 91 records · Page 5Linked to original sources
PubMed1998

Heavy metals in human hair and teeth: the correlation with metal concentration in the environment.

Biological samples were collected simultaneously with environmental quality investigations. Studies of metal levels in biological (hair and teeth) and environmental (soil and air) samples were performed in Zwardoń during 1991/1992. Zwardoń is a small mountain resort village, situated on the border pass of Zwardoń, in the close proximity of the southwestern border of Poland. Heavy metal levels in soil, air, and chemical metals forms in the soil were examined. Pearson's product correlation in soil (for total concentration of heavy metals and each chemical form) in hair and in teeth was calculated to investigate bioavailability of heavy metals in human organism. We received essential correlations simultaneously between: Pb vs Mn in exchangeable form of metal in soil, in teeth and in soil (total); Cd vs Zn and Mn vs Co in organically bound form in soil and in teeth and soil (total); and Cu vs Zn in all investigated samples (teeth, hair, soil total, and organically bound form in soil); Mn vs Co and Cr vs Mn in residual form in soil, in teeth, and in soil (total) and between Co vs Ni for hair, soil (total), and residual form in soil.

Adolescent↗
PubMed1998

[Prognostic significance of analysis of heart rate variability inpatients with dilated cardiomyopathy].

UNLABELLED: Sudden cardiac death is frequent in patients with dilated cardiomyopathy. To assess the risk of an arrhythmic event is still difficult. Here the analysis of the heart rate variability offers new possibilities. METHOD: 25 patients (18 males, 7 females, age 53 +/- 9 yrs) with dilated cardiomyopathy were included in the study. Analysis of heart rate variability assessed by time- and frequency-domain measures was determined from Holter recording. The mean follow-up was 18 +/- 5 months. RESULTS: 6 patients died (5 of sudden cardiac death, 1 of heart failure), 1 patient with an implanted defibrillator received an adequate shock. Parameters influenced by low- and mid-frequent oscillations of the heart rate were significantly lower in patients who died suddenly or had adequate shocks. The best predictive parameter was the s.d.RR: all patients with an s.d.RR < 50 ms had lethal arrhythmias whereas the s.d.RR of the surviving patients was > or = 50 ms. No significant difference was found or high frequency parameters, which are mainly influenced by parasympathetic activity. CONCLUSION: The analysis of heart rate variability is of prognostic relevance in patients with dilated cardiomyopathy. Especially the s.d.RR is able to identify patients with a high risk of a sudden cardiac death.

Adult↗
PubMed1998

Taurine chloramine down-regulates the generation of murine neutrophil inflammatory mediators.

We previously reported that taurine chloramine (TauCl), a product of activated neutrophils, inhibits the generation of macrophage inflammatory mediators such as nitric oxide (NO), TNF-alpha, and PGE2. Taurine, the most abundant free amino acid in the cytosol of neutrophils, is chlorinated to form TauCl by the halide-dependent myeloperoxidase (MPO) system. Under physiological conditions, TauCl reduces HOCl toxicity. In this study, we investigated the influence of TauCl on generation of oxygen free radicals, cytokines and eicosanoids by activated murine peritoneal neutrophils. We found that TauCl, but not taurine alone, inhibited the production of NO, prostaglandin E2, interleukin-6 and tumor necrosis factor-alpha, in a dose-dependent manner. In contrast, the products of the respiratory burst, as measured by luminol-dependent chemiluminescence (LCL), were reduced by both taurine and TauCl. However, taurine affected LCL at higher concentrations and to a lesser extent than TauCl. The results of these studies suggest that TauCl decreases production of tissue-damaging inflammatory mediators and may regulate the balance between protective, microbicidal and toxic effect of neutrophils.

Animals↗
PubMed1998

In vitro examination of the coronary artery wall after balloon angioplasty using intracoronary ultrasound.

After autopsy 12 human coronary arteries were investigated by intracoronary ultrasound in order to measure the vessel wall dimensions and to detect damage on the vessel wall architecture after balloon angioplasty. Histology revealed artherosclerosis in 11/12 arteries. A total of 41 representative coronary segments were selected for further off-line ultrasound and histological analysis. Intracoronary ultrasound and histological measurements of the vessel wall thickness after balloon dilatation demonstrated a good correlation between the maximum thickness of the intima (histology 0.62 mm vs. intracoronary ultrasound 0.65 mm, r = 0.87) and the intima-media complex (0.80 mm vs. 0.83 mm, r = 0.87), in contrast to a weak one between the minimum thickness (r = 0.46 and r = 0.37). A total of 21 cases of damage occurred during angioplasty; intracoronary ultrasound detected 17. Further analysis showed that it imaged 10 of 11 cases of damage involving more than 30 degrees of the vessel circumference and 7 of 10 cases of damage involving less than 30 degrees of the vessel circumference. After balloon angioplasty of diseased coronary arteries, intracoronary ultrasound is therefore reliable in measuring the maximum wall thickness and in imaging damage involving more than 30 degrees of the vessel wall circumference.

Angioplasty, Balloon↗
PubMed1998

Cross-talk between gammadelta T lymphocytes and immune cells in humoral response.

The role of gamma delta T cells in immunoregulation is largely unknown. In the current study we noted that gamma delta T cells play a positive role in the humoral response. These positively acting gamma delta T cells are required for the successful adoptive cell transfer of the humoral response, as well as for in vitro generation of plaque-forming cells (PFC). The presented results show that gammadelta T cells cause an increase in interleukin-10 (IL-10) production, which partly elucidates the mechanism of action of these cells. However, experiments with cell culture inserts strongly suggest that direct cell-cell contact between immune and gamma delta H-2-compatible regulatory T cells is critical to the exertion of the positive immunoregulatory function of gamma delta cells. The mechanism of cross-talk between these two cell populations is still not clear but we regard as most likely that the positively acting gamma delta T cells may interact with a complex of heat-shock protein-non-polymorphic MHC (IB) on the surface of T helper type 2 and/or B cells. This could provide, by direct cell-cell contact, the cognate recognition between gamma delta T-cell receptors and heat-shock protein-MHC that leads to positive internal signalling in the immune cells.

Animals↗
PubMed1998

Paroxysmal atrial fibrillation and high degree AV block: use of single-lead VDDR pacing with mode switching.

Dual chamber rate responsive pacing incorporating a mode switching option is increasingly used in patients with chronic paroxysmal atrial fibrillation and high degree AV block. Single-lead VDDR pacemakers have rarely used for this indication. The purpose of this study was to determine their reliability of atrial sensing during atrial fibrillation, the percentage of atrial synchronous ventricular pacing, and the behavior of the sinus rate outside the phases of atrial fibrillation. We studied ten patients with a single-lead VDDR pacemaker implanted for this indication. Follow-up visits were performed at predischarge and after 1, 3, 6, 12, 18, and 24 months. During the mean follow-up period of 18.9 +/- 6.9 months, the atrial sensing thresholds in sinus rhythm remained stable. Atrial synchronous ventricular stimulation was achieved in 68.7 +/- 31.2% (median 82.5%) of the whole follow-up time. All patients showed an adequate atrial rate response during sinus rhythm. Atrial fibrillation was detected by the pacemakers in 24.0 +/- 29.8% of time. In 3 of 10 patients the duration of atrial fibrillation showed a steady increase from visit to visit. The sensed amplitudes of atrial fibrillation ranged from 0.1-1.0 mV. A programmed atrial sensitivity of 0.1 mV was necessary to achieve complete sensing of atrial fibrillation. None of the patients experienced tachycardias with optimized pacemaker programming. Single-lead VDDR pacing incorporating a mode-switching option is useful in patients with high degree AV block and paroxysmal atrial fibrillation, since it provides atrial synchronous ventricular pacing in more than two-thirds of follow-up time. In a subgroup of patients, a progressive increase of the time during atrial fibrillation was demonstrated. A reliable detection of paroxysmal atrial fibrillation requires the programming of the atrial sensitivity to its most sensitive value.

Atrial Fibrillation↗
PubMed1998

Pacemaker therapy in premature children with high degree AV block.

The smallest pacemaker pulse generator and a steroid-eluting bipolar epicardial lead were implanted in two premature children with symptomatic AV block. Stable capture threshold and high amplitude evoked response electrogram resulted in normal function of the pacemaker Autocapture algorithm, which adjusts output 0.3 V above the measured capture threshold. Autocapture had previously been used only with endocardial leads. Longer-term observation is required.

Electrodes, Implanted↗
PubMed1998

How reliable is atrial sensing in single-lead VDD pacing: comparison of three systems.

UNLABELLED: This study evaluated the reliability of atrial sensing, expressed as AV synchronous stimulation, in three VDD systems with the atrial sensitivity (AS) programmed to a conventional value with a 2:1 safety margin compared to most-sensitive values. We studied 34 sex- and age-matched patients with 3 VDD systems: 14 with Unity 292-07, 10 with Saphir 600, and 10 with Thera VDD (5 model 8948 and 5 model 8968i). Two 24-hour Holters were performed on consecutive days. The AS was programmed in a randomized order to its most-sensitive value or to a 2:1 safety margin. All other parameters were programmed identically. The patients underwent a myopotential oversensing test and a daily life activity protocol. A beat-to-beat analysis of the Holters was performed to determine AV synchrony. For the entire group AV synchrony with conventional AS was 98.63% +/- 2.57%, compared to 99.80% +/- 0.43% with most-sensitive values (p = 0.002). There was no difference between the three systems with conventional AS. With the most-sensitive AS, AV synchrony was: Unity 99.99% +/- 0.03%, Saphir 99.42% +/- 0.60% (P = 0.002), Thera 99.81% +/- 0.35% (ns). In the Saphir system with an atrial blanking period of 150 ms, ventricular far-field sensing could be demonstrated in 5 of 10 patients. This reduced the percentage of AV synchrony due to an unwanted mode-switch to a nontracking mode. Myopotential oversensing was not detected in any patient. CONCLUSION: The VDD systems tested under identical conditions showed reliable P wave sensing at the most-sensitive atrial sensing setting without myopotential oversensing. Ventricular far-field sensing reduced AV synchrony and must be avoided by appropriate refractory periods.

Aged↗
PubMed1998

First experience with an automatic sensing algorithm in single-lead VDD stimulation.

UNLABELLED: An "Autosensing" algorithm available in SSI(R) and DDR(R) pacemakers automatically adapts the device's sensitivity to changing intracardiac signals. The atrial sensing function of this algorithm was tested for the first time with a VDD pacing system in which large variations of the atrial signal may occur because the atrial electrodes float in the atrial blood pool. METHODS: 15 patients with a VDD pacing system were studied (Unity 292-07, lead 425; Sulzer Intermedics). The atrial sensing threshold was measured, and the atrial sensitivity was programmed with a 2:1 safety margin. The autosensing algorithm and sensitivity profile were temporarily activated, and an ambulatory ECG with continuous marker annotation was recorded. All patients underwent a 30-minute daily life activities protocol. A beat-to-beat analysis of the ambulatory ECG was correlated with the changes in atrial sensitivity. RESULTS: The algorithm changed the baseline sensitivity from 0.57 +/- 0.23 mV during the test to 0.39 +/- 0.20 mV after the final rest period (P < 0.05). During the test 12.6 +/- 10.2 adaptations of the sensitivity occurred (range 0-33). In eight patients atrial undersensing occurred in 4.4% +/- 7.5% of the cycles (4-458 unsensed P waves). In these patients, the algorithm continuously adjusted the sensitivity towards more sensitive values, operating 19.1 +/- 18.3 changes compared with 5.4 +/- 7.3 changes in patients without undersensing (P = 0.009). Oversensing did not occur. CONCLUSION: The autosensing algorithm effectively optimized atrial sensitivity in VDD pacing. In patients with atrial undersensing the algorithm continuously remained near the most sensitive settings, thus reacting as intended. A faster sensitivity adjustment of the system would be desirable.

Activities of Daily Living↗
PubMed1998

Is atrial sensing of ventricular far-field signals important in single-lead VDD pacing?

UNLABELLED: In single-lead VDD pacing the atrial sensitivity frequently is programmed to sensitive values. Atrial sensing of ventricular far-field signals should be reduced by differential atrial sensing. The aim of the study was to evaluate the effectiveness of this approach. METHODS: The study included 10 patients with a single-lead VDD pacemaker (Thera 8948, Lead 5032). The atrial sensitivity was set to its most sensitive value of 0.18 mV and the telemetered intraatrial EGM was continuously recorded. After atrial tracked ventricular pacing, VVI pacing was performed with pacing rates from 100 to 160 beats/min in steps of 10 beats/min and up to 165 beats/min. The peak-to-peak amplitudes of P waves (P) and ventricular far-field signals (VFFS) were measured from the recordings. The ratio P/VFFS that defines the atrial signal-to-noise ratio was calculated, and the time from stimulus to maximum of the far-field signals amplitude (Tmax) was measured. RESULTS: P measured 0.98 +/- 0.76 mV. A VFFS was visible in the atrial channel in all patients with an amplitude of 0.45 +/- 0.25 mV (range 0.01-1.0 mV), independent of the pacing rate. The ratio P/VFFS was 3.9 +/- 4.2 (range 0.9-21.0). Tmax measured 99.4 +/- 15.2 ms during sinus rhythm. A rate dependent shortening of Tmax to 92.7 +/- 11.2 ms at 140 beats/min was observed (P = 0.001). At rates above 140 beats/min no further shortening occurred. CONCLUSION: Ventricular far-field signals are measurable in the atrial channel of VDD systems and may reach considerable amplitudes, which are not rate dependent. Although differential sensing provides favorable P waves to ventricular far-field signal ratios, refractory periods are needed to avoid far-field sensing. The rate dependent shortening of the ventricular signal can be detected in the atrial channel in VDD pacing.

Aged↗
PubMed1997

Feasibility and sensing thresholds of temporary single-lead VDD pacing in intensive care.

Long-term pacemaker treatment of patients with a high-degree atrioventricular (AV) block routinely uses AV synchronous pacing because of its hemodynamic advantages compared with VVI pacing. In cases of temporary pacing, however, the limitations inherent in attempting to reliably position a temporary atrial lead generally influences the use of VVI pacing. We therefore tested the use of temporary single-lead VDD pacing, making AV pacing possible with only 1 lead, in 22 patients requiring temporary pacing due to a high-degree AV block. AV synchronous stimulation was achieved in all patients using a quadripolar lead with an atrial dipole with the atrial rings spaced 30 mm apart. During follow-up (14.1 +/- 12.5 hours) intermittent undersensing was detected in 4 of the 22 patients. We initially evaluated the atrial sensing threshold by decreasing the pacemaker device sensitivity stepwise in all patients (1.54 +/- 1.08 mV; n = 22). In 15 patients an intra-atrial electrocardiogram was recorded. During the breathing cycle, the maximum P-wave amplitude was significantly different from the minimum P-wave amplitude (2.19 +/- 1.00 mV vs 1.25 +/- 0.65 mV, p < 0.005). The atrial signal detected by the single lead was further analyzed in 10 of 15 patients using various filters. A mean signal loss of 45% was observed, increasing the lower bandpass frequency from 0.1 to 40 Hz (1.73 +/- 0.71 mV vs 0.92 +/- 0.51 mV, p < 0.02). Lowering the upper filter range from 1,000 Hz down to 100 Hz did not significantly influence the atrial signal (1.73 +/- 0.71 mV vs 1.61 +/- 0.75 mV, NS). Single-lead VDD pacing, even on a temporary basis, is a reliable means of achieving AV synchronous pacing. Due to the floating atrial dipole, the system is characterized by a high degree of variability in the atrial signal with intermittent lower values. A significant signal loss must be expected when a lower bandpass frequency of 40 Hz is used.

Aged↗
PubMed1997

[Late potentials in the diagnosis of post-infarction patients: arrhythmogenic risk and clinical symptomatology].

A prospective study was performed of the correlation of ventricular late potentials (LP) and clinical parameters in patients after acute myocardial infarction. To evaluate the prognostic significance of the signal-averaged-electrocardiogram (SAECG) in risk stratification of sudden cardiac death and arrhythmogenic events, the clinical characteristics of these post-infarction patients were performed in a follow-up-period. 243 consecutive patients underwent SAECG for detection of late potentials in the second week after acute myocardial infarction. After a mean follow-up of 9 months the patients were asked a standardized questionnaire. Late potentials are independent of age, sex, left ventricular ejection fraction, peak activity of MB fraction of creatine kinase, and the cardiovascular risk factors in postinfarction patients. In patients, who received thrombolytic therapy, the incidence of late potentials is lower (p < 0.05) and in patients with posterior wall infarction it is significantly higher (p < 0.04). In the follow-up period patients with abnormal SAECG show a significantly higher rate of angina pectoris, palpitations, dizziness, and syncope. By way of contrast, postinfarction patients with normal SAECG feel mainly comfortable in the follow-up (p < 0.01). The mortality was even in both groups. Sudden cardiac death in the late postinfarction period shows a significant correlation with the finding of late potentials in SAECG in the early myocardial infarction period (p < 0.01). The SAECG for detection of late potentials as a non-invasive investigation in the early postinfarction period characterizes patients with an arrhythmogenic risk, especially sudden cardiac death, independent of other conventional methods. Furthermore, the impaired patient with clinical symptoms in the late postinfarction period is hereby identified.

Action Potentials↗
PubMed1997

[Stress response of slaughter pigs in two different access systems to electrical stunning].

Investigations on two batches of 25 pigs each were carried out to characterize two different access systems for electrical stunning by physiological responses such as heart frequency (HF) and the blood constituents lactate and cortisol. All animals were of the same hybrid breeding program. The access race in system A, where the animals are separated was 11 m long. The personnel used different equipments including electrical rods to move the pigs forward. The lairage time after transport was between 1 to 2 h. In system B the animals arrived the evening before slaughter and spent the night in groups in straw-littered lairage boxes. The access race was 3.5 m long. The heart frequencies of the pigs in system A were between 80 and 240 beats/min, in system B the average HF were between 60 and 170 beats/min. In the lairage the HF were at about 113 beats/min (system A) and 66 beats/min (system B). Blood samples were taken immediately after stunning. The lactate concentrations differed by 6 mmol/l (8.6 mmol/l in system A, 2.6 mmol/l in system B). Cortisol was distinctly higher in the blood of the animals from system A (166 ng/ml) compared to system B (126 ng/ml). The results show that the used techniques are suitable to examine stress indicators of pigs under practical conditions. Access systems with long races seem to pose a higher stress than short access ways. The influence of handling (human factor) and management (size of groups, origin of pigs) is equally important. The role of longer resting times in the lairage should be investigated in more detail. This should also include the keeping conditions on the farm where the animals are raised.

Animal Husbandry↗
PubMed1996

Intravascular ultrasound detected classification of coronary lesions as a predictor of dissections after balloon angioplasty.

Dissection after balloon angioplasty of coronary arteries may give rise to an unfavourable early outcome. Compared with coronary angiography, intravascular ultrasound (IVUS) allows more detailed characterisation of dissections. We investigated the incidence and type of dissections after balloon angioplasty in calcified coronary lesions. IVUS was performed in 43 patients with 48 lesions before and after percutaneous balloon angioplasty. Significant calcification was defined as an arc of more than 90 degrees with typical acoustic shadowing. Dissections were classified as type A when the media was not involved by the dissection and as type B when media involvement had occurred. In the group with significant calcification dissection was observed in 79% of the cases vs 38% in the control group (p < 0.03). Type B dissection was present in 71% of the dissections in the calcified lesions vs. 15% in the control group (p < 0.02). The balloon diameter and the ratio of balloon area to vessel area was not different in both groups but the required pressure for the first complete balloon inflation was significantly greater in the group with calcified lesions (9.46 +/- 3.6 atm vs. 6.65 +/- 2.6 atm; p < 0.001). Thus balloon angioplasty in calcified coronary lesions is more likely to lead to dissection with frequency involve the media.

Adult↗
PubMed1996

Occurrence of heavy metals, sodium, calcium, and potassium in human hair, teeth, and nails.

Heavy metals in biological samples: nails, teeth, and hair were examined during 1991-1993. Investigations of biological samples (hair n = 249 samples, teeth n = 145, nails n = 80 samples) were provided for inhabitants of selected towns in Beskid Slaski. The towns are small mountain towns in southern Poland: Wista, Szczyrk, Istebna, Koniakow, and Jaworzynka. The analysis of ANOVA and MANOVA variances were used for biological samples in the context of age, sex, and type of samples for 12 elements (Pb, Cd, Cr, Zn, Fe, Cu, Mn, Ni, Co, Ca, Na, and K). The matrix correlation and cluster analysis were applied to explain the behavior of metals in human hair, teeth, and nails.

Adolescent↗